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Gluconeogenesis- Multiple Choice Questions

1) A 4-month-old boy is being evaluated for seizures, psychomotor retardation, and hypotonia. Work up reveals elevated serum levels of lactate, alanine, pyruvate and keto acids. Based on the clinical presentation,pyruvate carboxylase activity is measured using fibroblasts from a skin biopsy and is found to be markedly decreased. This enzyme is normally used to directly synthesize which of the following molecules ? a) Pyruvate b) Oxaloacetate c) Malate d) Acetyl co A e) - Keto glutarate 2) A 34-year-old woman presents with central obesity, relatively thin extremities and purple stria on her abdomen. Further work up reveals an excessive serum cortisol level and a blood sugar level of 258 mg/dl. Which of the following is the most likely cause of her hyperglycemia ? a) Excessive consumption of processed carbohydrates b) A pancreatic adenoma secreting ACTH and glucagon c) Cortisol induced inhibition of insulin d) Glucorticoids cause induction of Phosphoenolpyruvate carboxy kinase gene e) Increased gluconeogenesis due to increased provision of substrates through fatty acid oxidation. 3) A 56-year-old, obese man complains of polydipsia, polyuria and fatigue. A glucose tolerance test confirms the diagnosis of diabetes. He is placed on Metformin, which works by which of the following mechanisms ? a) Inhibiting hepatic gluconeogenesis b) Increasing glucagon level c) Increasing cellular responsiveness to circulating insulin d) Stimulating the release or preformed insulin

e) Replacing the need for endogenous insulin 4) An enzyme used in both glycolysis and gluconeogenesis is: a) 3-phosphoglycerate kinase. b) Glucose 6-phosphatase c) Hexokinase d) Phosphofructokinase-1 e) Pyruvate kinase 5) Which one of the following statements about gluconeogenesis is false? a) For starting materials, it can use carbon skeletons derived from certain amino acids. b) It consists entirely of the reactions of glycolysis, operating in the reverse direction. c) It employs the enzyme glucose 6-phosphatase. d) It is one of the ways that mammals maintain normal blood glucose levels between meals. e) It requires metabolic energy (ATP or GTP). 6) All of the following enzymes involved in the flow of carbon from glucose to lactate (glycolysis) are also involved in the reversal of this flow (gluconeogenesis) except: a) 3-phosphoglycerate kinase. b) Aldolase c) Enolase d) Phosphofructokinase-1 e) Phosphohexoseisomerase 7) In humans, gluconeogenesis: a) can result in the conversion of protein into blood glucose. b) helps to reduce blood glucose after a carbohydrate-rich meal.

c) is activated by the hormone insulin d) is essential in the conversion of fatty acids to glucose. e) requires the enzyme hexokinase. 8) Which of the following substrates cannot contribute to net gluconeogenesis in mammalian liver? a) Alanine b) Glutamate c) Palmitate d) Pyruvate e) -Keto glutarate. 9) A 6-year-old boy begins playing soccer in a community league. After his first game of the year, he is brought to see his pediatrician because of his severe muscle cramps and blood in urine. He is subsequently found to be having deficiency of lactate dehydrogenase. This enzyme is important in which of the following conversions ? a) Pyruvate to Acetyl co A b) Pyruvate to Oxaloacetate c) Pyruvate to Alanine d) Pyruvate to Phosphoenol pyruvate e) Pyruvate to lactate 10) A new-born infant is found to be having persistent hypoglycemia, despite decreased feeding intervals. The child is also irritable with a moderate degree of hepatomegaly. He is found to have a normal level of muscle fructose 1,6 bisphosphatase but decreased level of liver isoform. Which of the following statement is true of fructose 1,6 bisphosphatase? a) It is induced by Adenosine mono phosphate (AMP) b) It is induced by Insulin c) It is inhibited by Fructose 2,6 bisphosphate d) It is induced in the fed state

e) It is inhibited during fasting. 11) A 14-year-old high school girl who is extremely conscious about her appearance has gone a full day fasting to fit in to a dress she intentionally brought a size smaller than her actual size for a dance party. Which of the following organs/tissues contributes to the glucose that is being synthesized through gluconeogenesis ? a) Spleen b) Red blood cells c) Skeletal muscle d) Liver e) Brain 12) An 8 -year-old boy presents with frequent episodes of weakness, accompanied by sweating and feelings of dizziness. Physical examination is remarkable for palpably enlarged liver and kidneys. Blood biochemistry reveals lactic acidemia. The patient is diagnosed with deficiency of glucose-6-phosphatase, which is normally only expressed ina) Liver and muscle b) Liver and brain c) Erythrocytes d) Liver and adipose tissues e) Liver and kidney. 13) A 32-year-old body builder has decided to go on a diet consisting of egg whites to ensure only proteins for muscle growth. After a few weeks he experiences decreased energy and is found to be hypoglycemic. A nutritionist tells the patient that he most likely has the deficiency of vitamin Biotin. Which of the following enzymes is unable to catalyze its step in synthesizing glucose from pyruvate? a) Pyruvate carboxylase b) Phospho enol pyruvate carboxy kinase c) Glucose-6-phosphatase d) Fr 1,6 bisphosphatase

e) Phosphoglycerate kinase. 14) In an individual at rest, who has fasted for 12 hours, which of the following occurs ? a) Gluconeogenesis is the major process by which blood glucose is maintained b) Liver glycogen stores are depleted c) Glycogen synthase is activated in liver d) Adenylate cyclase is inactivated in liver e) Phosphorylase, pyruvate kinase and glycogen synthase are phosphorylated in liver. 15) Which of the following is a common intermediate in the conversion of glycerol and lactate to glucose ? a) Pyruvate b) Oxaloacetate c) Malate d) Glucose-6-phosphate e) Phosphoenolpyruvate. 16) In the conversion of pyruvate to glucose during gluconeogenesis, a) Biotin is required b) CO2 added in one reaction, appears in the final product c) Energy is used up in the form of GTP d) All the reactions take place in the cytosol e) PDH is the allosteric enzyme used. 17) Which of the following glycolytic enzymes is used in gluconeogenesis ? a) Glucokinase b) Phosphofructokinase-1 c) Aldolase B

d) Phosphoglycerate kinase e) Pyruvate kinase. 18) The conversion of pyruvate to fructose 1,6 bisphosphate by the gluconeogenic pathway involves which of the followings ? a) Requires lactate dehydrogenase b) Requires hexokinase c) Produces 2 ATP and 2GTP d) Requires 4 ATP and 2 GTP e) Acetyl co A is not required to activate this pathway. 19) A high ratio of insulin to glucagon can: a) Promote gluconeogenesis b) Promote glycogenolysis c) Found in Type 1 Diabetes Mellitus d) Occurs during fasting state e) Promotes synthesis of Glycogen 20) Which of the followings is a precursor for gluconeogenesis ? a) Glycogen b) Glycerol c) Glucagon d) Galactose e) Glucose

TCA Cycle- Multiple Choice Questions


1) A 24-year-old woman presents with diarrhea, dysphagia, jaundice and white transverse lines on the fingernails (Mees lines). The patient is diagnosed with Arsenic poisoning,that inhibits which of the following enzymes of TCA cycle ? a) Citrate synthase b) Isocitrate dehydrogenase c) -Keto glutarate dehydrogenase complex d) Succinate dehydrogenase e) Malate dehydrogenase 2) A biochemistry graduate student isolated all enzymes of TCA cycle to produce NADH, oxidation of which of the following substrates in the citric acid cycle is not coupled to the production of NADH ? a) Succinate b) Malate c) -Keto glutarate d) Isocitrate e) Pyruvate. 3) A 3-Year-old boy presents to the pediatric clinic with the symptoms of hypotonia, lactic acidosis, and seizures. After an extensive workup , he is diagnosed with pyruvate dehydrogenase complex deficiency. Which of the following cofactors is not required by this enzyme to convert pyruvate to Acetyl co A ? a) Thiamine b) Lipoic acid c) Pantothenic acid d) Niacin e) Ascorbic acid.

4) Which of the following vitamins is required for the synthesis of a cofactor required for the conversion of Succinate to Fumarate? a) Thiamine b) Lipoic acid c) Pantothenic acid d) Niacin e) Riboflavin. 5) Pyruvate dehydrogenase complex deficiency is an autosomal recessive disorder and leads to anion gap metabolic acidosis. Which of the following accumulates to cause metabolic acidosis ? a) Beta hydroxy butyric acid b) Acetoacetic acid c) Fumaric acid d) Lactic acid e) Hydrochloric acid. 6) A 3 year-old child presents with a history of recurrent rash upon sun exposure and passage of purple colored urine. The child is diagnosed with Congenital Erythropoietic Porphyria, a disorder of pathway of haem biosynthesis. Which of the following intermediates of TCA cycle is used as a precursor for haem biosynthesis ? a) Succinyl co A b) Acetyl co A c) Succinate d) Malate e) Pyruvate 7) A 16 -year-old male comes to the clinic for a routine sports physical examination. His physical examination is unremarkable except for the skin findings of multiple pale masses which appear to be xanthomas. Xanthomas are generally associated with the underlying

hypercholesterolemia. Which of the followings is utilized as a precursor for cholesterol biosynthesis ? a) Succinyl co A b) Acetyl co A c) Succinate d) Malate e) Pyruvate. 8) A 2-year-old child was brought to pediatric emergency with convulsions. The child was diagnosed with ammonia intoxication due to some urea cycle disorder. Reduced formation of GABA is considered to be the most important cause of convulsion due to depletion of glutamate from where it is produced by decarboxylation. Which of the following intermediates of TCA cycle is involved in the formation of Glutamate ? a) Succinate b) Malate c) -Keto glutarate d) Isocitrate e) Pyruvate. 9) In TCA cycle , GTP is produced at one step by substrate level phosphorylation and that is subsequently utilized for Gluconeogenesis. Which of the following enzymes is involved in this process of formation of GTP from GDP ? a) Succinate Thiokinase b) Succinate dehydrogenase c) Citrate synthase d) Isocitrate dehydrogenase e) Malate dehydrogenase 10) A 5-year-old child was rushed to pediatric emergency as he accidently consumed Fluoroacetate, a known inhibitor of TCA cycle. Which of the following enzymes is inhibited by fluoroacetate?

a) Citrate synthase b) Aconitase c) Succinate dehydrogenase d) Isocitrate dehydrogenase e) Malate dehydrogenase. 11) Malonate is an inhibitor ofa) Citrate synthase b) Aconitase c) Succinate dehydrogenase d) Isocitrate dehydrogenase e) Malate dehydrogenase. 12) A 56-year- old chronic alcoholic has been brought in a semiconscious state to the medical emergency. Blood biochemistry reveals hypoglycemia with blood glucose level of 45 mg/dl. Which of the following intermediates of TCA cycle can be directly converted to phosphoenolpyruvate to trigger the pathway of gluconeogenesis ? a) Succinate b) Malate c) -Keto glutarate d) Oxaloacetate e) Pyruvate. 13) A 78-year-old male is brought to emergency with Acute myocardial infarction. Blood biochemistry reveals lactic acidosis. How much energy yield (ATP) per mol of glucose is expected in such a condition? a) 32 b)2 c) 34

d) 36 d) 38 14) Which of the following allosteric modulators is not effective in influencing the rate of TCA cycle ? a) NADH b) FADH2 c) Ca++ d) ADP e) ATP 15) How many molecules of CO2 are produced per mole of Acetyl co A in TCA Cycle ? a) 2 b) 1 c) 3 d) 0 e) 4 16) The cytosolic isoform of which of the following TCA cycle enzymes requires NADP+ as a coenzyme, that can further be utilized in the reduced state for reductive biosynthesis? a) Citrate synthase b) Aconitase c) Succinate dehydrogenase d) Isocitrate dehydrogenase e) Malate dehydrogenase. 17) Which of the following intermediates of TCA cycle is depleted in Type 1 Diabetes mellitus to suppress TCA cycle and to channel excess Acetyl co A towards pathway of ketogenesis ?

a) Succinate b) Malate c) -Keto glutarate d) Oxaloacetate e) Pyruvate. 18)- Which of the following enzymes is Thiamine dependent and essential for glucose oxidation in the brain? a) Pyruvate dehydrogenase complex b) Acetyl co A carboxylase c) Transaldolase d) Succinyl-co A Thiokinase e) Succinate dehydrogenase 19)-Anaplerotic reactions are those that result in replenishing intermediates in the TCA cycle. Which of the following enzymes catalyzes an anaplerotic reaction? a) Malate dehydrogenase b)Pyruvate carboxylase c) Pyruvate kinase d) Citrate synthase e) Succinyl-co A Thiokinase

20) -Which of the following intermediates of TCA cycle cannot be utilized for gluconeogenesis ? a) Succinate b) Malate c) -Keto glutarate

d) Oxaloacetate e) Acetyl co A.

Glycolysis- Multiple Choice Questions


1). A patient has chronic obstructive pulmonary disease, enough oxygen is not reaching her tissues. All of the followings are expected excepta) The electron transport chain would be inhibited b) Glycolysis would be activated by a low ATP/ADP ratio c) More than normal amounts of ATP would be synthesized . d) Concentrations of NADH and pyruvate would be lower than normal e) More than normal amounts of lactate would be produced 2). A 45- year- old woman is diagnosed with breast cancer. The oncologist orders a positron emission tomography(PET) scan of the head to rule out metastasis. This imaging modality covalently links a radioactive isotope most commonly to Glucose to appreciate highly active areas in the body such as tumor. Which of the following traps the tracer in the cell ? a) Insulin b) GLUT-1 c) GLUT-4 d) Glucokinase e) PFK-1 3) A 45-year-old obese man complains of having to get up frequently to urinate at nighttime. He has also noticed that he is constantly thirsty and hungry. The patient is diagnosed with type 2 diabetes mellitus. If this is a problem at the level of glucose transporters , which tissue would be most affected? a) Liver b) Red blood cells c) Muscle and adipose tissue d) Brain tissue

e) Small intestine. 4) A 24-year woman is getting training for her first marathon. Her coach instructed her to keep a pace that allows her to stay below her anaerobic threshold. Under such conditions pyruvate does not accumulate as it is converted toa) Ethanol b) Lactic acid c) Acetyl co A d) Alanine e) Oxaloacetate. 5) A patient presents with dizziness, fatigue and tremors. A fingerstick test indicates a blood glucose level of 45 mg/dl (hypoglycemia). Glucagon is released under such condition . Which of the following allosteric modifier of PFK-1 would be most effective in switching off glycolysis ? a) Low level of citrate b) Low level of Fr, 2,6 bisphosphate c) Low level of ATP d) Low level of NAD+ e) Low level of Glucose-6-P 6) A 30 -year-old woman is enduring her second trimester of pregnancy. The greater affinity fetal hemoglobin acquires oxygen released from the lesser affinity maternal hemoglobin due to the effect of an allosteric modifier, which isa) Fr-2,6 bisphosphate b) 2,3 bisphosphoglycerate c) Citrate d) Acetyl co A e) Fr-1,6 bisphosphoglycerate

7) A pediatric hematologist sees an 18 month-old patient with jaundice, splenomegaly and hemolytic anemia. Blood smear indicates red blood cells that are more rigid in appearance than normal. A diagnosis of pyruvate kinase deficiency is made. What products would be made in low amounts ? a) Acetyl co A b) Glucose c) Lactate d) ATP e) Alanine 8) In an embryo with a complete deficiency of pyruvate kinase, how many net moles of ATP would be generated in the conversion of one mole of glucose to one mole of pyruvate ? a) 0 b) 1 c) 2 d) 3 e) 4 9) Which out of the following enzymes cleaves a carbon-carbon bond in the pathway of glycolysis ? a) Aldolase b) Glyceraldehyde-3-P dehydrogenase c) Enolase d) Phosphoglycerate kinase e) Phosphoglycerate mutase 10) After a heavy meal, which out of the following allosteric activator would be most effective in increasing the rate of glycolysis ? a) ATP

b) Citrate c) Acetyl co A d) Fr-2,6 bisphosphate e) 2,3 bisphosphoglycerate. 11) Compared with the resting state a vigorously contracting muscle showsa) An increased conversion of pyruvate to lactate b) Increased oxidation of pyruvate to CO2 c) A decreased concentration of AMP d) Decreased level of fr-2,6 bisphosphate e) Decreased ratio of NADH/NAD+ 12) A 24 -year-old man presented with symptoms of shortness of breath, weakness and fatigue. His Hemoglobin level was 7G/dl. Red blood cell isolated from the patient showed abnormally low-level of lactate. A deficiency of which of the following enzymes would be the most likely cause for patients anemia? a) Phosphoglucose isomerase b) Phosphofructokinase c) Hexokinase d) Glucokinase e) Pyruvate kinase. 13) A mixture of sodium fluoride and potassium oxalate is added to sample collected for blood glucose estimation to prevent loss of glucose by anaerobic glycolysis. Fluoride is an inhibitor of glycolysis. Which of the following enzymes is inhibited by fluoride ? a) Hexokinase b) Phosphofructokinase c) Glyceraldehyde-3-P dehydrogenase d) Lactate dehydrogenase

e) Enolase 14) Oxamate is a competitive inhibitor of which of the following enzymes ? a) Hexokinase b) Phosphofructokinase c) Glyceraldehyde-3-P dehydrogenase d) Lactate dehydrogenase e) Pyruvate dehydrogenase 15) Which out of the following enzymes of glycolysis is inhibited by Arsenate ? a) Hexokinase b) Phosphofructokinase c) Glyceraldehyde-3-P dehydrogenase d) Lactate dehydrogenase e) Pyruvate dehydrogenase

Glycolysis- Multiple Choice Questions


1) Which of these enzyme reactions is not irreversible in glycolysis? a) Hexokinase b) Glucokinase c) 3-phosphoglycerate kinase d) Phosphofructokinase-1 e) Pyruvate kinase 2) Which out of the following statements is not true about aerobic glycolysis ? a) The rate limiting enzyme is phosphofructokinase-1 which converts fructose-6- phosphate to fructose-1,6-bisphosphate b) The pathway is inhibited allosterically by fructose-2,6-bisphosphate and AMP

c) The pathway takes place in mitochondria of every cell d) The pathway produces Pyruvate and NADH e) The pathway begins with glucokinase or hexokinase 3) The first step in the glycolytic pathway in Liver a) Is catalyzed by glucokinase b) Uses ATP and glucose as substrates c) Produces glucose-6-phosphate and ADP d) Is an irreversible step e) All of the above. 4) Phosphoglycerate kinase functions in carbohydrate metabolism to produce ATP via: a) Oxidative phosphorylation. b) Substrate level phosphorylation. c) Oxidative decarboxylation. d) Phosphorolysis e) Oxidative deamination 5). The phosphofructokinase-2 enzyme that transfers a phosphate group to fructose-6phosphate in glycolysisa) Is active in the phosphorylated form b) Catalyzes a reversible reaction c) Produces fructose-2,6-bisphosphate as a product d) Is the rate limiting enzyme for glycolysis e) Produces ATP as a product. 6). The enzyme that produces NADH from a triose phosphate in the glycolytic pathwaya) Uses NAD+ and dihydroxyacetone phosphate as substrates

b)Produces 3-phosphoglycerate and NADH c) Is reversible d) Is called 3-phosphoglycerate kinase e) Uses FADH2 and glyceraldehyde-3-phosphate as substrates 7). The enzyme that catalyzes first substrate level phosphorylation in glycolysisa) Produces 3-phosphoglycerate as a product b) Produces ADP from AMP c) Is called glyceraldehyde-3-phosphate dehydrogenase d) Is called phosphofructokinase e) Is the rate limiting enzyme of glycolysis. 8). The enzyme that catalyzes the second substrate level phosphorylation of glycolysisa) Is called phosphoglyceromutase b) Produces lactate as a product c) Uses phosphoenolpyruvate as a substrate d) Catalyzes a reversible reaction e) Is stimulated by Glucagon. 9). Which of the following statements about the Lactate dehydrogenase (LDH) reaction is false a) The enzyme converts pyruvate to lactate b)The enzyme converts NADH to NAD+ c) The reaction is reversible d) It is the last enzyme reaction in glycolysis e) The enzyme is highly active under aerobic conditions

10). The two major factors determining whether a cell oxidizes glucose by aerobic glycolysis or by anaerobic glycolysis area) FADH2 and the number of mitochondria b) NADH and the ATP/ADP ratio c) Ca++ and AMP d) Oxygen pressure and the number of mitochondria e) Presence of low Glucose and high AMP 11). When glucose is converted to lactate by anaerobic glycolysis, the equivalent of ________ ATPs are derived. When glucose is completely oxidized to CO2 by glycolysis, Pyruvate dehydrogenase, and the TCA cycle, the equivalent of _______ ATPs are derived. a) 7; 20 b) 2; 38 c) 7; 32 d)2; 12 e) 7; 25 12).Choose the incorrect statement about the condition When one molecule of glucose is oxidized to 2 molecules of lactate during anaerobic glycolysisa) One molecule of ATP is used by the phosphofructokinase-1 reaction b)One molecule of ATP is used by either the glucokinase or hexokinase reaction c) Two molecules of ATP are produced by the Glyceraldehyde -3-P dehydrogenase reaction d) Two molecules of ATP are produced by the pyruvate kinase reaction e) No ATP is produced at the level of lactate dehydrogenase reaction. 13). All of the following help to explain some cases of Lactic Acidosis excepta) High altitude b) Heart failure

c) Not enough oxygen to satisfy the needs of oxidative phosphorylation d) Congenital deficiency of liver lactate dehydrogenase e) Inhibition of the electron transport chain 14) . All of the following are part of the Cori Cycle excepta) Lactate is the result of anaerobic glycolysis in a number of tissues b) Lactate is transported to the liver c) Lactate is converted to glucose in the liver d) ATP is produced by the conversion of lactate to glucose e) Glucose is transported from liver to other tissues 15). The ATP/AMP ratio has a major effect upon the rate of ATP production by glycolysis. ATP and AMP bind to allosteric sites ona) Hexokinase b) Glucokinase c) Phosphofructokinase-1 d) Phosphofructokinase-2 e) 3-phosphoglycerate kinase 16). Which of the following statements about pyruvate kinase is false a) Can convert Phosphoenol pyruvate to pyruvate b) Is regulated by feed forward regulation c) Is active in the dephosphorylated form d) Is also involved in gluconeogenesis e) Deficiency causes haemolytic anemia. 17). Pasteur effect is due to inhibition of glycolysis by high concentration of a) Creatine phosphate

b) ATP c) ADP d) AMP e) Pi 18). In the liver, glucagon causes a decrease in the glycolytic pathway by all of the following mechanisms excepta) Increased binding of GTP to G-protein b) Activation of the cAMP cascade c) Increased phosphorylation of enzymes by protein kinase A d) Activation of fructose-2,6-bisphosphatase and inhibition of phosphofructokinase-2 e) Increased binding of fructose-2,6-bisphosphate to phosphofructokinase-1 19). An increased concentration of insulin after meals causes an increase in the rate of glycolytic pathway by all of the following mechanisms excepta) Increase uptake of glucose in adipose tissue and muscle b) Inactivation of the cAMP cascade c) Increased dephosphorylation of enzymes activated by protein kinase A d) Activation of fructose-2,6-bisphosphatase and inhibition of phosphofructokinase-2 e) Induction of Glucokinase and PFK-1 20).During fasting state, the insulin to glucagon ratio drops and all of the following occur excepta) Protein kinase A will phosphorylate pyruvate kinase b) The pyruvate kinase step will be activated c) Protein kinase A will phosphorylate phosphofructokinase-2/fructose-2,6-bisphosphatase d) The concentration of fructose-2,6-bisphosphate will decrease e)The liver will not be able to synthesize pyruvate from phosphoenolpyruvate.

21) A high concentration of Glucose-6-P is inhibitory to which of the following enzymes ? a) Hexokinase b) Glucokinase c) PFK-1 d) PFK-2 e) All of the above,

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