Chapter 25

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

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

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

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

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

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

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

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

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

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

Measuring serum ammonia levels has the potential to be fraught with preanalytical 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 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 are correct.

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

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

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 results below. $$ \begin{array}{ll} \text { Total bilirubin } & 2.8 \mathrm{mg} / \mathrm{dL} \\ \text { Direct bilirubin } & 0.1 \mathrm{mg} / \mathrm{dL} \\ \text { Indirect bilirubin } & 2.7 \mathrm{mg} / \mathrm{dL} \end{array} $$ These results most likely indicate? a. Normal bilirubin metabolism b. Extrahepatic obstruction c. Dubin-Johnson syndrome d. Gilbert's disease

Which of the following is measured 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

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 disease

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

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