Surgery > QUESTIONS & ANSWERS > Surgery Week Quiz Series - Part 3 [GRADED A+] (All)
Surgery Week Quiz Series - Part 3 [GRADED A+]
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Surgery week 3 quiz Q Possible Raw Score: 58 # 1 of 58 - 1 Points 1. A 31-year-old healthcare worker is referred to a hospital because of malaise; it is accompanied by slight pain under the right ... rib border and the elevation of serum transaminases. He states that 1 year ago, he had an episode of jaundice while working in a remote African area; elevated levels of transaminases persist since that period of time. Physical examination reveals mild subicterics of patient's sclera and an enlarged liver, which is palpated for 3 centimeters under the right rib border. The remainder of his general physical findings is unremarkable. Laboratory analyses reveal increased AST (79 IU/l; reference value 0 - 40 IU/l) and ALT levels (128 IU/l; reference value 0 - 40 IU/l), a slightly elevated serum bilirubin level (total bilirubin 1.5 mg/dL; reference values 0.3 to 1.0 mg/dL; direct bilirubin 0.5 mg/dL, reference values 0.1 to 0.3 mg/dL), and positive HbSAg and HbeAg. AntiHbSAg antibodies, antiHbeAg antibodies, and antiHbc antibodies are not present in patient's serum. Hepatitis B virus (HBV) DNA is present in patient's serum, while testing for presence of antibodies against hepatitis C virus, antinuclear, antimitochondrial, anti-smooth muscle antibodies, antithyroid and anti LKM antibodies do not reveal the presence of those antibodies. Other routine laboratory analyses do not reveal any abnormality. Echosonography reveals only the presence of hepatomegaly, and endoscopy reveals no abnormalities. Pathohistological examination of material obtained by blind liver biopsy reveals the presence of chronic hepatitis. Therapy with interferon alpha in a weekly dose of 5 million units 3 times a week is started. What laboratory parameter will first point to response to antiviral treatment? A. Loss of both HbeAg and HBV DNA B. Normalization of AST and ALT levels? C. Loss of both HbSAg and HBV DNA D. Appearance of anti-HbeAg antibody E. Appearance of antiHbSAg antibody 2. A 33-year-old woman presents for a sonograph of her gallbladder. History: Abdominal pain. Findings: Gallbladder is normal in size and contour with normal thickness of the gallbladder wall. There are no stones or other intraluminal defects. Common hepatic duct is normal caliber. There are no ascites. Visualized portions of the spleen, pancreas, and kidneys appear normal. Refer to the image and case. Pathology can often mimic multiple disease processes on a sonogram. This leads to the suggestion of the different possibilities for the presented pathology. What is the most likely differential for the solid mass in the liver? A. Hemangioma B. Metastasis C. Abscess D. Sonographic artifact E. Aerobilia [Show More]
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