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Drug Induced Liver Injury

Case Study thumbnail 287

Drug Induced Liver Injury - Case 1

Case Study thumbnail 288

Drug Induced Liver Injury - Case 2

Case Study thumbnail 289

Drug Induced Liver Injury - Case 3

1. What percentage of acute liver failure (ALF) cases is due to drug-induced liver injury (DILI)?

Select only 1 answer.

  1. A. 25%
  2. B. 50%
  3. C. 75%
  4. D. 100%

2. Which phase of drug metabolism involves cytochrome P450 enzymes?

Select only 1 answer.

  1. A. Phase 1
  2. B. Phase 2
  3. C. Phase 3
  4. D. Phase 4

3. Which type of DILI is predictable and dose-related?

Select only 1 answer.

  1. A. Idiosyncratic
  2. B. Indirect
  3. C. Direct
  4. D. Intrinsic

4. Which herbal supplement is associated with DILI?

Select only 1 answer.

  1. A. Green tea
  2. B. Chamomile
  3. C. Lavender
  4. D. Peppermint

5. What is the primary treatment for acetaminophen overdose?

Select only 1 answer.

  1. A. Activated charcoal
  2. B. N-Acetyl Cysteine (NAC)
  3. C. Intravenous fluids
  4. D. Steroids

6. Which type of liver injury does amoxicillin-clavulanate most commonly cause?

Select only 1 answer.

  1. A. Hepatocellular
  2. B. Cholestatic
  3. C. Mixed
  4. D. Autoimmune

7. What is the primary mechanism of direct DILI?

Select only 1 answer.

  1. A. Immune response
  2. B. Genetic polymorphisms
  3. C. Dose-dependent toxicity
  4. D. Allergic reaction

8. What is the significance of Hy's Law in DILI?

Select only 1 answer.

  1. A. It predicts drug interactions
  2. B. It indicates a high risk of mortality
  3. C. It measures liver enzyme activity
  4. D. It diagnoses autoimmune hepatitis

9. Which histologic feature is characteristic of acetaminophen-induced liver injury?

Select only 1 answer.

  1. A. Central vein necrosis
  2. B. Microvesicular steatosis
  3. C. Sinusoidal obstruction
  4. D. Macrovesicular steatosis

10. Which type of DILI can occur without dose dependency and is often unpredictable?

Select only 1 answer.

  1. A. Direct DILI
  2. B. Idiosyncratic DILI
  3. C. Intrinsic DILI
  4. D. Indirect DILI

11. How does N-Acetyl Cysteine (NAC) work in treating acetaminophen toxicity?

Select only 1 answer.

  1. A. It neutralizes NAPQI
  2. B. It activates liver enzymes
  3. C. It increases bile production
  4. D. It reduces liver inflammation

12. What is the recommended treatment protocol for a patient presenting with acetaminophen overdose within 8 hours of ingestion?

Select only 1 answer.

  1. A. Activated charcoal only
  2. B. NAC 72-hour PO protocol
  3. C. NAC 20-hour IV protocol
  4. D. Supportive care

13. What is the main reason for performing a liver biopsy in suspected DILI cases?

Select only 1 answer.

  1. A. To confirm DILI diagnosis
  2. B. To assess the severity of liver injury
  3. C. To determine genetic predisposition
  4. D. To initiate immediate treatment

14. Which factor is a significant predictor of poor prognosis in acetaminophen-induced liver injury?

Select only 1 answer.

  1. A. High ALT levels
  2. B. High BMI
  3. C. Older age
  4. D. Low blood pH

15. How can idiosyncratic DILI be distinguished from other types of liver injury?

Select only 1 answer.

  1. A. By genetic testing
  2. B. By liver biopsy
  3. C. By detailed drug history
  4. D. By serologic tests

16. Which enzyme level is typically elevated early in acetaminophen toxicity?

Select only 1 answer.

  1. A. ALT
  2. B. AST
  3. C. INR
  4. D. Bilirubin

17. What is a common presentation of immune checkpoint inhibitor (ICI) hepatotoxicity?

Select only 1 answer.

  1. A. Cholestatic liver injury
  2. B. Hepatocellular liver injury
  3. C. Autoimmune hepatitis
  4. D. Sinusoidal obstruction

18. Which factor contributes to the variability in latency of idiosyncratic DILI?

Select only 1 answer.

  1. A. Drug dosage
  2. B. Genetic polymorphisms
  3. C. Patient's diet
  4. D. Duration of drug use