Liver Cirrhosis: Causes, Mechanisms, and Complications

Question 1

The characteristic pathological feature of liver cirrhosis is:

Accepted Answer

Accumulation of fibrous scar tissue (fibrosis)

Answer

Loss of hepatocytes

Answer

Increased sinusoidal pressure

Answer

Portal hypertension

Question 2

Which mechanism plays a central role in the development of liver fibrosis?

Accepted Answer

Activation and proliferation of hepatic stellate cells

Answer

Increased production of collagen

Answer

Impaired liver regeneration

Answer

Kupffer cell dysfunction

Question 3

Liver transplantation is primarily considered as a treatment option for:

Accepted Answer

Advanced-stage liver cirrhosis with complications, to replace the failing liver

Answer

Early-stage liver cirrhosis, to prevent disease progression

Answer

Alcoholic liver disease, as a means of reversing the damage

Answer

Non-alcoholic fatty liver disease, to improve liver function

Question 4

Which nursing diagnosis is most appropriate for a patient with hepatic encephalopathy?

Accepted Answer

Impaired gas exchange

Answer

Ineffective airway clearance

Answer

Risk for injury

Answer

Altered nutrition

Question 5

What is the primary goal of liver transplantation in patients with end-stage liver disease?

Accepted Answer

To provide a new liver to the patient

Answer

To cure the underlying cause of liver damage

Answer

To improve the patient's quality of life

Answer

To prevent further liver damage

Question 6

What is the most important factor to consider when assessing a patient with liver cirrhosis?

Accepted Answer

The stage of liver disease

Answer

The patient's overall health status

Answer

The patient's social support system

Answer

The underlying cause of liver damage

Question 7

Hepatic fibrosis, a precursor to cirrhosis, is characterized by:

Accepted Answer

Replacement of liver cells with scar tissue

Answer

Increased blood flow to the liver

Answer

Deposition of fat in the liver

Answer

Inflammation of the liver

Question 8

Which type of liver biopsy is most commonly used to diagnose cirrhosis?

Accepted Answer

Percutaneous needle biopsy

Answer

Fine-needle aspiration

Answer

Laparoscopic biopsy

Answer

Open biopsy

Question 9

Select the option that is NOT a major cause of liver cirrhosis:

Accepted Answer

Indiscriminate use of over-the-counter medications

Answer

Excessive alcohol consumption

Answer

Chronic hepatitis from viral infections

Answer

Autoimmune disorders like autoimmune hepatitis

Question 10

The presence of esophageal varices in a patient with liver cirrhosis signifies:

Accepted Answer

Increased risk of gastrointestinal bleeding due to high pressure in the portal venous system

Answer

Impaired liver function and reduced ability to detoxify substances

Answer

Development of hepatocellular carcinoma, a type of liver cancer

Answer

Progression to end-stage liver disease and need for liver transplantation

Question 11

The development of liver fibrosis in cirrhosis is mainly driven by:

Accepted Answer

Proliferation of hepatic stellate cells, which are activated and produce excessive collagen

Answer

Increased inflammation caused by immune cell infiltration and cytokine release

Answer

Impaired regeneration of hepatocytes, limiting the liver's ability to repair itself

Answer

Direct viral infection that damages liver cells and triggers fibrosis

Question 12

What is the primary mechanism underlying liver damage in alcoholic liver disease?

Accepted Answer

Oxidative stress

Answer

Immune-mediated injury

Answer

Apoptosis

Answer

Necrosis

Question 13

Which of the following is NOT a recognized complication of end-stage liver disease?

Accepted Answer

Breast cancer

Answer

Hepatic encephalopathy

Answer

Variceal bleeding

Answer

Ascites

Question 14

What is the role of fibrosis in the progression of liver cirrhosis?

Accepted Answer

It contributes to the formation of scar tissue, impairing liver function.

Answer

It protects the liver from further damage.

Answer

It promotes the regeneration of hepatocytes.

Answer

It has no significant impact on liver function.

Question 15

Which of the following is NOT a recognized risk factor for developing liver cirrhosis?

Accepted Answer

Heart failure

Answer

Excessive alcohol consumption

Answer

Chronic viral hepatitis

Answer

Genetic disorders

Question 16

What is the primary mechanism of hepatocyte damage in alcoholic liver disease?

Accepted Answer

Oxidative stress

Answer

Immune-mediated inflammation

Answer

Apoptosis

Answer

Ischemia

Question 17

In the progression of liver cirrhosis, fibrosis plays a crucial role. What is the primary function of fibrosis?

Accepted Answer

Forming scar tissue and impairing liver function

Answer

Directly causing liver damage

Answer

Reversing the underlying cause of cirrhosis

Answer

Only occurring in advanced stages of cirrhosis

Question 18

Which type of liver disease is characterized by the immune system attacking and destroying liver cells?

Accepted Answer

Autoimmune hepatitis

Answer

Alcoholic liver disease

Answer

Non-alcoholic fatty liver disease

Answer

Viral hepatitis

Question 19

In the management of end-stage liver disease, which surgical procedure is most commonly performed?

Accepted Answer

Liver transplantation

Answer

Partial hepatectomy

Answer

Liver biopsy

Answer

Laparoscopic cholecystectomy

Question 20

Which statement about the role of the liver in detoxification is true?

Accepted Answer

The liver metabolizes medications and removes waste products from the blood.

Answer

The liver stores glucose and synthesizes proteins.

Answer

The liver is responsible for producing red blood cells.

Answer

The liver regulates body temperature.

Question 21

True or False: Cirrhosis can impair the liver's ability to synthesize blood clotting factors.

Accepted Answer

True

Answer

False

Question 22

What is the role of inflammation in the progression of liver cirrhosis?

Accepted Answer

It promotes fibrosis and scarring

Answer

It inhibits liver regeneration

Answer

It causes acute liver failure

Answer

It has no role in the progression of cirrhosis

Question 23

What is the primary function of hepatic stellate cells in liver cirrhosis?

Accepted Answer

They produce extracellular matrix proteins

Answer

They clear toxins from the liver

Answer

They secrete cytokines

Answer

They promote liver regeneration

Question 24

In liver cirrhosis, which liver function is most severely impaired, resulting in significant clinical manifestations?

Accepted Answer

Protein synthesis

Answer

Detoxification

Answer

Bile production

Answer

Carbohydrate metabolism

Question 25

Which non-invasive diagnostic technique is most effective for early detection of liver cirrhosis?

Accepted Answer

Ultrasound

Answer

Liver biopsy

Answer

Blood tests

Answer

MRI

Question 26

Which of the following is the most prevalent cause of liver cirrhosis in the United States?

Accepted Answer

Non-alcoholic fatty liver disease (NAFLD)

Answer

Alcohol abuse

Answer

Hepatitis B infection

Answer

Autoimmune hepatitis

Question 27

What is the primary mechanism responsible for hepatocellular injury in liver cirrhosis?

Accepted Answer

Oxidative stress and inflammation

Answer

Apoptosis

Answer

Necrosis

Answer

Kupffer cell activation

Question 28

Identify a clinical manifestation associated with hepatic encephalopathy in liver cirrhosis:

Accepted Answer

Asterixis

Answer

Anuria

Answer

Jaundice

Question 29

In liver cirrhosis, which consequence of vascular remodeling leads to portal hypertension?

Accepted Answer

Increased sinusoidal resistance

Answer

Decreased splanchnic arterial blood flow

Answer

Reduced portal venous pressure

Question 30

Which of the following is the most common etiology of liver cirrhosis in the United States?

Accepted Answer

Alcoholic Liver Disease (ALD)

Answer

Autoimmune Hepatitis

Answer

Hepatitis B

Answer

Non-alcoholic fatty liver disease (NAFLD)

Question 31

Which of the following is a potential complication of end-stage liver disease?

Accepted Answer

Hepatic Encephalopathy

Answer

Myocardial infarction

Answer

Stroke

Answer

Pneumonia

Question 32

What is the primary role of the liver in ammonia metabolism?

Accepted Answer

Converts ammonia to urea

Answer

Stores ammonia

Answer

Produces ammonia

Question 33

Which histological feature is characteristic of liver cirrhosis?

Accepted Answer

Fibrosis bridging portal tracts

Answer

Abscess formation

Answer

Granulomatous inflammation

Question 34

What is the primary treatment for Alcoholic Liver Disease (ALD)?

Accepted Answer

Alcohol abstinence

Answer

Medications to reduce inflammation

Answer

Surgery to remove damaged liver tissue

Answer

Liver transplantation

Question 35

Which laboratory test is commonly used to assess liver function?

Accepted Answer

Alanine aminotransferase (ALT)

Answer

Electrolytes

Answer

Blood glucose

Answer

White blood cell count

Question 36

What is the role of the liver in hemostasis?

Accepted Answer

Produces clotting factors I, II, V, VII, IX, X and XIII

Answer

Produces clotting factors II, III, IV, and VI

Answer

Activates clotting factors XI and XII

Question 37

Which of the following is a modifiable risk factor for developing liver cirrhosis?

Accepted Answer

Obesity

Answer

Race

Answer

Female gender

Answer

Age

Question 38

What is the prognosis for a patient with end-stage liver disease?

Accepted Answer

Poor

Answer

Excellent

Answer

Good

Answer

Fair

Question 39

Which mechanism is primarily responsible for alcoholic liver damage?

Accepted Answer

Increased production of reactive oxygen species

Answer

Activation of hepatic stellate cells

Answer

Impaired lipid metabolism

Question 40

To accurately assess the severity of liver cirrhosis, which diagnostic test is considered the gold standard?

Accepted Answer

Liver biopsy

Answer

Blood tests (e.g., liver function tests)

Answer

Ultrasound elastography

Question 41

In the management of alcoholic liver cirrhosis, the primary treatment approach involves:

Accepted Answer

Complete abstinence from alcohol consumption

Answer

Medications to suppress inflammation

Answer

Liver transplantation as the definitive treatment

Question 42

Which clinical sign is characteristic of hepatic encephalopathy?

Accepted Answer

Asterixis (flapping tremor)

Answer

Hematemesis

Answer

Ascites

Answer

Jaundice

Question 43

Which histological finding is characteristic of liver cirrhosis?

Accepted Answer

Nodular regeneration

Answer

Hepatocyte necrosis

Answer

Granulomatous inflammation

Answer

Cholestasis

Question 44

Which laboratory test result is most indicative of liver cirrhosis?

Accepted Answer

Elevated serum bilirubin and prolonged prothrombin time

Answer

Elevated liver enzymes

Answer

Increased serum albumin

Question 45

Which of the following is a definitive treatment option for liver cirrhosis?

Accepted Answer

Liver transplant

Answer

Laparoscopic surgery

Answer

Antiviral therapy

Answer

Diuretics

Question 46

Which nursing intervention is essential for patients with liver cirrhosis?

Accepted Answer

Monitoring for signs and symptoms of hepatic encephalopathy and administering lactulose

Answer

Administering antibiotics

Answer

Inserting a nasogastric tube

Question 47

Which patient education topic is most important for patients with liver cirrhosis?

Accepted Answer

Importance of medication adherence and regular medical follow-up

Answer

Signs and symptoms of infection

Answer

Healthy eating habits

Answer

Benefits of exercise