Bilirubin, Hyperbilirubinemia, and Related Topics MCQs
- Which of the following is associated with conjugated hyperbilirubinemia?
- A. Dubin-Johnson syndrome ✅
- B. Gilbert’s Syndrome
- C. Crigler Najjar syndrome
- D. Neonatal Jaundice
- E. Hemolytic anemia
- Which is a cause of unconjugated hyperbilirubinemia?
- A. Dubin-Johnson syndrome
- B. Rotor Syndrome
- C. Primary biliary cirrhosis
- D. Cancer head pancreas
- E. Gilbert’s syndrome ✅
- Which of the following conditions is associated with bilirubinuria?
- A. Hemolytic anemia
- B. Gilbert’s syndrome
- C. Rotor syndrome ✅
- D. Crigler-Najjar syndrome
- E. Neonatal Jaundice
- Which of the following is associated with monoclonal gammopathy?
- A. Rheumatoid arthritis
- B. SLE
- C. Tuberculosis
- D. Liver Cirrhosis
- E. Multiple myelomatosis ✅
- Of the following serum results, which are the most indicative of biliary tract involvement (and not parenchymal cell damage)?
- A. ALT = 1500 U/L (N:5-40)
- B. ALT=500 U/L, AST= 3000 U/L (N:5-40)
- C. LDH = 700 U/L (N:100-500)
- D. ALP = 650 U/L (N:30-100), GGT =130 U/L (N:10-50) ✅
- E. Total bilirubin = 4 mg/dl , direct bilirubin= 1 mg/dl
- Which of these statements is NOT true about bilirubin?
- A. It is derived exclusively from breakdown of hemoglobin ✅
- B. It is bounded in the unconjugated form serum albumin
- C. It’s reabsorbed in the small intestine after bacterial metabolism to urobilinogen
- D. It is normally undetectable in urine
- E. Normally, most of bilirubin in serum is unconjugated.
- One of the following is a feature of hemolytic jaundice:
- A. Pale stool
- B. Dark brown urine
- C. Conjugated hyperbilirubinemia
- D. Increased serum ALP and GGT
- E. Increased urine urobilinogen ✅
- Obstructive jaundice is accompanied by:
- A. Increased excretion of conjugated bilirubin in urine ✅
- B. Increased excretion of unconjugated bilirubin in urine
- C. Increased urinary urobilinogen excretion
- D. Almost equally increased serum conjugated and unconjugated bilirubin
- E. Increased serum unconjugated bilirubin
- Urinary urobilinogen is usually increased in case of:
- A. Extrahepatic biliary obstruction
- B. Primary biliary cirrhosis
- C. Acute hemolysis crisis ✅
- D. Icteric stage of acute hepatitis
- E. Women receiving oral contraceptives
- Which of these findings is expected in cases of acute viral hepatitis:
- A. Prolongation of prothrombin time
- B. Serum albumin is low
- C. AST/ALT ratio more than 1
- D. Serum IgA is usually LOW
- E. ALT/AST ratio is more than 1 ✅
- Which of these enzymes is most valuable to confirm the hepatic origin of an elevated serum alkaline phosphatase in a pregnant woman:
- A. Aspartate aminotransferase (AST)
- B. Creatine kinase (CK)
- C. Lactate dehydrogenase (LDH)
- D. 5 nucleotidase ✅
- E. Alanine aminotransferase (ALT)
- In follow-up of acute viral hepatitis, which enzyme is the earliest indicator of recovery?
- A. ALT
- B. AST✅
- C. ALP
- D. GGT
- E. LDH
