WorksheetsCC-P13
Total questions: 154
Worksheet time: 1hrs 17mins
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.
Blockage of the excretion of bilirubin into the canaliculi caused by hepatocyte membrane defect
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
56.
Intense dark pigmentation of the liver; elevated serum b2
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
57.
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
58.
Obstructive in nature
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
59.
Delta bilirubin is seen in this condition.
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
60.
Similar with dubin Johnson; unknown mechanism
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
61.
Defect of sinusoidal reuptake of B2
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
62.
Elevated B1 and B2 (B2 is more prominent)
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
63.
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
64.
Inhibitor of bilirubin conjugation
a)
Gilbert's syndrome
b)
Criggler-Najjar syndrome
c)
Dubin-Johnson
d)
Rotor
e)
Lucey Driscoll
65.
Type: Unconjugated; pre-hepatic
B1 = Severely increased (^^)
B2 = Normal
Urinary Urobilinogen = Severely increased (^^)
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
66.
↑ RBC destruction = ↑ Bilirubin production
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
67.
B1 = Increased (^)
B2 = Increased (^)
Urinary Urobilinogen = Early: Decreased ; Late = Increased
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
68.
B1 = Increased (^)
B2 = Severely Increased (^^)
Urinary Urobilinogen = Decreased (to absent)
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
69.
Pre-hepatic
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
70.
Its urinary urobilinogen levels are attributed to pale yellow or gray stool.
a)
Hemolytic disease
b)
Liver disease
c)
Bile duct obstruction
71.
Delta bilirubin is basically B2 + ...
a)
Albumin
b)
Pre-albumin
c)
Bilirubin
72.
B2 + Albumin
a)
Delta bilirubin
b)
Jaundice
73.
Conjugated bilirubin covalently bound to albumin
a)
Delta bilirubin
b)
Jaundice
74.
Formed due to prolonged elevation of conjugated bilirubin in biliary obstruction
a)
Delta bilirubin
b)
Jaundice
75.
Helps in monitoring decline of serum bilirubin following surgical removal of gallstones
a)
Delta bilirubin
b)
Jaundice
76.
Delta bilirubin has a long half-life of
a)
15 days
b)
17 days
c)
21 days
d)
23 days
77.
Delta bilirubin is separated from other fractions by
a)
GC-MS
b)
HPLC
c)
MS-MS
d)
ISE
78.
Delta bilirubin reaction with diazo reagent
a)
Direct
b)
Indirect
79.
Seen in Bile Duct obstruction
a)
Delta bilirubin
b)
Jaundice
80.
TB - DB + IB
a)
Delta bilirubin
b)
Jaundice
81.
Reacts with Diazo as B2
a)
Delta bilirubin
b)
Jaundice
82.
Called icterus or hyperbilirubinemia
a)
Delta bilirubin
b)
Jaundice
83.
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
84.
Visible icterisia
a)
3 to 4 mg/dL
b)
3 to 5 mg/dL
c)
3 to 6 mg/dL
d)
>25 mg/dL
85.
Water soluble
a)
Diazo reagent
b)
Digoxin reagent
c)
Diphenyl reagent
86.
reacts slowly
a)
B1
b)
B2
87.
requires accelerant
a)
B1
b)
B2
88.
no need for accelerant
a)
B1
b)
B2
89.
Evident: Bilirubin level exceeds 3 to 5 mg/dL
a)
Delta bilirubin
b)
Jaundice
90.
Overt __ not noticeable to the eye
a)
Delta bilirubin
b)
Jaundice
91.
What is the accelerant of Evelyn Malloy method?
a)
Methanol
b)
Caffeine sodium benzoate
92.
What is the accelerant of Jendrassik and Grof method?
a)
Methanol
b)
Caffeine sodium benzoate
93.
Jendrassik and Grof method
a)
Pink to purple azobilirubin
b)
Pink to blue azobilirubin
94.
Evelyn and Malloy Method
a)
Pink to purple azobilirubin
b)
Pink to blue azobilirubin
95.
Accelerant: Methanol
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
96.
Pink to purple azobilirubin
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
97.
Reaction at pH 1.2 with maximal absorbance at 560 nm
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
98.
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
99.
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
100.
acid pH reaction
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
101.
560 nm absorbance
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
102.
Bilirubin + Diazo + Accelerator → Azodipyrroles (all fractions)
a)
Total bilirubin
b)
Direct bilirubin
c)
Indirect bilirubin
103.
Bilirubin + Diazo → Azodipyrroles (B2 and delta only)
a)
Total bilirubin
b)
Direct bilirubin
c)
Indirect bilirubin
104.
Calculated → TB – DB
a)
Total bilirubin
b)
Direct bilirubin
c)
Indirect bilirubin
105.
Bilirubinometry
a)
Direct spectrophotometry
b)
Enzymatic
106.
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
107.
Appropriate only for neonates; not done on adult serum due to the presence of carotenoid pigments
a)
Direct spectrophotometry
b)
Enzymatic
108.
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
109.
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
110.
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
111.
Reference values: 0.2-0.8 mg/dL
a)
B1
b)
B2
c)
TB
112.
Reference values: 0-0.2 mg/dL
a)
B1
b)
B2
c)
TB
113.
Reference values: 0.2-1.0 mg/dL
a)
B1
b)
B2
c)
TB
114.
What is increased in pre-hepatic/hemolytic?
a)
B1
b)
B2
c)
TB
115.
What is increased in post-hepatic?
a)
B1
b)
B2
c)
TB
116.
What is increased in hepatic?
a)
B1
b)
B2
c)
TB
117.
OVERT JAUNDICE IF THIS IS >=3 MG/DL
a)
B1
b)
B2
c)
TB
118.
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
119.
Diazo reagent
Sodium acetate
Ascorbic acid
Alkaline tartrate (Fehling’s reagent)
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
120.
alkaline pH reaction
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
121.
600 nm absorbance
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
122.
Accelerant: Caffeine sodium benzoate
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
123.
Most commonly used method
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
124.
Not affected by Hb and pH changes
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
125.
Vitamin C terminates the reaction and destroy diazo
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
126.
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
127.
Only used for neonates
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
128.
Principle is reflectance photometry on skin
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
129.
Only used for neonates
Principle is reflectance photometry on skin
a)
Evelyn and Malloy Method
b)
Jendrassik and Grof
c)
Bilirubinometer
130.
Serum bilirubin: Increased due to B1
Urine bilirubin: Negative
Urine urobilinogen: 3+
a)
Pre-hepatic/hemolytic
b)
Hepatic
c)
Post-hepatic/obstructive
131.
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
132.
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
133.
Oxidation of bilirubin to biliverdin by bilirubin oxidase at different pH level followed by further oxidation to colorless product; decrease in absorbance is measured
a)
Direct Spectrophotometry (Bilirubinometry)
b)
Enzymatic Method
c)
Urobilinogen
134.
(−) in urine or stool = complete biliary obstruction
a)
Direct Spectrophotometry (Bilirubinometry)
b)
Enzymatic Method
c)
Urobilinogen
135.
Appropriate only for neonatal serum
a)
Direct Spectrophotometry (Bilirubinometry)
b)
Enzymatic Method
c)
Urobilinogen
136.
Transport defect coupled with UDPGT deficiency
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
137.
Transient UDPGT deficiency
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
138.
Total or partial UDPGT deficiency
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
139.
absolute deficiency of UDPGT; elevated serum B1
a)
Type 1 Criggler-Najjar Syndrome
b)
Type 2 Criggler-Najjar Syndrome
140.
partial deficiency of UDPGT; elevated serum B1
a)
Type 1 Criggler-Najjar Syndrome
b)
Type 2 Criggler-Najjar Syndrome
141.
Unconjugated, hepatic, Increased B1, normal B2
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
142.
Mixed, hepatic, increased B1 and B2
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
143.
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
144.
Conjugated; post-hepatic, b1 is normal, b2 is high
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
145.
Secretory defect
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
146.
↓ Conjugation; Bile flow interference
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
147.
Extrahepatic cholestasis
a)
Viral hepatitis / Cirrhosis, Hepatic carcinoma
b)
Dubin-Johnson syndrome, ROtor syndrome
c)
Biliary obstruction
148.
Circulating inhibitor of bilirubin conjugation
a)
Gilbert syndrome
b)
Lucey-Driscoll syndrome
c)
Physiologic jaundice of newborn
d)
Criggler-Najjar syndrome
149.
Too much destruction of RBCs
a)
Pre-hepatic/Hemolytic
b)
Hepatic
c)
Post-hepatic
150.
Malaria, hemolytic anemia
a)
Pre-hepatic/Hemolytic
b)
Hepatic
c)
Post-hepatic
151.
Hepatocyte injury caused by viruses, alcohol and parasite
a)
Pre-hepatic/Hemolytic
b)
Hepatic
c)
Post-hepatic
152.
anemia Cirrhosis, hepatitis
a)
Pre-hepatic/Hemolytic
b)
Hepatic
c)
Post-hepatic
153.
Failure of bile flow or reach the intestine
a)
Pre-hepatic/Hemolytic
b)
Hepatic
c)
Post-hepatic
154.
Cholelithiasis, bilateral pancreatic tumor
a)
Pre-hepatic/Hemolytic
b)
Hepatic
c)
Post-hepatic
100 %
