Q.1- Describe the fate of the hemoglobin molecules when senescent erythrocytes are broken down in the reticuloendothelial system. Explain what is meant by pre-hepatic, hepatic and post-hepatic jaundice. Give causes, laboratory findings and treatment of each of the above conditions.
Q.2- Explain the biochemical basis of Porphyria. Classify and discuss two clinical condition in which different metabolites of porphyrins accumulate to cause cutaneous hypersensitivity.
Q.3- What is the cause of neonatal jaundice? Explain the basis of blue light phototherapy of this condition.
Q.4- Explain how biliary obstruction could impair blood coagulation.
Q.5-Discuss the different clinical states of hyperbilirubinemia (congenital or acquired) caused due to impaired activity of UDP Glucuronyl transferase enzyme.
Q.6- Describe the biochemical basis and outline the laboratory tests for (a) obstructive jaundice; (b) acute intermittent Porphyria.
Q.7-(a) Explain the principle of measurement of total and free bilirubin by the van den Bergh reaction (b) Explain the diagnostic value in determining serum bilirubin.
Q.8- Explain how lead poisoning affects haem synthesis.
Q.9- From your knowledge of porphyrin metabolism, explain the justification for the current introduction of unleaded petrol.
Q.10- How is the biosynthesis of haem normally regulated?
Q.11- Explain why measurements of both bilirubin and urobilin are relevant to the diagnosis of obstructive jaundice?
Q.12- In a person with a defect in bilirubin metabolism, what can you deduce from the following laboratory results: (a) Bilirubin in urine and decreased urinary urobilinogen. (b) Absence of bilirubin in urine and increased urinary urobilinogen.
Q.13- In patients with a deficiency of coproporphyrinogen oxidase, what abnormalities in porphyrin metabolites would you expect to see?
Q.14- A rational approach to the diagnosis and treatment of jaundice rests on a good knowledge of the biochemistry of bilirubin metabolism. Discuss.
Q.15- What do you understand by the terms “direct” and “indirect”" Van Den Bergh reactions?
Q.16- Discuss briefly the diagnostic value of measuring stercobilin and or urobilin.
Q.17- Explain the use of biochemical tests to confirm the diagnosis of hepatocellular jaundice.
Q.18- Give the reactions catalysed by (a) haem oxygenase (b) ALA synthase (c) Ferrochelatase
Q.19- What is the biochemical basis of cutaneous hypersensitivity in Congenital Erythropoetic Porphyria?
Q.20- What is the biochemical basis of giving Hematin or Glucose infusion to treat acute attack of Porphyria?
Q.21- Discuss the basis of breast milk jaundice.
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