Unit 1: Carbohydrates d. Oligosaccharides 9.

Type 2 Diabetes Mellitus is often

associated with:
1. What is the primary function of 5. What is the term for the process by which a. Insulin resistance and relative insulin
carbohydrates in the human body? cells take up glucose from the bloodstream? deficiency*
a. Energy storage a. Glycolysis b. Autoimmune destruction of pancreatic
b. Structural support b. Gluconeogenesis cells
c. Cell communication c. Glycogenesis c. Excessive insulin production
d. All of the above* d. Glucose uptake* d. None of the above

2. Where does the digestion of 6. Which hormone is responsible for 10. Which investigation is commonly used
carbohydrates primarily begin in the human lowering blood glucose levels by promoting to diagnose diabetes mellitus and assess
digestive system? glucose uptake by cells? glucose tolerance?
a. Stomach a. Insulin* a. HbA1c
b. Small intestine* b. Glucagon b. OGTT (Oral Glucose Tolerance Test)*
c. Mouth c. Epinephrine c. GCT (Glucose Challenge Test)
d. Large intestine d. Cortisol d. Fasting blood glucose test

3. Which enzyme is responsible for the 7. Diabetes Mellitus is characterized by: 11. What is the primary indication for
breakdown of complex carbohydrates into a. Hyperglycemia* conducting an Oral Glucose Tolerance Test
simpler sugars during digestion? b. Hypoglycemia (OGTT)?
a. Amylase* c. Normoglycemia a. Monitoring daily glucose levels
b. Lipase d. Hyperinsulinemia b. Diagnosis of diabetes mellitus*
c. Protease c. Assessing HbA1c levels
d. Nuclease 8. What are the main symptoms of Type 1 d. Screening for hypoglycemia
Diabetes Mellitus?
4. In which form are most carbohydrates a. Polyphagia, polydipsia, polyuria* 12. How is OGTT performed?
absorbed in the small intestine? b. Weight gain, fatigue, hypertension a. Fasting overnight, followed by
a. Monosaccharides* c. Hyperactivity, insomnia, bradycardia consuming a glucose solution and
b. Disaccharides d. None of the above measuring blood glucose at intervals*
c. Polysaccharides b. Random blood glucose measurement
c. Continuous glucose monitoring d. Decreased glucose uptake by cells
d. Postprandial blood glucose test 21. What is the primary role of HbA1c in
17. How is hypoglycemia defined? diabetes management?
13. What is the main purpose of HbA1c a. Fasting blood glucose above 200 mg/dL a. Monitoring daily fluctuations in blood
testing in diabetes management? b. Postprandial blood glucose below 70 glucose
a. Diagnosing diabetes mg/dL* b. Assessing short-term changes in blood
b. Monitoring short-term changes in blood c. HbA1c levels above 8% glucose
glucose d. Random blood glucose below 100 mg/dL c. Providing an average of blood glucose
c. Assessing long-term glycemic control* levels over the past 2-3 months*
d. Evaluating insulin resistance 18. What is a potential cause of reactive d. Diagnosing diabetes mellitus
hypoglycemia?
14. What does GCT stand for in the context a. Tumor-induced hyperglycemia 22. Extended Glucose Tolerance Test
of diabetes investigations? b. Excessive alcohol consumption (eGTT) involves:
a. Glucose Clearance Test c. Delayed insulin response after eating* a. Fasting overnight followed by blood
b. Glucose Challenge Test* d. Insulinoma glucose measurement
c. Glycogen Content Test b. Repeated glucose measurements over an
d. Glucose Control Test 19. Which of the following is NOT a extended period after a glucose load*
symptom of hypoglycemia? c. Continuous monitoring of blood glucose
15. In hypoglycemia, blood glucose levels a. Sweating for 24 hours
are: b. Hyperactivity d. Oral glucose challenge without fasting
a. Normal c. Confusion
b. Elevated d. Weight gain* 23. Mini GTT is a shortened version of:
c. Below normal* a. Glucose Clearance Test
d. Unchanged 20. What are the common causes of b. Glucose Challenge Test*
hypoglycemia in diabetic patients? c. Glycogen Content Test
16. What is the primary cause of a. Overeating d. Glucose Control Test
hypoglycemia? b. Skipping meals
a. Excessive carbohydrate intake c. Excessive insulin or oral hypoglycemic 24. What is the primary goal of managing
b. Insufficient insulin production* medication* diabetes mellitus?
c. Overproduction of glucagon d. A and B a. Normalizing blood glucose levels*
b. Inducing hyperglycemia for weight loss c. Has no effect on blood glucose
c. Preventing insulin resistance d. Promotes glucose uptake by cells 33. What is the primary symptom of
d. Eliminating insulin production hyperglycemia?
29. Which of the following is a a. Excessive thirst
25. Which of the following is a long-term polysaccharide found in the human body? b. Increased urination
complication of diabetes mellitus? a. Glucose c. Elevated blood glucose levels*
a. Hypoglycemia b. Fructose d. A and B
b. Diabetic ketoacidosis c. Glycogen*
c. Nephropathy, neuropathy, and d. Sucrose 34. Which of the following is an example of
retinopathy* a monosaccharide?
d. Hyperinsulinemia 30. In which organ is glycogen primarily a. Sucrose
stored? b. Lactose
26. What is the primary role of insulin in a. Liver* c. Glucose*
blood glucose regulation? b. Pancreas d. Maltose
a. Stimulating glycogenolysis c. Kidney
b. Inhibiting gluconeogenesis d. Spleen 35. What is the primary function of the
c. Promoting glucose uptake by cells* hormone cortisol in glucose regulation?
d. A and B 31. Which hormone is responsible for a. Stimulates glucose uptake by cells
promoting glycogenolysis and b. Inhibits gluconeogenesis
27. What is the primary source of glucose gluconeogenesis? c. Promotes glycogenolysis and
during a prolonged fasting state? a. Insulin gluconeogenesis*
a. Glycogenolysis b. Glucagon* d. Lowers blood glucose levels
b. Gluconeogenesis* c. Epinephrine
c. Glycolysis d. Cortisol 36. What is the role of the pancreas in blood
d. Glucose uptake by cells glucose regulation?
32. What is the role of insulin in the liver? a. Produces insulin and glucagon*
28. What is the effect of glucagon on blood a. Promotes glycogenolysis b. Produces cortisol
glucose levels? b. Inhibits gluconeogenesis c. Stores glycogen
a. Decreases blood glucose levels c. Stimulates glycogenesis* d. Regulates glucose uptake by cells
b. Increases blood glucose levels* d. A and B
37. Which of the following is a symptom of 41. What is the primary cause of Type 1 45. What is the function of HbA1c in
hypoglycemia? Diabetes Mellitus? diabetes monitoring?
a. Polyuria a. Insulin resistance a. Reflects recent changes in blood glucose
b. Excessive hunger b. Autoimmune destruction of pancreatic b. Provides an average of blood glucose
c. Confusion and irritability* beta cells* levels over the past 2-3 months*
d. Blurred vision c. Obesity c. Measures fasting blood glucose
d. Genetic factors d. Predicts future glucose levels
38. What is the primary function of
glucagon in blood glucose regulation? 42. How does the body respond to 46. Which of the following is a
a. Promotes glycogenolysis hypoglycemia to restore normal blood characteristic feature of Type 2 Diabetes
b. Stimulates gluconeogenesis glucose levels? Mellitus?
c. Increases blood glucose levels* a. Increased insulin secretion a. Onset in childhood
d. A and B b. Release of glucagon and epinephrine* b. Insulin dependence from the time of
c. Inhibition of glucose uptake by cells diagnosis
39. Which type of diabetes mellitus is d. A and B c. Insulin resistance and relative insulin
characterized by insulin dependence from deficiency*
the time of diagnosis? 43. What is the primary effect of insulin on d. Rapid progression to ketoacidosis
a. Type 1 Diabetes Mellitus* adipose tissue?
b. Type 2 Diabetes Mellitus a. Inhibits lipolysis 47. What is the primary role of glucose in
c. Gestational diabetes b. Stimulates lipogenesis* cellular metabolism?
d. Maturity-Onset Diabetes of the Young c. Promotes fatty acid oxidation a. Source of energy*
(MODY) d. A and B b. Structural component of DNA
c. Precursor for amino acid synthesis
40. Which of the following is an example of 44. What is the primary storage form of d. Carrier of oxygen in blood
a complex carbohydrate? carbohydrates in plants?
a. Glucose a. Glycogen 48. What is the main difference between
b. Fructose b. Starch* Type 1 and Type 2 Diabetes Mellitus?
c. Starch* c. Cellulose a. Insulin resistance
d. Sucrose d. Sucrose b. Age of onset
c. Insulin dependence from the time of 2. How are fatty acids classified based on 6. What are the essential fatty acids that the
diagnosis* the presence of double bonds? human body cannot synthesize and must be
d. Genetic factors a. Saturated and unsaturated* obtained from the diet?
b. Monounsaturated and polyunsaturated a. Oleic acid and linoleic acid
49. What is the primary function of c. Short-chain and long-chain b. Linoleic acid and linolenic acid*
glycogen in the body? d. Essential and non-essential c. Palmitic acid and stearic acid
a. Long-term energy storage* d. Arachidonic acid and eicosapentaenoic
b. Short-term energy storage 3. Which of the following fatty acids is acid
c. Structural support considered essential for humans?
d. Facilitates cell communication a. Oleic acid 7. How are ketone bodies formed from
b. Linoleic acid* lipids in the body?
50. What is the primary role of the enzyme c. Palmitic acid a. By glycolysis
amylase in carbohydrate digestion? d. Stearic acid b. By beta-oxidation of fatty acids*
a. Breaks down disaccharides into c. By deamination of amino acids
monosaccharides 4. What is the clinical significance of d. By gluconeogenesis
b. Hydrolyses complex carbohydrates into monounsaturated fatty acids (MUFA)?
simpler sugars* a. They promote cardiovascular health 8. What is the clinical significance of ketone
c. Converts glucose into glycogen b. They contribute to insulin resistance bodies?
d. Facilitates glucose uptake by cells c. They are associated with a reduced risk of a. They serve as structural components of
heart disease* cell membranes
d. A and B b. They provide an alternative energy
Unit 2: Lipids source during fasting or low carbohydrate
5. Trans fatty acids are primarily formed intake*
1. What is the primary function of fatty during: c. They are precursors for steroid hormones
acids in the human body? a. Lipid absorption d. They promote insulin resistance
a. Energy storage b. Hydrogenation of oils*
b. Structural support c. Lipolysis 9. Which compound is a precursor for the
c. Cell communication d. Lipogenesis synthesis of steroid hormones, bile acids,
d. All of the above* and vitamin D?
a. Triglycerides
b. Cholesterol* 13. What is the lipid profile primarily used 17. What is the primary source of
c. Phospholipids to assess? triglycerides in the human diet?
d. Ketone bodies a. Blood glucose levels a. Meat and dairy products
b. Cholesterol and triglyceride levels* b. Nuts and seeds
10. What are lipoproteins primarily c. Ketone body concentration c. Oils and fats*
responsible for transporting in the d. Lipoprotein metabolism d. Fruits and vegetables
bloodstream?
a. Amino acids 14. Atherosclerosis is characterized by: 18. Which type of fatty acid has at least one
b. Glucose a. Accumulation of fatty acids in the liver double bond between carbon atoms?
c. Lipids* b. Formation of plaques in arteries due to a. Saturated fatty acid
d. Oxygen the deposition of cholesterol and other b. Monounsaturated fatty acid
substances* c. Polyunsaturated fatty acid*
11. What is the main function of c. Excessive synthesis of ketone bodies d. Trans fatty acid
lipoproteins in the body? d. Hypersecretion of lipoproteins
a. Energy storage 19. Lipoproteins transport lipids in the form
b. Structural support 15. How are lipids primarily absorbed in the of:
c. Transport of lipids in the bloodstream* small intestine? a. Chylomicrons
d. Facilitating cell communication a. In the stomach b. Free fatty acids
b. By passive diffusion c. Triglycerides*
12. Which of the following is a function of c. In the large intestine d. A and B
high-density lipoprotein (HDL)? d. Through the formation of micelles and
a. Transport of cholesterol to peripheral chylomicrons* 20. What is the primary role of triglycerides
tissues in the human body?
b. Transport of cholesterol from peripheral 16. Which lipoprotein is often referred to as a. Structural support
tissues to the liver* "bad cholesterol"? b. Source of energy*
c. Transport of triglycerides to adipose a. Low-density lipoprotein (LDL)* c. Precursor for steroid hormones
tissue b. High-density lipoprotein (HDL) d. Facilitates cell communication
d. A and C c. Very-low-density lipoprotein (VLDL)
d. Intermediate-density lipoprotein (IDL)
21. Which of the following is a b. Structural support d. A and B
characteristic feature of low-density c. Formation of lipid bilayers and cell
lipoprotein (LDL)? membranes* 28. Which lipoprotein is the largest and least
a. High protein content d. Facilitating cell communication dense among lipoproteins?
b. Transports cholesterol from peripheral a. Low-density lipoprotein (LDL)
tissues to the liver 25. Which lipoprotein is involved in b. Very-low-density lipoprotein (VLDL)
c. Elevated levels associated with an transporting dietary lipids from the intestine c. Intermediate-density lipoprotein (IDL)
increased risk of atherosclerosis and to other tissues? d. Chylomicrons*
cardiovascular disease* a. Low-density lipoprotein (LDL)
d. A and C b. Very-low-density lipoprotein (VLDL) 29. What is the primary role of cholesterol
c. High-density lipoprotein (HDL) in the body?
22. What is the role of essential fatty acids d. Chylomicrons* a. Energy storage
in the body? b. Structural support
a. Energy storage 26. What is the main function of lipase in c. Precursor for steroid hormones, bile
b. Structural support lipid digestion? acids, and vitamin D*
c. Precursors for the synthesis of a. Breaks down phospholipids into fatty d. Facilitating cell communication
eicosanoids and other bioactive acids
compounds* b. Hydrolyzes triglycerides into fatty acids 30. What is the main function of very-low-
d. Facilitating cell communication and glycerol* density lipoprotein (VLDL)?
c. Converts cholesterol into bile acids a. Transporting dietary lipids from the
23. What is the primary function of bile d. Promotes lipid synthesis intestine to other tissues
acids in lipid digestion? b. Transporting endogenous triglycerides
a. Emulsification of dietary lipids* 27. What is the clinical significance of from the liver to peripheral tissues*
b. Hydrolysis of triglycerides polyunsaturated fatty acids (PUFA)? c. Transporting cholesterol from peripheral
c. Synthesis of ketone bodies a. They are associated with an increased risk tissues to the liver
d. Absorption of lipids in the small intestine of heart disease d. A and C
b. They contribute to insulin resistance
24. What is the significance of c. They have anti-inflammatory effects and 31. How are trans fatty acids formed during
phospholipids in cellular membranes? may reduce the risk of cardiovascular food processing?
a. Energy storage disease* a. By fermentation
b. By hydrogenation of oils* c. Emulsification of dietary lipids*
c. By enzymatic digestion d. Transport of lipids in the bloodstream 39. How does cholesterol reach peripheral
d. By oxidation of lipids tissues in the body?
36. Which lipoprotein is synthesized in the a. Transported by chylomicrons
32. What is the primary function of liver and primarily transports endogenous b. Synthesized within peripheral tissues
phospholipids in the body? triglycerides? c. Transported by low-density lipoprotein
a. Energy storage a. Chylomicrons (LDL)*
b. Structural support b. Low-density lipoprotein (LDL) d. A and B
c. Formation of cell membranes and c. Very-low-density lipoprotein (VLDL)*
surfactants* d. High-density lipoprotein (HDL) 40. Which lipoprotein is involved in the
d. Precursor for steroid hormones reverse cholesterol transport process?
37. How do saturated fatty acids differ from a. Very-low-density lipoprotein (VLDL)
33. Which lipoprotein is often referred to as unsaturated fatty acids? b. Low-density lipoprotein (LDL)
"good cholesterol"? a. Saturated fatty acids have double bonds, c. Intermediate-density lipoprotein (IDL)
a. Low-density lipoprotein (LDL) while unsaturated fatty acids do not d. High-density lipoprotein (HDL)*
b. Very-low-density lipoprotein (VLDL) b. Unsaturated fatty acids have no carbon-
c. High-density lipoprotein (HDL)* carbon double bonds, while saturated fatty 41. Which of the following lipoproteins is
d. Intermediate-density lipoprotein (IDL) acids do not* synthesized in the intestine and transports
c. Both have the same chemical structure dietary lipids?
34. Which of the following lipoproteins is d. Saturated fatty acids are liquid at room a. Very-low-density lipoprotein (VLDL)
the densest and smallest? temperature, while unsaturated fatty acids b. Low-density lipoprotein (LDL)
a. Chylomicrons are solid c. High-density lipoprotein (HDL)
b. Very-low-density lipoprotein (VLDL) d. Chylomicrons*
c. Low-density lipoprotein (LDL) 38. Which lipoprotein transports cholesterol
d. High-density lipoprotein (HDL)* from peripheral tissues to the liver for 42. What is the primary role of lipids in the
excretion? body?
35. What is the primary function of bile a. Chylomicrons a. Energy storage
acids in lipid digestion and absorption? b. Very-low-density lipoprotein (VLDL) b. Structural support
a. Hydrolysis of triglycerides c. Low-density lipoprotein (LDL) c. Regulation of cellular processes
b. Formation of micelles d. High-density lipoprotein (HDL)* d. All of the above*
 a. Transport endogenous triglycerides to b. Low-density lipoprotein (LDL)
43. How are triglycerides primarily peripheral tissues c. Very-low-density lipoprotein (VLDL)
transported in the bloodstream? b. Transport cholesterol from the liver to d. Intermediate-density lipoprotein (IDL)*
a. Bound to albumin peripheral tissues
b. As free fatty acids c. Transport dietary lipids from the intestine 50. What is the primary role of lipids in the
c. Within lipoproteins, particularly to other tissues* formation of cell membranes?
chylomicrons and very-low-density d. Transport cholesterol from peripheral a. Serve as precursors for steroid hormones
lipoprotein (VLDL)* tissues to the liver b. Provide structural support
d. As individual molecules c. Form lipid bilayers and act as a barrier in
47. How are triglycerides stored in adipose cell membranes*
44. What is the significance of omega-3 tissue? d. Facilitate cell communication
fatty acids in the diet? a. As individual molecules
a. They promote insulin resistance b. Bound to albumin Unit 3: Proteins
b. They have anti-inflammatory effects and c. As free fatty acids
may reduce the risk of cardiovascular d. Within adipocytes in the form of 1. What is the classification of amino acids
disease* triglycerides* based on nutrition?
c. They are associated with an increased risk a. Essential and non-essential*
of heart disease 48. Which of the following is a potential b. Polar and non-polar
d. A and C consequence of elevated levels of low- c. Aliphatic and aromatic
density lipoprotein (LDL)? d. Acidic and basic
45. Which lipoprotein primarily transports a. Increased risk of atherosclerosis and
cholesterol from the liver to peripheral cardiovascular disease* 2. Which of the following amino acids is
tissues? b. Increased insulin sensitivity essential and must be obtained from the
a. High-density lipoprotein (HDL) c. Reduced risk of heart disease diet?
b. Low-density lipoprotein (LDL)* d. Enhanced reverse cholesterol transport a. Glycine
c. Very-low-density lipoprotein (VLDL) b. Alanine
d. Intermediate-density lipoprotein (IDL) 49. Which lipoprotein is synthesized in the c. Valine*
liver and contains the highest proportion of d. Proline
46. What is the primary function of cholesterol?
chylomicrons in lipid metabolism? a. High-density lipoprotein (HDL)
3. What is the metabolic fate of ketogenic 7. What is the primary metabolic fate of d. Cystinuria
amino acids? amino acids after absorption?
a. Converted to glucose a. Storage in the liver 11. Plasma proteins are classified into:
b. Converted to acetyl-CoA or ketone b. Conversion to glucose a. Albumins, globulins, and fibrinogens*
bodies* c. Used for energy production or protein b. Enzymes, hormones, and transporters
c. Used for protein synthesis synthesis* c. Collagens, elastins, and keratins
d. Excreted unchanged in urine d. Excreted unchanged in urine d. Neurotransmitters, cytokines, and
antibodies
4. During protein digestion, proteins are 8. Biologically important compounds
broken down into: synthesized from amino acids include: 12. What is the primary function of
a. Nucleotides a. Nucleotides, neurotransmitters, and albumins in the blood?
b. Amino acids* hormones* a. Blood clotting
c. Fatty acids b. Fatty acids, triglycerides, and cholesterol b. Immune response
d. Monosaccharides c. Glycogen, glucose, and insulin c. Maintaining osmotic pressure and
d. Steroid hormones, bile acids, and ketone transporting substances*
5. What is the primary site of protein bodies d. Oxygen transport
absorption in the digestive system?
a. Stomach 9. Inborn errors of amino acid metabolism 13. Causes of proteinuria include:
b. Small intestine* refer to genetic disorders affecting: a. Dehydration
c. Large intestine a. All amino acids b. Glomerular damage and inflammation*
d. Pancreas b. Branched-chain amino acids c. Increased protein intake
c. Aromatic amino acids* d. A and C
6. Which enzyme is responsible for the d. Essential amino acids
breakdown of proteins into peptides during 14. Hypoproteinemia may result from:
digestion? 10. A deficiency or dysfunction in the a. Dehydration
a. Amylase metabolism of aromatic amino acids can b. Malnutrition
b. Lipase lead to: c. Liver disease or kidney disease*
c. Protease* a. Maple syrup urine disease d. A and B
d. Nuclease b. Phenylketonuria (PKU)*
c. Alkaptonuria
15. Hyper-gamma globulinemia is a. Liver disease, kidney disease, or c. Decreased blood viscosity
characterized by: inflammation* d. A and C*
a. Increased levels of albumins b. Normal physiological variations
b. Elevated levels of immunoglobulins c. Increased protein intake 23. The normal values of gamma-globulins
(gamma globulins)* d. Dehydration are often referred to as:
c. Decreased levels of fibrinogens a. Gamma-globulinemia
d. A and C 19. What is the primary function of b. Hypogammaglobulinemia
fibrinogens in the blood? c. Hypergammaglobulinemia*
16. What is the principle of electrophoresis? a. Oxygen transport d. Normogammaglobulinemia
a. Separation of proteins based on their size b. Blood clotting*
and shape c. Immune response 24. The principle of electrophoresis
b. Separation of proteins based on their d. Maintaining osmotic pressure involves the movement of proteins in an
charge and size* electric field based on their:
c. Separation of proteins based on their 20. What is the normal range of total protein a. Size
solubility in the blood (g/dL)? b. Charge*
d. Separation of proteins based on their a. 1.5 - 3.5 c. Solubility
function b. 3.5 - 5.5* d. Concentration
c. 5.5 - 8.5
17. What is the normal electrophoretic d. 8.5 - 10.5 25. Which of the following is an example of
pattern of plasma proteins? an immunoglobulin?
a. Alpha-globulins migrating faster than 21. Causes of proteinuria may include: a. Albumin
beta-globulins a. Increased glomerular permeability b. Fibrinogen
b. Beta-globulins migrating faster than b. Inflammation of the renal tubules c. IgG*
alpha-globulins c. Renal disease or damage* d. Transferrin
c. Gamma-globulins migrating the fastest* d. All of the above*
d. No distinct pattern 26. What is the primary function of
22. The condition of hypoproteinemia may immunoglobulins (antibodies) in the
18. Abnormal electrophoretic patterns can lead to: immune system?
result from: a. Edema a. Transport of iron
b. Hyperlipidemia b. Blood clotting
c. Defense against pathogens and foreign b. Transport of lipids b. 3.5 - 5.5
substances* c. Antioxidant activity* c. 5.5 - 8.5
d. Maintaining osmotic pressure d. Blood clotting d. 3.5 - 5.0*

27. What is the primary cause of 31. The condition of 35. Causes of hypoproteinemia include:
hypergammaglobulinemia? hypergammaglobulinemia may be a. Malnutrition
a. Liver disease associated with: b. Liver disease or kidney disease*
b. Chronic infections or inflammatory a. Autoimmune disorders c. Chronic infections
disorders* b. Chronic infections* d. Both A and C
c. Malnutrition c. Protein malnutrition
d. Dehydration d. Both A and C 36. What is the primary function of
complement proteins in the immune
28. In electrophoresis, alpha-1 globulins 32. What is the primary function of beta- system?
include: globulins in the blood? a. Phagocytosis
a. Alpha-1 antitrypsin* a. Defense against pathogens b. Opsonization
b. Haptoglobins b. Transport of lipids c. Immune cell activation and pathogen
c. Transferrin c. Blood clotting lysis*
d. Both B and C d. Transport of proteins, including d. Antigen presentation
transferrin*
29. Which of the following proteins is 37. Causes of hypergammaglobulinemia
involved in the transport of iron in the 33. In electrophoresis, beta-globulins include:
blood? include: a. Chronic infections or inflammatory
a. Hemoglobin a. Beta-lipoproteins disorders*
b. Ferritin b. Complement proteins b. Liver disease
c. Transferrin* c. Both A and B* c. Malnutrition
d. Haptoglobin d. Neither A nor B d. Both B and C

30. What is the primary function of alpha-2 34. What is the normal range of albumin in 38. What is the primary cause of
globulins? the blood (g/dL)? hypergammaglobulinemia in chronic
a. Defense against pathogens a. 1.5 - 3.5 infections?
a. Increased production of antibodies* 47. What is the primary function of
b. Decreased production of antibodies 43. In electrophoresis, gamma-globulins haptoglobins in the blood?
c. Liver dysfunction include: a. Transport of iron
d. Inflammation of the renal tubules a. IgG, IgA, IgM* b. Defense against pathogens
b. Albumin c. Binding and neutralizing free
39. What is the normal range of gamma- c. Transferrin hemoglobin*
globulins in the blood (g/dL)? d. Fibrinogen d. Blood clotting
a. 1.5 - 3.5
b. 0.5 - 1.5* 44. What is the primary function of 48. What is the normal electrophoretic
c. 5.5 - 8.5 hemoglobin in the blood? pattern of proteins in the blood?
d. 8.5 - 10.5 a. Defense against pathogens a. Alpha-globulins migrating faster than
b. Oxygen transport* beta-globulins
40. Proteinuria refers to the presence of c. Blood clotting b. Beta-globulins migrating faster than
excessive amounts of: d. Antioxidant activity alpha-globulins
a. Albumin in the urine* c. Gamma-globulins migrating the fastest*
b. Hemoglobin in the urine 45. Causes of hyperproteinemia include: d. No distinct pattern
c. Glucose in the urine a. Liver disease
d. Bile acids in the urine b. Dehydration 49. Which of the following is a cause of
c. Chronic infections or inflammatory hypergamma globulinemia?
41. What is the principle of electrophoresis disorders* a. Liver disease
used for? d. Both A and B b. Chronic infections or inflammatory
a. Separating proteins based on their size disorders*
b. Separating proteins based on their 46. What is the primary cause of c. Malnutrition
charge* hyperproteinemia in dehydration? d. Dehydration
c. Quantifying protein concentrations a. Increased production of proteins
d. Analyzing protein structures b. Decreased blood volume and dilution of 50. What is the primary function of alpha-1
proteins* antitrypsin in the blood?
42. The normal electrophoretic pattern c. Liver dysfunction a. Transport of iron
shows alpha-globulins migrating faster than d. Inflammation of the renal tubules b. Defense against pathogens
beta-globulins. (True/False)
c. Inhibition of proteolytic enzymes like d. Gamma-glutamyl transferase (GGT)
trypsin and elastase* 8. Which enzyme is commonly used to
d. Blood clotting 4. Elevated levels of AST in the blood are assess muscle damage in conditions such as
indicative of: muscular dystrophy or rhabdomyolysis?
Unit 4: Clinical Enzymology a. Liver diseases a. Aspartate aminotransferase (AST)
b. Myocardial infarction b. Aldolase*
1. What is the definition of isoenzymes? c. Both A and B* c. Alkaline phosphatase (ALP)
a. Enzymes with similar functions but d. None of the above d. Gamma-glutamyl transferase (GGT)
different structures
b. Enzymes with different functions but 5. Alkaline phosphatase (ALP) is 9. Creatine kinase (CK) isoenzymes
similar structures commonly elevated in: include:
c. Enzymes with both similar functions and a. Liver diseases a. CK-MM, CK-MB, CK-BB*
structures* b. Bone diseases* b. CK-I, CK-II, CK-III
d. Enzymes with no functional or structural c. Muscle diseases c. CK-A, CK-B, CK-C
similarity d. Myocardial infarction d. CK-X, CK-Y, CK-Z

2. Which property is characteristic of 6. Gamma-glutamyl transferase (GGT) is a 10. Which enzyme is commonly used to
isoenzymes? marker for: assess bone metabolism and is elevated in
a. Same optimal pH a. Liver diseases* conditions such as Paget's disease?
b. Same substrate specificity b. Bone diseases a. Alanine aminotransferase (ALT)
c. Same catalytic activity but different c. Muscle diseases b. Aspartate aminotransferase (AST)
kinetic properties* d. Myocardial infarction c. Alkaline phosphatase (ALP)*
d. Same cofactor requirements d. Gamma-glutamyl transferase (GGT)
7. In myocardial infarction, which enzyme
3. In liver diseases, which enzyme is is considered a specific marker for cardiac 11. Prostate-specific antigen (PSA) is a
primarily used as a marker for muscle damage? marker used for the diagnosis and
hepatocellular damage? a. Creatine kinase (CK) monitoring of:
a. Alanine aminotransferase (ALT)* b. Aspartate aminotransferase (AST) a. Liver diseases
b. Aspartate aminotransferase (AST) c. Troponins* b. Bone diseases
c. Alkaline phosphatase (ALP) d. Lactate dehydrogenase (LDH) c. Prostate cancer*
d. Myocardial infarction d. Gamma-glutamyl transferase (GGT)
16. Cardiac troponins, particularly troponin
12. Acid phosphatase (ACP) is associated I and troponin T, are specific markers for: 20. Elevated levels of GGT in the blood
with diagnostic assessments related to: a. Liver diseases may indicate:
a. Liver diseases b. Bone diseases a. Liver diseases*
b. Bone diseases c. Myocardial infarction* b. Bone diseases
c. Muscle diseases d. Prostate cancer c. Muscle diseases
d. Prostate cancer* d. Myocardial infarction
17. In bone diseases, elevated levels of
13. Elevated levels of ALT in the blood are alkaline phosphatase (ALP) are primarily 21. What is the primary function of creatine
indicative of: due to: kinase (CK) in muscle tissue?
a. Liver diseases* a. Liver dysfunction a. Regulation of pH
b. Myocardial infarction b. Increased osteoblastic activity* b. Catalyzing the breakdown of creatine
c. Bone diseases c. Muscle damage phosphate*
d. Muscle diseases d. Elevated levels of calcium c. Synthesis of creatine phosphate
d. Facilitating energy production in the
14. The predominant form of creatine 18. Which enzyme is involved in the mitochondria
kinase (CK) found in skeletal muscle is: breakdown of phosphoric acid in bones,
a. CK-MM* making it a marker for bone diseases? 22. Troponins are released into the
b. CK-MB a. Alanine aminotransferase (ALT) bloodstream following:
c. CK-BB b. Aspartate aminotransferase (AST) a. Liver damage
d. CK-III c. Alkaline phosphatase (ALP)* b. Bone fractures
d. Gamma-glutamyl transferase (GGT) c. Muscle injury or myocardial infarction*
15. Which enzyme is commonly elevated in d. Prostate cancer
conditions affecting the biliary system, such 19. Which enzyme is primarily responsible
as obstructive jaundice? for the breakdown of creatine phosphate in 23. In clinical practice, elevated levels of
a. Alanine aminotransferase (ALT) muscle tissue? CK-MB are indicative of:
b. Aspartate aminotransferase (AST) a. Creatine kinase (CK)* a. Liver diseases
c. Alkaline phosphatase (ALP)* b. Aspartate aminotransferase (AST) b. Myocardial infarction*
d. Gamma-glutamyl transferase (GGT) c. Alkaline phosphatase (ALP) c. Bone diseases
d. Muscle diseases c. Alkaline phosphatase (ALP) b. Heart, brain, and skeletal muscle*
d. Gamma-glutamyl transferase (GGT) c. Kidney, lung, and pancreas
24. Which enzyme is commonly elevated in d. Spleen, bone marrow, and intestines
conditions such as muscular dystrophy or 28. What is the primary function of acid
crush injuries? phosphatase (ACP) in the prostate gland? 32. What is the normal range of serum
a. Aspartate aminotransferase (AST) a. Defense against pathogens alanine aminotransferase (ALT)?
b. Aldolase* b. Breakdown of amino acids a. 0 - 35 IU/L*
c. Alkaline phosphatase (ALP) c. Breakdown of nucleic acids b. 10 - 50 IU/L
d. Gamma-glutamyl transferase (GGT) d. Facilitating sperm function and c. 20 - 70 IU/L
liquefaction of semen* d. 30 - 90 IU/L
25. Which enzyme is associated with the
breakdown of glucose-6-phosphate in 29. In the diagnosis of prostate cancer, 33. What is the primary function of
glycolysis? which marker is commonly used for aspartate aminotransferase (AST) in the
a. Alanine aminotransferase (ALT) monitoring and recurrence detection? body?
b. Aspartate aminotransferase (AST) a. Alanine aminotransferase (ALT) a. Catalyzing the breakdown of amino acids
c. Aldolase* b. Alkaline phosphatase (ALP) b. Synthesizing amino acids
d. Alkaline phosphatase (ALP) c. Prostate-specific antigen (PSA)* c. Transferring amino groups between
d. Acid phosphatase (ACP) aspartate and ketoglutarate during amino
26. Elevated levels of AST in the blood are acid metabolism*
found in: 30. In clinical settings, elevated levels of d. Facilitating the breakdown of lipids
a. Liver diseases which enzyme are associated with liver
b. Myocardial infarction damage, especially in obstructive jaundice? 34. Which enzyme is commonly elevated in
c. Both A and B* a. Alanine aminotransferase (ALT) conditions affecting the liver, such as viral
d. None of the above b. Aspartate aminotransferase (AST) hepatitis or alcoholic liver disease?
c. Alkaline phosphatase (ALP)* a. Alanine aminotransferase (ALT)*
27. Which enzyme is commonly elevated in d. Gamma-glutamyl transferase (GGT) b. Creatine kinase (CK)
conditions affecting the liver, such as viral c. Lactate dehydrogenase (LDH)
hepatitis or cirrhosis? 31. Creatine kinase (CK) is found in various d. Aldolase
a. Alanine aminotransferase (ALT)* tissues, including:
b. Aspartate aminotransferase (AST) a. Liver, kidney, and brain
35. In the diagnosis of myocardial c. Alkaline phosphatase (ALP)* c. Lactate dehydrogenase (LDH)*
infarction, which marker is considered a d. Gamma-glutamyl transferase (GGT) d. Alkaline phosphatase (ALP)
gold standard due to its cardiac specificity?
a. Creatine kinase (CK) 39. What is the normal range of serum 43. Acid phosphatase (ACP) is elevated in
b. Aspartate aminotransferase (AST) aspartate aminotransferase (AST)? conditions such as:
c. Cardiac troponins* a. 0 - 35 IU/L a. Liver diseases
d. Lactate dehydrogenase (LDH) b. 10 - 50 IU/L b. Bone diseases
c. 20 - 70 IU/L c. Muscle diseases
36. Elevated levels of which enzyme in the d. 0 - 40 IU/L* d. Prostate cancer*
blood are indicative of damage to cardiac
muscle, especially in myocardial 40. Which enzyme is involved in the 44. In clinical practice, elevated levels of
infarction? breakdown of glucose-1-phosphate in CK-MB are indicative of:
a. Alanine aminotransferase (ALT) glycolysis? a. Liver diseases
b. Creatine kinase (CK) a. Alanine aminotransferase (ALT) b. Myocardial infarction*
c. Cardiac troponins* b. Aspartate aminotransferase (AST) c. Bone diseases
d. Lactate dehydrogenase (LDH) c. Aldolase* d. Muscle diseases
d. Alkaline phosphatase (ALP)
37. In the diagnosis of prostate cancer, 45. Which enzyme is commonly elevated in
which enzyme is considered more specific 41. Elevated levels of GGT in the blood are conditions such as muscular dystrophy or
than acid phosphatase (ACP)? often associated with: crush injuries?
a. Alanine aminotransferase (ALT) a. Liver diseases* a. Aspartate aminotransferase (AST)
b. Alkaline phosphatase (ALP) b. Bone diseases b. Aldolase*
c. Prostate-specific antigen (PSA)* c. Muscle diseases c. Alkaline phosphatase (ALP)
d. Acid phosphatase (ACP) d. Myocardial infarction d. Gamma-glutamyl transferase (GGT)

38. In bone diseases, elevated levels of 42. Which enzyme is involved in the 46. Which enzyme is associated with the
which enzyme are primarily due to breakdown of lactate to pyruvate in the breakdown of glucose-6-phosphate in
increased osteoblastic activity? body? glycolysis?
a. Alanine aminotransferase (ALT) a. Alanine aminotransferase (ALT) a. Alanine aminotransferase (ALT)
b. Aspartate aminotransferase (AST) b. Creatine kinase (CK) b. Aspartate aminotransferase (AST)
c. Aldolase* d. 7.5 - 8.0 c. Lungs
d. Alkaline phosphatase (ALP) d. Pancreas
3. What is the definition of pH?
47. Elevated levels of ALT in the blood are a. A measure of the concentration of 7. What is the role of respiratory
indicative of: hydrogen ions in a solution* mechanisms in acid-base regulation?
a. Liver diseases* b. A measure of the concentration of oxygen a. Excretion of hydrogen ions in urine
b. Myocardial infarction ions in a solution b. Production of bicarbonate ions in the
c. Bone diseases c. A measure of the concentration of kidneys
d. Muscle diseases hydroxide ions in a solution c. Elimination of carbon dioxide by
d. A measure of the concentration of ions in adjusting ventilation rate and depth*
48. The predominant form of creatine a solution d. Regulation of sodium-potassium balance
kinase (CK) found in skeletal muscle is:
a. CK-MM* 4. How is blood pH regulated in the body? 8. What is the normal range for arterial
b. CK-MB a. Only by respiratory mechanisms blood pH in arterial blood gas (ABG)
c. CK-BB b. Only by renal mechanisms analysis?
d. CK-III c. By a combination of blood buffer a. 7.20 - 7.35
systems, respiratory mechanisms, and renal b. 7.35 - 7.45*
Unit 5: Acid Base Maintenance mechanisms* c. 7.45 - 7.60
d. 7.60 - 7.75
1. What does pH measure in a solution? 5. Which of the following is a major blood
a. Pressure of Hydrogen buffer system? 9. In ABG analysis, what is the normal
b. Potential of Hydrogen* a. Sodium-Potassium Pump range for partial pressure of oxygen (PaO2)
c. Presence of Hydrogen b. Hemoglobin-Oxygen Binding in mmHg?
d. Permeability of Hydrogen c. Bicarbonate-Carbonic Acid* a. 60 - 80
d. Glucose-Insulin Regulation b. 80 - 100*
2. What is the normal pH range of human c. 100 - 120
blood? 6. Which organ primarily regulates the d. 120 - 140
a. 6.5 - 7.0 bicarbonate ion concentration in the blood?
b. 7.0 - 7.5 a. Liver 10. What does the term "acid-base
c. 7.35 - 7.45* b. Kidneys* disorders" refer to?
a. Disturbances in the levels of electrolytes 14. Metabolic acidosis can be caused by: d. Decreased renal excretion of hydrogen
in the blood a. Hyperventilation ions
b. Imbalances in the concentration of acids b. Kidney failure, diabetic ketoacidosis, and
and bases in the body fluids* lactic acidosis* 18. Which acid-base disorder is associated
c. Disruption of the blood clotting cascade c. Excessive vomiting with an increase in the anion gap?
d. Dysfunction of blood buffer systems d. Respiratory depression a. Respiratory acidosis
b. Metabolic alkalosis
11. What is the main cause of respiratory 15. In the context of acid-base disorders, c. Metabolic acidosis*
acidosis? what does the term "alkalemia" refer to? d. Respiratory alkalosis
a. Hyperventilation a. Elevated blood pH*
b. Retention of carbon dioxide due to b. Decreased blood pH 19. What is the primary compensatory
hypoventilation* c. Normal blood pH mechanism for respiratory acidosis?
c. Increased bicarbonate levels d. Abnormal levels of bicarbonate ions a. Increased renal excretion of bicarbonate
d. Alkalosis ions
16. Which of the following is a b. Increased respiratory rate and depth*
12. Metabolic alkalosis can be caused by: compensatory mechanism for metabolic c. Decreased production of carbon dioxide
a. Diarrhea acidosis? d. Decreased renal excretion of hydrogen
b. Kidney failure a. Increased respiratory rate and depth* ions
c. Excessive vomiting* b. Decreased renal excretion of hydrogen
d. Respiratory depression ions 20. Which of the following is a common
c. Decreased ventilation cause of metabolic alkalosis?
13. Respiratory alkalosis is characterized d. Increased production of bicarbonate ions a. Kidney failure
by: by the kidneys b. Excessive vomiting or gastric
a. Elevated levels of carbon dioxide in the suctioning*
blood 17. What is the typical compensation for c. Diabetic ketoacidosis
b. Decreased levels of carbon dioxide in the respiratory alkalosis? d. Respiratory depression
blood due to hyperventilation* a. Increased renal excretion of bicarbonate
c. Increased levels of bicarbonate ions ions 21. What is the anion gap used for in the
d. Acidic urine b. Decreased respiratory rate and depth* context of acid-base disorders?
c. Increased production of carbon dioxide
a. It helps diagnose the specific cause of d. Excessive vomiting b. 18 - 22 mEq/L
metabolic acidosis* c. 26 - 30 mEq/L
b. It measures the concentration of oxygen 25. What is the primary compensatory d. 30 - 34 mEq/L
in the blood mechanism for respiratory alkalosis?
c. It quantifies the compensatory a. Increased renal excretion of bicarbonate 29. Which of the following is a
mechanisms in respiratory alkalosis ions characteristic of metabolic alkalosis?
d. It assesses the levels of bicarbonate ions b. Increased production of carbon dioxide a. Decreased bicarbonate ion levels
in the blood c. Decreased respiratory rate and depth* b. Increased hydrogen ion concentration
d. Decreased renal excretion of hydrogen c. Increased bicarbonate ion levels*
22. Which acid-base disorder is ions d. Respiratory depression
characterized by an elevated anion gap?
a. Respiratory alkalosis 26. In the context of acid-base disorders, 30. What is the typical compensation for
b. Metabolic alkalosis what does the term "acidemia" refer to? respiratory acidosis?
c. Metabolic acidosis* a. Elevated blood pH a. Increased renal excretion of bicarbonate
d. Respiratory acidosis b. Decreased blood pH* ions
c. Normal blood pH b. Decreased respiratory rate and depth
23. What is the primary compensatory d. Abnormal levels of bicarbonate ions c. Increased production of carbon dioxide
mechanism for metabolic alkalosis? d. Increased renal excretion of hydrogen
a. Increased renal excretion of bicarbonate 27. In acid-base disorders, what is the ions*
ions primary cause of metabolic acidosis?
b. Increased respiratory rate and depth a. Hyperventilation 31. What is the primary compensatory
c. Decreased production of carbon dioxide b. Kidney failure, diabetic ketoacidosis, and mechanism for metabolic acidosis?
d. Decreased respiratory rate and depth* lactic acidosis* a. Increased renal excretion of bicarbonate
c. Excessive vomiting ions*
24. In acid-base disorders, what is the d. Respiratory depression b. Increased respiratory rate and depth
primary cause of respiratory alkalosis? c. Decreased production of carbon dioxide
a. Retention of carbon dioxide due to 28. What is the normal range for d. Decreased respiratory rate and depth
hypoventilation bicarbonate ion concentration in ABG
b. Hyperventilation* analysis? 32. Which acid-base disorder is associated
c. Kidney failure a. 22 - 26 mEq/L* with a decreased anion gap?
a. Respiratory alkalosis c. Excessive vomiting or gastric suctioning*
b. Metabolic alkalosis 36. What is the typical compensation for d. Respiratory depression
c. Metabolic acidosis respiratory alkalosis?
d. Respiratory acidosis* a. Increased renal excretion of bicarbonate 40. Which of the following is a
ions characteristic of metabolic acidosis?
33. In acid-base disorders, what is the b. Decreased respiratory rate and depth* a. Decreased bicarbonate ion levels*
primary cause of respiratory alkalosis? c. Increased production of carbon dioxide b. Increased hydrogen ion concentration
a. Retention of carbon dioxide due to d. Decreased renal excretion of hydrogen c. Increased bicarbonate ion levels
hypoventilation ions d. Respiratory depression
b. Hyperventilation*
c. Kidney failure 37. What is the normal range for arterial 41. In the context of acid-base disorders,
d. Excessive vomiting oxygen saturation (SaO2) in ABG analysis? what does the term "alkalosis" refer to?
a. 90 - 95% a. Elevated blood pH*
34. What is the normal range for partial b. 95 - 100%* b. Decreased blood pH
pressure of carbon dioxide (PaCO2) in ABG c. 80 - 85% c. Normal blood pH
analysis? d. 85 - 90% d. Abnormal levels of bicarbonate ions
a. 35 - 45 mmHg*
b. 25 - 35 mmHg 38. Which of the following is a 42. What is the normal range for oxygen
c. 45 - 55 mmHg characteristic of respiratory acidosis? content (CaO2) in ABG analysis?
d. 55 - 65 mmHg a. Increased respiratory rate and depth a. 10 - 15 vol%
b. Decreased PaCO2 levels b. 15 - 20 vol%
35. Which of the following is a c. Retention of carbon dioxide due to c. 20 - 25 vol%
compensatory mechanism for metabolic hypoventilation* d. 15 - 22 vol%*
alkalosis? d. Increased renal excretion of hydrogen
a. Increased renal excretion of bicarbonate ions 43. What is the typical compensation for
ions* respiratory acidosis?
b. Increased respiratory rate and depth 39. What is the primary cause of metabolic a. Increased renal excretion of bicarbonate
c. Decreased production of carbon dioxide alkalosis? ions
d. Increased renal excretion of hydrogen a. Hyperventilation b. Decreased respiratory rate and depth*
ions b. Kidney failure c. Increased production of carbon dioxide
d. Increased renal excretion of hydrogen c. Excessive vomiting 1. What is the primary product of heme
ions d. Respiratory depression degradation?
a. Biliverdin*
44. In the context of acid-base disorders, 48. What is the typical compensation for b. Bilirubin
what does the term "acidosis" refer to? metabolic alkalosis? c. Hemin
a. Elevated blood pH a. Increased renal excretion of bicarbonate d. Heme oxygenase
b. Decreased blood pH* ions*
c. Normal blood pH b. Increased respiratory rate and depth 2. Which enzyme is responsible for the
d. Abnormal levels of bicarbonate ions c. Decreased production of carbon dioxide conversion of heme to biliverdin?
d. Decreased respiratory rate and depth a. Biliverdin reductase
45. What is the primary cause of respiratory b. Heme oxygenase*
alkalosis? 49. In acid-base disorders, what is the c. Bilirubin oxidase
a. Retention of carbon dioxide due to primary cause of metabolic alkalosis? d. Urobilinogen synthase
hypoventilation a. Hyperventilation
b. Hyperventilation* b. Kidney failure 3. What is the fate of biliverdin in heme
c. Kidney failure c. Excessive vomiting or gastric suctioning* degradation?
d. Excessive vomiting d. Respiratory depression a. Excretion in urine
b. Conversion to bilirubin*
46. What is the normal range for base excess 50. Which of the following is a c. Conversion to urobilinogen
(BE) in ABG analysis? characteristic of respiratory alkalosis? d. Transport to the liver
a. -2 to +2 mEq/L a. Increased respiratory rate and depth*
b. -3 to +3 mEq/L b. Decreased PaCO2 levels 4. In the heme degradation pathway,
c. -2 to +2 mmHg c. Retention of carbon dioxide due to bilirubin is conjugated with:
d. -3 to +3 mmHg* hypoventilation a. Glucuronic acid*
d. Increased renal excretion of hydrogen b. Amino acids
47. In acid-base disorders, what is the ions c. Fatty acids
primary cause of metabolic acidosis? d. Phosphoric acid
a. Hyperventilation Unit 6: Heme Metabolism
b. Kidney failure, diabetic ketoacidosis, and 5. What is the main site of bilirubin
lactic acidosis* conjugation in the body?
a. Liver* c. Obstruction in the bile ducts 13. In the context of jaundice, what is the
b. Spleen d. Hepatocellular damage van den Berg test used for?
c. Kidneys a. Detection of biliverdin in urine
d. Intestines 10. Hepatocellular jaundice is characterized b. Detection of urobilinogen in urine
by: c. Detection of bile salts in urine
6. What is the water-soluble form of a. Increased unconjugated bilirubin d. Detection of bilirubin in urine*
bilirubin that is excreted in urine? b. Decreased total bilirubin
a. Biliverdin c. Increased conjugated bilirubin* 14. Conjugated bilirubin is excreted into the
b. Conjugated bilirubin* d. Normal bilirubin levels bile ducts and eventually into the:
c. Unconjugated bilirubin a. Bloodstream
d. Urobilinogen 11. Which of the following conditions is b. Urine*
associated with obstructive jaundice? c. Small intestine
7. Which type of jaundice is characterized a. Hemolysis d. Lymphatic system
by an obstruction in the bile ducts? b. Hepatitis
a. Hemolytic jaundice c. Gallstones or tumors blocking the bile 15. What is the primary cause of
b. Hepatocellular jaundice ducts* hepatocellular jaundice?
c. Obstructive jaundice* d. Aplastic anemia a. Hemolysis
d. Physiological jaundice b. Liver damage or dysfunction*
12. What is the primary cause of c. Obstruction in the bile ducts
8. Hemolytic jaundice is associated with: unconjugated hyperbilirubinemia in d. Physiological changes in newborns
a. Increased unconjugated bilirubin* hemolytic disorders?
b. Decreased total bilirubin a. Impaired bilirubin uptake by hepatocytes 16. In the heme degradation pathway, what
c. Increased conjugated bilirubin b. Increased bilirubin conjugation in the is the next step after the formation of
d. Normal bilirubin levels liver bilirubin?
c. Enhanced heme degradation due to a. Conjugation with glucuronic acid
9. Physiological jaundice in newborns is increased red blood cell breakdown* b. Transport to the liver
often due to: d. Deficient bilirubin excretion into the bile c. Excretion in bile ducts
a. Hemolysis of fetal red blood cells ducts d. Formation of urobilinogen*
b. Immature liver function and bilirubin
conjugation*
17. Which type of jaundice is characterized c. Obstruction in the bile ducts
by impaired liver function and reduced 21. Which of the following conditions is d. Hepatocellular damage
bilirubin conjugation? associated with an increased risk of
a. Hemolytic jaundice gallstones and, consequently, obstructive 25. What is the primary function of bilirubin
b. Hepatocellular jaundice* jaundice? in the body?
c. Obstructive jaundice a. Hemolysis a. Oxygen transport
d. Physiological jaundice b. Liver cirrhosis b. Antioxidant activity
c. Sickle cell disease* c. Removal of waste products, particularly
18. What happens to urobilinogen in the d. Physiological changes in newborns heme-derived ones*
intestines? d. Immune system modulation
a. Converted to bilirubin 22. What is the primary role of biliverdin
b. Reabsorbed into the bloodstream reductase in heme degradation? 26. Which of the following is a
c. Excreted in feces as stercobilin* a. Conversion of bilirubin to biliverdin characteristic of hemolysis?
d. Excreted in urine as urobilin b. Reduction of biliverdin to bilirubin* a. Increased unconjugated bilirubin*
c. Conjugation of bilirubin in the liver b. Decreased total bilirubin
19. What is the primary cause of obstructive d. Excretion of bilirubin in urine c. Increased conjugated bilirubin
jaundice? d. Normal bilirubin levels
a. Hemolysis 23. In the heme degradation pathway, what
b. Hepatocellular damage is the fate of unconjugated bilirubin in the 27. What is the main symptom of
c. Impaired bile flow due to gallstones or liver? obstructive jaundice?
tumors blocking the bile ducts* a. Excretion in bile ducts a. Dark urine
d. Physiological changes in newborns b. Conversion to conjugated bilirubin* b. Pale stools
c. Transport to the spleen c. Yellowing of the skin and eyes*
20. What is the significance of bilirubin in d. Formation of urobilinogen d. Abdominal pain
urine as detected by the van den Berg test?
a. Indicates normal liver function 24. What is the primary cause of 28. In the heme degradation pathway, what
b. Suggests obstructive jaundice physiologic jaundice in newborns? happens to the iron released from heme?
c. Suggests haemolysis or hepatocellular a. Hemolysis of fetal red blood cells a. Transported to the liver
damage* b. Immature liver function and bilirubin b. Converted to biliverdin
d. Indicates impaired bile flow conjugation* c. Stored in the spleen
d. Recycled for the synthesis of new c. Detection of hepatocellular damage 36. What is the primary function of bilirubin
hemoglobin* d. Converted to urobilin and excreted in the in the intestines?
feces* a. Excretion in bile ducts
29. What is the significance of urobilinogen b. Conversion to urobilinogen
in the intestines? 33. What type of bilirubin is water-insoluble c. Antioxidant activity
a. Converted to bilirubin and requires conjugation in the liver for d. Formation of stercobilin for fecal
b. Reabsorbed into the bloodstream excretion? excretion*
c. Excreted in feces as stercobilin a. Unconjugated bilirubin*
d. Converted to stercobilin and excreted in b. Conjugated bilirubin 37. What is the van den Berg test used for in
feces* c. Direct bilirubin the investigation of jaundice?
d. Indirect bilirubin a. Detection of biliverdin in urine
30. What is the primary cause of b. Detection of urobilinogen in urine
hepatocellular jaundice? 34. In which organ does bilirubin c. Detection of bile salts in urine
a. Hemolysis conjugation primarily occur? d. Detection of bilirubin in urine*
b. Liver damage or dysfunction* a. Liver*
c. Obstruction in the bile ducts b. Spleen 38. Which of the following is a
d. Physiological changes in newborns c. Kidneys characteristic of obstructive jaundice?
d. Intestines a. Increased unconjugated bilirubin
31. What is the primary function of b. Decreased total bilirubin
biliverdin in the heme degradation 35. What is the primary cause of c. Increased conjugated bilirubin*
pathway? unconjugated hyperbilirubinemia in d. Normal bilirubin levels
a. Excretion in bile ducts hemolytic disorders?
b. Conjugation with glucuronic acid a. Impaired bilirubin uptake by hepatocytes 39. What is the significance of bilirubin in
c. Antioxidant activity b. Increased bilirubin conjugation in the urine as detected by the van den Berg test?
d. Conversion to bilirubin* liver a. Indicates normal liver function
c. Enhanced heme degradation due to b. Suggests obstructive jaundice
32. What is the role of urobilinogen in the increased red blood cell breakdown* c. Suggests hemolysis or hepatocellular
urine? d. Deficient bilirubin excretion into the bile damage*
a. Formation of yellow urine ducts d. Indicates impaired bile flow
b. Neutralization of acidic urine
40. In the heme degradation pathway, what a. Hemolysis a. Stomach
is the fate of conjugated bilirubin in the b. Impaired bilirubin uptake by hepatocytes b. Duodenum
liver? c. Deficient bilirubin excretion into the bile c. Jejunum
a. Excretion in bile ducts ducts d. Ileum*
b. Conversion to urobilinogen d. Leakage of conjugated bilirubin from
c. Transport to the spleen damaged hepatocytes into the urine* 47. What is the significance of stercobilin in
d. Excretion in urine* feces?
44. In the heme degradation pathway, what a. Neutralization of acidic feces
41. Which of the following statements is is the fate of urobilinogen in the intestines? b. Formation of yellowish-brown color in
true regarding urobilin and stercobilin? a. Conversion to bilirubin feces*
a. Urobilin is excreted in urine, while b. Reabsorption into the bloodstream c. Detection of hepatocellular damage
stercobilin is excreted in feces* c. Excretion in feces as stercobilin* d. Conversion to urobilinogen
b. Urobilin is excreted in feces, while d. Excretion in urine as urobilin
stercobilin is excreted in urine 48. In the heme degradation pathway, what
c. Both are excreted in urine 45. Which of the following statements is is the final product that gives feces its
d. Both are excreted in feces true regarding unconjugated and conjugated characteristic brown color?
bilirubin? a. Biliverdin
42. What is the main cause of conjugated a. Unconjugated bilirubin is water-soluble, b. Bilirubin
hyperbilirubinemia in obstructive jaundice? while conjugated bilirubin is water- c. Stercobilin*
a. Impaired bilirubin uptake by hepatocytes insoluble d. Urobilinogen
b. Increased bilirubin conjugation in the b. Unconjugated bilirubin is water-
liver insoluble, while conjugated bilirubin is 49. Which of the following is a
c. Deficient bilirubin excretion into the bile water-soluble* characteristic of physiologic jaundice in
ducts* c. Both unconjugated and conjugated newborns?
d. Enhanced heme degradation due to bilirubin are water-soluble a. Hemolysis
increased red blood cell breakdown d. Both unconjugated and conjugated b. Immature liver function and bilirubin
bilirubin are water-insoluble conjugation*
43. What is the primary cause of c. Obstruction in the bile ducts
bilirubinuria in the context of hepatocellular 46. What is the main site of urobilinogen d. Hepatocellular damage
damage? formation in the intestines?
50. What is the primary cause of conjugated 3. What is the normal range for blood c. 0.6 - 1.2 mg/dL*
hyperbilirubinemia in hepatocellular urea nitrogen (BUN) concentration? d. 2.0 - 4.0 mg/dL
damage? a. 5 - 15 mg/dL
a. Hemolysis b. 15 - 30 mg/dL 7. Which hormone is released by the
b. Impaired bilirubin uptake by hepatocytes c. 8 - 20 mg/dL* kidneys to stimulate red blood cell
c. Deficient bilirubin excretion into the bile d. 25 - 45 mg/dL production in the bone marrow?
ducts* a. Insulin
d. Enhanced heme degradation due to 4. Which hormone is primarily b. Erythropoietin*
increased red blood cell breakdown responsible for regulating sodium c. Aldosterone
reabsorption and potassium d. Thyroxine (T4)
Unit 7: Organ Function Test excretion in the kidneys?
a. Insulin 8. What is the primary function of
1. What is the primary function of the b. Thyroid hormone thyroxine (T4) in the body?
kidneys? c. Aldosterone* a. Regulation of calcium
a. Digestion of nutrients d. Parathyroid hormone metabolism
b. Filtration and excretion of b. Control of metabolic rate
metabolic waste products* 5. Which of the following is a measure and energy production*
c. Synthesis of clotting factors of the kidney's ability to concentrate c. Stimulation of insulin
d. Storage of bile urine? release
a. Blood urea nitrogen (BUN) d. Inhibition of aldosterone
2. Which of the following is a marker b. Glomerular filtration rate secretion
for renal function and is often used (GFR)
to assess glomerular filtration rate c. Urine specific gravity* 9. Which trace element is essential for
(GFR)? d. Creatinine clearance the synthesis of thyroid hormones?
a. Alanine aminotransferase a. Iron
(ALT) 6. In renal function tests, what is the b. Zinc
b. Blood urea nitrogen (BUN) normal range for serum creatinine c. Iodine*
c. Creatinine* concentration? d. Selenium
d. Alkaline phosphatase (ALP) a. 0.5 - 1.5 mg/dL
b. 1.5 - 3.0 mg/dL
10. In hyperthyroidism, which thyroid c. Monitors thyroid b. Hashimoto's thyroiditis
hormone levels are typically autoimmunity c. Endemic goiter*
elevated? d. Evaluates thyroid cancer d. Thyroid storm
a. Thyroxine (T4) recurrence after treatment*
b. Triiodothyronine (T3)* 16. What is the primary cause of
c. Thyroid-stimulating 13. In thyroid function tests, what is the congenital hypothyroidism in
hormone (TSH) normal range for thyroxine (T4) newborns?
d. Thyroglobulin concentration in the blood? a. Genetic mutations affecting
a. 0.4 - 4.0 µg/dL thyroid receptors
11. What is the primary function of b. 5.0 - 10.0 µg/dL b. Iodine deficiency during
triiodothyronine (T3), another c. 0.8 - 1.8 ng/dL* pregnancy
thyroid hormone? d. 2.0 - 4.5 ng/dL c. Abnormal synthesis of
a. Regulation of calcium levels thyroid hormones*
in bones 14. What is the role of thyroid- d. Thyroid autoimmunity
b. Stimulation of insulin stimulating hormone (TSH) in
release thyroid function? 17. Which thyroid disorder is
c. Control of metabolic rate a. Stimulates the breakdown of characterized by inflammation of
and energy production* glycogen in the liver the thyroid gland and may lead to
d. Inhibition of aldosterone b. Inhibits the release of insulin hypothyroidism?
secretion from the pancreas a. Graves' disease
c. Promotes the synthesis and b. Thyroid storm
12. What is the significance of release of thyroid hormones c. Hashimoto's thyroiditis*
measuring thyroglobulin levels in from the thyroid gland* d. Endemic goiter
the blood? d. Regulates calcium
a. Indicates thyroid hormone metabolism in bones 18. What is the primary function of the
levels thyroid gland in pregnancy?
b. Assesses thyroid- 15. Which condition is characterized by a. Regulation of glucose
stimulating hormone (TSH) an enlarged thyroid gland due to metabolism
release iodine deficiency? b. Maintenance of bone density
a. Graves' disease
 c. Synthesis of thyroid c. Controls calcium levels in 25. Which liver enzyme is primarily found
hormones for fetal the blood by promoting bone in the bile ducts and is elevated in
development* formation* conditions related to bile flow obstruction?
d. Stimulation of insulin d. Inhibits red blood cell a. Alanine aminotransferase (ALT)
release production b. Aspartate aminotransferase (AST)
c. Alkaline phosphatase (ALP)*
19. Which of the following is a potential 22. Which thyroid hormone is more d. Gamma-glutamyl transferase (GGT)
complication of untreated potent but present in lower
hyperthyroidism? concentrations in the blood? 26. Elevated levels of gamma-glutamyl
a. Myxedema a. Thyroxine (T4) transferase (GGT) are often associated
b. Thyroid storm* b. Triiodothyronine (T3)* with:
c. Hashimoto's thyroiditis c. Thyroid-stimulating a. Hepatitis
d. Endemic goiter hormone (TSH) b. Cirrhosis
d. Calcitonin c. Alcohol consumption and biliary
20. In thyroid function tests, what is the 23. Which enzyme is specific to the obstruction*
normal range for thyroid- liver and is commonly used as a marker d. Hemolysis
stimulating hormone (TSH) for hepatocellular damage?
concentration? a. Alanine aminotransferase (ALT)* 27. What is the main function of albumin, a
a. 0.3 - 3.0 mIU/L* b. Aspartate aminotransferase (AST) protein synthesized by the liver?
b. 4.0 - 10.0 mIU/L c. Alkaline phosphatase (ALP) a. Blood clotting
c. 15 - 30 mIU/L d. Gamma-glutamyl transferase (GGT) b. Immune response
d. - 0.5 mIU/L c. Oncotic pressure and maintenance of
24. What does elevated levels of aspartate blood volume*
21. What is the main function of aminotransferase (AST) indicate? d. Digestion of fats
calcitonin produced by the thyroid a. Liver damage*
gland? b. Bone disorders 28. Which liver enzyme is primarily
a. Regulates metabolism c. Cardiac muscle damage associated with the breakdown of glycogen
b. Stimulates glucose d. Pancreatic dysfunction to glucose in the liver?
production a. Alanine aminotransferase (ALT)
b. Aspartate aminotransferase (AST)
c. Alkaline phosphatase (ALP) b. 4 a. IgA*
d. Glucose-6-phosphatase* c. 5 b. IgD
d. 6* c. IgG
29. What does an elevated level of bilirubin d. IgM
in the blood indicate? 3. Which immunoglobulin class is most
a. Kidney dysfunction abundant in the blood and is involved in 7. Which immunoglobulin class is involved
b. Hemolysis or hepatocellular damage* primary immune responses? in allergic reactions and parasitic
c. Pancreatic disorders a. IgA infections?
d. Bone disorders b. IgD a. IgA
c. IgG* b. IgD
30. In liver function tests, what is the d. IgM c. IgE*
normal range for serum bilirubin d. IgM
concentration? 4. The secretory form of immunoglobulin
a. 0.1 - 0.5 mg/dL found in mucosal secretions, saliva, and 8. Where is IgD primarily found in the
b. 0.6 - 1.2 mg/dL tears is: body?
c. 1.5 - 3.0 mg/dL a. IgE a. Blood
d. 0.1 - 1.0 mg/dL* b. IgA* b. Mucosal secretions
c. IgG c. Surface of B cells*
Unit 8: Immunochemistry d. IgM d. Connective tissues

1. What is the basic structural unit of 5. In which immunoglobulin class does the 9. Which region of the immunoglobulin
immunoglobulins? pentameric structure exist, facilitating molecule determines its specificity for
a. Antigen-binding site agglutination of antigens? antigens?
b. Heavy chain a. IgA a. Fc region
c. Light chain* b. IgD b. Heavy chain
d. Fc region c. IgG c. Light chain
d. IgM* d. Variable region*
2. How many classes of immunoglobulins
are there in humans? 6. The J chain is associated with which 10. The Fc region of immunoglobulins is
a. 3 immunoglobulin class? involved in:
a. Antigen binding a. T cells d. Enhance color development
b. Neutralization of toxins b. B cells*
c. Initiating complement activation c. Macrophages 18. In a sandwich ELISA, the capture
d. Interaction with immune cells and d. Natural killer cells antibody is immobilized on the solid phase,
complement components* and the detection antibody is labeled with:
15. The enzyme responsible for joining a. Fluorochrome
11. Which immunoglobulin class is segments of immunoglobulin genes during b. Radioisotope
transferred from mother to fetus through the B cell maturation is: c. Enzyme*
placenta? a. DNA polymerase d. Magnetic beads
a. IgA b. RNA polymerase
b. IgD c. DNA ligase 19. What is the purpose of the substrate in
c. IgG* d. Terminal deoxynucleotidyl transferase ELISA?
d. IgM (TdT)* a. Act as a blocking agent
b. Amplify the signal
12. The main function of IgM in the Investigations & Interpretation – ELISA: c. Bind to the target antigen
immune response is: d. Produce a measurable color or signal
a. Opsonization 16. ELISA stands for: upon enzyme reaction*
b. Neutralization of toxins a. Enzyme-Linked Insulin Assay
c. Complement activation* b. Electrochemical Luminescence 20. In a direct ELISA, the detection
d. Allergic reactions Immunoassay antibody is directly conjugated to:
c. Enzyme-Linked Immunosorbent Assay* a. Enzyme*
13. Which immunoglobulin class is d. Endoscopic Laser Imaging and Scanning b. Fluorochrome
involved in the formation of dimeric and Analysis c. Radioisotope
polymeric structures? d. Gold nanoparticles
a. IgA* 17. In ELISA, the primary purpose of the
b. IgD blocking step is to: 21. What is the basis of measuring signal
c. IgG a. Inactivate enzymes intensity in ELISA?
d. IgM b. Prevent non-specific binding of a. Radioactivity
antibodies* b. Fluorescence
14. Immunoglobulins are produced by: c. Promote antigen-antibody binding c. Color development*
d. Electrical conductivity 30. The optical density in ELISA is
26. In ELISA, the standard curve is used to: measured at a wavelength that corresponds
22. In competitive ELISA, the intensity of a. Determine the concentration of the target to:
the signal is inversely proportional to: antigen in the sample* a. Maximum antibody binding
a. Antibody concentration b. Calibrate the spectrophotometer b. Maximum enzyme activity
b. Antigen concentration* c. Normalize absorbance values c. Maximum color development*
c. Enzyme activity d. Calculate the background noise d. Minimum background noise
d. Background noise
27. False positives in ELISA may occur due
23. What is the main advantage of using a to:
sandwich ELISA over a direct ELISA? a. Low antibody concentration
a. Higher sensitivity* b. Non-specific binding*
b. Faster results c. Insufficient blocking
c. Lower cost d. High antigen concentration
d. Simplicity of procedure
28. What is the role of the chromogenic
24. The "capture" antibody in ELISA refers substrate in ELISA?
to the antibody that: a. Amplify the signal
a. Binds to the target antigen in the sample* b. Produce a measurable color or signal
b. Produces a color change upon enzyme reaction*
c. Is labeled with an enzyme c. Bind to the target antigen
d. Blocks non-specific binding d. Block non-specific binding

25. In an indirect ELISA, what is the 29. In a direct ELISA, what is directly
purpose of the secondary antibody? conjugated to the detection antibody?
a. Binds to the target antigen a. Enzyme*
b. Blocks non-specific binding b. Fluorochrome
c. Amplifies the signal by binding to the c. Radioisotope
labeled detection antibody* d. Gold nanoparticles
d. Initiates the enzyme reaction