Clinical Chemistry And Serology (Updated To Include Hemostasis And Cytology)
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A decrease in _________ may occur in chronic liver dease, starvation/malnutrition, malabsorption, enteritis, colitis, parasites, pregnancy and lactation, prolonged fever, uncontrolled diabetes, trauma, nephritis, ascites, protein losing enteropothy, and blood loss. (I really hope we don't have to know all of these.)
Explanation A decrease in albumin may occur in various conditions such as chronic liver disease, starvation/malnutrition, malabsorption, enteritis, colitis, parasites, pregnancy and lactation, prolonged fever, uncontrolled diabetes, trauma, nephritis, ascites, protein losing enteropathy, and blood loss. Albumin is a protein produced by the liver and is responsible for maintaining the osmotic pressure in the blood vessels, transporting hormones, drugs, and other substances, and regulating fluid balance in the body. A decrease in albumin levels can indicate impaired liver function, malnutrition, or other underlying health issues.
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2.
A sample tube should be immediately labeled with the following:
A.
Patient name
B.
Patient ID number
C.
Hospital name
D.
Date
E.
Time of collection
F.
Veterinarian name
G.
Owner's name
Correct Answer(s)
A. Patient name B. Patient ID number D. Date E. Time of collection G. Owner's name
Explanation When collecting a sample tube, it is important to immediately label it with the patient's name, patient ID number, date, time of collection, and owner's name. This information is crucial for proper identification and tracking of the sample. The hospital name and veterinarian's name may not be necessary for labeling the sample tube as they are not directly related to identifying the patient or the sample itself.
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3.
A serum sample is obtained by placing blood in an EDTA or sodium citrate tube and allowing it to clot before spinning it down.
A.
True
B.
False
Correct Answer
B. False
Explanation Tube should have no additives.
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4.
Increased BUN concentration may be present if a meal was high in ___________.
Correct Answer Protein
Explanation Increased BUN concentration may be present if a meal was high in protein. BUN stands for blood urea nitrogen, which is a waste product formed when the body breaks down proteins. When protein intake is high, more protein is broken down, leading to an increase in BUN levels. Therefore, if a meal is high in protein, it can result in an elevated BUN concentration.
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5.
Serum can be frozen or refrigerated.
A.
True
B.
False
Correct Answer
A. True
Explanation Serum can indeed be frozen or refrigerated. Freezing or refrigerating serum helps to preserve its stability and prolong its shelf life. This is particularly important for biological samples and medical applications where maintaining the integrity of the serum is crucial. By freezing or refrigerating serum, the growth of bacteria and other microorganisms can be inhibited, preventing degradation and maintaining its quality. Therefore, it is true that serum can be frozen or refrigerated.
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6.
Serum is plasma from which _________ has been removed. (not clotting factor)
Correct Answer Fibrinogen
Explanation Serum is the clear, yellowish fluid that remains after the blood has clotted and the clotting factors, including fibrinogen, have been removed. Fibrinogen is a protein that plays a key role in the clotting process by converting into fibrin, which forms a mesh-like structure to stop bleeding. Therefore, the correct answer is fibrinogen because it is one of the components that are removed from plasma to obtain serum.
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7.
What is ALB an acronym for?
Correct Answer Albumin
Explanation ALB is an acronym for Albumin. Albumin is a protein that is found in the blood and plays a crucial role in maintaining the osmotic pressure in the blood vessels. It helps transport various substances, such as hormones, drugs, and fatty acids, throughout the body. Albumin also helps regulate the balance of fluids in the body and acts as a buffer to maintain the pH level.
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8.
What serum protein helps evaluate hydration, hemorrhage, intestinal, liver, and kidney disease?
Correct Answer Albumin ALB
Explanation Albumin is a serum protein that helps evaluate hydration, hemorrhage, intestinal, liver, and kidney disease. It is commonly used as a marker to assess the overall nutritional status and fluid balance in the body. Low levels of albumin may indicate dehydration or fluid loss, while high levels may indicate liver or kidney disease. Therefore, measuring albumin levels can provide valuable information about various health conditions related to hydration, bleeding, and organ function.
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9.
What type of procedures are essential for any test (analyzers) that is performed on an in-clinic basis? (tests accuracy)
Correct Answer Quality control
Explanation Quality control procedures are essential for any test performed on an in-clinic basis to ensure the accuracy of the results. These procedures involve a set of measures and protocols that are implemented to monitor and maintain the quality and reliability of the testing process. Quality control helps to identify and correct any potential errors or issues that may affect the accuracy of the test results, thereby ensuring the validity and reliability of the test.
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10.
What type of blood samples are ideal for blood chemistries? (before/after meal, use correct term)
Correct Answer Preprandial
Explanation Preprandial refers to the period before a meal. In the context of blood chemistries, preprandial blood samples are ideal because they are taken before the individual has eaten. This ensures that the blood sample is not influenced by the digestion process or any substances that may be present in the food consumed. Preprandial blood samples provide a baseline measurement of the individual's blood chemistry, allowing for more accurate analysis and interpretation of the results.
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11.
Which anticoagulant can be used for more assays included in a routine biochemical profile?
Correct Answer Heparin
Explanation Heparin is a commonly used anticoagulant that can be used for a variety of assays included in a routine biochemical profile. It works by inhibiting the clotting factors in the blood, preventing the formation of clots. Heparin is preferred in many cases because it does not interfere with the results of most biochemical tests, allowing for accurate measurement of various parameters. Additionally, heparin has a relatively short half-life, making it suitable for routine testing as it can be quickly cleared from the system.
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12.
Which of the following are kidney assays?
A.
GGT
B.
BUN
C.
ALT
D.
ALK
E.
Creatinine
F.
Trypsin
G.
TBIL
H.
Amylase
I.
AST
J.
Lipase
K.
ALKP
L.
Glucose
Correct Answer(s)
B. BUN E. Creatinine
Explanation BUN (Blood Urea Nitrogen) and Creatinine are both kidney assays commonly used to assess kidney function. BUN measures the amount of nitrogen in the blood that comes from urea, a waste product produced by the liver and excreted by the kidneys. Creatinine is a waste product produced by the muscles and excreted by the kidneys. Elevated levels of BUN and Creatinine can indicate impaired kidney function. The other options listed are not kidney assays and are used to measure different aspects of liver function, pancreatic function, or glucose levels.
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13.
Which of the following are liver chemistries?
A.
GGT
B.
BUN
C.
ALT
D.
ALK
E.
Creatinine
F.
Trypsin
G.
TBIL
H.
Amylase
I.
AST
J.
Lipase
K.
ALKP
L.
Glucose
Correct Answer(s)
A. GGT C. ALT D. ALK G. TBIL I. AST K. ALKP
Explanation GGT, ALT, ALK, TBIL, AST, and ALKP are all liver chemistries. These are specific blood tests that measure the levels of various enzymes and substances in the blood that are produced by the liver. GGT (gamma-glutamyl transferase), ALT (alanine aminotransferase), ALK (alkaline phosphatase), TBIL (total bilirubin), AST (aspartate aminotransferase), and ALKP (alkaline phosphatase) are all commonly used liver function tests to assess liver health and function.
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14.
Which of the following are pancreas assays?
A.
GGT
B.
BUN
C.
ALT
D.
ALK
E.
Creatinine
F.
Trypsin
G.
TBIL
H.
Amylase
I.
AST
J.
Lipase
K.
ALKP
L.
Glucose
Correct Answer(s)
F. Trypsin H. Amylase J. Lipase L. Glucose
Explanation The correct answer includes Trypsin, Amylase, Lipase, and Glucose. These are all pancreas assays because they are tests that measure different aspects of pancreatic function. Trypsin, Amylase, and Lipase are enzymes produced by the pancreas that help with digestion. Elevated levels of these enzymes in the blood can indicate pancreatic inflammation or damage. Glucose is also included because the pancreas produces insulin, which regulates blood sugar levels. Dysfunction of the pancreas can lead to abnormal glucose levels.
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15.
What does ALKP stand for?
Correct Answer(s) Alkaline Phosphatase
Explanation ALKP stands for Alkaline Phosphatase. Alkaline phosphatase is an enzyme that is found in various tissues throughout the body, including the liver, bones, and intestines. It is involved in the process of removing phosphate groups from molecules, and its levels in the blood can be measured to assess liver and bone health.
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16.
What is another acronym for ALKP?
Correct Answer(s) AP
Explanation ALKP is an acronym for Alkaline Phosphatase. Another acronym for Alkaline Phosphatase is AP.
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17.
What isoenzyme is present in almost all tissues, particularly osteoblasts in bones, chondroblasts in cartilage, and called of the hepatobiliary system of the liver.
Correct Answer(s) ALKP Alkaline Phosphatase
Explanation Alkaline Phosphatase (ALKP) is an isoenzyme that is present in almost all tissues, including osteoblasts in bones, chondroblasts in cartilage, and the hepatobiliary system of the liver. It is commonly used as a marker for liver and bone disorders.
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18.
Elevations in ____________ may indicate liver damage, Cushing's disease, and active bone growth in young pets.
Correct Answer(s) ALKP Alkaline Phosphatase
Explanation Elevations in ALKP (Alkaline Phosphatase) may indicate liver damage, Cushing's disease, and active bone growth in young pets. Alkaline phosphatase is an enzyme that is primarily found in the liver, bones, and intestines. An increase in ALKP levels can be a sign of liver dysfunction or damage, such as hepatitis or cholestasis. It can also be elevated in pets with Cushing's disease, a hormonal disorder that affects the adrenal glands. Additionally, ALKP levels can be elevated in young animals during periods of active bone growth, as the enzyme is involved in bone mineralization.
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19.
Most ALKP in young animals comes from ______________ and ______________ because of active bone development. (include a comma between answers)
Explanation The correct answer is "osteoblasts, chondroblasts". ALKP stands for alkaline phosphatase, an enzyme that is used as a marker for bone formation. In young animals, active bone development occurs, and this is primarily carried out by osteoblasts and chondroblasts. Osteoblasts are responsible for bone formation, while chondroblasts are responsible for cartilage formation. Therefore, most of the ALKP in young animals comes from these two cell types.
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20.
Most ALKP in older animals comes from the __________ as bone development stabilizes.
Correct Answer(s) Liver
Explanation As animals age, their bone development stabilizes, resulting in a decrease in the production of alkaline phosphatase (ALKP) from the bones. Therefore, the majority of ALKP in older animals comes from the liver. The liver is responsible for producing and releasing ALKP into the bloodstream, where it plays a role in various physiological processes, including the breakdown of proteins and the metabolism of drugs and toxins.
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21.
Adult animals with bone injury or obstructive liver disease may have increased _____________.
Correct Answer(s) ALKP Alkaline Phosphatase
Explanation Adult animals with bone injury or obstructive liver disease may have increased levels of ALKP (Alkaline Phosphatase). ALKP is an enzyme found in high concentrations in the liver, bones, and intestines. In cases of bone injury, the increased ALKP levels can be attributed to the bone cells releasing the enzyme as part of the healing process. In obstructive liver disease, the liver cells are unable to properly process ALKP, leading to its accumulation in the bloodstream. Therefore, elevated ALKP levels can indicate these conditions in adult animals.
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22.
What two drugs will give a marked increase in ALKP for up to 2 weeks after administration? (include a comma between answers)
Explanation Glucocorticoids and anticonvulsants are the two drugs that can cause a marked increase in ALKP (alkaline phosphatase) levels for up to 2 weeks after administration.
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23.
What is ALT an acronym for?
Correct Answer(s) Alanine aminotransferase
Explanation ALT is an acronym for Alanine aminotransferase. This is an enzyme found primarily in the liver and is involved in the metabolism of amino acids. It is commonly used as a marker for liver function and can be elevated in cases of liver damage or disease.
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24.
ALT was formerly known as
Correct Answer(s) SGPT
Explanation ALT, which stands for alanine aminotransferase, was previously known as SGPT, which stands for serum glutamic-pyruvic transaminase. ALT is an enzyme found primarily in the liver and is used as a marker for liver health. The name change from SGPT to ALT reflects a more accurate description of the enzyme's function and its role in various metabolic processes.
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25.
What enzyme is found in large amounts in the hepatocytes of dogs, cats, and primates?
Correct Answer(s) ALT Alanine aminotransferase
Explanation ALT, also known as alanine aminotransferase, is an enzyme that is found in large amounts in the hepatocytes (liver cells) of dogs, cats, and primates. This enzyme plays a crucial role in the metabolism of amino acids, specifically alanine. Elevated levels of ALT in the blood can indicate liver damage or disease, making it an important marker in diagnosing liver conditions in these animals.
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26.
What enzyme is a sensitive indicator of active liver damage, but does not indicate the cause of it?
Correct Answer(s) ALT Alanine aminotransferase
Explanation ALT (Alanine aminotransferase) is an enzyme that is primarily found in the liver. It is released into the bloodstream when there is liver damage or inflammation. Therefore, elevated levels of ALT in the blood can be a sensitive indicator of active liver damage. However, ALT alone cannot determine the cause of the liver damage. Further diagnostic tests and medical evaluation are needed to identify the underlying cause.
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27.
What is AST an acronym for?
Correct Answer(s) Aspartate transferase
Explanation AST is an acronym for Aspartate transferase. This enzyme is found in various organs, especially the liver and heart. It plays a crucial role in amino acid metabolism and is commonly used as a diagnostic marker for liver and heart diseases. Measurement of AST levels in the blood can provide valuable information about the health and function of these organs.
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28.
AST was formerly known as
Correct Answer(s) SGOT
Explanation AST stands for Aspartate Aminotransferase, which is an enzyme found in various tissues of the body, particularly in the liver and heart. It is commonly used as a marker for liver damage or dysfunction. In the past, AST was known as SGOT, which stands for Serum Glutamic Oxaloacetic Transaminase. However, the name was changed to AST to better reflect its function and to align with the naming conventions of other enzymes.
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29.
Increases in what enzyme may indicate liver, heart, or skeletal muscle damage?
Correct Answer(s) AST Aspartate transferase
Explanation AST, also known as aspartate transferase, is an enzyme that is found in various tissues including the liver, heart, and skeletal muscles. An increase in the levels of this enzyme in the blood may indicate damage to these organs. Therefore, if there is an increase in AST levels, it suggests the possibility of liver, heart, or skeletal muscle damage.
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30.
Hepatic disease, muscle inflammation or necrosis, and spontaneous or artificial hemolysis are the most common causes of an increase in what enzyme?
Correct Answer(s) AST Aspartate transferase
Explanation The enzyme AST (aspartate transferase) is commonly increased in cases of hepatic disease, muscle inflammation or necrosis, and spontaneous or artificial hemolysis. This enzyme is found in various tissues, including the liver, heart, skeletal muscle, and red blood cells. An increase in AST levels can indicate damage or injury to these tissues. Therefore, AST is a useful marker for assessing liver function and diagnosing conditions such as liver disease, muscle disorders, and hemolytic anemia.
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31.
Horses have higher normal ______ values than other species.
A.
ALT
B.
AST
C.
GGT
Correct Answer
B. AST
Explanation Horses have higher normal AST (aspartate aminotransferase) values than other species.
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32.
AST should be evaluated in conjunction with _____ for dogs and cats.
A.
ALKP
B.
TBIL
C.
ALT
Correct Answer
C. ALT
Explanation AST should be evaluated in conjunction with ALT for dogs and cats. This is because AST (aspartate aminotransferase) and ALT (alanine aminotransferase) are both liver enzymes that are commonly measured in veterinary medicine to assess liver function. Evaluating both enzymes together provides a more comprehensive understanding of liver health and can help identify any abnormalities or diseases affecting the liver in dogs and cats.
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33.
Increased _____ with normal to mildly elevated _____ may indicate reversible liver damage. (include a comma between answers)
Correct Answer ALT, AST
Explanation Increased levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with normal to mildly elevated levels may indicate reversible liver damage. ALT and AST are enzymes found in the liver, and their levels in the blood can be used as indicators of liver function. When the liver is damaged, such as in cases of hepatitis or liver disease, these enzymes are released into the bloodstream, causing their levels to rise. However, if the liver damage is reversible and the liver cells are able to recover, the levels of ALT and AST may return to normal or only slightly elevated.
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34.
Marked elevations in _____ and _____ indicate hepatocellular necrosis. (include comma between answers)
Correct Answer ALT, AST AST, ALT
Explanation Marked elevations in ALT and AST indicate hepatocellular necrosis. ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are liver enzymes that are released into the bloodstream when liver cells are damaged or destroyed. An increase in their levels suggests hepatocellular necrosis, which is the death of liver cells. The order in which the enzymes are mentioned does not affect the explanation.
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35.
Increased ____ with normal ____ indicate that the source is NOT the liver. (include comma between answers)
Correct Answer AST, ALT
Explanation Increased AST and ALT with normal liver indicate that the source of the elevated levels is not the liver. AST (aspartate aminotransferase) and ALT (alanine aminotransferase) are enzymes found in various organs including the liver. Elevated levels of AST and ALT are typically seen in liver diseases such as hepatitis or cirrhosis. However, if these enzymes are elevated while the liver function tests remain normal, it suggests that the source of the elevated levels is not the liver. Other organs such as the heart or skeletal muscles may be the source of the increased AST and ALT.
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36.
What is GGT an acronym for?
Correct Answer Gamma glutamyl transferase
Explanation GGT is an acronym for Gamma glutamyl transferase. This term refers to an enzyme that is found in the liver and other organs. It plays a role in the transfer of amino acids across cell membranes and is commonly used as a marker for liver function and alcohol consumption.
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37.
What enzyme indicates liver disease or corticosteroid excess?
Correct Answer GGT gamma glutamyl transferase
Explanation GGT, also known as gamma glutamyl transferase, is an enzyme that is commonly used as a marker for liver disease or corticosteroid excess. Elevated levels of GGT in the blood can indicate liver damage or dysfunction, as it is primarily found in liver cells. Additionally, GGT levels can be increased in individuals who are taking corticosteroid medications, which are commonly used to reduce inflammation and suppress the immune system. Therefore, GGT is a valuable diagnostic tool in assessing liver health and identifying potential corticosteroid excess.
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38.
An increase in ____ will usually accompany an increase in GGT.
Correct Answer ALT
Explanation An increase in ALT (alanine aminotransferase) will usually accompany an increase in GGT (gamma-glutamyl transferase). ALT is an enzyme found primarily in the liver, while GGT is an enzyme found in various tissues including the liver and bile ducts. Both ALT and GGT are commonly used as markers of liver damage or disease. An increase in ALT indicates liver cell damage, and this can often be accompanied by an increase in GGT levels. Therefore, an increase in ALT is likely to be associated with an increase in GGT.
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39.
What enzyme is a good indicator for small animal fatty liver disease?
Correct Answer GGT gamma glutamyl transferase
Explanation GGT (gamma glutamyl transferase) is a good indicator for small animal fatty liver disease. GGT is an enzyme that is primarily found in the liver, and its levels in the blood can increase when there is damage or disease affecting the liver. In the case of small animal fatty liver disease, the liver becomes infiltrated with fat, leading to inflammation and potential liver damage. Therefore, measuring GGT levels can help in diagnosing and monitoring the progression of small animal fatty liver disease.
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40.
What is TBIL an acronym for?
Correct Answer total bilirubin
Explanation TBIL is an acronym for total bilirubin. Bilirubin is a yellow pigment that is produced when red blood cells break down. It is processed by the liver and excreted in bile. Total bilirubin refers to the overall amount of bilirubin in the blood, including both direct and indirect bilirubin. Measuring TBIL levels is important in diagnosing and monitoring liver and gallbladder disorders, as elevated levels can indicate liver dysfunction or obstruction of the bile ducts.
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41.
______ is a metabolite of the heme portion of hemoglobin.
Correct Answer TBIL Bilirubin
Explanation Bilirubin is a metabolite of the heme portion of hemoglobin. It is produced when red blood cells are broken down and heme is converted into biliverdin, which is then further converted into bilirubin. Bilirubin is then transported to the liver where it is conjugated and excreted in the bile. Elevated levels of bilirubin in the blood can indicate liver dysfunction or other medical conditions. TBIL is the abbreviation for total bilirubin, which includes both conjugated and unconjugated forms of bilirubin. Therefore, TBIL is the correct answer.
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42.
When RBCs die, heme is metabolized to ____________ and is carried to the liver.
Correct Answer bilirubin
Explanation When red blood cells (RBCs) die, heme, which is a component of hemoglobin, is broken down and metabolized into bilirubin. Bilirubin is then transported to the liver where it undergoes further processing and is eventually excreted in the bile. This process is a normal part of the breakdown and recycling of RBCs in the body.
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43.
___________ is assayed to determine the cause of jaundice, evaluate liver function, and check the patency of the bile ducts.
Correct Answer Bilirubin
Explanation Bilirubin is assayed to determine the cause of jaundice, evaluate liver function, and check the patency of the bile ducts. Bilirubin is a yellow pigment that is formed when red blood cells break down. It is processed by the liver and excreted in bile. Elevated levels of bilirubin in the blood can indicate liver disease or a blockage in the bile ducts. Therefore, measuring bilirubin levels can provide important information about the functioning of the liver and the presence of any underlying conditions causing jaundice.
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44.
_______________________ refers to increased serum bilirubin levels.
Correct Answer Hyperbilirubinemia
Explanation Hyperbilirubinemia refers to increased serum bilirubin levels. Bilirubin is a yellow pigment that is produced when red blood cells break down. It is normally processed by the liver and excreted in the bile. However, if there is a disruption in the normal functioning of the liver or an excessive breakdown of red blood cells, bilirubin levels can rise, leading to hyperbilirubinemia. This condition can be caused by various factors such as liver disease, hepatitis, gallstones, or certain medications. Hyperbilirubinemia can result in yellowing of the skin and eyes (jaundice) and may be an indication of an underlying health issue that requires further investigation and treatment.
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45.
Hyperbilirubinemia can cause
Correct Answer Jaundice
Explanation Hyperbilirubinemia is a medical condition characterized by an excess of bilirubin in the blood. Bilirubin is a yellow pigment that is produced when red blood cells break down. When there is an excessive amount of bilirubin in the blood, it can lead to jaundice. Jaundice is a yellowing of the skin and eyes, which occurs when bilirubin builds up in the body. Therefore, hyperbilirubinemia can cause jaundice.
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46.
The _____________ form of bilirubin is lipid soluble, bound to serum proteins, and carried to the liver to be conjugated.
Correct Answer Unconjugated
Explanation Unconjugated bilirubin is the correct answer because it is the form of bilirubin that is lipid soluble, bound to serum proteins, and transported to the liver for conjugation. Conjugated bilirubin, on the other hand, is water soluble and excreted in the bile.
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47.
The _____________ form of bilirubin is found mainly as glucuronic acid which is water soluble and more readily excreted from the body via the biliary system to the intestines and kidney.
Correct Answer Conjugated
Explanation Bilirubin is a yellow pigment that is produced when red blood cells break down. It is initially in an unconjugated form, which is not water soluble and cannot be easily excreted from the body. However, when bilirubin combines with glucuronic acid, it forms the conjugated form of bilirubin, which is water soluble and can be more readily excreted through the biliary system to the intestines and kidneys. Therefore, the correct answer is "Conjugated."
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48.
Bilirubin measured in urine is always the _____________ form unless there is renal damage.
Correct Answer Conjugated
Explanation Bilirubin is a yellow pigment that is produced when red blood cells are broken down. It is then processed by the liver, where it is conjugated (combined with other substances) to form a water-soluble form called conjugated bilirubin. This conjugated form is then excreted in the urine. Therefore, unless there is renal damage, the bilirubin measured in urine will always be in the conjugated form.
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49.
Which of the following animals do NOT have bilirubin in their urine?
A.
Cattle
B.
Cats
C.
Horses
D.
Dogs
E.
Rabbits
F.
Sheep
G.
Pigs
H.
Whales
Correct Answer(s)
B. Cats C. Horses F. Sheep G. Pigs
Explanation Cats, horses, sheep, and pigs do not have bilirubin in their urine. Bilirubin is a yellow pigment that is formed as a breakdown product of red blood cells. It is normally excreted in the urine and gives it a yellow color. However, these animals have a different way of excreting bilirubin, either through their feces or by other means, which is why it is not present in their urine.
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50.
_________ in the urine of a dog is considered a sensitive indicator of liver disease.
Correct Answer(s) Bilirubin
Explanation Bilirubin in the urine of a dog is considered a sensitive indicator of liver disease because bilirubin is a yellow pigment that is produced when red blood cells are broken down. Normally, the liver processes and excretes bilirubin, but when the liver is damaged or not functioning properly, it may not be able to effectively remove bilirubin from the body. As a result, bilirubin can accumulate in the bloodstream and be excreted in the urine, indicating liver dysfunction or disease.
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