JC1 - 2010

M4- Concepts and

Principles of
Biomedicine
MCQs
Which of the following amino acids is NOT essential? CPB2 SLIDE 9
A. Alanine.
B. Phenylalanine.
C. Valine.
D. Methionine.
E. Isoleucine.
ANSWER: A
An essential amino acid is one which cannot be synthesized in the body. Which
one of the following is a non-essential amino acid in health? CPB2 SLIDE 9
A. Leucine
B. Methionine
C. y!osine
D. Valine
E. A!"inine
ANSWER: C
Protein structure is determined by the amino-acid sequence. Which of the
following statements is true? CPB2 SLIDE #$
A. he al%ha heli& is a coile' st!uctu!e (ith the a)ino*aci' si'e*chains %ointin"
out(a!'s
B. Disul%hi'e +on's a!e ,o!)e' +et(een se!ine !esi'ues
C. Poly%e%ti'e chains in +eta*sheets a!e al(ays in %a!allel o!ientation
D. he %e%ti'e +on' allo(s ,!ee !otation o, the %oly%e%ti'e chain to occu!
E. All %!oteins can ,ol' co!!ectly on thei! o(n (ithout assistance
ANSWER: A
The alha-helical structure in roteins is maintained by a number of factors!
including hydrogen bonding between bac"bone olar grous and interactions
between amino-acid side-chains. Which amino acid may disrut the regularity of
an alha heli# due to the small size of its sidechain? CPB2 SLIDE #9
A. As%a!tate
B. Cysteine
C. -lycine
D. P!oline
E. !y%to%han
ANSWER: C
$edical researchers in%estigating a rare but de%astating inherited disease ha%e
identified the secific gene in%ol%ed. &urther studies identify a secific mutation
of that gene which is found in the ma'ority of sufferers. This mutation changes
the acti%ity of the rotein roduct of the gene by disruting the structure of a "ey
alha heli#. This occurs because an alanine residue is changed to another residue
which disruts alha helical structure. &rom the following list! choose the amino
acid which is most li"ely to ha%e relaced the normal alanine. CPB2 SLIDE #9
A. ty!osine
B. as%a!a"ine
C. lysine
D. %!oline
E. cysteine
ANSWER: D
Which of the following amino acid residues is least li"ely to be found in an alha-
heli#? CPB2 SLIDE #9
A. ty!osine
B. as%a!a"ine
C. lysine
D. "lycine
E. cysteine
ANSWER: D
(nzymes CPB2 SLIDE ..
A. they a!e !e/e!si+ly 'enatu!e' +y +oilin"
B. 'o not 'is%lay tissue s%eci,icity
C. cannot +e 0oine' co/alently to ca!+ohy'!ates
D. a!e insolu+le in the cyto%las) o, the cell
E. thei! secon'a!y an' te!tia!y st!uctu!es a!e sensiti/e to %1
ANSWER: E
)ou e#amine a ** year old male who has comlained of stiffness in the limbs on
wa"ing and ainful 'oints. Physical e#amination re%eals swelling in both "nee
'oints and in the "nuc"les. &urther tests lead to a diagnosis of inflammatory
arthritis and you rescribe a course of management which includes the use of
+O, inhibitors. +O, inhibitors reduce the le%el of the inflammatory mediators
"nown as rostaglandins by inhibiting their synthesis from arachidonic acid.
Which dietary liid is a recursor for arachidonic acid? CPB. SLIDE #2
A. Lau!ic aci'
B. Linoleic aci' 2its an essential ,atty aci'.
C. 3leic aci'
D. Pal)itic aci'
E. Stea!ic aci'
ANSWER: B
A arent brings her -- month old daughter into hosital for in%estigations into
the reasons for mental and s"eletal roblems. The infant has
heatoslenomegally and is diagnosed as suffering from one of the
mucoolysaccharidoses. This grou of diseases is characterized by the
intracellular storage of artially degraded. CPB4 SLIDE 25
A. )ucins
B. "lycosa)ino"lycans
C. "lyco"en
D. "an"liosi'es
E. colla"en
ANSWER: B
A arent brings her -- month old daughter into hosital for in%estigations into
the reasons for mental and s"eletal roblems. The infant has
heatoslenomegally and is diagnosed as suffering from one of the
mucoolysaccharidoses. This grou of diseases is characterized by the
intracellular storage of artially degraded. CPB4 SLIDE 25
A. )ucins
B. colla"en
C. "an"liosi'es
D. "lycosa)ino"lycans
E. "lyco"en
ANSWER: D
(nzymes are highly selecti%e biocatalysts. They act by. CPB6 SLIDE 5
A. Inc!easin" the !ate o, a !eaction
B. Alte!in" the e7uili+!iu) o, a !eaction
C. Inc!easin" the a)+ient te)%e!atu!e
D. Inc!easin" the a)ount o, its a/aila+le su+st!ate
E. Dec!easin" the !ate o, a !eaction
ANSWER: A
Protein "inases are enzymes that hoshorylate amino acid side chains of
roteins in ATP-deendent reactions. A rotein "inase can be classified as which
of the following. CPB6 SLIDE #4
A. 1y'!olase
B. Iso)e!ase
C. Lyase
D. !ans,e!ase
E. Li"ase
ANSWER: D
A cometiti%e inhibitor of an enzyme. CPB6 SLIDE .8
A. !aises the V)a&
B. !aises the 9)
C. lo(e!s the V)a&
D. co/alently )o'i,ies the en:y)e
E. co)+ines (ith alloste!ic sites on the en:y)e
ANSWER: B
A drug comany researcher is de%eloing new drugs to treat a secific infectious
disease by synthesising inhibitors to enzymes found only in the athogenc
organism. One articular comound shows romise and she carries out "inetic
e#eriments to identify the secific tye of inhibition that the comound e#hibits.
The e#eriments show that the aarent /ma# of the enzyme-catalysed reaction
is not changed by the inhibitor. The mode of inhibition is CPB6 SLIDE .8
A. Alloste!ic
B. Co)%etiti/e
C. Co/alent
D. Non*Co)%etiti/e
E. ;nco)%etiti/e
ANSWER: B
A non-cometiti%e inhibitor of an enzyme. CPB6 SLIDE .2
A. lo(e!s the a%%a!ent V)a&
B. !aises the a%%a!ent 9)
C. has a st!uctu!e si)ila! to the t!ansition state
D. co/alently )o'i,ies the en:y)e
E. +in's to the acti/e site o, the en:y)e
ANSWER: A
A biochemical athway con%erts molecule W into molecule 0 in a series of
enzyme catalyzed reactions. W , ) 0. $olecule 0 binds to the enzyme
that con%erts W to , at a site remote from the acti%e site and by doing so!
decreases the acti%ity of the enzyme. Thus! with regard to this enzyme! 0 acts as
CPB6 SLIDE .<
A. An alloste!ic inhi+ito! =sli"ht !e)ote ,!o) the acti/e site.
B. A coen:y)e
C. A co)%etiti/e inhi+ito!
D .An inte!)e'iate
E. A su+st!ate
ANSWER: A
Ariirazole is a doamine recetor artial agonist used in the treatment of
schizohrenia. Which of the following statements is 1N+O22(+T? A artial
agonist CPB#8 SLIDE 2$
A. P!o'uces su+*)a&i)al !es%onses
B. 1as a lo(e! e,,icacy than ,ull a"onists
C. Can !e/e!se constituti/e acti/ation
D. May ha/e 'i,,e!ent %otencies than ,ull a"onists
E. Bin' to the sa)e !ece%to!s as ,ull a"onists
ANSWER: C
1n the absence of other drugs! indolol increases heart rate by acti%ating
adrenorecetors. 3owe%er! when the heart rate has been increased by
adrenaline! indolol causes a dose-deendent re%ersible decrease in heart rate.
&rom this information! indolol is robably a. CPB#8 SLIDE 2$
A. non*co)%etiti/e anta"onist
B. co)%etiti/e anta"onist
C. %hysiolo"ical anta"onist
D. che)ical anta"onist
E. %a!tial a"onist
ANSWER: E
The affinity of a ligand is. CPB## SLIDE 9
A. a )easu!e o, its sa,ety
B. the lo" 'ose !es%onse cu!/e
C. i'entical to the 'ose (hich causes the )a&i)al e,,ect
D. !elate' to the concent!ation o, the li"an' (hich (ill %!o'uce a hal,*)a&i)al
!es%onse
E. a )easu!e o, the int!insic acti/ity
ANSWER: D
The affinity of a ligand is. CPB## SLIDE 9
A. a )easu!e o, its sa,ety
B. the lo" 'ose !es%onse cu!/e
C. i'entical to the 'ose (hich causes the )a&i)al e,,ect
D. !elate' to the concent!ation o, the li"an' (hich (ill %!o'uce a hal,*)a&i)al
!es%onse
E. a )easu!e o, the int!insic acti/ity
ANSWER: D
A **-year-old woman with congesti%e heart failure is to be treated with a diuretic
drug. 4rugs , and ) ha%e the same mechanism of diuretic action. 4rug , in a
dose of * mg roduces the same magnitude of diuresis as *55mg of drug ). This
suggests that. CPB## SLIDE ##
A. '!u" > is less e,,icacious than '!u" ?
B. '!u" ? is a%%!o&i)ately #88 ti)es )o!e %otent than '!u" >
C. to&icity o, '!u" ? is less than that o, '!u" >
D. '!u" ? is a sa,e! '!u" than '!u" >
E. '!u" ? (ill ha/e a sho!te! 'u!ation o, action than '!u" >
ANSWER: B
2egarding cometiti%e antagonists! which of the following is &A67(. CPB##
SLIDE 2#
A. they ha/e int!insic acti/ity e7ual to :e!o
B. they +in' !e/e!si+ly
C. they can +e 'is%lace' +y an e&cess o, a"onist
D. they %otentiate the actions o, an a"onist
E. they shi,t the a"onist 'ose*!es%onse cu!/e to the !i"ht
ANSWER: D
2egarding cometiti%e antagonists! which of the following is &A67(: CPB##
SLIDE 2#
A. they ha/e int!insic acti/ity e7ual to :e!o
B. they +in' !e/e!si+ly
C. they can +e 'is%lace' +y an e&cess o, a"onist
D. they +in' to a 'i,,e!ent site than the a"onist
E. they shi,t the a"onist 'ose*!es%onse cu!/e to the !i"ht
ANSWER: D
2egarding cometiti%e antagonists! which of the following statements is &A67(.
CPB## SLIDE 2#
A. thei! e,,ects cannot +e o/e!co)e (ith inc!easin" the concent!ation o, a"onist
B. +in' to the sa)e site as the a"onist
C. +in' !e/e!si+ly to the !ece%to!
D. ha/e an int!insic acti/ity o, :e!o @8A
E. shi,t the a"onist 'ose*!es%onse cu!/e to the !i"ht.
ANSWER: A
Which of the following statements is &A67(? The theraeutic inde# CPB##
SLIDE .<
A. is a )easu!e o, the sa,ety o, the '!u"
B. is 'e,ine' as a !atio o, the e,,ecti/e 'ose in 58B o, the %o%ulation /e!sus to&ic
'ose in 58B o, the %o%ulation
C. has a hi"he! /alue the )o!e selecti/e a '!u" is in %!o'ucin" the 'esi!e' !es%onse
D. can +e 'e!i/e' ,!o) the cu)ulati/e ,!e7uency 'ist!i+ution o, in'i/i'ual*e,,ecti/e
concent!ation cu!/es
E. With a lo( /alue (ill in'icate a hi"h le/el o, a'/e!se e,,ects at clinical 'oses
ANSWER: B
A **-year-old woman with atrial fibrillation is to be treated with digo#in. +areful
monitoring of the blood concentration of digo#in is required! as doubling the
effecti%e concentration may be enough to roduce harmful effects of the
medication. The degree of safety of a drug is described by the. CPB## SLIDE .6
A. the!a%eutic in'e&
B. 'issociation constant @9'A
C. 'ose that causes to&icity in hal, a %o%ulation @D58A
D. 'ose that causes a hal,*)a&i)al e,,ect @ED58A
E. )a&i)al e,,ecti/e concent!ation
ANSWER: A
A substance has an 64*5 of -5 mg8"g. What would be the fatal dose in an
a%erage man? CPB## SLIDE .<
A. 8.86 )"
B. 8.6 )"
C. 6 )"
D. 8 )"
E. 688 )"
ANSWER: E
A **-year-old woman with congesti%e heart failure is to be treated with a diuretic
drug. 4rugs , and ) ha%e the same mechanism of diuretic action. 4rug , in a
dose of * mg roduces the same magnitude of diuresis as *55mg of drug ). The
safety inde# of a drug is described by the. CPB## SLIDE .6
Choose one ans(e!.
A. 'issociation constant @9'A
B. 'ose that causes to&icity in hal, a %o%ulation @D58A
C. )a&i)al e,,ecti/e concent!ation
D. he!a%eutic in'e&
E. 'ose that causes a hal,*)a&i)al e,,ect @ED58A
ANSWER: D
Theraeutic inde# is. CPB## SLIDE .6
A. the !atio o, the to&ic 'ose o, a '!u" to the e,,ecti/e 'ose o, a 'i,,e!ent '!u"
B. is a )easu!e o, the sa,ety o, a '!u"
C. the !eco))en'e' 'ose o, a '!u"
D. is the 'ose o, a '!u" !e7ui!e' to %!o'uce a !es%onse in 58B o, the %o%ulation
E. the 'ose o, a '!u" that causes to&icity in 58B o, the %o%ulation
ANSWER: B
Theraeutic inde# is. CPB## SLIDE .6
A. the !atio o, the to&ic 'ose o, a '!u" to the e,,ecti/e 'ose o, a 'i,,e!ent '!u"
B. is a )easu!e o, the sa,ety o, a '!u"
C. the !eco))en'e' 'ose o, a '!u"
D. is the 'ose o, a '!u" !e7ui!e' to %!o'uce a !es%onse in 58B o, the %o%ulation
E. the 'ose o, a '!u" that causes to&icity in 58B o, the %o%ulation
ANSWER: B
A raid resonse is tyical of nicotinic cholinergic recetors because. CPB#2
SLIDE ##
A. they a!e li"an' "ate' ion channels
B. they a!e -*%!otein cou%le' !ece%to!s
C. acetylcholineste!ase only slo(ly )eta+olises acetylcholine
D. choline acetylt!ans,e!ase only slo(ly )eta+olises acetylcholine
E. )onoa)ine o&i'ase only slo(ly )eta+olises acetylcholine
ANSWER: A
A raid resonse is tyical of nicotinic cholinergic recetors because. CPB#2
SLIDE ##
A. they a!e li"an' "ate' ion channels
B. they a!e -*%!otein cou%le' !ece%to!s
C. acetylcholineste!ase only slo(ly )eta+olises acetylcholine
D. choline acetylt!ans,e!ase only slo(ly )eta+olises acetylcholine
E. )onoa)ine o&i'ase only slo(ly )eta+olises acetylcholine
ANSWER: A
Acti%ation of recetor 9oerated channels :2O+s; allows for fast transmission of
signals! based on ion mo%ement. The channels form a ore comle#! which oens
on binding of ligand to the recetor. 1n relation to ligand binding to 2O+s! which
of the following statements is an accurate reflection of this rocess? CPB#2
SLIDE #5
A. 3ne )olecule o, li"an' is su,,icient to o%en the channel.
B. he channel is "ate' +y the secon' t!ans)e)+!ane 'o)ain o, each su+unit.
C. Mo/e)ent o, ions (ith all R3Cs is ,!o) outsi'e*to*in only.
D. R3Cs al(ays cause 'e%ola!i:ation o, e&cita+le )e)+!anes
E. he !ate o, si"nal t!ans)ission +y R3Cs is in the o!'e! o, )inutes
ANSWER: B
Which of the following statements is &A67(? CPB#. SLIDE 5
A. -*%!otein*cou%le' !ece%to!s ha/e se/en t!ans)e)+!ane 'o)ains
B. -*%!oteins e&ist in an acti/e state as a hete!ot!i)e!
C. on acti/ation o, the !ece%to!2 -*%!oteins +in' to the thi!' int!acellula! loo%.
D. the al%ha*su+unit o, the -*%!otein acti/ates secon' )essen"e! casca'es
E. acti/ation o, a'enylyl cyclase !esults in the %!o'uction o, cyclic AMP
ANSWER: B
Which of the following statements about recetors is correct. CPB#. SLIDE 9
A. ty!osine Cinase !ece%to!s ha/e se/en t!ans)e)+!ane 'o)ains
B. !ece%to!*o%e!ate' ion channels )o'ulate "ene t!ansc!i%tion
C. se/en t!ans)e)+!ane 'o)ain @6MA !ece%to!s a!e locate' in the nucleus
D. se/en t!ans)e)+!ane 'o)ain @6MA !ece%to!s a!e cou%le' to - %!oteins
E. classical ste!oi' ho!)one !ece%to!s a!e )e)+!ane*+oun'
ANSWER: D
2ecetor mechanisms CPB#. SLIDE 9
A. ty!osine Cinase !ece%to!s ha/e se/en t!ans)e)+!ane 'o)ains
B. !ece%to!*o%e!ate' ion channels )o'ulate "ene t!ansc!i%tion
C. se/en t!ans)e)+!ane 'o)ain @6MA !ece%to!s a!e locate' in the nucleus
D. se/en t!ans)e)+!ane 'o)ain @6MA !ece%to!s a!e cou%le' to - %!oteins
E. ste!oi' !ece%to!s a!e locali:e' to the cell )e)+!ane
ANSWER: D
Acti%ation of 2ecetor Tyrosine <inases :2T<s; results in the regulation of gene
e#ression by a series of hoshorylation e%ents in a signaling cascade.
2egarding 2T<s! which of the following statements is &A67(? CPB#. SLIDE ..
A. R9s ha/e one t!ans)e)+!ane 'o)ain
B. (o li"an' )olecules +in' to each !ece%to! to in/oCe acti/ation
C. R9s ,o!) 'i)e!s (hen acti/ate'
D. y!osine Cinase 'o)ains in the cyto%las)ic tail o, the R9s c!oss*%hos%ho!ylate
othe! R9s
E. Phos%ho!ylate' )oti,s in the R9 cyto%las)ic tail act as 'ocCin" sites ,o! a'a%te!
%!oteins
ANSWER: B
Tyrosine "inase recetors CPB#. SLIDE .5
A. a!e ion channel %!oteins
B. a!e !ece%to!s ,o! "!o(th ,acto!s
C. a!e %a!t o, the 9!e+s cycle
D. a!e -*%!otein*cou%le' !ece%to!s
E. inclu'e a'!ene!"ic !ece%to!s
ANSWER: B
2egarding ascorbate :%itamin +;! which of the following is true? CPB#4 SLIDE <
A. Its 'e,iciency is a )a0o! cause o, %e!nicious anae)ia.
B. It is !e7ui!e' ,o! hy'!o&y%!oline ,o!)ation in cells.
C. Is a )a0o! ,at solu+le /ita)in.
D. Is )ost a+un'ant in !e' )eats.
E. May cause ni"ht +lin'ness i, 'e,icient.
ANSWER: B
What roortion of total caloric inta"e should be deri%ed from carbohydrate in
a healthy human diet? CPB#4 SLIDE #2
A. 5B.
B. #5B.
C. .5B.
D. 55B.
E. $8B.
ANSWER: D
1n a healthy human adult diet! carbohydrate should comrise what roortion of
total calorie inta"e? CPB#4 SLIDE #2
A. 55B
B. 48B
C. 28B
D. $8B
E. #8B
ANSWER: A
What roortion of total caloric inta"e should be deri%ed from carbohydrate?
CPB#4 SLIDE #2
A. $8B
B. #5B
C. .5B
D. 55B
E. 5B
ANSWER: D
The otimal resonse in the treatment of hyerliidemia is. CPB#4 SLIDE #.
A. an inc!ease in LDL an' 1DL
B. a 'ec!ease in LDL an' 1DL
C. an inc!ease in LDL an' 'ec!ease in 1DL
D. a 'ec!ease in LDL an' inc!ease in 1DL
E. none o, the a+o/e
ANSWER: D
&oam cells are characteristic constituents of atheromatous laques. These cells
usually contain a high concentration of which of the following? CPB#4 SLIDE #4
A. !i"lyce!i'es
B. Choleste!ol este!s
C. D!ee ,atty*aci's
D. A%oli%o%!otein B#88
E. Phos%holi%i's
ANSWER: B
The main liid constituent of the standard human diet is. CPB#4 SLIDE #<
A. Dat* solu+le /ita)ins.
B. Satu!ate' ,atty aci's.
C. Choleste!ol.
D. !i"lyce!i'e @t!iacyl"lyce!olsA.
E. Lecithin.
ANSWER: D
2egarding dietary %itamin =->! which of the following statements is T2?(?
CPB#5E#< SLIDE #9
A. It )ust +e in"este' 'aily in )illi"!a) 7uantities.
B. It is ,oun' a+un'antly in "!een /e"eta+les.
C. It !e7ui!es a "ast!ic ,acto! ,o! its intestinal a+so!%tion.
D. It is a+so!+e' in the u%%e! 'uo'enu).
E. It causes a )ic!ocytic anae)ia i, 'e,icient.
ANSWER: C
For next 3 questions: A 55 year old male subject presented at outpatients complaining
of lack of energy, weakness and feeling generally run down. e was pale and a
medical !istory indicated !e !ad a partial gastrectomy ".5 years pre#iously to remo#e
a malignant growt!. A blood sample, taken for !aematological analysis, indicated a
low !aemotcrit, confirmed by a low $%& count. A blood film indicated t!e presence
of many megaloblastic cells and a diagnosis of megaloblastic anaemia was
suggested. CPB#5E#< SLIDES #92 28
What is the most li"ely cause of anaemia in this atient?
A. Poo! u%taCe o, 'ieta!y i!on.
B. Ina'e7uate le/els o, int!insic ,acto!.
C. Poo! 'i"estion o, 'ieta!y %!otein.
D. Dat )ala+so!%tion.
E. No 'ieta!y /ita)in B#2.
ANSWER: B
The best way to treat this atient@s anaemia is.
A. o inc!ease 'ieta!y ,olate
B. o inc!ease 'ieta!y B#2
C. o inc!ease 'ieta!y i!on
D. o a')iniste! int!insic ,acto! int!a)uscula!ly
E. o a')iniste! /ita)in B#2 int!a)uscula!ly
ANSWER: E
What %itamin would best sulement this treatment?
A. Vita)in C
B. hia)in
C. Dolic aci'
D. Biotin
E. Vita)in D
ANSWER: C
A *> year old man attends his AP. The atient is an alcoholic and suffers from
malnutrition. 3e tells the doctor that he has noticed that his eyes are feeling %ery
dry and that he has recently started to ha%e difficulty seeing at night. The doctor
sends his atient to an ohthalmic consultant who confirms that the atient has
#erohthalmia! due to a %itamin deficiency. Which %itamin deficiency results in
this eye condition? CPB#5E#< SLIDE 24
AA Vita)in C
BA hia)ine
CA Dolic aci'
DA Vita)in A
EAVita)in D
ANSWER: D
A *> year old man attends his AP. The atient is an alcoholic and suffers from
malnutrition. 3e tells the doctor that he has noticed that his eyes are feeling %ery
dry and that he has recently started to ha%e difficulty seeing at night. The doctor
sends his atient to an Ohthalmic consultant who confirms that the atient has
#erohthalmia! due to a %itamin deficiency. Which %itamin deficiency results in
this eye condition? CPB#5E#< SLIDE 24
A. hia)ine
B. Vita)in D
C. Vita)in C
D. Vita)in A
E. Dolic aci'
ANSWER: D
A atient suffering from /itamin A deficiency is most li"ely to suffer from.
CPB#5E#< SLIDE 24
A. RicCets
B. Scu!/y
C. We!nicCeFs Ence%halo%athy
D. Ni"ht +lin'ness
E.Clottin" 'e,ects
ANSWER: D
2egarding %itamin 4 which of the following is false. CPB#5E#< SLIDE 25
A. it is acti/e in the +o'y as calcit!iol
B. it is a (ate! solu+le su+stance
C. it can +e synthesi:e' in the hu)an +o'y
D. 'e,iciency sy)%to)s )ay a%%ea! in !enal 'ialysis su+0ects
E. it +!in"s a+out inc!ease' intestinal calciu) a+so!%tion
ANSWER: B
For next " questions: A '3 year old woman presents wit! muscle weakness. (n
in#estigation !er plasma calcium le#el was ).*+ mmol,- .reference range ".)5 to
".'+/, plasma inorganic p!osp!ate le#el +.*+ mmol,- .reference range +.* to )."/ and
t!e plasma alkaline p!osp!atase acti#ity was raised at *5+0,-.
What is the most li"ely origin of the al"aline hoshatase enzyme. 1IS#2 SLIDE
.
A. 3steoclasts in the +one
B. -ast!ointestinal t!act
C. 1e%atocytes in the li/e!
D. SCeletal )uscle
E. 3steo+lasts in the +one
ANSWER: E
The most li"ely cause of this atientBs symtoms and biochemical findings is.
CPB#5E#< SLIDE 25
A. P!i)a!y hy%e!%a!athy!oi'is)
B. Li/e! ,ailu!e
C. 1y%o%a!athy!oi'is)
D.Vita)in D 'e,iciency
E. Renal ,ailu!e
ANSWER: D
Nurse $urhy reorted that the steatorrhea began *8C wee"s re%iously. A
laboratory reort indicated a rolonged rothrombin clotting time in her blood.
Which %itamin deficiency is she most li"ely to ha%e? CPB#5E#< SLIDE 2$
A. Vita)in 9.
B. Vita)inB#2.
C. Vita)in D.
D. Dolate.
E. Py!i'o&ine@B<A.
ANSWER: A
A microcytic anaemia is most li"ely to be caused by deficiency of which of the
following? CPB#5E#< SLIDE 44
A. Dieta!y ,olate.
B. Dieta!y B#2.
C. Dieta!y /ita)in 9.
D. Dieta!y i!on.
E Essential ,atty aci's.
ANSWER: D
2aised le%els of ammonia in the blood could arise from which of the following?
CPB#$ SLIDE #<
A. Dolate 'e,iciency.
B. De,iciency o, the en:y)e ca!+a)oyl %hos%hate synthetase.
C. Lo( ca!+ohy'!ate 'iet.
D. 1i"h %!otein 'iet.
E. LacC o, 'ieta!y essential a)ino aci's.
ANSWER: B
Phenyl"etonuria :P<?; is an inherited disorder of amino-acid metabolism due to
deficient acti%ity of the enzyme henylalanine hydro#ylase. The cofactor that
may be deficient in some cases of henyl"etonuria is. CPB#$ SLIDE 22
A. Py!i'o&al %hos%hate @Vita)in B<A
B. et!ahy'!o,olate
C. Dihy'!o%te!i'ine
D. Biotin
E. hia)ine %y!o%hos%hate
ANSWER: C
&asting blood glucose le%els were ordered for this atient. 3ormones allow the
body to control triglyceride metabolism in the D fed D and DfastedE state. Which
of the following catalyses the first ste in triglyceride brea"down? CPB28 SLIDE
#4
A. -luca"on.
B. Diacyl"lyce!ol acyl t!ans,e!ase.
C. 1o!)one*sensiti/e a'i%ose tissue li%ase.
D. Insulin.
E. Acetyl CoA ca!+o&ylase.
ANSWER: C
The T+A cycle. CPB2#E22 SLIDE #9
A. is a se!ies o, i!!e/e!si+le !eactions
B. taCes %lace in lysoso)es
C. is !e"ulate' +y le/els o, NAD1 an' AP
D. 'oes not e&ist in )uscle cells
E. "ene!ates o&i'i:e' coen:y)es
ANSWER: C
The bodyBs energy is deri%ed from intracellular metabolism. The inner
mitochondrial membrane is imermeable to reduced coenzymes li"e NA43F3F.
Which of the following systems does the cell use to transort these reducing
equi%alents generated in the cytosol across the inner mitochondrial membrane?
CPB 2#E22 SLIDE 22
A. AP synthase.
B. A'enine nucleoti'e ca!!ie!.
C. Py!u/ate ca!!ie! .
D. Malate =as%a!tate shuttle.
E. Phos%hate ca!!ie!.
ANSWER: D
1n order to synthesise the energy source ATP in the mitochondria! the cell needs
to o#idize reduced co-enzymes such as NA43. This is done %ia the electron
transort chain in the inner mitochondrial membrane. The inner mitochondrial
membrane is imermeable to NA43. Therefore! the cell uses which of the
following to transort reducing equi%alents generated in the cytosol across the
inner mitochondrial membrane? CPB 2#E22 SLIDE 22
A. AP synthase
B. Malate*as%a!tate shuttle
C. A'enine nucleoti'e ca!!ie!
D. Py!u/ate ca!!ie!
E. Phos%hate ca!!ie!
ANSWER: B
1atc! t!e numbered question to a lettered response. 2ac! response may be used
once, more t!an once or not at all.
A.Plas)a %!oteins.
B. Li/e! "lyco"en.
C. !i"lyce!i'es.
D. Muscle "lyco"en.
E. Plas)a choleste!ol.
The largest energy store in the human body.
&ound in human lasma associated mainly with /646.
=rea"s down to blood glucose under the influence of glucagon.
&ound in human lasma associated mainly with 646.
=rea"s down causing a rise in blood lactate le%els.
ANSWER: D2 C2 B2 E2 D
1atc! t!e numbered question to a lettered response. 2ac! response may be used
once, more t!an once, or not at all.
A. Chylo)ic!on
B. 1DL
C. LDL
D. IDL
E. VLDL
A ositi%e ris" factor for %ascular disease in humans
The most triglyceride-rich rotein in the body.
6e%els reduced in humans undergoing treatment with statins.
ANSWER: B2 A2 C
1atc! t!e numbered question to a lettered response. 2ac! response may be used
once, more t!an once, or not at all.
1any poisons in!ibit A34 synt!esis. For example, 5initrop!enol pre#ents A34
synt!esis by interfering wit! t!e proton gradient w!ile electron flow remains intact.
A. ;+i7uinone
B. -lyce!ol %hos%hate shuttle
C. Cytoch!o)e +
D. NAD1
E. Cyani'e
3ydrogen carrier
O#idation of this yields G ATP
ANSWER: A2 D
1uscle cells !a#e many mitoc!ondria and contain !ig! le#els of glycolytic en6ymes in
t!eir cytosol. 3!is enables t!em to utilise energy sources and ultimately generate t!e
A34 w!ic! is necessary for muscle contraction.
A. Py!u/ate Dehy'!o"enase
B. Cytoch!o)e c
C. ;+i7uinone
D. Actin
E. C!eatine %hos%hate
(nergy source used during muscle contraction
(lectron carrier
ANSWER: E2 B
4NA is the reository of genetic information! which is e#ressed through the
rocesses of transcrition and translation! and mainly effected through the
acti%ities of roteins. The base sequence of a strand of 4NA used as the temlate
for 2NA olymerisation is +TAAATA+. What is the sequence of the 2NA
roduct? :all sequences are written *B to GB;
A. -A;C;AC-
B. -CA;C;A-
C. -C;ACA;-
D. CA-A-C
E. -CACA-
ANSWER: B
4NA is the reository of genetic information! which is e#ressed through the
rocesses of transcrition and translation! and mainly effected through the
acti%ities of roteins. The base sequence of a strand of 4NA used as the temlate
for 2NA olymerisation is *B+TAAATA+. What is the sequence of the 2NA
roduct? :all sequences are written *B to GB;H
A. .G-A;C;AC-5G
B. -CA;C;A- !e/e!se'.
C. -C;ACA;-
D. CA-A-C
E. -CACA-
ANSWER: B
2egarding theray with digo#in! which of the following is &A67(.
A. has an e,,ect on the elect!ical acti/ity o, the hea!t
B. is associate' (ith a!!hyth)ias
C. is a ne"ati/e inot!o%e
D. has a lo( the!a%eutic in'e&
E. se!ious to&icity )ay +e t!eate' (ith a s%eci,ic anti+o'y
ANSWER: C

&amilial tye 11 diabetes is a genetic disease. A number of genetic diseases are
"nown in which the base sequence of a gene has been altered so that it can no
longer be transcribed into 2NA. Which of the following occcurs in normal gene
transcrition.?
A. he RNA %oly)e!ase en:y)e !eco"nises an' +in's to the %!o)ote! se7uence.
B. he %!ocess nee's a %!i)e!.
C. Both DNA st!an's o, e/e!y "ene is t!ansc!i+e'.
D. he +uil'in" +locCs o, the RNA a!e 'eo&y!i+onucleoti'es.
E. he RNA %oly)e!ase !ea's the te)%late in the 5G to .G 'i!ection.
ANSWER: A
1n a atient suffering from Tye 1 4iabetes :hyoinsulinaemia;
A. +loo' "lucose le/els a!e less than 4.5 ))olEL
B. li%o"enesis @,at synthesisA is inc!ease'
C. tissue "lyco"en le/els (ill ,all
D. the!e (ill +e a 'ec!ease' ,!e7uency o, u!ination
E. "luca"on le/els a!e 'ec!ease'
ANSWER: C
Which of the following regarding theray with digo#in is &A67(.
A. has an e,,ect on the elect!ical acti/ity o, the hea!t
B. is associate' (ith a!!hyth)ias
C. is a ne"ati/e ionot!o%e
D. has a lo( the!a%eutic in'e&
E. se!ious to&icity )ay +e t!eate' (ith a s%eci,ic anti+o'y
ANSWER: C
The hase of the cell cycle that is resistant to most chemotheraeutic agents is.
A. M %hase
B. -
2
%hase
C. S %hase
D. -
8
%hase
E. -
#
%hase
ANSWER: D
Which of the following regarding theray with digo#in is &A67(.
A. has an e,,ect on the elect!ical acti/ity o, the hea!t
B. is associate' (ith a!!hyth)ias
C. is a ne"ati/e ionot!o%e
D. has a lo( the!a%eutic in'e&
E. se!ious to&icity )ay +e t!eate' (ith a s%eci,ic anti+o'y
ANSWER: C
A GI year-old man is rescribed a benzodiazeine for se%ere an#iety.
Treatment with this class of drug will.
A. inc!ease cAMP %!o'uction
B. !e'uce c-MP %!o'uction
C. inc!ease the ,!e7uency o, o%enin" o, Cl
*
channels linCe' to -ABA
A
!ece%to!s
D. !e'uce the 'u!ation o, o%enin" o, Cl
*
channels linCe' to "luta)ate !ece%to!s
E. inhi+it -ABA t!ansa)inase H-ABA*I
ANSWER: C
(#cess carbohydrate inta"e by the body results in its being con%erted to body fat.
Which li%er enzyme is crucial to this rocess?
A. Lactate 'ehy'!o"enase
B. Phos%ho!ylase
C. Cit!ate lyase
D. !ansa)inase
E. Li%o%!otein li%ase
ANSWER: C
Which of the following is NOT a recognized function of thyroid hormone.
A. Raises the +o'y te)%e!atu!e
B. Sti)ulates "!o(th in chil'!en
C. Inc!eases ca!'iac out%ut /olu)e
D. Sti)ulates li%olysis
E. Inc!eases the %ulse !ate
ANSWER: D
An indi%idual on a high calorie! high carbohydrate diet would show increased
acti%ity of which of the following li%er enzymes?
A. Lactate 'ehy'!o"enase
B. Al'olase
C. -lyce!al'ehy'e .*%hos%hate 'ehy!o"enase
D. -lucose <*%hos%hatase
E. Acetyl CoA ca!+o&ylase
ANSWER: E
A C* year old man resented to AJ( suffering from sudden onset of a crushing
retrosternal ain that radiated along the medial asect of his left arm. 3e was
ale and ersiring. On questioning the man told the doctor that he had suffered
from retrosternal discomfort in the ast! which assed with rest. The muscle
in%ol%ed has all of the following traits e#cet:
A. st!iations
B. inte!calate' 'iscs
C. 'es)osones
D. non +!anchin" ,i+!es
E. in/olunta!y
ANSWER: D
Alycerol is a gluconeogenic substrate in human li%er. An enzyme which allows it
to interact with the gluconeogenic sequence! thereby generating blood glucose!
also lays a role in regenerating cytolasmic NA4
F
which is essential for the
maintenance of glycolysis. Which of the following enzymes fulfils this imortant
role?
A. -lyce!ol Cinase
B. Phos%ho"lyce!o)utase
C. -lyce!al'ehy'e .*%hos%hate 'ehy'!o"enase
D. -lyce!ol .*%hos%hate 'ehy'!o"enase
E. !iose %hos%hate iso)e!ase
ANSWER: D
2egarding nitric o#ide :NO;! which of the following is T2?(.
A. acts on the en'otheliu)
B. +in's to )e)+!ane +oun' "uanylate cyclase
C. causes s)ooth )uscle cell cont!action
D. acts to inc!ease c-MP le/els
E. can +e use' as a "ene!al anesthetic
ANSWER: D
;NANSWERED J;ESI3NS:
+alcium
A. Rea+so!%tion in !enal tu+ules is inc!ease' +y P1.
B. Bin'in" to al+u)in is inc!ease' +y lo(e!in" the %1.
C. In %las)a is la!"ely co)%le&e' (ith %hos%hate.
D. A+so!%tion is enhance' in %atients (ith steato!!hoea.
E. Is synthesise' +y osteo+lasts.
Which statement regarding inositol trihoshate :1P
G
; is false?
A. Is a ho!)one 2n' )essen"e! in )any cells.
B. Is ,o!)e' in cells to"ethe! (ith 'iacyl"lyce!ol.
C. Is ,o!)e' in cells ,!o) %hos%hati'yl inositol +is%hos%hate @PIP
2
A.
D. Le/els !ise in cells e&%ose' to co!tisol.
E. Causes calciu) ion !elease ,!o) int!acellula! sto!es.
2egarding cyclic A$P which statement is incorrect?
A. Is a su+st!ate ,o! %hos%ho'ieste!ase.
B. Is con/e!te' to AP +y the en:y)e2 a'enylate Cinase.
C. Le/els !ise in he%atocytes e&%ose' to "luca"on.
D. Le/els !ise in a'i%ocytes e&%ose' to a'!enalin.
E. Acti/ates %!otein CinaseA.
Which statement regarding the he#ose monohoshate shunt is false?
A. Is !e7ui!e' ,o! 'e no/o nucleoti'e synthesis.
B. Re7ui!es !i+ose*5*%hos%hate as an inte!)e'iate.
C. Is acti/e in all tissues in the hu)an +o'y.
D. Re7ui!es the acti/ity o, "lucose <*%hos%hate 'ehy'!o"enase.
E. -ene!ates NADP1 in cells.
K. G> 2egarding "etone bodies which statement is true?
A. hey a!e a ,o!) o, lon" chaine' ,atty aci's.
B. hey a!e ,o!)e' )ainly in a'i%ose tissue.
C. hey a!e a+un'ant in the +loo' o, hu)an neonates.
D. hei! le/els ,all in the +loo' o, sta!/in" in'i/i'uals.
E. hey a!e )ainly consu)e' +y the li/e!.
K. GG Which statement on the urea cycle is false?
A. It is acti/e in the Ci'neys un'e! aci'otic con'itions.
B. In/ol/es the en:y)e2 a!"inase.
C. I, )al,unctionin"2 causes hy%e!a))onae)ia in hu)ans.
D. In/ol/es o!nithine.
E. In/ol/es as%a!tate.
K. G* &ollowing the release of insulin from the ancreas all the following are
li"ely to be reduced e#cetL
A. issue cAMP le/els.
B. -lucoCinase acti/ity.
C. !i"lyce!i'e Li%ase acti/ity.
D. -lyco"en Phos%ho!ylase acti/ity.
E. -lucose < %hos%hatase acti/ity.