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Total questions: 91

Worksheet time: 47mins

Name
Class
Date
1.

A clinical condition in which scar tissue replaces normal, healthy liver tissue. As the scar tissue replaces the normal liver tissue, it blocks the flow of blood through the organ and prevents the liver from functioning properly

a)

Hepatitis

b)

Cirrhosis

c)

Hepatoma

d)

Reye syndrome

2.

Polyspecific AHG reagents contain:

a)

Anti-C3d

b)

Anti-IgG and anti-IgM

c)

Anti-IgG and anti-C3d

d)

Anti-IgG

3.

In treating hyperbilirubinemia in hemolytic disease of the fetus and newborn, light phototherapy is used to: *

a)

Prevent further hemolysis of fetal red cells

b)

Breakdown unconjugated bilirubin to a nontoxic isomer

c)

Breakdown conjugated into unconjugated bilirubin

d)

Stimulate production of fetal liver enzymes to breakdown unconjugated bilirubin

4.

In liver failure, the prolonged INR improves with vitamin K administration.

a)

False

b)

True

5.

are macrophages that line the sinusoids of the liver and act as active phagocytes capable of engulfing bacteria, debris, toxins, and other substances flowing through the sinusoids

a)

Langerhan's Cells

b)

Kupffer Cells

c)

Microglial cells

d)

Alveolar macrophages

6.

A 10% contamination with 5% dextrose will increase blood glucose by: *

a)

500 mg/dL

b)

1000 mg/dL

c)

50 mg/dL

d)

250 mg/dL

7.

Which of the following is an insulin-like growth factor? *

a)

Somatostatin

b)

Somatomedin

c)

Adrenomedulin

d)

Neurturin

8.

The conversion of amino acids by the liver and other specialized tissue such as the kidney, to substrates that can be converted to glucose is called:

a)

Glycogenesis

b)

Glucogenesis

c)

Glycogenolysis

d)

Gluconeogenesis

9.

Jaundice is usually not noticeable to the naked eye (known as overt jaundice) until bilirubin levels reach

a)

10 mg/dL

b)

15 mg/dL

c)

5 mg/dL

d)

3 mg/dL

10.

A 30-year old man has been fasting for religious reasons for several days. His blood glucose level is now about 60% of its normal value, but he does not feel lightheaded because his brain has reduced its need for serum glucose by using which of the following substances as an alternative energy source.

a)

Beta carotene

b)

BHBA-Beta Hydroxybutyrate

c)

Coenzyme A

d)

Glyceraldehyde-3-phosphate

11.

Signs of Type 2 diabetes mellitus include a brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the armpits, groin, navel, forehead and other areas which is termed as _____. *

a)

Acanthosis nigricans

b)

Generalized pruritis

c)

Dupuytren contractures

d)

Eruptive xanthomas

12.

Kernicterus is caused by the effects of *

a)

Post-hepatic bilirubin

b)

Water insoluble bilirubin

c)

Antibody titer

d)

Anemia

13.

HDFN is characterized by: *

a)

Mostly with the presence of anti-D

b)

IgM antibody

c)

Different RBC antigens between the father and mother

d)

Antibody titer less than 32

14.

The most common cause of chronic liver failure is

a)

Cirrhosis

b)

Hepatitis

c)

Fatty liver disease

d)

Acetaminophen overdose

15.

Which of the following is responsible for the production of blood group antibodies? *

a)

T cells

b)

B cells

c)

Dendritic cells

d)

NK cells

16.

Although many enzymes have been identified as useful in the assessment of liver function, the most clinically useful: I. AST II. ALT III. GGT IV. 5'NT V. ALP

a)

I, II, and III

b)

II, III, and V

c)

III, IV, and V

d)

I, II, III, IV, and V

17.

Glycolysis at refrigeration temperature

a)

7 mg/dL/hr.

b)

2 mg/dL/hr

c)

7 g/dL/hr.

d)

2 g/dL/hr.

18.

The test for weak D is performed by incubating patient's red cells with: *

a)

Different dilutions of anti-D

b)

Anti-D antiserum

c)

Anti-Du antiserum

d)

Antiglobulin antiserum

19.

Enzyme that is most specific for B-D-glucose *

a)

Hexokinase

b)

Glucose-6-phosphate dehydrogenase

c)

phosphohexose isomerase

d)

Glucose oxidase

20.

The main difference between the fetus and the newborn is: *

a)

Size of RBCs

b)

Presence of anemia

c)

Maternal antibody level

d)

Bilirubin metabolism

21.

Kimmelsteil Wilson syndrome is one of the most common complication of diabetes mellitus and is also termed as _____. *

a)

Diabetic Atherosclerosis

b)

Diabetic Retinopathy

c)

Diabetic Ketoacidosis

d)

Diabetic Nephropathy

22.

SELECT ALL THAT APPLIES. Advantages of cordocentesis

a)

Allows direct transfusion of fetal circulation

b)

Decrease the risk of trauma to the placenta

c)

Allows antigen typing of fetal blood

d)

Allows measurement of cordocentesis of fetal hemoglobin and hematocrit levels

23.

Glucose oxidase oxidizes glucose to gluconic acid and ________ *

a)

H2O

b)

CO2

c)

H2O2

d)

HCO3

24.

In the glycogen storage disease, Cori Forbes, what enzyme is deficient?

a)

Brancher

b)

Adenyl Kinase

c)

De Brancher

d)

NOTA

25.

Other terms of pre - hepatic bilirubin:

I. B2

II. B1

III. Conjugated bilirubin I

V. Water- soluble bilirubin

V. Polar bilirubin

VI. Unconjugated bilirubin

VII. Non - polar bilirubin

a)

I, II, III, and V

b)

II, VI, and VII

c)

I, III, V, and VII

d)

I, II, III, IV, V, VI, VII

26.

What produces the hormone that increases plasma glucose by inhibiting insulin secretion, increasing glycogenolysis and promoting lipolysis? *

a)

Adrenal Medulla

b)

Adrenal Cortex

c)

Pancreas

d)

Thyroid

27.

A 29-year old male is hemorrhaging severely. He is AB, Rh-negative. Six units of blood are required STAT. Of the following types available in the blood bank, which would be most preferable for crossmatch? *

a)

AB positive

b)

A positive

c)

A negative

d)

O negative

28.

A woman without prenatal care delivers a healthy term infant. A cord blood sample shows the infant is A-positive with a positive DAT. The workup of the unexpected finding should include: *

a)

ABO and Rh typing of the father

b)

Ant-C3 antiglobulin testing

c)

Maternal ABO testing

d)

DAT using mother's specimen

29.

The purpose of testing with anti-A1B is to detect: *

a)

Anti-A1

b)

Subgroups of O

c)

Subgroups of A

d)

Anti-A2

30.

All of the following are Hyperglycemic Hormones except: * I. Cortisol II. Epinephrine III. Glucagon IV. Growth Hormone

a)

I only

b)

II only

c)

I, II, IV

d)

None of the above

31.

All are true of Diabetes Mellitus type 2, except: *

a)

Hypoglycemic episodes are caused by overzealous treatment

b)

Impaired response of cells to insulin

c)

Insulin-independent treatment

d)

Lifestyle-based

32.

Diabetic Ketonuria is one of the symptoms of Type 1 diabetes mellitus which gives a _____ urine odor

a)

Mousy

b)

Rancid butter

c)

Fruity

d)

Cabbage

33.

All are true of Diabetes mellitus type 1, except: *

a)

Common in children

b)

Beta cell destruction

c)

Absolute insulin deficiency

d)

Dietary causes

34.

Impaired fasting glucose is seen as which of the following results? (mg/dl) *

a)

70-100

b)

100-124

c)

124-200

d)

>200

35.

ABO HDFN differs from Rh HDFN in that: *

a)

The direct antiglobulin test is weaker in Rh HDFN than ABO

b)

Rh HDFN occurs in the first pregnancy

c)

None of these

d)

Rh HDFN is clinically more severe than ABO HDFN

36.

SELECT ALL THAT APPLIES. Blood for intrauterine transfusion

a)

Gamma-irradiated

b)

Compatible with maternal serum

c)

Screened for Cytomegalovirus

d)

More than 7 days old

37.

Effect of high WBC count on blood glucose. *

a)

Increased

b)

Decreased

38.

What is the standard clinical specimen for glucose determination? *

a)

venous plasma glucose

b)

arterial plasma glucose

c)

fasting serum glucose

d)

capillary blood

39.

RhIg is indicated for: *

a)

Mothers who have anti-D

b)

Mothers who are Rh-negative

c)

Infants who have anti-D

d)

Infants who are Rh-negative

40.

SELECT ALL THAT APPLIES: True about sulfhydryl reagents when performing antibody identification: *

a)

Dithiothreitol

b)

J-chain of IgM is destroyed

c)

J-chain of IgG is destroyed

d)

Is used to establish immunoglobulin class of the antibody

41.

_________ is responsible for the yellow coloring in jaundice.

a)

Bilirubin

b)

Carotene

c)

Urobilinogen

d)

AST

42.

This hormone increases plasma glucose by decreasing intestinal entry into the cell and increasing gluconeogenesis, liver glycogen and lipolysis. *

a)

Norepinephrine

b)

Cortisol

c)

Epinephrine

d)

Growth Hormone

43.

The best liver function test is:

a)

INR

b)

Alkaline phosphatase

c)

AST/ALT

d)

Bilirubin

44.

Capillary blood glucose is same with arterial blood glucose. *

a)

FALSE

b)

TRUE

45.

Severe type of HDN-

a)

Rh

b)

ABO

46.

Anemia at birth

a)

Rh

b)

ABO

47.

Weakly positive DAT result

a)

Rh

b)

ABO

48.

Elevated bilirubin at birth

a)

Rh

b)

ABO

49.

Rare pr

a)

ABO

b)

Rh

50.

Most specific non-enzymatic glucose method: *

a)

Neocuproine

b)

Benedict’s

c)

Anthrone condensation

d)

Dubowski Method

51.

Liver disease refers to any abnormal process that affects the liver. *

a)

True

b)

False

52.

Enzyme markers of liver injury: Hepatocellular disorders

a)

AST

b)

ALT

c)

SGOT

d)

SGPT

e)

All of the above

53.

Fasting glucose in serum or plasma is 15% higher than glucose in whole blood.

a)

True

b)

False

54.

It has been described as geneticist's nightmare *

a)

Down syndrome

b)

Type 2 DM

c)

Rabson-Mendengall syndrome

d)

Type 1 DM

55.

A ketone test is recommended when plasma glucose reached 250 mg/dl *

a)

TRUE

b)

FALSE

56.

In a patient with chronic liver disease, all of the following suggest the presence of chronic liver insufficiency, except:

a)

Low albumin

b)

Prolonged prothrombin time

c)

Elevated bilirubin

d)

Elevated aminotransferases

57.

Describes the finding of immature RBCs or erythroblasts in the fetal circulation due to the action of bone marrow in respond to anemia. This term is commonly used now as HDN. *

a)

Kernicterus

b)

Jaundice

c)

Hydrops fetalis

d)

Erythroblastosis fetalis

58.

The most common cause of chronic liver failure is

a)

Cirrhosis

b)

Hepatitis

c)

Fatty liver disease

d)

Acetaminophen overdose

59.

Periodic monitoring of glucose should be requested to avoid diabetic complications. These tests include:

a)

FBS and HBA 1c

b)

SGOT

60.

Late-stage chronic liver disease is called ___________. *

a)

Cirrhosis

b)

Hepatitis

c)

Hyperbilirubinemia

d)

Jaundice

61.

What is the effect of hemolysis on hexokinase? *

a)

Falsely increased

b)

Variable

c)

Falsely decreased

d)

No effect

62.

Which glucose method can employ a polarographic oxygen electrode?

a)

Hexokinase

b)

Glucose oxidase

c)

Glucose dehydrogenase

d)

O-toluidine

63.

It is the accumulation of bilirubin in the brain when jaundice left untreated. Bilirubin reaches the toxic level, generally more than 18 mg/dL. *

a)

Erythroblastosis fetalis

b)

Jaundice

c)

Kernicterus

d)

Hydrops fetalis

64.

______ is greater than _____ in metastatic disease of the liver.

a)

ALT,AST

b)

AST, ALT

65.

Most specific liver enzyme

a)

AST

b)

ALT

66.

True about Kleihauer-Betke test:

a)

Hemoglobin F is resistant to alkaline

b)

Principle is alkaline resistance

c)

is used to quantitate the number of fetal Rhpositive cells in the mother’s circulation as a result of a fetomaternal hemorrhage

d)

All of the above

67.

Type 2 DM, except: *

a)

Macrovascular and microsvascular complications

b)

Microvascularcomplications are involved.

c)

C- peptide levels are measurable

d)

Also known as NIDDM

68.

In liver failure, the prolonged INR improves with vitamin K administration.

a)

True

b)

False

69.

The most common congenital form of glycogen storage disease: *

a)

Von Gierke

b)

Cori Forbes

c)

Andersen

d)

Tarui

70.

Normal Ratio of of B-hydroxybutyrate and acetoacetic acid: *

a)

3:1

b)

2:1

c)

1:1

d)

1:2

71.

The best liver function test is:

a)

Bilirubin

b)

INR

c)

Alkaline phosphatase

d)

AST/ALT

72.

1. Hemolysis and icterisia affect hexokinase method causing false deceased of glucose.

2. Hemolyzed samples containing >0.5 mg hemoglobin/dL are unsatisfactory for Hexokinase *

a)

Both Statements are correct

b)

Statement 1 is incorrect, statement 2 is correct

c)

Both statements are incorrect

d)

Statement 1 is correct, statement 2 is incorrect

73.

It is the development of high-output cardiac failure with generalized edema, effusions and ascites when severe anemia along with hypoproteinemia occurs. *

a)

Kernicterus

b)

Hydrops fetalis

c)

Jaundice

d)

Erythroblastosis fetalis

74.

A Kleihaue-Betke test or flow cytometry indicates 12 fetal cells per 950 adult cells. For a woman with 5,000 mL blood volume, the proper dose of RhIG is:

a)

None of these

b)

2 vials only

c)

1 plus one more vial

d)

3 vials only

75.

Decreased C-Peptide: *

a)

Type 2 DM

b)

Insulinoma

c)

Type1 DM

d)

Type 1 and 2 DM

76.

Selection of blood for intrauterine transfusion.

a)

Group O positive

b)

CMV-negative

c)

Hemoglobin S-positive is acceptable

d)

Hematocrit should be greater than 70%

77.

Blood selected for exchange transfusion must: *

a)

Lack red blood cell antigens corresponding to maternal antibodies

b)

Be <3 days old

c)

Be the same Rh type as the baby

d)

Be ABO compatible with the father

78.

Percentage/level of HbA1c that indicates increased risk for Diabetes (Pre-diabetes)

a)

6.5%

b)

5.7%-6.4%

79.

RhIG is indicated in which of the following circumstances? *

a)

Mother D-positive, infant D-positive

b)

Mother D-positive, infant D-negative

c)

Mother D-negative, infant D-positive

d)

Mother D-negative, infant D-negative

80.

To produce the most reliable results, a specimen for glucose testing should be collected *

a)

After 8 hours of fasting

b)

After 12 hours of fasting

c)

2 hours after eating

d)

Anytime

81.

Increased concentrations of ascorbic acid inhibit chromogen production in which of the following glucose methods? *

a)

Ferricyanide

b)

Ortho-toluidine

c)

Glucose oxidase

d)

Peroxidase

82.

Oxyhemoglobin is considered an interfering substance during spectrophotometric analysis of amniotic fluid bilirubin because:

a)

Its maximum absorbance occurs at 450 nm

b)

None of these

c)

Its maximum absorbance occurs at 410 nm

d)

Its maximum absorbance occurs at 550 nm

83.

This will occur because the fetus liver is not welldeveloped to conjugate the bilirubin after RBC destruction

a)

Hydrops fetalis

b)

Erythroblastosis fetalis

c)

Kernicterus

d)

Jaundice

84.

Patients to be taken an OGTT should ingest:

a)

At least 150 g/day of carbs

b)

At least 150 mg/day of carbs

85.

SELECT ALL THAT APPLIES: ABO HDFN *

a)

Most common cause of HDFN

b)

Can occur in first pregnancy

c)

Most severe cause of HDFN

d)

Antibody is IgM

86.

Why are antibodies formed from the mother in cases of Rh hemolytic disease of the newborn? *

a)

Mother lacks the Rh antigen and the fetus inherits the antigen from the father

b)

Mother happens to be Rh (+) and father is Rh (-)

87.

Amniocentesis can be performed after: *

a)

14th week of gestation

b)

21st week of gestation

88.

Reference value of CSF Glucose

a)

40-70 mg/dl

b)

50-60 mg/dl

89.

WHO standard glucose load: *

a)

75 grams

b)

70 grams

90.

Most commonly used method for bilirubin determination that uses caffeine sodium benzoate as an accelerator: *

a)

Van den Bergh

b)

Jendrassik and Grof

91.

Effects of hemolysis on insulin *

a)

Falsely increased

b)

Falsely decreased