Carbohydrate and its

metabolism
What are carbohydrates?
Q. Cellulose is a-
a. Fructose polymer
b. Non starch polysaccharide
c. Starch polysaccharide
d. Glycosaminoglycan
Q. Non-reducing disaccharide is-
a. Fructose
b. Sucrose
c. Maltose
d. Lactose
What is glycolysis?
Q. All of the following enzymes catalyze irreversible steps in glycolysis;
EXCEPT:
a. Hexokinase
b. Isomerase
c. Enolase
d. Pyruvate kinase
TCA cycle
Q. The net ATP yield when one molecule of pyruvate is completely
oxidized to CO2 and H2O is:
a. 10
b. 15
c. 18
d. 30
Gluconeogenesis
Q. Gluconeogenesis is mainly seen in-
a. Kidney
b. Spleen
c. Liver
d. Heart
Q. Glucose-6-phosphate dehydrogenase deficiency causes-
a. Megaloblastic anemia
b. Hemolytic anemia
c. Sickle cell anemia
d. Microcytic anemia
Q. A nurse recommends the consumption of dietary fibers to a person
with constipation. She suggests him the consumption of fibers not more
than 30 gm in a day. The probable objective of the recommended
consumption of the fibers is-
a. Excessive consumption of fiber may cause cancer of colon
b. Excessive consumption of fiber may lead to deficiency of iron
c. Excessive consumption of fiber may lead to obesity
d. All of the above
Q. The following metabolic abnormalities occur in Diabetes mellitus;
Except-
a. Increased lipolysis
b. Increased ketone bodies
c. Decreased glucose utilization
d. Decreases glucagon/insulin ratio
Diabetes mellitus
Q. Sodium fluoride is a good in-vitro preservative of glucose in blood
samples because it inhibits:
a. Enolase
b. Hexokinase
c. Phosphofructokinase
d. Pyruvate dehydrogenase
Lipids
What are lipids:
Classification of lipids:
Good fat vs bad fat
Q. Fats are stored in which of the following forms in tissue:
a. Fatty acids
b. Cholesterol
c. Triglycerides
d. Cholesterol esters
Q. Acetyl CoA directly gives rise to all except-
a. Fatty acids
b. Ketone bodies
c. Cholesterol
d. Glucose
Q. Which of the following is an Omega-3 fatty acid?
a. Linoleic acid
b. Alpha linolenic acid
c. Oleic acid
d. Arachidonic acid
Q. Which of the following is an example of omega-3 fatty acids:
a. Gamma linolenic acid
b. Oleic acid
c. Docosahexanoic acid
d. Palmitoleic acid
Lipoproteins
Composition of lipoproteins
Q. Which of the following is cardioprotective?
a. HDL
b. LDL
c. VLDL
d. Chylomicrons
Q. Which of the following has maximum cholesterol content?
a. HDL
b. LDL
c. VLDL
d. Chylomicrons
Q. Which of the following lipoprotein transports triglyceride from liver to
plasma?
a. HDL
b. LDL
c. VLDL
d. Chylomicrons
Cholesterol
Cholesterol synthesis
 Steroid hormones

Vitamin D
cholesterol
Bile acids

Incorporation in

biological

membrane
Q. The rate limiting enzyme in cholesterol synthesis is-
a. HMG CoA synthetase
b. HMG CoA reductase
c. HMG CoA lyase
d. Catalase
Q. Ketone body production occurs in:
a. Cytoplasm
b. Mitochondria
c. Golgi body
d. Nucleus
Q. Beta oxidation of odd chain fatty acid produces acetyl CoA and
………….?
a. Malonyl CoA
b. Succinyl CoA
c. Propionyl CoA
d. Methylmalonyl CoA
Protein chemistry
What are proteins?
Structural organization
of protein:
Amino acids:
Nutritional classification of amino acids
Q. A 20-year-old boy with severe mental retardation, mousy odor in body
fluids, hypopigmentation. Patient has frequent episodes of seizures and
aggressive behavior. What is the underlying diagnosis?
a. Phenylketonuria
b. Albinism
c. Alkaptonuria
d. Hemophilia
Q. Which of the following amino acid is excreted in urine in maple syrup
urine disease?
a. Tryptophan
b. Phenylalanine
c. Leucine
d. arginine
Q. A 40-year-old man presented with black pigmentation of pinna and
sclera of eyes. The color of urine changes to black on long standing. What
is the diagnosis?
a. Alkaptonuria
b. Phenylketonuria
c. Maple syrup urine disease
d. Hartnup disease
Q. Nitrogenous waste is excreted in the form of-
a. Glutamine
b. Urea
c. Uric acid
d. Nitric oxide
Q. 1g of protein yields-
a. 4 Kcal
b. 9 kcal
c. 2 kcal
d. 7 Kcal
Q. A child presents with complaints of urine turning black on standing.
What is the diagnosis?
a. Homocystenuria
b. Tyrosinemia
c. Alkaptonuria
d. Maple syrup urine disease
Q. Enzyme deficient in maple syrup urine disease-
a. Branched chain alpha keto acid decarboxylase
b. Methionine adenosyltransferase
c. Fumarylacetoacetate hydrolase
d. Tyrosine aminotransferase
Q7. Regular consumption of rice may lead to the deficiency of lysine.
Consider the following statement regarding lysine and pick out incorrect
statement.
a. Lysine is a non-essential amino acid.
b. Lysine is a ketogenic amino acid.
c. Lysine is a basic amino acid.
d. All of the above are incorrect.
Q. Urea is formed from which substrate?
a. Arginine
b. Ornithine
c. Citruline
d. Aspartate
Q. The best index for calculation of the nutritional value of protein is
which one of the following:
a. Biological value
b. Net protein utilization
c. Protein digestibility
d. Protein efficiency rate
Q. Which enzyme is used to convert phenylalanine to tyrosine?
a. Tyrosine synthase
b. Tyrosine hydroxylase
c. Phenylalanine hydroxylase
d. Phenylethanolamine methyltransferase
Q. Which one of the following is a precursor of tyrosine?
a. Epinephrine
b. Phenylalanine
c. DOPA
d. Norepinephrine
Q. Which vitamin can be synthesized from tryptophan:
a. Niacin
b. Riboflavin
c. Cobalmin
d. Folic acid
 Odor Disease

Fruity odor Ketosis

Cabbage type odor Methionine malabsorption

Maple sugar odor Maple sugar urine disease

Mousy Phenylketonuria
Vitamins
 Precursor Beta-carotene
Dietary source Cod liver oil, egg yolk, sweet
potato (NOT WHITE
POTATO)

Reservoir Liver (in form of retinol

esters)
Significance Vision, potent antioxidant
Vitamin A
Deficiency Nyctalopia (night blindness)
Bitot spots xerophthalmia

Excess Headache, vomiting, vertigo,

skin desquamation and
diplopia
 Dietary Whole grains, nuts, meat, fruits,
sources vegetables

Vitamin B Function Coenzyme component of Thiamine

Complex B1 (Thiamine) Pyrophosphate
Aka anti-
beriberi factor
Importance Normal functioning of nervous
system, muscle excitation

Deficiency Beriberi
 Dietary sources Milk, meat, mushrooms

Functions Component of coenzyme FMN and FAD

B2 (Riboflavin)
Aka lactoflavin
due to presence Importance Normal structure and function of mucous
in milk membrane and skin
Deficiency Lesion on lips
Cheilosis
fishy odor from the mouth
magenta colored tongue.
 Dietary sources Wheat, mushrooms, peanuts, eggs,
milk, seafoods

Functions Component of NAD and NADP

Importance Pellagra preventive factor

B3 (Niacin) Deficiency Pellagra
4 D’s of pellagra are dementia, dermatitis,
diarrhea and death
characteristic feature of pellagra
deficiency is Casal’s necklace
 Dietary sources Eggs, fish , green leafy vegetables,
banana, potato, cereals

Functions Coenzyme Pyridoxal-5-Phosphate

Importance Metabolism of amino acids

Maintains Homocysteine levels
B6 (Pyridoxine)

Deficiency Peripheral neuritis

Pantothenic Acid Dietary sources Chicken, egg yolk, broccoli, potatoes,
oats, whole grains

Functions Used in energy producing reactions and

fatty acid synthesis

Importance Integral part of CoA and acyl carrier protein

Deficiency Muscle cramps, burning feet

Folic Acid Dietary sources Spinach, broccoli, banana, orange,
brown rice

Functions Helps in formation of blood cells

Importance Carrier of one C moiety

Deficiency Megaloblastic macrocytic anemia

B12 (Cobalamine) Dietary sources Meat, fish, poultry products
Intrinsic factor is
required for Functions formation of RBC and metabolism of folic
absorption acid
Importance Important for nervous system,

Deficiency Pernicious anemia

Chronic alcoholism, prolonged antibiotic
use and lack of intrinsic factor in the body
can lead to a condition known as
pernicious anemia.
 Dietary sources Amla, citrus fruits, tomatoes,
guava, spinach, leafy vegetables

Functions Collagen synthesis

Vitamin C (Ascorbic Antioxidant
Acid) Iron absorption
Most heat sensitive Synthesis of other compounds e.g.
vitamin serotonin, throxine, bile acids,
purine, epinephrine etc.

Importance Recycling of oxidized vitamin E

Stabilizes reduced form of folic
acid
Deficiency Scurvy
 Sources By the action of sunlight on skin
Cod liver oil, fish oil (richest
source), egg yolk, fortified milk
Vitamin D
Functions Regulates blood calcium level

Importance Inhibit cell proliferation

Enhance cell differentiation

Deficiency Rickets
osteomalacia
Vitamin E Dietary Wheat germ oil, sunflower oil, nuts and
(Tocopherols) sources seeds

Functions Antioxidant

Importance Stabilizes cell membrane

Defend cells against oxidative damage
from free radicals

Deficiency Hemolytic anemia in infants

Muscular dystrophy
Vitamin K Dietary sources Green leafy vegetables, soyabean oils, broccoli
(Phylloquinone) Pumpkin, carrot and mangoes
Functions Blood coagulation
Deficiency Blood clotting failure
Cause of Vitamin K deficiency are prolonged
antibiotic therapy, obstructive jaundice and
administration of dicoumarol/warfarin.
Hemorrhagic diseases of newborn are due to vitamin
K deficiency. 1 mg IM injection of vitamin K is given
to infants to prevent this but large doses of vitamin K
can cause jaundice and hemolysis.
Vitamin Chemical name
A Retinol
B1 Thiamine
B2 Riboflavin
B3 Niacin
B5 Pantothenic acid
B6 Pyridoxine
B7 Biotin
B9 Folic acid
B12 Cobalamin
C Ascorbic acid
D Calciferol
Q. Vitamin deficiency causing tingling sensation:
a. Vitamin A
b. Vitamin B1
c. Folic acid
d. Vitamin B6
Q. Menke’s kink hair disease is due to-
a. P53 defect
b. Copper excess
c. Copper deficiency
d. Zinc deficiency
Q. A patient came to OPD with complaints of diarrhea, dermatitis and
dementia. It was also found that he was a maize eater. Which of the
following could be the most probable deficiency?
a. Thiamine
b. Niacin
c. Riboflavin
d. Biotin
Q. Patient who is a chronic alcoholic has signs of B1 deficiency. Which of
the following is the marker of vitamin B1 deficiency?
a. RBS transketolase activity
b. RBC glyceraldehyde reductase activity
c. Homocysteine activity
d. Pyridoxal-5-phosphate
Q. A 50-year-old male has bruising under the eyes. Which of the
following vitamin deficiency leads to easy bruising and bleeding gums?
a. Vitamin B12
b. Vitamin B2
c. Vitamin B6
d. Vitamin C
Q. Which vitamin can be synthesized from tryptophan:
a. Niacin
b. Riboflavin
c. Cobalmin
d. Folic acid
Q. Patient presents with drying of skin and appears as shown below.
Identify the vitamin deficiency.
a. B1
b. B2
c. B3
d. B9
Q. Pellagra is due to-
a. Utilization of tryptophan
b. Deficiency of tryptophan
c. Deficiency of thiamine
d. Utilization of niacin
Q. Water soluble form of vitamin K is-
a. Phylloquinone
b. Menaquinone
c. Menadione
d. None
Q. A vegetarian patient presents with anemia and hyper segmented
neutrophil. The most probable diagnosis is:
a. Anemia of chronic disease
b. Iron deficiency anemia
c. Megaloblastic anemia
d. Hemolytic anemia
Q. Patient presents with drying of skin and appears as shown below.
Identify the vitamin deficiency.
a. B1
b. B2
c. B3
d. B9
Q. Pellagra is due to-
a. Utilization of tryptophan
b. Deficiency of tryptophan
c. Deficiency of thiamine
d. Utilization of niacin
Q. Water soluble form of vitamin K is-
a. Phylloquinone
b. Menaquinone
c. Menadione
d. None
Q. Which of the following explains the role of sunlight in vitamin D
metabolism?
a. Conversion of cholecalciferol to 25 OH cholecalciferol
b. Conversion of 25 OH cholecalciferol to calcitriol
c. Conversion of 25 OH cholecalciferol to 24,25 dihydroxy cholecalciferol
d. Conversion of 7-dehydrocholesterol to cholecalciferol
Q. A patient has macrocytic anemia and high homocysteine levels. His
methylmalonyl CoA levels are normal. What is the underlying disorder?
Vitamin B6 deficiency
Vitamin B9 deficiency
Vitamin B12 deficiency
Anemia of chronic disease
Q. A patient is having fatigue and weakness. On examination, his Hb was
low, iron levels were low. Patient noted that his wound healing is delayed
since last one year. Which vitamin deficiency is possible in this patient?
a. Vitamin C
b. Vitamin A
c. Vitamin B12
d. Vitamin B2
Minerals
Minerals Dietary source Functions Deficiency
disease
Sodium Common salt Water &
electrolyte
balance
Potassium Fruits, veg and dairy Acid base Cardiac
products balance arrhythmia
Chloride Common salt Maintains
osmotic
pressure
Calcium Milk & milk products, Bone Rickets and
eggs, dry fruits, legumes, calcification & osteomalacia
cabbage teeth, blood
coagulation,
cofactor
Minerals Dietary source Functions Deficiency
disease
Phosphorus Milk and milk products, Bone Neural,
eggs, meat, legumes and calcification, muscular,
cereals nucleic acid, skeletal and
blood pH, renal
enzyme abnormalities
activator
Magnesium Whole grain cereals, Cofactor, Tremors, muscle
potatoes and seafoods synthesis of spasms,
fatty acids & personality
protein, changes,
phosphorylation anorexia, nausea
of glucose and vomiting,
tetany
Iron Meat, fish, eggs, Heme & nonheme Iron deficiency
green-leafy veg, protein ( anemia, reduced
cereals, legumes hemoglobin, work capacity
catalase and
cytochromes)
Zinc Meat, seafoods, eggs, cofactor Short stature,
legumes, milk hypogonadism,
mild anemia &
reduced immune
functions
Copper Nuts, leafy veg, dried Component of Anemia,
legumes, egg yolk, enzymes neutropenia, skeletal
fish abnormalities
Iodine Drinking water, Thyroid hormone Endemic goiter &
iodized salt, sea foods, synthesis, BMR cretinism
fruits, veg & meat regulation
Fluoride Drinking water & tea Devp of tooth enamel, Dental caries,
antibacterial agent osteoporosis
Chromium Brewer yeast, Potentiates Insulin
mushroom, black insulin action, resistance, lipid
pepper, whole grain, influence abnormalities
nuts, cheese metabolism

Molybdenum Pulses, cereals, green Component of Mental changes,

leafy veg, meat enzyme abnormality of
sulfur and
purine metab
Cobalt Food from animal origin Component of Macrocytic
vit B12 anemia &
pernicious
anemia

manganese Nuts, whole grain, Component of Sterlity, skeletal

cereals, legumes enzyme abnormalities,
ataxia

Selenium Plant foods, cereals, fish, Component of Liver necrosis

meat selenoprotein
Q. Hormones that regulate serum calcium levels:
a. Calcitonin, vitamin D & PTH
b. Thyroid, vitamin D & PTH
c. Calcitonin & vitamin B complex
d. Vitamin D, C & A
Q.Selenium deficiency causes-
a. Menke’s disease
b. Wilson’s disease
c. Keshan disease
d. Kashinbeck disease
Q. A child with alopecia, hyperpigmentation, hypogonadism and rash of
genital area and mouth is likely to suffer from:
a. Iron deficiency
b. Zinc deficiency
c. Calcium deficiency
d. Copper deficiency
Q. The optimum fluoride concentration in drinking water in India is-
a. 1-2 ppm
b. 3-5 ppm
c. 2-4 ppm
d. 0.3-0.5 ppm
Q. The mineral element and amino acid required for thyroxin synthesis –
a. Iodine and tyrosine
b. Iron and phenylalanine
c. Iodine and phenylalanine
d. Iron and tyrosine
Q. Iron is deficient in-
a. Cereals
b. Maize and corn
c. Pulses
d. Milk
Enzymes, coenzymes and diagnostic
importance of isoenzymes
Q. LDH1 is seen in-
a. Liver
b. Skeletal muscles
c. Heart
d. Kidney
Q. The isoenzyme CK(MB) is specifically increased in blood of patients
who have-
a. Skeletal muscle disease
b. Infective hepatitis
c. Myocardial infarction
d. Acute pancreatitis
Q. Hepatic disease leads to major elevation of-
a. Biliverdin
b. Total bilirubin
c. Albumin
d. Heme
Q. All of the following are the indicators of liver function; EXCEPT-
a. Creatinine
b. Bilirubin
c. Albumin
d. Cholesterol
Q. Blood urea is markedly increased in-
a. Liver disease
b. Renal disease
c. Cardiac disease
d. Protein intake
Q. LDH1 is seen in-
a. Liver
b. Skeletal muscles
c. Heart
d. Kidney
Q6. A patient arrives in the emergency department with symptoms of
myocardial infarction, progressing to cardiogenic shock. Which of the
following biochemical marker would help to confirm myocardial
infarction?
a. Decreased level of myoglobin
b. Increased level of troponin C
c. Increased level of LDH-5
d. Decreased level of CK-MB
Energy, classification of foods
and therapeutic diet
Q. DASH diet includes the following food except-
a. Rich in potassium
b. Rich in calcium
c. Rich in sodium
d. Rich in magnesium
Q. Adult metabolic rate decreases with an increase in-
a. Muscle mass
b. Fever
c. Body fat
d. Body surface area
Q. A nurse must be aware that eating maize alone may lead to:
a. Beriberi
b. Pellagra
c. Scurvy
d. Phyrnoderma
Q. The nurse is providing a teaching session to a client who has ulcerative
colitis. The nurse will instruct the client for which diet?
a. Carbohydrate consistent diet
b. High calorie, high protein diet
c. High calcium and high potassium diet
d. Low-residue, low-fiber diet
Q. BMI greater than 30 is considered as-
a. Overweight
b. Obesity
c. Normal
d. Underweight
Q. Highest energy yielding food group is-
a. Carbohydrates
b. Fats
c. Sugars
d. Proteins
Q. The best way of increasing the nutritive value of pulses is-
a. Mixing pulses
b. Fortification
c. Parboiling
d. Germination
Q. Which of the following food is usually fortified with iodine and iron?
a. Sugar
b. Salt
c. Wheat flour
d. Milk
Q. 1. A nurse was attending a woman who was complaining weakness,
tiredness and shortness of breath. The nurse recommended her blood
examination. The hemoglobin level of the woman was found to be 9 g/dl
which was marking the anemia. Which of the food item was most likely to
be suggested by the nurse to recover from anemia?

a. Citrus fruits

b. Milk

c. Brown bread

d. Canola oil
Q. Which of the following vitamin is known as magic bullet for
preventing neural tube disorders in developing foetus?
a. Ascorbic acid
b. Thiamine
c. Folic acid
d. Calcitriol
Q. A boy bought a packet of Chocolate coated with nuts and almonds. The
label of the chocolate mentions 10 gram carbohydrates, 2 gram proteins
with 1 gram fats. What is the overall energy that would be provided by
the chocolate?
57 Kcal
117 Kcal
48 Kcal
87 Kcal
Q. A female has been diagnosed with hypothyroidism. What could be the
effect of this disease on the BMR?
a. BMR increases
b. BMR decreases
c. BMR remains unchanged
d. BMR first increases then decreases
Q.
National Nutrition
Programs
Q. The first state which launched Mid-day meal program is-
a. Tamil Nadu
b. Haryana
c. Kerala
d. Bihar
Q. Anemia Mukt Bharat Program was launched by-
a. World Health Organisation
b. Ministry of Women and Child Development
c. Ministry of Health and family welfare
d. Ministry of Finance
Q. National Goitre Control Programme was launched in-
a. 1961
b. 1962
c. 1963
d. 1964
Acid-base balance
Q. Metabolic acidosis is caused due to increased H+ concentration or -
a. increased HCO3-
b. decreased HCO3-
c. increased CO2
d. decreased CO2
Q. In a man undergoing surgery, it is necessary to aspirate the contents of
the upper gastrointestinal tract. After surgery, the following values were
obtained from an arterial blood sample: pH 7.55, PCO2 52 mm Hg and
HCO3 - 40 mmol/l. The underlying disorder is-
a. metabolic acidosis
b. respiratory acidosis
c. metabolic alkalosis
d. respiratory alkalosis
Q. A 10-year-old boy develops severe diarrhea while traveling to
some other state. The laboratory investigation revealed the following
results:
Arterial blood pH = 7.25
Partial Pressure of carbon dioxide = 24 mmHg
Bicarbonate = 10 mEq/L
Normal anion gap
The correct diagnosis of this patient is..................................................?

a. metabolic acidosis
b. respiratory acidosis
c. metabolic alkalosis
d. respiratory alkalosis