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The serum total protein is made up mainly of:

1. AGlucose and urea
2. BSodium and chloride
3. CHemoglobin and iron
4. DAlbumin and globulins

A raised alkaline phosphatase (ALP) is most typical of:

1. ALow production of hormone by the thyroid gland
2. BBlocked bile flow or increased bone turnover
3. CInflammation of the lining of the urinary bladder
4. DAcute damage to the heart muscle

Chronic kidney disease is usually defined by an eGFR below which value for more than 3 months?

1. A60 mL/min/1.73 m²
2. B120 mL/min/1.73 m²
3. C90 mL/min/1.73 m²
4. D15 mL/min/1.73 m²

A patient with sickle cell disease takes hydroxyurea. Which laboratory test is monitored regularly for an adverse effect?

1. AUrine ketone level
2. BComplete blood count
3. CSerum amylase level
4. DSerum lithium level

A patient has started parenteral nutrition (PN) through a central line. Which test is monitored most frequently in the first days?

1. AThyroid hormones
2. BHemoglobin A1c
3. CBlood glucose
4. DSerum lipase

A patient has taken hydrochlorothiazide for several years. Which laboratory change is a recognized effect of this drug?

1. AA fall in serum calcium
2. BA fall in blood glucose
3. CA rise in serum uric acid
4. DA rise in serum potassium

A child with sickle cell disease and a recent viral illness is pale and tired. The hemoglobin has fallen sharply, and the reticulocyte count is very low. What is the most likely problem?

1. AA vaso-occlusive pain crisis in the bones
2. BAn aplastic crisis, often caused by parvovirus B19
3. CA normal finding in sickle cell disease
4. DIron deficiency from a poor diet over months

A patient with severe sepsis is oozing blood from IV sites. Platelets 40 × 10³/µL, fibrinogen low, D-dimer very high, PT and aPTT both prolonged. Which condition fits best?

1. AImmune thrombocytopenic purpura (ITP)
2. BHemophilia A (factor VIII deficiency)
3. CHeparin-induced thrombocytopenia (HIT)
4. DDisseminated intravascular coagulation (DIC)