OptoPrep Systemic Flashcards

1
Q
Of the four major variants of leukemia, which type typically presents in children and has the BEST prognosis following proper treatment?
A. Chronic lymphocytic leukemia
B. Acute myelocytic leukemia
C. Chronic myelocytic leukemia
D. Acute lymphocytic leukemia
A

Answer: D
Explanation - Acute lymphocytic (lymphoblastic) leukemia (ALL): This type of leukemia predominantly affects children but can affect adults as well (typically over the age of 65). The standard treatment for ALL involves chemotherapy and radiotherapy. Survival rates for children are very high, as about 85-90% of cases respond to treatment and close to 70% of patients become cured. Prognosis is more guarded in older populations, with an observed survival rate of about 50%.

An easy way to remember the answer to this question is that “ALL kids survive” (in ALL cases, the prognosis for children is very good).

Acute myelocytic (myeloblastic) leukemia (AML): AML is most frequently found in older populations and rarely affects children. The treatment of choice in these cases is chemotherapy, and remission rates are about 30% (for those under the age of 60).

Chronic lymphocytic leukemia (CLL): CLL typically affects adults over the age of 55. It may rarely affect younger adults, but almost never occurs in children. There is no cure for this type of leukemia, but there are many effective treatments. CLL has a very chronic course and is not typically fatal.

Chronic myelocytic leukemia (CML): CML more frequently affects older populations more frequently than younger adults or children. It has a progressive, chronic course with a less favorable prognosis. The mainstay of treatment for these patients is imatinib (a tyrosine-kinase inhibitor).

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2
Q
The type of juvenile idiopathic arthritis in which five or more joints are affected during the first six months of the disease is known as which of the following?
A. Oligoarticular onset
B. Extra-articular onset
C. Systemic onset
D. Polyarticular onset
E. Pauciarticular onset
A

Answer: D
Explanation - Juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis (JRA), is a type of inflammatory arthritis that occurs in children under the age of 16, for a duration of at least 6 weeks. It is the most common form of arthritis in children and adolescents, as well as the most common systemic disease associated with childhood anterior uveitis. JIA is classified based upon the extent of joint involvement in the first 6 months of the disease. These subtypes are as follows:
- Pauciarticular (aka Oligoarticular): JIA in which 4 or fewer joints are affected within the first 6 months. This type accounts for 50-60% of all cases of JIA, and uveitis affects about 20% of these children. Large joints are most commonly affected in these patients.
- Polyarticular: JIA in which 5 or more joints are affected within the same time period. This type accounts for 20% of cases of JIA, and uveitis occurs in about 5% of these cases. Usually the smaller joints are affected in these children.
- Systemic: In addition to polyarticular JIA, children with systemic JIA also experience symptoms such as fever and a salmon pink rash in conjunction with the arthritic conditions. This type of JIA typically involves both the small and large joints.

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3
Q
Brown hair is a dominant trait while blond hair is recessive. If a person who is heterozygous for this trait mates with a person who is homozygous recessive for this trait, what is the probability that their first child will have blond hair?
A. 1/4 (25%)
B. 4/4 (100%)
C. 3/4 (75%)
D. 1/2 (50%)
A
Explanation - A simple Punnett square can be used to help solve this question. One mate is heterozygous for the trait and is represented as Bb. The other person is homozygous recessive with the notation of bb. The Punnett square is as follows: 
B	b 
--------------------------------- 
B { Bb } bb 
b { Bb } bb 

Therefore, the probability of their first child having blond hair is 1/2 or 50%, and the probability of the child having brown hair is also 50%.

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4
Q
A 34-year old patient walks into your office concerned with distance blurry vision. During review of her case history, she also reports that she cannot stand cold temperatures, her skin is very dry, she feels sluggish, depressed and her heart rate is slowed. Which of the following conditions do you suspect is the culprit of her systemic concerns?
A. Myasthenia gravis
B. Grave's disease
C. Hypothyroidism
D. Hyperthyroidism
E. Cretinism
A

Answer: C
Explanation - The above case history is a textbook case of hypothyroidism. People who suffer from hypothyroidism are intolerant of the cold, have a slowed heart rate, display dry skin, possess dry, brittle nails and hair, have unintentional weight gain, and have feelings of sluggishness, fatigue, and depression. The most common treatment includes increasing TSH levels via medication (Levothyroxine).

Individuals who suffer from hyperthyroidism often complain of increased heart and metabolic rates, heat intolerance, weight loss, trouble sleeping, and excessive nervousness. Hyperthyroidism can also lead to Grave’s condition, an autoimmune disorder that attacks the thyroid gland and results in increased levels of thyroxine. A common sign of Grave’s disease is proptosis caused by inflammation of orbital fat and the extraocular muscles. Treatment includes radioactive iodine to destroy thyroid function.

Cretinism is a severe form of hypothyroidism that occurs in children due to a genetic defect that affects the thyroid gland of the fetus. Proper and early treatment is of essence; otherwise, the child’s growth is stunted and mental retardation occurs.

Myasthenia gravis is an autoimmune disorder that results in a weakness of skeletal muscles. Muscle weakness worsens with activity but will improve with rest.

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5
Q
A contracting muscle that develops tension but does not shorten displays which type of muscle tension?
A. Isometric
B. Isovelocity
C. Isotonic
D. Isovolume
A

Answer: A
Explanation - Isometric contraction occurs when a muscle is contracting but is not shortening. This type of muscle tension is used for load-bearing situations such as holding a plate of food in front of you. Muscles that shorten but maintain the same amount of tension are said to display isotonic contraction. An isovelocity contraction follows when the force of the contraction varies while the velocity remains constant.

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6
Q

A neuron is stimulated 12 points above threshold, resulting in an action potential. The same neuron is stimulated a few minutes later 60 points above threshold; how will the neuron respond?
A. It will generate an action potential involving a greater number of sodium channels
B. It will generate an action potential equal to the first
C. It will generate an action potential of longer duration
D. It will generate an action potential of greater magnitude
E. It will generate an action potential that involves more potassium channels

A

Answer: B
Explanation - Action potentials fire based upon an all-or-none principle. That is, once threshold is reached, an action potential will ensue, and its signal will not decay along the length of the axon. The magnitude and length of the action potential is always the same, regardless of the strength of the stimulus. However, in order to code for the strength of the stimulus, more action potentials will be generated with increased frequencies, which in turn determines the amount of neurotransmitter released by the pre-synaptic terminals.

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7
Q
hich 2 of the following systemic conditions are NOT considered HLA-B27 associated diseases? (Select 2)
A.  Behcet's disease
B. Ankylosing spondylitis
C. Sarcoidosis
D. Psoriatic arthritis
E. Crohn's Disease
F. Reiter's syndrome
A

Answer: A, C
Explanation - Of the above systemic conditions, all are considered HLA-B27 related diseases except for sarcoidosis and Behcet’s disease. HLA-B27 refers to a specific genotype related with chromosome 6. These disorders have a strong association with anterior uveitis; however, the trigger mechanism for acute uveitis in patients demonstrating this genotype remains unknown.

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8
Q
Which type of epithelium lines the throat, nasal passages, sinuses and trachea?
A. Pseudostratified
B. Stratified
C. Simple squamous
D. Simple
A

Answer: A
Explanation - The throat, nasal passages, sinuses, and trachea are lined with pseudostratified columnar epithelium. This type of tissue is actually a type of modified simple epithelium. It is actually a single layer but resembles stratified tissue due to the placement of its nuclei. Pseudostratified epithelium generally possesses cilia to help sweep mucous or fluid across its surface.

Simple epithelium is found lining the body’s cavities, tubes, and ducts. It is composed of a single layer of cells which is important for its function of absorption, secretion, filtering or diffusion. Stratified epithelium comprises two or more layers of cells and serves an important role in protection.

Epithelium always has one free surface whether it faces a lumen, cavity, or the environment. The other surface is anchored to a basement membrane.

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9
Q
The nerve tract that serves to maintain communication between the cerebral hemispheres is named which of the following?
A. The ventricles
B. The red nucleus
C. The thalamus
D. The corpus callosum
A

Answer: D
Explanation - The brain is divided into two hemispheres, both of which are capable of functioning independently. In terms of function, the left hemisphere is thought largely to govern spoken language skills while the right houses the centers for math, music and other nonverbal, abstract thinking. The two hemispheres are connected by a nerve tract called the corpus callosum which facilitates communication between the two sides.

The exact purpose of the red nucleus is still not fully understood but it is widely believed to be involved in motor function.

The thalamus serves as a relay for sensory information; it projects sensory signals to the appropriate destination.

The ventricles total four in number and function to synthesize and secrete cerebrospinal fluid (CSF).

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10
Q
Where is the sinoatrial node of the heart located?
A. The upper left atrium
B. The lower left ventricle
C. The upper right atrium
D. The lower right ventricle
A

Answer: C
Explanation - Think in terms of function to help determine and remember the answer to this question. The first area to contract is the right atrium (only briefly, before the left atrium). Logically, it therefore would make sense for the pacemaker of the heart to be located at the site of contraction origin. The atria contract first, followed by contraction of the ventricles.

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11
Q

You are performing a blood pressure measurement on your 61 year-old male patient in which the reading is 168/124mmHg. You repeat the measurement and it reads 166/126. Which of the following BEST describes the time period in which the patient should be referred out for a hypertension evaluation?
A. The patient should see his primary care doctor within 1 month
B. The patient should seek immediate emergency medical treatment
C. The patient should see his primary care doctor within 1 day
D. The patient should see his primary care doctor within 2 weeks
E. The patient should see his primary care doctor within 1 week

A

Answer: B
Explanation - Blood pressure measurements that have a systolic reading above 180mmHg OR a diastolic reading higher than 120mmHg are indicative that the patient is experiencing a hypertensive crisis and must seek immediate emergency medical treatment.

Blood pressure categories as defined by the American Heart Association are as follows:

  • Normal: Systolic less than 120 Diastolic less than 80
  • Prehypertension Systolic 120-139 Diastolic 80-89
  • Stage 1 HTN Systolic 140-159 Diastolic 90-99
  • Stage 2 HTN Systolic 160 or higher Diastolic 100 or higher
  • HTN crisis Systolic higher than 180 Diastolic higher than 120
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12
Q
When determining a newborn's APGAR score, which 2 of the following are NOT included in the 5 items that the physician evaluates? (Select 2)
A. Color
B. Weight
C. Heart rate
D. Length
E. Muscle tone
F. Respiratory effort
G. Reflex irritability
A

B and D. Explanation - The APGAR scoring system is a quick and accurate way of evaluating a baby’s physical status directly after delivery. A physician or nurse will observe 5 signs and record a score for each on a scale of 0-2 based upon the degrees to which the sign is present (0-poor, 1-fair, 2-good). The 5 scores are then added together and range from 0-10. A score of 10 implies that the baby is in the best possible condition. A score of 8 or 9 indicates that the baby is in good condition, 4-7 indicates a fair condition, and 0-3 indicates a poor condition and the need for prompt diagnosis and treatment. The 5 signs are:

  1. Heart rate: 0-not detectable, 1-slow (less than 100), 2-Above 100
  2. Respiratory effort: 0-absent, 1-slow, irregular, 2-good; crying
  3. Muscle tone: 0-flaccid, 1-some flexion of extremities, 2-active motion
  4. Reflex irritability: 0-no response, 1-grimace, 2-cry, cough, or sneeze
  5. Color: 0-blue, pale, 1-body pink, extremities bluish, 2-completely pink or absence of cyanosis

Weight and length of the baby are not related to the APGAR score.

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13
Q
Progressive narrowing of the arterial lumen is BEST known as which of the following terms?
A. Angina pectoris
B. Arteriosclerosis
C. Arrhythmia
D. Atherosclerosis
A

D. Explanation - When excess cholesterol or other lipids build up on the inside of the arterial wall, the lumen of that blood vessel narrows. This narrowing can become aggravated if a platelet becomes stuck on the rough edges of the plaque stimulating a blood clot. The artery may become so clogged that blood flow is impeded and the tissue or organs normally supplied by the vessel may become ischemic. If a coronary artery is affected, chest pains (angina pectoris) or a heart attack may ensue. Atherosclerosis is a type of arteriosclerosis.

Arteriosclerosis results from thickened and hardened arterial walls. Arteriosclerotic blood vessels have lost much of their elasticity.

Arrhythmias are irregular heartbeats. Remember, not all arrhythmias are evil. Endurance athletes can exhibit bradycardia (low cardiac rate).

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14
Q
During case history, your patient reports that he has a family history of Gardner's syndrome. Which of the following ocular conditions is MOST closely associated with this disease?
A. Congenital hypertrophy of the RPE
B. Chorioretinal atrophy
C. Anterior uveitis
D. Optic disc drusen
E. Choroidal nevi
F. Melanocytoma
A

A. Explanation - Congenital hypertrophy of the retinal pigmented epithelium (CHRPE) has been associated with some inherited gastrointestinal polyposis disorders such as familial adenomatous polyposis, Gardner’s syndrome, and Turcot’s syndrome. These diseases are autosomal dominant syndromes that have a very high risk of developing adenocarcinoma of the colon. An observation of multiple CHRPE lesions upon fundus evaluation may provide very useful diagnostic information as they often precede the polyposis of the gastrointestinal tract, and therefore can be considered a marker for the disease.

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15
Q
A typical sperm contains how many chromosomes?
A. 23
B. 21
C. 32
D. 46
A

A. Explanation - A typical sperm and a normal egg each contain 23 chromosomes. During reproduction the two join, eventually resulting in the creation of a baby with 46 chromosomes.

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16
Q

Inhibitory postsynaptic potentials have which type of effect on a neuron?
A. Brings the neuronal membrane closer to threshold
B. Hypopolarizing
C. Depolarizing
D. Hyperpolarizing

A

D. Explanation - Many neurons receive input from multiple other neurons. Some of the input is excitatory in nature, termed excitatory postsynaptic potentials (EPSPs), and others are inhibitory (IPSPs). Inhibitory signals push the membrane of the neuron away from its threshold point and therefore cause hyperpolarization because the inside of the membrane becomes even more negatively charged. When excitatory potentials cause the membrane of the neuron to become more positively charged relative to its resting state, they are hypopolarizing. All of the synaptic signals that reach the input zone at the same time are integrated together. If the resulting message causes the membrane to reach its threshold, an action potential ensues.

17
Q
Female ovulation is triggered primarily by a surge in which of the following hormones?
A. Gonadotropin-releasing hormone (GnRH)
B. Luteinizing hormone (LH)
C. Oxytocin
D. Follicle-stimulating hormone (FSH)
A

Explanation - At the beginning of the menstrual cycle, GnRH is released and stimulates the secretion of FSH and LH. FSH and LH cause growth of a follicle in the ovary. The oocyte and the glycoprotein surrounding the oocyte grow, forming the zona pellucida. FSH and LH stimulate the cells around the zona pellucida to secrete estrogen. As estrogen levels rise and the follicle matures, it completes meiosis, resulting in a secondary oocyte and a polar body. The increase in blood estrogen levels is detected by the pituitary gland; the pituitary responds by releasing LH, causing the mature secondary oocyte to rupture through the wall of the ovary and subsequent ovulation.

18
Q
Which of the following is an example of a fortified product?
A. Drinking milk with vitamin D added
B. Eating organically grown food
C. Sitting out in the sun
D. Taking a multi-vitamin daily
A

A. Explanation - Food and beverage fortification entails the addition of essential micronutrients to foods to increase their nutritional value while posing a minimal risk to health. Many countries (by law) have added vitamins to staple foods to help decrease sickness while promoting health. For example, Canada legally requires that liquid milk and margarine be fortified with vitamin D, because during the winter months where there is minimal sun exposure, many people suffer from hypovitaminosis D. The amount of vitamin D that is added is strictly controlled, as there exists the risk for toxicity if ingested in large quantities.

19
Q
Which of the following immune cells require activation by an antigen-presenting cell to be activated?
A. T helper cells (CD4+)
B. Neutrophils
C. Natural killer cells
D. Cytotoxic T cells (CD8+)
E. Macrophages
A

A. Explanation - Neutrophils and macrophages can both act as antigen-presenting cells (APCs) and do not require APC activation. Natural killer cells are lymphocytes that are neither T nor B in phenotype. They can respond against virally infected cells and some tumor cells, but they do not have specific antigen recognition sites. CD8+ cytotoxic T lymphocytes interact primarily with major histocompatibility complex I (MHC I) directly on infected cells. CD4+ T helper cells interact with MHC II on APCs, which activates them to stimulate other B and T cells to proliferate. These cells must recognize the specific antigen on an antigen-presenting cell to become activated.

20
Q
A young male presents with significant conjunctivitis. In discussing the patient's review of symptoms, he describes the following findings: arthritis, burning when urinating, rash around the head of the penis, and rash around the plantar aspect of the feet. This is highly suggestive of which of the following?
A. Reiter's syndrome
B. Behcet's syndrome
C. Sarcoidosis
D. Rosacea
A

A. Explanation - Reiter’s syndrome is associated with conjunctivitis (and occasionally uveitis), with other immunologic manifestations of the skin and joints. It is considered a serum RF-negative, HLA-B27-linked arthritis, affecting men more than women. The trigger is commonly thought to be infections, particularly sexually transmitted Chlamydia or other infections such as Shigella, Yersinia, and Campylobacter. (Remember this little rhyme to help recall the triad of findings associated with Reiter’s: Can’t see, can’t pee, can’t dance with me.)

Behcet’s syndrome shares the finding of uveitis and the association with HLA-B27. Sarcoid can produce uveitis and arthritis but is unlikely to produce the other clinical findings.

21
Q
Which of the following ophthalmic manifestations represents the MOST common initial ocular sign in patients with an acoustic neuroma?
A. Papilledema
B. Diminished corneal sensitivity
C. Elevated intraocular pressure
D. Lateral rectus palsy
E. Optic atrophy
D. Afferent pupillary defect
A

B. Explanation - An acoustic neuroma is a benign intracranial tumor involving the myelin-forming Schwann cells of the vestibulocochlear (8th) cranial nerve. These tumors are typically very slow growing over the period of several years and may not exhibit any obvious symptoms in early stages. Eventually, when symptoms become apparent, these will include ipsilateral sensorineural hearing loss (most common), diminished sense of balance, vertigo, a feeling of pressure in the ear, and tinnitus.

As the tumor grows, it may lead to compression of the adjacent areas of the brainstem, resulting in involvement of other nearby cranial nerves. The most commonly affected is the trigeminal nerve (5th cranial nerve), causing diminished corneal sensitivity. Due to its location, the sixth cranial nerve may become involved, and very large tumors can result in elevated intracranial pressure; however, these signs are much less commonly observed.

22
Q
What is the proper term for division of the cytoplasm during mitosis?
A. Telophase
B. Cytosynthesis
C. Anaphase
D. Cytokinesis
A

D. Explanation - During late anaphase/telophase, a layer forms at the center of the cell around the microtubules. An indent forms above this layer that leads to a cleavage furrow in which actin, a contractile protein, pulls at the plasma membrane of the cell, pulling it inwards and using it to essentially cut the cell in half, creating two daughter cells.

23
Q
A pregnant woman presents with a complaint of abnormal swelling of the face and hands and sudden excessive weight gain. She is sent for urine testing, which is positive for protein. This patient is most likely experiencing which of the following complications?
A. Placental abruption
B. Pre-eclampsia
C. Premature rupture of fetal membranes
D. Eclampsia
E. Anemia
A

B. Explanation - Pre-eclampsia is a combination of several classic factors that occur during pregnancy, including high blood pressure, fluid retention, and high levels of protein in the urine. This condition typically occurs in women after their 20th week of pregnancy and usually affects about 1 in 20 women. Some women may be asymptomatic; however, most patients experience symptoms of a reduction in the amount of urine produced, swelling of the face, hands, and feet, and/or sudden or excessive weight gain over a period of a couple of days. In addition, blood pressure is commonly elevated to levels above 140/90.

Pre-eclampsia is a dangerous condition, and if not properly treated, it can progress to eclampsia, which is a potentially fatal condition that involves seizures and comas. It is unclear as to the cause of pre-eclampsia, but certain women have been shown to posses a higher risk (first pregnancy, women over 40, African-American women, women who have already suffered from pre-eclampsia, and women who have a history of high blood pressure, diabetes, or kidney disease). Treatment typically involves bed rest, drinking a lot of water, and close monitoring of blood pressure. In some cases, inducing labor early may be necessary.

24
Q
CREST syndrome is a collection of symptoms associated with which of the following systemic diseases?
A. Systemic scleroderma
B. Wegener's granulomatosis
C. Multiple sclerosis
D. Rheumatoid arthritis
E. Systemic lupus erythematosus
A

A. Explanation - CREST syndrome is an acronym for the 5 main features of the limited cutaneous form of systemic sclerosis (scleroderma). These signs include Calcinosis, Raynaud’s syndrome, Esophageal dysmotility, Sclerodactyly, and Telangiectasia.

25
Q
Which 2 of the following anterior segment changes are MOST likely to occur during pregnancy? (Select 2)
A. Increase in intraocular pressure
B. Decrease in corneal sensitivity
C. Decrease in intraocular pressure
D. Darkening of iris pigmentation
E. Increase in corneal sensitivity
F. Lightening of iris pigmentation
A

B and C. Explanation - In addition to changes in corneal thickness that occur during pregnancy, other anterior segment findings also commonly appear during this time. These observations include a decrease in corneal sensitivity, which typically returns to normal by eight weeks postpartum. A decrease in intraocular pressure has also been observed during the second half of pregnancy. This finding may also persist for several months after giving birth. The reduction in IOP is likely caused by an increase in the outflow facility of aqueous as a result of a combination of several factors, including an increase in uveoscleral outflow (due to hormonal changes), decreased episcleral venous pressure, and a decrease in the overall pressure in the upper extremities. For these reasons, there have been cases of pre-existing glaucoma that have actually improved during pregnancy.

Reduced tear production resulting from a disruption of lacrimal acinar cells commonly causes an increase in the possibility of dry eyes, infection, and contact lens intolerance. Some studies have also reported a development of Krukenberg spindles in pregnant women. This observation is not typically associated with other commonly seen findings in pigment dispersion, and the presence usually decreases during the third trimester and postpartum. The development of eyelid ptosis and other ocular motility defects have also been reported both during and after normal pregnancies; this is commonly related to fluid retention and hormonal changes.

26
Q
Homocysteine levels can be reduced by which of the following vitamins?
A. Vitamin E
B. B vitamins
C. Vitamin C
D. Vitamins A and D
A

B. Explanation - The B vitamins, B12, B6, and folic acid (also known as B9) can reduce homocysteine levels. The other vitamins have no impact on homocysteine. Homocysteine is a metabolic product of the metabolism of methionine. It is associated with premature atherosclerosis and thrombotic complications such as thrombophlebitis. There is great excitement in the medical community about the ability of B vitamins to reduce homocysteine levels; they have been found to do so in multiple studies. Unfortunately, a reduction in cardiovascular disease has not occurred as a consequence of the reduction in this risk factor. It is probably appropriate to maintain homocysteine within a healthy range by restricting foods that are high in methionine and by maintaining an adequate supply of these B Vitamins.

27
Q
Which of the following vessels lack a layer of smooth muscle?
A. Arterioles
B. Veins
C. Capillaries
D. Arteries
A

C. Explanation - Smooth muscle that lines the walls of blood vessels helps to regulate blood flow through the vessels via relaxation or constriction. Capillaries are extremely important for diffusion and exchange of gases. These vessel walls are very thin and therefore lack muscle so as to maximize diffusion. The velocity of blood flow decreases tremendously by the time that it reaches the capillaries, many of which possess lumens that are so small that red blood cells must pass through in single file.

28
Q

Which 3 of the following blood tests are used in the analysis of liver function? (Select 3)
A. Alkaline phosphatase (ALP)
B. Alanine and aspartate transaminase (ALT & AST)
C. Blood urea nitrogen (BUN)
D. Serum creatinine
E. Glomerular filtration rate (GFR)
F. Bilirubin levels

A

A, B, and F. Explanation - Analysis of certain blood tests can aid in determining whether or not the liver is functioning properly. The most commonly performed blood tests in liver disease include serum bilirubin levels, alkaline phosphatase test, and a measure of alanine and aspartate transaminase levels.

Serum bilirubin levels

  • Bilirubin is produced by the liver and excreted in the bile
  • Elevated levels of bilirubin in the blood can indicate an obstruction of bile flow or a problem in the production of bile by the liver

Serum alkaline phosphatase levels

  • Alkaline phosphatase is an enzyme found in many tissues of the body but in highest concentration in the liver, biliary tract, and bone
  • Test used to assess liver function; can be used in the detection of liver lesions that may cause biliary obstruction, such as tumors or abscesses

Alanine and aspartate transaminase levels

  • Alanine is an enzyme found predominantly in the liver and is released into the bloodstream after acute damage to liver cells
  • Alanine transaminase levels can assess liver function and are used to evaluate treatment effectiveness in acute liver disease (such as hepatitis)
  • Aspartate is an enzyme found in the liver, kidneys, pancreas, heart, skeletal muscle and red blood cells
  • Aspartate is released into the bloodstream following liver or heart problems