2.5.4 Assessment of Liver Function (Derangements of Bilirubin Metabolism)

Question 1

Increase B1, Decrease delivery and uptake or a conjugation

a. Unconjugated hyperbilirubinemia
b. Conjugated hyperbilirubinemia
c. Mixed hyperbilirubinemia

Answer 1

a

Question 2

Increase B2 due to intrahepatic or extrahepatic cholestasis

a. Unconjugated hyperbilirubinemia
b. Conjugated hyperbilirubinemia
c. Mixed hyperbilirubinemia

Answer 2

b

Question 3

Increase B1 and B2 due to a combination of defects

a. Unconjugated hyperbilirubinemia
b. Conjugated hyperbilirubinemia
c. Mixed hyperbilirubinemia

Answer 3

c

Question 4

Serum Bil: Increased B1
Urine Bil: Neg
Urine UroBil: 3+

a. Pre-hepatic/Hemolytic
b. Hepatic
c. Post-hepatic/Obstructive

Answer 4

a

Question 5

Serum Bil: Increased B2
Urine Bil: 3+
Urine UroBil: Normal (RST)

a. Pre-hepatic/Hemolytic
b. Hepatic
c. Post-hepatic/Obstructive

Answer 5

c

Question 6

Serum Bil: Increased B1 and B2
Urine Bil: (+) if B2 or both / (-) if B1
Urine UroBil: 2+

a. Pre-hepatic/Hemolytic
b. Hepatic
c. Post-hepatic/Obstructive

Answer 6

b

Question 7

Crigler-Najjar syndrome, Lucey-Driscoll syndrome, Physiologic jaundice of the newborn, and Gilbert syndrome

a. Increased B1
b. Increased B2
c. Increased B1 and B2

Answer 7

a

Question 8

Dubin-Johnson syndrome

a. Increased B1
b. Increased B2
c. Increased B1 and B2

Answer 8

b

Question 9

Hepatitis, cirrhosis, and hepatic carcinoma

a. Increased B1
b. Increased B2
c. Increased B1 and B2

Answer 9

c

Question 10

B1 Can be seen in urine

T or F

Answer 10

F

Question 11

Urobilinogen in the urine is increased when:

a. Less B1
b. Impede recirculation pathway
c. Abnormalities in Albumin
d. All of the above

Answer 11

b

Question 12

Hemolytic anemia may cause increase in urobilinogen in the urine

T or F

Answer 12

T

Since Bilirubin is increased when RBCs are destroyed, the liver will overwork itself and may not take up urobilinogen

Question 13

Liver disease may increase urobilinogen

Answer 13

T

Question 14

In post hepatic, urobilinogen will no be exceted due to blockage in excretory path so the result for urobilinogen in the urine is?

Answer 14

Normal

Question 15

Gilbert syndrome

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 15

b

Question 16

Viral hepatitis, Cirrhosis, Hepativ carcinoma

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 16

c

Question 17

Lucey-Driscoll syndrome

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 17

b

Question 18

Physiologic jaundice of the newborn

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 18

b

Question 19

Crigler-Najjar syndrome

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 19

b

Question 20

Biliary obstruction

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 20

e

Question 21

Dubin Johnson syndrome

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 21

d

Question 22

Rotor syndrome

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 22

d

Question 23

Due to secretory defect

a. Hemolytic disease
b. Viral hepatitis, cirrhosis, Hepatic carcinoma
c. Dubin-Johnson and Rotor syndrome
d. Biliary obstruction

Answer 23

c

Question 24

Extrahepatic cholestasis

a. Hemolytic disease
b. Viral hepatitis, cirrhosis, Hepatic carcinoma
c. Dubin-Johnson and Rotor syndrome
d. Biliary obstruction

Answer 24

d

Question 25

Increase RBCs destruction = Increase bilirubin production

a. Hemolytic disease
b. Viral hepatitis, cirrhosis, Hepatic carcinoma
c. Dubin-Johnson and Rotor syndrome
d. Biliary obstruction

Answer 25

a

Question 26

Increase B1 = Decrease conjugatio

Increase B2 = Bile flow interference

a. Hemolytic disease
b. Viral hepatitis, cirrhosis, Hepatic carcinoma
c. Dubin-Johnson and Rotor syndrome
d. Biliary obstruction

Answer 26

b

Question 27

Transport Defect (Mild UDPGT deficiency)

a. Gilbert syndrome
b. Lucey-Driscoll syndrome
c. Physiologic jaundice of the newborn
d. Crigler-Najjar syndrome

Answer 27

a

Question 28

Circulating inhibitor of bilirubin conjugation

a. Gilbert syndrome
b. Lucey-Driscoll syndrome
c. Physiologic jaundice of the newborn
d. Crigler-Najjar syndrome

Answer 28

b

Question 29

Transient UDPGT deficiency

a. Gilbert syndrome
b. Lucey-Driscoll syndrome
c. Physiologic jaundice of the newborn
d. Crigler-Najjar syndrome

Answer 29

c

Question 30

Total or partial UDPGT deficiency

a. Gilbert syndrome
b. Lucey-Driscoll syndrome
c. Physiologic jaundice of the newborn
d. Crigler-Najjar syndrome

Answer 30

d

Question 31

B1: Increased
B2: Normal

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 31

a and b

Question 32

B1: Increased
B2: Increased

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 32

c

Question 33

B1: Normal - Increased
B2: Increased

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 33

d

Question 34

B1: Normal
B2: Increased

a. Pre-hepative, unconjugated
b. Hepatic, unconjugated
c. Hepatic, mixed
d. Hepatic, Conjugated or mixed
e. Post-hepatic conjugated

Answer 34

e

Question 35

How to differentiate Dubin-Johnson syndrome and Rotor syndrome?

Answer 35

Dark pigmentation in hepatocyte