1. AFP is the widely used tumour marker to screen Hepatocellular carcinoma. Which of the following other markers can be used as an adjunct to AFP to improve the sensitivity of screening test for HCC
2. In the absence of liver disease, unconjugated hyperbilirubinemia is most often due to hemolysis or to Gilbert’s syndrome, an inherited abnormality of bilirubin metabolism. What laboratory finding is not expected in cases of hemolytic jaundice
3. Alkaline phosphatase is an enzyme with many isoforms. They are present in liver, bone, placenta and intestinal epithelium. Pathological conditions such as cholestatic liver disease and bone disease can elevate ALP levels. However, its expected to rise physiologically as well
4. A 40 year old man underwent work up for a deranged liver function test. He has a history of type 2 diabetes. The biochemical test results are the following
Bilirubin 11 μmol/L(<20)
ALT 221 U/L(<42)
ALP 210 U/L (<250)
Albumin 40g/L (35-45)
GGT 268 U/L (<55)
Ferritin 1840 μg/L (15-300)
Iron 40 μmol/L (11-30)
TIBC 42 μmol/L (54-80)
Iron saturation 95% (plasma iron/TIBC × 100%)
His genetic test revealed that he was homozygous for C282Y mutation of HFE gene. Which of these biochemical parameters suggest a diagnosis towards hemochromatosis?
5. An elderly woman with a history of loss of appetite and weight loss underwent a work up, which revealed carcinoma of caecum and deranged liver function due to hepatic metastases. What abnormalities can you expect?
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