Clinical Second

24 Questions | Total Attempts: 172

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Clinical Second

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Questions and Answers
  • 1. 
    Which of the following may cause hypocalcemia?
    • A. 

      Primary hyperparathyroidism 

    • B. 

      Thiazide diuretics 

    • C. 

      Magnesium deficiency 

    • D. 

      Vitamin D intoxication  

    • E. 

      Thyrotoxicosis 

  • 2. 
    All of the following are correct regarding osteoporosis EXCEPT:
    • A. 

      Patients have normal alkaline phosphatase  (ALP)

    • B. 

      Bones become more fragile 

    • C. 

      Plasma calcium is usually high

    • D. 

      Elderly persons have higher risk of osteoporosis compared toyoung persons 

    • E. 

      Females have higher risk of osteoprosis compared to males 

  • 3. 
    Which of the following may be associated with decreased plasma free ionized calcium?
    • A. 

      Acidosis

    • B. 

      Hyperkalemia

    • C. 

      Alkalosis

    • D. 

      Primary hyperparathyroidism 

    • E. 

      Hypermagnesemia

  • 4. 
    All of the following are correct regarding parathyroid hormone (PTH) EXCEPT : 
    • A. 

      It increases osteoclastic bone resorption 

    • B. 

      It decrease renal calcium reabsorption 

    • C. 

      It decreases renal phosphate reabsorption 

    • D. 

      It decreases renal bicarbonate reabsorption causing mild acidosis 

    • E. 

      It increases alpha 1 hydroxylation of vitamin D 

  • 5. 
    In which condition this pattern is most likely: decreased calcium, decreasedphosphate, increased ALP and increased calcium excretion :
    • A. 

      Hypoparathyroidism 

    • B. 

      Renal failure

    • C. 

      Osteomalacia 

    • D. 

      Paget's disease 

    • E. 

      Fanconi syndrome 

  • 6. 
    Caeruloplasmin level may decrease in all of the following EXCEPT:
    • A. 

      Wilson's disease

    • B. 

      Malnutrition and malabsorption 

    • C. 

      Decompensated liver cirrhosis 

    • D. 

      Acute phase response

    • E. 

      Nephrotic syndrome

  • 7. 
    Which of the following is used to asses iron body stores ? 
    • A. 

      Transferrin

    • B. 

      Haptoglobin

    • C. 

      CRP 

    • D. 

      Ferritin 

    • E. 

      Prealbumin 

  • 8. 
    All of the following are correct about Albumin EXCEPT: 
    • A. 

      It is used as a test for liver function

    • B. 

      Patients with septicemia may develop hypoalbuminemia 

    • C. 

      It act as a carrier for free fatty acids(FFA)

    • D. 

      Hyperalbuminemia may cause oedema  

    • E. 

      Albumin is a major protein in the blood  

  • 9. 
    Alpha 1 antitrypsin :
    • A. 

      Concentration may increase in patients with nephrotic syndrome 

    • B. 

      Deficiency may result in edema 

    • C. 

      Is normally excreted in urine 

    • D. 

      Is an acute phase protein that is usually increased during infection 

    • E. 

      Concentration may increase in patient with liver disease 

  • 10. 
    Which of the following may increase in hepatocellular carcinoma: 
    • A. 

      Alpha 1 antitrypsin

    • B. 

      Alpha 1 fetoprotein 

    • C. 

      Alpha 2 macroglobulin 

    • D. 

      Transferrin 

    • E. 

      Haptoglobin 

  • 11. 
    Which of the following is CORRECT regarding C reactive protein (CRP): 
    • A. 

      It is decreased in acute phase response

    • B. 

      It is decreased in bacterial infections 

    • C. 

      Its elevation is a marker of cardiovascular risk 

    • D. 

      It is increased in viral infection 

    • E. 

      It is a valuable marker of inflammatory conditions such as rheumatoid arthritis 

  • 12. 
    Which of the following is an expected findings in hemolytic jaundice ?
    • A. 

      Deep orange to brown urine

    • B. 

      Decreased haptoglobin 

    • C. 

      Increased conjugated bilirubin 

    • D. 

      Marked elevation in AST

    • E. 

      Marked increase in Lactate dehydrogenase (LDH) 

  • 13. 
    All of the following are correct regarding jaundice EXCEPT : 
    • A. 

      It may indicate the presence of liver disease

    • B. 

      The drug rifampcin is among the causes of jaundice 

    • C. 

      Neonatal jaundice is almost pathological 

    • D. 

      It may result from reduced uptake of unconjugated bilirubin by the liver

    • E. 

      Patients with jaundice may have increased serum level of either conjugated or unconjugated bilirubin.

  • 14. 
    Alkaline phosphatase (ALP) activity is expected to be elevated in all of the following conditions EXCEPT: 
    • A. 

      Paget's diseas

    • B. 

      Rickets 

    • C. 

      Cholestasis 

    • D. 

      Cirrhosis 

    • E. 

      Pre-icteric phase of acute hepatitis 

  • 15. 
    Regarding transaminases (AST and ALT) , which of the following is TRUE: 
    • A. 

      AST is more liver specific compared to ALT 

    • B. 

      Both enzymes are usually highly elevated in crush injures and muscle diseases 

    • C. 

      Both enzymes are usually highly elevated in nonalcoholic fatty liver disease

    • D. 

      ALT is one of the markers that are usually elevated in acute hepatitis 

    • E. 

      Both are highly elevated in myocardial infraction 

  • 16. 
    Patients with Criglar najjar's syndrome may have:
    • A. 

      Unconjugated hyperbilirubinemia 

    • B. 

      Decreased number of reticulocytes 

    • C. 

      Decreased bilirubin excretion 

    • D. 

      G6PD deficiency 

    • E. 

      Hemolysis and rhabdomyolysis 

  • 17. 
    Which of the following statements about uric acid is correct : 
    • A. 

      Excretion occurs mainly though kidneys and to less extent through intestine 

    • B. 

      In plasma, it is highly bound to protein , especially immunoglobulins 

    • C. 

      It is the end product of protein catabolism 

    • D. 

      In urine, it is excreted as urea , which is the most soluble form.

    • E. 

      Allopurinol is a medication that enhances its renal excretion 

  • 18. 
    Which of the following may cause increased uric acid in blood (hyperuricemia) 
    • A. 

      Anemia

    • B. 

      High dose of salicylates 

    • C. 

      Increased phosphoribosyl pyrophosphate synthase 

    • D. 

      Liver cirrhosis 

    • E. 

      Excess of dietary pyrimidine intake

  • 19. 
    Patients with liver cirrhosis may develop ascites because of :
    • A. 

      Reduced pre-albumin 

    • B. 

      Decreased renin secretion 

    • C. 

      Increased ammonia level

    • D. 

      Decreased albumin synthesis 

    • E. 

      Esophageal bleeding.

  • 20. 
    Patients with prolonged prothrombin time may have:
    • A. 

      Increased risk of thrombosis

    • B. 

      Defective hepatic excretory function 

    • C. 

      Acute phase response 

    • D. 

      Vitamin K deficiency 

    • E. 

      Increased synthesis of clotting factors 

  • 21. 
    All of the following are typical findings in multiple myeloma EXCEPT: 
    • A. 

      Increased creatinine 

    • B. 

      IgA or IgG paraproteins 

    • C. 

      Normal alkaline phosphatase (ALP) activity 

    • D. 

      Anemia 

    • E. 

      Decreased calcium

  • 22. 
    All of the following findings are expected in the icteric phase of acute hepatitis EXCEPT : 
    • A. 

      Increased ALT 

    • B. 

      Normal or increased ALP

    • C. 

      Increased urinary urobilinogen 

    • D. 

      Normal albumin level

    • E. 

      Marked elevation in plasma bilirubin 

  • 23. 
    Regarding bilirubin metabolism , which of the followingis NOT true:
    • A. 

      Conjugation of bilirubin does occur in heptocytes and is mediated by glucuronyl transferase 

    • B. 

      Unconjugated bilirubin is water insoluble and is totally bound to plasma protein albumin 

    • C. 

      Conjugation of bilirubin is done with glucuronic acid to form mono- and di- glucuronides  

    • D. 

      Conjugated bilirubin is normally excreted in urine 

    • E. 

      Bilirubin is converted into urobilinogen in intestine by bacteria

  • 24. 
    Which of the following may cause secondary hyperparathyroidism 
    • A. 

      Hypocalcemia 

    • B. 

      Acidosis 

    • C. 

      Obesity 

    • D. 

      Hypermagnesmia 

    • E. 

      Hyperaldosteronism