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. Which of the following is the most specific serum marker for alcohol dependency?AFP-L3%Gamma-Glutamyl Transferase Carbohydrate Deficient TransferrinLactate DehydrogenaseLipase 2. Warfarin metabolism is mainly performed by:P450 CYP2D6 P450 CYP3A4 N-Acetyl-Transferases (NATs) Thiopurine S-Methyltransferase (TPMT) P450 CYP2C9 3. 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 levelsLipase 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 is more specific than elevated lipase for pancreatitis 4. Macroamylase refers to:The presence of elevated serum amylase levels in acute pancreatitis The elevation of amylase levels in cases of biliary tract obstruction. 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. 5. Which of the following is not true of drug metabolism:Phase II reactions typically involve enzyme-mediated congujation of compounds Phase I reactions typically involve oxidation of compounds Most Phase II reactions are mediated by the cytochrome P450 (CYP) enzymes In general, metabolism serves to increase the water solubility of xenobiotic compoundsGlutathione and Acetyl CoA often serve as cofactors in Phase II reactions 6. 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 Hemolytic AnemiaGilberts SyndromeCrigler-Najjar syndrome Fasting 7. 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 Alcoholic Hepatitis Acute Viral Hepatitis Acute Mononucleosis Chronic Viral Hepatitis Reye’s Syndrome 8. 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?Intermediate Metabolizers (IM)Poor Metabolizers (PM) Extensive metabolizers (EM) FemalesUltrarapid metabolizers (UM) 9. 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 Gamma-glutamyltransferaseTotal Bilirubin Aspartate AminotransferaseConjugated Bilirubin 10. Which of the following is untrue in cases of toxic overdose of acetaminophen?Glutathione depletion in alcoholics can lead to increased acetaminophen hepatotoxicity 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. Children are generally not at risk of developing Reye’s syndrome. Depression of P450 enzyme activities by other therapeutic drugs result in the increased production of the toxic metabolite: N-acetyl-p-benzoquinone immine Administration of N-acetylcystiene is a common antidotal therapy. 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