[ مختبرات ] : كيمياء خامسسسسسسسسسسسسسس

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كيمياء
1. Adv clinical chemistry


the process of digestion of food starts from
mouth .
small intestine
large intestine
non of above
Excess ACTH will cause……….
Acromegally and gigantism.
Amenorrhea, infertility and galactorrhoea.
Cushing syndrome.
Hyper thyroidism.
Deficiency of growth hormone will cause……….
precocious puberty.
dwarfism.
secondary thyroid hypofunction.
Hyper thyroidism.
intrinsic factor is essential for
vitamin B12 absorption
iron absorption.
magnesiumabsorption.
All of the above are correct.
functions of Hcl include
activation of pepsinogen to pepsin
killing of bacteria and parasites
calcium and iron absorption
All of the above are correct
hyper secretion of gastric juice is due to
duodenal ulceration.
malaria.
typhoid
non of above
pancreatic secretions contain
endocrine component
exocrine component
a+b.
non of above.
GGT occurs in.
liver
kidney
pancreas.
All above
plasma ck activities increase in.
myocardial infraction
shock
circulation failture.
All above
ALP is markedly increased in plasma in ………
Rickets.
Myocardial infarction.
pancreatitis.
Arrested bone growth.
Hemolysis of a sample will increase plasma value of…
LD.
ACP.
CK.
All of the above are correct
all are correct about raised plasma amylase except
acute pancreatitis
diabetes ketoacidosis
headache.
Peptic ulcer
amylase is produced by
pancreas
kidney
lung
all above
acid phosphatase is found in
liver
prostate
hand
a+b
Plasma amylase activity is increase in
Acute pancreatitis.
Chronic pancreatitis.
Liver disease.
Anemia.
Presence of lactase deficiency is accompanied by……..
Low PH.
Lactic acid formation.
Lactose in feaces.
All of the above are correct.
The presence of invisible blood in faeces is named as…
Steatorrhoea.
Occult faecal blood.
Melena.
Diabetes.
ALP increases in all the following except
children
pregnancy
malaria
rickets
The main source of unconjugated bilirubin is………..
RBCs destruction.
Myoglobin.
cytochromes.
None of the above is correct.
Conjugated bilirubin is…………
Water soluble.
toxic.
Fat soluble.
All of the above are correct.
Post-hepatic jaundice is caused by…………
Liver cirrhosis with toxins.
Liver cirrhosis with viral infection.
Hemolytic anemia.
Gall stones.
There is no bilirubin in urine in cases of ……………
Hemolytic jaundice.
Hepatic jaundice.
Post-hepatic jaundice.
None of the above is correct.
Normal plasma bilirubin is about…………….
1 mg/dl.
2 mg/dl.
3 mg/dl.
13 mg/dl.
ALT is abbreviation of
Alanine transaminase
Acid base balance
Alkaline phosphatase
Non of above .
most enzymes present in
cells
plasma.
A+b
None of the above is correct.
clinical enzymology deals with study of
enzymes.
glucose.
acids.
alcohols.
ELISA means
Enzyme immunosorbant assay
Enzyme assay
Enzyme alkaline phosphatase
All above
Indication/s for drug monitoring is/are……..
Monitoring if the patient is taking the drug or not.
Diagnose obscure conditions.
Monitor overdosage.
d. All of the above are corre
The presence of fat in faeces is named as………..
Steatorrhoea.
Occult faecal blood.
Melaena.
Diabetes.
………………..gives urine and stool their characteristic color and odour.
urobilinogen
urobilin.
Calcium.
d.None of the above is correct
bile secreted by liver is concentrated in
stomach .
gall bladder
intestine
non of above.
ALP shows its maximum activity in.
liver
bone .
placenta
All of the above are correct.
jaundice clinically apparent when the bilirubin concentration exceeds
2 mg/dl
6 mg/dl
0.8 mg/dl
Non of above
hypofunction of pituitary hormone secretion causes
malaria
typhoid
Addison;s disease
Non of above
accumulation of bilirubin in blood is called
malaria
jaundice
anemia
non of above.
The presence of fat in faeces is named as………..
Steatorrhoea.
Occult faecal blood.
Melaena.
Diabetes.
the cells of the anterior pituitary can be classified by
size
shape
staining reaction
non of the above
stimulation tests are used mainly for
deficient hormone secretion
excessive hormone secretion
a+b
non of above.
diagnosis of myocardial infraction enzymes required is
AST
LD
CK
None of the above.
cholesterol stone may occur when
cholesterol crystals precipitate
unknown initiating factors
a&b
non of the above
increased bile salt in the blood leads to:
Itching
bradycardia
a&b
none of the above
relevant points in the clinical evaluation in suspected chronic liver disease
history of hepatitis
alcohol intake
autoimmune disorder
all above
the time taken for the plasma drug concentration to fall to half its original level
.The elimination half life
The elimination life
a & b
Non of the above
.LD activity increased in
hepatitis
myocardial infarction
a & b
.non of above
.function of gastric secretion is
digestion
Vitamin B12 absorption
activates pepsinogen
all of the above
. Hypo secretion of gastric juice occur most commonly in
pernicious anemia
. chronic gastritis
chemo taxis
d. a & b
. pancreatic lipase is essential for
. carbohydrate digestion
protein digestion
fat digestion
.non of the above
.
.Acid in pylorus…………..
Inhibit insulin secretion.
Increase calcium ions.
Inhibit gastrin secretion.
All of the above are correct.
.Chemical tests for examination of occult blood are
Specific tests.
.Instant view test is an example.
.Are more expensive than immunological tests.
Are not specific to hemoglobin.
.plasma amylase is consists of
salivary isoenzymes
water
iron
non of the above.
.occult blood can be tested by
.hema screen
.benzidine chemical test
aminophenazone test.
d.all of the above.
.all are correct about specimen collection for occult blood except
not to eat red meat
not to eat fish
c.not to eat of plenty of vegetables
not to eat horse radish
.all are correct about fatty stool except
.pale in color
.bulky
float on water
white in color
Excess fat in faeces may occur as :-
Neutral fat globule
Fatty acid crystals
Soapy flakes
All of them
- Hepatocellular jaundice is due to liver damage by :-
Cirrhosis
Viral hepatitis
Toxins
All of above

*:Choose the correct answer:(MCQs) (55 marks)
1- Disturbance of water, electrolyte, hydrogen ion homeostasis are common in the following states except one:
A. diarrhea
B. vomiting
C. function of intestinal cell impaired
D. fever
2- Acid phosphatase is found in the;-
a) Prostate
b) Erythrocytes
c) Bone
d) All of them
3- Which of the following substance is protect the mucosa from proteolytic effect of gastric enzymes:
A. mucin
B. rennin
C. pepsin
D. A&B
4- Hepatocellular jaundice is due to liver damage by :-
a) Cirrhosis
b) Viral hepatitis
c) Toxins
d) All of them

5- Cysteamine is adrug causes :-
a) Cardiac arrthmias
b) Abdomina painl
c) Vomiting
d) All of the above
6- Double antibody technique in ELISA is used to detect:
A-antibody.
B-antigen.
C-Substrate..
D-Solid phase..
7- Drug level in blood is affected by…………
A-Its degree of binding to plasma albumin.
B-The surface area of the body(volume of distribution).
C-Time of sampling.
D-All of the above are correct
8- Low plasma level of ACTH with low level of cortisol suspects:
A-Primary adrenal insufficiency.
B-secondary adrenal insufficiency
C-secondary hypothyroidism.
D-Primary hypothyroidism.
9- Glucose tolerance test is used for diagnosis of……..
A-acromegally.
B-Dwarfism.
C-Cancer.
D-All of the above are correct.
10- Deficiency of growth hormone will cause:
A-precocious puberty.
B-dwarfism.
C-secondary thyroid hypofunction.
D-Hyper thyroidism.
11- Excess ACTH will cause……….
A-Acromegally and gigantism.
B-Amenorrhea, infertility and galactorrhoea.
C-Cushing syndrome.
D-Hyper thyroidism.
12- Antidiuretic hormone(ADH) and oxytocin are secreted from :
A-The posterior lobe of the pituitary.
B-The anterior lobe of the pituitary.
C-The middle lobe of the pituitary.
D-The left lobe of the pituitary.


13- ………. Do not rise in late myocardial infarction.
A-CK (MM)
B-CK (MB).
C-AST.
D-LD.
14- ………..is high in cases of metastatic tumor in the liver.
A-ALP.
B-AST.
C-Factor VIII.
D-albumin.
15-…………test denotes the synthetic function of the liver.
A-Bilirubin.
B-Transaminases (ALT and AST)
C-Alkaline phosphatase (ALP)
D-Albumin.
16- CK(BB) is found in high concentration in
A-Brain.
B-Skeletal muscles.
C-Cardiac muscle.
D- None of the above is correct.


17- ALP is markedly increased in plasma in ………
A-Rickets.
B-Myocardial infarction.
C-pancreatitis.
D-Arrested bone growth.
18- Excess secretion of G.H lead to:
A. Acromegaly
B. Gigantism
C. Dwarfism
D. A & B
19- Cushing´s syndrome is due to :
A. high G.H level
B. high cortisol level
C. high prolactin level
D. b & c
20- Testosterone hormones secreteted from:
A. testis
B. ovary
C. adrenal cortex
D. A & B


21- Monitor the therapeutic use by trying to
A. check that patient is taking the drug as prescribed
B. ensure that the dose is enough to treatment
C. diagnose obscure condition
D. all the above
22- If the blood sample taken before absorption of drug is complete result my be:
A. falsely low
B. falsely high
C. moderate
D. B & C
23-The dose may have to be calculate according to:
A. weight of patient
B. age of patient
C. sex of patient
D. A & B
24- Competition for binding site on protein it commonly between:
A. many drugs
B. unconjugated bilirubin
C. hydrogen ion
D. all of the above

25- All the following about Lithium except one:
A. the margin between therapeutic and toxic level is narrow
B. it is give to psychiatric patient
C. it is protein-bound
D. should be measured 12 hours after the evening dose
26- Abuse of purgative drugs lead to:
A. hypokalaemia
B. hypoglyceamia
C. hyperkalaemia
D. a& b
27- If patient have taken known drug in over dose what he need to do in such case:
A. necessary to measure plasma level
B. need for gastric lavage
C. measurement of electrolyte and blood gas
D. B & C
28- The total concentration plasma enzymes protein is:
A. < 1g/l
B. > 1g/l
C. = 1g/l
D. none

29- Plasma enzyme activity must be interpreted in relation to:
A. sex
B. age
C. weight
D. A& B
30- In myocardial infraction AST get it is maximum level after:
A. 12 hours
B. 24 hours
C. 72 hours
D. 6 hours
31-Liver test of synthetic function include:
A. serum albumin
B. coagulation factors
C. bilirubin
D. A & B
32- ALT present in high concentration in:
A. liver
B. heart
C. kidney
D. skeletal muscle


33- Plasma ALP in adult is mainly derived from:
A. liver
B. bone
C. intestine
D. a & b
34- Moderate raised levels of ALT in the following except :
A. cirrhosis
B. cholestatic jaundice
C. acute viral infection
D. infectious mononucleosis
35- Alkaline phosphatase it is show it is maximum activity in PH of :
A. 9---10.5
B. 6-------7
C. 4-------6
D. 2-------4
36- In case of Gilbert´s disease un conjugated bilirubin rarely exceeding:
A. 5mg/dl
B. 2.5mg/dl
C. 4mg/dl
D. none


37- Acid phosphatase (ACP) show it is maximum activity in:
A. low Ph
B. high pH
C. neutral pH
D. a & b
38- Which of the following samples are not suitable for ACP measure:
A. heparinized one
B. heamolytic sample
C. clotted sample
D. a & b
39- Moderate increase of LD seen in the following except:
A. pulmonary embolism
B. skeletal muscles disease
C. malignancy of any tissue
D. myocardial infraction
40- Moderate increase of plasma amylase seen in such case except:
A. acute abdominal disorder
B. salivary gland disorder
C. acute pancreatitis
D rupture ectopic pregnancy


41-Function of gastric secretion are:
A. digestion
B. protection
C. absorption
D. all of the above

42-Steatorrhoea occur in such case except:
A. malabsorption
B. giardiasise
C. chronic pancreatitis
D. schistosomisis(mansoni)

43-Hepatocytes synthesize all the following except:
A. immunoglobulin
B. most coagulation factors
C. lipoprotein
D. primary bile acids
44-All the following about natural globules except one:
A. can be stained orange-red with sudan III and oil red
B. dissolve with methanol or diethyl ether
C. highly refractile
D.colored
45-Damage to the centrilobular area of liver is cause by:
A. hypoxia
B. toxins
C. alcohol
D. B & C
46-Substance which are inactivated and excreted by the liver include the following except:
A. amino acid
B. drugs
C. steroid hormone
D. enzymes
47- All the following about unconjugated bilirubin except:
A. water soluble
B. fat soluble
C .toxic
D. water insoluble
48-The function of bile salt are:
A. digestion of lipid
B. anti-putrifactive action
C. absorption of lipid
D. all of the above

49- Extra hepatic causes which lead to decrease of plasma albumin are the following except:
A. loss of protein through the kidney
B. liver diseases
C. inflammation or infection
D.A & C
50- There is no bilirubin in urine in case of:
A. hemolytic jaundice
B. hepatic jaundice
C. pos-hepatic jaundice
D. A&B
51- The cells of anterior pituitary can be classified by their staining reaction as follow except :
A. acidophilic
B. basophilic
C. chromophobase
D. neutrophilic
52-Somatotrophs cell of anterior pituitary secrete:
A. Growth hormone
B. prolactine
C. FSH hormone
D. non of the above

53-which of the following hormone are secreted from anterior pituitary:
A. Growth hormone
B. ACTH
C. ADH
D. A & B
54- Somatostatin is formed in:
A. Hypothalamus
B. brain
C. gastrointestinal tract
D. all the above
55- Most digestion takes place in the :
A. duodenum and upper jejunum
B. ileum
C. colon
D. A& B