MMSC436 - Quiz 5 Liver Functions

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

3. infection with hepatitis B or C viruses.

The functional unit of the liver is the:
1. cord.
2. nephron.
3. acinus.
4. glomerulus.

3. acinus.

Bilirubin that is attached to albumin before it is transported across the hepatocyte membrane is called:
1. conjugated bilirubin.
2. unconjugated bilirubin.
3. urobilinogen.
4. jaundice.

2. 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:
1. antihepatitis B core antigen.
2. hepatitis B immune globulin.
3. antihepatitis B surface antigen.
4. hepatitis B surface antigen.

4. hepatitis B surface antigen.

Which one of the following is not a consequence of portal hypertension in an individual?
1. Bleeding esophageal varices
2. Hemochromatosis
3. Altered estrogen metabolism
4. Increased prothrombin time

2. Hemochromatosis

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

1. Aspartate transaminase.

Nonalcoholic steatohepatitis is characterized by all of the following EXCEPT:
1. No inflammation or scarring of the liver.
2. Necroinflammatory liver disease associated with accumulation of fat in the liver.
3. Consumption of less than 20g of ethanol daily.
4. AST greater than ALT.

4. AST greater than ALT.

The liver is supplied by what major source(s) of oxygen-containing blood?
1. the hepatic artery
2. the portal vein
3. the hepatic vein
4. both 1 and 2

4. both 1 and 2 - hepatic artery and portal vein

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

3. Hepatitis C

Deficiency of which of the following vitamins will result in decreased heme synthesis?
1. Niacin
2. Riboflavin
3. Pyridoxal phosphate (PLP)
4. Thiamine

3. Pyridoxal phosphate (PLP)

Which one of the following vitamins will aid in the absorption of iron by the intestine?
1. C
2. A
3. D
4. B12

1. C

The most commonly used method of analysis for assessing vitamins A, K, and B6 is:
1. competitive protein binding.
2. spectrophotometry.
3. high performance liquid chromatography (HPLC).
4. immunoassay.

3. high performance liquid chromatography (HPLC).

Production of bilirubin occurs in the ......................, and conjugation of bilirubin to glucuronide occurs in the .......................
1. RES; liver
2. Liver; RES
3. Liver; intestine
4. RES; intestine

1. RES; liver

Serum bilirubin is unstable because of:
1. Digestion by proteolytic enzymes
2. Light sensitivity
3. Precipitation due to acid pH
4. Precipitates on standing

2. Light sensitivity

The enzyme that conjugates bilirubin in the hepatocyte is:
1. UDP-glucuronyl transferase
2. Glucuronic aminotransferase
3. Biliverdin reductase
4. Beta-glucuronidase
5. Microsomal heme oxygenase

1. UDP-glucuronyl transferase

What reagent is used in the bilirubin method to shift the color reaction to a wavelength with less interference?
1. Hydrochloric acid
2. Ascorbic acid
3. Active diazo
4. Alkaline tartrate

4. Alkaline tartrate

Acute intermittent porphyria (AIP) patients have a deficiency of:
1. Coproporphyrinogen oxidase
2. PBG deaminase
3. Ferrochelatase
4. Protoporphyrinogen oxidase

2. PBG deaminase

The number of pyrrole rings found in the structure of all porphyrins is:
1. 2
2. 3
3. 8
4. 4

4. 4

Bile formed in the liver is stored in the:
1. Gall bladder.
2. Liver.
3. Large intestine.
4. Duodenum.

1. Gall bladder.

A breakdown product of bilirubin metabolism that is produced in the colon from the oxidation of urobilinogen by microorganisms is:
1. Porphobilinogen.
2. Urobilin.
3. Protoheme.
4. Stercobilinogen.
5. Protoporphyrin.

2. Urobilin.

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

1. It is produced from the destruction of RBCs.

Which is a characteristic of unconjugated bilirubin?
1. It reacts faster than conjugated bilirubin.
2. It has the same absorbance properties as conjugated bilirubin.
3. It is water-soluble.
4. It a not water-soluble.

4. It a not water-soluble.

The term δ-bilirubin (delta) refers to:
1. Direct-reacting bilirubin.
2. Water-soluble bilirubin.
3. Free unconjugated bilirubin.
4. Bilirubin tightly bound to albumin.

4. Bilirubin tightly bound to albumin.

What is the most common cause of unconjugated hyperbilirubinemia?
1. Bile duct obstruction
2. Hemolytic anemia
3. Gilbert's disease
4. Neonatal physiologic jaundice
5. Dubin-Johnson

4. Neonatal physiologic jaundice

In obstructive liver disease, the following test results are found:
1. Feces: urobilinogen decreased or negative; urine: urobilinogen decreased or negative; serum: conjugated bilirubin decreased.
2. Feces: urobilinogen increased; urine: bilirubin: normal; serum: conjugated bilirubin normal or slightly elevated.
3. None of the above.
4. Feces: urobilinogen decreased; urine: bilirubin: positive; serum: conjugated bilirubin increased.

4. 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:
1. Alcoholic cirrhosis.
2. Alcoholic hepatitis.
3. Alcoholic fatty liver.
4. None of the above.

3. Alcoholic fatty liver.

The reagent (accelerator) in the Jendrassik-Grof bilirubin procedure that makes indirect bilirubin water-soluble is:
1. Caffeine.
2. Hydrochloric acid.
3. Alkaline tartrate.
4. Methanol.

1. Caffeine.

If a total bilirubin is 4.0 mg/dL and the conjugated bilirubin is 2.5 mg/dL, the unconjugated bilirubin is:
1. 2.0 mg/dL.
2. 3.0 mg/dL.
3. 1.5 mg/dL.
4. 1.0 mg/dL.

3. 1.5 mg/dL.

n the Jendrassik-Grof bilirubin, what converts purple azobilirubin to blue azobilirubin measured at 600nm?
1. Alkaline tartrate
2. Hydrochloric acid
3. Methanol
4. Caffeine

1. Alkaline tartrate

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

1. 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:
1. Reye syndrome.
2. hepatitis C virus.
3. hepatitis B virus.
4. hepatitis A virus.

4. hepatitis A virus.

In the liver, ammonia is metabolized to form:
1. amino acids.
2. urea.
3. glucuronic acid.
4. ketoacids.

2. urea.

Caffeine is used in bilirubin assays to:
1. Stop the diazo reaction
2. Accelerate indirect bilirubin reaction
3. Reduce sodium nitrite
4. Accelerate direct bilirubin reaction
5. Precipitate proteins

2. Accelerate indirect bilirubin reaction

When elevated amounts of bilirubin are presented to the liver with elevated serum unconjugated bilirubin, what type of jaundice occurs?
1. Posthepatic
2. Hepatic
3. Prehepatic
4. Biliary

3. Prehepatic