Quiz 5: Liver Functions (Exam:2)

The major risk factor for development of hepatocellular carcinoma is:
A. infection with hepatitis B or C viruses.
B. hepatic encephalopathy.
C. infection with hepatitis A virus.
D. hepatorenal syndrome.

infection with hepatitis B or C viruses

The functional unit of the liver is the:
A. acinus.
B. cord.
C. glomerulus.
D. nephron

acinus

Bilirubin that is attached to albumin before it is transported across the hepatocyte membrane is called:
A. unconjugated bilirubin.
B. jaundice.
C. urobilinogen.
D. conjugated bilirubin

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

hepatitis B surface antigegn

Which one of the following is not a consequence of portal hypertension in an individual?
A. Altered estrogen metabolism
B. Increased prothrombin time
C. Hemochromatosis
D. Bleeding esophageal varices

hemochromatosis

A Model for End-Stage Liver disease staging system to predict prognosis in cirrhosis uses the following laboratory determinations EXCEPT:
A. Creatinine.
B. Bilirubin.
C. INR.
D. Aspartate transaminase.

Aspartate transaminase

Nonalcoholic steatohepatitis is characterized by all of the following EXCEPT:
A. No inflammation or scarring of the liver.
B. Necroinflammatory liver disease associated with accumulation of fat in the liver.
C. AST greater than ALT.
D> Consumption of less than 20g of ethanol daily.

AST greater than ALT

The liver is supplied by what major source(s) of oxygen-containing blood?
A. the hepatic artery
B. the hepatic vein
C. the portal vein
D. both a and b

both a and b

Which type of hepatitis is a leading cause of chronic hepatitis and is caused by a mutating RNA virus?
A. Fulminant hepatitis
B. Hepatitis B
C. Hepatitis A
D. Hepatitis C

Hepatitis C

Deficiency of which of the following vitamins will result in decreased heme synthesis?
A. Riboflavin
B. Pyridoxal phosphate (PLP)
C. Thiamine
D. Niacin

pyridoxal phosphate (PLP)

Which one of the following vitamins will aid in the absorption of iron by the intestine?
A. vitamin A
B. vitamin B12
C. vitamin D
D. vitamin C

vitamin 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. competitive protein binding.
D. immunoassay.

high performance liquid chromatography (HPLC)

Production of bilirubin occurs in the ......................, and conjugation of bilirubin to glucuronide occurs in the .......................
A. Liver; intestine
B. Liver; RES
C. RES; liver
D. RES; intestine

RES; liver

Serum bilirubin is unstable because of:
A. Light sensitivity
B. Digestion by proteolytic enzymes
C. Precipitates on standing
D. Precipitation due to acid pH

light sensitivity

The enzyme that conjugates bilirubin in the hepatocyte is:
A. Microsomal heme oxygenase
B. UDP-glucuronyl transferase
C. Biliverdin reductase
D. Glucuronic aminotransferase
E. Beta-glucuronidase

UDP-glucuronyl transferase

What reagent is used in the bilirubin method to shift the color reaction to a wavelength with less interference?
A. Ascorbic acid
B. Active diazo
C. Hydrochloric acid
D. Alkaline tartrate

alkaline tartrate

Acute intermittent porphyria (AIP) patients have a deficiency of:
A. Coproporphyrinogen oxidase
B. PBG deaminase
C. Ferrochelatase
D. Protoporphyrinogen oxidase

PBG deeaminase

The number of pyrrole rings found in the structure of all porphyrins is:
A. 4
B. 2
C. 8
D. 3

4

Bile formed in the liver is stored in the:
A. Gall bladder.
B. Liver.
C. Large intestine.
D. Duodenum

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. Protoheme.
C. Porphobilinogen.
D. Protoporphyrin.
E. Stercobilinogen

urobilin

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

It is produced from the destruction of RBCs.

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

it a not water-soluble

The term δ-bilirubin (delta) refers to:
A. Free unconjugated bilirubin.
B. Direct-reacting bilirubin.
C. Bilirubin tightly bound to albumin.
D. Water-soluble bilirubin.

bilirubin tightly bound to albumin

What is the most common cause of unconjugated hyperbilirubinemia?
A. Dubin-Johnson
B. Neonatal physiologic jaundice
C. Gilbert's disease
D. Bile duct obstruction
E. Hemolytic anemia

Neonatal physiologic jaundice

In obstructive liver disease, the following test results are found:
A. Feces: urobilinogen decreased; urine: bilirubin: positive; serum: conjugated bilirubin increased.
B. Feces: urobilinogen decreased or negative; urine: urobilinogen decreased or negative; serum: conjugated bilirubin decreased.
C. None of the above.
D. Feces: urobilinogen increased; urine: bilirubin: normal; serum: conjugated bilirubin normal or slightly elevated.

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

alcoholic fatty liver

The reagent (accelerator) in the Jendrassik-Grof bilirubin procedure that makes indirect bilirubin water-soluble is:
A. Hydrochloric acid.
B. Alkaline tartrate.
C. Caffeine.
D. Methanol.

caffeine

If a total bilirubin is 4.0 mg/dL and the conjugated bilirubin is 2.5 mg/dL, the unconjugated bilirubin is:
A. 1.0 mg/dL.
B. 2.0 mg/dL.
C. 1.5 mg/dL.
D. 3.0 mg/dL

1.5 mg/dL

In the Jendrassik-Grof bilirubin, what converts purple azobilirubin to blue azobilirubin measured at 600nm?
A. Alkaline tartrate
B. Methanol
C. Caffeine
D. Hydrochloric acid

Alkaline tartrate

Viral hepatitis that results in the largest percentage of chronic hepatitis is:
A. Hepatitis B.
B. Hepatitis D
C. Hepatitis C.
D. Hepatitis A.

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

hepatitis A virus

In the liver, ammonia is metabolized to form:
A. glucuronic acid.
B. urea.
C. ketoacids.
D. amino acids.

urea

Caffeine is used in bilirubin assays to:
A. Accelerate direct bilirubin reaction
B. Stop the diazo reaction
C. Precipitate proteins
D. Accelerate indirect bilirubin reaction
E. Reduce sodium nitrite

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. Posthepatic
B. Prehepatic
C. Hepatic
D. Biliary

Prehepatic