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1) A 30-year-old man has been fasting for religious reason for several days.  His brain has reduced its need for glucose by using which of the following substances as an alternate source of energy?

A. Fatty acids

B. Beta hydroxy butyrate

C. Glycerol

D. Beta carotene

E. Alanine

2) A 7-year-old girl is brought to the emergency department by her parents with complaints of severe polyuria and polydipsia. Laboratory examination reveals ketones in her urine. Which of the followings is the most likely source of ketones?

A. Fatty acid breakdown

B. Protein break down

C. Glycogenolysis

D. Gluconeogenesis

E. Side chain of cholesterol

3) A breast-fed infant began to vomit frequently and lose weight. Several days later she developed jaundice, hepatomegaly and bilateral cataract. What is the possible cause for these symptoms? 

A. Galactosemia

B. Von-Gierke’s disease

C. Juvenile diabetes Mellitus

D. Hereditary fructose intolerance

E.  Gaucher disease

4) The major metabolic product produced under normal circumstances by erythrocytes and by muscle cells during intense exercise is recycled through liver in the Cori cycle. The metabolite is-

A. Oxaloacetate

B. Alanine

C. Glycerol

D. Lactate


5) A 3-month-old infant presents with hepatosplenomegaly and failure to thrive. A liver biopsy reveals glycogen with an abnormal, amylopectin like structure with long outer chains and missing branches.  Which of the following enzymes would most likely be deficient?

A. Alpha Amylase

B. Branching enzyme

C. Debranching enzyme

D. Glycogen phosphorylase       

E. Glucose-6-phosphatase          

6) Prior to a race, many marathon runners will try to increase their glycogen concentrations by loading up with foods with high starch content, such as pasta. Alpha amylase secreted by the pancreas will digest the starch into which of the following major products?

A. Amylose, amylopectin, and maltose

B. Glucose, galactose, and fructose

C. Glucose, sucrose, and maltotriose

D. Limit dextrins, maltose, and maltotriose

E. Maltose, glucose and fructose

7) Which of the following substrates cannot contribute to net Gluconeogenesis in mammalian liver?

A. Alanine

B. Glutamate

C. Palmitate

D. Pyruvate

E. Odd chain fatty acids

8) Which of the following complications is less likely to occur in type II diabetics, as opposed to type I diabetics?

A. Retinopathy

B. Weight gain

C. Cardiovascular disease

D. Hypoglycemic coma

E. Non ketotic hyperosmolar coma

9) Familial fructokinase deficiency causes no symptoms because

A. Hexokinase can phosphorylate fructose

B. Liver Aldolase can metabolize it

C. Excess fructose does not escape in to urine

D. Excess fructose is excreted through feces

E. Excess fructose is converted to glucose

10) Which of the followings generates free glucose during the enzymatic breakdown of glycogen in skeletal muscles?

A. Phosphorylase

B. α-1-6-amyloglucosidase

C. Debranching enzyme

D. Glucose-6-phosphatase

E. Alpha amylase

1)   The answer is –B- Beta hydroxy Butyrate, a ketone body. Ketone bodies serve as alternative fuel for brain during prolonged fasting or starvation. Fatty acids due to long hydrophobic chain cannot cross blood brain barrier. Glycerol is a substrate of gluconeogenesis. In fact during prolonged fasting this is the only substrate left to provide glucose through pathway of gluconeogenesis. It can also be oxidized through glycolysis upon phosphorylation. Beta carotene is a provitamin; it is not a source of energy. Alanine is a transporter of amino group of amino acids from the muscle (glucose-alanine cycle), but it cannot be used as an alternative source of energy.

 2)   The answer is –A. Fatty acid break down provides Acetyl co A that serves as a precursor for ketone bodies. In Diabetes Mellitus glucose utilization is impaired due to absolute or relative insulin deficiency. Fatty acid breakdown occurs to provide energy and the resultant excessive Acetyl co A enters the pathway of ketogenesis. Protein breakdown provides amino acids, 6 amino acids are ketogenic, while 14 are glucogenic. Hence protein breakdown contributes only a little towards formation of Acetyl co A. The major contribution is through fatty acid breakdown. Glycogenolysis and Gluconeogenesis produce glucose only. Side chain of cholesterol provides propionyl co A which is a glucogenic component; it is converted to succinyl co A to gain entry in to TCA cycle.

 3)   The answer is –A. Galactosemia. The clinical manifestations are typical of classical Galactosemia. Bilateral cataract rules out the possibility of Von Gierke’s disease and hereditary fructose intolerance, although other symptoms are there in both these diseases. In juvenile diabetes mellitus, jaundice and hepatomegaly are not observed. In Gaucher disease, hepatomegaly is observed but cataract is never there.

 4)   The answer is-D- Lactate, the end product of glycolysis in erythrocytes and during intense exercise in skeletal muscle, is mobilized through Cori cycle to liver to provide glucose by the process of gluconeogenesis. (Erythrocytes lack mitochondria so the end product of glycolysis is always lactate.  The mode of glycolysis during intense exercise is anaerobic; hence lactate is formed as a result of glycolysis.

Alanine is transported to liver through Glucose Alanine cycle. Glycerol is also similarly transported but not from the erythrocytes or skeletal muscles, rather from the adipose tissues. Glycerol is a waste product in adipose tissues since without phosphorylation it cannot be utilized and the phosphorylating enzyme glycerol kinase is absent in adipose tissues.

 NADH produced at the step of glyceraldehyde dehydrogenase step is regenerated in the oxidized form NAD+ by reduction of pyruvate to lactate. These two reactions are coupled to have a continuous supply of NAD+.

 5)   The answer is-B- Branching enzyme. During the process of glycogen synthesis, branching enzyme creates branch points and further elongation is carried out by Glycogen synthase. In its deficiency stored glycogen is abnormal in chemistry, in the form of long polysaccharide chains with few branch points, resembling the structure of Amylopectin, thus this defect is also called Amylopectinosis. Alpha Amylase is an enzyme for digestion of starch and glycogen. Debranching enzyme deficiency results in the accumulation of abnormal glycogen, There is inability to remove the branch points, the resultant structure resembles Limit dextrin, and thus it is also called Limit dextrinosis. Glucose-6-phosphatase deficiency is observed in Von-Gierke’s diseases, a type 1 glycogen storage disease, the stored glycogen is always normal in chemistry.

 6)   The answer is-D.  The hydrolysis of starch is catalyzed by salivary and pancreatic amylases, which catalyze random hydrolysis of alpha (1- 4) glycoside bonds, yielding dextrins, and further hydrolysis yields a mixture of glucose, maltose, isomaltose (from the branch points in amylopectin) and maltotriose. Sucrose, galactose and fructose are not components of starch.

 7)   The answer is- C. Palmitate, a fatty acid with 16 carbon atoms, is not a substrate of gluconeogenesis. Even chain fatty acids, predominantly present in our body, yield Acetyl co A upon oxidation, which can not contribute towards gluconeogenesis.  The Pyruvate to Acetyl co A conversion is irreversible and moreover both of the carbon atoms of Acetyl co A are lost in the TCA cycle in the form of CO2.Oddchain fatty acid do act as substrates of gluconeogenesis, since propionyl co A the product of their oxidation can enter TCA cycle through formation of Succinyl co A, hence can contribute towards Glucose production. Alanine, pyruvate and glutamine are glucogenic.

 8)   The answer is-D- Hypoglycemic coma occurs as a result of insulin over dosage in Type 1diabetes Mellitus.  It is not observed in Type 2 diabetes. Weight gain can occur in both types, it is the result of treatment with insulin or certain hypoglycemic drugs. Non ketotic hyperosmolar coma is a frequent complication of coma especially in the elderly group.

 9)   The answer is-A Hexokinase is a non specific enzyme, it can phosphorylate fructose as well as other sugars but it has high km (low affinity) for fructose.  Glucose is the true substrate for this enzyme.Fructose-6-phosphatethe end product of Hexokinase reaction can enter glycolytic pathway to be utilized further, so it does not accumulate to produce the toxic effects. Liver Aldolase (Aldolase B) cleaves Fructose-1-P only, the product of fructokinase catalyzed reaction.  Aldolase A, present in all the cells of the body cleaves Fructose 1, 6 bisphosphate, the product of PFK-1 catalyzed reaction of glycolysis. Fructose to glucose conversion takes place only in the phosphorylated form.

 10) The answer is-B- Free glucose is released by the action of α-1-6-amyloglucosidase enzyme, a component of debranching enzyme. Debranching enzyme has two components. α-[1 4] to α-[1 4] Glucan transferase and α-1-6-amyloglucosidase.Glucan transferase shifts the trisaccharide on a branch bound by α-[1- 4] linkage to the straight chain and joins by α-[1 4] linkage. The exposed branch point is hydrolyzed by α-1-6-amyloglucosidase enzyme. Both components are present on the same polypeptide chain. Glucose-6- phosphatase does produce free glucose but it is absent in skeletal muscles. Alpha amylase is a digestive enzyme; it has no role in glycogen degradation in the muscle.

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2 Responses to MCQs Carbohydrate Metabolism (Problem based) with completed discussion

  • I guess the answer to question 10 could also be the debranching enzyme, because it contains alpha 1,6 amyloglucosidase, therefore I think question 10 should be removed.

  • Dr. Namrata Chhabra says:

    Thank you for your interest, but sir, it has already been explained about the role of debranching enzyme, it can produce free glucose, out of its α 1,6 Amylo glucosidase component but it has additional role also of glucan transferase. Hence the precise answer is correctly mentioned, it is α 1,6 Amylo glucosidase Thanks once again.