Clinical Second
.
- 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
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