كيمياء حيويه (1) | أسئلة الهيئة السعودية للتخصصات الصحية

الأخصائيين

 كيمياء حيوية 

مراجع الامتحان 

1.Textbook of Clinical Chemistry and Molecular Diagnostics, Tietz , Latest Edition.

2. Biochemistry and Metabolism (Core Science and Clinical Cases in One Book), Andrew Davison, Anna Milan, Suzannah Phillips, Lakshminarayan Ranganath, Latest Edition.

3.  Clinical Biochemistry: An Illustrated Colour Text, Allan Gaw, Latest Edition.

4.  Lecture Notes: Clinical Biochemistry, Geoffrey Beckett, Latest Edition.

الأخصائيين 

                            (1) كيمياء حيوية 

Choose the most appropriate single answer.

 1.      Water deprivation test is used in the diagnosis of:

a.      Anterior pituitary disease.

b.      Posterior pituitary disease.

c.      Hypothyroidism. 

(a) A fungus is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds. Bacteria constitute a large domain of prokaryotic microorganisms. Chlamydia is a genus of pathogenic bacteria that are obligate intracellular Gram-negative bacterium. Chlamydia is incorrectly called the PLT viruses, Bedsonia, or basophilic viruses. Mycoplasma is a genus of bacteria that are lacking a rigid cell wall during their entire life cycle, although they are also much smaller than bacteria.

2.      The method used to estimating insulin is?

a.      Electrophoresis

b.      Kinetic estimation.

c.      Spectrophotometer.

d.      Radioimmuno assay.

d Immunoassay (multiple labels) is used for the measurement of insulin.

3.      Elevation of LDH is caused by:

a.      Myocardial disease

b.      Liver disease

c.      Prostatic disease

d.      many organ disease because it has many distribution

d LDH is present in the cells of the heart, liver, muscles, blood and malignancies.

4.      MI is diagnosed by:

a.      CKMB

b.      CKBB

c.      CKMM

d.      LDH

a CK-MB is specific for cardiac muscle, CK-BB for brain and CK-MM for skeletal muscle.

5.      The better for diagnosis of acute pancreatitis is?

a.      Amylase

b.      Lipase

c.      ALP

d.      ACP

b Lipase elevation is of a greater magnitude (2-10 xN) and duration than amylase in acute pancreatitis. When lipase method is optimized, the test is more sensitive and specific than amylase for detection of acute pancreatitis.

6.      Which lipoprotein has highest concentration of cholesterol?

a.      VLDL

b.      LDL

c.      IDL

d.      HDL

b VLDL are the TG rich lipoproteins HDL has 20% cholesterol. IDL has cholesterol and TG in equal amounts. LDL is the richest lipoprotein in cholesterol esters.

7.      Which is important for atherosclerosis?

a.      Increase of HDL

b.      Increase of  LDL

c.      Increase of  Chylomicrons.

b

8.      Gluconic amino acids include:

a.      Alanine.

b.      Methionine.

c.      Valine.

d.      Glutamic acid.

e.      All of the above.

a Ketogenic amino acids are: Leucine and lysine, Mixed amino acids are: Isoleucine, phenylalanine, threonine, tryptophan and tyrosine. Gluconic amino acids are all the other amino acids.

9.      Hypoalbuminemia is associated with all except?

a.      Tetanus

b.      hypocalcaemia

c.      oedema

d.      toxic effect of sulfonamide

a Tetanus is clostridial infection caused be C. tetani has nothing to do with albumin.

10. Diet rich in phenylalanine should be restricted in?

a.      Phenyl ketonuria

b.      Tyrosinemia

c.      Maple syrup disease

a In phenylketonuria, there is ↓ phenylalanine hydroxylase leading to accumulation of phenylpuruvate and its derivatives and their excretion in urine. Diet rich in phenylalanine should be restricted to prevent brain damage

11. Chronic glomerulonephritis is diagnosed by:

a.      Blood urea.

b.      Creatinine.

c.      Proteinuria

d.      All of the above

d In chronic glomerulonephritis, there is persistent deterioration of renal functions ending with renal failure.

12. Nephrotic syndrome is characterized by all except:

a.      Hypocholesterolemia.

b.      Hypoalbuminemia.

c.      Albuminuria.

d.      Hypertriglyceridemia.

e.      None of the above

a Nephrotic syndrome consists of: - Heavy proteinuria. - Hypoalbuminemia. - Oedema. - Hypercholesterolemia (Almost always present). - Hypertriglyceridemia is present in 50% of cases.

13. Which of the following result shows renal impairment?

a.      urea 9 mmol

b.      creatinine 10 mmol/l

c.      urates

d.      cholesterol

e.      urine osmolarity less than 800 after 12 hrs of water deprivation.

e A urine osmolarity less than 800 after 12 hrs of water deprivation denotes renal impairment. Urea 9mmol is high normal (n: 2.9-8.2) and is not a very sensitive measure of GFR. Creatinine, although a sensitive measure of GF, 10umol is normal (n: 53-106) Cholesterol and urates are useless in this regard.

14. Bile duct obstruction can be diagnosed by:

a.      AST

b.      T. Bilirubin

c.      Bilirubin in urine

d.      Ester bilirubin

c Cholestatic hyperbilirubinemia is characterized by conjugated hyperbilirubinemia and hyperbilirubinuria (only the conjugated fraction appears in urine).

15. Hypernatremia occurs with

a.      Cushing disease

b.      Dehydration

c.      hypothalamic injury

d.      All of the above

d Hypernatremia occurs with: -decrease body Na : due to extrarenal water loss or renal diuresis. -Normal body Na: due to extrarenal loss e.g. hyperthermia or renal loss e.g. DI. -Na retention e.g. steroids or Na intake.

16. Regarding excretion of Na+

a.      Not dependent on aldosterone.

b.      Major share of GF osmolarity with associated ions.

c.      It passively diffuses in proximal tubules.

d.      In distal tubules it is exchanged for K+

e.      Coupled with K+

b Na+ excretion is influenced by mineralocorticoids (mainly aldosterone):↑ reabsorption. The GF is isoosmolar with plasma i.e. Na is the major electrolyte. 90% of Na is actively (not passively) reabsorbed in the PCT. K is excreted from DCT in exchange with Na (not the reverse and not coupled with it).

17. All are inborn error of glycogen metabolism except?

a.      Essential fructosuria

b.      Phenyl ketonuria

c.      Galactosemia

d.      Glycogen storage disease

b Essential fructosuria is due to aldolase B defect leading to accumulation of fructose-1-P Galactosemia (serious) is due to decreased Galactose-6-P uridyl transferase leading to decreased glycogen synthesis. Types of glycogen storage diseases (GSD) include: Type I (VonGierke's): ↓ G6P Type II (Pompe's): ↓ lysosomal maltase Type III (Cori's) : ↓debranching enzyme. Type IV (Anderson's): Absent debranching enzyme Type V (McArdle's): ↓ muscles phosphorylation.

18. Xylose test is done to detect the function of:

a.      Stomach.

b.      Pancreas.

c.      Upper small intestine.

d.      Lower small intestine.

e.      Large intestine

c Xylose is absorbed from proximal small intestine independent on pancreas.

19. Which of these is not a ketone body?

a.      Acetone.

b.      Acetoacetic acid.

c.      Butyric acid.

d.      B-hydroxy butyric acid.

e.      None of the above.

c Ketone bodies are formed by condensation of 2 acetyl Co A → Acetoacetic acid which gives B hydroxyl butyric acid by reduction or acetone by decarboxylation. Butyric acid is a fatty acid.

20. All of the following are samples used in the biochemistry lap except :

a.      Serum

b.      Plasma

c.      Urine

d.      Bone marrow aspirate

d

21. What lipoprotein is also referred to as "pre-beta" lipoprotein?

a.      HDL

b.      VLDL

c.      LDL

d.      Lipo B

b

22. ALP is elevated in the following disorder?

a.      Addison's Disease

b.      Paget's Disease

c.      Diabetes Insipidus

d.      Scleroderma

b

23. The renal threshold for glucose is__________________.

a.      180 mg/dl

b.      160 mg/dl

c.      140mg/dl

d.      120 mg/dl

a

24. Feces gets its brown pigmentation from ___________.

a.      Stecobilirubin

b.      Stercobilin

c.      Stercobilinogen

d.      Stecobilin

b

25. What is enzyme is more specific for acute pancreatitis?

a.      AST

b.      Amylase

c.      GGT

d.      Lipase

d

26. The "MM" fraction of CK is most abundant in_______.

a.      Skeletal muscle

b.      Cardiac muscle

c.      Brain tissue

d.      None of the above

a

27. Tetany is caused primarily by__________________,

a.      Hypokalemia

b.      Hyperkalemia

c.      Hypercalcemia

d.      Hypocalcemia

d

28. Hyperkalemia can cause all of the following EXCEPT.

a.      Decreased Vitamin D absorption

b.      Muscle weakness

c.      Heart arrhythmias

d.      Neuromuscular symptoms

a

29. In a hemolytic crisis, bilirubin levels are_____________.

a.      Normal

b.      Increased

c.      Decreased

d.      Unchanged

b

30. All of the following true about Gout except:

a.      is characterized by hyperuricaemia.

b.      is diagnosed by hyperuricaemia

c.      causes scleritis

d.      patient with gout should avoid eating offal

e.      typically affects the first metatarsophalangeal joint.

bWhile hyperuricaemia is important for the development of gout, a high hyperuricaemia is not diagnostic of gout as hyperuricaemia can exists without gout. A definite diagnosis depends on the finding of uric acid crystals within the affected joint by needle aspiration. Deposit of uric acid in the sclera can give rise to scleritis. Uric acid results from the breakdown of nucleic acid and offal (ie. Liver, kidney and heart) is a rich source of such material.

يُتبع  Continued