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Laboratory findings in Gatrointestinal System

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

A 32-year-old woman presents with jaundice and pruritus. Laboratory tests show ALP 650 U/L, GGT 420 U/L, mild elevation of ALT and AST, and conjugated hyperbilirubinemia.
The most likely diagnosis is:

a)

Acute viral hepatitis

b)

Hemolytic anemia

c)

Cholestatic liver disease

d)

hepatocellular carcinoma

2.

A 45-year-old man with chronic hepatitis B shows HBeAg negative, anti-HBe positive, and low HBV DNA levels.
This phase is best described as:

a)

Replicative phase

b)

Non-replicative carrier phase

c)

Acute hepatitis

d)

Immune-tolerant phase

3.

A patient presents with pale stools, dark urine, pruritus, and low urinary urobilinogen. Which jaundice type best fits this pattern?

a)

Hemolytic jaundice with increased stercobilin

b)

Hepatocellular jaundice with fluctuating pruritus

c)

Obstructive jaundice with absent stercobilin

d)

Physiologic jaundice with normal urine color

4.

Which test best evaluates hepatocellular integrity rather than bile flow disturbances?

a)

GGT, ALP, acid phosphatase, 5′-nucleotidase

b)

Serum bilirubin and blood ammonia levels

c)

Serum albumin concentration and cholinesterase activity

d)

ALT (SGPT) and AST (SGOT) enzyme activities

5.

Which scenario most likely elevates serum bilirubin while also allowing bilirubin to appear in urine?

a)

Increased hemoglobin breakdown with normal hepatic conjugation

b)

Reduced hepatic uptake with intact bile duct patency

c)

Impaired hepatic conjugation producing unconjugated bilirubin

d)

Obstructed bile ducts causing reflux of conjugated bilirubin

6.

A patient with jaundice has AST/ALT ratio >1 with moderately elevated transaminases.
This laboratory pattern most strongly suggests:

a)

Acute hepatitis A

b)

Cholestasis

c)

Chronic liver disease

d)

Muscle injury

7.

Which laboratory marker most directly assesses the liver’s ability to produce clotting factors?

a)

Alkaline phosphatase level

b)

Prothrombin Time measurement

c)

Gamma-glutamyl transferase

d)

Serum bilirubin concentration

8.

Which laboratory finding supports the diagnosis of acute cholangitis?

a)

Isolated ALT elevation

b)

Leukocytosis, elevated ALP, and culture (+)

c)

Low bilirubin

d)

Normal liver enzymes

9.

A patient presents with epigastric pain radiating to the back. Serum lipase is elevated and remains high for 10 days.
This finding supports the diagnosis of:

a)

Pancreatic carcinoma

b)

Acute pancreatitis

c)

Gastric ulcer

d)

Cholecystitis

10.

A 25-year-old man presents with jaundice, fatigue, and dark urine for 5 days. Laboratory results show ALT 1,200 U/L, AST 980 U/L, total bilirubin 8 mg/dL, and positive IgM anti-HAV.
Which laboratory finding best explains the mechanism of jaundice in this patient?

a)

Increased unconjugated bilirubin due to hemolysis

b)

Extrahepatic bile duct obstruction

c)

Hepatocellular injury impairing bilirubin conjugation and excretion

d)

Genetic defect of bilirubin transport

11.

In chronic hepatitis B infection, which serologic pattern best indicates transition from HBeAg positivity to reduced viral replication?

a)

Rapid decline of HBsAg with rising ALT levels

b)

Appearance of anti-HBe with persistent HBsAg

c)

Early rise of anti-HCV followed by loss of HCV RNA

d)

Disappearance of total anti-HBc and IgM anti-HBc

12.

A patient with hepatocellular carcinoma is MOST likely to have elevated:

a)

CA 19-9

b)

CEA

c)

AFP

d)

PSA

13.

The rapid urease test detects Helicobacter pylori by identifying:

a)

Lactate production

b)

Urea hydrolysis producing ammonia

c)

Bacterial DNA

d)

Antigen–antibody reaction

14.

A patient with prolonged diarrhea develops dehydration.
Which laboratory test is MOST useful to assess severity and complications?

a)

Stool culture

b)

Serum electrolytes

c)

Stool Fat Analysis

d)

Serum bilirubin

15.

Which laboratory test confirms active hepatitis C infection?

a)

Anti-HCV

b)

HCV RNA by RT-PCR

c)

Serum ALT and AST

d)

Serum albumin