2)- A 27 –year-old female with epilepsy has been taking Phenytoin to control her seizures. She is pregnant and considering the risk of potential bleeding episodes in the infant, her physician is considering to change her medicine. What biochemical activity might be deficient in the baby if her medication is continued as such?
a) Hydroxylation of proline
b) Gamma carboxylation of glutamic acid residues
c) Glucuronidation of bilirubin
d) Oxidation of lysine
e) Oxidation of glutathione.
3)- A 75-year-old female is seen in the emergency room with fractured arm. Physical examination reveals multiple bruises, perifollicular hemorrhages and bleeding gums. Her diet consisted mainly of plain buns, pasta, rolls and coffee. Laboratory result indicates Microcytic hypochromic anemia. Which of the following enzymes should be less active than the normal in this patient?
a) Glutathione peroxidase
b) Prolyl hydroxylase
c) Gamma Glutamyl transferase
d) ALA synthase
e) Glutathione reductase
4)- An 8-year-old child of IDDM (Insulin dependent diabetes mellitus) has been brought to emergency in a semi conscious state. History reveals that he had flu like episode 8 days back. His breathing is rapid and his breath has a fruity odor. His blood glucose is 345 mg/dl. The physician has started with I/V fluids, Insulin and potassium chloride. Insulin under such condition would rapidly stimulate which of the following processes-
a) Gluconeogenesis in liver
b) Glycogenolysis in liver
c) Uptake of glucose in peripheral cells
d) Lipolysis in adipose tissue
e) Ketone body utilization in brain cells.
5)- A 55-year-old chronic alcoholic was brought to emergency by his friends. During their night time gathering in the local bar he fell unconscious and they had been unable to revive him. The attending physician ordered for I/V Glucose and an injection of Thiamine. The patient was well oriented and alert next morning, his vital signs were stable, blood glucose was normal and he was discharged from the hospital. Which of the following enzymes is thiamine dependent and vital for glucose oxidation in brain?
d) Pyruvate dehydrogenase complex
e) Alpha keto acid dehydrogenase complex
6)- During acute myocardial infarction, the oxygen supply to an area of heart is reduced forcing the cardiac muscle cells to switch to anaerobic oxidation. Under this conditions the activity of which of the following enzymes is increased by the increasing concentration of AMP?
a) Phospho fructo kinase-1
b) Pyruvate kinase
c) Citrate synthase
d) Lactate dehydrogenase
e) Succinate dehydrogenase
7)- A 50- year-old male is seen in the emergency with severe headache. His blood pressure is 210/130 mm Hg. An evidence of retinal hemorrhage and epistaxis is also there. He has been given an infusion of nitroprusside. Which of the following enzymes is directly affected by the active metabolite of this drug ?
a) Phospholipase A2
b) Phospholipase C
c) Guanylate cyclase
e) Adenylate cyclase
8) A 16-month-old girl was found to have ingested approximately 30 mL of an acetonitrile-based cosmetic nail remover when she vomited 15 minutes post ingestion The poison control center was contacted, but no treatment was recommended because it was confused with an acetone-based nail polish remover. The child was put to bed at her normal time, which was 2 hours post-ingestion Respiratory distress developed sometime after the child was put to bed, and she was found dead the next morning.
Inhibition of which of the following enzymes was the most likely cause of this child’s death?
a) Cytochrome c reductase
b) Cytochrome oxidase
c) Coenzyme Q reductase
d) NADH dehydrogenase
e) Succinate dehydrogenase
9)- Excess of nitroprusside sometimes causes cyanide toxicity and is treated by giving thiosulfate, Which complex associated with electron transport chain or oxidative phosphorylation gets inhibited by the toxic metabolic product of nitroprusside?
a) ATP synthase complex
b) Succinate dehydrogenase complex
c) ADP/ATP transporter
d) NADH dehydrogenase complex
e) Cytochrome a-a3 oxidase
10)-A patient has been exposed to toxic compound that increases the permeability of mitochondrial membrane for protons. Which of the following will not be observed in the liver cells ?
a) Increased glycolysis
b) Increased activity of ATP synthase complex
c) Increased concentration of ADP
d) Increased activity of PFK-1
e) Increased activity of pyruvate kinase
11) – A 56-year-old man with a history of genetic disease underwent hip replacement surgery for arthritis. During surgery black stains were observed in the cartilage. These stains are usually observed in patients suffering from Ochronosis, a condition initially characterized by darkening of urine upon standing (Alkaptonuria). There is deficiency of Homogentisic acid oxidase in this condition. Which of the following vitamins acts as a coenzyme for the above said enzyme ?
a) Vitamin B12
b) Folic acid
c) Ascorbic acid
12) In a patient with Abetalipoproteinemia, abnormal red blood cells (Acanthocytes- thorny looking cells) are observed, there is defective synthesis of Apo B protein in this condition. Which of the following would have impaired absorption, the deficiency of which leads to impaired membrane formation in this condition ?
a) Folic acid
b) Ascorbic acid
c) Palmitic acid
d) Arachidonic acid
e) Linolenic acid
13) Failure of down regulation of extra hepatic receptors for oxidized LDL is mainly responsible for the formation of foam cells and for triggering the process of atherosclerosis. This process can be prevented by timely supplementation of antioxidants. Which of the following should be considered the best choice to be considered as an antioxidant ?
a) Vitamin B6
b) Vitamin K
c) Vitamin D
d) Vitamin E
e) Folic acid
14)- A factory worker is on hunger strike from the last 3 days. Beta oxidation is presumed to be highly active, under such condition. What would be the expected fate of mitochondrial pyruvate ?
a) Oxidatively decarboxylated to form Acetyl co A to be used in TCA cycle
b) Carboxylated to Phosphoenol pyruvate to be used for gluconeogenesis
c) Reduced to lactate to be used for gluconeogenesis
d) Oxidatively decarboxylated to form Acetyl co A to be used for ketogenesis
e) Carboxylated to Oxalo acetate to be used for gluconeogenesis.
15) -In the fed state after a very heavy meal, there is active lipogenesis in the adipose tissue. Glycolysis must go on at the same pace to provide which of the following intermediate from glycolysis required for fat storage ?
a) Acetyl co A
e) Dihydroxy acetone phosphate
16) A child is diagnosed with congenital deficiency of medium chain Acyl co A dehydrogenase. Which of the following biochemical finding would be observed in the fasting state ?
b) Low blood lactate level
d) Dicarboxylic acidosis
17) A 6-year-old child has been brought with impairment of vision. He is diagnosed with Galactosemia. Which enzyme is responsible for causing premature cataract in such affected children ?
a) Sorbitol dehydrogenase
b) Aldose reductase
d) Galactose-1-P- Uridyl transferase
e) Aldolase -B
Key to Answers-
1)- c, 2)- b, 3)- b, 4)- c, 5)- d, 6)- a, 7)-c, 8)- b, 9)- e, 10)- b, 11)- c, 12)- d, 13)-d, 14)- e, 15)-e, 16)-d, 17)-b.
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