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Foundations of Clinical Biochemistry (Weeks 10 - 14 content) > Week 13- Hepatobiliary disease > Flashcards

Week 13- Hepatobiliary disease Flashcards

1
Q

Autoimmune hepatitis is when the body produces an inappropriate immune response against itself; sometimes develops ——against own liver tissue.

a) Antibodies
b) Antigens

A

a) Antibodies

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2
Q

Liver cirrhosis could be / regarded to:
Alcoholism
Hepatitis
Obstruction of bile ducts

a) True
b) False

A

a) True

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3
Q 
Liver disease could be / regarded to:
Genetic
Hepatitis
Infections
Obstruction of bile ducts

a) True
b) False

A

a) True

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4
Q 
Which of the following are markers for hepatocellular damage?
Albumin
ALP
ALT
AST
Bilirubin
LDH
yGT
Prothrombin

a) Albumin, ALP, AST and ALT
b) Bilirubin, ALP, AST and ALT
c) ALT, AST, ALP, yGT
d) LDH, ALP, AST, yGT
e) LDH, ALP, AST and ALT

A

c) ALT, AST, ALP, yGT

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5
Q

The marker for liver excretory function is

a) Albumin
b) Bilirubin
c) ALT
d) AST
e) LDH

A

b) Bilirubin

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6
Q

The marker for liver synthesis function is

a) Albumin
b) ALP
c) ALT
d) AST
e) Bilirubin

A

a) Albumin

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7
Q

The marker for hepatocellular damage is

a) Albumin
b) yGT
c) Bilirubin

A

b) yGT

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8
Q

ALT is present in many organs. So, why its elevation is a marker for liver disease? Because it is coming primarily from the ——.

a) Brain
b) Heart
c) Kidney
d) Liver
e) Pancreas

A

d) Liver

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9
Q

Serum ALT level, serum AST level, and their ratio (AST/ALT ratio) are commonly measured clinically as biomarkers for ——health.

a) Brain
b) Heart
c) Kidney
d) Liver
e) Pancreas

A

d) Liver

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10
Q

De Ritis Ratio is the ratio of Serum —– to ——.

a) ALT
b) AST

A

b) AST

a) ALT

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11
Q

De Ritis Ratio is used to differentiate between causes of hepatocellular damage or hepatotoxicity (e.g. alcoholic).

a) True
b) False

A

a) True

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12
Q

De Ritis Ratio is used to differentiate between cholestasis and hepatotoxicity (e.g. alcoholic).

a) True
b) False

A

b) False

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13
Q
  • –is a more specific indicator of liverinflammationthan —, however, —often follows —.
    a) ALT
    b) AST
    c) ALP
A

a) ALT
b) AST
b) AST
a) ALT

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14
Q
  • –is a more specific indicator of liverinflammationthan —.
    a) ALT
    b) AST
A

a) ALT

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15
Q

Serum AST to ALT ratio of 2 or 3:1 is an indication for——.

a) Alcoholic liver disease
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia

A

a) Alcoholic liver disease

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16
Q

Liver —rises with obstruction or infiltrative diseases (i.e., stones or tumors) and this is why it is considered a marker for —-.

a) ALP
b) ALT
c) Alcoholic liver disease
d) Cholestasis
e) Glycemia

A

a) ALP

d) Cholestasis

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17
Q

An increase in ALP accompanied with normal GT, could be due to bone remodeling and pregnancy (3rd term)

a) True
b) False

A

a) True

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18
Q

An increase in ALP accompanied with normal GGT, is consistent with which of the following?

a) Alcohol or other drug induction
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia

A

c) Bone/skeletal diseases

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19
Q

An increase in GGT accompanied with normal ALP, and AST is consistent with which of the following?

a) Alcohol or other drug induction
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia

A

a) Alcohol or other drug induction

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20
Q

An increase in GGT and ALP is consistent with which of the following?

a) Alcohol or other drug induction
b) Cholestasis
c) Bone / skeletal diseases
d) Hyperalbuminaemia

A

b) Cholestasis

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21
Q
  • —rises as a result of bone and liver diseases as well as cholestasis or drug/alcohol intake.
    a) yGT
    b) Bilirubin
    c) Cholestasis
    d) Glycemia
A

a) yGT

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22
Q

A rise in —is a sign of cholestasis, whereas, a rise in —— and normal —– is a sign of alcoholism/drugs.

a) ALP
b) Bilirubin
c) yGT
d) yGT and ALP

A

d) yGT and ALP
c) yGT
a) ALP

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23
Q

To differentiate between cholestasis and hepatocellular disease, if there are rise of yGT, ALT and AST and with normal-high ALP, it is a sign of ——–, whereas, if there are rise in yGT, ALP, with normal-high ALT and AST, it is a sign of ——–.

a) Cholestasis
b) Hepatocellular disease

A

b) Hepatocellular disease

a) Cholestasis

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24
Q

Bilirubin or unconjugated bilirubin is formed from the breakdown of —. It is then get —in the liver and —in the bile to the intestine.

a) Conjugated
b) Excreted
c) Glycogen
d) Heam
e) Hydrolysed

A

d) Haem
a) conjugated
b) excreted

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25
Q

The water —form of bilirubin needs to be converted to water —-form to be excreted.

a) Insoluble
b) Soluble

A

a) Insoluble

b) soluble

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26
Q 
The enzyme 
UDP-glucuronosyl-transferase transforms ---------- to ----------.
a) Albumin 
b) Conjugated bilirubin 
c) Haem
d) Unconjugated bilirubin
A

d) Unconjugated bilirubin

b) conjugated bilirubin

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27
Q

Bilirubin or ——or indirect bilirubin is water —, whereas, —-or direct bilirubin is water –.

a) Conjugated bilirubin
b) Unconjugated bilirubin
c) Insoluble
d) Soluble

A

b) Unconjugated bilirubin
c) Insoluble
a) Conjugated bilirubin
d) Soluble

28
Q

Gilbert’s syndrome causes ——- due to reduced activity of the enzyme

a) UDP-glucuronosyl-transferase.
b) Haemolysis
c) Cholestasis
d) Conjugated hyperbilirubinemia
e) Unconjugated hyperbilirubinemia

A

d) Conjugated hyperbilirubinemia

29
Q

There is no direct bilirubin in urine.

a) True
b) False

A

b) False

30
Q

RBCs in bone and spleen breakdown to produce —, which breaks down to bilirubin. Unconjugated bilirubin is transported via blood’s —to the liver.
In the liver, bilirubin gets conjugated via UDP glucuronosyl
transferase, then gets excreted via the bile duct to the —, where via the effect of certain bacteria, it forms stercobilinogen.
Stercobilinogen gets excreted in feces as stercobilin or reabsorbed by the —-to kidney and gets excreted in —as urobilin.
a) Albumin
b) Blood
c) Heam
d) Intestine
e) Urine

A

c) Haem
a) Albumin
d) Intestine
b) blood
e) urine

31
Q

Jaundice is a syndrome characterised by ———and yellowish pigmentation of the sclerae, skin and mucous membrane.

a) Hypobilirubinemia
b) Hyperbilirubinemia

A

b) Hyperbilirubinemia

32
Q

Jaundice could be regarded to increased —and consequently increased bilirubin secretion that exceeded the capacity of the —to remove it from the —.

a) Blood
b) Haemolysis
c) Kidney
d) Liver
e) Urine

A

b) haemolysis
d) Liver
a) blood

33
Q
  • ——is a condition where there is a decrease in thebile flow (blocked fully or partially) from theliverto theduodenum.
    a) Cholestasis
    b) Gilbert’s syndrome
    c) Haemolysis
    d) Hyperbilirubinemia
A

a) Cholestasis

34
Q

Gilbert’s syndrome cause ——-due to reduced activity of the enzyme glucuronyltransferase, which conjugates bilirubin.

a) Haemolysis
b) Hyperbilirubinemia
c) Hypobilirubinemia
d) Obstruction of the bile duct

A

b) Hyperbilirubinemia

35
Q

Jaundice is the result of hyperbilirubinemia. It could be the result of hepatic disease such as obstruction or cholestasis, also could be regarded to all the followings:

  • Increased haemolysis
  • Gilbert’s syndrome due to lack of gulcuronyltransferase, which conjugates bilirubin
  • Cholestasis
  • Obstruction of bile duct

a) True
b) False

A

a) True

36
Q

The major protein synthesized by the ——is albumin.

a) Brain
b) Heart
c) Kidney
d) Liver
e) RBCs

A

d) Liver

37
Q

The half life time of albumin is 20 days. That could be an indicator to differentiate between acute and chronic liver disease based on —-. If albumin remained low after 20 days, then it is —liver disease and if it returned back to normal, then it is —liver disease.

a) Acute
b) Chronic
c) Hypoalbuminemia
d) Hypomilirubinemia

A

c) Hypoalbuminemia
b) Chronic
a) Acute

38
Q

A decrease in prothrombin could be seen in case of ——-jaundice due to lack in bile salt.

a) Hemolytic
b) Obstructive

A

a) Hemolytic

39
Q
  • — is fat soluble and it needs the bile salts for its absorption by the blood.
    a) Vitamin A
    b) Vitamin B
    c) Vitamin C
    d) Vitamin D
    e) Vitamin K
A

e) Vitamin K

40
Q
  • —- is one of the earliest markers of decline in liver synthetic capacity and it has a shorter ½ life compared to other markers such as albumin. However, it needs vitamin —— for the coagulation process. In case there is haemorrhage, or diarrhoea, the vitamin becomes low in blood and patients need to be injected with the vitamin.
    a) A
    b) Albumin
    c) C
    d) K
    e) Prothrombin time
A

e) Prothrombin time

d) K

41
Q

The liver is responsible for the detoxification of —–by converting it to —(a product found in urine). Lack of this process, may end up with high ammonia in blood and that can cause hepatic comma.

a) Ammonia
b) Blood
c) Urea
d) Urine

A

a) Ammonia

c) urea

42
Q

Checking —- is not a regular test in clinical lab, however, patients with severe liver disease may have this test to check the possibility of having hepatic comma (encephalopathy).

a) Albumin
b) Ammonia
c) Prothrombin

A

b) Ammonia

43
Q

In some clinical labs, 5’ nucleotidase (5’NTD) is used as a substitute of —— for ascertaining whether an elevated ALP is of biliary or extra-biliary origin.

a) Albumin
b) ALP
c) Bilirubin
d) γGT
e) Prothrombin

A

d) yGT

44
Q

Some of the genetic diseases of liver could be from —overload, haemochromatosis, or —overload, Wilson’s disease.

a) Copper
b) Iron
c) Potassium
d) Sodium
e) Zinc

A

b) Iron

a) Copper

45
Q

Increased intestinal absorption of ——from the gastrointestinal tract is termed haemochromatosis:

a) Calcium
b) Copper
c) Haeme
d) Iron
e) Potassium

A

d) Iron

46
Q

Why men are more vulnerable to haemochromatosis than women?
Because women have the menstruation.
a) True
b) False

A

a) True

47
Q

Women are more likely to have hemochromatosis than men.

a) True
b) False

A

b) False

48
Q

The preferred treatment of patients with hemochromatosis is:

a) Chelation of excess iron
b) Drinking too much fluids
c) Phlebotomy

A

c) Phlebotomy

49
Q

Wilson’s disease is due to excess —— in the tissues due to lack of ceruloplasmin.

a) Calcium
b) Copper
c) Iron
d) Potassium

A

b) Copper

50
Q

Alpha-1-antitrypsin inhibits a wide variety of —-. It protects tissues from enzymes of inflammatory cells. Alpha-1-antitrypsin could be detected from low alpha-1-antitrypsin level.

a) Oxidoreductases
b) Proteases
c) Transferases
d) Ligases

A

b) Proteases

51
Q

Hepatitis is a breakdown of the person’s immune system due to viruses, alcohol, drugs or toxins leading to inflammation of the ——.

a) Heart
b) Kidney
c) Liver
d) Pancreas
e) Spleen

A

c) Liver

52
Q

The stages of Hepatitis and liver damage are:

a) Cirrhosis – Fatty – Fibrosis
b) Fat accumulation – Fibrosis – Cirrhosis
c) Fibrosis – Fat accumulation – Cirrhosis
d) Fat accumulation – Cirrhosis – Fibrosis
e) Fibrosis – Cirrhosis - Fat accumulation

A

b) Fat accumulation – Fibrosis – Cirrhosis

53
Q
  • ——–: theliverdoes not function properly due to long-term damage.
    a) Cirrhosis
    b) Necrosis
A

a) Cirrhosis

54
Q
  • ——–: is a form ofcell injurywhich results in the prematuredeathofcellsin livingtissuebyautolysis.
    a) Cirrhosis
    b) Necrosis
A

b) Necrosis

55
Q

Cirrhosisis a form ofcell injurywhich results in the prematuredeathofcellsin livingtissuebyautolysis.

a) True
b) False

A

b) False

56
Q

In hepatitis, ALT and AST are higher in case of —hepatitis than —hepatitis

a) Alcoholic
b) Chronic

A

a) Alcoholic

b) Chronic

57
Q

It is interesting to find more rise in ALT and AST in –viral hepatitis than alcoholic than —than cirrhotic liver cells. That could be regarded to the amount of good tissues to be lysed to release enzymes are —–in that order.

a) Acute
b) Chronic
c) Decreasing
d) Increasing

A

a) Acute
b) Chronic
c) decreasing

58
Q

In hepatitis, ALT and AST are higher in case of —-hepatitis than —-hepatitis

a) Acute
b) Chronic

A

a) Acute

b) Chronic

59
Q

Hepatic encephalopathy is the loss of —–function that occurs when the liver is unable to remove toxins from the blood.

a) Brain
b) Heart
c) Kidney
d) Muscles
e) Pancreas

A

a) Brain

60
Q

Cirrhosis could be due to all of the following EXCEPT

a) Alcoholic
b) Biliary
c) Cardiac
d) Post necrotic or post viral Cirrhosis
e) Skeletal muscles

A

e) Skeletal muscles

61
Q

A major cause of fatty liver is excessive —. Accumulation of fat may also be accompanied by a progressive inflammation of the liver (hepatitis), and this is termed —-

a) Albumin
b) Alcohol
c) AIDS
d) Steatohepatitis
e) Urea

A

b) Alcohol

d) Steatohepatitis

62
Q 
The following are primary causes of Non-alcoholic fatty liver disease:
Diabetes mellitus (type II) 
Increased insulin resistance syndrome
Hyperlipidemia
Obesity

a) True
b) False

A

a) True

63
Q
  • ——–occurs when fat is deposited (steatosis) in the liver due to causes other than excessive alcohol use. It is now the most common cause of cryptogenic cirrhosis.
    a) Alcoholic cirrhosis
    b) Diabetes mellitus (type II)
    c) Hyperlipidemia
    d) Obesity
    e) Non-alcoholic steatohepatitis
A

e) Non-alcoholic steatohepatitis

64
Q

Hepatocellular carcinoma is the most common type of liver cancer.

a) True
b) False

A

a) True

65
Q

The two specific tumour markers for hepatoma are:

  • ——- and ———–
    a) Albumin
    b) Alpha fetoprotein
    c) Hepatic ultrasound
    d) Gamma GT
    e) Prothrombin
A

b) Alpha fetoprotein

c) Hepatic ultrasound

Foundations of Clinical Biochemistry (Weeks 10 - 14 content) (5 decks)

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