CLINICAL CHEMISTRY I ASCP EXAM REVIEW SOLVED QUESTIONS COMPLETE ANSWERS GRADED A PLUS

CLINICAL CHEMISTRY I ASCP EXAM REVIEW SOLVED QUESTIONS COMPLETE
ANSWERS GRADED A PLUS
Clinical Chemistry I ASCP Practice Solution
2026/2027 Questions and Answers Verified Solutions
Latest Update

Question:
Direct (conjugated) bilirubin

Answer:
once bilirubin is conjugated to a water soluble molecule



Question:
how and where is bilirubin reduced to urobilinogen

Answer:
in the intestines by bacterial enzymes. can now be excreted in the urine and feces



Question:
breakdown in heme proteins results in how much bilirubin?

Answer:
250-300mg bilirubin



Question:
normal plasma bilirubin

Answer:
<1mg/dL



Question:
3 types of jaundice

,Answer:
prehepatic, hepatic, posthepatic



Question:
prehepatic jaundice

Answer:
increased bilirubin production (from hemolysis, ineffective erythropoiesis)



Question:
hepatic jaundice

Answer:
due to abnormal bilirubin metabolism (cell damage, hepatitis, hereditary, neonatal jaundice)



Question:
posthepatic jaundice

Answer:
decreased bilirubin excretion due to obstruction (can't be excreted into the intestine)



Question:
prehepatic jaundice characteristics

Answer:
caused by increased hgb breakdown. bilirubin in serum- indirect is increased. direct is normal. urine
bilirubin is negative. urobilinogen in stool and urine is increased.



Question:
elevated indirect bilirubin occurs when

Answer:

, the rate of production exceeds the rate of conjugation. the liver isn't able to keep up with conjugating
bilirubin, so the unconjugated bilirubin remains in the serum. (seen in hemolytic anemia, neonates
(due to immature liver).



Question:
hepatic jaundice characteristics

Answer:
caused by conjugation failure (enzyme deficiency such as glutano transferase, seen in immature
livers of neonates), transport failure, and hepatic cell damage (cirrhosis, hepatitis). indirect and
direct serum bilirubin will be elevated. urine bilirubin is positive. urobilinogen in stool is variable
and in urine is increased.



Question:
post hepatic jaundice characteristics

Answer:
caused most frequently by obstruction of bile duct (gall stone or tumor). indirect and direct serum
bilirubin is increased (no place for it to go, so spills into bloodstream). urine bilirubin is positive.
urobilinogen in stool and urine is decreased or negative.



Question:
liver enzymes released in inflammation and lesions

Answer:
AST, ALT, ALP, GGT, LDH



Question:
ALT > AST

Answer:
true hepatic problem (hepatitis)