CGRN Hepatobiliary and Pancreatic Disorders 3

Question 1

Which endoscopic procedure is used to treat acute gallstone pancreatitis complicated by cholangitis?

Accepted Answer

ERCP with sphincterotomy and stone extraction

Answer

Endoscopic ultrasound (EUS) with fine-needle aspiration

Answer

Percutaneous transhepatic cholangiography (PTC)

Answer

Endoscopic retrograde pancreatography (ERP)

Question 2

A patient with known Wilson's disease presents with neuropsychiatric symptoms and liver disease. Which finding on slit-lamp exam confirms the diagnosis?

Accepted Answer

Kayser-Fleischer rings

Answer

Cherry-red macular spot

Answer

Band keratopathy

Answer

Anterior subcapsular cataracts

Question 3

A nurse is preparing a patient for endoscopic ultrasound (EUS)-guided drainage of a pancreatic pseudocyst. Which nursing assessment is most important pre-procedure?

Accepted Answer

Verify NPO status and review coagulation parameters including INR and platelet count

Answer

Assess bowel sounds and last bowel movement

Answer

Check hepatitis B surface antigen results

Answer

Confirm patient has stopped all vitamins for 48 hours

Question 4

Which condition is most strongly associated with the development of primary sclerosing cholangitis (PSC)?

Accepted Answer

Ulcerative colitis

Answer

Crohn's disease with ileal involvement

Answer

Celiac disease

Answer

Autoimmune hepatitis

Question 5

A patient with hemochromatosis is found to have a serum ferritin of 2,800 ng/mL and transferrin saturation of 72%. What is the first-line treatment?

Accepted Answer

Therapeutic phlebotomy weekly until ferritin < 50 ng/mL

Answer

Intravenous deferoxamine chelation therapy

Answer

Dietary iron restriction alone

Answer

Liver transplant evaluation

Question 6

During a biliary sphincterotomy, the patient develops acute onset of severe abdominal pain and hypotension. A post-procedure CT shows free air under the diaphragm. What complication has occurred?

Accepted Answer

Duodenal perforation

Answer

Post-ERCP pancreatitis

Answer

Retroperitoneal hemorrhage

Answer

Cholangitis

Question 7

A patient with non-alcoholic fatty liver disease (NAFLD) is progressing to NASH with fibrosis. Which intervention has the strongest evidence for improving liver histology?

Accepted Answer

Sustained weight loss of ≥ 7-10% body weight

Answer

Initiation of statin therapy

Answer

Daily vitamin E supplementation alone

Answer

Strict carbohydrate restriction without calorie reduction