The consequence of what process is a renal proteinuria?
Under which of the following diseases there is a next correlation of activity of enzymes: Amylase>> АlАТ > АsАТ ≈ Glutamate DH > CPK?
A. Myocardial infarction
B. Pulmonary embolism
C. Acute hepatitis
D. Acute pancreatitis
E.Cancer ofpancreas
Patient suffers from chronic alcoholism. The activity of all of the following enzymes are increased in blood plasma, EXCEPT:
A. GGTP
B. Alkaline phosphatase
C. Acid phosphatase
D. AsAT
E. Glutamate DH
Patient of 55 years old was hospitalized with signs of poisoning of organophosphorous compounds. Laboratory test of activity of which enzyme must be determined in order to confirm diagnosis:
A. Choline esterase
B. Creatine kinase
C. Methemoglobin reductase
D. Amylase
E. UDP- glucuronil transferase
Determination of activity of which of the following enzymes is a specific indicator of liver parenchyma affection?
A. Alkaline phosphatase
B. AsAT
C. LDH
D. Sorbitol dehydrogenase
E. Amylase
Patient suffers from acute pain in thorax and abdomen. It was revealed an increased activity of blood serum enzymes: АlАТ > GGTP >> АsАТ > Amylase >> CPK. Which of the following is the most likely diagnosis in this patient?
A. Acute pancreatitis
B. Hepatocellular pathology
C. Renal colic
D. Myocardial infarction
E. Pulmonary embolism
Determination of activity of which of the following enzymes is used as marker of cholestasis?
A. АsАТ, АlАТ
B. Isoenzymes of LDH and CPK
C. Histidase, urokinase, sorbitol dehydrogenase
D. 5- nucleotidase, GGTP, alkaline phosphatase
E. Lipase, choline esterase, arginase
*For the examination of patients with blood diseases diagnostic value have all of the following enzymes, EXCEPT:
A. Glucose-6-phosphate dehydrogenase.
B. LDH isoenzymes.
C. Hexokinase.
D. Malate dehydrogenase isoenzymes.
E. Alkaline phosphatase isoenzymes.
In the case of which of the following diseases excretion of amylase with urine is decreased?
A. Acute pancreatitis.
B. Chronic relapsing pancreatitis.
C. Myocardial infarction.
D.Glomerulonephritis.
E. All answers are correct.
Patient was hospitalized. Laboratory test revealed an increased activity of alkaline phosphatase. This patient likely suffers from which of the following?
A. Hypothyroidism
B. Hemolytic jaundice
C. Obstructive jaundice
D. Fatty degeneration of liver
E. Acute pancreatitis
Under which of the following diseases there is an increased activity of GGTP in blood serum?
A. Prostatitis
B. Encephalitis
C. Pancreatitis
D. Cholestasis
E. Pyelonephritis
Activity of which of the following enzymes is decreased under the chronic hepatitis?
A. AsAT
B. GGTP
C. Choline esterase
D. LDH1
E. Sorbitol dehydrogenase
Serum analysis would most likely show an elevation of activity of aminotransferases in all of the following diseases, EXCEPT:
A. Viral hepatitis
B. Myocardial infarction
C. Hepatic colic
D. Renal colic
E. Acute pancreatitis
Determination of activity of which of the following enzymes is NOT used for differential diagnostics of jaundices?
A. Alkaline phosphatase
B. Acid phosphatase
C. Sorbitol dehydrogenase
D. Aminotransferase
E. GGTP
*For examination of patients with kidney disease diagnostic value have all of the following enzymes, EXCEPT:
A. LDH isoenzymes.
B. Transamidynase.
C. Urokinase.
D. Acid phosphatase.
E. Leucinaminopeptydase.
For examination of patients with diseases of the pancreas diagnostic value have all of the following enzymes, EXCEPT:
A. Amylase.
B. Arginase.
C. Lipase.
D. Trypsin.
E. LDH isoenzymes.
For which organ glutamate dehydrogenase is an organospecific enzyme?
A. Lungs.
B. Kidneys.
C. Heart.
D. Pancreas.
E. Liver.
Patient of 28-years old suffers from diabetes mellitus during 6 months, he gets the injections of insulin. Patient has weakness, absence of appetite. In 2 weeks from the beginning of illness a patient noticed the dark colouring of urine, and afterwards jaundice and general condition of his health continued to get worse. Enlargememt of liver and spleen were revealed. Determination of activity of which of the following enzymes in a blood must be appointed for confirmation of diagnosis?
A. LDH
B. Amylase
C. AlAT
D. CPK
E. Acid phosphatase
The increase of activity of hyaluronidase was revealed in the blood serum of patient. Determination of which biochemical index of blood serum is used to confirm supposition about pathology of connecting tissue?
A. Galactose.
B. Bilirubin.
C. Uric acid.
D. Glucose.
E. Sialic acids.
It was revealed that a sample of blood plasma taken from a patient on an empty stomach was opalescent. All of the following may be a reason for lipaemic plasma, EXCEPT:
A. High concentration of chylomicrons.
B. High concentration of triglycerides.
C. High concentration of LDL.
D. Untreated diabetes mellitus.
E. High concentrations of VLDL.
A 55-year-old woman presents with crushing substernal chest pain and shortness of breath. A coronary artery is occluded due to an atherosclerotic plaque, and she is diagnosed with a having had a myocardial infarct. High serum HDL levels are protective against the development of atherosclerosis because HDL does which of the following?
A. Inhibits cholesterol production by the liver.
B. Inhibits HMG-CoA reductase.
C. Increases VLDL production.
D. Increases LDL production.
E. Brings cholesterol esters back to the liver.
What changes of blood biochemical parameters are observed under the excessive consumption of alcohol?
A. Increased content of LDL.
B. Increased concentration of triglycerides.
C. Decreased level of VLDL.
D. Decreased level of HDL.
E. Reduced cholesterol concentration.
A woman of 55 years old suffers from obesity. Laboratory analysis of blood revealed following results: blood plasma was opalescent (turbid), plasma was left undisturbed and after settling creamy supernatant layer was formed, under which serum remained muddy, total cholesterol - 7.5 mmol / l, holesterol of HDL - 1,5 mmol / l, LDL - 3,2 g / l, triglycerides - 4,5 mmol / liter. What type of hyperlipoproteinaemia are in patient?
A. I.
B. IIa.
C. IIb.
D. IV.
E. V.
By biochemical analysis it was revealed that the patient's blood plasma was slightly turbid, the concentration of lipoproteins was increased at the expense of β- and pre-β-lipoproteins, concentrations of cholesterol and triglycerides were sharply increased. What type of hyperlipoproteinaemia are in patient?
A. I.
B. IIa.
C. IIb.
D. IV.
E. V.
In the case of which of the listed diseases there is a decreased cholesterol concentration in blood?
A. Diabetes mellitus.
B. Hyperthyroidism.
C. Atherosclerosis.
D. Jaundice.
E. Chronic glomerulonephritis with nephrotic component.
*Specify a disease under which the level of phospholipids in blood serum is increased:
A. Atherosclerosis.
B. Severe form of acute hepatitis.
C. Chronic glomerulonephritis.
D. Fatty degeneration of liver.
E. All answers are correct.
Under biochemical analysis it was revealed that patient’s blood plasma was clear, and after electrophoresis an increased fraction of β-lipoproteins was revealed, concentration of total cholesterol was increased (16.8 mmol / l) and triglyceride content was normal (1,1 mg / l). What type of hyperlipoproteinaemia are in patient?
A. I.
B. IIa.
C. IIb.
D. IV.
E. V.
Hypertriglyceridemia is characteristic for all of the following diseases and states, EXCEPT:
A. Obesity.
B. Alcoholism.
C. Diabetes mellitus of II type.
D. Hereditary hyperlipidemia.
E. Abetalipoproteinaemia.
It was revealed a significantly elevated level of LDL in the blood of patient who has a genetic defect of Apo-B100. Specify the main reason for this:
A. Violation of LDL interaction with their receptors.
B. Impossibility to activate lipoprotein lypase by LDL.
C. Reduced ability of LDL to activate the transfer of cholesterol into HDL.
D. Increased synthesis of LDL.
E. Failure of endocytosis after interaction of LDL with its receptor.
A 40-year-old man presents with severe pain in his legs upon walking. He is diagnosed with atherosclerotic plaques in the arteries of his legs. High levels of cholesterol and LDL contribute to the formation of atherosclerosis. Which of the following is digested to form LDL?
A. HDL.
B. Cholesterol.
C. Cholesterol esters.
D. IDL.
E. Chylomicrons.
Laboratory assistant noticed that the blood plasma of patient is lipaemic (milky). Specify the possible reason for this:A. High concentration of LDL. B. High concentration of VLDL. C. High concentration of HDL. D. High concentration of cholesterol. E. Low concentration of chylomicrons. Under which of the following diseases there are an increased triglycerides level in the blood serum?A. Cholestasis. B. Diabetes mellitus C. Malabsorption. D. Cerebral infarction. E. Leukemia. Investigation of the plasma lipid spectrum of a patient revealed that blood plasma was uniformly turbid after settling. The concentration of total cholesterol - 10,3 mmol / l, triglycerides - 3,2 mmol / l, LDL - 9,3 g / l, VLDL - 2,84 g / l. After separation of lipoproteins by electrophoresis a broad band between LDL and VLDL was obtained. What type of hyperlipoproteinaemia are in patient?A. IIA. B. IIb. C. III. D. IV. E. V. A men of 40 years old. From a case history father and mother of a patient suffer from cardiovascular diseases. Patient complains to frequent attack of stenocardia. Results of analysis: blood plasma is clear; cholesterol - 14.3 mmol / l, triglycerides - 1.7 mmol / l, cholesterol of HDL - 0,72 mmol / l. What type of hyperlipoproteinaemia are in patient? A. I. B. IIa. C. IIb. D. IV. E. V. In the case of which of the following diseases or states an increased level of cholesterol is observed in the blood? A. Insulin intake. B. Acute hepatitis. C. Obstructive jaundice. D. Fever. E. Starvation. In the case of which of the following diseases a decreased level of phospholipids is observed in blood serum?A. Fatty liver degeneration. B. Diabetes mellitus (severe form). C. Hepatic coma. D. Chronic glomerulonephritis. E. All answers are correct. Patient’s blood plasma is turbid, and after standing in refrigerator chylomicrons float to the surface, leaving turbid plasma under supernatant layer. What type of hyperlipoproteinaemia are in patient? A. I. B. II. C. III. D. IV. E. V. Which of the following conditions and diseases are accompanied with hypocholesterolaemia?A. Nephrotic syndrome. B. Hypothyroidism. C. Insulin deficiency. D. Heavy physical activity. E. Pheochromocytoma. An 8-year-old boy presents with orange- colored tonsils, a very low HDL level, and an enlarged liver and spleen. He is diagnosed with Tangier disease. Tangier disease is a disease of cholesterol transport, such that cholesterol cannot properly exit the cell and form HDL. Which the following statements describes HDL?
A. It is produced in skeletal muscle.
B. It scavenges cholesterol from cell membranes.
C. Its major protein is apo E.
D. It is formed when VLDL is digested by lipoprotein lipase.
E. It activates acylCoA:cholesterol acyl transferase (ACAT).
Patient women of 58 years old, is suffering for a long time from rheumatoid arthritis and from a periodic loss of consciousness. She has a postural hypotension. The concentration of sodium in blood plasma is 128 mg/l, in random urine sample - 80 mmol / liter. Such changes may be in the case of all of the following diagnoses, EXCEPT: A. Nephropathy caused by usage of analgesics. B. An overdose of diuretics. C. Adrenal hypofunction. D. Excessive usage of purgatives. E. All answers are correct. Men of 62 years old was hospitalized with urinary retention. The concentration of urea in blood serum - 48 mmol / L, creatinine - 520 mmol / liter. About the diagnosis of chronic renal failure in patient may indicate all of the following features EXCEPT: A. Reduced glomerular filtration rate of 15 ml / min. B. Anemia. C. Hypophosphatemia. D. The small size of the kidneys in sonography. E. High activity of alkaline phosphatase in serum. Kidney stones were revealed in the patient. Factors that may lead to the formation of kidney stones are all listed, EXCEPT: A. Increased concentration of calcium in urine. B. Increased concentration of uric acid in urine. C. Increased concentration of oxalate in urine. D. Increased concentration of copper in urine. E. Stagnation of urine (because of obstruction). The middle-aged man is suffering from a renal colic. Possible cause of the disease can be assumed on the basis of all observed symptoms, EXCEPT:A. Signs of malabsorption, which lead to oxaluria. B. Xanthomatosis of tendons. C. At a case history - arthritis of big toe of leg (last year). D. Hypercalcemia. E. Hyperuricemia. What violation is reason of renal glucosuria?
A. Reabsorption of glucose in the distal tubules of kidneys.
B. Reabsorption of glucose in the proximal tubules of nephron.
C. Filtration of glucose through intact kidney filter.
D. Secretion of glucose by a renal epithelium.
E. Digestion of polysaccharides.
The consequence of what process is a renal proteinuria?
A. Dysproteinemia.
B. Availability of kidney stones.
C. Ingress of fluid in the urine with inflammation of the ureters.
D. Violation of filtration and reabsorption of proteins.
E. High concentration of Bence Jones proteins.
At which disease or condition there is an alkaline reaction (alkaline pH) of urine? A. Cystitis. B. Pyelonephritis. C. Acute glomerulonephritis. D. Diabetes. E. Starvation. Patient K. , 46 years old, was hospitalized on the second day after mushroom poisoning with complaints of general weakness, nausea, headache, yellowness of skin, the appearance of brown-colored urine. Blood pressure 170/110 mm Hg., liver 3 cm. Urine analysis: specific gravity 1039, protein 0.78 g / liter., a large number of red blood cells. Creatinine and urea are increased in 7 times. What is the most likely diagnosis? A. Toxic glomerulonephritis. B. Toxic gastritis. C. Toxic pancreatitis. D. Acute enteritis. E. Acute renal failure. What changes of diuresis are characteristic for acute renal failure?
A. The increase of daily diuresis.
B. Reduction or complete cessation of urine output.
C. Predominance of night diuresis.
D. Frequent urination.
E. None of the above answers is correct.
For a patient a glucosuria is diagnosed. The reasons for such changes may be all listed factors EXCEPT:
A. Use of excessive amounts of carbohydrate meal.
B. Injection of adrenaline.
C. Acute pancreatitis.
D. A high renal threshold for glucose.
E. Usage of corticosteroids.
Which of the following diseases is characterized by bilirubinuriya?
A. Subhepatic jaundice.
B. Hemolytic jaundice.
C. Urolithiasis.
D. Chronic nephritis.
E. Parenchymal jaundice.
Which of the following diseases is characterized by hemoglobinuria?
A. Acute nephritis.
B. Cystitis.
C. Parenchymal jaundice.
D. Hemolytic anemia.
E. Renal amyloidosis.
Which of the following diseases is accompanied by oliguria?
A. Chronic glomerulonephritis.
B. Pyelonephritis.
C. Nephrotic syndrome.
D. Acute renal failure.
E. All answers are correct.
Which of the following diseases is accompanied by appearance of ketone bodies in urine?
A. Acute glomerulonephritis.
B. Urolithiasis.
C. Diabetes.
D. Tuberculosis of the kidney.
E. Hemolytic jaundice.
In a pregnant woman blood pressure is 180/100 mm Hg., swelling, daily diuresis 400 ml, relative density of urine is 1.030, acid reaction, 8 g protein/liter, in the sediment there are single red cells and white blood cells. This woman likely suffers from which of the following?
A. Acute glomerulonephritis.
B. Pregnant nephropathy.
C. Acute pyelonephritis.
D. Acute cystitis.
E. Acute renal failure.
What biochemical index is the most informative for the estimation of glomerular filtration in the kidneys?
A. Urea.
B. Endogenous creatinine.
C. Exogenous creatinine.
D. Indican.
E. Uric acid.
Renin secretion in the kidney is stimulated by all listed factors EXCEPT:
A. By the reduction of pressure in glomerular arteries.
B. By the reduction of sodium in distal tubules of kidneys.
C. By the excitation of the sympathetic nervous system.
D. By the increased blood pressure in the body.
E. By the reduction of renal blood flow.
Patient M., 24-years-old is suffering from a chronic glomerulonephritis. Results of analyses: urine relative density - 1,010 kg/liter, urine protein - 1,63 g/liter; creatinine of blood - 0,350 mmol/liter, serum sodium - 148 mmol/liter. What is the main reason of azotemia in a patient?
A. Reduced renal blood flow .
B. Increased proteinuria.
C. Reduced tubular reabsorption.
D. Delay of sodium in the body.
E. Reduced glomerular filtration.
Excretion of which substances in urine does increase for patients with amyloidosis?
A. Creatinine.
B. Ketone bodies.
C. Glucose.
D. Urea.
E. Glycoproteins.
Patient was hospitalized with acute glomerulonephritis. Reduced glomerular filtration under these conditions is one of the most important mechanisms that cause the delay in the body:
A. Calcium.
B. Potassium.
C. Sodium.
D. Iron.
E. Copper.
A 23-year-old man develops steatorrhea, weight loss, and a bloody diarrhea. He notes that the diarrhea is worse when he eats breads or cereals. A gastroenterologist performs a biopsy during a colonoscopy, which reveals celiac disease. This disorder is most directly due to which of the following?
A. Excess lipids in the feces
B. Deficiency of enterokinase
C. Defective transport of the amino acid cysteine
D. A defect in the transport of neutral amino acids
E. Hypersensitivity to the protein gluten
A 3-year-old child presents to the pediatrician for failure to thrive. A workup including an ultrasound of his liver shows cirrhosis. A biopsy of the liver demonstrates a deficiency of an enzyme involved in glycogen synthesis. Which of the following is the most likely glycogen storage disease that affects this child?
A. Type I: von Gierke disease
B. Type II: Pompe disease
C. Type III: Cori disease
D. Type IV: Andersen disease
E. Type V: McArdle disease
An infant was brought into the emergency room after her parents witnessed her having a seizure. The child's blood glucose was 2,8 mmol/L. After a thorough workup, a glycogen storage disease (GSD) is suspected, and a muscle biopsy is significant for the accumulation of dextrin, a form of glycogen with branching limited to only a few glucose molecules. Which of the following GSDs is most likely the cause of the hypoglycemia and subsequent seizure?
A. Type I: von Gierke disease
B. Type II: Pompe disease
C. Type III: Cori disease
D. Type IV: Andersen disease
E. Type V: McArdle disease
A 5-year-old, mentally retarded child is seen by an ophthalmologist due to "blurry vision." Ocular examination demonstrates bilateral lens dislocations. On further work-up, imaging is significant for osteoporosis, and a urine analysis is remarkable for an accumulation of homocysteine. Serum analysis would most likely show an elevation of which of the following substances?
A. Tryptophan.
B. Valine.
C. Phenylalanine.
D. Tyrosine.
E. Methionine.
A 2-year-old girl was seen in the emergency room for vomiting and tremors. The elevated plasma ammonium ion concentration was 195 pM (normal, 11-50 pM). Metabolic screens of serum and urine were ordered and were remarkable for an elevation in the amino acid arginine in serum. You conclude that this patient may have a defect in which of the following enzymes?
A. Carbamoyl phosphate synthetase I.
B. Carbamoyl phosphate synthetase II.
C. Ornithine transcarbamoylase.
D. Arginase.
E. Argininosuccinate lyase.
A couple of African-American descent gives birth to a boy after an otherwise uneventful pregnancy. The child is exceptionally fair-skinned and has almost white hair. Further exam reveals red pupils. A postnatal screen is likely to confirm the deficiency of which of the following enzymes?
A. Peroxidase.
B. Inducible nitric oxide synthase (iNOS).
C. Glutathione reductase.
D. Tyrosinase.
E. S-Adenosylmethionine.
A 4-day-old infant develops severe jaundice and is transferred to the neonatal intensive care unit for aggressive phototherapy. He is found to have complete lack of uridine diphosphate glucosyl transferase. Which of the following disoders does the infant have?
A. Crigler-Najjar syndrome.
B. Lesch-Nyhan syndrome.
C. Dubin-Johnson syndrome.
D. Hereditary orotic aciduria.
E. Gout.