MMSC436 Practice Quiz 5 Liver Functions Exam 2

The major risk factor for development of hepatocellular carcinoma is:

A. epatorenal syndrome.
B. infection with hepatitis A virus.
C. hepatic encephalopathy.
D. infection with hepatitis B or C viruses

D. infection with hepatitis B or C viruses

The functional unit of the liver is the:

A. glomerulus.
B. acinus.
C. nephron.
D. cord.

B. acinus.

Bilirubin that is attached to albumin before it is transported across the hepatocyte membrane is called:

A. urobilinogen.
B. unconjugated bilirubin.
C. conjugated bilirubin.
D. jaundice.

B. unconjugated bilirubin.

The first protein marker to appear approximately 1 to 2 months after infection with the hepatitis B virus and also the last marker to disappear is the:

A. hepatitis B immune globulin.
B. antihepatitis B surface antigen.
C. antihepatitis B core antigen.
D. hepatitis B surface antigen.

D. hepatitis B surface antigen.

Which one of the following is not a consequence of portal hypertension in an individual?

A. Increased prothrombin time
B. Bleeding esophageal varices
C. Altered estrogen metabolism
D. Hemochromatosis

D. Hemochromatosis

A Model for End-Stage Liver disease staging system to predict prognosis in cirrhosis uses the following laboratory determinations EXCEPT:

A. Aspartate transaminase.
B. Creatinine.
C. INR.
D. Bilirubin.

A. Aspartate transaminase.

Nonalcoholic steatohepatitis is characterized by all of the following EXCEPT:

A. Necroinflammatory liver disease associated with accumulation of fat in the liver.
B. No inflammation or scarring of the liver.
C. AST greater than ALT.
D. Consumption of less than 20g of ethanol daily.

C. AST greater than ALT.

The liver is supplied by what major source(s) of oxygen-containing blood?

A. the hepatic vein
B. the hepatic artery
C. the portal vein
D. both a and b

D. both a and b

Which type of hepatitis is a leading cause of chronic hepatitis and is caused by a mutating RNA virus?

A. Hepatitis A
B. Hepatitis C
C. Hepatitis B
D. Fulminant hepatitis

B. Hepatitis C

Deficiency of which of the following vitamins will result in decreased heme synthesis?

A. Thiamine
B. Pyridoxal phosphate (PLP)
C. Riboflavin
D. Niacin

B. Pyridoxal phosphate (PLP)

Which one of the following vitamins will aid in the absorption of iron by the intestine?

A. C
B. A
C. D
D. B12

A. C

The most commonly used method of analysis for assessing vitamins A, K, and B6 is:

A. high performance liquid chromatography (HPLC).
B. spectrophotometry.
C. immunoassay.
D. competitive protein binding.

A. high performance liquid chromatography (HPLC).

Production of bilirubin occurs in the ......................, and conjugation of bilirubin to glucuronide occurs in the .......................

A. Liver; RES
B. RES; intestine
C.Liver; intestine
D. RES; liver

D. RES; liver

Serum bilirubin is unstable because of:

A. Light sensitivity
B. Precipitation due to acid pH
C. Precipitates on standing
D. Digestion by proteolytic enzymes

A. Light sensitivity

The enzyme that conjugates bilirubin in the hepatocyte is:

A. Glucuronic aminotransferase
B. Beta-glucuronidase
C. Biliverdin reductase
D. UDP-glucuronyl transferase
E. Microsomal heme oxygenase

D. UDP-glucuronyl transferase

What reagent is used in the bilirubin method to shift the color reaction to a wavelength with less interference?

A. Active diazo
B. Alkaline tartrate
C. Ascorbic acid
D. Hydrochloric acid

B. Alkaline tartrate

Acute intermittent porphyria (AIP) patients have a deficiency of:

A. Coproporphyrinogen oxidase
B. PBG deaminase
C. Ferrochelatase
D. Protoporphyrinogen oxidase

B. PBG deaminase

The number of pyrrole rings found in the structure of all porphyrins is:

A. 2
B. 8
C. 4
D. 3

C. 4

Bile formed in the liver is stored in the:

A. Gall bladder.
B. Liver.
C. Large intestine.
D. Duodenum.

A. Gall bladder.

A breakdown product of bilirubin metabolism that is produced in the colon from the oxidation of urobilinogen by microorganisms is:

A. Urobilin.
B. Protoporphyrin.
C. Porphobilinogen.
D. Stercobilinogen.
E. Protoheme.

A. Urobilin.

Which of the statements regarding bilirubin metabolism is TRUE?

A. It is reduced to biliverdin before excretion.
B. It is produced from the destruction of RBCs.
C. It is a product of porphyrin metabolism.
D. It is formed by the hydrolysis of the α-methene bridge of urobilingen.

B. It is produced from the destruction of RBCs.

Which is a characteristic of unconjugated bilirubin?

A. It is water-soluble.
B. It reacts faster than conjugated bilirubin.
C. It has the same absorbance properties as conjugated bilirubin.
D. It a not water-soluble.

D. It a not water-soluble.

The term δ-bilirubin (delta) refers to:

A. Free unconjugated bilirubin.
B. Bilirubin tightly bound to albumin.
C. Water-soluble bilirubin.
D. Direct-reacting bilirubin.

B. Bilirubin tightly bound to albumin.

What is the most common cause of unconjugated hyperbilirubinemia?

A. Gilbert's disease
B. Dubin-Johnson
C. Neonatal physiologic jaundice
D. Bile duct obstruction
E. Hemolytic anemia

C. Neonatal physiologic jaundice

In obstructive liver disease, the following test results are found:

A. Feces: urobilinogen decreased or negative; urine: urobilinogen decreased or negative; serum: conjugated bilirubin decreased.
B. Feces: urobilinogen decreased; urine: bilirubin: positive; serum: conjugated bilirubin increased.
C. None of the above.
D. Feces: urobilinogen increased; urine: bilirubin: normal; serum: conjugated bilirubin normal or slightly elevated.

B. Feces: urobilinogen decreased; urine: bilirubin: positive; serum: conjugated bilirubin increased.

Alcoholic liver disease that follows six months to a year of moderate consumption, few lab abnormalities, and is reversible with abstinence from alcohol is termed:

A. Alcoholic cirrhosis.
B. Alcoholic fatty liver.
C. Alcoholic hepatitis.
D. None of the above.

B. Alcoholic fatty liver.

The reagent (accelerator) in the Jendrassik-Grof bilirubin procedure that makes indirect bilirubin water-soluble is:

A. Alkaline tartrate.
B. Caffeine.
C. Hydrochloric acid.
D. Methanol.

B. Caffeine.

If a total bilirubin is 4.0 mg/dL and the conjugated bilirubin is 2.5 mg/dL, the unconjugated bilirubin is:

A. 1.5 mg/dL.
B. 2.0 mg/dL.
C. 3.0 mg/dL.
D. 1.0 mg/dL.

A. 1.5 mg/dL.

In the Jendrassik-Grof bilirubin, what converts purple azobilirubin to blue azobilirubin measured at 600nm?

A. Alkaline tartrate
B. Hydrochloric acid
C. Caffeine
D. Methanol

A. Alkaline tartrate

Viral hepatitis that results in the largest percentage of chronic hepatitis is:

A. Hepatitis B.
B. Hepatitis C.
C. Hepatitis D.
D. Hepatitis A.

B. Hepatitis C.

The type of RNA virus that is considered to be the cause of the most common type of acute hepatitis that does not lead to chronic hepatitis is:

A. hepatitis B virus.
B. hepatitis A virus.
C. Reye syndrome.
D. hepatitis C virus.

B. hepatitis A virus.

In the liver, ammonia is metabolized to form:

A. ketoacids.
B. glucuronic acid.
C. urea.
D. amino acid

C. urea.

Caffeine is used in bilirubin assays to:

A. Reduce sodium nitrite
B. Precipitate proteins
C. Stop the diazo reaction
D. Accelerate direct bilirubin reaction
E. Accelerate indirect bilirubin reaction

E. Accelerate indirect bilirubin reaction

When elevated amounts of bilirubin are presented to the liver with elevated serum unconjugated bilirubin, what type of jaundice occurs?

A. Biliary
B. Prehepatic
C. Hepatic
D. Posthepatic

B. Prehepatic