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PRCC_3MT-P5

Total questions: 134

Worksheet time: 1hrs 7mins

Name
Class
Date
1.
It is the principal pigment in bile.
a)
Bilirubin
b)
Albumin
c)
UDPGT
d)
RBC
2.
___ Phagocytosis where heme is converted to Bilirubin.
a)
Bilirubin
b)
Albumin
c)
UDPGT
d)
RBC
3.
___ Phagocytosis --> heme is converted to Bilirubin.
a)
Bilirubin
b)
Albumin
c)
UDPGT
d)
RBC
4.
a. RBC Phagocytosis --> heme is converted to ____ .
a)
Bilirubin
b)
Albumin
c)
UDPGT
d)
RBC
5.
b. Bilirubin + ____ -> Liver: Released Bilirubin + Glucoronic acid - UDPGT -> B2
a)
B2
b)
Albumin
c)
UDPGT
d)
RBC
6.
b. Bilirubin + Albumin-> Liver: Released Bilirubin + Glucoronic acid - ____-> B2
a)
B2
b)
Albumin
c)
UDPGT
d)
RBC
7.
b. Bilirubin + Albumin-> Liver: Released Bilirubin + Glucoronic acid - UDPGT-> ____
a)
B2
b)
Albumin
c)
UDPGT
d)
RBC
8.
c. ____ is secreted from the liver to Bile canaliculi -> Hepatic duct -> Gall bladder -> Cystic duct >>
a)
B1
b)
B2
9.
d. Intestine -> B2 + ____ -> Mesobilirubin reduced to mesobilirubinogen -> reduced to Urobilinogen
a)
Urobilinogen
b)
Albumin
c)
UDPGT
d)
RBC
e)
Normal flora
10.
d. Intestine -> B2 + Normal flora-> Mesobilirubin reduced to mesobilirubinogen -> reduced to _____
a)
Urobilinogen
b)
Albumin
c)
UDPGT
d)
RBC
e)
Normal flora
11.
Oxidizes; becomes urobilin or stercobilin
a)
80% urobilinogen
b)
20% urobilinogen
12.
Gives color orange or brown feces
a)
80% urobilinogen
b)
20% urobilinogen
13.
Recycled and reexcreted to the liver.
a)
80% urobilinogen
b)
20% urobilinogen
14.
Filtered to the kidneys and excreted in the urine
a)
80% urobilinogen
b)
20% urobilinogen
15.
Water insoluble or nonpolar
a)
Bilirubin 1
b)
Bilirubin 2
16.
Not excreted in urine
a)
Bilirubin 1
b)
Bilirubin 2
17.
Excreted in urine (when free)
a)
Bilirubin 1
b)
Bilirubin 2
18.
Hemobilirubin falls under which form of bilirubin?
a)
Bilirubin 1
b)
Bilirubin 2
19.
In unconjugated hyperbilirubinemia, what is increased due to ↑ production, ↓ delivery and uptake, or ↓ conjugation?
a)
Bilirubin 1
b)
Bilirubin 2
20.
In conjugated hyperbilirubinemia, what is increased due to due to intra- or extrahepatic cholestasis?
a)
Bilirubin 1
b)
Bilirubin 2
21.
↑ B1 due to ↑ production, ↓ delivery and uptake, or ↓ conjugation
a)
Unconjugated hyperbilirubinemia
b)
Conjugated hyperbilirubinemia
c)
Mixed hyperbilirubinemia
22.
↑ B2 due to intra- or extrahepatic cholestasis
a)
Unconjugated hyperbilirubinemia
b)
Conjugated hyperbilirubinemia
c)
Mixed hyperbilirubinemia
23.
↑ B1 and B2 due to a combination of defects
a)
Unconjugated hyperbilirubinemia
b)
Conjugated hyperbilirubinemia
c)
Mixed hyperbilirubinemia
24.
Indirect reacting with Diazo
a)
Bilirubin 1
b)
Bilirubin 2
25.
Pre-hepatic/hemolytic bilirubin
a)
Bilirubin 1
b)
Bilirubin 2
26.
What is ELEVATED OR INCREASED in Gilbert's syndrome?
a)
Bilirubin 1
b)
Bilirubin 2
27.
High affinity for brain tissue
a)
Bilirubin 1
b)
Bilirubin 2
28.
What is increased in Criggler Najjar syndrome?
a)
Bilirubin 1
b)
Bilirubin 2
29.
Water soluble or polar
a)
Bilirubin 1
b)
Bilirubin 2
30.
What is elevated or increased in Dubin-Johnson syndrome?
a)
Bilirubin 1
b)
Bilirubin 2
31.
What is elevated or increased in Rotor syndrome?
a)
Bilirubin 1
b)
Bilirubin 2
32.
Cholebilirubin
a)
Bilirubin 1
b)
Bilirubin 2
33.
Direct reacting with Diazo
a)
Bilirubin 1
b)
Bilirubin 2
34.
Post-hepatic or obstructive and regurgitate type of bilirubin
a)
Bilirubin 1
b)
Bilirubin 2
35.
Low affinity for brain tissue
a)
Bilirubin 1
b)
Bilirubin 2
36.
Bilirubin 1(ONE!!!!)
a)
Water insoluble or nonpolar
b)
Water soluble or polar
37.
Bilirubin 2 (TWO!!!)
a)
Water insoluble or nonpolar
b)
Water soluble or polar
38.
Bilirubin 1(ONE!!!!)
a)
Hemobilirubin
b)
Cholebilirubin
39.
Bilirubin 2 (TWO!!!)
a)
Hemobilirubin
b)
Cholebilirubin
40.
Bilirubin 1(ONE!!!!)
a)
Indirect reacting
b)
Direct reacting
41.
Bilirubin 2 (TWO!!!)
a)
Indirect reacting
b)
Direct reacting
42.
Bilirubin 1(ONE!!!!)
a)
Pre-hepatic bilirubin
b)
Post hepatic or obstructive and regurgitate bilirubin
43.
Bilirubin 2 (TWO!!!)
a)
Pre-hepatic bilirubin
b)
Post hepatic or obstructive and regurgitate bilirubin
44.
Bilirubin 1(ONE!!!!)
a)
High affinity for brain tissue
b)
Low affinity for brain tissue
45.
Bilirubin 2 (TWO!!!)
a)
High affinity for brain tissue
b)
Low affinity for brain tissue
46.
Bilirubin 2(TWO!!!)
a)
Water insoluble or nonpolar
b)
Water soluble or polar
47.
Bilirubin TRANSPORT deficit; Bilirubin 1 is elevated.
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
48.
Bilirubin TRANSPORT deficit
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
49.
Most common derangement of bilirubin metabolism
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
50.
Conjugation deficit
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
51.
Type 1 shows deficiency of UDGPT (Absent) Type 2 shows partial deficiency
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
52.
Most serious
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
53.
Increased B1 >= 20 mg/dL is associated with kernicterus. The treatment of choice could be either phototherapy or UV exposure or exchange transfusion.
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
54.
Bilirubin excretion deficit
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
55.
Obstructive in nature and Delta bilirubin is seen in this condition.
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
56.
Obstructive in nature
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
57.
Delta bilirubin is seen in this condition.
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
58.
Similar with dubin Johnson; unknown mechanism
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
59.
It can be differentiated from Dubin-Johnson syndrome by the pattern of urinary coproporphyrin excretion
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
60.
Inhibitor of bilirubin conjugation
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
61.
Type: Unconjugated; pre-hepatic B1 = Severely increased (^^) B2 = Normal Urinary Urobilinogen = Severely increased (^^)
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
62.
↑ RBC destruction = ↑ Bilirubin production
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
63.
B1 = Increased (^) B2 = Increased (^) Urinary Urobilinogen = Early: Decreased ; Late = Increased
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
64.
B1 = Increased (^) B2 = Severely Increased (^^) Urinary Urobilinogen = Decreased (to absent)
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
65.
Pre-hepatic
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
66.
Its urinary urobilinogen levels are attributed to pale yellow or gray stool.
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
67.
Delta bilirubin is basically B2 + ...
a)
Albumin
b)
Pre-albumin
c)
Bilirubin
68.
B2 + Albumin
a)
Delta bilirubin
b)
Jaundice
69.
Conjugated bilirubin covalently bound to albumin
a)
Delta bilirubin
b)
Jaundice
70.
Delta bilirubin has a long half-life of
a)
15 days
b)
17 days
c)
21 days
d)
23 days
71.
Delta bilirubin is separated from other fractions by
a)
GC-MS
b)
HPLC
c)
MS-MS
d)
ISE
72.
Delta bilirubin reaction with diazo reagent
a)
Direct
b)
Indirect
73.
Seen in Bile Duct obstruction
a)
Delta bilirubin
b)
Jaundice
74.
TB - DB + IB
a)
Delta bilirubin
b)
Jaundice
75.
Reacts with Diazo as B2
a)
Delta bilirubin
b)
Jaundice
76.
Called icterus or hyperbilirubinemia
a)
Delta bilirubin
b)
Jaundice
77.
Jaundice is evident when bilirubin level exceeds..
a)
3 to 4 mg/dL
b)
3 to 5 mg/dL
c)
3 to 6 mg/dL
d)
>25 mg/dL
78.
Visible icterisia
a)
3 to 4 mg/dL
b)
3 to 5 mg/dL
c)
3 to 6 mg/dL
d)
>25 mg/dL
79.
Water soluble
a)
Diazo reagent
b)
Digoxin reagent
c)
Diphenyl reagent
80.
reacts slowly
a)
B1
b)
B2
81.
requires accelerant
a)
B1
b)
B2
82.
no need for accelerant
a)
B1
b)
B2
83.
Evident: Bilirubin level exceeds 3 to 5 mg/dL
a)
Delta bilirubin
b)
Jaundice
84.
Overt __ not noticeable to the eye
a)
Delta bilirubin
b)
Jaundice
85.
What is the accelerant of Evelyn Malloy method?
a)
Methanol
b)
Caffeine sodium benzoate
86.
What is the accelerant of Jendrassik and Grof method?
a)
Methanol
b)
Caffeine sodium benzoate
87.
Jendrassik and Grof method
a)
Pink to purple azobilirubin
b)
Pink to blue azobilirubin
88.
Evelyn and Malloy Method
a)
Pink to purple azobilirubin
b)
Pink to blue azobilirubin
89.
Accelerant: Methanol
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
90.
Pink to purple azobilirubin
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
91.
Reaction at pH 1.2 with maximal absorbance at 560 nm
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
92.
Accelerant: Methanol Pink to purple azobilirubin Reaction at pH 1.2 with maximal absorbance at 560 nm
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
93.
Diazo reagent ▪ Diazo A = 0.1% sulfanilic acid in HCl ▪ Diazo B = 0.5% sodium nitrite ▪ Diazo blank = 1.5% HCl
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
94.
acid pH reaction
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
95.
560 nm absorbance
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
96.
Bilirubin + Diazo + Accelerator → Azodipyrroles (all fractions)
a)
Total bilirubin
b)
Direct bilirubin
c)
Indirect bilirubin
97.
Bilirubin + Diazo → Azodipyrroles (B2 and delta only)
a)
Total bilirubin
b)
Direct bilirubin
c)
Indirect bilirubin
98.
Calculated → TB – DB
a)
Total bilirubin
b)
Direct bilirubin
c)
Indirect bilirubin
99.
Bilirubinometry
a)
Direct spectrophotometry
b)
Enzymatic
100.
based on the absorption of light by bilirubin at 450 nm; correction for oxyhemoglobin is achieved by measuring absorbance at two wavelengths
a)
Direct spectrophotometry
b)
Enzymatic
101.
Appropriate only for neonates; not done on adult serum due to the presence of carotenoid pigments
a)
Direct spectrophotometry
b)
Enzymatic
102.
involves oxidation of bilirubin to biliverdin by bilirubin oxidase at different pH levels followed by further oxidation to a colorless product and measurement of the decrease in absorbance
a)
Direct spectrophotometry
b)
Enzymatic
103.
What is the reference value of B1?
a)
0.2 to 0.8 mg/dL
b)
0 to 0.2 mg/dL
c)
0.2 to 1.0 mg/dL
104.
What is the reference value of total bilirubin?
a)
0.2 to 0.8 mg/dL
b)
0 to 0.2 mg/dL
c)
0.2 to 1.0 mg/dL
105.
Reference values: 0.2-0.8 mg/dL
a)
B1
b)
B2
c)
TB
106.
Reference values: 0-0.2 mg/dL
a)
B1
b)
B2
c)
TB
107.
Reference values: 0.2-1.0 mg/dL
a)
B1
b)
B2
c)
TB
108.
OVERT JAUNDICE IF THIS IS >=3 MG/DL
a)
B1
b)
B2
c)
TB
109.
What is the reference value of B2?
a)
0.2 to 0.8 mg/dL
b)
0 to 0.2 mg/dL
c)
0.2 to 1.0 mg/dL
110.
Diazo reagent Sodium acetate Ascorbic acid Alkaline tartrate (Fehling’s reagent)
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
111.
alkaline pH reaction
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
112.
600 nm absorbance
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
113.
Accelerant: Caffeine sodium benzoate
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
114.
Most commonly used method
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
115.
Not affected by Hb and pH changes
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
116.
Vitamin C terminates the reaction and destroy diazo
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
117.
Accelerant: Caffeine sodium benzoate Most commonly used method Not affected by Hb and pH changes Vitamin C terminates the reaction and destroy diazo
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
118.
Only used for neonates
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
119.
Principle is reflectance photometry on skin
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
120.
Only used for neonates Principle is reflectance photometry on skin
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
121.
Serum bilirubin: Increased due to B1 Urine bilirubin: Negative Urine urobilinogen: 3+
a)
Pre-hepatic/hemolytic
b)
Hepatic
c)
Post-hepatic/obstructive
122.
Serum bilirubin: Increased due to B1 or B2, or BOTH Urine bilirubin: Variable Urine urobilinogen: 2+
a)
Pre-hepatic/hemolytic
b)
Hepatic
c)
Post-hepatic/obstructive
123.
Serum bilirubin: Increased due to B2 Urine bilirubin: 3+ Urine urobilinogen: Normal in reagent strip pads, negative or decreased in quanti method
a)
Pre-hepatic/hemolytic
b)
Hepatic
c)
Post-hepatic/obstructive
124.
Transport defect coupled with UDPGT deficiency
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
125.
Transient UDPGT deficiency
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
126.
Total or partial UDPGT deficiency
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
127.
Unconjugated, hepatic, Increased B1, normal B2
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
128.
Mixed, hepatic, increased B1 and B2
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
129.
Conjugated or mixed hepatic, b1 is normal to high, b2 is high
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
130.
Conjugated; post-hepatic, b1 is normal, b2 is high
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
131.
Secretory defect
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
132.
↓ Conjugation; Bile flow interference
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
133.
Extrahepatic cholestasis
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
134.
Circulating inhibitor of bilirubin conjugation
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome