1. A 55-year-old man with alcohol-related cirrhosis presents with new-onset ascites. Which of the following is the most appropriate next step in management?
A. Initiate diuretic therapy
B. Recommend large-volume paracentesis
C. Recommend liver transplantation
D. Recommend salt restriction and fluid restriction
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
2. A 62-year-old woman with decompensated cirrhosis secondary to nonalcoholic steatohepatitis (NASH) develops hepatic encephalopathy. Which of the following is the most appropriate management?
A. Initiate lactulose therapy
B. Initiate rifaximin therapy
C. Recommend liver transplantation
D. Recommend protein-restricted diet
E. Recommend supportive care only
3. A 48-year-old man with compensated cirrhosis secondary to hepatitis C presents with an upper gastrointestinal bleed. Which of the following is the most appropriate management?
A. Initiate beta-blocker therapy
B. Initiate proton pump inhibitor therapy
C. Recommend endoscopic variceal ligation
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
4. A 72-year-old woman with decompensated cirrhosis secondary to alcohol abuse develops spontaneous bacterial peritonitis (SBP). Which of the following is the most appropriate management?
A. Administer intravenous albumin
B. Administer intravenous antibiotics
C. Recommend large-volume paracentesis
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
5. A 58-year-old man with alcohol-related cirrhosis presents with new-onset hepatorenal syndrome. Which of the following is the most appropriate management?
A. Administer intravenous albumin
B. Administer vasopressin analogue therapy
C. Recommend hemodialysis
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
6. A 45-year-old woman with decompensated cirrhosis secondary to primary biliary cholangitis develops hepatocellular carcinoma. Which of the following is the most appropriate management?
A. Initiate sorafenib therapy
B. Recommend liver transplantation
C. Recommend locoregional therapy
D. Recommend surgical resection
E. Recommend supportive care only
7. A 60-year-old man with decompensated cirrhosis secondary to hepatitis B develops refractory ascites. Which of the following is the most appropriate management?
A. Administer intravenous albumin
B. Recommend large-volume paracentesis
C. Recommend liver transplantation
D. Recommend sodium restriction and diuretic therapy
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
8. A 52-year-old woman with compensated cirrhosis secondary to primary sclerosing cholangitis develops portal hypertensive gastropathy. Which of the following is the most appropriate management?
A. Administer proton pump inhibitor therapy
B. Initiate beta-blocker therapy
C. Recommend endoscopic variceal ligation
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
9. A 68-year-old man with decompensated cirrhosis secondary to nonalcoholic steatohepatitis (NASH) develops hepatorenal syndrome. Which of the following is the most appropriate management?
A. Administer intravenous albumin
B. Administer vasopressin analogue therapy
C. Recommend hemodialysis
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
10. A 50-year-old woman with compensated cirrhosis secondary to primary biliary cholangitis presents with new-onset ascites. Which of the following is the most appropriate management?
A. Initiate diuretic therapy
B. Recommend large-volume paracentesis
C. Recommend liver transplantation
D. Recommend salt restriction and fluid restriction
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
11. A 62-year-old man with decompensated cirrhosis secondary to alcohol abuse develops hepatocellular carcinoma. Which of the following is the most appropriate management?
A. Initiate sorafenib therapy
B. Recommend liver transplantation
C. Recommend locoregional therapy
D. Recommend surgical resection
E. Recommend supportive care only
12. A 55-year-old woman with decompensated cirrhosis secondary to hepatitis C develops spontaneous bacterial peritonitis (SBP). Which of the following is the most appropriate management?
A. Administer intravenous albumin
B. Administer intravenous antibiotics
C. Recommend large-volume paracentesis
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
13. A 48-year-old man with compensated cirrhosis secondary to nonalcoholic steatohepatitis (NASH) develops variceal bleeding. Which of the following is the most appropriate management?
A. Initiate beta-blocker therapy
B. Initiate proton pump inhibitor therapy
C. Recommend endoscopic variceal ligation
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)
14. A 70-year-old woman with decompensated cirrhosis secondary to primary biliary cholangitis develops hepatic encephalopathy. Which of the following is the most appropriate management?
A. Initiate lactulose therapy
B. Initiate rifaximin therapy
C. Recommend liver transplantation
D. Recommend protein-restricted diet
E. Recommend supportive care only
15. A 58-year-old man with alcohol-related cirrhosis presents with new-onset portal hypertensive gastropathy. Which of the following is the most appropriate management?
A. Administer proton pump inhibitor therapy
B. Initiate beta-blocker therapy
C. Recommend endoscopic variceal ligation
D. Recommend liver transplantation
E. Recommend transjugular intrahepatic portosystemic shunt (TIPS)