PathMD Quizes, Clinical Clinical Chemistry – 02 October 29, 2017 peferguson Author: Josh Bornhosrt, Ph.D. Make sure to subscribe to PathMD to stay up to date with new content and features!! 1. Warfarin metabolism is mainly performed by:P450 CYP3A4 Thiopurine S-Methyltransferase (TPMT) P450 CYP2D6 N-Acetyl-Transferases (NATs) P450 CYP2C9 2. A 52-year-old man with a history of alcohol abuse presents with sudden severe abdominal pain associated with nausea and vomiting. Which of the following is true when considering serum testing for acute pancreatitis?Elevated amylase is more specific than elevated lipase for pancreatitisLipase has both salivary and pancreatic isoforms, which reduces specificityElevated Amylase and elevated lipase are equally specific for pancreatitis Elevated lipase is more specific than elevated amylase for pancreatitisElevated amylase levels appear well before elevated lipase levels 3. A 53-year-old woman presents with chronic intermittent acute abdominal pain that is determined to stem from common bile duct obstruction. Which of the following liver function markers would one not expect to be highly elevated in the serum?Gamma-glutamyltransferaseTotal Bilirubin Aspartate AminotransferaseConjugated BilirubinAlkaline Phosphatase 4. A 33-year-old jaundiced man is found to have the following serum laboratory values: Total Bilirubin of 3.0 mg/dL (normal <1.0), Direct bilirubin of 2.7 mg/dL (normal <0.2). Which of the following is the most likely cause?Crigler-Najjar syndrome FastingBile Duct Obstruction Hemolytic AnemiaGilberts Syndrome 5. An active form of an antidepressant is subsequently oxidized by P450 CYP2C9. Which patients would you generally expect to need the highest dose of antidepressants to maintain similar serum concentrations of active drug?Extensive metabolizers (EM) Poor Metabolizers (PM) Ultrarapid metabolizers (UM)Intermediate Metabolizers (IM)Females 6. Which of the following is untrue in cases of toxic overdose of acetaminophen?The Rumack-Matthew nomogram can be used to estimate the probability of hepatic toxicity if the time of ingestion and acetaminophen plasma concentration is known. Administration of N-acetylcystiene is a common antidotal therapy.Depression of P450 enzyme activities by other therapeutic drugs result in the increased production of the toxic metabolite: N-acetyl-p-benzoquinone immine Children are generally not at risk of developing Reye’s syndrome. Glutathione depletion in alcoholics can lead to increased acetaminophen hepatotoxicity 7. Which of the following is not true of drug metabolism:Most Phase II reactions are mediated by the cytochrome P450 (CYP) enzymes Glutathione and Acetyl CoA often serve as cofactors in Phase II reactions Phase I reactions typically involve oxidation of compounds In general, metabolism serves to increase the water solubility of xenobiotic compoundsPhase II reactions typically involve enzyme-mediated congujation of compounds 8. A 63-year-old woman with weight loss is found to have a slightly elevated alanine aminotransferase level of 45 U/L (N=8-33 U/L) and an elevated aspartate aminotransferase level of 150 U/L (N=4-36 U/L). Which of the following is the most likely cause?Acute Viral Hepatitis Acute Alcoholic Hepatitis Acute Mononucleosis Chronic Viral Hepatitis Reye’s Syndrome 9. Macroamylase refers to:The elevation of serum salivary amylase isoform in cases of ectopic pregnancy or ovarian malignancy.The presence of complexes consisting of amylase and immunglobulins that result in elevated amylase levels. The elevation of amylase levels in cases of biliary tract obstruction. The presence of elevated serum amylase levels in acute pancreatitis The false elevation of amylase levels in lipemic specimens. 10. Which of the following is the most specific serum marker for alcohol dependency?Gamma-Glutamyl Transferase Carbohydrate Deficient TransferrinAFP-L3%Lactate DehydrogenaseLipase Loading... Share this:TwitterWhatsAppFacebookEmailPrintLinkedIn Related
