Hepatobiliary Quiz (Answers)—15 (2015) Answers to Multiple Choice Questions
2. Answers A, B, C, D and E Magnesium deficiency is common in chronic liver disease, and is associated with peripheral insulin resistance as well. Supplementation has been shown to improve hepatic enzyme levels.10, Selenium is a co-factor for multiple seleno-proteins which have antioxidant functions. Chronic liver disease is associated with decreases in serum, whole blood, and hepatic selenium content.11, Total body manganese stores are increased in cirrhosis, and accumulation of manganese in basal ganglia is common.12, Copper and copper-associated protein accumulation may be observed in chronic biliary obstructive processes and cirrhosis.2 3. Answers A, B and E Patients with cirrhosis are usually malnourished and require careful nutritional management to prevent energy and nutrient depletion and correction of macro- and micronutrient deficiencies. Carbohydrate content should constitute 45–75% of caloric intake divided in 4–6 carbohydrate rich meals. A late evening or nighttime snack prevents gluconeogenesis, reduce protein utilization and favor a positive nitrogen balance. Protein intake of 1.2– 1.5 g/kg should be maintained even in patients with hepatic encephalopathy. Vegetable and dairy protein is preferable.2, Branched chain amino acid supplementation may be considered as they are not metabolized by the liver, providing an alternative source of proteins.13, Total body manganese stores are increased in patients with liver disease and its supplementation is not recommended.14
http://dx.doi.org/10.1016/j.jceh.2015.08.008 © 2015, INASL
4. Answers A and D The spectrum of nonalcoholic fatty liver disease (NAFLD) ranges from simple steatosis to nonalcoholic steatohepatitis (NASH). The physiological level of fat in the hepatocytes is
2. Answers A, B, C, D and E Magnesium deficiency is common in chronic liver disease, and is associated with peripheral insulin resistance as well. Supplementation has been shown to improve hepatic enzyme levels.10, Selenium is a co-factor for multiple seleno-proteins which have antioxidant functions. Chronic liver disease is associated with decreases in serum, whole blood, and hepatic selenium content.11, Total body manganese stores are increased in cirrhosis, and accumulation of manganese in basal ganglia is common.12, Copper and copper-associated protein accumulation may be observed in chronic biliary obstructive processes and cirrhosis.2 3. Answers A, B and E Patients with cirrhosis are usually malnourished and require careful nutritional management to prevent energy and nutrient depletion and correction of macro- and micronutrient deficiencies. Carbohydrate content should constitute 45–75% of caloric intake divided in 4–6 carbohydrate rich meals. A late evening or nighttime snack prevents gluconeogenesis, reduce protein utilization and favor a positive nitrogen balance. Protein intake of 1.2– 1.5 g/kg should be maintained even in patients with hepatic encephalopathy. Vegetable and dairy protein is preferable.2, Branched chain amino acid supplementation may be considered as they are not metabolized by the liver, providing an alternative source of proteins.13, Total body manganese stores are increased in patients with liver disease and its supplementation is not recommended.14
http://dx.doi.org/10.1016/j.jceh.2015.08.008 © 2015, INASL
4. Answers A and D The spectrum of nonalcoholic fatty liver disease (NAFLD) ranges from simple steatosis to nonalcoholic steatohepatitis (NASH). The physiological level of fat in the hepatocytes is
