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Hyperbilirubinemias- Part 1
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Hyperbilirubinemias- Part 1 | Hyperbilirubinemias- Part 2
1.What proportion of bilirubin is derived from degradation of
the hemoglobin of senescent red blood cells ?
A. ~ 30 – 50 %
B. ~ 50 – 70 %
C. ~ 70 – 90 %
D. ~ 100 %
2.Glutathione-S-transferase is related to which of the following
steps in bilirubin metabolism ?
A. Hepatocellular uptake
B. Intracellular binding
C. Conjugation
D. Biliary excretion
3. Bilirubin-UDP-glucuronosyltransferase is related to which of
the following steps in bilirubin metabolism ?
A. Hepatocellular uptake
B. Intracellular binding
C. Conjugation
D. Biliary excretion
4. Aqueous insolubility of bilirubin is due to which of the
following ?
A. Internal phosphate bonding
B. Internal hydrogen bonding
C. Internal sulphate bonding
D. All of the above
5. UDP-glucuronosyltransferases (UGT) that conjugate bilirubin
belong to which UGT family ?
A. UGT1
B. UGT2
C. UGT3
D. UGT4
6. Human UGT1 gene complex is on which of the following
chromosomes ?
A. 2
B. 4
C. 6
D. 8
7. Multidrug resistance – associated protein 2 (MRP2) is related
to which of the following steps in bilirubin metabolism ?
A. Hepatocellular uptake
B. Intracellular binding
C. Conjugation
D. Biliary excretion
8. Which of the following is false about urobilinogen ?
A. Made from unconjugated bilirubin in gut
B. Water-soluble
C. Colorless
D. Undergoes enterohepatic cycling
9. Which of the following interrupts bilirubin enterohepatic
cycling ?
A. Aluminum hydroxide
B. Magnesium sulphate
C. Calcium phosphate
D. Calcium carbonate
10. In response to hemolytic stress, bone marrow is capable of
increasing erythrocyte production by ?
A. Two fold
B. Four fold
C. Six fold
D. Eight fold
11. Hemolysis alone cannot result in a sustained hyperbilirubinemia
of more than ?
A. ~2 mg/dL
B. ~4 mg/dL
C. ~6 mg/dL
D. ~8 mg/dL
12. Direct-reacting fraction is how much of total serum bilirubin in
isolated hemolysis ?
A. <= 10 %
B. <= 12 %
C. <= 15 %
D. <= 18 %
13. Ineffective erythropoiesis is seen in all except ?
A. Thalassemia major
B. Congenital erythropoietic porphyria
C. Crigler-Najjar syndrome
D. Lead poisoning
14. Which of the following produces hyperbilirubinemia due to
decreased hepatic bilirubin uptake ?
A. Pregnanediol
B. Chloramphenicol
C. Gentamicin
D. Cholecystographic contrast agents
15. Fetal bilirubin is cleared by ?
A. Fetal liver
B. Fetal kidney
C. Placenta
D. All of the above
16. Most neonates develop mild unconjugated hyperbilirubinemia
between days ?
A. 1 and 3 after birth
B. 2 and 5 after birth
C. 5 and 7 after birth
D. 7 and 10 after birth
17. What are the peak levels of physiologic neonatal jaundice ?
A. 3 – 5 mg/dL
B. 5 – 10 mg/dL
C. 10 – 15 mg/dL
D. 15 – 20 mg/dL
18. Bilibubin levels of physiologic neonatal jaundice return to
normal adult concentrations within ?
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks
19. Which of the following is false for bilirubin encephalopathy, or
kernicterus ?
A. Rapidly rising unconjugated bilirubin concentration
B. Immature blood-brain barrier
C. Deposition in the basal ganglia
D. None of the above
20. Which of the following drugs may produce unconjugated
hyperbilirubinemia by inhibiting UGT1A1 activity ?
A. Pregnanediol
B. Chloramphenicol
C. Gentamicin
D. All of the above
21. ‘Breast milk jaundice’ in neonates is due to presence of what in
breast milk ?
A. Immunoglobulins
B. Proteins
C. Fatty acids
D. Carbohydrates
22. Lucey-Driscoll syndrome is related to ?
A. UGT1A1 inhibitor in breast milk
B. UGT1A1 inhibitor in maternal serum
C. Low UGT1A1 levels at birth
D. All of the above
23. Which of the following about Crigler-Najjar Syndrome, Type I
is false ?
A. Unconjugated hyperbilirubinemia of ~ 20 – 45 mg/dL
B. Appears in the neonatal period
C. Persists for life
D. Bilirubin is found in the urine
24. Which of the following about Crigler-Najjar Syndrome, Type I
is false ?
A. Normal serum aminotransferases
B. Normal alkaline phosphatase
C. No evidence of hemolysis
D. None of the above