Questions and Answers
What indicates the presence of bilirubin in urine during Fouchet's test?
What role does trichloroacetic acid play in Fouchet's test?
Which component is responsible for oxidizing bilirubin in Fouchet's test?
What does the presence of yellow bilirubin indicate in a patient's urine?
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What is formed when barium chloride is added to urine in the context of Fouchet's test?
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In the context of a 4-day old premature infant, what skin condition is suggested by the mother's complaint?
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What symptom is the infant presented with that indicates a possible concern regarding bilirubin levels?
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Why is it important to identify bilirubin levels in the urine of a premature infant?
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Which amino acids are primarily detected using the xanthoproteic test?
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What is the color change observed in the xanthoproteic test when alkali is added to the nitro derivatives?
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What concentration of NaOH solution is used in the preparation for the xanthoproteic test?
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Which reagent is used alongside heating in the xanthoproteic test to create yellow color nitro derivatives?
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What is the main purpose of the xanthoproteic test?
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What happens to coagulable protein when heated at isoelectric pH according to the method described?
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Which of the following materials is NOT required for conducting the xanthoproteic test?
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What is the resulting color of the solution after the xanthoproteic test when positive for aromatic amino acids?
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What is the most likely diagnosis for the infant described in the case?
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What observation was noted in the infant's physical examination?
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What mechanism is suggested to explain the jaundice observed in the infant?
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How did the jaundice progress in the infant over time?
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What advice would be given to the mother regarding the infant's condition?
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What symptom was NOT observed during the infant's physical examination?
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What is a potential consequence of decreased Beta glucuronidase in terms of bilirubin levels?
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Which of the following findings is characteristic of physiologic jaundice in newborns?
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Which statement is true regarding the activity of δ-aminolevulinic acid synthase in the liver?
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What does the catabolism of hemoglobin primarily involve?
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What is a key product formed during the catabolism of hemoglobin?
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Which of the following statements is true about the transport of urobilin?
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Which heavy metal ion is known to strongly inhibit the activity of δ-aminolevulinic acid synthase?
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Which of the following is a symptom that could be explained by issues related to porphyrin metabolism?
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Which role does biotin play in the body concerning amino acids?
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What is a common effect of increased levels of heavy metals in the body on enzyme activity?
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What characterizes physiologic jaundice in newborns?
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What might indicate pathologic jaundice in a newborn?
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Which of the following is associated with kernicterus?
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What is the gold standard for diagnosing bilirubin levels in newborns?
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What total bilirubin level defines the threshold for pathologic jaundice?
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Which clinical manifestation is NOT typically associated with jaundice in newborns?
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What may cause an increase in unconjugated bilirubin levels in newborns?
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Which of the following statements about bilirubin levels in newborns is TRUE?
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Study Notes
Xanthoproteic Test
- Detects aromatic amino acids, specifically Tyrosine and Tryptophan.
- Heated protein solution with concentrated HNO3 produces yellow-colored nitro derivatives.
- Differentiates aromatic amino acids that yield positive results from non-aromatic amino acids.
Materials Required
- Bunsen burner
- Test tubes
- Distilled water
- Concentrated HNO3
- 40% NaOH solution (prepared as 40g NaOH in 100mL distilled water)
Methodology
- Add 1 mL of the test solution to a test tube.
- Boil the mixture and observe the resulting color change.
Fouchet's Test
- Oxidizing reagent for detecting bilirubin in urine.
- Barium chloride precipitates sulfate radicals as barium sulfate.
- Presence of bile pigments leads to adsorption on barium sulfate; oxidized by ferric chloride to form green biliverdin.
Clinical Application
- Case study of a premature infant presenting with jaundice.
- Diagnosis: Physiologic jaundice due to decreased beta-glucuronidase and lower conjugated bilirubin.
- Monitoring and reassurance advised to the mother due to the typical progression of physiologic jaundice.
Jaundice Characteristics
- Physiologic jaundice:
- Appears after 24 hours of life, resolves by 2 weeks.
- Characterized by increased unconjugated bilirubin, total levels ≤ 12mg/dL.
- Pathologic jaundice:
- Onset < 24 hours or > 2 weeks.
- May show increased bilirubin and possibly serious symptoms.
Clinical Manifestations of Jaundice
- Yellowish skin discoloration.
- Poor suck reflex.
- Kernicterus:
- Bilirubin deposition affects basal ganglia, leading to permanent damage.
- Symptoms include lethargy and seizures at bilirubin levels ~30mg/dL.
Diagnostic Measures
- Gold standard: Transcutaneous bilirubin measurement.
- Kramer scoring for visual estimation of jaundice severity.
Biochemical Insights
- δ-Aminolevulinic acid synthase
- Activity decreased with drugs like phenobarbital.
- Catalyzes rate-limiting steps in porphyrin biosynthesis, requiring biotin.
- Inhibited by heavy metals (e.g., lead).
- Hemoglobin catabolism
- Occurs in red blood cells.
- Involves oxidative cleavage of the porphyrin ring, producing bilirubin.
Patient Case Insights
- 50-year-old male with blisters on hands post-golfing suggests possible photosensitivity or dermatological conditions linked to porphyrin metabolism.
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Description
This quiz covers the Xanthoproteic and Fouchet's tests, focusing on their methodologies and clinical applications. Understand how these tests are used to detect specific amino acids and bilirubin, respectively. Test your knowledge of the materials and processes involved in these important biochemical analyses.