Medical faculty
2- d course
Module 3
Metabolism of carbohydrates, lipids, amino acids and its regulation
1. Biochemical blood analysis of a 32 year old patient, who starved for 3 days, showed that the glucose
level in blood is normal. What process provides the normal glucose level in the blood after 3-4 days of
starvation?
A. Gluconeogenesis
B. Glycolysis
C. Pentose-phosphate pathway
D. Krebs cycle
E. Glycogen synthesis
ANSWER: A
2. A woman of 58 years is in hard condition. Consciousness is blear, skin is dry, eyes are sunken,
cyanosis, the smell of aceton with breathing. Blood glucose - 15,1 mmol/l, urine glucose 3,5%. What is
the most real reason for such condition?
A. Hypoglycemic coma
B. Uremic coma
C. Hypovolemic coma
D. Anaphylactic shock
E. Hyperglycemic coma
ANSWER: E
3. The acids which are irreplaceable (essential) for human organism:
A. Lipoic acid, stearic acid, palmitic acid
B. Oleic acid, linoleic acid, linolenic acid
C. Palmitic acid, stearic acid, arachidonic acid
D. Arachidonic acid, linolenic acid, linoleic acid
E. Butyric acid, oleic acid, linolenic acid
ANSWER: D
4. Which of the below-mentioned metabolites is formed by oxidation of fatty acids with odd amount of
carbon atoms:
A. Propionyl-CoA
B. Butyryl-CoA
C. Malonyl-CoA
D. Enoil-CoA
E. Acetacetyl-CoA
ANSWER: A
5. The hormone, which depresses the lipolysis in the fat tissue:
A. Insulin
B. Epinephrine
C. Glucagon
D. Thyroxin
E. Adrenocorticotropin
ANSWER: A
6. Phospholipids in the organism perform such functions, except:
A. Are a part of cellular membranes
B. Own atherosclerotic properties
C. Own antiatherosclerotic activity
D. Are lipotropic factors
E. Participate in the formation of blood lipoproteins
ANSWER: B
7. The first stage of acyl-CoA dehydrogenating in mitochondria causes the formation of:
A. Alpha-keto-acyl-CoA
B. Acetyl-CoA
C. Beta-oxyacyl-CoA
D. Enoil-CoA
E. Acylcarnitine
ANSWER: D
8. Energetic functions in the organism play the following lipids, except:
A. Tryacylglycerol
B. Saturated fatty acids
C. Diacylglycerol
D. Monounsaturated fatty acids
E. Cholesterol
ANSWER: E
9. Glycerol is transformed into an active form by the enzyme:
A. Pphosphatidate phosphatase
B. Glycerol kinase
C. Glycerol phosphate dehydrogenase
D. Glycerol phosphate acyltransferase
E. Diglyceride-acyl-transferase
ANSWER: B
10. Where the resynthesis of lipids takes place?
A. In a liver
B. In kidneys
C. In muscles
D. In the intestinal epithelium
E. In the spleen
ANSWER: D
11. In oxidation of fatty acids with odd number of carbon atoms propionyl-CoA is transformed into:
A. Malonyl-CoA
B. Succinyl-CoA
C. Enoil-CoA
D. Butyryl-CoA
E. Acetacetyl-CoA
ANSWER: B
12. Lisophospholipids, formed after action of phospholipase A2, have the following feature:
A. Activate lipase
B. Hemolytic
C. Form conjugates with bile acids
D. Participate in phospholipids resynthesis
E. Accompany absorption of fatty acids
ANSWER: B
13. The bile acids in bile are in conjugated condition with:
A. Cholesterol
B. Bilirubin
C. Glycine and alanine
D. Glycine and taurine
E. Taurine and valine
ANSWER: D
14. The function of pentose-phosphate pathway in the synthesis of fatty acids and cholesterol is the
following:
A. Main energy source
B. Source of acetyl-CoA
C. Source of malonyl-CoA
D. Source of NADPH2
E. Source of NADH2
ANSWER: D
15. The products of lipids digestion are the following, except:
A. Glycerol
B. Serine
C. Phosphoric acid
D. Fatty acids
E. Methionine
ANSWER: B
16. Bile acids are metabolic products of :
A. Cholesterol
B. Phospholipids
C. Tryglycerins
D. Glycogen
E. Glycolipids
ANSWER: A
17. Hepatoenteral circulation of bile acids has such aim as:
A. Fats resynthesis
B. Formation of chylomicrons
C. Economical usage of bile acids
D. Cholesterol absorption
E. Glycerol absorption
ANSWER: C
18. In humans, a dietary essential fatty acid is
A. Palmitic acid
B. Stearic acid
C. Oleic acid
D. Linoleic acid
E. All of the above
ANSWER: D
19. In mammals, the major fat in adipose tissues is
A. Phospholipids
B. Cholesterol
C. Sphingolipids
D. Triacylglycerols
E. All of the above
ANSWER: D
20. The enzymes of beta -oxidation are found in
A. Mitochondria
B. Cytosol
C. Golgi apparatus
D. Nucleus
E. EPR
ANSWER: A
21. Long chain fatty acids penetrate the inner mitochondrial membrane
A. Freely
B. As acyl-CoA derivative
C. As carnitine derivative
D. Requiring Na dependent carrier
E. As lipoproteins
ANSWER: C
22. Which of the following is a polyunsaturated fatty acid?
A. Palmitic acid
B. Palmitoleic acid
C. Linoleic acid
D. Oleic acid
E. All of these
ANSWER: C
23. The major lipid in chylomicrons is
A. Triglycerides
B. Phospholipids
C. Cholesterol
D. Free fatty acids
E. A and B
ANSWER: A
24. Number of carbon atoms in cholesterol is
A. 17
B. 19
C. 27
D. 30
E. 25
ANSWER: C
25. Sucrase hydrolyses sucrose into:
A. Glucose and galactose;
B. Glucose and glucose;
C. Glucose and fructose;
D. Glucose and mannose.
E. None of the above.
ANSWER: C
26. The family of GluT (glucose transporters) is:
A. The proteins embedded into the cell membrane and facilitating the glucose transport across the
membrane;
B. The proteins embedded into the cell membrane and inhibiting the glucose transport across the
membrane;
C. The cytoplasmic proteins transporting glucose in the cytoplasm of cell;
D. The proteins of blood plasma transporting glucose via the blood.
E. None of the above.
ANSWER: A
27. The main hormones that regulate the synthesis and decomposition of glycogen are:
A. Insulin, glucocorticoids, thyroxin;
B. Glucagons, glucocorticoids, vasopressin;
C. Insulin, glucagons, epinephrine;
D. Glucocorticoids, glucagons, epinephrine.
E. All of the above.
ANSWER: C
28. Glycolysis is defined as:
A. Aerobic process in which glucose is transformed to CO2 and H2O;
B. Anaerobic process in which glucose is transformed to pyruvate;
C. Anaerobic process in which glucose is converted to pentoses and NADPH is produced;
D. Aerobic process in which glucose is converted to glycogen.
E. Anaerobic process in which glucose is transformed to lactate;
ANSWER: E
29. Glycolysis takes place in:
A. Mitochondria;
B. Nucleus;
C. Lysosomes;
D. Cytoplasm;
E. None of the above.
ANSWER: D
30. The possible metabolic pathways for pyruvate in anaerobic conditions are:
A. Conversion to lactate or acetyl CoA;
B. Conversion to ethanol or acetyl CoA;
C. Conversion to lactate or ethanol;
D. Conversion to lactate or ethanol or acetyl CoA.
E. All of the above.
ANSWER: C
31. How many molecules of ATP have to be spent during glycolysis?
A. 1;
B. 2;
C. 3;
D. 4.
E. 0
ANSWER: B
32. A. 1;
B. 2;
C. 3;
D. 4.
E. 0
ANSWER: B
33. Lactate is formed from pyruvate in an ____________ organism in ____________ conditions.
A. Yeast; aerobic;
B. Animal; aerobic;
C. Fungi; aerobic;
D. Animal; anaerobic.
E. Yeast; aerobic.
ANSWER: D
34. The three control sites in glycolysis are the reactions catalyzed by:
A. Hexokinase, phosphofructokinase 1 and aldolase;
B. Phosphofructokinase 1, aldolase and pyruvate kinase;
C. Hexokinase, aldolase and pyruvate kinase;
D. Hexokinase, phosphofructokinase 1 and pyruvate kinase.
E. All of the above.
ANSWER: D
35. Which of the following is not regulated in glycolysis?
A. Pyruvate kinase
B. Phosphoglycerate kinase
C. Hexokinase
D. PFK-1
E. A and D
ANSWER: B
36. The enzyme which the key regulatory step in glycogen biosynthesis is
A. Glycogen synthase
B. Glycogenin
C. Branching enzyme
D. Phosphoglucomutase
E. UDP-glucose pyrophosphorylase
ANSWER: A
37. A patient is found to be deficient in the enzymes galactose 1-phosphate uridylyltransferase.
Specifically due to this deficiency what might a doctor recommend ?
A. Avoid all strenuous exercise
B. Eat a fat-free diet
C. Increase intake of vitamin C
D. Avoid ingestion of milk and milk products
E. All of the above.
ANSWER: D
38. The enzyme that catalyzes the conversion of pyruvate to lactate is ______________.
A. Lactate reductase
B. Pyruvate kinase
C. Lactoenolpyruvate
D. Lactate dehydrogenase
E. None of the above
ANSWER: D
39. Which substance causes muscles to ache during strenuous exercise?
A. Pyruvic acid
B. Lactose dehydrogenase
C. Lactate ion
D. Lactic acid
E. None of the above
ANSWER: D
40. The pentose phosphate pathway has two primary products. They are _________.
A. ATP and NADPH
B. Oxaloacetate and acetyl CoA
C. Sorbitol and fructose
D. Ribose-5-phosphate and NADPH
E. A and d
ANSWER: D
41. An enzyme that catalyzes conversions of L-sugars to D-sugars is called an
A. Lyase
B. Hydrolase
C. Synthetase
D. Synthase
E. Isomerase
ANSWER: E
42. In the oxygen insufficiency glycolisis is used as the energy source. Select glycolisis among the below
mentioned processes.
A. Glucose to lactate oxidation
B. Glucose to CO2 and H2O oxidation
C. Pyruvate to acetyl CoA oxidation
D. Glucose to glucuronic acid oxidation
E. Glycogen to glucose oxidation
ANSWER: A
43. The preparatory stage of glycolysis ends with the formation of:
A. Fructose-1,6-diphosphate
B. Glucose-6-phosphate
C. Two trioses (dihydroxyacetone phosphate and glyceraldehydetryphosphate)
D. 2-phosphoglycerate
E. Phosphoenolpyruvate
ANSWER: C
44. Name the glycolysis reactions, flowing with the formation of ATP:
A. Hexokinase, enolase
B. Enolase, aldolase
C. Phosphoglycerate kinase, pyruvate kinase
D. Pyruvate kinase, lactate dehydrogenase
E. Hexokinase, phosphofructokinase
ANSWER: C
45. Metabolite, formed in the process of glucose phosphorylation under influence of hexokinase is:
A. Glucose-6-phosphate
B. Fructose-1-phosphate
C. Fructose-6-phosphate
D. Glucose-1,6-diphosphate
E. Fructose-1,6-diphosphate
ANSWER: A
46. Enzyme which catalyzes the first glycolysis reaction:
A. Hexokinase
B. Glucose-6-phosphatase
C. Phosphorylase
D. Glucose-6-phosphate dehydrogenase
E. Amylase
ANSWER: A
47. The products, which are formed by the decomposition of fructose-1,6-biphosphate in the glycolysis:
A. Glycerol, pyruvate
B. Dihydroxyacetone phosphate, glyceraldehyde 3-phosphate
C. Pyruvate, dihydroxyacetone phosphate
D. Lactic acid, acetyl CoA
E. Acetyl CoA, glycerin
ANSWER: B
48. Energetic value of anaerobic glycolysis:
A. 2 ATP molecules
B. 10 ATP molecules
C. ATP molecules
D. 40 ATP molecules
E. 32 ATP molecules
ANSWER: A
49. How many ATP molecules are formed with complete oxidation of glucose in aerobic condition?
A. 2
B. 8
C. 38
D. 42
E. 30
ANSWER: C
50. The process of glucose oxidation in anaerobic condition is:
A. Glycolisis
B. Glyconeogenesis
C. Glycogenolysis
D. Glycogenogenesis
E. Lipolysis
ANSWER: A
51. Enzyme that catalyzes the reaction of transformation acetaldehyde to ethanol is:
A. Pyruvate decarboxylase
B. Malate dehydrogenase
C. Lactate dehydrogenase
D. Succinate dehydrogenase
E. Alcohol dehydrogenase
ANSWER: E
52. The end produtcs of aerobic glucose oxidation:
A. Lactic acid
B. Pyruvate
C. CO2 and H2O
D. Ethanol
E. Acetaldehyde
ANSWER: B
53. The concentration of glucose in the blood is normal. Which of the below-mentioned index proves
this?
A. 3-10 mmol/l
B. 3,3-5,5 mmol/l
C. 4-8 mmol/l
D. 10-15 g/l
E. 1-2 mmol/l
ANSWER: B
54. How long at starvation in humans glycogen store in a liver may be used?
A. 10 minutes
B. 4 hours
C. 24 hours
D. 1 week
E. 2 weeks
ANSWER: C
55 What is the prosthetic group of transketolase?
A. Thiamine pyrophosphate
B. Biotin
C. Pyridoxal phosphate
D. NAD+
E. FAD
ANSWER: A
56. Pathway for synthesis of glycogen (from glucose)
A. Glycolysis
B. Gluconeogenesis
C. Glycogenesis
D. Glycogenolysis
E. Pentose phosphate pathway
ANSWER: C
57. The enzymes of glycolysis are located in the:
A. Mitochondrion
B. Nucleus
C. Cytoplasm
D. Lysosomes
E. Interstitial fluid
ANSWER: C
58. The patient with diabetes mellitus has hypoglycemic coma. The reasons for this can be:
A. Overdosage of insulin
B. Starvation
C. Dehydration of the organism
D. Hyperproduction of epinephrine
E. Addison's disease
ANSWER: A
59. How many grams of glucose is it necessary for a patient to perform a method of sugary loading
A. 1 g per 1 kg of body weight
B. 100 g
C. 20 g
D. 50 g
E. 1 mg per 1 kg of body weight
ANSWER: A
60. Which of the below-mentioned processes is the main source of NADPH2 in an organism?
A. Gluconeogenesis
B. Pentose-phosphate cycle
C. Glycolysis
D. Glycogenolysis
E. Glycogenogenesis
ANSWER: B
61. Oxidation of fatty acids occurs
A. In the cytosol
B. In the matrix of mitochondria
C. On inner mitochondrial membrane
D. On the microsomes
E. In the EPR
ANSWER: B
62. Carnitine is required for the transport of
A. Triglycerides out of liver
B. Triglycerides into mitochondria
C. Short chain fatty acids into mitochondria
D. Long chain fatty acids into mitochondria
E. C and D
ANSWER: D
63. The main function of the bile salts is to __________.
A. Emulsify lipids in the intestin
B. Act as counterions for the ionized forms of lipids
C. Cleave the ester bonds in triacylglycerols to release free fatty acids
D. Form the surface layer of chylomicrons
E. None of the above.
ANSWER: A
64. The largest lipoproteins are the __________.
A. Chylomicrons
B. VLDLs
C. LDLs
D. HDLs
E. None of the above.
ANSWER: A
65. After having fatty food the patient had nausea and steatorrhea. The cause of this condition can be:
A. Amylase insufficiency
B. Increase of lipase excretion
C. Trypsin synthesis malfunction
D. Lack of bile acids
E. Increased acidity of gastric juice
ANSWER: D
66. For the patient was prescribed bile preparation for improvement of fatty food digestion. Which
components of the preparation participate in fat emulsification?
A. Bile acid salt
B. Fatty acids
C. Cholesterol and it's esters
D. Bilirubin monoglucuronides
E. Diglycerides
ANSWER: A
67. HDL is synthesized and secreted from
A. Pancreas
B. Liver
C. Kidney
D. Muscle
E. Lung
ANSWER: B
68. Cholesterol is transported from liver to extrahepatic tissues by
A. Chylomicrons
B. VLDL
C. HDL
D. LDL
E. Carnitin
ANSWER: D
69. Elevated plasma level of the following projects against atherosclerosis:
A. Chylomicrons
B. VLDL
C. HDL
D. LDL
E. A and B
ANSWER: C
70. Beta-oxidation results in the formation of:
A. Pyruvate.
B. Acetyl-CoA.
C. Carbon monoxide.
D. Oxaloacetate.
E. None of the above
ANSWER: B
71. The normal amount of cholesterol in blood plasma is:
A. 3-7 mmol/l
B. 10-15 mmol/l
C. 20-25 mmol/l
D. 1-3 mmol/l
E. 5-7 mmol/l
ANSWER: A
72. The cyclization of squalene causes the formation of:
A. Lanosterol
B. Beta-oxy-beta-methylglutaryl-CoA
C. Phosphomevalonate
D. Acetoacetyl-CoA
E. Cholesterol
ANSWER: A
73. Cholesterol performs in the organism the following functions, but:
A. Is a part of cell membranes
B. Substratum for bile acids synthesis
C. Substratum for D vitamin synthesis
D. Is a source of energy
E. Substratum for steroid hormones synthesis
ANSWER: D
74. Obesity is accumulation of _______ in the body.
A. Water
B. NaCl
C. Fats
D. Proteins
E. Vitamins
ANSWER: C
75. One of the leading pathogenetic chains in the development of radial pathology is the intensification
of free-radical oxidation processes. What matters are the main source of free radicals formation?
A. Water
B. Lipids
C. Carbohydrates
D. Proteins
E. Metal ions
ANSWER: B
76. Analysis of patient's lipogram showed the increase of some lipoproteins level. Choose the most
atherogenic representative of lipoproteins:
A. LDL
B. HDL
C. Chylomicrons
D. VLDL
E. Albumins
ANSWER: A
77. Protein anabolism is stimulated by
A. ACTH
B. Testosterone
C. Glucagon
D. Epinephrine
E. All of these
ANSWER: B
78. The amino acids abstracted from the liver are not utilized for repair or special synthesis but are
broken down to
A. Glucose
B. Sulphur dioxide
C. Water
D. Ammonia
E. A and D
ANSWER: D
79. Amino acids provide the nitrogen for the synthesis of
A. Nitrogen bases
B. Uric acid
C. Glycolipids
D. Chondroitin sulphates
E. None of these
ANSWER: A
80. Which of the amino acid produces a vasodilator on decarboxylation?
A. Glutamin acid
B. Histidine
C. Ornithine
D. Cysteine
E. C and D
ANSWER: B
81. The milk protein in the stomach of the infants is digested by
A. Pepsin
B. Trypsin
C. Chymotrypsin
D. Rennin
E. All of the above
ANSWER: D
82. Which pathological component appears in the gastric juice in cancer of the stomach?
A. Lactic acid
B. Hydrochloric acid
C. Acetic acid
D. Sulfuric acid
E. Citric acid
ANSWER: A
83. Which enzyme activates the trypsinogen?
A. Chymotrypsin
B. Carboxypeptidase
C. Enterokinase
D. Trypsin
E. Aminopeptidase
ANSWER: C
84. Which compounds are formed during the oxidative deamination of amino acids?
A. Keto acid and ammonia.
B. Saturated fatty acid and ammonia.
C. Unsaturated fatty acid and ammonia.
D. Keto acid and H2O.
E. A and D.
ANSWER: A
85. Which of the following is an essential amino acid?
A. Glutamine
B. Proline
C. Methionine
D. Cysteine
E. Asparagine
ANSWER: C
86. Bioactive amines are formed in reaction of:
A. Transamination.
B. Decarboxylisation.
C. Oxidation.
D. Deamination.
E. All of these
ANSWER: B
87. What disease can be proved by increase of AsAT in blood?
A. Parotiditis
B. Gastritis
C. Pancreatitis
D. Cardiac infarction
E. Pneumonia
ANSWER: D
88. Patient has positive nitrogenous balance. The reason of this can be:
A. Starvation
B. Tuberculosis
C. Pregnancy
D. Cancer
E. AIDS
ANSWER: C
89. To endopeptidases belong all below-mentioned enzymes, except:
A. Pepsin
B. Elastase
C. Carboxypeptidase
D. Chymotrypsin
E. Trypsin
ANSWER: C
90. Chymotrypsinogen is transformed to chymotrypsin in the effect of:
A. Renin, gastrixin
B. Elastase, enterokinase
C. Hydrochloric acid, pepsin
D. Trypsin, chymotrypsin
E. Pepsin, enterokinase
ANSWER: D
91. In the stomach act such proteolytic enzymes:
A. Trypsin, chymotrypsin
B. Pepsin, enterokinase
C. Trypsin, renin
D. Pepsin, gastrixin, rennin
E. Chymotrypsin, enterokinase
ANSWER: D
92. The activator of trypsinogen is:
A. Hydrochloric acid
B. Chymotrypsin
C. Enterokinase
D. Aminopeptidase
E. Carboxypeptidase
ANSWER: C
93. Achylia is lack of:
A. Gastric juices acidity
B. Pepsin in gastric juices
C. Pepsin and hydrochloric acid in gastric juices
D. Free hydrochloric acid in gastric juices
E. Lactic acid in gastric juices
ANSWER: C
94. The major site of urea synthesis is
A. Brain
B. Kidneys
C. Muscles
D. Both B and C
E. Liver
ANSWER: E
95. Daily excretion of nitrogen by an adult man is about
A. 15–20 mg
B. 1.5–2 gm
C. 15–20 gm
D. 2-3 mg
E. 6–17 gm
ANSWER: E
96. Maple syrup urine diseases is an inborn error of metabolism of
A. Sulphur-containing amino acids
B. Aromatic amino acids
C. Dicarboxylic amino acids
D. All of these
E. Branched chain amino acids
ANSWER: E
97. Urea is transported by
A. Plasma
B. Blood
C. RBC
D. WBC
E. None af the above
ANSWER: A
98. Excess amino acids in the body are broken down to form urea in
A. Kidney
B. Liver
C. Spleen
D. Pancreas
E. Stomach
ANSWER: B
99. The amount of urea in patient's urine is normal. Which of the below mentioned indexes is true in
this case?
A. 10-15 g
B. 20-40 g
C. 10-35 g
D. 30-35 g
E. 50-60 g
ANSWER: D
100. Control of urea cycle involves the enzyme:
A. Carbamoyl phosphate synthetase
B. Ornithine transcarbamoylase
C. Argininosuccinase
D. Arginase
E. Fumarase
ANSWER: A