CGRN Hepatobiliary and Pancreatic Disorders 2

Question 1

A patient with hepatitis C cirrhosis undergoes surveillance ultrasound revealing a 2 cm hepatic lesion with arterial enhancement and washout on MRI. What is the most likely diagnosis?

Accepted Answer

Hepatocellular carcinoma (HCC)

Answer

Arterial enhancement followed by portal venous washout on contrast imaging is the hallmark radiologic pattern of hepatocellular carcinoma in a cirrhotic liver.

Question 2

Which medication is first-line therapy for primary sclerosing cholangitis (PSC) to slow bile duct fibrosis?

Accepted Answer

No proven disease-modifying therapy currently exists

Answer

Unlike PBC, PSC has no proven disease-modifying medical therapy; management focuses on symptom control, surveillance, and liver transplant evaluation for end-stage disease.

Question 3

A cirrhotic patient develops sudden onset fever, abdominal pain, and ascitic fluid with PMN count >250 cells/mm³. What is the diagnosis?

Accepted Answer

Spontaneous bacterial peritonitis (SBP)

Answer

Spontaneous bacterial peritonitis is defined by an ascitic fluid PMN count ≥250 cells/mm³ without an evident surgically treatable source, and is a life-threatening complication of cirrhosis.

Question 4

Which scoring system is used to assess short-term mortality risk in acute variceal bleeding in cirrhotic patients?

Accepted Answer

MELD-Na Score

Answer

The MELD-Na (Model for End-Stage Liver Disease-Sodium) score is the primary tool used to predict 90-day mortality in cirrhotic patients and prioritizes liver transplant allocation.

Question 5

A patient with chronic pancreatitis presents with foul-smelling, oily stools and significant weight loss. What is the underlying mechanism?

Accepted Answer

Exocrine pancreatic insufficiency causing fat malabsorption

Answer

Chronic pancreatitis destroys acinar cells, reducing pancreatic lipase secretion and causing fat malabsorption, which manifests as steatorrhea.

CGRN - Certified Gastroenterology Registered Nurse Practice Test

CGRN - Certified Gastroenterology Registered Nurse Practice Test

CGRN Hepatobiliary and Pancreatic Disorders 2