Second Midterm Examination - Past
For each of the following questions, pick the most appropriate answer of those provided:
1) Hyperammonemia is caused by lack of which of the following enzymes?
a) Ornithine Carbamoyltransferase (OCT) b) GLDH
c) Alkaline Phosphatase (ALP) d) Alanine Transaminase (ALT)
2) Total cholesterol assay is based on which of the following methods?
a) Precipitation by PEG & MgCl2 b) Sequential enzymatic reactions producing a pink complex
c) Mathematical calculation d) Electrophoretic movement coupled with isoelectric focusing
3) Increased serum creatinine and azotemia are features of each of the following disorders EXCEPT:
a) Glomerulonephritis b) Renal Tubular Acidosis
c) Nephrotic Syndrome d) Renal Failure
4) The most sensitive test for renal disease is:
a) Proteinuria b) Hematuria
c) Serum creatinine d) BUN
5) Which of the following specimens must be put on ice during delivery?
a) Arterial blood for ABG’s b) Blood for ammonia
c) Urine for bilirubin d) a & b
State whether the following sentences are true or false:
-Hypoalbuminemia is associated with chronic hepatocellular damage.
-Hemolysis poses no effect on ammonia nor cholesterol blood levels.
-GGT is the most sensitive test for alcoholic liver disease.
-Biliary obstruction presents with increased direct bilirubin and ALP activity.
-Elevated ADH produces urine with low osmolality (high serum/urine osm. ratio).
-Results of renal function will not be abnormal unless 20% of function has been lost.
-Reagent strip pad for blood is based on hemoglobin's ability to reduce peroxides.
-Hypothyroidism may lead to hyperlipidemia.
-Cholesterol:HDL ratio is the best parameter for assessing the risk of CHD.
-Familial hypercholesterolemia type IV is characterized by a turbid appearance of serum.
A two year old boy was admitted to Accident and Emergency unconscious and hyperventilating. History revealed painkiller administration. The boy had the following clinical chemistry results:
Serum:
Sodium = 130 mmol/L
Potassium = 3.3 mmol/L
Chloride = 94 mmol/L
Arterial Blood:
pH = 7.24
pCO2 = 31 mmHg
HCO3- = 15 mmol/L
(a) What’s the primary acid-base disturbance?
(b) What’s the likeliest cause? Justify your answer.
(c) What further test(s) would be helpful.