Midterm exam of biochemistry for 2nd year faculty of medicine

(80 points total)

You have 160 minutes for this exam

Exams written in pencil or erasable ink will not be re-graded under any circumstances.
Explanations should be concise and clear. I have given you more space than you should need.

a. Short notes : (35 points)

1. Discuss the mechanism of uncouplers in ETC, give 5 examples of uncouplers.
(5 points)

2. Discuss the of mechanism of activation of fatty acids to Acyl CoA. (5 points)

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3. Mechanism of action of both glycogen and insulin in synthesis of glycogen in liver.
(6 points)

a. Discuss the mechanisms of regulation of HMG CoA reductase.

(7 points)

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4. Discuss the regulation of gluconeogenesis (key enzymes, reactions, their regulation)
(6 points)

5. Explain biochemically the mechanism of Diabetic ketoacidosis.

(6 points)

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B. Read each question very carefully. Choose and mark the single, best answer.
(55 points)

1) Which one of the following statements concerning glucose metabolism is correct?

(A) The conversion of Glucose to lactate occurs only in the R.B.C
(B) Glucose enters most cells by a mechanism in which Na+ and glucose are co-transported
(C) Pyruvate kinase catalyses an irreversible reaction
(D) An elevated level of insulin leads to a decreased level of fructose 2, 6-bisphosphate in
hepatocyte
2) Which one of the following compounds cannot give rise to the net synthesis of
Glucose?
(A) Lactate
(B) Glycerol
(C) α-ketoglutarate
(D) Acetyl CoA
3) Which of the following reactions is unique to gluconeogenesis?
(A) Lactate →Pyruvate
(B) Phosphoenol→ pyruvate pyruvate
(C) Oxaloacetate →phosphoenol pyruvate
(D) Glucose-6-phosphate → Fructose-6-phosphate
4) The synthesis of glucose from pyruvate by gluconeogenesis
(A) Requires the participation of biotin
(B) Occurs exclusively in the cytosol
(C) Is inhibited by elevated level of insulin
(D) Requires oxidation/reduction of FAD
5) The conversion of pyruvate to acetyl CoA and CO2
(A) Is reversible
(B) Involves the participation of lipoic acid
(C) Depends on the coenzyme biotin
(D) Occurs in the cytosol
6) Reduced glutathione functions in R.B.Cs to
(A) Produce NADPH
(B) Reduce methemoglobin to hemoglobin
(C) Produce NADH
(D) Reduce oxidizing agents such as H2O2
7) Which one of the following would be expected in pyruvate kinase deficiency?
(A) Increased levels of lactate in the R.B.C
(B) Hemolytic anemia
(C) Decreased ratio of ADP to ATP in R.B.C
(D) Increased phosphorylation of Glucose to Glucose-6-phosphate
8) Compared to the resting state, vigorously contracting muscle shows
(A) An increased conversion of pyruvate to lactate
(B) Decreased oxidation of pyruvate of CO2 and water
(C) A decreased NADH/NAD+ ratio
(D) Decreased concentration of AMP

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9) The reaction catalysed by phosphofructokinase
(A) Is activated by high concentrations of ATP and citrate
(B) Uses fruitose-1-phosphate as substrate
(C) Is the rate-limiting reaction of the glycolytic pathway
(D) Is inhibited by fructose 2, 6-bisphosphate
10) Glucokinase
(A) Is widely distributed and occurs in most mammalian tissues
(B) Has a high km for glucose and hence is important in the phosphorylation of glucose primarily
after ingestion of a carbohydrate rich meal
(C) Is widely distributed in Prokaryotes
(D) None of these
11) In presence of the following cofactor, pyruvate carboxylase converts pyruvate to
oxaloacetate:
(A) ATP, Protein and CO2
(B) CO2 and ATP
(C) CO2
(D) Protein
12) Which of the following enzyme is not involved in HMP shunt?
(A) Glyceraldehyde-3-p dehydrogenase
(B) Glucose-6-p-dehydrogenase
(C) Transketolase
(D) Phosphogluconate dehydrogenase
13) An allosteric enzyme responsible for controlling the rate of T.C.A cycle is
(A) Malate dehydrogenase
(B) Isocitrate dehydrogenase
(C) Fumarase
(D) Aconitase
14) The glycolysis is regulated by
(A) Hexokinase
(B) Phosphofructokinase
(C) Pyruvate kinase
(D) All of these
15) Which of the following statements regarding T.C.A cycle is true?
(A) It is an anaerobic process
(B) It occurs in cytosol
(C) It contains no intermediates for Gluconeogenesis
(D) It is amphibolic in nature
16) Which of the following is a substrate for aldolase activity in Glycolytic pathway?
(A) Glyceraldehyde-3-p
(B) Glucose-6-p
(C) Fructose-6-p
(D) Fructose1, 6-bisphosphate
17) An essential for converting Glucose to Glycogen in Liver is
(A) Lactic acid
(B) GTP
(C) CTP
(D) UTP

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18) Which of the following compound is a positive allosteric modifier of the enzyme
pyruvate carboxylase?
(A) Biotin
(B) Acetyl CoA
(C) Oxaloacetate
(D) ATP
19) A specific inhibitor for succinate dehydrogenase is
(A) Arsinite
(B) Melonate
(C) Citrate
(D) Cyanide
20) Most of the metabolic pathways are either anabolic or catabolic. Which of the
following pathways is considered as “amphibolic” in nature?
(A) Glycogenesis
(B) Glycolytic pathway
(C) Lipolysis
(D) TCA cycle
21) Transketolase activity is affected in
(A) Biotin deficiency
(B) Pyridoxine deficiency
(C) PABA deficiency
(D) Thiamine deficiency
22) The following metabolic abnormalities occur in Diabetes mellitus except
(A) Increased plasma FFA
(B) Increased pyruvate carboxylase activate
(C) Decreased lipogenesis
(D) Decreased gluconeogenesis
23) A substance that is not an intermediate in the formation of D-glucuronic acid from
glucose is
(A) Glucoss-1-p
(B) 6-Phosphogluconate
(C) Glucose-6-p
(D) UDP-Glucose
24) In conversion of Lactic acid to Glucose, three reactions of Glycolytic pathway are
circumvented, which of the following enzymes do not participate?
(A) Pyruvate Carboxylase
(B) Phosphoenol pyruvate carboxy kinase
(C) Pyruvate kinase
(D) Glucose-6-phosphatase
25) The following co-enzyme is needed for the oxidative decarboxylation of ketoacids:
(A) NADP+
(B) TPP
(C) Folate coenzyme
(D) Biotin coenzyme

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26) Synthesis of Glucose from amino acids is termed as
(A) Glycolysis
(B) Gluconeogenesis
(C) Glycogenesis
(D) Lipogenesis
27) ATP is ‘wasted’ in Rapoport-Lueberring cycle in RBCs as otherwise it will inhibit
(A) Phosphoglucomutase
(B) Phosphohexo isomerase
(C) Phosphofructo kinase
(D) Phosphoenol pyruvate carboxy kinase
28) . From arachidonate, synthesis of prostaglandins is catalysed by
(A) Cyclooxygenase
(B) Lipoxygenase
(C) Thromboxane synthase
(D) Isomerase
29) The lipoprotein with the fastest electrophoretic mobility and lowest TG content are
(A) VLDL
(B) LDL
(C) HDL
(D) Chylomicrones
30) LCAT activity is associated with which of the lipo-protein complex?
(A) VLDL
(B) Chylomicrones
(C) IDL
(D) HDL
31) Each of the following can be an intermediate in the synthesis of phosphatidyl choline
except
(A) Phosphatidyl inositol
(B) CDP-choline
(C) Phosphatidyl ethanolamine
(D) Diacylglycerol
32) During each cycle of on going fatty acid oxidation, all the following compounds are
generated except
(A) H2O (B) Acetyl CoA
(C) Fatty acyl CoA (D) NADH
33) Which of the following regulates lipolysis in adipocytes?
(A) Activation of fatty acid synthesis mediated by CAMP
(B) Glycerol phosphorylation to prevent futile esterification of fatty acids
(C) Activation of triglyceride lipase as a result of hormone stimulated increases in cAMP levels
(D) Activation of cAMP production by Insulin
34) The rage limiting step cholesterol biosynthesis is
(A) Squalene synthetase
(B) Mevalonate kinase
(C) HMG CoA synthetase
(D) HMG CoA reductase

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35) Ketosis in partly ascribed to
(A) Over production and Glucose
(B) Under production of Glucose
(C) Increased carbohydrate utilization
(D) Increased fat utilization
36) The free fatty acids in blood are
(A) Stored in fat depots
(B) Mainly bound to -lipoproteins
(C) Mainly bound to serum albumin
(D) Metabolically most inactive
37) β-Oxidation of odd-carbon fatty acid chain produces
(A) Succinyl CoA
(B) Propionyl CoA
(C) Acetyl CoA
(D) Malonyl CoA
38) Which of the following cofactors or their derivatives must be present for the
conversion of acetyl CoA to malonyl CoA extramitochondrial fatty acid synthesis?
(A) Biotin
(B) FAD
(C) FMN
(D) ACP
39) A pathway that requires NADPH as a cofactor is
(A) Fatty acid oxidation
(B) Extra mitochondrial denovo fatty acid synthesis
(C) Ketone bodies formation
(D) Glycogenesis
40) The ‘Committed step’ in the biosynthesis of cholesterol from acetyl CoA is
(A) Formation of acetoacetyl CoA from acetyl CoA
(B) Formation of mevalonate from HMG CoA
(C) Formation of HMG CoA from acetyl CoA and acetoacetyl CoA
(D) Formation of squalene by squalene synthetase
41) In β-Oxidation of fatty acids, which of the following are utilized as coenzymes?
(A) NAD+ and NADP+
(B) FADH2 and NADH + H+
(C) FAD and FMN
(D) FAD and NAD+
42) The most important source of reducing equivalents for FA synthesis on the liver is
(A) Glycolysis
(B) HMP-Shunt
(C) TCA cycle
(D) Uronic acid pathway
43) All of the following tissue are capable of using ketone bodies except
(A) Brain
(B) Renal cortex
(C) R.B.C.
(D) Cardiac muscle

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44) The major source of cholesterol in arterial smooth muscle cells is from
(A) IDL
(B) LDL
(C) HDL
(D) Chylomicrons
45) Ketone bodies are synthesized from fatty acid oxidation products by which of the
following organs?
(A) Liver
(B) Skeletal muscles
(C) Kidney
(D) Brain
46) Very low density lipoproteins are relatively rich in
(A) Cholesterol
(B) Triacyl glycerol
(C) Free fatty acids
(D) Phospholipids
47) HMG CoA is formed in the metabolism of
(A) Cholesterol, ketones and leucine
(B) Cholesterol, fatty acid and Leucine
(C) Lysine, Lecuine and Isoleucine
(D) Ketones, Leucine and Lysine
48) NADPH is produced when this enzyme acts
(A) Pyruvate dehydrogenase
(B) Malic enzyme
(C) Succinate dehydrogenase
(D) Malate dehydrogenase
49) The acetyl CoA formed on β-oxidation of all long chain fatty acids is metabolized
under normal circumstances to
(A) CO2 and water
(B) Cholesterol
(C) Fatty acids
(D) Ketone bodies
50) Phospholipase A2 is an enzyme which removes a fatty acid residue from lecithin to
form
(A) Lecithin fragments
(B) Phosphotidic acid
(C) Glyceryl phosphate
(D) Lysolecithin
51) Pancreatic lipose is an enzyme which hydrolyzes facts. It acts as a/an
(A) peptidase
(B) hydrolase
(C) carbohydrates
(D) dehydrogenase
52) This interferes with cholesterol absorption
(A) Lipoprotein lipase
(B) Creatinase
(C) 7-dehydrocholesterol
(D) β-sitosterol
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53) Acyl carrier protein is involved in the synthesis of
(A) protein
(B) glycogen
(C) fatty acid outside the mitochondria
(D) fatty acid in the mitochondria
54) While citrate is converted to isocitrate in the mitochondria, it is converted to ______
in the cytosol.
(A) Acetyl CoA + oxaloacetate
(B) Acetyl CoA + malonyl CoA
(C) Acetyl CoA + Pyruvate
(D) Acetyl CoA + acetoacetyl CoA
55) Lysolecithin is formed from lecithin by the action of
(A) Phospholipase A1
(B) Phospholipase A2
(C) Phospholipase C
(D) Phospholipase D
………………………………………………………………….

Best wishes

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