1. In this method of bilirubin determination, unconjugated and conjugated bilirubin interact with a specific charged polymer called mordant and the concentrations of Bu and Bc are calculated from the measured reflection densities and the predetermined molar reflectivities of the two bilirubin species at two wavelengths and use of simultaneous equations.
   • A. Jendrassik-Grof
   • B. Enzymatic method
   • C. Multi-layer film slide technology✅
   • D. Direct spectrophotometry


2. This enzyme is used to oxidize bilirubin to biliverdin:
   • A. Bilirubin reductase
   • B. Bilirubin diglucoronidase
   • C. Bilirubin oxidase ✅
   • D. Bilirubin dehydrogenase


3. Which of the following statements about unconjugated bilirubin is not correct?
   • A. It is practically insoluble in water at physiologic pH and body temperature
   • B. In plasma, it is present in a folded structure or so-called Z-Z(trans) conformation loosely bound to albumin
   • C. It is transported in plasma loosely bound to albumin
   • D. It is covalently bound to albumin ✅


4. Which measurement is a better criterion for the differential diagnosis of jaundice?
   • A. Conjugated bilirubin
   ✅
   • B. Unconjugated bilirubin
   • C. Delta bilirubin
   • D. Total bilirubin


5. In adults and older children, hyperbilirubinemia causes jaundice if bilirubin value is >2.5mg/dL, whereas in infants, jaundice is seen if bilirubin values is greater than:
   • A. 2.5mg/dL
   • B. 3.0mg/dL
   • C. 3.5mg/dL
   • D. 4.0mg/dL ✅


6. What classification of hyperbilirubinemia is caused by ineffective erythropoiesis?
   • A. Prehepatic jaundice ✅
   • B. Intrahepatic jaundice
   • C. Posthepatic jaundice
   • D. none of these


7. What classification of hyperbilirubinemia is caused by medication-induced parenchymal and cholestatic liver damage as well as hepatic involvement in other primary diseases?
   • A. Prehepatic jaundice
   • B. Intrahepatic jaundice ✅
   • C. Posthepatic jaundice
   • D. none of these


8. Which of the following conditions are associated with unconjugated hyperbilirubinemias?
   • 1. Crigler-Najjar syndrome
   • 2. Dubin-Johnson syndrome
   • 3. Gilbert’s syndrome
   • 4. Rotor syndrome
   
   
   • A. only 1 and 3 are correct ✅
   • B. only 2 and 4 are correct
   • C. only 1,2, and 3 are correct
   • D. 1,2,3 and 4 are correct


9. Which of the following conditions are associated with conjugated hyperbilirubinemias?
   • 1. Crigler-Najjar syndrome
   • 2. Dubin-Johnson syndrome
   • 3. Gilbert’s syndrome
   • 4. Rotor syndrome
   • A. only 1 and 3 are correct
   • B. only 2 and 4 are correct ✅
   • C. only 1,2, and 3 are correct
   • D. 1,2,3 and 4 are correct


10. Which of the following statements about bilirubin is true?
    • A. A decline in unconjugated bilirubin is a sensitive indicator of recovery
    • B. An increase in delta bilirubin suggests a protracted disease course ✅
    • C. An increase of conjugated bilirubin >10% of total bilirubin suggest a hepatogenic cause
    • D. In the differentiation of prehepatic to hepatic jaundice, a LD/AST ratio of >2 is suggestive of hemolytic jaundice.