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Biochemistry Quiz | Biochemistry Objective Type Questions and Answers

(21) With which of the following is hyperprolactinaemia associated?
[A] Cabergoline therapy
[B] Depression
[C] Fluoxetine therapy
[D] Hyperthyroidism
Answer: Fluoxetine therapy
(22) Primary hyperparathyroidism may occur in association with the following conditions
[A] Chronic renal failure
[B] Vitamin D deficiency
[C] Gastrinoma
[D] Autoimmune polyendocrine syndrome
Answer: Gastrinoma

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(23) A 73 year old male presented with an acute attack of gout in his left knee. What is the most likely underlying metabolic cause?
[A] decreased renal excretion of uric acid
[B] endogenous overproduction of uric acid
[C] excessive dietary purine intake
[D] lactic acidosis
Answer: decreased renal excretion of uric acid
(24) Polymyalgia rheumatica associated with
[A] raised creatinine kinase
[B] increased alkaline phosphotase
[C] sudden loss of vision in one eye
[D] shoulder and pelvic girdle pain in 40 year old man
Answer: increased alkaline phosphotase
(25) An Afro-Carribean male aged 48 years presents with gradual onset of exertional dyspnoea, non productive cough, malaise, weight loss and polyarthralgia. Schirmers test indicates a dry eye. X-ray of the hand shows punched out osteopenic lesions. Which of the following investigation is unlikely to be helpful in establishing the diagnosis of this condition:
[A] Serum calcium
[B] Serum phosphorus
[C] Urea and electrolytes
[D] Thallium Scan
Answer: Thallium Scan
(26) Which of the following techniques would be most useful in the differential diagnosis between ectopic Cushing's syndrome and pituitary dependent Cushing's disease.
[A] Urine free cortisol
[B] High dose Dexamethasone suppression test
[C] ACTH concentrations
[D] Inferior petrosal sinus sampling
Answer: Inferior petrosal sinus sampling
(27) Phenytoin:
[A] is a benzalkonium Derivative
[B] is clinically effective serum level is in the range on 2-10 micrograms/ml.
[C] A steady state blood level is achieved by 2-5 days
[D] Can be used in management of alchohol withdrawl syndrome
Answer: Can be used in management of alchohol withdrawl syndrome
(28) A 53-year-old man presented with hypertension of 150/110 mmHg. He is generally asymptomatic and has no previous medical history of note. He is a smoker of 5 cigarettes daily and drinks modest quantities of alcohol. He takes no prescribed medications. Examination reveals a BMI of 33.5 kg/2 but nil else. The following detail his investigations:

Serum sodium 146 mmol/l (NR 133-145)

Serum potassium 3.2 mmol/l (NR 3.5 - 5)

Urinary potassium excretion 42 mmol/l (NR less than 30)

What is the likely diagnosis?
[A] Adrenocortical adenoma
[B] Bartter's syndrome
[C] Liddle's syndrome
[D] Liquorice ingestion
Answer: Adrenocortical adenoma
(29) Which of the following is associated with Hyperuricaemia?
[A] is usually due to an excess purine consumption
[B] occurs in association with acute lymphoblastic leukaemia
[C] in primary gout is inherited in an autosomal dominant manner
[D] can be reduced with low dose aspirin therapy
Answer: occurs in association with acute lymphoblastic leukaemia
(30) Which of the following features would be expected on lipid analysis in a 57 year old female with two year history of primary biliary cirrhosis?
[A] A lipaemic appearance of the serum would be expected.
[B] is treated with clofibrate therapy
[C] is characteristically associated with tendon xanthomas
[D] is characteristically associated with palmar xanthomas
Answer: is characteristically associated with palmar xanthomas
31 Which one of the following is true of IgE?
[A] Is present in plasma in the same concentration as IgG
[B] Is increased acutely in an asthmatic attack
[C] Crosses the normal placenta
[D] Is increased in the serum of atopic individuals
Answer: Is increased in the serum of atopic individuals
32 A 60-year-old man was diagnosed last year with adenocarcinoma of the lung, and a 4 cm mass lesion was treated with a right lower lobectomy. He now has an abdominal CT scan that reveals scattered hepatic mass lesions and hilar lymphadenopathy. For several weeks, he has had increasing malaise. A urinalysis reveals marked proteinuria, and a 24 hour urine protein collection is 2.7 g/24hr. His serum urea is 30 mmol/L (2.5 - 7.5) with creatinine of 450 µmol/L (60 - 110). A renal biopsy is performed, and there is focal deposition of IgG and C3 with a granular pattern. He is most likely to have which of the following conditions?
[A] Goodpasture's syndrome
[B] Membranous glomerulonephritis
[C] Minimal change glomerulonephritis
[D] Nodular glomerulosclerosis
Answer: Membranous glomerulonephritis
33 A 35 year old male presents with weakness and tiredness. He is noted to be hyertensive. Electrolytes show a hypokalaemia and a hypomagnesaemia. What investigation would you select for this patient?
[A] Colonoscopy
[B] Plasma renin toaldosterone ratio
[C] Serum amylase
[D] Serum calcium
Answer: Plasma renin toaldosterone ratio
34 Which of the following may be responsible for a hypokalaemic hypertension
[A] Non-classical congenital adrenal hyperplasia
[B] Barter's syndrome
[C] Diabetic nephropathy
[D] Liddle's syndrome
Answer: Liddle's syndrome
35 A 19 year-old female is referred following a visit to the dentist where marked erosion of her teeth was noted. She was entirely asymptomatic and her only medication was the oral contraceptive pill. On examination her blood pressure was 110/70 mmHg and her body mass index was 21.5 kg/m2 (18 - 25). Investigations sodium 135 mmol/l potassium 2.1 mmol/l bicarbonate 42 mmol/l urea 2.6 mol/L corrected calcium 2.08 mmol/ alkaline phosphatase 201 iu/l (50-110) What is the most likely diagnosis?
[A] Bulimia nervosa
[B] Conn's syndrome
[C] Laxative abuse
[D] Primary hypoparathyroidism
Answer: Primary hypoparathyroidism
36 Metabolic alkalosis is characteristically found in which of the following?
[A] An infusion of sodium chloride
[B] Ileostomy
[C] Mineralocorticoid deficiency
[D] Pyloric stenosis
Answer: Pyloric stenosis
37 Osteomalacia may be expected in
[A] Sarcoidosis
[B] Auto-immune adrenalitis
[C] Pseudo-hypoparathyroidism
[D] Mercury poisoning
Answer: Mercury poisoning
38 Which of the following suggests a diagnosis of familial combined hyperlipidaemia (FCHL) rather than heterozygous familial hypercholesterolaemia (FH)?
[A] Tendon xanthomas
[B] Presence of glucose intolerance
[C] Strong family history of premature coronary artery disease
[D] Presence of arcus senilus
Answer: Presence of glucose intolerance
39 Which of the following is a characteristic feature of acute intermittent porphyria?
[A] autosomal recessive inheritance
[B] excessive faecal protoporphyrin excretion
[C] excessive urinary porphobilinigoen between acute attacks
[D] hypernatraemia during attacks
Answer: excessive urinary porphobilinigoen between acute attacks
40 Which of the following suggests a diagnosis of Hurler's Syndrome rather than Hunter's Syndrome?
[A] X-linked inheritance
[B] Mental retardation
[C] Skeletal abnormalities
[D] Cloudy cornea
Answer: Cloudy cornea

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