Biochemistry of Blood & Kidney

1. 12 hours after an acute attack of retrosternal pain a patient presented a jump of aspartate aminotransferase activity in blood serum. What pathology is this deviation typical for?

A. Viral hepatitis

B. Diabetes insipidus

C. Collagenosis

D. Diabetes mellitus

E. *Myocardial infarction

2. A patient who had been working hard under condition of elevated temperature of the environment has now a changed quantity of blood plasma proteins. What phenomenon is the case?

A. Absolute hyperproteinemia

B. *Relative hyperproteinemia

C. Absolute hypoproteinemia

D. Disproteinemia

E. Paraproteinemia

3. 62 y.o. woman complains of frequent pains in the area of her chest and backbone, rib fractures. A doctor assumed myelomatosis (plasmocytoma).What of the following laboratory characteristics will be of the greatest diagnostic importance?

A. Proteinuria

B. Hypoproteinemia

C. Hypoglobunemia

D. Hyperalbuminemia

E. *Paraproteinemia

4. Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. What disorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodies in blood?

A. Metabolic alkalosis

B. *Metabolic acidosis

C. Respiratory alkalosis

D. Respiratory acidosis

Any changes won't happen

5. A 63-year-old woman developed symptoms of rheumatoid arthritis. Their increase of which blood values indicators could be most significant in proving the diagnosis?

A. R-glycosidase

B. Acid phosphatase

C. Lipoproteins

D. General cholesterol

E. *Additive glycosaminoglycans

6. Marked increase of activity of MB-forms of CPK (creatinephosphokinase) and LDH-1 was revealed by examination of the patient's blood. What is the most probable pathology?

A. *Myocardial infarction

B. Hepatitis

C. Pancreatitis

D. Rheumatism

E. Cholecystitis

7. There is high activity of LDH_1,2 , aspartate aminotransferase, creatine phosphokinase in the blood of patient. In what organs (tissues) the development of pathological process is the most probable?

A. *In the heart muscle {initial stage of myocardium infraction}

B. In skeletal muscle {dystrophy, atrophy}

C. In kidneys and adrenals

D. In liver and kidneys

E. In connective tissue

8. The high level of Lactate Dehydrogenase (LDH) isozymes concentration showed the increase of LDH-1 and LDH-2 in a patient’s blood plasma. Point out the most probable diagnosis.

A. Diabetes mellitus

B. Skeletal muscle dystrophy

C. *Myocardial infarction

D. Acute pancreatitis

E. Viral hepatitis

9. Analysis of blood serum of a patient revealed the increase of alanine aminotransferase and aspartate aminotransferase levels. What cytological changes can cause such a situation?

A. Disturbance of genetic apparatus of cells

B. *Cellular breakdown

C. Disorder of enzyme systems of cells

D. Disturbance of cellular interrelations

E. Disturbed energy supply of cells

10. A worker has decreased buffer capacity of blood due to exhausting muscular work. What acidic substance that came to blood caused this phenomenon?

A. 3-phosphoglycerate

B. 1,3-bisphosphoglycerate

C. *Lactate

D. α-ketoglutarate

E. Pyruvate

11. Blood sampling for bulk analysis is recommended to be performed on an empty stomach and in the morning. What changes in blood composition can occur if to perform blood sampling after food intake?

A. Reduced contents of erythrocytes

B. Increased contents of erythrocytes

C. Increased contents of leukocytes

D. *Increased plasma proteins

E. Reduced contents of thrombocytes

12. A 34-year-old patient was diagnosed with chronic glomerulonephritis 3 years ago. Edema has developed within the last 6 months. What caused the edema?

A. Liver dysfunction of protein formation

B. Hyperosmolarity of plasma

C. *Proteinuria

D. Hyperproduction of vasopressin

E. Hyperaldosteronism

13. Examination of a 43 y.o. anephric patient revealed anemia symptoms. What is the cause of these symptoms?

A. Folic acid deficit

B. Vitamin B₁₂ deficit

C. *Reduced synthesis of erythropoietins

D. Enhanced destruction of erythrocytes

E. Iron deficit

14. A 55 y.o. women consulted a doctor about having continuous cyclic uterine hemorrhages for a year, weakness, dizziness. Examination revealed skin pallor. Hemogram: Hb – 70 g/L, erythrocytes-3.2 x 10¹²/L, color index – 0.6; leukocytes – 6.0 x 10⁹/L, reticulocytes – 1%, erythrocyte hypochromia. What anemia is it?

A. *Iron-deficiency anemia

B. B₁₂-folate-deficiency anemia

C. Hemolytic anemia

D. Aplastic anemia

E. Chronic posthemorrhagic anemia

15. Blood plasma of healthy man contains several dozens of proteins. During an illness new proteins can originate named as the “proteins of acute phase». Select such protein from the listed below:

A. Albumin

B. Immunoglobulin G

C. Immunoglobulin E

D. C-reactive protein*

E. Prothrombin

16.A patient complains about dyspnea provoked by the physical activity. Clinical examination revealed anaemia and presence of the para-protein in the zone of gamma- globulins. To confirm the myeloma diagnosis it is necessary to determine the following index in the patient’s urine:

A. Ceruplasmin

B. Bilirubin

C. Antitrypsin

D. Bence Jones protein*

E. Haemoglobin

17.Examination of 27-year-old patient revealed pathological changes in liver and brain. Blood plasma analysis revealed an abrupt decrease in the copper concentration, urine analysis revealed an increased copper, concentration. The patient was diagnosed with Wilson’s degeneration. To confirm the diagnosis it is necessary to study the activity of the following enzyme in blood serum:

A. Leucine aminopeptidase

B. Xanthine oxidase

C. Alcohol dehydrogenase

D. Ceruloplasmin*

E. Carbonic anhydrase

18. After a surgery a 36-year-old woman was given an intravenous injection of concentrated albumin solution. This has induced intensified water movement in the following direction:

A. From the intercellular fluid to the capillaries*

B. No changes of water movement will be observed

C. From the intercellular to the cells

D. From the cells to the intercellular fluid

E. From the capillaries to the intercellular fluid

19. Electrophoretic study of a blood serum sample, taken from the patient with pneumonia, revealed an increase in one of the protein fractions. Specify this fraction:

1. γ-globulins *
2. Albumins
3. α₁-globulins
4. β-globulins
5. α₂-globulins

20. Examination of a 56-year-old female patient with a history of type 1 diabetes revealed a disorder of protein metabolism that is manifested by aminoacidemia in the laboratory blood test values, and clinically by the delayed wound healing and decreased synthesis of antibodies. Which of the following mechanisms causes the development of aminoacidemia?

*Increased proteolysis

Decrease in the concentration of amino acids in blood

Albuminosis

Increase in the oncotic pressure in the blood plasma

Increase in low-density lipoprotein level

21.A 49-year-old male patient with acute pancreatitis was likely to develop pancreatic necrosis, while active pancreatic proteases were absorbed into the blood stream and tissue proteins broke up. What protective factors of the body can inhibit these processes?

Immunoglobulin

Ceruloplasmin, transferrin

*a₂-macroglobulin, a₁-antitrypsin

Cryoglobulin, interferon

Hemopexin, haptoglobin

22. A patient is diagnosed with hereditary coagulopathy that is characterized by factor VIII deficiency. Specify the phase of blood clotting during which coagulation will be disrupted in the given case:

Clot retraction

*Thromboplastin formation

Fibrin formation

-

Thrombin formation

23.A biochemical urine analysis has been performed for a patient with progressive muscular dystrophy. In the given case muscle disease can be confirmed by the high content of the following substance in urine:

Urea

Porphyrin

Hippuric acid

*Creatine

Creatinine

24. A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol – 12.3 mmol/l, total lipids – 8.2 g/l, increased low-density lipoprotein fraction (LDL). What type of hyperlipoproteinemia is observed in the patient?

Hyporlipoproteinemia type I.

Hyperlipoproteinemia type IV

Cholesterol, hyperlipoproteinemia

*Hyperlipoproteinemia type IIa

Hyperlipoproteinemia type IIb

25. Human red blood cells do not contain mitochondria. What is the main pathway for ATP production in these cells?

Creatine kinase reaction

*Anaerobic glycolysis

Cyclase reaction

Aerobic glycolysis

Oxidative phosphorylation

26. Lymphocytes and other cells of our body synthesize universal antiviral agents as a response to viral invasion. Name this protein factors

Interferon*

Tumor necrosis factor

Cytokines

Interleukin-2

Interleukin-4

27. Biochemical analysis of an infant`s erythrocytes revealed evident glutathione peroxidase deficiency and low concentration of reduced glutathione. What pathological condition can develop in this infant?

Hemolytic anemia*

Megaloblastic anemia

Siclemia

Iron-deficiency anemia

Pernicous anemia

28. A 28-year-old patient undergoing treatment in a pulmonological department has been diagnosed with pulmonary emphysema caused by splitting of alveolar septum by tripsin. The disease is caused by the congenital deficiency of the following protein:

Alpha-1-proteinase inhibitor*

Haptoglobin

Cryoglobulin

Alpha-2-macroglobulin

Transferrin

Date: 2016-04-22; view: 2218