CGRN Hepatobiliary and Pancreatic Disorders

Question 1

A patient with cirrhosis develops confusion, asterixis, and an elevated ammonia level. Which intervention is the priority?

Accepted Answer

Administer lactulose as ordered

Answer

Restrict all dietary protein

Answer

Prepare for emergent liver transplant

Answer

Administer IV thiamine

Question 2

Which finding on a liver biopsy is most characteristic of primary biliary cholangitis (PBC)?

Accepted Answer

Granulomatous destruction of bile ducts

Answer

Centrilobular necrosis

Answer

Steatosis with lobular inflammation

Answer

Bridging fibrosis without bile duct changes

Question 3

A patient presenting with severe epigastric pain radiating to the back, elevated lipase, and grey-Turner sign most likely has which condition?

Accepted Answer

Acute hemorrhagic pancreatitis

Answer

Acute cholecystitis

Answer

Peptic ulcer perforation

Answer

Mesenteric ischemia

Question 4

Which lab abnormality pattern is most consistent with obstructive jaundice from a common bile duct stone?

Accepted Answer

Elevated direct bilirubin, markedly elevated ALP and GGT

Answer

Elevated indirect bilirubin, normal ALP, elevated LDH

Answer

Elevated AST/ALT with mild direct bilirubin elevation

Answer

Elevated ammonia with normal bilirubin

Question 5

During ERCP for suspected choledocholithiasis, the nurse notices the patient's oxygen saturation drops to 88%. What is the first action?

Accepted Answer

Notify the physician and apply supplemental oxygen

Answer

Pause the procedure and administer reversal agents

Answer

Increase IV fluid rate

Answer

Document the finding and continue monitoring

Question 6

A patient with autoimmune hepatitis is most likely to have which serologic marker?

Accepted Answer

Anti-smooth muscle antibody (ASMA)

Answer

Anti-mitochondrial antibody (AMA)

Answer

Anti-neutrophil cytoplasmic antibody (ANCA)

Answer

Hepatitis B surface antigen (HBsAg)

Question 7

Which complication of acute pancreatitis involves liquefied necrotic pancreatic tissue enclosed in a fibrous wall?

Accepted Answer

Walled-off necrosis (WON)

Answer

Pancreatic pseudocyst

Answer

Peripancreatic abscess

Answer

Pancreatic ductal disruption