Liver Function MCQ Flashcards
In the liver, bilirubin is converted to
bilirubin diglucuronide
In the Jendrassik – Grof method for the determination of serum bilirubin concentration, quantitation is obtained by measuring the green color of:
Azobilirubin
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are both elevated in which of the following disease?
liver parenchymal disease
Which of the following serum constituents is greatly affected if a blood specimen is left standing at room temperature for 8 hours before processing?
Bilirubin
The most sensitive enzymatic indicator for liver damage from ethanol intake (alcoholic cirrhosis) is:
GGT
Which two physiological conditions are characterized by elevated serum alkaline phosphatase?
growth,third trimester of pregnancy
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:
Obstructive jaundice
Kernicterus is an abnormal accumulation of bilirubin in:
Brain tissue
In the total bilirubin assay, bilirubin reacts with diazotized sulfanilic acid to form:
Azobilirubin
- In the Malloy and Evelyn method for the determination of bilirubin, the reagent that is reacted with bilirubin to form a purple azobilirubin is:
Diazotized sulfanilic acid
Bile acid concentrations are useful to assess
Intestinal malabsorption
Which of the following enzymes are used in the diagnosis of obstructive jaundice?
5’-nucleotidase(5’NT) and gamma-glutamyltransferase(GGT)
In which of the following disease states is unconjugated bilirubin NOT a major serum component?
Bile duct atresia
If the total bilirubin is 4.3 mg/dL and the conjugated bilirubin is 2.1 mg/dL, the unconjugated bilirubin is:
37.62 mmol/L
The principle of the tablet test for bilirubin in urine or feces is:
chemical coupling of bilirubin with a diazonium salt to
form a purplecolor
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:
The sample was exposed to light
What substance gives feces its normal color:
Stercobilin
A breakdown product of hemoglobin is
Bilirubin
Kernicterus is an abnormal accumulation of bilirubin in:
Brain tissue
Urobilinogen is formed in the:
Intestine
In bilirubin determinations, the purpose of adding a concentrated caffeine solution or methyl alcohol is to:
Allow indirect bilirubin to react with color reagent
the total bilibirubin is 3.1 mg/dL and the conjugated bilirubin is 2.0 mg/dL., unconjugated bilirubin is
1.1 mg/dL
The most widely used methods for bilirubin measurement are those based on the :
Jenfrassik Grof Method
A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is:
Ammonia
In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates?
Crigler-Najjar syndrome
Which of the following tests has no clinical application in assessing liver function?
Amylase
Urobilinogen is synthesized in the:
Intestinal lumen
Which enzyme ratio is the best indicator of acute or chronic hepatitis:
AST/ALT ratio
When measuring serum bilirubin, the purpose of adding caffeine-sodium benzoate or methanol to the reaction mixture is to:
Accelerate the reaction of uncojugated bilirubin
The diazo-bilirubin color appearing after addition of methanol represents:
Total bilirubin
Formation of bile acids is the major mechanism for eliminating:
Cholesterol
To quantitate serum bilirubin levels, it is necessary that bilirubin couples with diazotized sulfanilic acid to form:
Azobilirubin
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:
Obstructive jaundice
Which assay below will most likely require a sample blank to reduce sample interference:
Triglyceride determination using the Hantzsch reaction
Type I glycogen storage disease is due to a deficiency in glucose-6-phoshatase in the liver. This condition is called:
von Gierke’s disease
The term delta bilirubin refers to
Bilirubin tightly bound to albumin
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
D
Elevated blood levels of ammonia occur in all of the following disorders except
Diabetes mellitus
The transport protein associated with bilirubin in the blood is
Albumin
Which reagent would not dissolve indirect bilirubin?
Water
Post-hepatic jaundice may be due to
neoplasm of the common bile duct
immediate precursor of bilirubin is
Biliverdin
This compound is partially reabsorbed from the intestine through the portal circulation is
Urobilinogen
The type of bilirubin which is covalently linked to albumin is
Delta
Caffeine-benzoate reagent is used in this bilirubin test
Jendrassik-Grof
Post-hepatic jaundice is caused by all of these except
hemoglobinopathies
The conversion factor to use to convert bilirubin in mg% to micromoles/L is
17.1
Dubin-Johnson syndrome is characterized by all of the following except
Inability to form conjugated bilirubin
The use of methanol or caffeine benzoate in bilirubin determination will measure
Total bilirubin
Which of the following is not a function of the liver?
Production of bilirubin
Post-hepatic jaundice may be due to
Neoplasm of the common bile duct
What is the immediate precursor of bilirubin?
Biliverdin
What enzyme system is responsible in the conjugation of bilirubin?
Uridine diphosphate glucuronyltransferase
Oxidation of urobilinogen by microorganisms will produce
Urobilin
Which of the following functions as a transport protein for bilirubin in the blood?
Albumin
Which bilirubin fraction is unconjugated and weakly bound to albumin?
Alpha
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
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
B
Which method uses sulfanilic acid, HCl and sodium nitrite?
Diazo
Indirect-reacting bilirubin may be quantified by reacting it initially in which reagent?
Caffeine benzoate
In the bilirubin oxidase method, bilirubin is oxidized to a colorless compound
Biliverdin
Mesobilirubinogen, urobilinogen and stercobilinogen are collectively known as
Urobilinogen
Increased total bilirubin due to increased direct bilirubin suggests
Obstructive jaundice
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
B
Post-hepatic jaundice is caused by all of these except
A. cholelithiasis C. pancreatic CA
B. hemoglobinopathies D. biliary atresia
B hemoglobinopathies
The use of methanol or caffeine benzoate in bilirubin determination will measure
Total bilirubin
Inside the liver, bilirubin is conjugated with:
Glucuronic acid
Which of the following substances is NOT increased in liver disease?
Albumin
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
C
The conjugation of bilirubin occurs in the:
Liver
The polarity and water solubility of bile acids are increased upon conjugated with:
Either glycine or taurine
Which of these is NOT a liver function test:
PAH CLEARANCE
Increased levels of indirect bilirubin only is seen in:
Hemolytic disease
is one of the best tests for bilirubin:
Jendrassik-Gof
One of the following is used to assess liver function. Which one is it?
Hippuric Acid Test
