Q.1 Which enzyme is most specific for detecting pancreatic injury?
Amylase
Lipase
ALT
AST
Explanation - Lipase is more specific than amylase for pancreatic injury, as it remains elevated longer and is more directly related to pancreatic damage.
Correct answer is: Lipase
Q.2 Which liver function test is most indicative of hepatocellular injury?
AST and ALT
Alkaline phosphatase
Bilirubin
Gamma-glutamyl transferase
Explanation - AST and ALT are enzymes released from damaged hepatocytes, making them reliable markers of hepatocellular injury.
Correct answer is: AST and ALT
Q.3 Which condition is characterized by inflammation of the gallbladder, often due to gallstones?
Cholecystitis
Hepatitis
Pancreatitis
Cirrhosis
Explanation - Cholecystitis refers to inflammation of the gallbladder, typically resulting from obstruction by gallstones.
Correct answer is: Cholecystitis
Q.4 Which symptom is most commonly associated with acute pancreatitis?
Severe epigastric pain radiating to the back
Right upper quadrant pain
Jaundice
Pruritus
Explanation - Acute pancreatitis typically presents with sudden, severe epigastric pain that may radiate to the back, often associated with nausea and vomiting.
Correct answer is: Severe epigastric pain radiating to the back
Q.5 Which laboratory finding is most characteristic of cholestasis?
Elevated alkaline phosphatase
Elevated amylase
Elevated ALT
Elevated lipase
Explanation - Alkaline phosphatase increases when there is obstruction in bile flow, making it a key marker of cholestasis.
Correct answer is: Elevated alkaline phosphatase
Q.6 Which type of hepatitis is primarily transmitted via the fecal-oral route?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Explanation - Hepatitis A virus is typically transmitted through contaminated food or water, leading to acute infection.
Correct answer is: Hepatitis A
Q.7 Which imaging modality is most sensitive for detecting gallstones?
Ultrasound
CT scan
MRI
X-ray
Explanation - Ultrasound is the first-line imaging study for gallstones due to its high sensitivity, non-invasiveness, and low cost.
Correct answer is: Ultrasound
Q.8 Which condition involves chronic inflammation of the liver that can progress to cirrhosis?
Chronic hepatitis
Acute pancreatitis
Cholelithiasis
Gallbladder cancer
Explanation - Chronic hepatitis involves persistent liver inflammation, often due to viral infections or autoimmune disease, which may lead to fibrosis and cirrhosis.
Correct answer is: Chronic hepatitis
Q.9 Which dietary modification is recommended for patients with pancreatitis?
Low-fat diet
High-fat diet
High-protein diet
High-carbohydrate diet
Explanation - A low-fat diet reduces pancreatic stimulation and helps prevent exacerbation of pancreatitis.
Correct answer is: Low-fat diet
Q.10 Which sign is associated with chronic liver disease?
Spider angiomas
Rash on extremities
Pallor only
Edema of the fingers
Explanation - Spider angiomas are small, dilated blood vessels seen on the skin, commonly associated with chronic liver disease due to hormonal imbalance.
Correct answer is: Spider angiomas
Q.11 Which lab test is used to assess synthetic liver function?
Serum albumin
ALT
AST
Amylase
Explanation - Serum albumin reflects the liver's ability to synthesize proteins, providing insight into its synthetic function.
Correct answer is: Serum albumin
Q.12 Which bile pigment accumulation causes jaundice?
Bilirubin
Bile acids
Cholesterol
Lipase
Explanation - Jaundice occurs due to accumulation of bilirubin, a breakdown product of hemoglobin, leading to yellowing of the skin and eyes.
Correct answer is: Bilirubin
Q.13 Which condition is a risk factor for developing gallstones?
Obesity
Hypothyroidism
Diabetes insipidus
Asthma
Explanation - Obesity increases cholesterol saturation in bile, which can precipitate gallstone formation.
Correct answer is: Obesity
Q.14 Which virus can cause chronic hepatitis leading to cirrhosis and hepatocellular carcinoma?
Hepatitis B
Hepatitis A
Hepatitis E
Hepatitis D
Explanation - Hepatitis B virus can cause chronic liver infection, leading to cirrhosis and increased risk of hepatocellular carcinoma.
Correct answer is: Hepatitis B
Q.15 Which symptom is commonly seen in biliary colic?
Right upper quadrant pain after fatty meals
Left lower quadrant pain
Diffuse abdominal bloating
Epigastric burning at night
Explanation - Biliary colic results from temporary obstruction of the cystic duct, causing postprandial right upper quadrant pain, especially after fatty meals.
Correct answer is: Right upper quadrant pain after fatty meals
Q.16 Which enzyme is primarily elevated in alcoholic liver disease?
AST
ALT
Amylase
Lipase
Explanation - In alcoholic liver disease, AST is typically elevated more than ALT, often in a ratio of 2:1.
Correct answer is: AST
Q.17 Which type of gallstone is most common in Western countries?
Cholesterol stones
Pigment stones
Mixed stones
Calcium stones
Explanation - Cholesterol stones are the most common type of gallstones in Western countries, related to cholesterol supersaturation of bile.
Correct answer is: Cholesterol stones
Q.18 Which complication is most concerning in acute pancreatitis?
Pancreatic necrosis
Hepatic steatosis
Gallstone formation
Portal hypertension
Explanation - Pancreatic necrosis is a serious complication of acute pancreatitis and can lead to systemic infection and multi-organ failure.
Correct answer is: Pancreatic necrosis
Q.19 Which imaging study is preferred for detecting liver tumors?
MRI with contrast
Plain X-ray
Ultrasound without contrast
CT scan without contrast
Explanation - MRI with contrast provides high-resolution images and is preferred for detailed evaluation of liver tumors and vascular involvement.
Correct answer is: MRI with contrast
Q.20 Which vitamin deficiency is commonly seen in cholestatic liver disease?
Vitamin K
Vitamin C
Vitamin B12
Vitamin B1
Explanation - Cholestasis leads to impaired absorption of fat-soluble vitamins, including vitamin K, which is essential for clotting factor synthesis.
Correct answer is: Vitamin K
Q.21 Which symptom is characteristic of chronic pancreatitis?
Steatorrhea
Jaundice
Hematemesis
Diarrhea with mucus
Explanation - Chronic pancreatitis leads to exocrine insufficiency, causing fat malabsorption and greasy, foul-smelling stools known as steatorrhea.
Correct answer is: Steatorrhea
Q.22 Which lab value is typically elevated in obstructive jaundice?
Direct bilirubin
Indirect bilirubin
Amylase
Lipase
Explanation - Obstruction of bile flow causes conjugated (direct) bilirubin to accumulate in the blood, leading to jaundice.
Correct answer is: Direct bilirubin
Q.23 Which condition can cause painless jaundice and weight loss in adults?
Pancreatic cancer
Acute hepatitis
Cholecystitis
Cirrhosis
Explanation - Pancreatic cancer, especially in the head of the pancreas, can obstruct the bile duct, leading to painless jaundice and unintentional weight loss.
Correct answer is: Pancreatic cancer
Q.24 Which lab test is useful to monitor chronic hepatitis B infection?
HBsAg and HBV DNA
ALT only
AST only
Bilirubin only
Explanation - Monitoring HBsAg and HBV DNA levels helps assess viral replication and guide antiviral therapy in chronic hepatitis B.
Correct answer is: HBsAg and HBV DNA