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Clinical Chemistry II > Liver Function MCQ > Flashcards

Liver Function MCQ Flashcards

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1
Q

In the liver, bilirubin is converted to

A

bilirubin diglucuronide

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2
Q

In the Jendrassik – Grof method for the determination of serum bilirubin concentration, quantitation is obtained by measuring the green color of:

A

Azobilirubin

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3
Q

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are both elevated in which of the following disease?

A

liver parenchymal disease

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4
Q

Which of the following serum constituents is greatly affected if a blood specimen is left standing at room temperature for 8 hours before processing?

A

Bilirubin

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5
Q

The most sensitive enzymatic indicator for liver damage from ethanol intake (alcoholic cirrhosis) is:

A

GGT

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6
Q

Which two physiological conditions are characterized by elevated serum alkaline phosphatase?

A

growth,third trimester of pregnancy

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7
Q

Given the following results:
Alkaline phosphatase marked increase
Alanine aminotransferase slight increase
Aspartate aminotrnaferase slight increase
Gamma – glutamyl transferase marked increase
This is most consistent with:

A

Obstructive jaundice

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8
Q

Kernicterus is an abnormal accumulation of bilirubin in:

A

Brain tissue

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9
Q

In the total bilirubin assay, bilirubin reacts with diazotized sulfanilic acid to form:

A

Azobilirubin

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10
Q
  1. In the Malloy and Evelyn method for the determination of bilirubin, the reagent that is reacted with bilirubin to form a purple azobilirubin is:
A

Diazotized sulfanilic acid

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11
Q

Bile acid concentrations are useful to assess

A

Intestinal malabsorption

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12
Q

Which of the following enzymes are used in the diagnosis of obstructive jaundice?

A

5’-nucleotidase(5’NT) and gamma-glutamyltransferase(GGT)

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13
Q

In which of the following disease states is unconjugated bilirubin NOT a major serum component?

A

Bile duct atresia

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14
Q

If the total bilirubin is 4.3 mg/dL and the conjugated bilirubin is 2.1 mg/dL, the unconjugated bilirubin is:

A

37.62 mmol/L

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15
Q

The principle of the tablet test for bilirubin in urine or feces is:

A

chemical coupling of bilirubin with a diazonium salt to
form a purplecolor

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16
Q

A serum sample was assayed for bilirubin at 10AM and the result was 12 mg/dL. The same sample was retested at 3PM. The result now is 8 mg/dL/. The most likely explanation for this discrepancy is:

A

The sample was exposed to light

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17
Q

What substance gives feces its normal color:

A

Stercobilin

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18
Q

A breakdown product of hemoglobin is

A

Bilirubin

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19
Q

Kernicterus is an abnormal accumulation of bilirubin in:

A

Brain tissue

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20
Q

Urobilinogen is formed in the:

A

Intestine

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21
Q

In bilirubin determinations, the purpose of adding a concentrated caffeine solution or methyl alcohol is to:

A

Allow indirect bilirubin to react with color reagent

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22
Q

the total bilibirubin is 3.1 mg/dL and the conjugated bilirubin is 2.0 mg/dL., unconjugated bilirubin is

A

1.1 mg/dL

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23
Q

The most widely used methods for bilirubin measurement are those based on the :

A

Jenfrassik Grof Method

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24
Q

A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is:

A

Ammonia

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25
Q

In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates?

A

Crigler-Najjar syndrome

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26
Q

Which of the following tests has no clinical application in assessing liver function?

A

Amylase

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27
Q

Urobilinogen is synthesized in the:

A

Intestinal lumen

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28
Q

Which enzyme ratio is the best indicator of acute or chronic hepatitis:

A

AST/ALT ratio

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29
Q

When measuring serum bilirubin, the purpose of adding caffeine-sodium benzoate or methanol to the reaction mixture is to:

A

Accelerate the reaction of uncojugated bilirubin

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30
Q

The diazo-bilirubin color appearing after addition of methanol represents:

A

Total bilirubin

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31
Q

Formation of bile acids is the major mechanism for eliminating:

A

Cholesterol

32
Q

To quantitate serum bilirubin levels, it is necessary that bilirubin couples with diazotized sulfanilic acid to form:

A

Azobilirubin

33
Q

The quantitation of both conjugated ad unconjugated bilirubin may be helpful in differentiating between several types of jaundice. A condition characterized by an elevation of total bilirubin primarily because of an increase in the conjugated bilirubin fraction is:

A

Obstructive jaundice

34
Q

Which assay below will most likely require a sample blank to reduce sample interference:

A

Triglyceride determination using the Hantzsch reaction

35
Q

Type I glycogen storage disease is due to a deficiency in glucose-6-phoshatase in the liver. This condition is called:

A

von Gierke’s disease

36
Q

The term delta bilirubin refers to

A

Bilirubin tightly bound to albumin

37
Q

Which of the following is not a function of the liver?
A. 25-hydroxylation of vitamin D C. storage of iron
B. production of bile acids D. production of insulin

A

D

38
Q

Elevated blood levels of ammonia occur in all of the following disorders except

A

Diabetes mellitus

39
Q

The transport protein associated with bilirubin in the blood is

A

Albumin

40
Q

Which reagent would not dissolve indirect bilirubin?

A

Water

41
Q

Post-hepatic jaundice may be due to

A

neoplasm of the common bile duct

42
Q

immediate precursor of bilirubin is

A

Biliverdin

43
Q

This compound is partially reabsorbed from the intestine through the portal circulation is

A

Urobilinogen

44
Q

The type of bilirubin which is covalently linked to albumin is

A

Delta

45
Q

Caffeine-benzoate reagent is used in this bilirubin test

A

Jendrassik-Grof

46
Q

Post-hepatic jaundice is caused by all of these except

A

hemoglobinopathies

47
Q

The conversion factor to use to convert bilirubin in mg% to micromoles/L is

A

17.1

48
Q

Dubin-Johnson syndrome is characterized by all of the following except

A

Inability to form conjugated bilirubin

49
Q

The use of methanol or caffeine benzoate in bilirubin determination will measure

A

Total bilirubin

50
Q

Which of the following is not a function of the liver?

A

Production of bilirubin

51
Q

Post-hepatic jaundice may be due to

A

Neoplasm of the common bile duct

52
Q

What is the immediate precursor of bilirubin?

A

Biliverdin

53
Q

What enzyme system is responsible in the conjugation of bilirubin?

A

Uridine diphosphate glucuronyltransferase

54
Q

Oxidation of urobilinogen by microorganisms will produce

A

Urobilin

55
Q

Which of the following functions as a transport protein for bilirubin in the blood?

A

Albumin

56
Q

Which bilirubin fraction is unconjugated and weakly bound to albumin?

A

Alpha

57
Q

All of the following describe the direct bilirubin except
A. insoluble in water C. conjugated in the liver
B. conjugated with glucuronic acid D. excreted in jaundiced patients’ urine

A

A

58
Q

All of the following methods have been used for the measurement of of serum bilirubin except
A. Bilirubinometer C. Jendrassik-Grof
B. BSP excretion D. Bilirubin oxidase

A

B

59
Q

Which method uses sulfanilic acid, HCl and sodium nitrite?

A

Diazo

60
Q

Indirect-reacting bilirubin may be quantified by reacting it initially in which reagent?

A

Caffeine benzoate

61
Q

In the bilirubin oxidase method, bilirubin is oxidized to a colorless compound

A

Biliverdin

62
Q

Mesobilirubinogen, urobilinogen and stercobilinogen are collectively known as

A

Urobilinogen

63
Q

Increased total bilirubin due to increased direct bilirubin suggests

A

Obstructive jaundice

64
Q

Complete obstruction of the common bile duct would yield all of the following results except

A. negative urine urobilinogen
B. negative urine bilirubin
C. negative fecal urobilinogen and urobilin
D. passage of acholic stools

A

B

65
Q

Post-hepatic jaundice is caused by all of these except
A. cholelithiasis C. pancreatic CA
B. hemoglobinopathies D. biliary atresia

A

B hemoglobinopathies

66
Q

The use of methanol or caffeine benzoate in bilirubin determination will measure

A

Total bilirubin

67
Q

Inside the liver, bilirubin is conjugated with:

A

Glucuronic acid

68
Q

Which of the following substances is NOT increased in liver disease?

A

Albumin

69
Q

In which method is diazotized sulfanilic acid used?
A. Evelyn-Malloy method
B. Neither Evelyn-Malloy nor Jendrassik-Grof
C. Both Evelyn-malloy and Jendrassik-Grof
D. Jendrassick-Grof method

A

C

70
Q

The conjugation of bilirubin occurs in the:

A

Liver

71
Q

The polarity and water solubility of bile acids are increased upon conjugated with:

A

Either glycine or taurine

72
Q

Which of these is NOT a liver function test:

A

PAH CLEARANCE

73
Q

Increased levels of indirect bilirubin only is seen in:

A

Hemolytic disease

74
Q

is one of the best tests for bilirubin:

A

Jendrassik-Gof

75
Q

One of the following is used to assess liver function. Which one is it?

A

Hippuric Acid Test

Clinical Chemistry II (45 decks)

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