Clinical pathology

1. 1Liver enzymes are measure in concentration

   1. ATrue
   2. BFalse
2. 2The magnitude of increased in liver enzyme correlates to the degree of damage

   1. ATrue
   2. BFalse
3. 3What can be ascertained from raised liver enzymes?

   1. APrognosis of damage
   2. BReversibility of damage
   3. CDegree of cellular damage
   4. DHepatocellular function
4. 4What condition is not associated with mild increases in AST?

   1. AMuscle damage
   2. BHaemolysis
   3. CCholestasis
   4. DCirrhosis
5. 5What liver enzyme is used principally to detect hepatocyte damage in small animals?

   1. AALT
   2. BAST
   3. CGGT
   4. DALP
   5. EGLDH
6. 6What is AST?

   1. AMainly liver specific
      Detects small animal hepatocyte damage
   2. BPresent in the liver and muscle
      Detects large animals hepatocyte damage
   3. CHepatocyte specific
      Detects cholestasis in large animals
   4. DPresent in the liver and muscle
      Used to detect cholestasis in small animals
7. 7Myocyte damage is not associated with mild increases in what enzyme?

   1. AAST
   2. BALT
   3. CSDH
   4. DLDH
8. 8Which enzyme is not normally used for large animal liver evaluation?

   1. AALP
   2. BGGT
   3. CALT
   4. DLDH
9. 9Which enzyme can be raised by muscle damage and haemolysis ?

   1. AGLDH
   2. BSDH
   3. CAST
   4. DGGT
10. 10Small increases in liver enzymes are always significant in small animals

    1. ATrue
    2. BFalse

11. 11Which liver enzyme is most useful for determining cholestasis in small animals?

    1. AALT
    2. BGGT
    3. CAST
    4. DALP
12. 12How many isoenzymes are there of ALP?

    1. A2
    2. B4
    3. C1
    4. D3
13. 13Which is the most sensitive parameter for detecting cholestasis?

    1. ABile acids
    2. BRaised cholesterol
    3. CRaised ALP
    4. DRaised GGT
14. 14What breed of dog may have high activity of ALP?

    1. ADalmatians
    2. BGSD
    3. CScottish terrier
    4. DBedlington terrier
15. 15What ALP isofrom is a neagtive prognostic indicator in osteosarcoma?

    1. AL-ALP
    2. BI-ALP
    3. CC-ALP
    4. DB-ALP
16. 16What ALP isoform does not contribute to plasma ALP levels?

    1. AC-ALP
    2. BB-ALP
    3. CL-ALP
    4. DI-ALP
17. 17What ALP isoform is associated with hyperthyroidism in cats?

    1. AB-ALP
    2. BC-ALP
    3. CI-ALP
    4. DL-ALP
18. 18What product of haem breakdown is transported bound to albumin?

    1. AUrobillogen
    2. BStercobilin
    3. CUnconjugated bilirubin
    4. DConjugated bilirubin
19. 19How is sterocobilin produced?

    1. APhagocytosis by macrophages
    2. Bglucuronidation in the liver
    3. CMetabolism by bacterial proteases
    4. DOxidation by bacteria
20. 20What product of haem breakdown is excreted mainly in urine filtrate

    1. ABilirubin
    2. BUrobillin
    3. CConjugated bilirubin
    4. DStercobillin
21. 21What percentage of urobillinogen is resorbed from the gut?

    1. A5%
    2. B10%
    3. C15%
    4. D20%
22. 22What is an example of prehepatic cholestasis?

    1. ACirrhosis
    2. BPyrazine alkaloid poisoning
    3. CIMHA
    4. DObstruction of the bile duct
23. 23What form of hyperbilirubinaemia is caused by reduced uptake and conjugation of bilirubin?

    1. APre hepatic
    2. Bhepatic
    3. Cpost hepatic
24. 24Which finding is not associated with cholestasis due to bile obstruction

    1. AHighly elevated ALP
    2. BHighly elevated AST
    3. CHigh serum cholesterol
    4. DHigh conjugated serum bilirubin
25. 25What will be associated with prehepatic hyperbilirubinaemia?

    1. APale mm and tachycardia
    2. BHighly elevated ALT
    3. CVery high serum cholesterol
26. 26Which is not associated with raised unconjugated bilirubin?

    1. AHaemolytic anaemia
    2. BFasting equine hyperbilirubinaemia
    3. CBile duct obstruction
27. 27Jaundice persists for a long time after liver function has returned to normal?

    1. ATrue
    2. BFalse
28. 28What condition will not present with bilirubinuria?

    1. AHaemolytic anaemia
    2. BCholestasis
    3. CDelta-bilirubinaemia
29. 29What are the useful biochemistry findings of reduced hepatic function?

    1. AIncrease in conjugated bilirubin
    2. BIncrease in unconjugated bilirubin
    3. CDecreased albumin
    4. DIncreased BUN
    5. ECoagulopathies
    6. FHypoglycaemia
    7. GHypercholesterolaemia
30. 30What is not a sign of altered hepatic blood flow?

    1. AIncreased plasma bile acids
    2. BReduced ammonia
    3. CRaised immunoglobulins
31. 31How is ammonia produced?

    1. AMetabolism by hepatocytes
    2. BMetabolism by the kidneys
    3. CProtein digestion in the GIT
32. 32What disease is not associated with raised ammonia in plasma (BUN)?

    1. APSS
    2. BUrea cycle enzyme deficit
    3. CCirrhosis
    4. DBile obstruction
33. 33What is hepatic encephalopathy associated with?

    1. AHypoglycaemia due to reduced gluconeogenesis
    2. BHyperbilirubinaemia due to cholestasis
    3. CHypercholesterolaemia due to IMHA
    4. DReduced ammonia metabolism due to reduced detoxification by the liver
34. 34What coagulation factor results are associated with loss of hepatic function?

    1. AIncreased PT
    2. BIncreased fibrinogen
    3. CIncreased PTT
35. 35What is an non-enzymatic clotting factor?

    1. AII
    2. BVII
    3. CFibrinogen (I)
    4. DXIII
36. 36Which will alter first in a coagulopathy?

    1. APT
    2. BPTT
    3. CFibrinogen
37. 37Bile acids
    Bile acids are produced by h[blank_start]epatocytes[blank_end] and released into the biliary system and then the i[blank_start]ntestine[blank_end]
    Amphipathic steroids synthesised from c[blank_start]holesterol[blank_end]
    Allow fat d[blank_start]igestion[blank_end] – e[blank_start]mulsification[blank_end] of fats
    o M[blank_start]icelle[blank_end] formation → solubilising of lipids within the intestine and facilitating their digestion and a[blank_start]bsorption[blank_end]
    90% of BAs are then absorbed from the i[blank_start]leum[blank_end] and enter the portal vein – return to the liver and re-c[blank_start]irculate[blank_end]
    Serum bile acids are used to access hepatic f[blank_start]unction[blank_end] – indicated for further evaluation of persistently elevated serum liver activity
    Used for suspected P[blank_start]SS[blank_end] or c[blank_start]irrhosis[blank_end] and monitoring patients with hepatic disease
    

    1. Aepatocytes
    2. Bntestine
    3. Cholesterol
    4. Digestion
    5. Emulsification
    6. Ficelle
    7. Gbsorption
    8. Hleum
    9. Iirculate
    10. Junction
    11. KSS
    12. Lirrhosis
38. 38The maximum sensitivity of a bile acid stimulation test is using a 12hr fasting preprandial sample and a 2 hour postprandial sample

    1. ATrue
    2. BFalse
39. 39What does not reduce the accuracy of the bile acid stimualtion test

    1. AHaemolysis
    2. BLipaemia
    3. CCorticosteroid use
    4. DIleal disease
40. 40What disease will increase serum bile acids?

    1. AIMHA
    2. BPhenobarbitone administation
    3. CPSS
    4. DAnti-epileptic therapy
41. 41Magnitude of bile acid increase is associated with prognosis

    1. ATrue
    2. BFalse
42. 42Which is more sensitive for liver disease?

    1. ABilirubinaemia
    2. BBile acid stimulation
43. 43What is an normal result for fasting BA?

    1. A25-30
    2. B>30
    3. C>25
    4. D15-20
44. 44The bile acid stimulation test cannot differentiate between cholestasis and hepatopathy

    1. ATrue
    2. BFalse
45. 45What will have a marked elevation in bile acids?

    1. AHypoxia
    2. BDiabetes
    3. CSepsis
    4. DPancreatitis
46. 46What haematology result is associated with cats with lipodosis?

    1. AMicrocytosis
    2. BOvalocytes
    3. CAcanthocytes
47. 47What are acanthocytes?

    1. AReduced red cell size
    2. BOvoid shaped erythrocytes
    3. CCaused by shearing forces on erythrocytes
48. 48What erythrocyte morphology is associated with Fe insufficiency?

    1. AAcanothocytes
    2. BMacrocytosis
    3. CMicrocytosis
    4. DOvalocytes
49. 49What is not associated with liver disease in dogs?

    1. APUPD
    2. BHyposthenuria
    3. CAmmonium biurate crystals
    4. DBilirubinuria (+)
50. 50What breed is not susceptible to urate urolithiasis

    1. ADalmatians
    2. BEnglish springer spaniel
    3. CMiniature schnauzer
    4. DEnglish bulldogs
51. 51WHat form of bilirubin is excreted in urine?

    1. AUnconjugated
    2. BConjugated
52. 52What is a function of the endocrine pancreatic cells?

    1. ASecretion of pancreatic enzymes
    2. BBicarbonate secretion
    3. CIncreases B12 absorption
    4. DSecretes insulin
    5. EAids zinc absorption
53. 53What test is used to assess pancreatic integrity

    1. AEnzyme assay
    2. BBA stimulation
    3. CLipaemia
54. 54What enzyme hydrolyses starch, has a short half life and shouldnt be present in normal blood plasma?

    1. ALipase
    2. BAmylase
    3. CTrypsin
55. 55High enzyme has a very short half life and is more useful in dog pancreatic analysis compared to cats?

    1. AAmylase
    2. BLipase
56. 56Which test has a higher specificity for pancreatitis?

    1. AAmylase
    2. BLipase
    3. CDGGR
57. 57What is the cut off for normal in the dog DGGR lipase test?

    1. A>34
    2. B>21
    3. C>15
    4. D>40
58. 58Which test does not quantify pancreatic enzyme activity?

    1. AAmylase
    2. BDGGR
    3. CLipase
    4. DcPL
59. 59Which pancreatic enzyme has the shortest half life?

    1. AAmylase
    2. BLipase
60. 60What cPL level is associated with pancreatitis?

    1. A0
    2. B100
    3. C200
    4. D400
61. 61What are the criteria for pancreatitis in dogs?

    1. AAbdominal ultrasound with evidence of pancreatitis
    2. BPresence of surgical disease
    3. CcPL >400
    4. DcPL>200
    5. ESerum DGGR >34
    6. FGross lipaemia
    7. GSerum PE-1 >17.24ng/l
    8. HTotal lipase 3x greater than the reference interval
62. 62What is not another cause of raised pancreatic enzymes that pancreatitis?

    1. AGI obstruction
    2. BHAC
    3. CHypoT
    4. DIMHA
63. 63What test is most important in the diagnosis of exocrine pancreatic insufficiency?

    1. AcPL
    2. BSerum amylase
    3. CSerum lipase
    4. DTLI
64. 64What serum TLI is associated with EPI in dogs?

    1. A3.5
    2. B2.5
    3. C8
    4. D1.5
65. 65What is not associated with EPI in cats?

    1. ALow B12
    2. BChronic D+
    3. CSerum TLI>2.5
    4. DSerum TLI>8
66. 66What is a functional cause of dysphagia

    1. AObstructive neoplasia
    2. BForeign body
    3. CSecondary hyperparathyroidism
    4. DHypothyroidism

Description

Small animal studies Quiz on Clinical pathology , created by Naomi Hall on 18/02/2019.

Author

Naomi Hall

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