LIVER FUNCTION TESTS III

Question 1

it helps to monitor the decline of serum bilirubin following surgical removal of gallstones

a. uncojugated bilirubin
b. conjugated bilirubin
c. delta bilirubin
d. jaundice

Answer 1

Delta Bilirubin

• tightly bound to ALBUMIN
• has a LONGER HALF LIFE than other bilirubin
• it is formed due to PROLONGED ELEVATION OF CONJUGATED BILIRUBIN IN BILIARY OBSTRUCTION
• it helps to monitor the decline of serum bilirubin following surgical removal of gallstones
• reference value: <0.2 mg/dL

Question 2

which of the classification of jaundice is caused by Failure of bile to flow to the intestine/ impaired bilirubin excretion

a. pre hepatic jaundice
b. post hepatic jaundice
c. hepatocellular combined jaundice

Answer 2

1. pre hepatic
   - caused : too much destruction of RBCs
2. Post hepatic
   - caused : Failure of bile to flow to the intestine/ impaired bilirubin excretion
3. hepatocellular combined jaundice
   - caused : hepatocyte injury caused by VIRUSES, ALCOHOL AND PARASITES

Question 3

Which of the derangement of bilirubin metabolism is bilirubin transport deficit

a. Gilbert’s bilirubin
b. Crigler - Najjar syndrome
c. dubin johnson syndrome
d. lucey driscoli syndrome

Answer 3

gilbert’s syndrome - Bilirubin TRANSPORT bilirubin

• characterized by IMPAIRED CELLULAR UPTAKE BILIRUBIN
• LAB RESULT : elevated B1

Question 4

Which of the derangement of bilirubin metabolism is blockage of the excretion of bilirubin into the canaliculi

a. Gilbert’s bilirubin
b. Crigler - Najjar syndrome
c. dubin johnson syndrome
d. lucey driscoli syndrome

Answer 4

Dubin Johnson syndrome and Rotor syndrome

• Bilirubin EXCRETION deficit
• blockage of the excretion of bilirubin into the canaliculi, caused by hepatocyte membrane defect ; hereditary disorders
• intense dark pigmentation in the liver due to accumulation of lipofuchsin pigment
• lab result : elevated TOTAL BILIRUBIN AND B2

Question 5

familial form of unconjugated hyperbilirubinemia

a. Gilbert’s bilirubin
b. Crigler - Najjar syndrome
c. dubin johnson syndrome
d. lucey driscoli syndrome

Answer 5

Lucey driscoli syndrome

• familial form of unconjugated hyperbilirubinemia caused by a circulating inhibitor of bilirubin conjugation
• elevated b1

Question 6

measurement of _________ is sensitive and specific marker for hepatic and post hepatic jaundice because it is not elevated with hemolytic anemia

a. B1
b. B2
c. delta bilirubin
d. total protein

Answer 6

measurement of B2/ CONJUGATED BILIRUBIN is sensitive and specific marker for hepatic and post hepatic jaundice because it is not elevated with hemolytic anemia

Question 7

bilirubin standard solution is made from __________

a. B1
b. B2
c. delta bilirubin
d. total protein

Answer 7

bilirubin standard solution is made from B1 / UNCONJUGATED BILIRUBIN

Question 8

VISIBLE ICTERSIA OCCURS WHEN BILIRUBIN IS ___

A. >3MG/DL
B. <3MG/DL
C. >25 MG/DL
D.>2-3 MG/DL

Answer 8

VISIBLE ICTERSIA OCCURS WHEN BILIRUBIN Is > 25mg/dL

jaundice
bilirubin levels exceed 2-3 mg/dL

Question 9

coupling accelerator for evelyn and malloy method

a. albumin
b, caffeine sodium benzoate
c. methanol
d. sodium acetate

Answer 9

evelyn and malloy method
coupling accelator : METHANOL
final reaction : pink to PURPLE azobilirubin

Question 10

coupling accelerator for jendrassik and grof

a. albumin
b, caffeine sodium benzoate
c. methanol
d. sodium acetate

Answer 10

Jendrassik and Grof
coupling accelerator : Caffeine Sodium Benzoate
Buffer : sodium acetate
ascorbic acid : terminates the initial reaction and destroy the excess diazo reagent
final reaction : pink to BLUE azobilirubin

Question 11

most commonly used bilirubin assay

a. evelyn and malloy method
b. jendrassik and Grof

Answer 11

Jendrassik and Grof
most commonly used
popular technique for the discreet analyzers
more sensitive than evelyn and malloy

Question 12

which of the following does not belong in increased b1

a. biliary obstruction
b. gilbert’s syndrome
c. lucey Driscoll syndrome
d. G6pd

Answer 12

increased B1
 1. Gilbert's Syndrome
 2. Crigler najjar syndrome
 3. hemolytic anemia
 4. hepatocellular disease
 5. lucey driscoll syndorme
 6 G6pd

answer: biliary obstruction ( increasd in B2)

Question 13

which of the following does not belong in increased b2

a. biliary obstruction
b. gilbert’s syndrome
c. biliary atresia
d. dubin johnson syndrome

Answer 13

increased B2 ( BBDaPA)

1. Biliary obstruction
2. biliary atresia
3. dubin - johnson syndrome
4. pancreatic cancer
5. alcohol and viral hepatitis

Question 14

coloreless end product of bilirubin metabolism that is oxidized by intestinal bacteria to the brown pigment urobilin

a. total protein
b, albumin
c, bilirubin
d, urobilinogen

Answer 14

urobilinogen
- COLORLESS END PRODUCT of bilirubin metabolism that is oxidized by intestinal bacteria to the brown pigment urobilin

Question 15

what is the method in Urobilinogen

a. ehrlich method
b. mac donald method
c. rosenthal white method
d. nota

Answer 15

Bromsulfonthalein (BSP) dye excretion test

1. rosenthal white (double collection method)
2. mac donald method (single collection method)

urobilinogen
methods: EHRLICH’S METHOD (p- dimethyl aminobenzaldehyde reagent)

Question 16

it is used to assess the extent of liver damage and differentiate HEPATOCELLULAR FROM OBSTRUCTIVE DISEASE

a. Enzyme tests
b. ammonia
c. total protein
b. bilirubin

Answer 16

enzyme test

• it is used to assess the extent of liver damage and differentiate HEPATOCELLULAR (functional) FROM OBSTRUCTIVE DISEASE (mechanical)
• only indication of cell injury in early or localized liver disease

Question 17

which of the ff enzymes is secreted in the liver

a. ggt
b. lap
c. alp
d. aota

Answer 17

enzymes secrteted in the liver 
 GGT
 OCT
 ALP
 LDH

LAP
AMINOTRANSFERASES (AST, ALT)
5- NUCLEOTIDASE

nag GOAL ko ay makabili nang LANd