Clin Chem mult. choice ques. (Chapter 25 Liver Functions)

Which of the following enzymes would best aid in identifying hepatobiliary disease?
a. Alkaline phosphatase (ALP)
b. Aspartate aminotrasferase (AST)
c. Alanine aminotransferase (ALT)
d. Ammonia

a

In which of the following types of cells does the conjugation of bilirubin take place?
a. Hepatocytes
b. Kupffer cells
c. Macrophages
d. Phagocytic cells

a

Which of the following enzymes is responsible for the conjugation of bilirubin?
a. UDP-glucuronosyltransferase
b. Alkaline phosphatase
c. Glutamate dehydrogenase
d. Leucine aminopeptidase

b

Which of the following fractions of bilirubin is water soluble and reacts with a diazo reagent without the addition of an accelerator?
a. Conjugated bilirubin
b. Unconjugated bilirubin
c. Total bilirubin
d. Indirect bilirubin

a

Which form of hepatitis is caused by a DNA virus?
a. Hep B
b. Hep A
c. Hep C
d. Hep D

a

Which of the following enzymes is most useful in establishing the hepatic origin of an elevated serum alkaline phosphatase?
a. 5'-Nucleotidase
b. Alanine aminotransferase (ALT)
c. Aspartate aminotransferase (AST)
d. Lactate dehydrogenase

a

Hepatitis E is likely to cause serious consequences in
a. Pregnant women
b. Children
c. Travelers in Third World countries
d. Older people

a

Worldwide, most primary malignant tumors of the liver are related to
a. Alcoholism
b. Gallstones
c. Reye's syndrome
d. Malaria

a

The reagent p-dimethylaminobenzaldehyde is used to measure which of the following?
a. Urobilinogen
b. Total bilirubin
c. Ammonia
d. Alkaline phosphatase

a

Which of the following conditions would result in elevations in primarily conjugated bilirubin?
a. Dubin-Johnson syndrome
b. Physiologic jaundice of the newborn
c. Crigler-Najjar syndrome
d. Gilbert's syndrome

a

A urinalysis dipstick test indicated that urobiliinogen was absent. Which condition does this support?
a. Biliary obstruction.
b. Hep A acute infection
c. Defective liver cell function
d. Hepatocellular disease
e. This would support all of the above conditions.

a

Measuring serum ammonia levels has the potential to be fraught with preanalytic al errors that may interfere with achieving an accurate result. Of the following preanalytical steps, which is incorrect?
a. After phlebotomy, the patient's blood should be immediately placed on the ice.
b. The blood should be collected in a red clot tube without anticoagulant.
c. Hemolyzed samples should be rejected as this interferes by falsely increasing ammonia levels.
d. Lipemia may also interfere with plasma ammonia measurements.
e. All of the above

`b

A patient presents with elevated levels of IgG anti-HAV, while levels of IgM anti-HAV are nondetectable. This patient is likely to
a. Have an acute infection of HAV
b. Have a chronic infection of HAV
c. Have an immunity to HAV
d. Be a carrier of HAV

c

The product produced and measured when reacting with bilirubin with a diazo reagent is
a. NADPH
b. NAD
Azobilirubin
d. Bilirubin diglucuronide

c

A healthy 28 year old female sees her physician for a routine examination and has received a "relatively" clean bill of health except for the following results:
Total bilirubin: 2.8 mg/dL
Direct bilirubin: 0.1 mg/dL
Indirect bilirubin: 2.7 mg/dL
These results most likely indicate:
a. Normal bilirubin metabolism
b. Extrahepatic obstruction
c. Dubin-Johnson syndrome
d. Gilbert's disease

d

Which of the following is measured and using glutamate dehydrogenase and is a measure of advanced stages, poor prognosis, and coma in liver disease?
a. Total bilirubin
b. Ammonia
c. Unconjugated bilirubin
d. Urea

b

In which of the following disease states would you see an elevation in total bilirubin and conjugated bilirubin only?
a. Biliary obstruction
b. Hemolysis
c. Neonatal jaundice
d. Gilbert's diasese

a

As a reduction product of bilirubin catabolism, this compound is partially reabsorbed from the intestine through the portal circulation for reexcretion by the liver. What is this compound?
a. Urobilinogen
b. Azobilirubin
c. Biliverdin
d. Urobilin
e. Bilirubin

a

You are the technologist on duty and you are performing the following assay:
Pct sample+Diazo reagent+accelerator-->Product
Which fraction (s) of bilirubin will react in the above reaction?
a. Conjugated
b. Delta
c. Unconjugated
d. All of the above

d

Choose the diagnosis most consistent with the following laboratory findings:
Serum: total bilirubin 5.8 mg/dL
Direct bilirubin: 0.1 mg/dL
Indirect bilirubin 5.7 mg/dL
a. Physiologic jaundice of the newbo5rn
b. Posthepatic bile obstruction
c. Dubin-Johnson syndrome
d. Rotor's syndrome
e. None of the above

a