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. Macroamylase refers to:The false elevation of amylase levels in lipemic specimens. The presence of complexes consisting of amylase and immunglobulins that result in elevated amylase levels. The elevation of serum salivary amylase isoform in cases of ectopic pregnancy or ovarian malignancy.The elevation of amylase levels in cases of biliary tract obstruction. The presence of elevated serum amylase levels in acute pancreatitis 2. Which of the following is untrue in cases of toxic overdose of acetaminophen?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. 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. Glutathione depletion in alcoholics can lead to increased acetaminophen hepatotoxicity 3. Which of the following is not true of drug metabolism:Glutathione and Acetyl CoA often serve as cofactors in Phase II reactions Phase II reactions typically involve enzyme-mediated congujation of compounds In general, metabolism serves to increase the water solubility of xenobiotic compoundsMost Phase II reactions are mediated by the cytochrome P450 (CYP) enzymes Phase I reactions typically involve oxidation of compounds 4. 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?Ultrarapid metabolizers (UM)FemalesPoor Metabolizers (PM) Intermediate Metabolizers (IM)Extensive metabolizers (EM) 5. 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?Alkaline Phosphatase Aspartate AminotransferaseTotal Bilirubin Gamma-glutamyltransferaseConjugated Bilirubin 6. 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 Mononucleosis Reye’s Syndrome Chronic Viral Hepatitis Acute Viral Hepatitis Acute Alcoholic Hepatitis 7. Which of the following is the most specific serum marker for alcohol dependency?Gamma-Glutamyl Transferase LipaseLactate DehydrogenaseCarbohydrate Deficient TransferrinAFP-L3% 8. 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 levels appear well before elevated lipase levelsElevated amylase is more specific than elevated lipase for pancreatitisElevated Amylase and elevated lipase are equally specific for pancreatitis Elevated lipase is more specific than elevated amylase for pancreatitisLipase has both salivary and pancreatic isoforms, which reduces specificity 9. 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?Bile Duct Obstruction Crigler-Najjar syndrome Gilberts SyndromeHemolytic AnemiaFasting 10. Warfarin metabolism is mainly performed by:P450 CYP2C9N-Acetyl-Transferases (NATs) P450 CYP3A4 Thiopurine S-Methyltransferase (TPMT) P450 CYP2D6 Loading... Share this: Share on X (Opens in new window) X Share on WhatsApp (Opens in new window) WhatsApp Share on Facebook (Opens in new window) Facebook Email a link to a friend (Opens in new window) Email Print (Opens in new window) Print Share on LinkedIn (Opens in new window) LinkedIn Related
