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1. Which of the following factors is the LEAST likely to be associated with a worse prognosis in patients with HRS?

A. Presence of infection B. Increased SCr C. Low cardiac output D. Decreased cystatin C E. Unsure

2. MK presents with alcohol-induced liver failure and a SCr increase from 0.8 mg/dL to 3 mg/dL over the past 5 days. The patient has no history of spontaneous bacterial peritonitis but has progressive jaundice. Providers suspect HRS. Which factor predicts a worse outcome in MK?

A. Type 1 HRS B. Type 2 HRS C. Prior use of alcohol D. Lack of spontaneous bacterial peritonitis E. Unsure

3. Which of the following is the definitive treatment for HRS?

A. Vasoconstrictor therapy with albumin B. Renal replacement therapy C. Transjugular intrahepatic portosystemic shunting D. Liver transplantation E. Unsure

4. Which of the following therapies may lead to hepatic encephalopathy?

A. Vasoconstrictor therapy with albumin B. Renal replacement therapy C. Transjugular intrahepatic portosystemic shunting D. Liver transplantation E. Unsure

5. A medical resident inquires why terlipressin, the most extensively studied and preferred vasopressor in Europe, is not approved in the United States. Please select the most appropriate response.

A. Because the study performed in the United States and Canada showed similar clinical outcomes for terlipressin with albumin and albumin monotherapy B. Because terlipressin increases the risk for ischemic events C. Because administration of terlipressin requires patients to have electrocardiograms (ECGs) D. Because only case reports and not randomized studies support terlipressin infusion for outpatient use E. Unsure

6. Which statement does the evidence regarding therapies for HRS support?

A. The combination of octreotide and midodrine has promising data for improving survival and resolving HRS B. Patients receiving norepinephrine for HRS experienced a significant increase in mortality compared to patients receiving terlipressin alone C. Increasing cumulative doses of albumin may improve survival in HRS due to a dose-response relationship D. A combination of midodrine and albumin is more effective at resolving HRS compared with albumin alone E. Unsure

7. LS is admitted to an intensive care unit in a South Carolina hospital with severe hepatic encephalopathy, gastrointestinal bleeding, and oliguria. His SCr increases from 1.4 to 2.8 mg/dL over the past 5 days ago. The medical team diagnoses LS with HRS. Based on the published evidence, what pharmacologic therapy may improve clinical outcomes in LS?

A. Albumin B. Albumin and norepinephrine C. Albumin and terlipressin D. Albumin and midodrine and octreotide E. Unsure

8. What is the recommended dose for albumin 25% in combination with vasoconstrictors in patients with HRS?

A. 1 g/kg for the first day, and then 20 to 40 g per day B. 25 g on the first day, repeated every 8 hours as needed C. 50 to 100 g on the first day, and then 50 g per day D. 1.5 g/kg for the first day, and then 1 g/kg per day E. Unsure

9. DM, a 65-year old patient diagnosed with type 1 HRS, is awaiting liver transplantation. The medical team inquires about the evidence for pharmacologic therapies to manage type 1 HRS on an outpatient basis. What does the published literature suggest regarding the best pharmacologic agent and its dosing in this patient?

A. Administer albumin at 40 g per day B. Administer norepinephrine infusion at 1 mg/h C. Administer vasopressin infusion at 0.01 units/min D. Administer terlipressin infusion at 1.7 mg per day E. Unsure

10. Which of the following agents must be monitored in the intensive care unit?

A. Albumin B. Terlipressin C. Norepinephrine D. Octreotide E. Unsure

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following factors is the LEAST likely to be associated with a worse prognosis in patients with HRS?

2. MK presents with alcohol-induced liver failure and a SCr increase from 0.8 mg/dL to 3 mg/dL over the past 5 days. The patient has no history of spontaneous bacterial peritonitis but has progressive jaundice. Providers suspect HRS. Which factor predicts a worse outcome in MK?

3. Which of the following is the definitive treatment for HRS?

4. Which of the following therapies may lead to hepatic encephalopathy?

5. A medical resident inquires why terlipressin, the most extensively studied and preferred vasopressor in Europe, is not approved in the United States. Please select the most appropriate response.

6. Which statement does the evidence regarding therapies for HRS support?

8. What is the recommended dose for albumin 25% in combination with vasoconstrictors in patients with HRS?

10. Which of the following agents must be monitored in the intensive care unit?

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following factors is the LEAST likely to be associated with a worse prognosis in patients with HRS?

2. MK presents with alcohol-induced liver failure and a SCr increase from 0.8 mg/dL to 3 mg/dL over the past 5 days. The patient has no history of spontaneous bacterial peritonitis but has progressive jaundice. Providers suspect HRS. Which factor predicts a worse outcome in MK?

3. Which of the following is the definitive treatment for HRS?

4. Which of the following therapies may lead to hepatic encephalopathy?

5. A medical resident inquires why terlipressin, the most extensively studied and preferred vasopressor in Europe, is not approved in the United States. Please select the most appropriate response.

6. Which statement does the evidence regarding therapies for HRS support?

8. What is the recommended dose for albumin 25% in combination with vasoconstrictors in patients with HRS?

10. Which of the following agents must be monitored in the intensive care unit?

« Return to Activity

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