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Flashcards in Chemistry Final Deck (73)
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1

A 23-year-old woman enters the hospital with dark urine and yellow eyes complaining of tiredness and not feeling well for the 2 previous weeks. What would be the most likely diagnosis of this patient?

  • Bilirubin 9.5 (direct- 6.0; indirect- 3.5)
  • Alkaline phosphatase 220 (normal is up to 80)
  • LDH 8,040 (Normal is up to 150)

a. Hepatitis

b. Cirrhosis

c. Hemolytic anemia

d. Gall stones

e. A drug that is competing with bilirubin for albumin

a. Hepatitis

2

The slow-moving fraction of LD 5 is typically elevated in patients with:

a)       Heart disease

b)      Stroke

c)       Hepatitis

d)      Pancreatitis

e)      Peptic ulcers

c)       Hepatitis

3

Increased serum levels of direct reacting bilirubin are characteristic of:

a)       Dubin-Johnson syndrome

b)      Gilbert’s disease

c)       Sherlock syndrome

d)      Prematurity

e)      Crigler-Najjar syndrome

a)       Dubin-Johnson syndrome

4

What happens if there is an under-function of the anterior pituitary gland?

Dwarfism

5

What does the luteinizing hormone do in men and women?

Stimulates interstitial cells of testes to produce sex hormones and ovulation, promotes ovarian secretion of estrogen and progestins and prepares the body for pregnancy.

6

1)      The effects of under-function include a decrease in the endocrine gland functions and:

a)       Fatigue

b)      Mood swings

c)       Elephantitis

d)       Dwarfism

d)       Dwarfism

7

The release of the seven hormones secreted by the anterior pituitary gland are controlled by which other gland?

Hypothalamus

8

Where is the anterior pituitary gland located?

Sella turcica at the base of the brain

9

Which of the following is not a general function of the pituitary gland?

a. growth

b. breast milk production

c. thyroid function

d. hair growth

d. Hair growth

10

What is the hormone secreted by the anterior pituitary gland that stimulates the mammary glands to produce milk?

Prolactin

11

Where does the anterior pituitary gland receive releasing hormones from?

Hypothalamus

12

What does the growth hormone stimulate?

Growth and cell reproduction in only humans and other vertebrates

13

What is the general function of the posterior pituitary gland?

To store and later release hormones

14

What is NOT a way that drugs can cause jaundice?

By selective toxic effect on Kupffer cells

15

What is bilirubin NOT derived from?

a. Destroyed RBCs

b. Cytochromes

c. Coenzymes

d. Hemoglobin

e. Myoglobin

c. Coenzymes

16

What enzyme is responsible for the conjugation of bilirubin?

Glycyronyl transferase

17

Decreased uptake of bilirubin in the liver is the cause of hyperbilirubinemia in what syndrome?

Gilbert's Syndrome

18

Impaired conjugation of bilirubin is the cause of hyperbilirubinemia is what syndrome?

Crigler-Najjar Syndrome

19

Indirect reacting bilirubin is:

a)       Water soluble and excreted in the urine

b)      Conjugated with glucuronide

c)       Unable to cause jaundice

d)       Elevated in hemolytic anemia

d)       Elevated in hemolytic anemia

20

Jaundice usually first becomes visible when the serum bilirubin concentration is about __________.

2.0 mg/dl

21

When jaundice results from hepatitis, the unconjugated fraction of the total serum bilirubin is usually:

a)       At least 85%

b)      50-85%

c)       Less than 50%

d)      85-90%

e)      90-100%

c)       Less than 50%

22

In patients with cirrhosis, the percent of unconjugated bilirubin is:

a)       5-15%

b)      15-50%

c)       50-70%

d)      70-90%

e)      90-100%
 

c)       50-70%

23

In patients with hepatocellular jaundice, as compared to those with purely obstructive jaundice, tend to have

a)       Higher serum alkaline phosphatase, LD, and AST activity

b)      Lower serum alkaline phosphatase, LD, and AST activity

c)       Higher serum ALP, lower LD and AST activity

d)       Lower serum ALP, higher LD and AST activity

d)       Lower serum ALP, higher LD and AST activity

24

If the results of serum bilirubin, ALP, LD, and AST determinations suggest obstructive jaundice the best confirmatory test of the following would be the determination of:

a)       Serum urobilinogen

b)      5-nucleotidase

c)       Protein electrophoresis

d)      ALT

e)      Choline esterase

b)      5-nucleotidase

25

Intrahepatic cholestasis simulating extra hepatic obstructive jaundice, can be caused by all the following except:

a)       Estrogens

b)      Oral contraceptives

c)       Cholangiolitic hepatitis

d)      Biliary cirrhosis

e)      Alcoholism

e)      Alcoholism

26

What is a breakdown product of hemoglobin?

Bilirubin

27

What is bilirubin converted to in the liver?

Bilirubin glucuronide

28

Kernicterus is an abnormal accumulation of bilirubin in what tissue?

Brain tissue

29

A stool specimen that appears black and tarry should be tested for the presence of what?

Occult blood

30

What substance gives feces its normal color?

Urobilin