Biochemistry Practical

MBBS Supplementary Examination 2021

Total marks: 10x3=30

Time: 90 min

1. A 50-year-old female presents to the OPD with generalized edema, itching, nausea,
vomiting and loss of appetite. She had a previous history of type 2 Diabetes Mellitus for more
than 20 years, treated with antidiabetic agents initially and insulin for the last 5 years, and
with poor metabolic control. Her blood sample was taken for examination.

Findings:
(i) Serum urea - 82 mg/dl
(ii) Serum calcium - 7.6 mg/dl
(iii)Serum phosphorus –5.9 mg/dl
(iv) Haemoglobin – 9.1 g/dl

Additional information: For Fasting blood glucose and creatinine estimation –

Fasting blood Serum creatinine

glucose
Absorbance of Standard 0.44 0.72
Absorbance of Test 0.65 0.49
Absorbance of Blank 0.02 0.01
Concentration of Standard 100 mg/dl 2 mg/dl, Dilution factor = 4

a. Write down the experiment for the estimation of fasting blood sugar (glucose) by Glucose
oxidase peroxidase method under the following headings:
(i) Principle (1)
(ii) Calculation (1)
(iii) Result (1)
(iv) Reference Range (1)

b. Write down the experiment for the estimation of serum creatinine by kinetic Jaffe method
under the following headings:
(i) Principle (1)
(ii) Calculation (1)
(iii) Result (1)
(iv) Reference Range (1)

c. Give your final diagnosis in the above case. Justify. (2)

d. What is microalbuminuria? Write down it’s clinical significance. (1+1)

e. What is the reference range for serum urea? (1)
f. Which physiological factors affects the creatinine estimation. (Any two) (2)
2. A 50-year obese female presented in the emergency with acute severe abdominal pain in
right upper quadrant, radiating to the back. Patient also complained of nausea, vomiting, weight
loss, yellowish discoloration of skin and sclera, dark yellow urine and clay-colored stools. Her
blood sample was sent to the biochemistry lab.
Findings
(i) Serum aspartate transaminase - 40 U/L
(ii) Serum alanine transaminase - 52 U/L
(iii) Serum alkaline phosphatase - 600 U/L

Additional information: For serum bilirubin estimation –

Serum Direct Bilirubin Serum Total Bilirubin

Absorbance of Standard 0.30 0.55
Absorbance of Test 0.33 0.91
Absorbance of Blank 0.02 0.00
Concentration of Standard 10 mg/dl 10 mg/dl

a. Write down the experiment for the estimation of serum total bilirubin under the
following headings:
(i) Principle (1)
(ii) Calculation (1)
(iii) Result (1)
(iv) Reference Range (1)

b. Write down the experiment for the estimation of serum direct bilirubin under the
following headings:
(i) Principle (1)
(ii) Calculation (1)
(iii) Result (1)
(iv) Reference Range (1)

c. Give your final diagnosis in the above case. Justify. (2)

d. Name two urine tests to support your diagnosis (2)
e. Name any two serum tests besides alkaline phosphatase to support your diagnosis.(2)
f. Give reason for clay colored stool found in this patient? (1)