Bio Mcqs
Bio Mcqs
a) Hyaluronic acid
b) Maltose
c) Lactose
d) Sucrose
a) CH3OH
b) C12H22O11
c) C6H1206
d) C6H12O5
a) Starch
b) Dextrins
c) Glycogen
d) Cellulose
a) Glycogen
b) Starch
c) Dextrin
d) Cellulose
Q.6- Choose a sugar out of the following that is non reactive to Seliwanoff reagent?
a) Sucrose
b) Fructose
c) Inulin
d) Ribose
b) Dihydroxyacetone
c) Erythrose
d) Arabinose
a) Xylose
b) Xylulose
c) Lyxose
d) Aldose
a)Stereo isomers
b)Anomers
d) Optical isomers
Q.10- All the following tests are positive for Lactose except-
a) Benedict
b) Barfoed
c) Molisch
d) Osazone
Q.11- Glucose can have — isomers due to the presence of 4 asymmetric carbon atoms-
a) 4
b) 2
c) 12
d) 16
a) Epimers
b) Anomers
c) Ketoses
Q.13- The compounds having same structural formula but differing in configuration around one
carbon atom are called-
a) Optical isomers
b) Anomers
c) Stereo isomers
d) Epimers
a) Stereoisomerism
b) Optical isomerism
c) Mutarotation
d) Epimerization
a) Fucose
b) Maltose
c) Lactose
d) Fructose
a) Sugar acid
b) Deoxy sugar
c) Amino sugar
d) Sugar alcohol
a) Arabinose
b) Trehalose
c) Xylulose
d) Ribulose
Q.18- Which of the following gives a brown color on reaction with iodine?
a) Starch
b) Glycogen
c) Dextrin
d) Cellulose
a) Starch
b) Fructose
c) Glucose
a) Hyaluronic acid
b) Chitin
c) Inulin
d) Starch
Key to Answers
1) -a, 2)-c, 3)-b, 4)-a, 5) -d, 6)- d, 7)- b, 8)-c, 9)-d, 10)- b,11) -d, 12)-c, 13)-d, 14)- c,15)-d, 16)-a,17)-b,
18)- b, 19)- d, 20)- b.
a) Galactose
b) Maltose
c) Trehalose
d) Sucrose
a) Starch
b) Heparin
c) Glycogen
d) Cellulose
a) Glycogen
b) Agar
c) Inulin
d) Cellulose
a) Maltose
b) Fructose
c) Ribulose
d) Lactose
a) Glyceraldehyde
b) Dihydroxyacetone
c) Erythrose
d) Arabinose
a) Xylose
b) Erythrulose
c) Fructose
d) Sedoheptulose
a) Stereo isomers
b) Anomers
d) Optical isomers
a) Benedict
b) Barfoed
c) Molisch
d) Osazone
Q.11- Which out of the following is a carbohydrate with 6 carbon atoms and a keto group as the
functional group?
a) Glyceraldehyde
b) Dihydroxy acetone
c) Fructose
d) Galactose
a) Glycosides
b) Sugar acids
d) Sugar alcohols
a) Optical isomers
b) Anomers
c) Stereo isomers
d) Epimers
Q.14- Which of the following tests is not based on the reaction of carbohydrates with strong
acids?
a)Molisch
b) Benedict’s
c) Bial’s
d) Seliwanoff’s
Q.15- Which out of the following does not form osazone crystals?
a)Galactose
b) Maltose
c) Lactose
d) Sucrose
a) Sugar acid
c) Amino sugar
d) Sugar alcohol
Q.17- Which of the following gives a negative reaction with Barfoed’s test
a) Glucose
b) Maltose
c) Erythrose
d) Fructose
a) Inulin
b) Amylose
c) Agar
d) Cellulose
a) Starch
b) Fructose
c) Sucrose
d) Glucose
Q.20- Which of the following Mucopolysaccharides is non sulfated and most abundant in tissues?
a) Hyaluronic acid
b) Keratan sulphate
c) Heparin
d) Dermatan sulphate
Key to answers
1)-c, 2)-b, 3)-b, 4)-b, 5)- c, 6)-b, 7)-d, 8)-b, 9)-b, 10)-b, 11)-c,12)-b, 13)-d, 14)-b, 15)-d, 16)-b, 17)-b, 18)-
d,19)b, 20)-a .
a) Galactose
b) Lactose
c) Maltose
d) Sucrose
a) CH3OH
b) C6H1206
c) C12H22O11
d) C6H12O5
a) Starch
b) Glycogen
c) Dextrins
d) Cellulose
a) Glycogen
b) Inulin
c) Starch
d) Cellulose
a) Sucrose
b) Ribulose
c) Fructose
d) Ribose
a) Glyceraldehyde
b) Erythrose
c) Dihydroxyacetone
d) Arabinose
b) Lyxose
c) Xylulose
d) Aldose
a) Epimers
c) Anomers
d) Optical isomers
a) Benedict
b) Seliwanoff
c) Barfoed
d) Osazone
Q.11- Glucose can have ————- isomers due to the presence of 4 asymmetric carbon atoms-
a) 4
b) 12
c) 8
d) 16
a) Epimers
b) Isomers
c) Anomers
Q.13- The compounds having same structural formula but differing in configuration around one
carbon atom are called-
a) Optical isomers
b) Stereo isomers
c) Anomers
d) Epimers
b) Mutarotation
c) Optical isomerism
d) Epimerization
a) Fucose
b) Xylose
c) Lyxose
d) Fructose
Q.16- Dulcitol is a –
a) Sugar acid
b) Amino sugar
c) Deoxysugars
d) Sugar alcohol
a) Arabinose
b) Erythrose
c) Trehalose
d) Ribulose
a) Starch
b) Dextrin
c) Glycogen
d) Cellulose
a) Starch
b) Glucose
c) Fructose
a) Hyaluronic acid
b) Cellulose
c) Chitin
d) Chondrosamine
a) Inulin
b)Dextrin
c) Cellulose
d) Glycogen
a) Sucrose
b) Lactose
c) Maltose
d) Trehalose
a) Glucopyranose
b) Glucoside
c) Glucofuranose
d) Glucosamine
Q.24- Which test can be undertaken to differentiate between Glucose and Fructose?
a) Benedict
b) Molisch
c) Seliwanoff
d) Osazone
a) C3 H7O2N
b) C13H26O2
c) C6H12O6
d) C20H40O2
a) Ribose
b) Fructose
c) Glucose
d) Glyceraldehyde
Q.27-Which of following is an anomeric pair?
a) Glucuronate
b) Gluconate
c) Glucose
d) Muramic acid
Q.29- From the abbreviated name of the compound Gal (β 1 →4) Glc, we know that:
Q.30- The compound that consists of ribose linked by an N-glycosidic bond to N-9 of adenine is:
a) A purine nucleotide.
b) A pyrimidine nucleotide.
c) Adenosine.
d) AMP
Key to answers
1)-a, 2)-b, 3)-a, 4)-b, 5)-b, 6)-d, 7)-c, 8)-b, 9)-c, 10)-b, 11)-d, 12)-a, 13)-d, 14)-b, 15)-a,
16)-d, 17)-c, 18)-d, 19)-d, 20)-c, 21)-a, 22)-c, 23)-a, 24)-c, 25)-c, 26)-b, 27)-b, 28)-c,
29)-c, 30)-c
1- A 64 year-old man who develops acute renal failure while recovering from a severe acute
myocardial infarction (Acute MI), Blood chemistry reveals:
Na+ 140 mEq/L, K+ 4 mEq/L, Cl– 115 mEq/L, CO2 5 mEq/L, pH = 7.12, PaCO2 13 mmHg, and HCO3– 4
mEq/L. Calculate the anion gap and then choose the best answer for acid-base status.
Q.2- A 48-year-old man with bronchiectasis presents to the hospital emergency room with 3 days
of increasing cough, sputum, and dyspnea. About 1 month ago, his arterial blood gas analysis
showed pH 7.38, PaO2 55 mmHg, PaCO2 65 mmHg, and HCO3– 32 mEq/L. His current vital signs are
BP 117/65 mmHg, Pulse 123/min, Temperature 100°F. His current ABG(Blood gas analysis) in the
Emergency Room is pH 7.28, PaCO2 70 mmHg, PaO2 50 mmHg, and HCO3– 23 mEq/L. Which of the
following best characterizes the current acid-base status?
Q.3- A hospital patient with AIDS has diarrhea and becomes hypovolemic within a short period of
time. Which of the following laboratory results would best fit this clinical history?
Q.4- A 50-year-old chronic alcoholic is brought to the emergency room in a semiconscious state.
Blood pressure is 100/50 mmHg, heart rate 120 beats/min, respiratory rate 35/min, and his
temperature is 104F (40C).
Blood chemistry reveals : Sodium 150mEq/L (135-145), Potassium 2.5mEq/L (3.5-5.0), Chloride
107mEq/L (95-105),Bicarbonate 10mEq/L (24-26), pH 7.2 (7.35-7.45), PCO2 25mmHg (35-45),
Alcohol 40mmol/L (0), Osmolality 370mOsm/L (280-295), Glucose 50mg/dl (60-110) BUN 40mg/dl
(5-22). What is the acid-base status?
A) Metabolic acidosis
B) Metabolic Alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Q.5-All of the following statements are correct about potassium balance, except:
A) Cholera
B) Starvation
D) Lactic acidosis
E) Methanol poisoning.
Q.7- Which of the following is more appropriate for a 17-year-old Female suffering from IDDM with
the following blood chemistry report:
pH: 7.2, PO2 : 108 mm Hg, PCO2 : 12 mmHg and HCO3– : 5 meq/L
B) Respiratory Acidosis
C) Metabolic Alkalosis
D) Respiratory alkalosis
Q.8- A middle-aged person collapsed on the road side and was brought to emergency, Blood
chemistry revealed the following:
Which of the following is the most appropriate acid base imbalance in the above said condition?
A) Metabolic acidosis
D) Respiratory acidosis
Q.9- A 24 –year female reported to the emergency with difficulty in breathing. History revealed that
she had ingested some unknown drug. The blood chemistry revealed the following:
Which of the following is the most appropriate acid base imbalance in the above said condition?
B) Respiratory acidosis
C) Respiratory Alkalosis
D) Metabolic alkalosis
E) None of the above.
D) It is the minimum volume of urine excreted to eliminate the “waste products” of metabolism.
D) Stress
E) Hyponatremia
B) Excessive sweating
C) Renal failure
D) Mineralocorticoid deficiency
E) Chronic diarrhea
Q.14- Hypokalemia is serum K concentration < 3.5 mEq/L and is caused by:
A) Renal losses
B) GI losses
C) Diuretics
D) Insulin administration
Q.15- – Hyponatremia is decrease in serum Na concentration < 136 mEq/L and is caused by :
A) Diuretic use
B) Crush injuries
C) Hemolysis
D) High fever
A) Stimulation of thirst,
B) Secretion of ADH,
C) Renin-angiotensin-aldosterone system,
Q.17- Factors that shift Potassium in or out of cells include the following:
B) Blood volume
C) Acid-base status
B) Trauma
C) Metabolic acidosis
D) Respiratory alkalosis
E) Intake of bananas.
C) pH = pKa – log(A–/HA)
D) pH = pKa – log(HA/A–)
E) pH = pKa + log(H+/HA)
Q.20- All are true for renal handling of acids in metabolic alkalosis except
Key to answers
1)- D, 2)- D, 3)-B, 4)- E, 5)-D, 6)-A, 7)- A, 8)-E, 9)-A, 10)-E, 11)-C, 12)- B, 13)-A,14)-E, 15)- A, 16)- E, 17)-
E, 18)- D, 19)- A, 20)-E.
A) 40 nEq/L
B) 24 mEq/L
C) 400 mEq/L
D) 7.4 nEq/L
E) 100 mEq/L
Q.2- Which of the following is not a source of hydrogen ion in the body?
D) Starvation
Q.3- Which of the following is the most important chemical buffer of the plasma?
B) HPO42―/H2PO4―
D) Proteins
E) Hemoglobin
Q.4- A primigravida in labor is breathing rapidly, what you expect out of the following
A) Metabolic Acidosis
B) Metabolic Alkalosis
C) Respiratory Acidosis
D) Respiratory Alkalosis
A) pH = pK + log (A–/HA)
B) pH = pK + log (HA/A–)
C) pH = pK – log(A–/HA)
D) pH = pK – log(HA/A–)
E) pH = pK + log(H+/HA)
B) pH = pKa ±3 pH units
C) pH = pKa ±5 pH units
D) pH = pKa
A) 6 to 7.4
B) 7 to 7.2
C) 7.35 to 7.45
D) 7.5 to 8
E) 8 to 8.5
Q.8- All are true for renal handling of acids in metabolic acidosis except
Q.9- Which of the following is most appropriate for a female suffering from Insulin dependent
diabetes mellitus with a pH of 7.2, HCO3-17 mmol/L and pCO2-20 mm Hg?
B) Metabolic Alkalosis
C) Respiratory Acidosis
D) Respiratory Alkalosis
Q.10-A 50-year-old homeless man was brought to the emergency room in a stuporous state.
Below are his lab results, Bicarbonate 10mEq/L (24-26), pH 7.2 (7.35-7.45), PCO2 25mmHg (35-45),
Alcohol 40mmol/L (0), Osmolality 370mOsm/L (280-295), Glucose 50mg/dl (60-110) BUN 40mg/dl
(5-22). What is the acid-base status?
D) Respiratory acidosis
E) Metabolic alkalosis
Q.11- A 44-year-old man is brought to the emergency room stuporous and obtunded. Serum
chemistries are: HCO3 = 42 mEq/L; arterial pH = 7.5; PCO2 = 50mmHg. What is the acid-base
status?
D) Respiratory acidosis
E) Metabolic alkalosis
Q.12-The medical student next to you, realizing that there is an examination question on acid base
balance, begins nervously hyperventilating and then faints. You make him breathe into a paper
bag and he recovers. If you had drawn and analyzed his blood when he fainted you would have
expected to see :
A) Bilirubin Sulphate
B) Bilirubin Phosphate
C) Bilirubin diglucuronate
D) Bilirubin Acetate
E) Methylated Bilirubin
A) Glutathione
B) Glutamine
C) S-Adenosyl Methionine
E) D- Glucuronic acid
A) Excessive sweating
B) Comatose patient
C) Vomiting
D) Diarrhea
A) 2-6 G/litre
B) 4-8 G/litre
C) 5-10 G/litre
D) 6-16 G/litre
18) The minimum excretory volume to eliminate waste products from the body in dehydration is :
A) 100-200ml
B) 200-400 ml
C) 500-600 ml
D) 1500 ml
E) 600-800 ml
A) Excretion of Potassium
B) Reabsorption of potassium
C) Reabsorption of sodium
D) Excretion of sodium
B) Cushing syndrome
C) GI losses
D) Crush injuries
E) Insulin administration
Key to answers
1)- A, 2)- A, 3)-A, 4)-D, 5)-A, 6)-A, 7)-C, 8)-B, 9)-A, 10)- B, 11)-E, 12)-C, 13)-D, 14)-C, 15)-B, 16)-B, 17)-
D, 18)-C, 19)-E, 20)-D.
Systemic arterial pH is maintained between 7.35 and 7.45 by extracellular and intracellular chemical
buffering together with respiratory and renal regulatory mechanisms. The control of arterial CO 2 tension
(paCO2) by the central nervous system and respiratory systems; and the control of the plasma
bicarbonate by the kidneys stabilize the arterial pH by excretion or retention of acid or alkali.
The metabolic (bicarbonate) and respiratory components (carbonic acid) that regulate systemic pH are
described by the Henderson-Hassel Balch equation:
Under most circumstances, CO2 production and excretion are matched, and the usual steady-state
paCO2 is maintained at 40 mm Hg. Under excretion of CO2produces hypercapnia, and over excretion
causes hypocapnia. Nevertheless, production and excretion are again matched at a new steady-state
paCO2. Therefore, the PaCO2 is regulated primarily by neural respiratory factors and is not subject to
regulation by the rate of CO2 production. Hypercapnia is usually the result of hypoventilation rather than
of increased CO2 production. Increases or decreases in paCO2 represent derangements of neural
respiratory control or are due to compensatory changes in response to a primary alteration in the plasma
[HCO3–].
In conditions of low plasma [HCO3–] due to acidity in the medium (high H+ concentration), medullary
chemo receptors are stimulated with the resultant hyperventilation and elimination of H 2CO3(CO2), the
ratio of HCO–3/ H2 CO3 is restored back to normal , pH is also restored back to normal.
Reverse occurs in conditions of high plasma bicarbonate concentration (low H +), the medullary chemo
receptors are depressed with the resultant hypoventilation and retention of CO2 (H2CO3). The ratio is
restored, bringing pH also back to normal.
Effect of pCO2
¼ of normal ventilation → ↓ pH
Effect of [H+]
Respiratory Mechanism has effectiveness between 50-75% and is 1-2 times as great as the buffering
power of all other chemical buffers in ECF. The lungs should be healthy for these compensatory changes.
Acids are added daily to the body fluids. These acids first are buffered by the HCO 3 –/H2 CO3 system as
follows:
The net result is buffering of a strong acid (H2 SO4) by 2 molecules of HCO3 – and production of a weak
acid (H2 CO3), which minimizes the change in pH. The lungs excrete the CO 2 produced, and the kidneys
replace the consumed HCO3 –, to prevent progressive HCO3 – loss and metabolic acidosis, (principally by
H+secretion in the collecting duct).
The first is to reabsorb all the filtered HCO3 – (any loss of HCO3 – is equal to the addition of an equimolar
amount of H+), a function principally of the proximal tubule.
The second is to excrete the daily H+ load (loss of H+ is equal to addition of an equimolar amount of
HCO3 –), a function of the collecting duct.
HCO3 – re-absorption
With a serum HCO3 – concentration of 24 mEq/L, the daily glomerular ultra filtrate of 180 L, in a healthy
subject, contains 4300 mEq of HCO3 –, all of which has to be reabsorbed. Approximately 90% of the
filtered HCO3 – is reabsorbed in the proximal tubule, and the remainder is reabsorbed in the thick
ascending limb and the medullary collecting duct (figure-1).
The 3Na+ -2K+ «ATPase (sodium-potassium «adenosine triphosphatase) provides the energy for this
process, which maintains a low intracellular Na+concentration and a relative negative intracellular
potential. The low Na+ concentration indirectly provides energy for the apical Na+/H+ exchanger, which
transports H+ into the tubular lumen. H+ in the tubular lumen combines with filtered HCO3 – in the following
reaction:
Carbonic Anhydrase (CA IV isoform) present in the brush border of the first 2 segments of the proximal
tubule accelerates the dissociation of H2 CO3 into H2O + CO2, which shifts the reaction shown above to
the right and keeps the luminal concentration of H+ low. CO2 diffuses into the proximal tubular cell
perhaps via the aquaporin-1 water channel, where carbonic anhydrase (CA II isoform) combines CO 2 and
water to form HCO3 – and H+. The HCO3 – formed intracellularly returns to the pericellular space and then
to the circulation via the basolateral Na+/3HCO3 – co transporter.
In essence, the filtered HCO3 – is converted to CO2 in the lumen, which diffuses into the proximal tubular
cell and is then converted back to HCO3 – to be returned to the systemic circulation, thus reclaiming the
filtered HCO3 –
Acid excretion
Excretion of the daily acid load (50-100 mEq of H+) occurs principally through H+ secretion by the apical
H+ «ATPase in A-type intercalated cells of the collecting duct.
HCO3 – formed intracellularly is returned to the systemic circulation via the basolateral Cl –/HCO3 –
exchanger, and H+ enters the tubular lumen via 1 of 2 apical proton pumps, H+ «ATPase or H+ -
K+ «ATPase. The secretion of H+ in these segments is influenced by Na+ reabsorption in the adjacent
principal cells of the collecting duct. Hydrogen ions secreted by the kidneys can be excreted as free ions
but, at the lowest achievable urine pH of 5.0 (equal to free H+ concentration of 10 µEq/L), would require
excretion of 5000-10,000 L of urine a day. Urine pH cannot be lowered much below 5.0 because the
gradient against which H+«ATPase has to pump protons (intracellular pH 7.5 to luminal pH 5) becomes
too steep. Maximally acidified urine, even with a volume of 3 L, would thus contain a mere 30 µEq of free
H+. Instead, more than 99.9% of the H+ load is excreted buffered by the weak bases NH3 or phosphate.
Titratable acidity
The amount of secreted H+ that is buffered by filtered weak acids is called titratable acidity. Phosphate as
HPO4 2- is the main buffer in this system(figure-2) but other urine buffers include uric acid and creatinine.
The amount of phosphate filtered is limited and relatively fixed, and only a fraction of the secreted H + can
be buffered by HPO4 2-.
Figure-2- showing the buffering of secreted H+ by HPO4–
Ammonia mechanism
A more important urine-buffering system for secreted H+ than phosphate, ammonia (NH3) buffering occurs
via the following reaction:
NH3 + H+ «NH4 +
Ammonia is produced in the proximal tubule from the amino acid glutamine, and this reaction is enhanced
by an acid load and by hypokalemia. Ammonia is converted to ammonium (NH 4 +) by intracellular H+ and
is secreted into the proximal tubular lumen by the apical Na+/H+ (NH4 +) antiporter. It can be secreted as
such also and can later combine with H+ in the lumen to form NH4+.
NH4 + is trapped in the lumen and excreted as the Cl salt, and every H + ion buffered is an HCO3 – gained
to the systemic circulation (figure-3)
The kidneys can adjust the amount of NH3 synthesized to meet demand, making this a powerful system
to buffer secreted H+ in the urine.
Figure –3- showing ammonia mechanism. Glutamine is first converted to glutamate and then to alpha
keto glutarate
Renal glutaminase activity is increased in conditions of acidosis, to excrete out the excess acid load
whereas it is decreased in conditions of alkalosis to conserve acids (H+) to maintain the acid base
balance of the body.
An acid is a substance that can donate hydrogen ions (H+), and a base is a substance that can accept
H+ ions, regardless of the substance’s charge.
Strong acids are those that are completely ionized in body fluids, and weak acids are those that are
incompletely ionized in body fluids.
HCl « H+ + Cl–
Hydrochloric acid (HCl) is considered a strong acid because it is present only in a completely ionized form
in the body, whereas H2 CO3 is a weak acid because it is ionized incompletely, and, at equilibrium, all 3
reactants are present in body fluids.
In body fluids, the concentration of hydrogen ions ([H+]) is maintained within very narrow limits, with the
normal physiologic concentration being 40nEq/L. The concentration of HCO 3– (24mEq/L) is 600,000 times
that of [H+]. The tight regulation of [H+] at this low concentration is crucial for normal cellular activities.
Significance of pH
1) Specific tautomeric forms exist at physiologic pH. This helps in proper hydrogen bonding between the
complementary base pairs in the structure of DNA.
2) The solubility and biologic activity of a protein depends upon its 3D structure and that depends upon
net charge on protein for the maintenance of hydrogen and ionic interactions. The net charge depends
upon the pH of the medium.
3) The movement of ions across the membrane depends upon their net charge as determined by the pH.
4) Ionic state of the nucleic acids, lipids and mucopolysaccharides is also determined by the physiological
pH
Maintenance of pH is important for proper physiological functioning of cells and tissues. Any changes in
pH can alter enzyme activity, cellular uptake, incorporation and use of minerals and metabolites, uptake
and release of oxygen, and the formation of biological structural components.
Normal plasma pH = 7.40 (±0.05). The pH range that is compatible with life is from 6.8 to 7.8. The body
can comfortably tolerate a shift in pH of about 0.04. Most cells of the body have a pH = 7.0, but RBC’s
boast a pH of 7.2. The pH of the body affects its acid-base balance and the pH of blood has the greatest
effect.
1) Organic acids- The most common sources for pH disturbances are the body’s production of organic
acids (acetic, acetoacetate, propionic, butyric, lactic, etc.), which are the major sources of hydrogen ion.
2) Carbonic acid is the chief acid (volatile acid) produced in the body by the metabolic processes in the
body. Approximately 300 litres of CO2 are produced and eliminated daily in the body of an adult.
3) Sulphuric acid- it is produced during the oxidation of sulphur-containing amino acids and vitamins.
4) Phosphoric acid- is produced from the metabolism of dietary phosphoproteins, phospholipids, nucleic
acids and hydrolysis of phosphoesters.
Under normal conditions, acids and, to a lesser extent, bases are being added constantly to the
extracellular fluid compartment but still a physiologic [H+] of 40 nEq/L is maintained and the following 3
processes must take place:
Buffers
Buffers are weak acids or bases that are able to minimize changes in pH by taking up or releasing H +.
Phosphate is an example of an effective buffer, as in the following reaction:
(4) Proteins.
Proteins with side chains that contain more carboxyl terminal groups than amino terminal groups promote
an acidic environment. Proteins with side chains that contain more amino terminal groups than carboxyl
terminal groups promote an alkaline environment. Protein with side chains containing equal numbers of
amino and carboxyl side groups are neutral, not affecting the pH.
Details of Buffers
In the ECF bicarbonate buffer is the most important buffer. Its function is illustrated by the following
reactions:
When an acid load (H+) is added to the body fluids, it results in consumption of HCO3 – by the added H+.
Carbonic acid thus formed, in turn, forms water and CO2. CO2 concentration is maintained within a narrow
range via the respiratory drive, which eliminates accumulating CO 2. The kidneys regenerate the HCO3 –
consumed during this reaction.
Put simply, whereas simple buffers rapidly become ineffective as the association of the hydrogen ion and
the weak anion of the weak acid reaches equilibrium, the bicarbonate system keeps working because the
carbonic acid is removed as CO2. The limit to the effectiveness of the bicarbonate system is the initial
concentration of bicarbonate. The acid base status of the patient is assessed by the bicarbonate
concentration in the plasma. The association of hydrogen ion with bicarbonate occurs rapidly but the
dissociation of H2CO3 to CO2 and H2O is slow. This process is accelerated by the enzyme Carbonic
anhydrase, which is present in the erythrocytes and in the kidney whenever this reaction is needed.
Buffering at the expense of bicarbonate effectively removes hydrogen ions from ECF. CO 2 is removed
from the lungs and water assimilates in the ECF without producing any change in p H. The ECF contains
a large amount of bicarbonate to the extent of 24 mmol/L, when the H+ concentration increases the
bicarbonate concentration comes down since it is used up during the process of buffering.
This reaction continues to move to the left as long as CO 2 is constantly eliminated or until HCO3 – is
significantly depleted, making less HCO3 – available to bind H+. Since HCO3 – and PaCO2 can be
managed independently (kidneys and lungs, respectively) that makes this a very effective buffering
system. One of the major factors that make this system very effective is the ability to control PaCO 2 by
changes in ventilation. As can be noted from this reaction, increased carbon dioxide (CO 2) concentration
drives the reaction to the right, whereas a decrease in CO 2 concentration drives it to the left.
An indication of the acid base status of the patient can be determined by measuring the components of
the bicarbonate system.
The Henderson-Hassel Balch equation describes the relationship between blood pH and the components
of the H2 CO3 buffering system.
Carbonic acid (H2 CO3) is in equilibrium with the respiratory component, as shown by the below equation:
Note that changes in pH or [H+] are a result of relative changes in the ratio of PaCO 2 to [HCO3 –] rather
than to absolute change in either one. In other words, if both PaCO 2 and [HCO3 –] change in the same
direction, the ratio stays the same and the pH or [H+] remains relatively stable. To diminish the alteration
in pH that occurs when either HCO3 – or PaCO2 changes, the body, within certain limits, changes the
other variable in the same direction.
Upon addition of acid, the H+ is neutralized by the Na2 HPO4 component forming NaH2PO4 that is
eliminated through the kidney without any change in pH.
Similarly upon addition of OH–, the acid component reacts to form, Na2 HPO4 that can be eliminated as
well through the kidney without any change in pH
In other words Phosphate buffer system works in conjunction with the kidney.
Chemically it is a very good buffer, as pKa is close to Physiological pH, but physiologically due to its less
concentration (1.0 mmol/L as compared to bicarbonate 26-28 mmol/L) it is less efficient.
The buffering capacity of Hb is due to the presence of “Imidazole” nitrogen group of Histidine.
Oxygenated Hb is a stronger acid than deoxygenated Hb. Acidity of the medium favors delivery of oxygen
to the tissues. Alkalinity of the medium favors oxygenation of Hb. Sequence of events that occur in lungs
and tissues is as follows;
In the lungs
The formation of oxy hemoglobin from deoxy hemoglobin, must release H+, which will react with HCO3– to
form H2CO3. Due to the low CO2 tension in the lungs H2CO3, dissociates to form CO2 and H2O . CO2 is
then eliminated in the expired air (Figure-1).
Figure-1- Role of Hb as a buffer in the lungs.
In the tissues
Oxy Hb dissociates to give O2 to the tissues and the deoxy Hb (Reduced Hb) is formed. At the same time
CO2 produced as a result of metabolism, is hydrated to for H2CO3, which ionizes to form H+ and HCO3-.
Deoxy Hb acts as anion and accepts H+ to form acid reduced Hb (Figure-2)
Buffering capacity of plasma proteins is much less than Hb. In acidic medium protein acts a base and
NH2 group takes up H+ forming NH3+, protein becomes positively charged.
Reverse occurs in the alkaline medium. Acidic COOH to give H+ that neutralizes the OH– forming H2O.
Overall protein becomes negatively charged in the alkaline medium.
Alcohol
Methanol (formate)
Ethylene glycol (oxalate)
Salicylates
1) GI HCO3 – loss
Colostomy
Diarrhea
Enteric fistulas
Ileostomy
2)Urologic procedures
Tubulointerstitial renal
disease
Renal tubular acidosis
4) Ingestions
Acetazolamide
CaCl2
Mg sulfate (MgSO4)
C) Parenchymatous damage
/Inflammation
Emphysema
Bronchitis
Adult Respiratory distress
syndrome
Pleurisy
Barotrauma
D) Neuromuscular
Poliomyelitis
Kyphoscoliosis
Myasthenia gravis
Muscular dystrophies
E) Misc.
A person was admitted in a coma. Analysis of the arterial blood gave the following values:
PCO2 16 mm Hg, HCO3– 5 mmol/l and pH 7.1. What is the underlying acid-base disorder?
a) Metabolic Acidosis
b) Metabolic Alkalosis
c) Respiratory Acidosis
d) Respiratory Alkalosis
Q.2- In a man undergoing surgery, it was 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. What is the underlying
disorder?
a) Metabolic Acidosis
b) Metabolic Alkalosis
c) Respiratory Acidosis
d) Respiratory Alkalosis
Q.3- A young woman is found comatose, having taken an unknown number of sleeping
pills an unknown time before. An arterial blood sample yields the following values: pH –
6.90, HCO3– 13 meq/liter, PaCO2 68 mmHg. This patient’s acid-base status is most
accurately described as
Q.4- A student is nervous for a big exam and is breathing rapidly, what do you expect out
of the following
a) Metabolic Acidosis
b) Metabolic Alkalosis
c) Respiratory Acidosis
d) Respiratory Alkalosis
Q.5- A 45- year-old female with renal failure, missed her dialysis and was feeling sick,
what could be the reason ?
a) Metabolic Acidosis
b) Metabolic Alkalosis
c) Respiratory Acidosis
d) Respiratory Alkalosis
Q.6- An 80-year-old man had a bad cold. After two weeks he said, “It went in to my chest, I
am feeling tightness in my chest, I am coughing, suffocated and unable to breathe!” What
could be the possible reason?
a) Metabolic Acidosis
b) Metabolic Alkalosis
c) Respiratory Acidosis
d) Respiratory Alkalosis
Q.7- A post operative surgical patient had a naso gastric tube in for three days. The nurse
caring for the patient stated that there was much drainage from the tube that is why she
felt so sick. What could be the reason?
a) Metabolic Acidosis
b) Metabolic Alkalosis
c) Respiratory Acidosis
d) Respiratory Alkalosis
Q.8- The p H of the body fluids is stabilized by buffer systems. Which of the following
compounds is the most effective buffer system at physiological pH ?
a) Bicarbonate buffer
b) Phosphate buffer
c) Protein buffer
Q.9- Which of the following laboratory results below indicates compensated metabolic
alkalosis?
a) Lysine
b) Histidine
c) Aspartic acid
d) Leucine
Q.11- Which of the following is most appropriate for a female suffering from Insulin
dependent diabetes mellitus with a pH of 7.2, HCO3-17 mmol/L and pCO2-20 mm HG
a) Metabolic Acidosis
b) Metabolic Alkalosis
c) Respiratory Acidosis
d) Respiratory Alkalosis
a) Mineralocorticoid deficiency.
b) Hypokalemia
d) Recurrent vomiting.
b) Respiratory Acidosis
b) Hypoxia
c) Circulatory failure
d) Infections
Q.15- Which out of the following conditions will not cause respiratory alkalosis?
a) Fever
b) Anxiety
c) Laryngeal obstruction
d) Salicylate toxicity
d) Plasma
Q.19- All are true for renal handling of acids in metabolic acidosis except
Q.20- Choose the incorrect statement about anion gap out of the following
Q.21- Excessive citrate in transfused blood can cause which of the following
abnormalities?
a) Metabolic alkalosis
b) Metabolic acidosis
c) Respiratory alkalosis
d) Respiratory acidosis
Answers- 1-a, 2-b, 3-c, 4-d, 5-a, 6-c, 7-b, 8-a, 9-d, 10-b, 11-a, 12-a, 13-c, 14-d, 15-c, 16-a, 17-c,
18-d, 19-b, 20-d, 21-a.
Q.1- Explain clearly how hyperventilation and hypoventilation affect blood p H ? Give suitable
examples in support of your answer.
Q.2- Explain the role of hemoglobin as a buffer in the maintenance of acid base balance in the
body.
Q.3-The maintenance of intracellular pH within narrow limits is essential for life processes.
Briefly discuss why this is so and describe the mechanism by which the human body maintains
a relatively constant pH despite continuous acid production from cellular metabolism.
Q.4- Name 3 physiological buffer systems, and explain the mode of action of any one of them.
Q.5-A person was brought to the hospital after ingesting a large amount of ammonium
chloride. His arterial blood pH was found to be 7.29. Calculate the ratio of [HC0 3] to [dissolved
CO2] in the blood.
Dissolved CO2 + H20 H2CO3 H+ + HCO3– (pKa = 6.1) How might changes in the pulmonary
ventilation help to minimize the fall in pH?
Q.6- Discuss the role of kidneys in the maintenance of acid base balance of the body. Support
your answer with flow charts showing the details of the mechanisms.
Q.7- What is anion gap? State all the conditions of variations of anion gap in the body?
Q.8- Calculate the anion gap for a patient who has reported to emergency in a state of shock
with following blood reports
p H- 7.2
Pco2- 45 mm Hg
HCO3—12 meq/L
Cl – – -85 meq/L
1- Choose the incorrect statement out of the following for human immune deficiency virus
c) p32 is an Integrase
Q.2- The specific binding of HIV to the CD 4 surface molecules of the host cell membrane
is brought about by-
a) gp 120
b) gp 41
c) p32
d) p55
a) Monocytes
b) T –helper cells
c) T-Cytotoxic cells
d) Macrophages
Q.4- Which immune marker is present during the window period of HIV infection?
a) p24 antigen
b) Antibodies to gp 120
c) Antibodies to gp 41
d) p17 antigens
Q.5. Which out of the following is a preferred mode of transmission of HIV infection from
mother to child?
Q.6-Which out of the following are the high risk subjects for acquiring HIV infection?
b) Drug addicts
Q.7- The pol gene does not encode for which of the following enzymes?
a) Protease
b) Integrase
c) Reverse Transcriptase
d) RNA polymerase
a) gag
b) tat
c) nif
d) rev
Q.10-Which statement best describes the basis for failure to produce a vaccine against HIV
b) HIV Integrase its genome in to the host DNA, hence protected from immune system
c) HIV is not killed only by humoral response, cellular immunity is also required
Q.11-A gynaecologist while doing a caesarean section for an HIV positive female got
accidentally pricked by a needle. After 2 weeks of acquiring the infection the serum
sample was sent for analysis, which of the following markers might have been positive for
confirmation of diagnosis?
a) p24
b) viral RNA
c) Free virus
Q.12-An HIV positive male presented to the emergency with fever, pneumonia and oral
thrush. The attending physician described that all the presenting symptoms are due to
underlying collapsed immune system. What is the possible cause for immune
incompetence?
b) NK cells are depleted; cancer and virally infected cells are not removed
c)T-helper cells are depleted, all components of immune system are paralyzed
Q.13- At present the reasonable approach to initiate antiretroviral therapy to any one is–
b) Pregnant women
Q.14- Viral nucleic acids can be detected by which of the following techniques?
a) ELISA
b) Western Blotting
c) PCR
d) viral isolation
Q.15- Which of the following is not a rapid test for the diagnosis of HIV infection?
c) Western Blotting
Q.16- Western Blotting is considered a gold standard for the confirmation of HIV infection.
Which statement best describes the basis?
b) Protease Inhibitors
c) Integrase inhibitors
Q.18- Which structural component of HIV is required for cell –cell fusion ?
a) p 24
b) gp 41
c) gp 120
d) p32
Answers-
1)-d
2)- a
3)- c
4)- a
5)- d
6)- d
7)- d
8)- c
9)- a
10)-d
11)- d
12)- d
13)- d
14)- c
15)-c
16)-c
17)-d
Enzymes of which type are responsible for converting Pro carcinogens to Ultimate carcinogens ?
b) Hydrolase
c) Transferases
d) Acetylases
Q.2- Which of the following is the most commonly mutated oncogene in cancer ?
a) p53
b) abl
c) ras
d) myc
e) BRCA
Q.3- A 23-year-old woman is seen for a lump in her breast that she palpated on self beast
examination. History reveals that her mother and her aunt both had breast and ovarian cancer.
Given this presentation, you suspect the patient may have a mutation in which of the following
genes involved in DNA repair ?
a) BRCA-1
b) ras
c) bcl-2
d) p 53
e) Rb
Q.4- A 47 -year- old man , with no known family history of cancer, develops changes in his bowel
habits, including occasional blood in his stools. A colonoscopy and biopsy confirms the
diagnosis of adenocarcinoma of colon. Furthermore, the tumor is found to have mutation in the
ras protein. Which of the following best describes the protein ?
c) A receptor kinase
Q.5- A 56-year-old woman is recently diagnosed with breast cancer. She undergoes a lumpectomy
and a lymph node dissection, which shows that there are tumor cells that have migrated to the
lymph nodes. He oncologist recommends the chemotherapy including an agent that inhibits the
provision of folic acid which is required for the synthesis of purines and pyrimidines. Which of the
following agents should be the drug of first choice ?
a) Cyclophosphamide
b) Busulfan
c) Methotrexate
d) Etoposide
e) Vinblastin
Q.6- A 53-year-old man presents to the physician complaining of unwellness and easy fatigue.
The doctor orders a routine set of tests, which demonstrates a white blood cell count of 85,000/ml.
(Normal 3,000- 10,000/ml). Molecular studies suggest that he has chronic myelogenous leukemia.
A chromosomal translocation is responsible for this disease. Which of the following
translocations is associated with this disorder ?
a) t( 8;14)
b) t (14;18)
c) t (11;14)
d) t (9;22)
e) t (15;17)
Q.7- A 78-year-old male was brought to emergency with difficulty in passing urine and weight
loss. The attending urologist suspected carcinoma prostate. Which of the following molecular
marker would help in the confirmation of diagnosis ?
d) Alkaline phosphatase
e) Acid phosphatase
Q.8- A 23-year-old man was diagnosed with metastatic liver disease. The grain storage facility
outside his house was contaminated with aflatoxin B. In addition which of the following might act
as a co carcinogen in the development of patient’s cancer ?
b) Hepatitis B virus
c) Asbestos
e) Aniline dyes
Q.9- An 82-year-old woman presented to her primary care physician with a 10-year history of
episodic confusion and somnolence. The episodes occurred about twice a year, typically in the
morning, just after waking. They lasted minutes and were relieved when she ate her breakfast or
had juice. Her admission laboratory value of glucose level was 36 mg/dl and plasma insulin was
highly raised. What is the possible diagnosis for this patient ?
a) Hypothyroidism
b) Hypopituitarism
c) Diabetes mellitus
e) Insulinoma.
Q.10- A 54-year-old postmenopausal woman, presented to internist for care of hot flashes that
had returned 2 years after menopause. The symptoms occurred mostly after meals, when she
drank wine, or when she went for running. There was history of hypertension and frequent
diarrhea also. The 24 hour urine levels of 5-HIAA (5-hydroxyindoleacetic acid), a breakdown
product of serotonin was found to be highly elevated. What is the probable diagnosis for this
patient ?
a) Pheochromocytoma
b) Carcinoid tumor
c) Hartnup disease
d) Hyperpituitarism
Key to answers
Advertisement
- Which of the following is not a disaccharide?
a) Hyaluronic acid
b) Maltose
c) Lactose
d) Sucrose
a) CH3OH
b) C12H22O11
c) C6H1206
d) C6H12O5
a) Starch
b) Dextrins
c) Glycogen
d) Cellulose
a) Glycogen
b) Starch
c) Dextrin
d) Cellulose
Q.6- Choose a sugar out of the following that is non reactive to Seliwanoff reagent?
a) Sucrose
b) Fructose
c) Inulin
d) Ribose
a) Glyceraldehyde
b) Dihydroxyacetone
c) Erythrose
d) Arabinose
a) Xylose
b) Xylulose
c) Lyxose
d) Aldose
a)Stereo isomers
b)Anomers
d) Optical isomers
Q.10- All the following tests are positive for Lactose except-
a) Benedict
b) Barfoed
c) Molisch
d) Osazone
Q.11- Glucose can have — isomers due to the presence of 4 asymmetric carbon atoms-
a) 4
b) 2
c) 12
d) 16
a) Epimers
b) Anomers
c) Ketoses
Q.13- The compounds having same structural formula but differing in configuration around one
carbon atom are called-
a) Optical isomers
b) Anomers
c) Stereo isomers
d) Epimers
a) Stereoisomerism
b) Optical isomerism
c) Mutarotation
d) Epimerization
a) Fucose
b) Maltose
c) Lactose
d) Fructose
a) Sugar acid
b) Deoxy sugar
c) Amino sugar
d) Sugar alcohol
a) Arabinose
b) Trehalose
c) Xylulose
d) Ribulose
Q.18- Which of the following gives a brown color on reaction with iodine?
a) Starch
b) Glycogen
c) Dextrin
d) Cellulose
a) Starch
b) Fructose
c) Glucose
a) Hyaluronic acid
b) Chitin
c) Inulin
d) Starch
Key to Answers
1) -a, 2)-c, 3)-b, 4)-a, 5) -d, 6)- d, 7)- b, 8)-c, 9)-d, 10)- b,11) -d, 12)-c, 13)-d, 14)- c,15)-d, 16)-a,17)-b,
18)- b, 19)- d, 20)- b.
a) Galactose
b) Maltose
c) Trehalose
d) Sucrose
a) Starch
b) Heparin
c) Glycogen
d) Cellulose
a) Glycogen
b) Agar
c) Inulin
d) Cellulose
a) Maltose
b) Fructose
c) Ribulose
d) Lactose
a) Glyceraldehyde
b) Dihydroxyacetone
c) Erythrose
d) Arabinose
Q.8- Which of the following is a keto tetrose?
a) Xylose
b) Erythrulose
c) Fructose
d) Sedoheptulose
a) Stereo isomers
b) Anomers
d) Optical isomers
a) Benedict
b) Barfoed
c) Molisch
d) Osazone
Q.11- Which out of the following is a carbohydrate with 6 carbon atoms and a keto group as the
functional group?
a) Glyceraldehyde
b) Dihydroxy acetone
c) Fructose
d) Galactose
a) Glycosides
b) Sugar acids
d) Sugar alcohols
a) Optical isomers
b) Anomers
c) Stereo isomers
d) Epimers
Q.14- Which of the following tests is not based on the reaction of carbohydrates with strong
acids?
a)Molisch
b) Benedict’s
c) Bial’s
d) Seliwanoff’s
Q.15- Which out of the following does not form osazone crystals?
a)Galactose
b) Maltose
c) Lactose
d) Sucrose
a) Sugar acid
c) Amino sugar
d) Sugar alcohol
Q.17- Which of the following gives a negative reaction with Barfoed’s test
a) Glucose
b) Maltose
c) Erythrose
d) Fructose
a) Inulin
b) Amylose
c) Agar
d) Cellulose
a) Starch
b) Fructose
c) Sucrose
d) Glucose
Q.20- Which of the following Mucopolysaccharides is non sulfated and most abundant in tissues?
a) Hyaluronic acid
b) Keratan sulphate
c) Heparin
d) Dermatan sulphate
Key to answers
1)-c, 2)-b, 3)-b, 4)-b, 5)- c, 6)-b, 7)-d, 8)-b, 9)-b, 10)-b, 11)-c,12)-b, 13)-d, 14)-b, 15)-d, 16)-b, 17)-b, 18)-
d,19)b, 20)-a .
a) Galactose
b) Lactose
c) Maltose
d) Sucrose
a) CH3OH
b) C6H1206
c) C12H22O11
d) C6H12O5
a) Starch
b) Glycogen
c) Dextrins
d) Cellulose
b) Inulin
c) Starch
d) Cellulose
a) Sucrose
b) Ribulose
c) Fructose
d) Ribose
a) Glyceraldehyde
b) Erythrose
c) Dihydroxyacetone
d) Arabinose
a) Xylose
b) Lyxose
c) Xylulose
d) Aldose
a) Epimers
c) Anomers
d) Optical isomers
a) Benedict
b) Seliwanoff
c) Barfoed
d) Osazone
Q.11- Glucose can have ————- isomers due to the presence of 4 asymmetric carbon atoms-
a) 4
b) 12
c) 8
d) 16
a) Epimers
b) Isomers
c) Anomers
Q.13- The compounds having same structural formula but differing in configuration around one
carbon atom are called-
a) Optical isomers
b) Stereo isomers
c) Anomers
d) Epimers
a) Stereo isomerism
b) Mutarotation
c) Optical isomerism
d) Epimerization
a) Fucose
b) Xylose
c) Lyxose
d) Fructose
Q.16- Dulcitol is a –
a) Sugar acid
b) Amino sugar
c) Deoxysugars
d) Sugar alcohol
a) Arabinose
b) Erythrose
c) Trehalose
d) Ribulose
a) Starch
b) Dextrin
c) Glycogen
d) Cellulose
a) Starch
b) Glucose
c) Fructose
a) Hyaluronic acid
b) Cellulose
c) Chitin
d) Chondrosamine
a) Inulin
b)Dextrin
c) Cellulose
d) Glycogen
a) Sucrose
b) Lactose
c) Maltose
d) Trehalose
a) Glucopyranose
b) Glucoside
c) Glucofuranose
d) Glucosamine
Q.24- Which test can be undertaken to differentiate between Glucose and Fructose?
a) Benedict
b) Molisch
c) Seliwanoff
d) Osazone
a) C3 H7O2N
b) C13H26O2
c) C6H12O6
d) C20H40O2
a) Ribose
b) Fructose
c) Glucose
d) Glyceraldehyde
a) Glucuronate
b) Gluconate
c) Glucose
d) Muramic acid
Q.29- From the abbreviated name of the compound Gal (β 1 →4) Glc, we know that:
Q.30- The compound that consists of ribose linked by an N-glycosidic bond to N-9 of adenine is:
a) A purine nucleotide.
b) A pyrimidine nucleotide.
c) Adenosine.
d) AMP
Key to answers
1)-a, 2)-b, 3)-a, 4)-b, 5)-b, 6)-d, 7)-c, 8)-b, 9)-c, 10)-b, 11)-d, 12)-a, 13)-d, 14)-b, 15)-a,
16)-d, 17)-c, 18)-d, 19)-d, 20)-c, 21)-a, 22)-c, 23)-a, 24)-c, 25)-c, 26)-b, 27)-b, 28)-c,
29)-c, 30)-c
a) Cholesterol
b) Glycerol
c) Cetyl Alcohol
d) Sphingol
a) Oleic acid
b) Linoleic acid
c) Linolenic acid
d) Stearic acid
Q.3- Which of the following lipids is abundantly present in the white matter of brain?
a) Galactocerebroside
b) Glucocerebroside
c) Triglycerides
d) Gangliosides
a) Cardiolipin
b) Plasmalogen
c) Lecithin
d) Sphingomyelin
a) β- Glucocerebrosidase
b) Hexosaminidase A
c) Sphingomyelinase
d) β- Galactocerebosidase
Q.6- Choose the Glycerophospholipid that acts as a precursor for second messenger-
a) Phosphatidyl choline
b) Phosphatidyl Inositol
c) Phosphatidyl Serine
d) Phosphatidyl Ethanolamine
Q.7- Cholesterol is transported from extra hepatic tissues to liver by which of the following
lipoproteins?
a) Chylomicrons
b) VLDL
c) LDL
d) HDL
a)Palmitic acid
b) Linolenic
c) Oleic acid
d) Stearic acid
a) Linoleic acid
b) Arachidonic acid
c) Eicosapentaenoic acid
d) Linolenic acid
a)Ergo sterol,
b) Stigma sterol,
c) Sitosterol
d) Cholesterol
11) Which out of the following is a fatty acid with 16 carbon atoms and one double bond?
a) Palmitoleic acid
b) Stearic acid
c) Erucic acid
d) Elaidic acid
12) Which out of the following is an ώ 6 fatty acid?
a) α Linolenic acid
b) Elaidic acid
c) Oleic acid
d) Arachidonic acid
a) Bile salt
b) Oestrogen
c) Vitamin D
d) Progesterone
14) Which type of lipid is a receptor for cholera toxin in the intestine?
a) GM2 Ganglioside
b) GM1Ganglioside
c) Sphingomyelin
d) Galactocerebroside
a) Anemia,
b) Diabetes Mellitus,
c) Hypothyroidism
d) Nephrotic syndrome
17) Which out of the following is an inter mediate both for the synthesis of phospholipids and
Triacylglycerols?
a) Diacyl glycerol
b) Cholesterol
c) Choline
d) Inositol
18) Which fatty acid would have the least melting point out of the following-?
a) Stearic acid
b) Arachidonic acid
c) Timnodonic acid
d) Palmitic acid
19) A 3 year child was brought with hepatosplenomegaly and mental retardation. Biopsy reveals
accumulation of sphingomyelin. What is the nature of the disease?
a)Gaucher’s
b) Niemann Pick’s
c) Krabbe’s
d Tay Sach’s
a) Diet
b) Adipolysis
c) Glycolysis
d) Glycogenolysis
Answer Key
1)- c, 2)-b, 3)-a, 4)-d, 5)-a, 6)-b, 7)-d, 8)-b, 9)-b,10)-d,11)-a,12)-d,13)-a,14)-b,15)-d,16)-a, 17)-a, 18)-c,
19)-b, 20)-d.
a) Phospholipid
b) Cholesterol
b) Triacyl glycerol
d) Glucocerebroside
a) Oleic acid
b) Linoleic acid
c) Linolenic acid
d) Stearic acid
Q.3- Choose the incorrect statement about fatty acids out of the following-
a) The melting point of fatty acids decreases with the increasing degree of unsaturation
d) Naturally occurring unsaturated long-chain fatty acids are nearly all of the Trans configuration.
a) Cardiolipin
b) Galactosyl ceramide
c) GM2
d) Sphingomyelin
Q.5- Which out of the following enzymes is defective in Niemann Pick’s disease?
a) β- Glucocerebrosidase
b) Hexosaminidase A
c) Sphingomyelinase
d) β- Galactocerebosidase
a) Cholesterol
b) Sphingosine
d) Phosphatidic acid
Q.7- Dietary triacylglycerols are transported from liver to extra hepatic tissues by which of the
following lipoproteins?
a) Chylomicrons
b) VLDL
c) LDL
d) HDL
Q.8) All except one are fatty acids with 18 carbon atoms –
a)Oleic acid
b) Linolenic
c) Palmitic acid
d) Stearic acid
Q.9) For which out of the following compounds cholesterol serves as a precursor?
a) Bile pigments
b) Bile salts
c) Vitamin K
d) Triacyl glycerol
Q.10) Glycerol is required for the formation of all of the following compounds except-
a) Glucose
b) Triacyl glycerol
c) Phospholipids
d) Glycolipids
Q.11) Which out of the following is a fatty acid with 18 carbon atoms and one double bond in the
trans configuration?
a) Palmitoleic acid
b) Oleic acid
c) Erucic acid
d) Elaidic acid
a) α Linolenic acid
b) Linoleic acid
c) Palmitic acid
d) Cerebronic acid
a) Phospholipase A1
b) PhospholipaseA2
c) Phospholipase B
d) Phospholipase D
a) GM2 Ganglioside
b) Glucocerebroside
c) Sphingomyelin
d) Galactocerebroside
a) 1
b) 6
c) 4
d) 3
a) Arachidonic acid
b) Diacyl glycerol
c) HDL
d) Vitamin D
a) Arachidic acid
b) Arachidonic acid
c) Linoleic acid
d) Linolenic acid
Q. 18) – The number of mgms of KOH required to neutralize the free and combined fatty acids in
one gram of a given fat is called-
a) Acid number
b) Polenske number
c) Saponification number
d) Iodine number
Q. 19) – Choose out of the following, a fatty acid with 20 carbon atoms and four double bonds-
a) Timnodonic acid
b) Arachidonic acid
c) Clupanodonic acid
d) Nervonic acid
a) Cerebrosides
c) Lecithin
d) Plasmalogen
Answer key
1)-a, 2)-a, 3)-d, 4)-a, 5)- b, 6)- d, 7)- b, 8)- c, 9)- b, 10)- d, 11)- d, 12)- d, 13)- b, 14)- a, 15)- b, 16)- c,
17)- a, 18)- c, 19)- b, 20)-a.
a) Phospholipid
b) Glycolipid
c) Triacyl glycerol
d) Sulfolipid
a) Oleic acid
b) Linoleic acid
c) Linolenic acid
d) Stearic acid
Q.3- Choose the correct statement about fatty acids out of the following-
a) The melting point of fatty acids increases with the increasing degree of unsaturation
d) Naturally occurring unsaturated long-chain fatty acids are nearly all of the Trans configuration.
a) Cardiolipin
b) Plasmalogen
c) Lecithin
d) Sphingomyelin
a) β- Glucocerebrosidase
b) Hexosaminidase A
c) Sphingomyelinase
d) β- Galactocerebosidase
a) Phosphatidyl choline
b) Phosphatidyl Inositol
c) Phosphatidyl Serine
d)Cardiolipin
Q.7- Dietary triacylglycerols are transported from intestine to hepatic and extra hepatic tissues by
which of the following lipoproteins?
a) Chylomicrons
b) VLDL
c) LDL
d) HDL
a)Oleic acid
b) Linolenic
c) Palmitic acid
d) Stearic acid
Q.9) For which out of the following compounds cholesterol does not serve as a precursor?
a) Bile pigments
b) Bile salts
c) Vitamin D
d) Sex hormones
Q.10) Glycerol is required for the formation of all of the following compounds except-
a) Glucose
b) Triacyl glycerol
c) Phospholipids
d) Glycolipids
Q.11) Which out of the following is a fatty acid with 18 carbon atoms and one double bond in the
cis configuration?
a) Palmitoleic acid
b) Oleic acid
c) Erucic acid
d) Elaidic acid
a) α Linolenic acid
b) Linoleic acid
c) Palmitic acid
d) Cerebronic acid
Q. 13) The normal level of serum Total cholesterol is———–?
a) 150-220 mg/dl
b) 100-200 mg/dl
c) 1.5-2.5g/dl
d) 20-40 mg/dl
a) GM2 Ganglioside
b) GM1Ganglioside
c) Sphingomyelin
d) Galactocerebroside
a) 1
b) 2
c) 4
d) 3
Q. 17) Which phospholipid out of the following is a component of inner mitochondrial membrane?
a) Cardiolipin
b) Lecithin
c) Plasmalogen
d) Cephalin
Q. 18)- The significance of estimating L: S ratio of amniotic fluid in a pregnant female lies in
evaluating-
Q. 19) – Choose out of the following, a fatty acid with 20 carbon atoms and four double bonds-
a) Timnodonic acid
b) Arachidonic acid
c) Clupanodonic acid
d) Nervonic acid
a) Cerebrosides
b) Gangliosides
c) Sphingomyelin
d) Plasmalogen
Key to Answers
1)- c, 2)-a,3)-b,4)-d,5)-a,6)-a,7)-a,8)-b,9)-a,10)-d,11)-b,12)-b,13)-b,14)-c,15)-b,16)-a,17)-a,18)-b,19)-
b,20)-d
Q.1- Endogenously synthesized triacylglycerols are transported from liver to extra hepatic tissues
by which of the following lipoproteins?
a) Chylomicrons
b) VLDL
c) LDL
d) HDL
Q.2- All of the following have 18 carbon atoms except –
a) Linoleic acid
b) Palmitic acid
c) Linolenic acid
d) Stearic acid
Q.3- Sphingosine is not present in-
a) Cerebrosides
b) Gangliosides
c) sphigomyelin
d) Plasmalogen
Q.4- Triacylglycerols are-
a) Energy rich compounds
b) Nonpolar in nature
c) Can be stored in unlimited amounts
d) All of the above
Q.5- All are essential fatty acids except-
a)Linoleic,
b) Linolenic
c) Arachidonic acid
d) Stearic acid
Q.6- The deficiency of Lung surfactant, Dipalmitoyllecithin (DPL) causes, Respiratory Distress
Syndrome. DPL is a –
a) Cerebroside
b) Ganglioside
c) Phospholipid
d) Lipoprotein
Q.7- Choose the correct statement
a) The melting point of a fatty acid increases with the increasing degree of unsaturation in the
hydrophobic chain
b) Most of the naturally fatty acids have trans double bonds
c) Arachidonic acid is a relatively nonessential fatty acid
d) The membrane lipids are rich in saturated fatty acids.
Q.8- Which out of the following fatty acids is a precursor of series -1 Eicosanoids?
a) Linoleic acid
b) Arachidonic acid
c) Eicosapentaenoic acid
d) Linolenic acid
Q.9- What is the cause of hyper acidity on long-term usage of Aspirin?
a) Inhibition of cyclo oxygenase
b) Increased synthesis of PGs
c) Inhibition of Phospholipase A2
d) All of the above
Q.10- Which nitrogenous base out of the following is present in lecithin —?
a) Choline
b) Adenine
c) Ethanolamine
d) Any of the above
Q.11- Cholesterol is a precursor of all except-
a)Bile salts,
b)Bilirubin
c) Steroids
d) vitamin D
Q.12- Glycerol is used for the synthesis of all except-
a) Glucose.,
b) Phospholipids,
c) Glycolipids,
d) Triacylglycerol
Q.13- Which out of the following is a fatty acid with 16 carbon atoms and one double bond?
a) Palmitoleic acid
b) Oleic acid
c) Erucic acid
d) Elaidic acid
Q.14-Which out of the following is an ώ 3 fatty acid?
a) α Linolenic acid
b) Linoleic acid
c) Palmitic acid
d) Arachidonic acid
Q.15- Fats on keeping fora long time under go spontaneous hydrolysis, what is this process
called?
a) Saponification
b) Hydrolytic Rancidity
c) Decomposition
d) All of the above
Q.16- Which out of the following enzymes is deficient in Gaucher’s disease?
a) Beta Glucosidase
b) Beta Galactosidase
c) Hexosaminidase A
d) Neuraminidase
Q.17- Prostcyclins are synthesized in- ———?
a) Platelets
b) Endothelial cells
c) Gastric mucosa
d) Basophils
Q.18- Cyclo-oxygenase is inhibited by all except——–?
a) Aspirin
b) Indomethacin
c) Brufen
d) Zileuton
Q.19- The normal level of serum Total cholesterol is———–?
a) 150-220 mg/dl
b) 100-200 mg/dl
c) 1.5-2.5g/dl
d) 20-40 mg/dl
Q.20- Choose out of the followings, a fatty acid with 20 carbon atoms and five double bonds-
a) Timnodonic acid
b) Arachidonic acid
c) Clupanodonic acid
d) Nervonic acid
Q.21- Which type of lipid is a receptor for cholera toxin in the intestine?
a) GM2 Ganglioside
b) GM1 Ganglioside
c) Sphingomyelin
d) Galactocerebroside
Q.22- The significance of estimating L: S ratio of amniotic fluid in a pregnant female lies in
evaluating-
a) Fetal heart rate
b) Fetal lung maturity
c) Fetal head size
d) Expected date of delivery
Q.23- Iodine number is a measure of-
a) Degree of unsaturation of a fat
b) Degree of rancidity of a fat
c) Measure of volatile fatty acids in a fat
d) Measure of number of –OH groups in a fat
Q.24-Which phospholipid out of the following is antigenic in nature -?
a) Cardiolipin
b) Lecithin
c) Plasmalogen
d) Cephalin
Q.25- Which out of the followings is not a derived lipid?
a) Ketone body
b) PGE2
c) Diacylglycerol,
d) Galactosyl ceramide
Q.26- What are the components of a ceramide?
a) Sphingosine+ fatty acid
b) Glycerol+Fatty acids+Phosphoric acid
c) Glycerol+Fatty acids+Phosphoric acid+Nitrogenous base
d) Sphingosine+ fatty acids+Phosphoric acid
Q.27- Choose the incorrect statement-
a) The chemical name of Arachidonic acid is Eicosa penta enoic acid
b) Cyclo-oxygenase and peroxidase are the components of PG-H synthase complex
c) Oleic acid is represented by 18;1,∆9
d) NSAIDs act by inhibiting Phospholipase A2 enzyme.
Answers-
1-(b)- VLDL
2-(b)- Palmitic acid
3-(d)- Plasmalogen
4-(d) All of the above
5-(d) Stearic acid
6-(c) Phospholipid
7-(c) Arachidonic acid
8-(a) Linoleic acid
9-(a)- Inhibition of cyclo-oxygenase enzyme
10-(a) Choline
11-(b) Bilirubin
12-(c) Glycolipids
13-(a) –Palmitoleic acid
14-(a)-α– Linolenic acid
15-(b)-Hydrolytic Rancidity
16-(a) Beta Glucosidase
17-(b)-Endothelial cells
18-(d)-Zileuton
19-(a) 150-220 mg/dL
20-(a) Timnodonic acid
21-(b) GM1- Ganglioside
22-(b) Fetal lung maturity
23-(a)- Degree of unsaturation
24-(a)- Cardiolipin
25-(a)- Galactosyl Ceramide
26-(a)- Sphingosine+Fatty acid
27-(d) NSAIDs act by inhibiting Phospholipase A2 enzyme
Please help "Biochemistry for Medics" by CLICKING ON THE ADVERTISEMENTS above!
a) Caffeine
b) Theophylline
c) Theobromine
d) Thymine
e) Dimethyl Xanthine
a) 5-fluorouracil
b) 5-iodouracil,
c) 3-deoxyuridine,
d) 6-thioguanine
e) Pseudouridine
4- Feedback inhibition of pyrimidine nucleotide synthesis can occur by which of the following ?
5- Which base derivative can serve as a precursor for the synthesis of two of the other pyrimidine
base derivatives ?
a) Cytidine triphosphate
a) Guanosine triphosphate
e) Inosine diphosphate
7- Which of the following contributes nitrogen atoms to both purine and pyrimidine rings ?
a) Aspartate
b) Carbamoyl phosphate
c) Carbon dioxide
d) Glutamate
e) Tetrahydrofolate
9- In patients with Lesch Nyhan Syndrome, purine nucleotides are overproduced and over
excreted. The hypoxanthine analogue Allopurinol, which effectively treats gout , has no effect on
the severe neurological symptoms of Lesch- Nyhan patients because it does not-
10- A 4- year old presents to a pediatric clinic with megaloblastic anemia and failure to thrive.
Blood biochemistry reveals “Orotic aciduria”. Enzyme measurement of the white blood cells
reveals a deficiency of pyrimidine biosynthesis enzyme Orotate Phospho ribose transferase and
abnormally high activity of the enzyme Aspartate transcarbamoylase. Which of the following
treatment will reverse all symptoms ?
a) Blood transfusion
c) Oral thymidine
d) Oral Uridine
e) Plasmaphresis
a) 5- methyl thymidine
b) Ara -C
c) Ribose phosphate
d) PRPP
e) 5-Fluoro uracil
a) Ara C
b) Allopurinol
c) Ribose phosphate
d) PRPP
e)5-FU
13)-A Pentose with a 5′ phosphate group, a 2′ OH group and 1′ pyrimidine group describes which
of the following structures ?
a) Cytosine
b) Thymidine
c) Thymidylate
d) Cytidylate
e) Guanosine
14) Which is the rate limiting step of pyrimidine synthesis that exhibits allosteric inhibition by
cytidine triphosphate-
a) Aspartate transcarbamoylase
c) Thymidylate synthase
d) Xanthine oxidase
e) PRPP synthetase
16)- A 56-year -old diabetic with end stage renal disease receives a kidney transplant from his son.
His nephrologist is concerned for the possibility of transplant rejection and puts the patient on
mycophenolic acid, that inhibits which of the following enzyme in the synthesis of nucleotides ?
a) PRPP synthetase
b) IMP dehydrogenase
d) Ribonucleotide reductase
e) Adenylosuccinase
17- A physician evaluates a 32-year-old patient for fatigue. The patient is found to have an
elevated white blood cell count and an enlarged spleen. A referral to an oncologist results in a
diagnosis of chronic myelogenous leukemia. Treatment with hydroxyurea, a ribonucleotide
reductase inhibitor is begun. The normal functioning of this enzyme is to do which of the
followings ?
b) Formation of AMP
c) Synthesis of UMP
19- A 7-year-old boy suffers from mental retardation and self-mutilation and has an increased
levels of serum uric acid. These symptoms are characteristic of Lesch Nyhan syndrome, which is
due to defective-
c) Xanthine oxidase
e) Formyl transferase
20- A 58-year-old man is awoken by a throbbing ach in his great toe. He had a similar attack earlier
also, after indulging in a rich meal. On examination, he is noted to have an angry inflammed great
toe and several nodules on the antihelix of his ear. Inhibition of which of the following enzymes
might prevent the occurrence of such symptoms ?
a) Amido transferase
b) PRPP synthetase
c) Xanthine oxidase
Key to answers- 1)- c, 2)-d, 3)-c, 4)-c, 5)- b, 6)- c, 7)-a, 8)- b, 9)- a, 10)- a, 11)-d, 12)- b, 13)- d, 14)- a,
15)- d, 16)- b, 17)- b, 18)- e, 19)- d, 20)- c.
a) 0.54 nm
b) 1.5 nm
c) 3 nm
d) 1.83 nm
a) Bleomycin
b) Penicillin
c) Microcystine
d) Creatine
Q.3- Which protein out of the given has a length: width ratio >10?
a) Hemoglobin
b) Myoglobin
c) Fibrinogen
d) Albumin
a) Glycine
b) Serine
c) Alanine
d) Tryptophan
Q.5- Choose the incorrect statement about peptide bond out of the following?
b) Stable
c) Trans in configuration
a) Sakaguchi test
b) Ninhydrin test
d) Millon’s test
a) Lysine
b) Tryptophan
c) Phenyl alanine
d) Methionine
Q.8- All of the following are interactions that stabilize the tertiary structure of a protein except-
a) Vander Waal’s
b) Hydrogen
c) Peptide
d) Ionic
Q.9- Which out of the following is NOT a non standard amino acid?
a) Hydroxy Proline
b) Beta Alanine
c) Ornithine
d) Arginine
Q.10- Choose the right set of amino acids in the structure of Glutathione-
a) Glutamine- Glycine-Cysteine
a) Albumin
c) Glycoprotein
d) Visual purple
Q.12- Which out of the following features is not observed at isoelectric pH of a protein?
a) Maximum solubility
c) Maximum precipitation
d) Maximum Viscosity
Q.15- Which out of the following amino acids is a precursor of niacin (Vitamin)?
a) Tyrosine
b) Threonine
c) Tryptophan
d) Phenyl alanine
a) Glutathione
b) Gramicidin-S
c) Met encephalin
d) Leuencephalin
Q.17- Which out of the following amino acids is a precursor of a mediator of allergies and
inflammation?
a) Histidine
b) Tyrosine
c) Phenyl Alanine
d) Tryptophan
a) Vasopressin
b) Angiotensin II
c) Bradykinin
d) Angiotensinogen
a) Tyrosine
b) Tryptophan
d) Arginine
Q.20- Which out of the following protein does not possess a quaternary structure?
a) Myoglobin
b) Lactate dehydrogenase
c) Immunoglobulin M
Key to Answers
1)- a, 2)-b, 3)-c, 4)-a, 5)-d, 6)-c, 7)-d, 8)-c, 9)-d, 10)-d,11)-a, 12)-a,13)-d,14)-c,15)-a, 16)-b,17)-a,18)-
b,19)-d, 20)-a.
1) – A mutation has changed an isoleucine residue of a protein to Glutamic acid, which statement
best describes its location in a hydrophilic exterior-
d) Inside the core of protein since it has a polar but uncharged side chain
2) – Glycine and proline are the most abundant amino acids in the structure of-
a) Hemoglobin
b) Myoglobin
c) Insulin
d) Collagen
3) – Some proteins contain additional amino acids that arise by modification of an amino acid
already present in a peptide, examples include-
a) 4 -hydroxy proline
b) 5- hydroxy Lysine
a) Oxytocin
b) Vasopressin
c) Bradykinin
6) – Which out of the following amino acids carries a net positive charge at the physiological p H ?
a) Valine
b) Leucine
c) Isoleucine
7) – Which out of the following amino acids is a precursor for a mediator of allergies and
inflammation?
a) Histidine
b) Tyrosine
c) Phenyl Alanine
d) Tryptophan
8) – Mother of a mal nourished child has been instructed to include a complete protein in diet for
her child, which out of the following proteins should be recommended?
a) Pulses
b) Wheat
c) Soy Protein
d) Milk
9) – All of the below mentioned amino acids can participate in hydrogen bonding except one –
a) Serine
b) Cysteine
c) Threonine
d) Valine
10) – All of the following amino acids are both glucogenic as well as ketogenic except –
a) Isoleucine
b) Leucine
c) Tyrosine
d) Phenyl alanine
11) – Which out of the following amino acid is a precursor of niacin (Vitamin)?
a) Tyrosine
b) Threonine
c) Tryptophan
d) Phenylalanine
12) – The greatest buffering capacity at physiological p H would be provided by a protein rich in
which of the following amino acids?
a) Serine
b) Cysteine
c) Alanine
d) Histidine
a) Glutathione
b) Gramicidin
c) Met encephalin
d) Leuencephalin
a) Carbonic anhydrase
b) Collagen
c) Fibrinogen
d) Keratin
15) -Which of the following amino acid is a limiting amino acid in pulses?
a) Leucine
b) Lysine
c) Methionine
d) Glutamine
a) Catalase
b) Myeloperoxidase
c) Glutathione peroxidase
d) Aconitase
a) Carbonic anhydrase
b) Xanthine oxidase
c) Lactate dehydrogenase
d) Superoxide dismutase
a) Erythromycin
b) Gramicidin
c) Ciprofloxacin
d) Tetracycline
a) Bleomycin
b) Methotrexate
c) Cytosine Arabinoside
d) Dideoxy Inosine
20) – Which of the following amino acids is most compatible with an α- helical structure?
a) Tryptophan
b) Alanine
c) Leucine
d) Proline
a) Melanin
b) Keratin
c) Collagen
d) Myosin
22) – In scurvy, which amino acid that is normally part of collagen is not synthesized?
a) Hydroxy Tryptophan
b) Hydroxy Tyrosine
c) Hydroxy Alanine
d) Hydroxy Proline
23) – A child with tall stature, loose joints, and detached retinas is found to have a mutation in
collagen. Which of the following amino acids is the recurring amino acid most likely to be altered
in mutations that distort collagen molecules?
a) Glycine
b) Tyrosine
c) Tryptophan
d) Tyrosine
24) – Which one of the following amino acids may be considered a hydrophobic amino acid at
physiological p H of 7.4?
a) Isoleucine
b) Arginine
c) Aspartic acid
d) Threonine
a) Optically inactive
c) Hydrophobic
26) – Which of the following amino acids in myoglobin, a globular protein, is highly likely to be
localized within the interior of the molecule?
a) Arginine
b) Valine
c) Aspartic acid
d) Lysine
27) – Which of the amino acids below is the uncharged derivative of an acidic amino acid?
a) Cystine
b) Tyrosine
c) Glutamine
d) Serine
28) – Choose the correct category for milk protein casein out of the following-
a) Nucleoprotein
b) Phospho protein
c) Lipoprotein
d) Glycoprotein
Answers-
1- a
2- d
3- d
4- c
5- d
6- d
7- a
8- d
9- d
10- b
11- c
12- d
13- b
14- a
15- c
16- d
17- c
18- b
19- a
20- b
21- b
22- d
23- a
24- a
25- a
26- b
27- c
28- b
a) Leptin
b) Ghrelin
c) Peptide YY
d) Glucagon
2. Brown adipose tissue (BAT), plays an important role in energy metabolism in many mammals.
The false statement about BAT,out of the followings is –
d) BAT dissipates the hydrogen ion gradient in the oxidative respiration chain
3) Body Mass Index(BMI) gives a measure of relative weight adjusted for height. The healthy range
for BMI is between-
a) 15- 19.5
b) 19.5- 25.0
c) 25- 29.9
b) High waist–hip ratios (> 1.0 in women and > 0.85 in men)
c) Risk of diabetes mellitus, stroke, coronary artery disease, and early death
d) Visceral fat within the abdominal cavity is more hazardous to health than subcutaneous fat around the
abdomen.
b) Waist to hip ratio (< 1.0 for women and <0.8 for men)
d) Associated with increased risk for coronary heart disease stroke and diabetes mellitus.
6) Although the adipocyte has generally been regarded as a storage depot for fat, it is also an
endocrine cell that releases numerous molecules in a regulated fashion. Which of the followings
is not an adipose derived chemical ?
a)Leptin
b) Ghrelin
c) Resistin
d) Adiponectin
a) Cushing syndrome
b) Insulinoma
c) Hypothyroidism
d) Diabetes mellitus
9) Which of the following adipose derived hormones promotes insulin sensitivity in peripheral
tissues ?
a) Adiponectin
b) Resistin
c) Amylin
d) Leptin
d) Associated with increased risk for diabetes mellitus and cardiovascular diseases
11) Orlistat is the only FDA approved drug for treatment of obesity, the mechanism of action
involves-
a) Increasing BMR
c) Promotes satiety
12)- Dieting is the most commonly practiced approach to weight control. One can estimate the
effect of calorie restriction on the reduction in adipose tissue. Since one pound of adipose tissue
corresponds to ———— kilo calories.
a) 1000
b) 2000
c) 3000
d) 3500
13) Bariatric surgery is an increasingly prevalent treatment option for patients with obesity.
Choose the incorrect statement about it-
Key to answers- 1)- d, 2)- a, 3)-b, 4)- b, 5)-c , 6)-b, 7)- d, 8)- d, 9)- a, 10)-d, 11)-d, 12)-d, 13)-c
The amount of energy required by an individual varies directly with the degree of activity and
environmental conditions, but the rate of energy consumption in an individual by its overall cellular
metabolism is more or less constant under some basal conditions i.e. standard conditions. This cellular
metabolism under basal conditions is Basal metabolic rate. The rate of energy consumption under such
basal conditions per unit time (one hour) per square meter of surface area is known as “Basal metabolic
rate”. A constant ratio of carbohydrates, lipids and proteins are metabolized under such basal conditions.
To simplify BMR
The energy required by an individual during physical, emotional and digestive rest.
It is the minimum energy required to sustain vital functions like working of heart, brain, circulation,
respiration, ion transport and maintenance of cellular integrity
Basal Conditions
2) Person should be without food for 12-18 hours- Post absorptive state. This is to avoid the effect of
digestion and absorption, the SDA of food stuffs and to prevent any chances of starvation.
4) There should be normal conditions of environment- temperature, pressure and humidity. The
temperature should be between 200– 250 C. Under above conditions, energy expended by the individual
is to maintain respiration, circulations, muscle tone, functions of viscera like kidney, heart, liver and brain
and for the maintenance of body temperature.
Energy Expenditure in basal metabolism– Usually 50- 70% of the daily expenditure in sedentary
individuals, BMR can be responsible for burning 70% of the total calories but the figure varies due to
different factors. The factors that affect BMR are as follows-
1) Age- BMR decreases with advancing age. In children it is high due to more surface area.
2) Sex-Males have more muscle mass and lower body weight. Thus they have high BMR. Females have
lower muscle mass more body fat thus have lower BMR.
3) Hereditary factors– Some people are born with faster metabolism and some with slower metabolism
4) Body Surface area- Surface area depends on weight and height. Greater the surface area, higher is
the BMR and vice versa. Tall, thin people have a higher BMR than short persons. Since much of the
basal metabolism is for the maintenance of body temperature and the heat loss is proportional to body
surface area. Thus BMR is proportional to surface area.
5) Environmental conditions- Temperature outside body also affects BMR. Exposure to cold causes an
increase in BMR so as to create the extra need for heat for the maintenance of body temperature. A short
exposure to heat has little or no effect on BMR but upon prolonged exposure to high temperature there is
compensatory heat loss, this results in increase in BMR. In colder regions of the world, BMR is higher and
in tropical regions the BMR is lower.
6) Body Temperature-For every 0.5 degree rise in body temperature there is 7% increase in BMR. With
the rise in temperature, there is increase in the rate of chemical reactions causing increased BMR.
7) Exercise- Physical exercise not only influences body weight by burning calories. It also helps to raise
BMR by building extra lean tissues. Lean tissue is metabolically more demanding than fat tissue. The
increase in BMR due to exercise is also due to increased cardiac output.
8) Drugs- Caffeine, Benzedine, alcohol, epinephrine and nicotine increase BMR. Reverse is seen with
certain anesthetics.
9) Pregnancy- The BMR of pregnant mother rises after 6 months of gestation. BMR of mother is a sum
total of her own BMR as in the non pregnant state and of that of fetal metabolism.
10) Racial variations- BMR varies with different racial groups. Higher values of > 33 % above normal
have been reported in Eskimos.
11) Barometric pressure- Moderate decrease in pressure causes no effect on BMR, but a fall of
pressure to half an atmosphere as occurs in mountain climbing increases BMR.
12) State of nutrition- BMR is lowered in states of starvation, malnutrition and wasting diseases.
13) Hormones-Thyroid hormone increases BMR. In thyrotoxicosis BMR rises 50-100% above normal,
while in Myxoedema, BMR falls 35-45% below normal. Adrenaline, catecholamines, growth hormone, all
of them increase BMR, Male sex hormone increases BMR to 10% or more. Anterior pituitary through its
effect on TSH also affects BMR.
Illnesses such as fever, high level of stress hormones in the body and either an increase or decrease in
environmental temperature result in an increase in BMR. Fasting, starvation or malnutrition all result in a
lowering of BMR.
Measurement of BMR
1) Open Circuit system- In this system both O2 consumption and CO2 output are measured. Although it
is very accurate but due to high degree of skills involved, it is less commonly used.
2) Closed circuit method-In clinical practice, the BMR is estimated by measuring O2 consumption of the
patient for 2-6 minutes period under basal conditions. The O2 consumption is measured under closed
circuit system. The apparatus commonly used is Benedict’s Roth metabolism apparatus. The test is
usually run for 6 minutes and the volume of O2 consumed in that period is measured and corrected to
standard conditions of temperature and pressure.
Calculation
The average O2 consumption for 6 minutes is multiplied by 10 to convert into hourly basis and then
multiplied by 4.825oC. The heat production is represented by each litre of O 2 consumed. This gives the
heat production in C/hour. Since the BMR is expressed as C/Sq.met/Hour, the energy output per hour
has to be divided by the surface area of the individual.
1) Du- Bois Surface area formula- A simple formula for calculating the surface area is as follows
where the weight is in kilograms and the height is in centimeters and body surface area is in square
meters.
2) By using normograms– Most conveniently the surface area is calculated from the normograms if the
height and weight are known. Height is measured in feet/cm ; weight is measured in pounds/kg and
surface area is calculated in square meters.
3) Harris–Benedict equations
4) Read’s formula
PR is pulse rate
PP is pulse pressure.
The result is expressed as percentage of the normal and is corrected within a range of ± 10%
A healthy adult male has a BMR of about 40C/sq.m/hour and adult female has about 37 C/Sq.m/hour
1) The normal BMR for an individual of the patient’s age and sex is obtained from the standard tables.
3) In a male aged 35 years with height-170 cm , weight- 70 kg and O2 consumption 1.2 liters in a 6
minutes time, the BMR can be calculated as follows-
or 12 x 4.825 = 58 Kcal/hour
The normal BMR for this patient by reference to standard table is 39.5 C/Sq.m/hour.
Significance of BMR
1) Diagnostic Aid
It is used for the diagnosis of various pathological conditions specially assessing the thyroid functions.
The pathological variations in BMR are as follows-
a) Fever- Infections and febrile diseases elevate BMR, usually in proportion to increase in body
temperature.
Leukemias
Polycythemia
Some types of anemia
Cardiac failure
Hypertension
Dyspnea
Perforation of ear drum(False increase)
Hyperthyroidism
Cushing syndrome
Acromegaly
Addison’s disease
Hypothyroidism
3) To know the effect of food and drugs- BMR is calculated to know the effect of special food stuffs and
drugs.
1- Glycogen phosphorylase, which mobilizes glycogen for energy, requires which of the following
as a cofactor?
a)Pyridoxal phosphate
b)Tetra hydro folate
c)Adenosyl Cobalamine
d) Coenzyme A
(a)
Q.2-Choose the incorrect statement about Active Site of an enzyme-
a) The active site is a three-dimensional cleft
b) The active site takes up a large part of the total volume of an enzyme
c) Substrates are bound to enzymes by multiple weak attractions
d) The specificity of binding depends on the precisely defined arrangement of atoms in an active site.
(b)
Q.3- Any of the following processes except one are involved at the active site of an enzyme to
accelerate the rate of reaction-
a) Catalysis by Bond Strain
b) Catalysis by Proximity and Orientation
c) Non covalent catalysis
d) Acid base catalysis
(c)
Q.4-A given substrate may be acted upon by a number of different enzymes, each of which uses
the same substrate(s) and produces the same product(s). The individual members of a set of
enzymes sharing such characteristics are known as-
a)Group specific enzymes
b)Isoenzymes
c)Substrate specific enzymes
d)Allosteric enzymes
(b)
Q.5-A recently diagnosed hypertensive patient has been prescribed an ACE inhibitor(Angiotensin
converting enzyme inhibitor) which is known to act by lowering V max,what is the possible
mechanism of inhibition of this drug?
a) Competitive
b)Non Competitive
c) Uncompetitive
d)None of the above.
(a)
Q.6-Which statement out of the following is incorrect about the effect of increasing temperature
on enzyme activity-
a)Raising the temperature increases the kinetic energy of molecules
b) Aten degree Centigrade rise in temperature will increase the activity of most enzymes by 50 to 100%.
c)Most animal enzymes rapidly become denatured at temperatures above 40oC
d)Storage of enzymes at 5°C or below is generally not suitable.
(d)
Q.7-A54-year –old male was rushed to emergency when he collapsed in the middle of a business
meeting. Examination revealed excessive sweating and high blood pressure.ECG chest was
conclusive of Acute Myocardial infarction. Which biochemical investigation out of the following
would be of no help in the confirmation of diagnosis?
a) Cardiac Troponins
b)Serum myoglobin
c)Lactate dehydrogenase
d)Creatine Phospho kinase-MB(CPK-MB)
(c)
Q.8-A coal mine worker was brought in an unconscious state to emergency room after a blast in
the mine. His blood Carboxy hemoglobin level was high and he was diagnosed with CO
poisoning. CO is a known inhibitor of electron transport chain. Which complex of electron
transport chain is inhibited by CO?
a) Complex I
b) Complex II
c) Complex III
d) Complex IV
(d)
Q.9-A 42-year-old obese female presented to the emergency center with complaints of worsening
nausea, vomiting, and abdominal pain.Her pain was located in the mid epigastric area and right
upper quadrant. Blood biochemistry revealed high serum amylase level.What is the probable
diagnosis for this patient?
a)Viral hepatitis
b) Acute Pancreatitis
c) Renal colic
d) Acute gastritis
(b)
Q.10-A 60 year old chronic alcoholic was brought to the hospital with complaints of protuberant
abdomen (ascites) and edema feet. He also had history of hemorrhages. Blood biochemistry
revealed – High serum transaminases, low Serum total proteins, Albumin and a prolonged
prothrombin time. Urine analysis was normal. What could be the possible diagnosis?
a)Renal failure
b)Protein malnutrition
c) Cirrhosis of liver
d) Heart failure
(c)
Q.11-A 2 -week –old child was brought to the emergency. The parents were fearful that the child
had been given some poison as they noted black discoloration on the diaper. A diagnosis of
Alkaptonuria was made and the child was given Vitamin C as a supplement. Alkaptonuria occurs
due to reduced activity of Homogentisic acid oxidase enzyme. What is the role played by vitamin C in this
defect?
a)Acts as an oxidant
b)Acts as a coenzyme
c)Acts as an inducer
d) Acts as a positive allosteric modifier
(b)
Q.12-A 67- year-old army officer in good health previously presented with sudden pain in the great
toe. Serum uric acid level was high, and a diagnosis of gouty arthritis was made He was advised
bed rest,pain killers and Allopurinol. What is the mechanism of action of Allopurinol in lowering
serum uric acid levels?
a) Suicidal inhibition
b) Non competitive inhibition
c)Allosteric inhibition
d) Feed back inhibition
(a)
Q.13-One out of the following enzymes has absolute specificity for its substrate; choose the
correct option-
a) Urease
b) Carboxy peptidase
c) Pancreatic lipase
d) Lipoprotein lipase
(a)
Q.14-Which out of the following is a substrate-specific enzyme?
a) Hexokinase
b) Thiokinase
c) Lactase
d) Decarboxylase
(c)
Q.15-Which out of the following is not a substrate-specific enzyme?
a) Glucokinase
b) Fructokinase
c) Hexokinase
d) Phosphofructokinase
(c)
Q.16-Group I Co enzymes participate in which of the following reactions-
a) Oxidation-reduction
b)Transamination
c) Phosphorylation
d) All of the above
(a)
Q.17-Which out of the following co enzymes takes part in hydrogen transfer reactions in the
electron transport chain-
a) Tetrahydrofolate
b) Methyl Cobalamine
c)Co enzyme Q
d) Biotin
(c)
Q.18.The conversion of Pyruvate to oxaloacetate involves the participation of—- as a coenzyme –
a) NAD+
b) NADPH
c) Biotin
d) All of the above
(c)
Q.19- The drug Fluorouracil is recommended for the treatment of cancers. It undergoes a series of
changes and then binds to Thymidylate synthase enzyme resulting in its inhibition and blockage
of cell division. This mode of inhibition is most probably due to-
a) Allosteric inhibition
b) Competitive inhibition
c) Noncompetitive Inhibition
d) Suicidal inhibition
(d)
Q.20-The activities of many enzymes, membrane transporters and other proteins can be quickly
activated or inactivated by phosphorylation of specific amino acid residues. This regulation is
called-
a) Allosteric modification
b) Covalent modification
c) Induction
d) Repression
(b)
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