Bilirubin, Hyperbilirubinemia, and Related Topics MCQs

Bilirubin, Hyperbilirubinemia, and Related Topics MCQs

  1. 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

  2. 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 ✅

  3. 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

  4. Which of the following is associated with monoclonal gammopathy?
    • A. Rheumatoid arthritis
    • B. SLE
    • C. Tuberculosis
    • D. Liver Cirrhosis
    • E. Multiple myelomatosis ✅

  5. 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

  6. 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.

  7. 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 ✅

  8. 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

  9. 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

  10. 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 ✅

  11. 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)

  12. 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

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