13.

Urobilinogen is formed in: a) The gall bladder b) The reticuloendothelial system c) Erythrocytes d) The liver parenchymal cells e) The gut 24. Lead poisoning characteristically leads to inhibition of the following: a) Uroporphyrinogen decarboxylase b) ALA dehydratase c) ALA synthase and ferrohectase d) Porphobilinogen deaminase e) Bilirubin reductase and eoproporphyrin 25. In acute intermittent porphyria the appearance of high levels of deltaaminolevulinic acid and porphobilinogen in the urine is due to deficiency of the following enzyme: a) Delta aminolevulinate synthase b) Delta aminolevulinate dehydratase c) Uroporphyrinogen I synthase d) Ferrochelastase e) Microsomoal heme oxygenase 26. Increased excretion of urobilinogen is most likely caused by: a) Erythropoetic porphyria b) Liver disease such as viral hepatitis c) Hemolysis d) Iron deficiency e) Common bile duct obstruction 27. An increase in plasma conjugated bilirubin concentration is most often associated with: a) Increased heme synthesis b) Erythropoetic porphyria c) Viral hepatitis d) High level of bilverdin e) Common bile duct obstruction 28. The formation of bilirubin from heme: a) Requires oxygenase b) Requires bilverdin reductase c) Occurs in the reticuloendothelial system d) Releases carbon monoxide and iron e) All of the above 29. The commited step in heme biosynthesis produces: a) ALA b) Porphobilinogen c) Protoporphyrinogen d) Uroporphyrinogen e) Hydroxymethylbilane

30. The immediate precursor of heme in its biosynthesis is: a) Protoporphyrin III b) Coproporphyrinogen III c) Protoporphyrinogen d) Prophobilinogen e) Urobilin 31. Urobilinogen in the intestine is: a) Synthesized from conjugated bilirubin b) Converted to urobilin in stools c) Reabsorbed in the terminal ileum and large intestine d) Colourless e) All of the above 40. In hemoglobin S the mutation in the beta chain results from: a) Insertion of a nucleotide b) Replacement of alanine by serine in position 6 c) Deletion of a nucleotide d) Replacement of glutamate by valine in position 6 e) A and C are correct 43. Urobilinogen is detected in the urine of a patient with: a) Obstructive jaundice b) Hemolytic jaundice c) Hepatocellular jaundice d) Acute pancreatitis e) None of the above is correct 45. The immediate precursor of heme in its biosynthesis is: a) Protoporphyrin IX b) Coproporphhyrinogen III c) Protoporphyrinogen IX d) Porphobilinogen e) Urobilin 46. The cells which are very active in heme biosynthesis include: a) Erythroid precursors b) The liver cells c) Adipose tissue cells d) Cardiac muscles e) Intestinal mucosal cells ]

29. The following statements are true: a) Transferrin transports calcium in the circulation b) Hemochromatosis is characterized by excessive storage of ions in tissues c) Haptoglobin binds extra corpuscular hemoglobin d) All of the above is correct e) B and C are correct