1.Thekeyenzy
mei
nt
her
egul
at
i
onoff
at
t
yaci
dsy
nt
hesi
si
s
A. acet
y
l
CoAcar
boxy
l
ase
B. AMPact
i
v
at
edpr
ot
ei
nki
nase
C. pr
ot
ei
nphosphat
ase
D. noneoft
hese
Answer
:
Opt
i
onA
2.
Ar
achi
donat
ehas20car
bonat
omswi
t
h
A. 3doubl
ebonds
B. 2doubl
ebonds
C. 4doubl
ebonds
D. 8doubl
ebonds
Answer
:
Opt
i
onC
3.
I
nt
hei
nt
est
i
ne,
t
hedi
et
ar
yf
at
sar
ehy
dr
ol
y
sedby
A. t
r
i
acy
l
gl
y
cer
ol
l
i
pase
B. adeny
l
at
ecy
cl
ase
C. pancr
eat
i
cl
i
pase
D. pr
ot
ei
nki
nase
Answer
:
Opt
i
onC
4.
HDLsar
esy
nt
hesi
zedi
n
A. bl
ood
B. l
i
v
er
C. i
nt
est
i
ne
D. pancr
eas
5.
Tr
i
acy
l
gl
y
cer
ol
sar
e
A. sol
ubl
ei
nwat
er
B. i
nsol
ubl
ei
nwat
er
C. sol
ubl
ei
nwat
eratel
ev
at
edt
emper
at
ur
e
D. par
t
i
al
l
ysol
ubl
ei
nwat
er
Answer
:
Opt
i
onB
6.
Ani
mal
scannotconv
er
tf
at
t
yaci
dsi
nt
ogl
ucosebecause
A. acet
y
l
CoAcannotbeconv
er
t
edt
opy
r
uv
at
e
B. absenceofmal
at
esy
nt
hase
C. absenceofdehy
dr
ogenase
D. absenceofaket
ogl
ut
ar
at
edehy
dr
ogenase
Answer
:
Opt
i
onA
7.
I
neukar
y
ot
esf
at
t
yaci
dbr
eakdownoccur
si
n
A. mi
t
ochondr
i
al
mat
r
i
x
B. cy
t
osol
C. cel
l
membr
ane
D. endopl
asmi
cr
et
i
cul
um
Answer
:
Opt
i
onA
8.
Whati
st
hemaj
orpr
ot
ei
nconst
i
t
uentofhi
ghdensi
t
yl
i
popr
ot
ei
n(
HDL)
?
A. Apol
i
popr
ot
ei
nAl
B. Apol
i
popr
ot
ei
nCl
C. Apol
i
popr
ot
ei
nE
D. Noneoft
hese
Answer
:
Opt
i
onA
9.
Phosphol
i
pi
dcont
ai
ns
A. hy
dr
ophi
l
i
cheadsandhy
dr
ophobi
ct
ai
l
s
B. l
ongwat
er
sol
ubl
ecar
bonchai
ns
C. posi
t
i
v
el
ychar
gedf
unct
i
onal
gr
oups
D. bot
h(
b)and(
c)
Answer
:
Opt
i
onA
10.
Mi
cel
l
esoff
at
t
yaci
dsi
nwat
erar
eor
gani
zedsucht
hatt
he_
_
_
_
_
_
_
_
_
_
f
acest
hesol
v
entandt
he_
_
_
_
_
_
_
_
_
_ar
edi
r
ect
edt
owar
dt
hei
nt
er
i
or
A. car
boxy
l
i
caci
dgr
oups,
hy
dr
ocar
bonchai
nsheads
B. hy
dr
ophi
l
i
cheads,
hy
dr
ophobi
ct
ai
l
s
C. hy
dr
ocar
bonchai
ns,
car
boxy
l
i
caci
dgr
oups
D. bot
h(
a)and(
b)
Answer
:
Opt
i
onD
11.
Chol
est
er
ol
emi
ameans
A. l
ackoff
unct
i
onal
LDLr
ecept
or
s
B. l
ackoff
unct
i
onal
HDLr
ecept
or
C. hi
ghsensi
t
i
v
i
t
yt
of
at
t
yf
oodi
nt
ake
D. noneoft
heabov
e
Answer
:
Opt
i
onA
12.
Fat
t
yaci
dsbr
eakdownofeukar
y
ot
esoccur
si
n
A. mi
t
ochondr
i
al
mat
r
i
x
B. cel
l
membr
ane
C. cy
t
osol
D. endopl
asmi
cr
et
i
cul
um
Answer
:
Opt
i
onA
13.
VLDLsar
esy
nt
hesi
zedi
n
A. bl
ood
B. l
i
v
er
C. i
nt
est
i
ne
D. pancr
eas
Answer
:
Opt
i
onB
14.
Chy
l
omi
cr
onsar
esy
nt
hesi
zedi
n
A. bl
ood
B. l
i
v
er
C. i
nt
est
i
ne
D. pancr
eas
Answer
:
Opt
i
onC
15.
Howmanyt
y
pesofl
i
popr
ot
ei
nsar
et
her
e?
A. 2
B. 6
C. 8
D. 5
Answer
:
Opt
i
onD
16.
Whi
choft
hef
ol
l
owi
ngi
scor
r
ect
?
A. Cobal
ti
spar
tofv
i
t
ami
nB12.
B. Cobal
twi
l
l
notr
epl
acet
heneedf
orv
i
t
ami
nB12i
nhumans
C. Bot
h(
a)and(
b)
D. Cobal
twi
l
l
r
epl
acet
heneedf
orv
i
t
ami
nB12i
nhumans
Answer
:
Opt
i
onC
17.
Whi
choft
hef
ol
l
owi
ngi
sr
equi
r
edasacomponentofbl
oodhemogl
obi
n?
A. I
r
on
B. Magnesi
um
C. Cal
ci
um
D. Copper
Answer
:
Opt
i
onA
18.
Addi
ng_
_
_
_
_
_
_
_
_
_t
oabr
eakf
astofcer
eal
wi
l
l
hel
py
ourbodyabsor
bi
r
on.
A. mi
l
k
B. or
angej
ui
ce
C. cof
f
ee
D. wat
er
Answer
:
Opt
i
onB
19.
Whi
choft
hef
ol
l
owi
ngi
oni
sr
equi
r
edf
ort
hedev
el
opmentofsoundt
eet
h
wi
t
hr
esi
st
ancet
ot
oot
hdecay
?
A. Fl
uor
i
dei
on
B. Sodi
um i
on
C. Chl
or
i
dei
on
D. Magnesi
um i
on
Answer
:
Opt
i
onA
20.
Whi
choft
hef
ol
l
owi
ngt
wobev
er
agescont
r
i
but
e20t
o30per
centofour
dai
l
ymanganesei
nt
ake?
A. Mi
l
kort
ea
B. Col
aorcof
f
ee
C. Teaoror
angej
ui
ce
D. Mi
l
koror
angej
ui
ce
Answer
:
Opt
i
onA
21.
Thel
owestener
gyv
al
uel
i
pi
df
orhumannut
r
i
t
i
oni
s
A. ol
i
v
eoi
l
B. ol
est
r
a
C. mar
gar
i
ne
D. car
di
ol
i
pi
h
Answer
:
Opt
i
onB
22.
Howmanycl
assesofst
er
oi
dhor
monesar
et
her
e?
A. 3
B. 2
C. 4
D. 5
Answer
:
Opt
i
onD
23.
Thenumberofwat
ermol
ecul
esconsumedbyt
hef
or
mat
i
onof
phosphat
i
dy
l
ser
i
near
e
A. 0
B. 1
C. 2
D. 4
Answer
:
Opt
i
onA
24.
Sy
nt
hesi
soff
at
t
yaci
dt
akespl
acewhen
A. f
at
t
yaci
dar
epl
ent
i
f
ul
B. car
bohy
dr
at
ei
spl
ent
i
f
ul
C. car
bohy
dr
at
eandener
gyar
epl
ent
i
f
ul
D. noneoft
hese
Answer
:
Opt
i
onC
25.
Whi
choft
hef
ol
l
owi
ngi
scal
l
edmi
l
kej
ect
i
onhor
mone?
A. Pr
ol
act
i
n
B. Vasopr
essi
n
C. Oxy
t
oci
n
D. Al
l
oft
hese
Answer
:
Opt
i
onC
CHOLESTEROLANDLI
POPROTEI
NS
Q.
1–Agal
l
st
onet
hatbl
ockedt
heupperpar
toft
hebi
l
eductwoul
dcause
i
ncr
easei
nwhi
choft
hef
ol
l
owi
ngs?
a)Theexcr
et
i
onoff
at
si
nt
hef
eces
b)For
mat
i
onofchy
l
omi
cr
ons
c)Excr
et
i
onofbi
l
esal
t
s
d)Conj
ugat
i
onofbi
l
eaci
ds
e)Recy
cl
i
ngofbi
l
esal
t
s
ANSWER:
A
Q.
2-An8y
ear
ol
dboypr
esent
swi
t
hor
angecol
or
edt
onsi
l
s,
av
er
yl
owHDL
l
ev
el
sandanenl
ar
gedl
i
v
erandspl
een.Hei
sdi
agnosedwi
t
hTangi
er
di
sease.Tangi
erdi
seasei
sadi
seaseofchol
est
er
ol
t
r
anspor
t
,
sucht
hat
chol
est
er
olcannotpr
oper
l
yexi
tt
hecel
l
andf
or
m HDL.Whi
choft
he
f
ol
l
owi
ngst
at
ement
sbestdescr
i
besHDL?
a)I
ti
spr
oducedi
nskel
et
al
muscl
es
b)I
tscav
engeschol
est
er
ol
f
r
om cel
lmembr
anes
c)I
t
smaj
orpr
ot
ei
ni
sapoE
d)I
ti
sf
or
medwhenVLDLi
sact
eduponbyl
i
popr
ot
ei
nl
i
pase
e)I
tact
i
v
at
esACAT
ANSWER.
.B
Q3-I
ncont
r
astt
osecondar
ybi
l
esal
t
s,
whi
choft
hef
ol
l
owi
ngi
snota
char
act
er
i
st
i
cofpr
i
mar
ybi
l
esal
t
s
a)Ar
ehy
dr
oxy
l
at
edatposi
t
i
on17
b)Hav
eanoxi
di
zedsi
dechai
n
c)Canbeconj
ugat
edt
oTaur
i
neandgl
y
ci
ne
d)Ar
er
eabsor
bedi
nt
hei
nt
est
i
ne
e)For
medf
r
om chol
y
l
coA.
ANSWER.
.
.A
Q.
4I
nt
heconv
er
si
onofchol
est
er
ol
t
obi
l
esal
t
s,
whi
choft
hef
ol
l
owi
ng
st
at
ement
sbestdescr
i
best
hepr
ocess?
a)Car
bon8i
shy
dr
oxy
l
at
ed
b)Thesi
dechai
ncanbeconj
ugat
edwi
t
hgl
y
ci
neorTaur
i
ne
c)Thedoubl
ebondi
soxi
di
zed
d)Thehy
dr
oxy
l
gr
oupat3car
bonr
emai
nsi
nt
hebet
aposi
t
i
on
e)I
toccur
si
nt
hebi
l
educt
.
ANSWER.
.
.B
Q.
5-Whi
choft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
besl
owdensi
t
y
l
i
popr
ot
ei
n(
LDL)?
a)I
thast
hemostTr
i
acy
l
gl
y
cer
ol
andt
hel
eastpr
ot
ei
n
b)I
thasmor
eTr
i
acy
l
gl
y
cer
ol
t
hanv
er
yl
owdensi
t
yl
i
popr
ot
ei
n(
VLDL)
c)I
thast
hel
owestTr
i
acy
l
gl
y
cer
ol
cont
ent
d)I
thast
hehi
ghestpr
ot
ei
ncont
ent
e)I
thast
hehi
ghestchol
est
er
ol
cont
ent
.
ANSWER.
.
.E
Q.
6-Whi
choft
hef
ol
l
owi
ngapopr
ot
ei
nsi
sanact
i
v
at
orofl
i
popr
ot
ei
nl
i
pase?
a)ApoA
b)ApoB
c)ApoCI
I
d)ApoD
e)ApoE
ANSWER.
.C
Q.
7-Whi
choft
hef
ol
l
owi
ngl
i
popr
ot
ei
nsar
et
hemaj
orcar
r
i
er
sofTr
i
acy
l
gl
y
cer
ol
?
a)I
DLandLDL
b)VLDLandLDL
c)Chy
l
omi
cr
onsandVLDL
d)HDLandVLDL
e)Chy
l
omi
cr
onsandHDL.
ANSWER.
.C
Q.
8-A60y
ear
ol
dwomanpr
esent
swi
t
hchestpai
nr
adi
at
i
ngt
oherl
ef
t
ar
m.Shei
sdi
agnosedwi
t
hMy
ocar
di
al
i
nf
ar
ct
i
onandi
spr
escr
i
bedast
at
i
n
medi
cat
i
on.St
at
i
nsi
nhi
bi
tHMGCoAr
educt
ase.Howdoesi
nhi
bi
t
i
onof
HMGCoAr
educt
asecausel
ower
i
ngofchol
est
er
ol
andLDLl
ev
el
s?
a)I
ti
ncr
easeser
um l
ev
el
ofHDL
b)I
tdecr
easesser
um l
ev
el
ofLDLbypr
omot
i
ngcat
abol
i
sm
c)I
ti
nhi
bi
t
st
hef
or
mat
i
onofLDLf
r
om I
DL
d)I
ti
nhi
bi
t
st
her
at
el
i
mi
t
i
ngst
epi
nchol
est
er
ol
bi
osy
nt
hesi
s
e)I
ti
nhi
bi
t
ssy
nt
hesi
sofLDLr
ecept
or
s.
ANSWER.
.
.D
Q.
9)A35y
ear
ol
dwomanpr
esent
swi
t
hcr
ushi
ngsubst
er
nal
chestpai
n
andshor
t
nessofbr
eat
h.Acor
onar
yar
t
er
yi
soccl
udedduet
oan
at
her
oscl
er
ot
i
cpl
aque,
andshei
sdi
agnosedwi
t
hhav
i
ngmy
ocar
di
al
i
nf
ar
ct
i
on.Herser
um chol
est
er
ol
l
ev
el
i
s700mg/
dl
.Thef
ami
l
yhi
st
or
yi
s
posi
t
i
v
ef
orhi
ghchol
est
er
ol
l
ev
el
andsheseemst
obehav
i
ngf
ami
l
i
al
hy
per
chol
est
er
ol
emi
a.Whati
st
hepossi
bl
ebi
ochemi
cal
def
ecti
nt
hi
s
genet
i
cdi
sor
der?
a)Hi
ghact
i
v
i
t
yofHMGCoAr
educt
ase
b)Lowact
i
v
i
t
yof7-hy
dr
oxy
l
ase
c)Abnor
mal
LDLr
ecept
or
s
d)Mor
econv
er
si
onofVLDLt
oLDL
e)Lessconcent
r
at
i
onofHDL.
ANSWER.
.
.C
Q.
10)
-A40-y
ear
ol
dmanpr
esent
swi
t
hsev
er
epai
ni
nt
hel
egsupon
wal
ki
ng.Hei
sdi
agnosedwi
t
hat
her
oscl
er
ot
i
cpl
aquesi
nt
hear
t
er
i
esofhi
s
l
egs.Hi
ghl
ev
el
ofchol
est
er
ol
andLDLcont
r
i
but
et
ot
hef
or
mat
i
onof
at
her
oscl
er
osi
s.Whi
choft
hef
ol
l
owi
ngi
sdi
gest
edt
of
or
m LDL?
a)I
DL
b)Chy
l
omi
cr
ons
c)HDL
d)Chol
est
er
y
l
est
er
s
e)Chol
est
er
ol
.
ANSWER.
.
.A
Q.
11-A23y
ear
ol
df
emal
epr
esent
swi
t
hl
owr
edbl
oodcel
l
count
,
cor
neal
opaci
t
i
esandki
dneyi
nsuf
f
i
ci
ency
.Shei
sdi
agnosedwi
t
h
l
eci
t
hi
n:
chol
est
er
ol
acy
l
t
r
ansf
er
ase(
LCAT)def
i
ci
ency
.I
nwhi
chof
t
hef
ol
l
owi
ngr
eact
i
onsLCATi
si
nv
ol
v
ed?
a)Tr
ansf
erofchol
est
er
ol
est
er
sf
r
om HDLt
oVLDL
b)Hy
dr
ol
y
si
sofHDL
c)Upt
akeofchol
est
er
ol
f
r
om l
i
v
ercel
l
s
d)Conv
er
t
i
ngchol
est
er
ol
t
oChol
est
er
y
l
est
er
s
e)Pr
omot
i
ngupt
akeofHDLi
nt
ol
i
v
ercel
l
s
ANSWER.
.
.D
Q.
12-Whi
choft
hef
ol
l
owi
ngsi
snotahy
pol
i
pi
demi
cdr
ug?
a)St
at
i
n
b)Ni
aci
n
c)Fol
i
caci
d
d)Cl
of
i
br
at
e
e)Ezet
i
mi
be.
ANSWER.
.
.C
Q.
13-Thesy
nt
hesi
sofHMGCoAcant
akepl
ace-
a)onl
yi
nmi
t
ochondr
i
a
b)Onl
yi
ncy
t
opl
asm ofal
lnucl
eat
edmammal
i
ancel
l
s
c)I
nt
heendopl
asmi
cr
et
i
cul
um ofal
l
mammal
i
ancel
l
s
d)I
nt
hel
y
sosomes
e)I
nbot
hcy
t
osol
andmi
t
ochondr
i
a.
ANSWER.
.
.B
Q.
14-Whi
choft
hef
ol
l
owi
ngbestdescr
i
best
her
ol
eofchol
est
er
ol
est
ert
r
ansf
erpr
ot
ei
n(
CETP)?
a)I
tconv
er
t
schol
est
er
ol
f
r
om LDLt
ochol
est
er
ol
est
er
s
b)I
ti
st
hemaj
orpr
ot
ei
nofHDL
c)I
texchangeschol
est
er
ol
est
er
sf
r
om HDLt
oot
herl
i
popr
ot
ei
ns
d)I
tact
sasal
i
gandf
orhepat
i
cr
ecept
or
sofHDL
e)I
ti
sanact
i
v
at
orofLCAT.
ANSWER.
.
.C
Q.
15-Whi
choft
hef
ol
l
owi
ngsar
enotl
i
pot
r
opi
cagent
s?
a)Essent
i
alami
noaci
ds
b)Essent
i
al
f
at
t
yaci
ds
c)Vi
t
ami
nA,
CandE
d)Bi
ot
i
nandPant
ot
heni
caci
d
e)Sy
nt
het
i
cant
i
oxi
dant
s
ANSWER.
.
.D.
SET2
1)
-Chol
est
er
ol
i
sapr
ecur
sorofal
l
oft
hef
ol
l
owi
ngsexcept
-
a)Taur
ochol
at
e
b)Gl
y
cochol
at
e
c)Cal
ci
t
r
i
ol
d)Cor
t
i
cost
er
oi
ds
e)Cal
ci
t
oni
n.
ANSWER.
.
.E
2)
-Al
l
t
he27car
bonat
omsofchol
est
er
ol
ar
eder
i
v
edf
r
om-
a)Acet
y
l
coA
b)Acet
oacet
y
l
coA
c)Pr
opi
ony
l
coA
d)Succi
ny
l
coA
e)Mal
ony
l
coA
ANSWER.
.
.A
3)
-Cy
t
osol
i
c3hy
dr
oxy
3met
hy
l
gl
ut
ar
y
l
CoA(
HMGCoA)i
sr
educed
t
oMev
al
onat
ef
ort
hesy
nt
hesi
sofchol
est
er
ol
,
t
heenzy
mecat
al
y
zi
ng
t
hi
si
r
r
ev
er
si
bl
est
epi
s-
a)Thi
ol
ase
b)Thi
oest
er
ase
c)Thi
ophor
ase
d)HMGCoAsy
nt
hase
e)HMGCoAr
educt
ase.
ANSWER.
.
.E
4)
-Whi
choutoft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
besaboutACAT
(
Acy
l
coAchol
est
er
ol
acy
l
t
r
ansf
er
ase)?
a)Requi
r
edf
orr
ev
er
sechol
est
er
ol
t
r
anspor
t
b)Rat
el
i
mi
t
i
ngenzy
mef
orbi
l
eaci
dsy
nt
hesi
s
c)Requi
r
esmonounsat
ur
at
edf
at
t
yaci
df
orest
er
i
f
i
cat
i
onof
chol
est
er
ol
d)Requi
r
edf
ordegr
adat
i
onofchy
l
omi
cr
onsandVLDL
e)I
ti
samaj
orcomponentofHDL.
ANSWER.
.
.C
5)
-Whi
choutoft
hef
ol
l
owi
ngst
at
ement
si
si
ncor
r
ectaboutbi
l
esal
t
s
?
a)Maj
orconst
i
t
uentofbi
l
e
b)Sol
ubi
l
i
zedi
et
ar
yl
i
pi
ds
c)Maj
orbr
eakdownpr
oduct
sofchol
est
er
ol
d)Taur
ochol
at
ei
st
hemaj
orbi
l
esal
t
.
e)Bi
l
esal
t
sar
ehi
ghl
yef
f
ect
i
v
edet
er
gent
s
ANSWER.
.
.D
6)–Adef
i
ci
encyofapopr
ot
ei
nCl
l
r
esul
t
si
nt
hedi
sease
hy
per
l
i
popr
ot
ei
nemi
at
y
peI
,
i
nwhi
cht
her
ei
sasi
gni
f
i
canti
ncr
easei
n
t
heconcent
r
at
i
onofpl
asmat
r
i
acy
l
gl
y
cer
ol
.Whi
choft
hef
ol
l
owi
ngi
s
t
r
ueaboutt
hecondi
t
i
on?
a)VLDLandHDLi
ncr
ease
b)Pl
asmaappear
smi
l
ky
c)Ther
ei
sar
i
skf
orpr
emat
ur
eI
HD
d)Ser
um t
ot
al
chol
est
er
ol
i
ncr
eases
e)ApoCI
Iact
sasanact
i
v
at
orofLCATenzy
me.
ANSWER.
.B
7)
-Whi
choft
hef
ol
l
owi
ngl
i
pi
dl
ower
i
ngdr
ugsactbyi
nhi
bi
t
i
ngt
he
absor
pt
i
onofdi
et
ar
ychol
est
er
ol
?
a)St
at
i
ns
b)Ezet
i
mi
be
c)Col
est
i
pol
d)Cl
of
i
br
at
e
e)Chol
est
y
r
ami
ne
ANSWER.
.
.B
8)
-I
nf
ami
l
i
al
hy
per
chol
est
er
ol
emi
a,
chol
est
er
ol
i
sdeposi
t
edi
n
v
ar
i
oust
i
ssuesbecauseoft
hehi
ghconcent
r
at
i
onofLDLchol
est
er
ol
i
nt
hepl
asma.Ofpar
t
i
cul
arconcer
ni
st
heoxi
dat
i
onoft
heexcess
bl
oodLDLt
of
or
m oxi
di
zedLDL(
oxLDL)
.TheoxLDLi
st
akenupby
i
mmunesy
st
em cel
l
scal
l
edmacr
ophages,
whi
chbecomeengor
ged
t
of
or
mf
oam cel
l
s.Whi
chst
at
ementbestdescr
i
best
hef
or
mat
i
onof
f
oam cel
l
s?
a)LDLr
ecept
or
sonper
i
pher
al
cel
l
sar
eupr
egul
at
ed
b)LDLr
ecept
or
sf
ormodi
f
i
edLDL(
OxLDL)ar
enotdownr
egul
at
ed
c)LDLent
er
sbypi
nocy
t
osi
st
of
or
mf
oam cel
l
s
d)Ther
ei
si
ncr
easeddenosy
nt
hesi
sofchol
est
er
ol
e)Chol
est
er
ol
i
snotext
r
act
edf
r
om macr
ophagesbyHDL
ANSWER.
.
.B
9)
-Apat
i
entpr
esent
swi
t
hv
er
yhi
ghl
ev
el
sofser
um chol
est
er
ol
.
Af
t
eraser
i
esoft
est
s,
i
ti
sconcl
udedt
hatt
hepat
i
enthashi
gh
ci
r
cul
at
i
ngl
ev
el
sofLDLchol
est
er
ol
,
buthasnor
mal
l
ev
el
soft
hel
i
v
er
LDLr
ecept
or
.Onepossi
bl
eexpl
anat
i
onf
ort
hi
sobser
v
at
i
oni
swhi
ch
oft
hef
ol
l
owi
ng?
a)Thepat
i
enthasamut
at
edf
or
m ofapopr
ot
ei
nB100.
b)Thei
nabi
l
i
t
yt
osel
ect
i
v
el
yr
emov
echol
est
er
ol
f
r
om t
heLDL
compl
ex.
c)Theabsenceoft
heenzy
mel
i
popr
ot
ei
nl
i
pase.
d)Decr
easedl
ev
el
sofacy
l
CoA:
chol
est
er
ol
acy
l
t
r
ansf
er
ase.
e)Al
t
er
edphosphor
y
l
at
i
onoft
heLDLr
ecept
or
.
ANSWER.
.
.A
10)
-Apat
i
entpr
esent
si
ny
ourof
f
i
cewi
t
hv
er
yhi
ghl
ev
el
sofser
um
chol
est
er
ol
.Hest
at
est
hathehast
r
i
edt
of
ol
l
owt
hedi
etandexer
ci
se
r
egi
meny
ougav
ehi
ml
asty
ear
.Youdeci
det
hatt
hi
spat
i
entwoul
d
benef
i
tf
r
om adr
ugsuchasLi
pi
t
or(
at
or
v
ast
at
i
n)
.Thi
scl
assofdr
ugs
i
sef
f
ect
i
v
ei
nt
r
eat
i
nghy
per
chol
est
er
ol
emi
abecausei
thaswhat
ef
f
ect
?
a)St
i
mul
at
esphosphor
y
l
at
i
onoft
he hy
dr
oxy
-met
hy
l
gl
ut
ar
y
l
-CoA
r
educt
aseenzy
me
b)Decr
easest
hest
abi
l
i
t
yoft
he hy
dr
oxy
-met
hy
l
gl
ut
ar
y
l
CoA
r
educt
asepr
ot
ei
n
c)Bi
ndschol
est
er
ol
pr
ev
ent
i
ngi
tf
r
om bei
ngabsor
bedbyt
he
i
nt
est
i
ne
d)Di
r
ect
l
ypr
ev
ent
st
hedeposi
t
i
onofchol
est
er
ol
onar
t
er
ywal
l
s
e)I
nhi
bi
t
st
heenzy
me hy
dr
oxy
-met
hy
l
gl
ut
ar
y
l
CoAr
educt
ase.
ANSWER.
.
.E
11)
-Fr
eechol
est
er
ol
canaf
f
ectchol
est
er
ol
met
abol
i
sm i
nt
hebodyby
i
nhi
bi
t
i
ngchol
est
er
ol
bi
osy
nt
hesi
s.Thest
epatwhi
chf
r
eechol
est
er
ol
i
nhi
bi
t
si
t
sbi
osy
nt
hesi
si
sbyi
nhi
bi
t
i
ngwhi
choft
hef
ol
l
owi
ngpr
ocesses?
a)Cy
cl
i
zi
ngofsqual
enet
of
or
ml
anost
er
ol
b)Reduct
i
onof7dehy
dr
ochol
est
er
ol
t
of
or
m chol
est
er
ol
c)For
mat
i
onofmev
al
onat
ef
r
om hy
dr
oxy
met
hy
l
gl
ut
ar
y
l
CoA
d)Ki
naset
hatphosphor
y
l
at
eshy
dr
oxy
met
hy
l
gl
ut
ar
y
l
CoAr
educt
ase
e)Condensat
i
onofacet
y
l
CoAandacet
oacet
y
l
CoAt
of
or
m hy
dr
oxy
met
hy
l
gl
ut
ar
y
l
CoA
ANSWER.
.C
12)
-Apat
i
entwi
t
hher
edi
t
ar
yt
y
peIhy
per
l
i
pi
demi
apr
esent
swi
t
hel
ev
at
ed
l
ev
el
sofchy
l
omi
cr
onsandVLDLt
r
i
gl
y
cer
i
desi
nt
hebl
ood.Themai
n
f
unct
i
onoft
hechy
l
omi
cr
onsi
nci
r
cul
at
i
oni
st
odowhi
choft
hef
ol
l
owi
ng?
a)Tr
anspor
tl
i
pi
dsf
r
om t
hel
i
v
er
b)Tr
anspor
tdi
et
ar
yl
i
pi
dsf
r
om t
hei
nt
est
i
net
ot
ar
gett
i
ssues
c)Tr
anspor
tchol
est
er
ol
f
r
om I
DLt
oLDL
d)Actasar
ecept
orf
ort
r
i
acy
l
gl
y
cer
ol
si
nt
hel
i
v
er
e)Bi
ndchol
est
er
ol
est
er
sexcl
usi
v
el
y
ANSWER.
.
.B
13)
-Themodi
f
i
cat
i
ont
obi
l
esal
t
st
hati
ncr
easest
hewor
ki
ngpHr
angeand
amphi
pat
hi
cnat
ur
eofbi
l
esal
t
si
s
a)7 Hy
dr
oxy
l
at
i
on
b)Dehy
dr
oxy
l
at
i
onbyi
nt
est
i
nal
bact
er
i
a
c)Est
er
i
f
i
cat
i
on
d)Conj
ugat
i
ont
ot
aur
i
neorgl
y
ci
ne
e)For
mat
i
onofsal
t
swi
t
hsodi
um andPot
assi
um.
ANSWER.
.D
14)
-A53y
ear
ol
dmal
epat
i
entwi
t
hel
ev
at
edl
ev
el
sofl
owdensi
t
y
l
i
popr
ot
ei
n(
LDL)chol
est
er
ol
,
si
gnsofpr
emat
ur
echol
est
er
ol
gal
l
st
one
di
seaseandsubst
ant
i
al
l
yel
ev
at
edt
r
i
gl
y
cer
i
desv
i
si
t
edhi
sphy
si
ci
anf
ora
f
ol
l
owupt
ocheckhi
scur
r
entst
at
us.Thepat
i
enthadr
ecei
v
edv
ar
i
ous
st
at
i
n,
HMGCoAr
educt
asei
nhi
bi
t
or
st
her
api
esf
ort
hepast2y
ear
s.
Howev
er
,
af
t
erbl
oodwor
kdoneatt
hi
sf
ol
l
owupv
i
si
t
,
compl
i
cat
i
onshad
st
i
l
l
notsubsi
ded.Thi
spat
i
enthassi
mi
l
arpr
obl
emsast
woofhi
ssi
bl
i
ngs.
Whi
choft
hef
ol
l
owi
ngbestexpl
ai
nst
hi
spat
i
ent
sdy
sl
i
pi
demi
a?
a)Ani
nf
l
uxofabnor
mal
phosphol
i
pi
dsi
nt
hegal
l
bl
adderasar
esul
tofi
l
eal
di
sease
b)Al
ossofHMGCoAr
educt
asef
unct
i
on
c)Al
ossofCYP7A1(
chol
est
er
ol
7-hy
dr
oxy
l
ase)f
unct
i
on
d)El
ev
at
edl
ev
el
sofACAT
e)LessnumberofLDLr
ecept
or
s
ANSWER.
.C
15)
-Apat
i
enthasbeenoncombi
nat
i
onst
at
i
nandChol
est
y
r
ami
net
her
apy
t
ol
owerhi
sser
um chol
est
er
ol
l
ev
el
s.Pr
i
ort
oanysur
ger
y
,
t
hi
spat
i
ent
woul
dbewel
l
adv
i
sedt
obesuppl
ement
edwi
t
hwhi
choft
hef
ol
l
owi
ng?
a)Vi
t
ami
nA
b)Vi
t
ami
nB12
c)Vi
t
ami
nC
d)Vi
t
ami
nK
e)Li
nol
eni
caci
d.
ANSWER.
.D
17)
-A18y
ear
ol
dmal
ewi
t
hsi
ckl
ecel
l
anemi
adev
el
opssev
er
er
i
ghtupper
abdomi
nal
pai
nr
adi
at
i
ngt
ohi
sl
owerr
i
ghtchestandhi
sr
i
ghtf
l
ank36
hour
spr
i
ort
oadmi
ssi
ont
ot
heER.Heal
sor
epor
t
st
hathi
sur
i
nei
st
he
col
orofi
cedt
eaandhi
sst
ool
nowhasal
i
ghtcl
aycol
or
.Onexami
nat
i
on,
hi
st
emper
at
ur
ei
ssl
i
ght
l
yel
ev
at
ed,
andhear
tr
at
ei
sr
api
d.Hei
sexqui
si
t
el
y
t
endert
opr
essur
eov
erhi
sr
i
ghtupperabdomen.Thescl
er
aeofhi
sey
es
ar
esl
i
ght
l
yy
el
l
owi
shi
ncol
or
.
Whati
st
hemostl
i
kel
ycauseoft
hi
spat
i
ent
’
ssy
mpt
oms?
a)Achol
est
er
ol
r
i
chgal
l
st
one
b)Adef
ecti
nt
hesy
nt
hesi
sofbi
l
eaci
ds
c)Adef
ecti
nhemesy
nt
hesi
s
d)Agal
l
st
oner
i
chi
ncal
ci
um bi
l
i
r
ubi
nat
e
e)Asi
ckl
ecel
l
cr
i
si
sbr
oughtonbyov
er
exer
t
i
on
ANSWER.
.
.D
18)Whi
choft
hef
ol
l
owi
ngcompoundsdi
r
ect
l
yi
nhi
bi
t
st
heexpr
essi
onof
t
heHMGCoAr
educt
asegene?
a)Squal
ene
b)HMGCoA
c)Lanost
er
ol
d)I
sopent
eny
l
py
r
ophosphat
e
e)Chol
est
er
ol
ANSWER.
.
.E
19)Whi
choft
hef
ol
l
owi
ngv
i
t
ami
nscanbeusedi
nhi
ghdosest
ot
r
eat
hy
per
chol
est
er
ol
emi
a?
a)Ni
aci
n
b)Ri
bof
l
av
i
n
c)Py
r
i
doxi
ne
d)Fol
i
caci
d
e)Thi
ami
ne.
ANSWER.
.
.A
20)At
eenageboypr
esent
swi
t
hmoder
at
et
osev
er
eepi
gast
r
i
cpai
n.
Phy
si
cal
exami
nat
i
onr
ev
eal
sext
ensi
v
eer
upt
i
v
exant
homasand
hepat
ospl
enomegal
y
.Abl
oodsampl
er
ev
eal
smi
l
kypl
asma.Whi
choft
he
f
ol
l
owi
ngi
st
hemostl
i
kel
yl
i
popr
ot
ei
nt
obeel
ev
at
edi
nt
hi
spat
i
ent‘
s
pl
asma?
a)Chy
l
omi
cr
ons
b)Chy
l
omi
cr
onr
emnant
s
c)HDL
d)I
DL
e)LDL
ANSWER.
.
.A
21)–A25y
ear
ol
df
emal
ewasr
ef
er
r
edt
oal
i
pi
dr
esear
chcent
erf
or
i
nv
est
i
gat
i
onofmoder
at
ehy
per
t
r
i
gl
y
cer
i
demi
abecauset
hepl
asmal
i
pi
d
andl
i
popr
ot
ei
npr
of
i
l
esshowedabnor
mal
i
t
i
es.Bot
hHDLandLDLwer
e
mor
ebuoy
antandshowedel
ev
at
i
onsi
nTGcont
entwi
t
ht
hemassofTG
appr
oxi
mat
el
yt
hesameast
hatofchol
est
er
ol
.Adef
i
ci
encyi
nwhi
choft
he
f
ol
l
owi
ngi
st
hemostl
i
kel
ycauseoft
hi
spat
i
ent
’
sl
i
pi
dabnor
mal
i
t
y
?
a)Leci
t
hi
nchol
est
er
ol
acy
l
t
r
ansf
er
ase(
LCAT)
b)Li
popr
ot
ei
nl
i
pase
c)Apopr
ot
ei
nCI
I
d)Hepat
i
cl
i
pase
e)Apopr
ot
ei
nB100
ANSWER.
.
.D
22)
-Labor
at
or
yr
esul
t
sf
orapat
i
entwi
t
huncont
r
ol
l
edTy
peIdi
abet
es
mel
l
i
t
usr
ev
eal
hy
per
gl
y
cemi
a(
634mg/
dL)andhy
per
t
r
i
gl
y
cer
i
demi
a(
498
mg/
dL)
.Themostl
i
kel
ycauseoft
hehy
per
t
r
i
gl
y
cer
i
demi
ai
nt
hi
spat
i
enti
s
whi
choft
hef
ol
l
owi
ng?
a)Def
i
ci
encyi
napopr
ot
ei
nCI
I
b)I
ncr
easedhepat
i
ct
r
i
gl
y
cer
i
desy
nt
hesi
s
c)Decr
easedl
i
popr
ot
ei
nl
i
paseact
i
v
i
t
y
d)Def
i
ci
encyi
nLDLr
ecept
or
s
e)Absenceofhor
monesensi
t
i
v
el
i
pase
ANSWER.
.
.
.C
SETTHREE
Q.
1-Gl
ucosecanbeconv
er
t
edt
oGl
y
cer
ol
3Pt
hr
oughwhi
choft
he
f
ol
l
owi
ngi
nt
er
medi
at
es?
a)Gl
y
cer
ol
b)Di
hy
dr
ox
yacet
onephosphat
e
c)Acet
y
l
coA
d)Py
r
uv
at
e
e)Mal
at
e.
ANSWER.
.B
Q.
2-Whi
choft
hef
ol
l
owi
ngsuppl
i
est
he2car
bonuni
t
st
hatar
eaddedt
o
t
heel
ongat
i
onoff
at
t
yaci
dchai
n?
a)Acet
y
l
coA
b)Mal
ony
l
coA
c) -Ket
oacy
l
coA
d)Gl
ucose
e)Py
r
uv
at
e.
ANSWER.
.B
Q.
3Theconv
er
si
onofAcet
y
l
coAt
oMal
ony
l
CoAr
equi
r
eswhi
choft
he
f
ol
l
owi
ng?
a)Bi
ot
i
n
b)Adenosi
neDi
phosphat
e(
ADP)
c)NADPH
d)H2O
e)Fol
i
caci
d.
ANSWER.
.
.A
Q.
4-NADPHi
ssy
nt
hesi
zedbyt
heact
i
onofwhi
choft
hef
ol
l
owi
ngenzy
mes?
a)Gl
ucose6Pdehy
dr
ogenase
b)Py
r
uv
at
edehy
dr
ogenase
c)Acet
y
l
coAcar
boxy
l
ase
d)Li
popr
ot
ei
nl
i
pase
e)Gl
y
cer
ol
ki
nase.
ANSWER.
.
.A
Q.
5-A45y
ear
ol
df
emal
epr
esent
swi
t
hsev
er
eupperabdomi
nal
pai
n,
nausea,
andv
omi
t
i
ng.Shei
sdi
agnosedwi
t
hPancr
eat
i
t
i
s(
ani
nf
l
ammat
i
on
oft
hepancr
eas)
.
Herser
um t
r
i
gl
y
cer
i
del
ev
el
i
sf
oundt
obe3000mg/
dl
and
i
sdeemedast
hecausef
orPancr
eat
i
t
i
s.Tof
or
m Tr
i
acy
l
gl
y
cer
ol
,
whi
chof
t
hef
ol
l
owi
ngi
saddedt
odi
acy
l
gl
y
cer
ol
?
a)Gl
y
cer
ol
b)Gl
y
cer
ol
3Phosphat
e
c)Fat
t
yacy
l
coA
d)Acet
y
l
coA
e)Succi
ny
l
coA.
ANSWER.
.C
Q.
6-A35y
ear
ol
dmanpr
esent
swi
t
hy
el
l
owxant
homasonhi
sski
nand
hepat
omegal
y(
enl
ar
gedl
i
v
er
)
.Hi
sTr
i
gl
y
cer
i
del
ev
el
i
s1500mg/
dl
.Hei
s
di
agnosedwi
t
ht
y
peVhy
per
l
i
pi
demi
a.Tr
i
gl
y
cer
i
desar
epr
i
mar
i
l
y
sy
nt
hesi
zedi
nwhi
choft
hef
ol
l
owi
ngt
i
ssues?
a)Skel
et
al
muscl
e
b)Hear
tmuscl
e
c)Li
v
er
d)Spl
een
e)Bl
oodcel
l
s.
ANSWER.
.C
Q.
7-An18y
ear
ol
df
emal
ei
sdi
agnosedasobese.Shemai
nt
ai
nsa
sedent
ar
yl
i
f
est
y
l
eandeat
sahi
ghf
at
,
hi
ghsugardi
et
.Mai
nt
enanceoft
hi
s
di
etandl
i
f
est
y
l
ehasl
edt
ol
i
pogenesi
sandobesi
t
y
.Whi
choft
hef
ol
l
owi
ng
af
f
ect
sexcessi
v
ef
at
t
yaci
dsy
nt
hesi
s?
a)Gl
y
cer
ol
i
sobt
ai
nedt
hr
oughgl
y
col
y
si
s
b)Fat
t
yaci
dsar
eexcessi
v
el
ysy
nt
hesi
zedf
r
om Acet
y
l
coA
c)NADPHi
sexcessi
v
el
yobt
ai
nedf
r
om HMPpat
hway
d)Tr
i
gl
y
cer
i
desar
eexcessi
v
el
ysy
nt
hesi
zed
e)Al
l
oft
heabov
e.
ANSWER.
.
.E
Q.
8-A30-y
ear
ol
dpr
egnantwomanhasasugarcr
av
i
ngandconsumesa
hotf
udgesundae.Herser
um gl
ucosel
ev
el
i
ncr
eases,
whi
chcauses
r
el
easeofI
nsul
i
n.I
nsul
i
ni
sknownt
oi
ncr
easet
heact
i
v
i
t
yofacet
y
l
coA
car
boxy
l
ase,
t
her
at
el
i
mi
t
i
ngenzy
meoff
at
t
yaci
dbi
osy
nt
hesi
s.Whi
chof
t
hef
ol
l
owi
ngbestdescr
i
best
hi
sr
egul
at
or
yenzy
me?
a)I
ti
sact
i
v
at
edbycar
boxy
l
at
i
on
b)I
tcat
al
y
zesar
eact
i
ont
hatcondensesanacet
y
l
gr
oupwi
t
hmal
ony
l
gr
oup
c)I
tcat
al
y
zesar
eact
i
ont
hatr
equi
r
esbi
ot
i
nandATP
d)I
tconv
er
t
sMal
ony
l
coAt
oAcet
y
l
coA
e)I
ti
sact
i
v
at
edbymal
ony
l
coA.
ANSWER.
.
.C
Q.
9-A16y
ear
ol
df
emal
epr
esent
swi
t
hxant
homasonherey
el
i
ds.Shei
s
f
oundt
ohav
ear
ar
egenet
i
cdef
i
ci
encyofl
i
popr
ot
ei
nl
i
paseandi
s
di
agnosedwi
t
ht
y
pe1hy
per
l
i
pi
demi
a.I
nt
hi
sdi
sor
derchy
l
omi
cr
onsar
e
abnor
mal
l
yel
ev
at
edi
nt
heser
um.I
nwhatt
y
peofcel
l
ar
et
r
i
acy
l
gl
y
cer
ol
s
packagedi
nt
ochy
l
omi
cr
ons?
a)I
nt
est
i
nal
epi
t
hel
i
al
cel
l
s
b)Li
v
ercel
l
c)Muscl
ecel
l
d)Hear
tcel
l
e)Adi
posecel
l
.
ANSWER.
.A
Q.
10-A50y
ear
ol
d,
al
cohol
i
cmal
epr
esent
swi
t
haswol
l
enf
ace,
di
st
ended
abdomen,
andanenl
ar
gedf
at
t
yl
i
v
er
.Fat
t
yaci
dsr
eactwi
t
hgl
y
cer
ol
3Pt
o
f
or
mt
r
i
gl
y
cer
i
des,
whi
chaccumul
at
et
ocausef
at
t
yl
i
v
er
.Thel
i
v
erhas
gl
y
cer
ol
ki
nase,
whi
l
eadi
poset
i
ssuel
acksgl
y
cer
ol
ki
nase.Asar
esul
t
,
i
n
adi
poset
i
ssue,
whi
choft
hef
ol
l
owi
ngoccur
s?
a)Gl
ucosecannotbeconv
er
t
edt
oDHAP
b)Gl
y
cer
ol
cannotbeconv
er
t
edt
oGl
y
cer
ol
3P
c)DHAPcannotbeconv
er
t
edt
oGl
y
cer
ol
3P
d)Di
acy
l
gl
y
cer
ol
cannotbeconv
er
t
edt
oTr
i
acy
l
gl
y
cer
ol
e)Tr
i
acy
l
gl
y
cer
ol
scannotbest
or
ed.
ANSWER.
.
.B
Q.
11-A25y
ear
ol
dmani
sbr
oughtt
ot
heemer
gencyr
oom af
t
eramot
or
v
ehi
cl
eacci
dent
.Hehasadi
sl
ocat
edhi
p,
r
i
bf
r
act
ur
esandaf
aci
al
l
acer
at
i
on.Toxi
col
ogyscr
eenshowsahi
ghl
ev
el
ofet
hanol
i
nhi
sbl
ood.
Oxi
dat
i
onofet
hanol
pr
oducesacet
al
dehy
deandNADH.Ahi
ghl
ev
el
of
NADHr
el
at
i
v
et
oNAD+sl
owsTCAcy
cl
eandpr
omot
est
heconv
er
si
onof
whi
choft
hef
ol
l
owi
ngr
eact
i
ons?
a)Di
hy
dr
oxyacet
onephosphat
et
ogl
y
cer
ol
3P
b)Gl
y
cer
ol
3Pt
oDi
hy
dr
oxyacet
onephosphat
e
c)Ci
t
r
at
et
oi
soci
t
r
at
e
d)Mal
at
et
oOxal
oacet
at
e
e)Al
l
oft
heabov
e.
ANSWER.
.
.
Q.
12-A35y
ear
ol
dwomanpr
esent
swi
t
hf
l
at
ul
ence,
bl
oat
i
ng,
and
st
eat
or
r
hea(
f
ati
nt
hest
ool
)
.Shehadbeeneat
i
ngl
ar
geamount
sofpot
at
o
chi
pst
hatwer
emadeusi
ngOl
est
r
a,
af
atsubst
i
t
ut
e.Nor
mal
l
y
,
di
et
ar
y
t
r
i
acy
l
gl
y
cer
ol
ar
ehy
dr
ol
y
zedi
nt
ocomponent
st
hatar
er
econst
r
uct
edi
nt
o
t
r
i
acy
l
gl
y
cer
ol
st
hatbecomeacomponentofchy
l
omi
cr
ons.I
nt
hei
nt
est
i
nal
cel
l
,
t
hei
ni
t
i
al
pr
ecur
sorf
orf
at
t
yaci
dsy
nt
hesi
si
swhi
choft
hef
ol
l
owi
ng?
a)Gl
y
cer
ol
b)Gl
y
cer
ol
3P
c)2Monoacy
l
gl
y
cer
ol
d)Phosphat
i
di
caci
d
e)Acet
y
l
coA.
ANSWER.
.
.C
Q.
13-Thecompl
et
eoxi
dat
i
onofoddchai
nf
at
t
yaci
dpr
oduceswhi
choft
he
f
ol
l
owi
ngs?
a)Acet
y
l
coAonl
y
b)Acet
y
l
coAandPr
opi
ony
l
coA
c)But
y
r
y
l
coA
d)Pal
mi
t
oy
l
coA
e)Pr
opi
ony
l
coAonl
y
ANSWER.
.
.B
Q.
14-Theact
i
v
at
i
onofl
ongchai
nf
at
t
yaci
dsr
equi
r
eswhi
choft
he
f
ol
l
owi
ngcomponent
s?
a)2ATP
b)2ATPandCoA
c)2ATP,
CoAandf
at
t
yacy
l
coA
d)Fat
t
yacy
l
car
ni
t
i
ne
e)Car
ni
t
i
neacy
l
t
r
ansf
er
aseIandI
I
.
ANSWER.
.
.B
Q.
15-Whi
choft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
best
he -oxi
dat
i
onof
f
at
t
yaci
ds?
a)OneAcet
y
l
coAi
spr
oducedi
neacht
ur
noft
he -oxi
dat
i
onspi
r
al
b) -oxi
dat
i
onoff
at
t
yaci
dsi
sanext
r
ami
t
ochondr
i
al
pr
ocess
c)Theenzy
mespr
esenti
nt
hef
or
m ofmul
t
i
enzy
mecompl
exes
d)Thei
nt
er
medi
at
esar
ecar
r
i
edbyAcy
l
car
r
i
erpr
ot
ei
n
e)129ATPar
er
equi
r
edf
ort
hef
or
mat
i
onofonemol
ofPal
mi
t
i
caci
d.
ANSWER.
.A
Q.
16- -ox
i
dat
i
onofl
ongchai
nf
at
t
yaci
dsoccur
spr
i
mar
i
l
yi
nwhi
choft
he
f
ol
l
owi
ngl
ocat
i
ons?
a)Cy
t
osol
b)Per
oxi
somes
c)Mi
t
ochondr
i
a
d)Endopl
asmi
cr
et
i
cul
um
e)Gol
gi
appar
at
us.
ANSWER.
.C
Q.
17-Howmanycar
bonsar
er
emov
edf
r
om f
at
t
yacy
l
coAi
nonet
ur
nof oxi
dat
i
onspi
r
al
?
a)1
b)2
c)3
d)4
e)6
ANSWER.
.
.B
Q.
18- -ox
i
dat
i
onoff
at
t
yaci
dsi
spr
omot
edbywhi
choft
hef
ol
l
owi
ngs?
a)ATP
b)NAD+
c)FADH2
d)Acet
y
l
coA
e)Pr
opi
ony
l
coA.
ANSWER.
.B
Q.
19-Whati
st
her
ol
eofThi
ol
asei
nt
he -oxi
dat
i
onoff
at
t
yaci
ds?
a)Cl
eav
esofCoA
b)Cl
eav
est
hebondbet
ween -and -car
bons
c)AddsH2Oacr
osst
hedoubl
ebond
d)Gener
at
esNADH
e)Gener
at
esFADH2
ANSWER.
.
.B
Q.
20-Whi
choft
hef
ol
l
owi
ngpr
oduct
si
sr
el
easedi
noxi
dat
i
onoff
at
t
y
aci
ds?
a)CoA
b)CO2
c)H2O
d)Acet
y
l
coA
e)Hy
dr
ogenper
oxi
de.
ANSWER.
.
.
.
.B
Q.
21-A16y
ear
ol
dext
r
emel
ysl
endergi
r
l
pr
esent
swi
t
habodywei
ghtt
hat
i
s35%bel
owexpect
ed.Shest
i
l
l
f
eel
sher
sel
ft
obeobeseandsev
er
el
y
r
est
r
i
ct
sherf
oodi
nt
ake.Shei
sdi
agnosedwi
t
hAnor
exi
aNer
v
osa.I
nt
hi
s
pat
i
ent
,
duet
oi
mpr
operdi
et
ar
yi
nt
ake,
t
hebr
eakdownoff
at
t
yaci
dsi
s
r
equi
r
edt
opr
ov
i
deener
gy
.Whi
choft
hef
ol
l
owi
ngsubst
ancei
sf
or
medi
n
t
hef
i
r
stst
epoft
hebet
aoxi
dat
i
onoff
at
t
yaci
ds?
a)ATP
b)CoA
c)Fat
t
yacy
l
coA
d)Car
ni
t
i
ne
e)Mal
ony
l
coA.
ANSWER.
.C
Q.
22-A5y
ear
ol
dboypr
esent
swi
t
hal
t
er
edment
al
st
at
us,
hear
tf
ai
l
ur
e,
andmuscl
eweakness.Hi
sser
um l
ev
el
ofket
onesandgl
ucosear
e
abnor
mal
l
yl
ow.Hei
sdi
agnosedwi
t
hpr
i
mar
ycar
ni
t
i
nedef
i
ci
ency
.I
nwhi
ch
oft
hef
ol
l
owi
ngi
scar
ni
t
i
nedi
r
ect
l
yi
nv
ol
v
ed?
a)Act
i
v
at
i
onoff
at
t
yaci
ds
b)Tr
anspor
toff
at
t
yacy
l
coA
c) Oxi
dat
i
on
d) -Oxi
dat
i
on
e) -Oxi
dat
i
on.
ANSWER.
.B
Q.
23-A10y
ear
ol
dgi
r
l
pr
esent
swi
t
hdi
f
f
i
cul
twal
ki
ng,
muscl
eweakness
andal
t
er
edment
al
st
at
us.Shei
sdi
agnosedwi
t
hcar
ni
t
i
neacy
l
t
r
ansf
er
ase
def
i
ci
ency
.Car
ni
t
i
neacy
l
Tr
ansf
er
aseIcat
al
y
zesar
eact
i
ont
hatpr
oduces
whi
choft
hef
ol
l
owi
ng?
a)Fat
t
yacy
l
coA
b)Fat
t
yacy
l
Car
ni
t
i
ne
c)Fat
t
yenoy
l
coA
d) -OH-Acy
l
coA
e) -Ket
oacy
l
coA.
ANSWER.
.C
Q.
24-Anobese,
40y
ear
ol
dwoman,
whor
ecent
l
yunder
wentgast
r
i
c
by
passsur
ger
y
,
pr
esent
swi
t
hsev
er
ev
omi
t
i
ngduet
or
api
di
nt
akeofl
ar
ge
quant
i
t
i
esoff
ood,
whi
chmustbeav
oi
dedaf
t
ergast
r
i
cby
passsur
ger
y
.
Shehadsuccessf
ul
l
yl
ost10I
bov
ert
hel
astmont
haf
t
ert
hesur
ger
ydi
et
o
mobi
l
i
zat
i
onoff
atst
or
est
opr
ov
i
deacet
y
l
coAandener
gy
.When
pal
mi
t
oy
l
coAi
soxi
di
sed,
howmanyAcet
y
l
coAar
epr
oduced?
a)
1
b)10
c)6
d)8
e)4
ANSWER.
.
.D
Q.
25-A16y
ear
ol
dmar
at
honr
unnert
r
ai
nsbyr
unni
ng15mi
l
esev
er
y
mor
ni
ng,
r
equi
r
i
ngaconst
antsuppl
yofATP.Appr
oxi
mat
el
yHowmany
ATPar
epr
oducedwhenpal
mi
t
oy
l
coAi
soxi
di
zedt
oCO2andH2O?
a)100
b)129
c)136
d)96
e)Noneoft
heabov
e.
ANSWER.
.
.B
1.Whi
choft
hef
ol
l
owi
ngar
et
heket
onebodi
es?
a)Acet
y
l
coAandPr
opi
ony
l
coA
b)Leci
t
hi
nandLy
sol
eci
t
hi
n
c)Acet
oacet
at
eandBet
ahy
dr
oxybut
y
r
at
e
d)Py
r
uv
at
eandl
act
at
e
e)Succi
ny
l
coAandsucci
nat
e
ANSWER.
.C
2.Theenzy
me‘
Thi
ol
ase’
cat
al
y
zest
heconv
er
si
onof
-
a)2Acet
y
l
coAt
oAcet
oacet
y
l
coA
b)Acet
y
l
coAt
oMal
ony
l
coA
c)Fat
t
yaci
dt
oFat
t
yAcy
l
coA
d)Succi
ny
l
coAt
osucci
nat
e
e)Pr
opi
ony
l
coAt
oD-Met
hy
l
mal
ony
l
coA
ANSWER.
.
.A
3.I
ncont
r
astt
osecondar
ybi
l
esal
t
s,
whi
choft
hef
ol
l
owi
ngi
s
char
act
er
i
st
i
cofpr
i
mar
ybi
l
esal
t
s?
a)Ar
ehy
dr
oxy
l
at
edatcar
bon7
b)Hav
eanoxi
di
zedsi
dechai
n
c)For
m coAder
i
v
at
i
v
es
d)Canbeconj
ugat
edt
oGl
y
ci
neorTaur
i
ne
e)Ar
er
eabsor
bedi
nt
hei
nt
est
i
ne
ANSWER.
.
.A
4.Whi
choft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
best
hef
at
t
yaci
d
sy
nt
hasecompl
ex?
a)I
sadi
merofdi
ssi
mi
l
arsubuni
t
s
b)i
scomposedof7di
f
f
er
entpr
ot
ei
ns
c)Di
ssoci
at
esi
nt
oei
ghtdi
f
f
er
entpr
ot
ei
ns
d)Cat
al
y
zes8di
f
f
er
entenzy
mat
i
cst
eps
e)I
scomposedofcov
al
ent
l
yl
i
nkedenzy
mes
ANSWER.
.E
5.Theendpr
oductoff
at
t
yaci
dsy
nt
hesi
si
nmammal
si
s–
a)Ar
achi
doni
caci
d
b)Li
nol
ei
caci
d
c)St
ear
i
caci
d
d)Pal
mi
t
i
caci
d
e)Er
uci
caci
d
ANSWER.
.D
6.Whi
chenzy
meof
t
enmal
f
unct
i
onsi
ndi
seasesassoci
at
edwi
t
ht
he
sy
mpt
omsofhi
ghbl
oodt
r
i
gl
y
cer
i
del
ev
el
sandSt
eat
or
r
hea?
a)Phosphol
i
paseD
b)Li
popr
ot
ei
nl
i
pase
c)Thi
oki
nase
d)Acet
y
l
coAcar
boxy
l
ase
e)Pancr
eat
i
cl
i
pase
ANSWER.
.
.E
7.Whi
chenzy
mei
sanal
l
ost
er
i
cr
egul
at
orofanot
herenzy
meont
hel
i
st?
a)Acet
y
l
coAcar
boxy
l
ase
b)Pancr
eat
i
cl
i
pase
c)Car
ni
t
i
neacy
l
t
r
ansf
er
ase1
d)Acet
y
l
t
r
ansacy
l
ase
e)Ket
oacy
l
sy
nt
hase
ANSWER.
.A
8.Anewbor
nhassev
er
er
espi
r
at
or
ypr
obl
ems.Ov
ert
henextf
ewday
si
ti
s
obser
v
edt
hatt
hebabyhassev
er
emuscl
epr
obl
ems,
demonst
r
at
esl
i
t
t
l
e
dev
el
opment
,
andhasneur
ol
ogi
cal
pr
obl
ems.Al
i
v
erbi
opsyr
ev
eal
sav
er
y
l
owl
ev
el
ofacet
y
l
coAcar
boxy
l
ase,
butnor
mal
l
ev
el
soft
heenzy
mesof
gl
y
col
y
si
sandgl
uconeogenesi
s,
t
heci
t
r
i
caci
dcy
cl
e,
andt
hepent
ose
phosphat
epat
hway
.Whati
st
hemostl
i
kel
ycauseofi
nf
ant
’
sr
espi
r
at
or
y
pr
obl
ems?
a)Lowl
ev
el
ofphosphat
i
dy
l
chol
i
ne
b)Bi
ot
i
ndef
i
ci
ency
c)Ket
oaci
dosi
s
d)Hi
ghl
ev
el
ofci
t
r
at
e
e)Gl
y
cogendepl
et
i
on
ANSWER.
.A
9.I
ncy
st
i
cf
i
br
osi
s,
t
hepancr
eat
i
cduct
sbecomeobst
r
uct
edbyv
i
scous
mucus.Consequent
l
ydi
gest
i
onofwhi
choft
hef
ol
l
owi
ngsubst
ances
woul
dbemosti
mpai
r
ed?
a)St
ar
ch
b)Gl
y
cogen
c)Cel
l
ul
ose
d)Li
pi
ds
e)Mal
t
ose
ANSWER.
.D
10.I
nsul
i
npr
omot
eswhi
choft
hef
ol
l
owi
ng?
a)Tr
anspor
tofgl
ucosei
nt
ocel
l
s
b)Conv
er
si
onofTr
i
acy
l
gl
y
cer
ol
t
odi
acy
l
gl
y
cer
ol
c)Fat
t
yaci
doxi
dat
i
on
d)Decr
easedact
i
v
i
t
yofl
i
popr
ot
ei
nl
i
pase
e)I
ncr
easedbl
oodgl
ucosel
ev
el
ANSWER.
.A
11.
Di
car
boxy
l
i
caci
dur
i
ai
sadef
ectassoci
at
edwi
t
hi
mpai
r
ed-
a)Al
phaoxi
dat
i
onoff
at
t
yaci
ds
b)Bet
aoxi
dat
i
onoff
at
t
yaci
ds
c)Fat
t
yaci
dsy
nt
hesi
s
d)Omegaoxi
dat
i
onoff
at
t
yaci
ds
e)denov
ochol
est
er
ol
sy
nt
hesi
s
ANSWER.
.B
12.I
nal
phaoxi
dat
i
onwhi
choft
hef
ol
l
owi
ngpr
oduct
si
sr
el
eased?
a)CoA
b)CO2
c)H2O
d)Acet
y
l
coA
e)Mal
ony
l
coA
B
13.A2y
earol
dboyhasbeendi
agnosedwi
t
hZel
l
wegersy
ndr
ome,
a
di
sor
dercausedbymal
f
or
mat
i
onofper
ox
i
somes.Theoxi
dat
i
onofwhi
ch
oft
hef
ol
l
owi
ngf
at
t
yaci
dsi
si
mpai
r
edi
nt
hi
sdef
ect?
a)Pal
mi
t
i
caci
d
b)Unsat
ur
at
edf
at
t
yaci
ds
c)Ver
yl
ongchai
nf
at
t
yaci
ds
d)Br
anchedhai
l
f
at
t
yaci
ds
e)Cy
cl
i
cf
at
t
yaci
ds
ANSWER.
.C
14.A15y
ear
ol
df
emal
ehasbeendi
agnosedwi
t
hanor
exi
aner
v
osa.I
nt
hi
s
pat
i
entbr
eakdownoff
at
t
yaci
dsi
sr
equi
r
edt
opr
ov
i
deener
gy
.Pr
i
ort
of
at
t
y
aci
doxi
dat
i
onact
i
v
at
i
onoff
at
t
yaci
dt
akespl
acei
nt
hecy
t
osol
.Whi
chof
t
hef
ol
l
owi
ngi
st
hepr
oductoff
at
t
yaci
dact
i
v
at
i
on?
a)ATP
b)CoA
c)Fat
t
yacy
l
CoA
d)Car
ni
t
i
ne
e)Mal
ony
l
coA
ANSWER.
.C
15.Tangi
erdi
seasei
sadi
seaseofchol
est
er
ol
t
r
anspor
t
.Thef
i
r
stcase
wasi
dent
i
f
i
edi
napat
i
entwhol
i
v
edont
hei
sl
andofTangi
erandwhohad
char
act
er
i
st
i
cor
angecol
or
edt
onsi
l
s,
av
er
yl
owHDLandanenl
ar
gedl
i
v
er
andspl
een.Duet
omut
at
i
oni
nat
r
anspor
tpr
ot
ei
n,
chol
est
er
ol
cannot
pr
oper
l
yexi
tt
hecel
l
t
obi
ndt
oapoA.Whi
choft
hef
ol
l
owi
ngi
st
hemost
i
mpor
t
antr
i
skf
act
orf
orsuchpat
i
ent
sduet
odeceasedl
ev
el
ofHDL?
a)Di
abet
esmel
l
i
t
us
b)At
her
oscl
er
osi
s
c)Cat
ar
act
d)Ket
osi
s
e)Fat
t
yl
i
v
er
ANSWER.
.B
16.A40y
ear
ol
dmanpr
esent
swi
t
hsev
er
epai
ni
nhi
sl
egsuponwal
ki
ng.
Hei
sdi
agnosedwi
t
hat
her
oscl
er
ot
i
cpl
aquesi
nt
hear
t
er
i
esofhi
sl
egs.
Hi
ghl
ev
el
sofchol
est
er
ol
andLDLcont
r
i
but
et
ot
hef
or
mat
i
onof
at
her
oscl
er
osi
s.Theoxi
di
zedf
or
m ofLDLt
r
i
gger
st
hepr
ocessof
at
her
oscl
er
osi
s.Whi
choft
hef
ol
l
owi
ngi
st
hemosti
mpor
t
antst
r
uct
ur
al
componentofLDL?
a)ApoB48
b)ApoB100
c)ApoA
d)ApoC
e)ApoE
ANSWER.
.B
17.A30y
ear
ol
dmanhasbeendi
agnosedwi
t
hf
ami
l
i
al
hy
per
chol
est
er
ol
emi
a,
adi
sor
dercausedbyadef
i
ci
encyofLDLr
ecept
or
s.
Whi
choft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
best
hest
at
usoft
hese
pat
i
ent
s?
a)Ser
um chol
est
er
ol
decr
eases
b)Excessi
v
echol
est
er
ol
i
sr
el
easedbyHDL
c)Chol
est
er
ol
sy
nt
hesi
sbyhepat
ocy
t
esi
si
ncr
eased
d)NumberofLDLr
ecept
or
sont
hesur
f
aceofhepat
ocy
t
esi
ncr
ease
e)Af
t
erbi
ndi
ngt
oLDLr
ecept
or
s,
LDLi
sr
api
dl
ydegr
aded
ANSWER.
.C
18.A25y
ear
ol
dwomanpr
esent
swi
t
hal
owr
edbl
oodcel
l
count
,
cor
neal
opaci
t
i
esandki
dneyi
nsuf
f
i
ci
ency
.Shei
sdi
agnosedwi
t
hLeci
t
hi
n
:
Chol
est
er
ol
acy
l
t
r
ansf
er
ase(
LCAT)def
i
ci
ency
.Whi
choft
hef
ol
l
owi
ngi
s
LCATi
nv
ol
v
edi
n?
a)Conv
er
t
i
ngchol
est
er
ol
t
ochol
est
er
y
l
est
er
b)Tr
ansf
erofchol
est
er
ol
t
oot
herl
i
popr
ot
ei
ns
c)Degr
adat
i
onofHDLi
nl
i
v
er
d)Degr
adat
i
onofchy
l
omi
cr
ons
e)Decr
easedupt
akeofchol
est
er
ol
byhepat
ocy
t
es
ANSWER.
.A
19.A34y
ear
ol
df
emal
ehasbeendi
agnosedwi
t
ht
y
pe1hy
per
l
i
pi
demi
a.
Whi
choft
hef
ol
l
owi
ngl
i
popr
ot
ei
nconcent
r
at
i
oni
sel
ev
at
edi
nsuch
di
sor
der?
a)VLDL
b)I
DL
c)LDL
d)Chy
l
omi
cr
ons
e)Al
l
oft
heabov
e
ANSWER.
.
.D
20.Abundanceofwhi
choft
hef
ol
l
owi
ngi
nhi
bi
t
sbet
aoxi
dat
i
onoff
at
t
y
aci
ds?
a)ATP
b)Longchai
nf
at
t
yaci
ds
c)Mal
ony
l
coA
d)Ci
t
r
at
e
e)Acet
y
l
coA
ANSWER.
.C
1)Whi
choft
hef
ol
l
owi
ngi
st
hebestmar
kerf
ort
hedi
agnosi
sofAcut
e
pancr
eat
i
t
i
s?
a)Lact
ase
b)Amy
l
ase
c)Chol
est
er
y
l
est
er
ase
d) -Gl
ut
amy
l
t
r
anspept
i
dase
e)Sucr
ase
2)Agal
l
st
onet
hatbl
ockedt
heupperpar
toft
hebi
l
eductwoul
dcausean
–
a)I
ncr
easedf
or
mat
i
onofchy
l
omi
cr
on
b)I
ncr
easedr
ecy
cl
i
ngofbi
l
esal
t
s
c)I
ncr
easedexcr
et
i
onofbi
l
esal
t
s
d)Decr
easedexcr
et
i
onoff
at
si
nt
hef
eces
e)I
ncompl
et
el
i
pi
ddi
gest
i
onandabsor
pt
i
on
3)Amol
ecul
eofPal
mi
t
i
caci
dat
t
achedt
ocar
bon1ofgl
y
cer
ol
moi
et
yofa
t
r
i
acy
l
gl
y
cer
ol
i
si
ngest
edanddi
gest
ed.Whi
choft
hef
ol
l
owi
ngmol
ecul
ar
compl
exesi
nt
hebl
oodcar
r
i
est
hepal
mi
t
at
er
esi
duef
r
om t
hel
umenoft
he
gutt
ot
hesur
f
aceoft
hegutepi
t
hel
i
al
cel
l
?
a)VLDL
b)LDL
c)I
DL
d)HDL
e)Bi
l
esal
t
4)Whi
choft
hef
ol
l
owi
ngsuppl
i
esal
l
t
hecar
bonat
omst
hatar
eneededf
or
denov
osy
nt
hesi
sofchol
est
er
ol
?
a)Gl
ucose
b)Acet
y
l
coA
c)Mal
ony
l
coA
d)Succi
ny
l
coA
e)Ci
t
r
at
e
5)Whi
choft
hef
ol
l
owi
ngi
snotneededf
ort
hedenov
osy
nt
hesi
soff
at
t
y
aci
ds?
a)NADPH
b)Acet
y
l
coA
c)Bi
car
bonat
e
d)ATP
e)Fol
i
caci
d
6)Gl
y
cer
ol
pr
oducedf
r
om hy
dr
ol
y
si
soft
r
i
gl
y
cer
i
desi
nadi
poset
i
ssuei
sa
wast
epr
oduct
,
si
ncei
thast
obei
ngl
y
cer
ol
3Pf
or
m andt
heenzy
mef
or
phosphor
y
l
at
i
on,
gl
y
cer
ol
ki
nasei
sabsenti
nt
headi
poset
i
ssue.Gl
y
cer
ol
3
Pcanst
i
l
l
bepr
oducedi
nt
headi
poset
i
ssuet
hr
oughi
nt
er
conv
er
si
onof
oneoft
hegl
y
col
y
t
i
ci
nt
er
medi
at
e.Whi
choft
hef
ol
l
owi
nggl
y
col
y
t
i
c
i
nt
er
medi
at
ecanbeusedf
ort
hesy
nt
hesi
sofgl
y
cer
ol
3P?
a)Phosphoenol
py
r
uv
at
e
b)1,
3Bi
sphosphogl
y
cer
at
e
c)Di
hy
dr
oxy
acet
onephosphat
e
d)Fr
uct
ose1,
6bi
sphosphat
e
e)2,
phosphogl
y
cer
at
e
7)Whi
choft
hef
ol
l
owi
ngenzy
mesi
sr
equi
r
edf
orr
el
easi
ngt
henewl
y
sy
nt
hesi
zedf
at
t
yaci
df
r
om t
hef
at
t
yaci
dsy
nt
hasecompl
ex?
a)Thi
ol
ase
b)Thi
ophor
ase
c)Thi
oest
er
ase
d)Thi
oki
nase
e)Hy
dr
at
ase
8)Whi
choft
hef
ol
l
owi
ngi
st
hekeyr
egul
at
or
yenzy
meoff
at
t
yaci
d
sy
nt
hesi
s?
a)ATPci
t
r
at
el
y
ase
b)Ket
oacy
l
sy
nt
hase
c)Acet
y
l
t
r
ansacy
l
ase
d)Acet
y
l
coAcar
boxy
l
ase
e)Thi
ol
ase
9)The“
mi
cr
osomal
sy
st
em “
el
ongat
essat
ur
at
edandunsat
ur
at
edf
at
t
y
acy
l
CoAs(
f
r
om C10upwar
d)byt
wocar
bons,
usi
ng-
a)Mal
ony
l
coA
b)Acet
y
l
coA
c)Succi
nat
e
d)Py
r
uv
at
e
e)Ci
t
r
at
e
10)Whi
choft
hef
ol
l
owi
ngi
sabr
eakdownpr
oductofoddchai
nf
at
t
yaci
ds?
a)Acet
y
l
coAonl
y
b)Acet
y
l
coAandBut
y
r
y
l
coA
c)Acet
y
l
coAandPr
opi
ony
l
coA
d)Pr
opi
ony
l
coAonl
y
e)But
y
r
y
l
coAonl
y
11)Li
pogenesi
si
si
ncr
easedwhensucr
osei
sf
edi
nst
eadofgl
ucose
because-
a)Sucr
osei
sdi
gest
edandabsor
bedr
api
dl
y
b)Sucr
osemet
abol
i
sm causesr
el
easeofi
nsul
i
n
c)Fr
uct
ose,
t
hehy
dr
ol
y
t
i
cpr
oductact
i
v
at
esacet
y
l
coAcar
boxy
l
ase
d)Fr
uct
oseby
passest
hephosphof
r
uct
oki
nasecont
r
ol
poi
nti
ngl
y
col
y
si
s
andf
l
oodst
hepat
hway
e)Al
l
oft
heabov
e
12)Anobese,
40-y
ear
ol
dwoman,
whor
ecent
l
yunder
wentgast
r
i
cby
pass
sur
ger
y
,
pr
esent
swi
t
hsev
er
ev
omi
t
i
ngduet
or
api
di
nt
akeofl
ar
ge
quant
i
t
i
esoff
ood,
whi
chmustbeav
oi
dedaf
t
ergast
r
i
cby
passsur
ger
y
.
Shehadsuccessf
ul
l
yl
ost10poundsov
ert
hel
astmont
haf
t
ert
hesur
ger
y
duet
omobi
l
i
zat
i
onoff
atst
or
est
opr
ov
i
deacet
y
l
coAandener
gy
.When
St
ear
i
caci
di
soxi
di
zed,
howmanyAcet
y
l
coAar
epr
oduced?
a)1
b)8
c)9
d)2
e)10
13)A4mont
hol
di
nf
antpr
esent
swi
t
hasei
zur
e.Hi
smot
herr
epor
t
st
hat
heri
nf
anthasbeeni
r
r
i
t
abl
eandl
et
har
gi
cov
ert
hepastsev
er
al
day
s.The
i
nf
anti
sf
oundt
ohav
eapr
of
oundl
yl
owser
um gl
ucoseandket
onebody
l
ev
el
.Thei
nf
anti
sdi
agnosedwi
t
hmedi
um chai
nacy
l
coAdehy
dr
ogenase
def
i
ci
ency
.Whati
st
hebi
ochemi
cal
basi
sofi
nf
ant
’
ssy
mpt
oms?
a)Bet
aoxi
dat
i
onoff
at
t
yaci
di
si
mpai
r
ed
b)Fat
t
yaci
dsy
nt
hesi
si
si
mpai
r
ed
c)Adi
pol
y
si
si
si
nhi
bi
t
ed
d)TCAcy
cl
ei
si
nhi
bi
t
ed
e)Py
r
uv
at
et
oacet
y
l
coAconv
er
si
oni
si
nhi
bi
t
ed
14)Whi
choft
hef
ol
l
owi
ngi
snotani
nt
er
medi
at
eofpat
hwayofchol
est
er
ol
sy
nt
hesi
s?
a)Mev
al
onat
e
b)Squal
ene
c)Lanost
er
ol
d)Desmost
er
ol
e)7-dehy
dr
ochol
est
er
ol
15)A45y
ear
ol
df
emal
epr
esent
swi
t
hpai
ni
nt
her
i
ghthy
pochondr
i
um
r
adi
at
i
ngt
owar
dsshoul
derandback.Shei
sdi
agnosedwi
t
hacut
e
chol
ecy
st
i
t
i
s(
i
nf
l
ammat
i
onoft
hegal
l
bl
adder
)
.
Thegal
l
st
onescan
obst
r
uctt
hegal
l
bl
adder
,
l
eadi
ngt
oani
nadequat
econcent
r
at
i
onofbi
l
e
sal
t
si
nt
hei
nt
est
i
ne.Whi
choft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
best
he
bi
l
esal
t
s?
a)Squal
eneandLanost
er
ol
ar
eexampl
esofpr
i
mar
ybi
l
esal
t
s
b)Bi
l
esal
t
sar
er
equi
r
edf
ort
r
anspor
t
at
i
onofl
i
pi
dsf
r
om i
nt
est
i
net
ol
i
v
er
c)95%oft
hebi
l
esal
t
sar
eex
cr
et
edi
nt
hef
ecesperday
d)Theyar
er
equi
r
edf
ordi
gest
i
onandabsor
pt
i
onofl
i
pi
ds
e)Bi
l
esal
t
sar
esy
nt
hesi
zedf
r
om gl
y
ci
neandt
aur
i
ne
16)Whi
choft
hef
ol
l
owi
ngapopr
ot
ei
nsi
sanact
i
v
at
orofLCAT?
a)ApoA
b)ApoB
c)ApoCI
I
d)ApoA-I
e)ApoE
17)I
nAbet
al
i
popr
ot
ei
nemi
a(
ar
ar
edi
sease)
,
l
i
popr
ot
ei
nscont
ai
ni
ngapoB
ar
enotf
or
medandl
i
pi
ddr
opl
et
saccumul
at
ei
nt
hei
nt
est
i
neandl
i
v
er
.
Whi
choft
hef
ol
l
owi
ngl
i
popr
ot
ei
nsdoesnotcont
ai
nApoBpr
ot
ei
n?
a)LDL
b)I
DL
c)HDL
d)Chy
l
omi
cr
ons
e)Lp(
a)
18)Whi
choft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
beschol
est
er
ol
est
er
t
r
ansf
erpr
ot
ei
n(
CETP)
?
a)I
tconv
er
t
schol
est
er
ol
f
r
om LDLt
ochol
est
er
ol
est
er
s
b)I
ti
st
hemaj
orpr
ot
ei
nofChy
l
omi
cr
ons
c)I
texchangeschol
est
er
ol
est
er
sf
r
om HDLf
orot
herl
i
pi
ds
d)I
tact
sasal
i
gandf
orLDLr
ecept
or
s
e)I
tt
r
ansf
er
schol
est
er
y
l
est
er
sf
r
om per
i
pher
al
t
i
ssuest
oHDL
19)Ani
nf
anti
sbor
npr
emat
ur
el
yat28weeksandhasdev
el
oped
i
ncr
easi
ngdi
f
f
i
cul
t
yi
nbr
eat
hi
ng.Hi
sski
nst
ar
t
st
ot
ur
nbl
uef
r
om l
ackof
oxy
gen(
cy
anosi
s)
.
Hei
sdi
agnosedwi
t
hRespi
r
at
or
ydi
st
r
esssy
ndr
omedue
t
odef
i
ci
encyofl
ungsur
f
act
ant.Whi
choft
hef
ol
l
owi
ngi
st
hephosphol
i
pi
d
ofpr
i
mar
yi
mpor
t
ancei
nsur
f
act
ant
?
a)Di
pal
mi
t
oy
l
phosphat
i
dy
l
chol
i
ne
b)Di
pal
mi
t
oy
l
phosphat
i
dy
l
et
hanol
ami
ne
c)Di
pal
mi
t
oy
l
phosphogl
y
cer
i
de
d)Di
pal
mi
t
oy
l
phosphat
i
dy
l
I
nosi
t
ol
e)Di
pal
mi
t
oy
l
phosphat
i
dy
l
ser
i
ne
20)Amal
ei
nf
anti
sbor
nwi
t
hambi
guousgeni
t
al
i
a(
f
r
om l
ackofandr
ogens
suchast
est
ost
er
one)andsev
er
al
sal
twast
i
ng(
duet
ol
ackofal
dost
er
one)
.
Hei
sdi
agnosedwi
t
h3-hy
dr
oxy
l
asedef
i
ci
ency
.Test
ost
er
onei
spr
oduced
f
r
om whi
choft
hef
ol
l
owi
ngcompounds?
a)Ar
achi
doni
caci
d
b)Li
nol
eni
caci
d
c)Gl
ucose
d)Chol
est
er
ol
e)Acet
y
l
coA
21)A20-y
ear
ol
dwomanhasamy
ocar
di
al
i
nf
ar
ctandi
sgi
v
enanAspi
r
i
n
t
ochew.Taki
ngaspi
r
i
nhasbeenshownt
obecar
di
opr
ot
ect
i
v
ei
n
my
ocar
di
al
i
nf
ar
ct
i
on.Aspi
r
i
ni
sanonst
er
oi
dal
ant
i
i
nf
l
ammat
or
ydr
ugt
hat
i
nhi
bi
t
scy
cl
ooxy
genaseenzy
me(
COX)
.Cy
cl
ooxy
genasei
sr
equi
r
edf
or
t
hepr
oduct
i
onofwhi
choft
hese?
a)
Thr
omboxanef
r
om Ar
achi
doni
caci
d
b)Leukot
r
i
enesf
r
om Ar
achi
doni
caci
d
c)Ar
achi
doni
caci
df
r
om Li
nol
ei
caci
d
d)Rel
easeofAr
achi
doni
caci
df
r
om membr
anePhosphol
i
pi
ds
e)Hy
dr
oper
oxyei
cosat
et
r
aenoi
caci
d(
HPETEs)f
r
om Ar
achi
doni
caci
d!
Keyt
oanswer
s
1)–b
2)–e
3)–e
4)–b
5)–e
6)–c
7)c
8)–d
9)–a
10)–c
11)–d
12)–c
13)–a
14)–e
15)–d
16)–d
17)–c
18)–c
19)–a
20)–d
21)–a
1)
-Chol
est
er
ol
i
sapr
ecur
sorofal
l
oft
hef
ol
l
owi
ngsexcept
-
a)Taur
ochol
at
e
b)Gl
y
cochol
at
e
c)Cal
ci
t
r
i
ol
d)Cor
t
i
cost
er
oi
ds
e)Cal
ci
t
oni
n.
ANSWER.
.E
2)
-Al
l
t
he27car
bonat
omsofchol
est
er
ol
ar
eder
i
v
edf
r
om-
a)Acet
y
l
coA
b)Acet
oacet
y
l
coA
c)Pr
opi
ony
l
coA
d)Succi
ny
l
coA
e)Mal
ony
l
coA
ANSWER.
.B
3)
-Cy
t
osol
i
c3hy
dr
oxy
3met
hy
l
gl
ut
ar
y
l
CoA(
HMGCoA)i
sr
educedt
o
Mev
al
onat
ef
ort
hesy
nt
hesi
sofchol
est
er
ol
,
t
heenzy
mecat
al
y
zi
ngt
hi
s
i
r
r
ev
er
si
bl
est
epi
s-
a)Thi
ol
ase
b)Thi
oest
er
ase
c)Thi
ophor
ase
d)HMGCoAsy
nt
hase
e)HMGCoAr
educt
ase.
ANSWER.
.E
4)
-Whi
choutoft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
besaboutACAT(
Acy
l
coAchol
est
er
ol
acy
l
t
r
ansf
er
ase)?
a)Requi
r
edf
orr
ev
er
sechol
est
er
ol
t
r
anspor
t
b)Rat
el
i
mi
t
i
ngenzy
mef
orbi
l
eaci
dsy
nt
hesi
s
c)Requi
r
esmonounsat
ur
at
edf
at
t
yaci
df
orest
er
i
f
i
cat
i
onofchol
est
er
ol
d)Requi
r
edf
ordegr
adat
i
onofchy
l
omi
cr
onsandVLDL
e)I
ti
samaj
orcomponentofHDL.
ANSWER.
.C
5)
-Whi
choutoft
hef
ol
l
owi
ngst
at
ement
si
si
ncor
r
ectaboutbi
l
esal
t
s?
a)Maj
orconst
i
t
uentofbi
l
e
b)Sol
ubi
l
i
z
edi
et
ar
yl
i
pi
ds
c)Maj
orbr
eakdownpr
oduct
sofchol
est
er
ol
d)Taur
ochol
at
ei
st
hemaj
orbi
l
esal
t
.
e)Bi
l
esal
t
sar
ehi
ghl
yef
f
ect
i
v
edet
er
gent
s
ANSWER.
.D
6)–Adef
i
ci
encyofapopr
ot
ei
nCl
l
r
esul
t
si
nt
hedi
sease
hy
per
l
i
popr
ot
ei
nemi
at
y
peI
,
i
nwhi
cht
her
ei
sasi
gni
f
i
canti
ncr
easei
nt
he
concent
r
at
i
onofpl
asmat
r
i
acy
l
gl
y
cer
ol
.Whi
choft
hef
ol
l
owi
ngi
st
r
ue
aboutt
hecondi
t
i
on?
a)VLDLandHDLi
ncr
ease
b)Pl
asmaappear
smi
l
ky
c)Ther
ei
sar
i
skf
orpr
emat
ur
eI
HD
d)Ser
um t
ot
al
chol
est
er
ol
i
ncr
eases
e)ApoCI
Iact
sasanact
i
v
at
orofLCATenzy
me.
ANSWER.
.B
7)
-Whi
choft
hef
ol
l
owi
ngl
i
pi
dl
ower
i
ngdr
ugsactbyi
nhi
bi
t
i
ngt
he
absor
pt
i
onofdi
et
ar
ychol
est
er
ol
?
a)St
at
i
ns
b)Ezet
i
mi
be
c)Col
est
i
pol
d)Cl
of
i
br
at
e
e)Chol
est
y
r
ami
ne
ANSWER.
.B
8)
-I
nf
ami
l
i
al
hy
per
chol
est
er
ol
emi
a,
chol
est
er
ol
i
sdeposi
t
edi
nv
ar
i
ous
t
i
ssuesbecauseoft
hehi
ghconcent
r
at
i
onofLDLchol
est
er
ol
i
nt
hepl
asma.
Ofpar
t
i
cul
arconcer
ni
st
heoxi
dat
i
onoft
heexcessbl
oodLDLt
of
or
m
oxi
di
zedLDL(
oxLDL)
.TheoxLDLi
st
akenupbyi
mmunesy
st
em cel
l
s
cal
l
edmacr
ophages,
whi
chbecomeengor
gedt
of
or
mf
oam cel
l
s.Whi
ch
st
at
ementbestdescr
i
best
hef
or
mat
i
onoff
oam cel
l
s?
a)LDLr
ecept
or
sonper
i
pher
al
cel
l
sar
eupr
egul
at
ed
b)LDLr
ecept
or
sf
ormodi
f
i
edLDL(
OxLDL)ar
enotdownr
egul
at
ed
c)LDLent
er
sbypi
nocy
t
osi
st
of
or
mf
oam cel
l
s
d)Ther
ei
si
ncr
easeddenosy
nt
hesi
sofchol
est
er
ol
e)Chol
est
er
ol
i
snotext
r
act
edf
r
om macr
ophagesbyHDL
ANSWER.
.B
9)
-Apat
i
entpr
esent
swi
t
hv
er
yhi
ghl
ev
el
sofser
um chol
est
er
ol
.Af
t
era
ser
i
esoft
est
s,
i
ti
sconcl
udedt
hatt
hepat
i
enthashi
ghci
r
cul
at
i
ngl
ev
el
sof
LDLchol
est
er
ol
,
buthasnor
mal
l
ev
el
soft
hel
i
v
erLDLr
ecept
or
.One
possi
bl
eexpl
anat
i
onf
ort
hi
sobser
v
at
i
oni
swhi
choft
hef
ol
l
owi
ng?
a)Thepat
i
enthasamut
at
edf
or
m ofapopr
ot
ei
nB100.
b)Thei
nabi
l
i
t
yt
osel
ect
i
v
el
yr
emov
echol
est
er
ol
f
r
om t
heLDLcompl
ex
.
c)Theabsenceoft
heenzy
mel
i
popr
ot
ei
nl
i
pase.
d)Decr
easedl
ev
el
sofacy
l
CoA:
chol
est
er
ol
acy
l
t
r
ansf
er
ase.
e)Al
t
er
edphosphor
y
l
at
i
onoft
heLDLr
ecept
or
.
ANSWER.
.A
10)
-Apat
i
entpr
esent
si
ny
ourof
f
i
cewi
t
hv
er
yhi
ghl
ev
el
sofser
um
chol
est
er
ol
.Hest
at
est
hathehast
r
i
edt
of
ol
l
owt
hedi
etandexer
ci
se
r
egi
meny
ougav
ehi
ml
asty
ear
.Youdeci
det
hatt
hi
spat
i
entwoul
dbenef
i
t
f
r
om adr
ugsuchasLi
pi
t
or(
at
or
v
ast
at
i
n)
.Thi
scl
assofdr
ugsi
sef
f
ect
i
v
e
i
nt
r
eat
i
nghy
per
chol
est
er
ol
emi
abecausei
thaswhatef
f
ect
?
a)St
i
mul
at
esphosphor
y
l
at
i
onoft
he hy
dr
oxy
-met
hy
l
gl
ut
ar
y
l
-CoA
r
educt
aseenzy
me
b)Decr
easest
hest
abi
l
i
t
yoft
he hy
dr
oxy
-met
hy
l
gl
ut
ar
y
l
CoAr
educt
ase
pr
ot
ei
n
c)Bi
ndschol
est
er
ol
pr
ev
ent
i
ngi
tf
r
om bei
ngabsor
bedbyt
hei
nt
est
i
ne
d)Di
r
ect
l
ypr
ev
ent
st
hedeposi
t
i
onofchol
est
er
ol
onar
t
er
ywal
l
s
e)I
nhi
bi
t
st
heenzy
me hy
dr
oxy
-met
hy
l
gl
ut
ar
y
l
CoAr
educt
ase.
ANSWER.
.E
11)
-Fr
eechol
est
er
ol
canaf
f
ectchol
est
er
ol
met
abol
i
sm i
nt
hebodyby
i
nhi
bi
t
i
ngchol
est
er
ol
bi
osy
nt
hesi
s.Thest
epatwhi
chf
r
eechol
est
er
ol
i
nhi
bi
t
si
t
sbi
osy
nt
hesi
si
sbyi
nhi
bi
t
i
ngwhi
choft
hef
ol
l
owi
ngpr
ocesses?
a)Cy
cl
i
zi
ngofsqual
enet
of
or
ml
anost
er
ol
b)Reduct
i
onof7dehy
dr
ochol
est
er
ol
t
of
or
m chol
est
er
ol
c)For
mat
i
onofmev
al
onat
ef
r
om hy
dr
oxy
met
hy
l
gl
ut
ar
y
l
CoA
d)Ki
naset
hatphosphor
y
l
at
eshy
dr
oxy
met
hy
l
gl
ut
ar
y
l
CoAr
educt
ase
e)Condensat
i
onofacet
y
l
CoAandacet
oacet
y
l
CoAt
of
or
m hy
dr
oxy
met
hy
l
gl
ut
ar
y
l
CoA
ANSWER.
.C
12)
-Apat
i
entwi
t
hher
edi
t
ar
yt
y
peIhy
per
l
i
pi
demi
apr
esent
swi
t
hel
ev
at
ed
l
ev
el
sofchy
l
omi
cr
onsandVLDLt
r
i
gl
y
cer
i
desi
nt
hebl
ood.Themai
n
f
unct
i
onoft
hechy
l
omi
cr
onsi
nci
r
cul
at
i
oni
st
odowhi
choft
hef
ol
l
owi
ng?
a)Tr
anspor
tl
i
pi
dsf
r
om t
hel
i
v
er
b)Tr
anspor
tdi
et
ar
yl
i
pi
dsf
r
om t
hei
nt
est
i
net
ot
ar
gett
i
ssues
c)Tr
anspor
tchol
est
er
ol
f
r
om I
DLt
oLDL
d)Actasar
ecept
orf
ort
r
i
acy
l
gl
y
cer
ol
si
nt
hel
i
v
er
e)Bi
ndchol
est
er
ol
est
er
sexcl
usi
v
el
y
ANSWER.
.B
13)
-Themodi
f
i
cat
i
ont
obi
l
esal
t
st
hati
ncr
easest
hewor
ki
ngpHr
angeand
amphi
pat
hi
cnat
ur
eofbi
l
esal
t
si
s
a)7 Hy
dr
oxy
l
at
i
on
b)Dehy
dr
oxy
l
at
i
onbyi
nt
est
i
nal
bact
er
i
a
c)Est
er
i
f
i
cat
i
on
d)Conj
ugat
i
ont
ot
aur
i
neorgl
y
ci
ne
e)For
mat
i
onofsal
t
swi
t
hsodi
um andPot
assi
um.
ANSWER.
.D
14)
-A53y
ear
ol
dmal
epat
i
entwi
t
hel
ev
at
edl
ev
el
sofl
owdensi
t
y
l
i
popr
ot
ei
n(
LDL)chol
est
er
ol
,
si
gnsofpr
emat
ur
echol
est
er
ol
gal
l
st
one
di
seaseandsubst
ant
i
al
l
yel
ev
at
edt
r
i
gl
y
cer
i
desv
i
si
t
edhi
sphy
si
ci
anf
ora
f
ol
l
owupt
ocheckhi
scur
r
entst
at
us.Thepat
i
enthadr
ecei
v
edv
ar
i
ous
st
at
i
n,
HMGCoAr
educt
asei
nhi
bi
t
or
st
her
api
esf
ort
hepast2y
ear
s.
Howev
er
,
af
t
erbl
oodwor
kdoneatt
hi
sf
ol
l
owupv
i
si
t
,
compl
i
cat
i
onshad
st
i
l
l
notsubsi
ded.Thi
spat
i
enthassi
mi
l
arpr
obl
emsast
woofhi
ssi
bl
i
ngs.
Whi
choft
hef
ol
l
owi
ngbestexpl
ai
nst
hi
spat
i
ent
sdy
sl
i
pi
demi
a?
a)Ani
nf
l
uxofabnor
mal
phosphol
i
pi
dsi
nt
hegal
l
bl
adderasar
esul
tofi
l
eal
di
sease
b)Al
ossofHMGCoAr
educt
asef
unct
i
on
c)Al
ossofCYP7A1(
chol
est
er
ol
7-hy
dr
oxy
l
ase)f
unct
i
on
d)El
ev
at
edl
ev
el
sofACAT
e)LessnumberofLDLr
ecept
or
s
ANSWER.
.C
15)
-Apat
i
enthasbeenoncombi
nat
i
onst
at
i
nandChol
est
y
r
ami
net
her
apy
t
ol
owerhi
sser
um chol
est
er
ol
l
ev
el
s.Pr
i
ort
oanysur
ger
y
,
t
hi
spat
i
ent
woul
dbewel
l
adv
i
sedt
obesuppl
ement
edwi
t
hwhi
choft
hef
ol
l
owi
ng?
a)Vi
t
ami
nA
b)Vi
t
ami
nB12
c)Vi
t
ami
nC
d)Vi
t
ami
nK
e)Li
nol
eni
caci
d.
ANSWER.
.D
17)
-A18y
ear
ol
dmal
ewi
t
hsi
ckl
ecel
l
anemi
adev
el
opssev
er
er
i
ghtupper
abdomi
nal
pai
nr
adi
at
i
ngt
ohi
sl
owerr
i
ghtchestandhi
sr
i
ghtf
l
ank36
hour
spr
i
ort
oadmi
ssi
ont
ot
heER.Heal
sor
epor
t
st
hathi
sur
i
nei
st
he
col
orofi
cedt
eaandhi
sst
ool
nowhasal
i
ghtcl
aycol
or
.Onexami
nat
i
on,
hi
st
emper
at
ur
ei
ssl
i
ght
l
yel
ev
at
ed,
andhear
tr
at
ei
sr
api
d.Hei
sexqui
si
t
el
y
t
endert
opr
essur
eov
erhi
sr
i
ghtupperabdomen.Thescl
er
aeofhi
sey
es
ar
esl
i
ght
l
yy
el
l
owi
shi
ncol
or
.
Whati
st
hemostl
i
kel
ycauseoft
hi
spat
i
ent
’
ssy
mpt
oms?
a)Achol
est
er
ol
r
i
chgal
l
st
one
b)Adef
ecti
nt
hesy
nt
hesi
sofbi
l
eaci
ds
c)Adef
ecti
nhemesy
nt
hesi
s
d)Agal
l
st
oner
i
chi
ncal
ci
um bi
l
i
r
ubi
nat
e
e)Asi
ckl
ecel
l
cr
i
si
sbr
oughtonbyov
er
exer
t
i
on
ANSWER.
.D
18)Whi
choft
hef
ol
l
owi
ngcompoundsdi
r
ect
l
yi
nhi
bi
t
st
heexpr
essi
onof
t
heHMGCoAr
educt
asegene?
a)Squal
ene
b)HMGCoA
c)Lanost
er
ol
d)I
sopent
eny
l
py
r
ophosphat
e
e)Chol
est
er
ol
ANSWER.
.
.E
19)Whi
choft
hef
ol
l
owi
ngv
i
t
ami
nscanbeusedi
nhi
ghdosest
ot
r
eat
hy
per
chol
est
er
ol
emi
a?
a)Ni
aci
n
b)Ri
bof
l
av
i
n
c)Py
r
i
doxi
ne
d)Fol
i
caci
d
e)Thi
ami
ne.
ANSWER.
.A
20)At
eenageboypr
esent
swi
t
hmoder
at
et
osev
er
eepi
gast
r
i
cpai
n.
Phy
si
cal
exami
nat
i
onr
ev
eal
sext
ensi
v
eer
upt
i
v
exant
homasand
hepat
ospl
enomegal
y
.Abl
oodsampl
er
ev
eal
smi
l
kypl
asma.Whi
choft
he
f
ol
l
owi
ngi
st
hemostl
i
kel
yl
i
popr
ot
ei
nt
obeel
ev
at
edi
nt
hi
spat
i
ent‘
s
pl
asma?
a)Chy
l
omi
cr
ons
b)Chy
l
omi
cr
onr
emnant
s
c)HDL
d)I
DL
e)LDL
ANSWER.
.
.A
21)–A25y
ear
ol
df
emal
ewasr
ef
er
r
edt
oal
i
pi
dr
esear
chcent
erf
or
i
nv
est
i
gat
i
onofmoder
at
ehy
per
t
r
i
gl
y
cer
i
demi
abecauset
hepl
asmal
i
pi
d
andl
i
popr
ot
ei
npr
of
i
l
esshowedabnor
mal
i
t
i
es.Bot
hHDLandLDLwer
e
mor
ebuoy
antandshowedel
ev
at
i
onsi
nTGcont
entwi
t
ht
hemassofTG
appr
oxi
mat
el
yt
hesameast
hatofchol
est
er
ol
.Adef
i
ci
encyi
nwhi
choft
he
f
ol
l
owi
ngi
st
hemostl
i
kel
ycauseoft
hi
spat
i
ent
’
sl
i
pi
dabnor
mal
i
t
y
?
a)Leci
t
hi
nchol
est
er
ol
acy
l
t
r
ansf
er
ase(
LCAT)
b)Li
popr
ot
ei
nl
i
pase
c)Apopr
ot
ei
nCI
I
d)Hepat
i
cl
i
pase
e)Apopr
ot
ei
nB100
ANSWER.
.
.D
22)
-Labor
at
or
yr
esul
t
sf
orapat
i
entwi
t
huncont
r
ol
l
edTy
peIdi
abet
es
mel
l
i
t
usr
ev
eal
hy
per
gl
y
cemi
a(
634mg/
dL)andhy
per
t
r
i
gl
y
cer
i
demi
a(
498
mg/
dL)
.Themostl
i
kel
ycauseoft
hehy
per
t
r
i
gl
y
cer
i
demi
ai
nt
hi
spat
i
enti
s
whi
choft
hef
ol
l
owi
ng?
a)Def
i
ci
encyi
napopr
ot
ei
nCI
I
b)I
ncr
easedhepat
i
ct
r
i
gl
y
cer
i
desy
nt
hesi
s
c)Decr
easedl
i
popr
ot
ei
nl
i
paseact
i
v
i
t
y
d)Def
i
ci
encyi
nLDLr
ecept
or
s
e)Absenceofhor
monesensi
t
i
v
el
i
pase
Answer
.
.
.C
Q.
1–Agal
l
st
onet
hatbl
ockedt
heupperpar
toft
hebi
l
eductwoul
dcause
i
ncr
easei
nwhi
choft
hef
ol
l
owi
ngs?
a)Theexcr
et
i
onoff
at
si
nt
hef
eces
b)For
mat
i
onofchy
l
omi
cr
ons
c)Excr
et
i
onofbi
l
esal
t
s
d)Conj
ugat
i
onofbi
l
eaci
ds
e)Recy
cl
i
ngofbi
l
esal
t
s
Q.
2-An8y
ear
ol
dboypr
esent
swi
t
hor
angecol
or
edt
onsi
l
s,
av
er
yl
owHDL
l
ev
el
sandanenl
ar
gedl
i
v
erandspl
een.Hei
sdi
agnosedwi
t
hTangi
er
di
sease.Tangi
erdi
seasei
sadi
seaseofchol
est
er
ol
t
r
anspor
t
,
sucht
hat
chol
est
er
olcannotpr
oper
l
yexi
tt
hecel
l
andf
or
m HDL.Whi
choft
he
f
ol
l
owi
ngst
at
ement
sbestdescr
i
besHDL?
a)I
ti
spr
oducedi
nskel
et
al
muscl
es
b)I
tscav
engeschol
est
er
ol
f
r
om cel
lmembr
anes
c)I
t
smaj
orpr
ot
ei
ni
sapoE
d)I
ti
sf
or
medwhenVLDLi
sact
eduponbyl
i
popr
ot
ei
nl
i
pase
e)I
tact
i
v
at
esACAT
Q3-I
ncont
r
astt
osecondar
ybi
l
esal
t
s,
whi
choft
hef
ol
l
owi
ngi
snota
char
act
er
i
st
i
cofpr
i
mar
ybi
l
esal
t
s
a)Ar
ehy
dr
oxy
l
at
edatposi
t
i
on17
b)Hav
eanoxi
di
zedsi
dechai
n
c)Canbeconj
ugat
edt
oTaur
i
neandgl
y
ci
ne
d)Ar
er
eabsor
bedi
nt
hei
nt
est
i
ne
e)For
medf
r
om chol
y
l
coA.
Q.
4I
nt
heconv
er
si
onofchol
est
er
ol
t
obi
l
esal
t
s,
whi
choft
hef
ol
l
owi
ng
st
at
ement
sbestdescr
i
best
hepr
ocess?
a)Car
bon8i
shy
dr
oxy
l
at
ed
b)Thesi
dechai
ncanbeconj
ugat
edwi
t
hgl
y
ci
neorTaur
i
ne
c)Thedoubl
ebondi
soxi
di
zed
d)Thehy
dr
oxy
l
gr
oupat3car
bonr
emai
nsi
nt
hebet
aposi
t
i
on
e)I
toccur
si
nt
hebi
l
educt
.
Q.
5-Whi
choft
hef
ol
l
owi
ngst
at
ement
sbestdescr
i
besl
owdensi
t
y
l
i
popr
ot
ei
n(
LDL)?
a)I
thast
hemostTr
i
acy
l
gl
y
cer
ol
andt
hel
eastpr
ot
ei
n
b)I
thasmor
eTr
i
acy
l
gl
y
cer
ol
t
hanv
er
yl
owdensi
t
yl
i
popr
ot
ei
n(
VLDL)
c)I
thast
hel
owestTr
i
acy
l
gl
y
cer
ol
cont
ent
d)I
thast
hehi
ghestpr
ot
ei
ncont
ent
e)I
thast
hehi
ghestchol
est
er
ol
cont
ent
.
Q.
6-Whi
choft
hef
ol
l
owi
ngapopr
ot
ei
nsi
sanact
i
v
at
orofl
i
popr
ot
ei
nl
i
pase?
a)ApoA
b)ApoB
c)ApoCI
I
d)ApoD
e)ApoE
Q.
7-Whi
choft
hef
ol
l
owi
ngl
i
popr
ot
ei
nsar
et
hemaj
orcar
r
i
er
sofTr
i
acy
l
gl
y
cer
ol
?
a)I
DLandLDL
b)VLDLandLDL
c)Chy
l
omi
cr
onsandVLDL
d)HDLandVLDL
e)Chy
l
omi
cr
onsandHDL.
Q.
8-A60y
ear
ol
dwomanpr
esent
swi
t
hchestpai
nr
adi
at
i
ngt
oherl
ef
t
ar
m.Shei
sdi
agnosedwi
t
hMy
ocar
di
al
i
nf
ar
ct
i
onandi
spr
escr
i
bedast
at
i
n
medi
cat
i
on.St
at
i
nsi
nhi
bi
tHMGCoAr
educt
ase.Howdoesi
nhi
bi
t
i
onof
HMGCoAr
educt
asecausel
ower
i
ngofchol
est
er
ol
andLDLl
ev
el
s?
a)I
ti
ncr
easeser
um l
ev
el
ofHDL
b)I
tdecr
easesser
um l
ev
el
ofLDLbypr
omot
i
ngcat
abol
i
sm
c)I
ti
nhi
bi
t
st
hef
or
mat
i
onofLDLf
r
om I
DL
d)I
ti
nhi
bi
t
st
her
at
el
i
mi
t
i
ngst
epi
nchol
est
er
ol
bi
osy
nt
hesi
s
e)I
ti
nhi
bi
t
ssy
nt
hesi
sofLDLr
ecept
or
s.
Q.
9)A35y
ear
ol
dwomanpr
esent
swi
t
hcr
ushi
ngsubst
er
nal
chestpai
n
andshor
t
nessofbr
eat
h.Acor
onar
yar
t
er
yi
soccl
udedduet
oan
at
her
oscl
er
ot
i
cpl
aque,
andshei
sdi
agnosedwi
t
hhav
i
ngmy
ocar
di
al
i
nf
ar
ct
i
on.Herser
um chol
est
er
ol
l
ev
el
i
s700mg/
dl
.Thef
ami
l
yhi
st
or
yi
s
posi
t
i
v
ef
orhi
ghchol
est
er
ol
l
ev
el
andsheseemst
obehav
i
ngf
ami
l
i
al
hy
per
chol
est
er
ol
emi
a.Whati
st
hepossi
bl
ebi
ochemi
cal
def
ecti
nt
hi
s
genet
i
cdi
sor
der?
a)Hi
ghact
i
v
i
t
yofHMGCoAr
educt
ase
b)Lowact
i
v
i
t
yof7-hy
dr
oxy
l
ase
c)Abnor
mal
LDLr
ecept
or
s
d)Mor
econv
er
si
onofVLDLt
oLDL
e)Lessconcent
r
at
i
onofHDL.
Q.
10)
-A40-y
ear
ol
dmanpr
esent
swi
t
hsev
er
epai
ni
nt
hel
egsupon
wal
ki
ng.Hei
sdi
agnosedwi
t
hat
her
oscl
er
ot
i
cpl
aquesi
nt
hear
t
er
i
esofhi
s
l
egs.Hi
ghl
ev
el
ofchol
est
er
ol
andLDLcont
r
i
but
et
ot
hef
or
mat
i
onof
at
her
oscl
er
osi
s.Whi
choft
hef
ol
l
owi
ngi
sdi
gest
edt
of
or
m LDL?
a)I
DL
b)Chy
l
omi
cr
ons
c)HDL
d)Chol
est
er
y
l
est
er
s
e)Chol
est
er
ol
.
Q.
11-A23y
ear
ol
df
emal
epr
esent
swi
t
hl
owr
edbl
oodcel
l
count
,
cor
neal
opaci
t
i
esandki
dneyi
nsuf
f
i
ci
ency
.Shei
sdi
agnosedwi
t
hl
eci
t
hi
n:
chol
est
er
ol
acy
l
t
r
ansf
er
ase(
LCAT)def
i
ci
ency
.I
nwhi
choft
hef
ol
l
owi
ng
r
eact
i
onsLCATi
si
nv
ol
v
ed?
a)Tr
ansf
erofchol
est
er
ol
est
er
sf
r
om HDLt
oVLDL
b)Hy
dr
ol
y
si
sofHDL
c)Upt
akeofchol
est
er
ol
f
r
om l
i
v
ercel
l
s
d)Conv
er
t
i
ngchol
est
er
ol
t
oChol
est
er
y
l
est
er
s
e)Pr
omot
i
ngupt
akeofHDLi
nt
ol
i
v
ercel
l
s
Q.
12-Whi
choft
hef
ol
l
owi
ngsi
snotahy
pol
i
pi
demi
cdr
ug?
a)St
at
i
n
b)Ni
aci
n
c)Fol
i
caci
d
d)Cl
of
i
br
at
e
e)Ezet
i
mi
be.
Q.
13-Thesy
nt
hesi
sofHMGCoAcant
akepl
ace-
a)onl
yi
nmi
t
ochondr
i
a
b)Onl
yi
ncy
t
opl
asm ofal
lnucl
eat
edmammal
i
ancel
l
s
c)I
nt
heendopl
asmi
cr
et
i
cul
um ofal
l
mammal
i
ancel
l
s
d)I
nt
hel
y
sosomes
e)I
nbot
hcy
t
osol
andmi
t
ochondr
i
a.
Q.
14-Whi
choft
hef
ol
l
owi
ngbestdescr
i
best
her
ol
eofchol
est
er
ol
est
er
t
r
ansf
erpr
ot
ei
n(
CETP)?
a)I
tconv
er
t
schol
est
er
ol
f
r
om LDLt
ochol
est
er
ol
est
er
s
b)I
ti
st
hemaj
orpr
ot
ei
nofHDL
c)I
texchangeschol
est
er
ol
est
er
sf
r
om HDLt
oot
herl
i
popr
ot
ei
ns
d)I
tact
sasal
i
gandf
orhepat
i
cr
ecept
or
sofHDL
e)I
ti
sanact
i
v
at
orofLCAT.
Q.
15-Whi
choft
hef
ol
l
owi
ngsar
enotl
i
pot
r
opi
cagent
s?
a)Essent
i
alami
noaci
ds
b)Essent
i
al
f
at
t
yaci
ds
c)Vi
t
ami
nA,
CandE
d)Bi
ot
i
nandPant
ot
heni
caci
d
e)Sy
nt
het
i
cant
i
oxi
dant
s
Keyt
oAnswer
s-
1)
-a, 2)
b, 3)
a,
10)
a, 11)
d, 12)
c
13)
b, 14)
c, 15)
d.
4)
b, 5)
e, 6)
c,
7)
c,
8)
d, 9)
c,