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Questions and Answers
Which of the following laboratory markers is 50/F with elevated total cholesterol and LDL cholesterol most likely to have increased?
Which of the following laboratory markers is 50/F with elevated total cholesterol and LDL cholesterol most likely to have increased?
What action leads to the beneficial effect of a drug known to increase gallstone risk as an adverse effect?
What action leads to the beneficial effect of a drug known to increase gallstone risk as an adverse effect?
Which enzyme allows hepatocytes to secrete ketone bodies into the circulation in the absence of insulin?
Which enzyme allows hepatocytes to secrete ketone bodies into the circulation in the absence of insulin?
Beta-hydroxybutyrate dehydrogenase
What is the direct derivative of an essential fatty acid that is most likely deficient in a case of essential fatty acid deficiency with generalized dry and scaly rash?
What is the direct derivative of an essential fatty acid that is most likely deficient in a case of essential fatty acid deficiency with generalized dry and scaly rash?
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Which of the following diseases is characterized by a deficiency of alpha-galactosidase?
Which of the following diseases is characterized by a deficiency of alpha-galactosidase?
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Which compound is responsible for the greenish-yellow color of the patient's phlegm?
Which compound is responsible for the greenish-yellow color of the patient's phlegm?
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In a three-step reaction involving Propagation, Termination, and Initiation, what is the correct order?
In a three-step reaction involving Propagation, Termination, and Initiation, what is the correct order?
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Which mechanism accounts for the massive diarrhea caused by Cholera toxin?
Which mechanism accounts for the massive diarrhea caused by Cholera toxin?
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Which of the following is/are true for anabolic pathways?
Which of the following is/are true for anabolic pathways?
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Which of the following enzyme deficiencies explains recurrent dark infections upon exposure to nitroblue tetrazolium?
Which of the following enzyme deficiencies explains recurrent dark infections upon exposure to nitroblue tetrazolium?
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Which of the following chromatographic techniques is used to extract the substrate for the laboratory test related to neutrophil activation?
Which of the following chromatographic techniques is used to extract the substrate for the laboratory test related to neutrophil activation?
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What are the three modes of heat transfer experienced by the patient with multiple burns after a community fire incident, in order?
What are the three modes of heat transfer experienced by the patient with multiple burns after a community fire incident, in order?
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All of the following are state functions, EXCEPT?
All of the following are state functions, EXCEPT?
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What is the entropy change in a mixture of oil and water that separates, usually evident as drops of oil in the toilet that do not mix with water?
What is the entropy change in a mixture of oil and water that separates, usually evident as drops of oil in the toilet that do not mix with water?
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The compound responsible for the nail polish remover-like odor of a diabetic patient's breath is derived from?
The compound responsible for the nail polish remover-like odor of a diabetic patient's breath is derived from?
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Which of the following is true for DHT?
Which of the following is true for DHT?
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Considering the most probable diagnosis in the 68-year-old female patient, what type of non-essential compound is defective in this patient’s condition?
Considering the most probable diagnosis in the 68-year-old female patient, what type of non-essential compound is defective in this patient’s condition?
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What is the mechanism of toxicity of the substance that most likely causes the symptoms in the 35-year-old female patient?
What is the mechanism of toxicity of the substance that most likely causes the symptoms in the 35-year-old female patient?
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What is the charge of the primary amino acid substrate of the enzyme AST at the patient’s serum pH?
What is the charge of the primary amino acid substrate of the enzyme AST at the patient’s serum pH?
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Which of the following compounds does not have an L-enantiomer?
Which of the following compounds does not have an L-enantiomer?
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Which amino acid is nutritionally essential for the patient with elevated phenylacetate level?
Which amino acid is nutritionally essential for the patient with elevated phenylacetate level?
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Which type of compound accumulates in the patient presenting with skin lesions and vesicles?
Which type of compound accumulates in the patient presenting with skin lesions and vesicles?
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Which compound is composed significantly of Glycine?
Which compound is composed significantly of Glycine?
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Which parts of the amino acids in a protein interact to form its tertiary structure?
Which parts of the amino acids in a protein interact to form its tertiary structure?
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Which of the following is an immediate substrate for the synthesis of the molecule needed for the excretion of amino groups?
Which of the following is an immediate substrate for the synthesis of the molecule needed for the excretion of amino groups?
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What enzyme is deficient in the patient presenting with elevated phenylalanine levels?
What enzyme is deficient in the patient presenting with elevated phenylalanine levels?
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What is true about Alzheimer disease?
What is true about Alzheimer disease?
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Which of the following is true about sickle cell disease?
Which of the following is true about sickle cell disease?
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The primary metabolic waste product in a patient with uremia contains which of the following functional groups: ________.
The primary metabolic waste product in a patient with uremia contains which of the following functional groups: ________.
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What pathway product is caused by the overproduction of the end-
What pathway product is caused by the overproduction of the end-
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Which type of enzyme is deficient in this case?
Which type of enzyme is deficient in this case?
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Which enzyme is most likely deficient in this patient?
Which enzyme is most likely deficient in this patient?
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What is the mechanism of action of the antidote for this patient?
What is the mechanism of action of the antidote for this patient?
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What most likely caused this patient's anemia?
What most likely caused this patient's anemia?
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What is the best estimate of the immediate daily caloric needs of this patient?
What is the best estimate of the immediate daily caloric needs of this patient?
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Which of the following constitutes the hepatic reaction occurring during periods of acidosis?
Which of the following constitutes the hepatic reaction occurring during periods of acidosis?
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What is the underlying cause of this patient's condition?
What is the underlying cause of this patient's condition?
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What is the mechanism of the antidote for this patient?
What is the mechanism of the antidote for this patient?
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Which of the following statements is true for insulin?
Which of the following statements is true for insulin?
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Which of these foods is most likely responsible for his postprandial high glucose?
Which of these foods is most likely responsible for his postprandial high glucose?
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Which of the following findings is most likely in this patient's serum?
Which of the following findings is most likely in this patient's serum?
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The primary toxic substance responsible for the patient's presentation can be classified as which of the following?
The primary toxic substance responsible for the patient's presentation can be classified as which of the following?
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Which of the following adverse events most likely occurred in patients who participated in the research?
Which of the following adverse events most likely occurred in patients who participated in the research?
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The release of which of the following substances from platelets is most likely involved in the pathogenesis of the patient's angiography findings?
The release of which of the following substances from platelets is most likely involved in the pathogenesis of the patient's angiography findings?
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Which of the following functional groups is the direct sequelae of excess alcohol consumption?
Which of the following functional groups is the direct sequelae of excess alcohol consumption?
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Which of the following will be deficient in the 16-year-old's ability to synthesize various lipids after being on a fat-free diet?
Which of the following will be deficient in the 16-year-old's ability to synthesize various lipids after being on a fat-free diet?
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Which vitamin deficiency is responsible for the patient's presentation with decreased sensation in a stocking-glove pattern?
Which vitamin deficiency is responsible for the patient's presentation with decreased sensation in a stocking-glove pattern?
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How are folic acid deficiency and vitamin B12 deficiency related?
How are folic acid deficiency and vitamin B12 deficiency related?
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Which vitamin is deficient in a patient presenting with chronic fatigue, low Hgb, high MCV, and elevated methylmalonic acid levels?
Which vitamin is deficient in a patient presenting with chronic fatigue, low Hgb, high MCV, and elevated methylmalonic acid levels?
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What is required for the reaction catalyzed by the enzyme that converts oxaloacetate to citrate in the TCA cycle?
What is required for the reaction catalyzed by the enzyme that converts oxaloacetate to citrate in the TCA cycle?
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What could have caused the elevated PT (prothrombin time) in a patient with non-traumatic bruises?
What could have caused the elevated PT (prothrombin time) in a patient with non-traumatic bruises?
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Study Notes
Biochemistry Practice Test Handout
- The handout is only valid for the March 2023 PLE batch and will be rendered obsolete for the next batch since it is updated regularly.
- The handout, videos, and other review materials are protected by RA 8293, otherwise known as the Intellectual Property Code of the Philippines.
Thermodynamics
- The entropy of a system can never decrease; it can decrease when the entropy of the surroundings increases by at least as much.
- The entropy of a system decreases when the system is isolated, and the process is irreversible.
Chromatography
- Ion-exchange chromatography is a type of chromatographic technique used to extract a substrate, which is an antimicrobial agent found in milk.
- The substrate is extracted using a column of charged resin.
Heat Transfer
- The three modes of heat transfer are: radiation, conduction, and convection.
- The correct order of heat transfer experienced by a patient who went inside a house with hot smoke, touched a hot steel doorknob, and felt the heat around his neck is: radiation, conduction, and convection.
State Functions
- All of the following are state functions, except: temperature.
Biochemical Reactions
- The compound responsible for the greenish-yellow color of a patient's phlegm participates in three reaction steps: propagation, termination, and initiation.
- The correct order of this three-step reaction is: initiation, propagation, and termination.
Enzymes
- Aldose reductase is responsible for the cloudy lens opacities in a patient with diabetes.
- Glucose-6-phosphatase is deficient in a patient who presents with leg cramps, myoglobinuria, hyperuricemia, and hyperbilirubinemia.
- Phospholipase A2 is directly affected by the active metabolite of nitroprusside.
Biochemistry and Pathology
- Cholera toxin causes massive diarrhea by continually synthesizing cAMP.
- Anabolic pathways are stimulated in the fed state, and they require energy.
- The deficiency of glutathione synthetase explains the recurrent infections in a patient.
Pharmacology
- The active metabolite of nitroprusside directly affects phospholipase A2.
- Hydrogen peroxide is used to clean wounds, and its mechanism of action is the formation of free radicals.
- The enzyme affected by the active metabolite of nitroprusside is phospholipase A2.### Enzyme Deficiencies
- Glucose-6-phosphate dehydrogenase deficiency is associated with myocardial disease.
- Isocitrate dehydrogenase deficiency is associated with cardiac muscles.
- NADPH oxidase deficiency is associated with myeloperoxidase.
- Angiotensin-converting enzyme 2 deficiency is associated with cardiac disease.
Inherited Disorders
- Galactokinase deficiency is associated with cataract formation.
- Galactose-1-phosphate uridyltransferase (GALT) deficiency is associated with classic galactosemia.
- McArdle disease is caused by a deficiency in glycogen phosphorylase.
- Pyruvate kinase deficiency is associated with hemolytic anemia.
Lipid Metabolism
- Increased lipoprotein lipase activity is associated with reduced mortality risk from atherosclerotic cardiovascular disease.
- Statins inhibit the enzyme HMG-CoA reductase.
- HMG-CoA reductase is the rate-limiting enzyme in the biosynthesis of unesterified fatty acids.
- Squalene is an important intermediate in the biosynthesis of unesterified fatty acids.
- Carnitine is an important intermediate in the biosynthesis of unesterified fatty acids.
Cardiovascular Disease
- Bisoprolol is used to treat hypertension.
- Elevated total cholesterol and LDL cholesterol levels are associated with increased cardiovascular disease risk.
- Xanthomas are associated with familial hypercholesterolemia.
- Autosomal recessive hypercholesterolemia is characterized by a mutation in the LDL receptor gene.
Diabetes Mellitus
- Type 1 diabetes mellitus is associated with elevated serum ketones.
- Hepatocytes secrete ketone bodies into the circulation due to the absence of the enzyme HMG-CoA lyase.
- Beta-hydroxybutyrate dehydrogenase is involved in the metabolism of ketone bodies.
Lipid Storage Diseases
- Fabry disease is caused by a deficiency of alpha-galactosidase.
- Gaucher disease is caused by a deficiency of glucocerebrosidase.
- Krabbe disease is caused by a deficiency of galactocerebrosidase.
- Niemann-Pick disease is caused by a deficiency of sphingomyelinase.
- Tay-Sachs disease is caused by a deficiency of hexosaminidase A.
Hormones
- Dihydrotestosterone (DHT) plays a role in male-pattern baldness.
- DHT promotes development of the prostate and is involved in the development of the testes.
Nutrition
- Essential fatty acid deficiency is associated with a dry and scaly rash.
- Lauric acid is a direct derivative of an essential fatty acid.
- Prostaglandin H2 is involved in the metabolism of essential fatty acids.
Toxicology
- Carbon monoxide toxicity is associated with competitive binding to heme.
- Carbon monoxide toxicity is associated with oxidation of Fe2+.### Biochemistry Case Studies
- A 37-year-old male presents with pain, swelling, and redness in the right big toe, likely due to gout caused by hyperuricemia.
- The patient has a history of chronic alcoholism and drank expensive whiskey, which may have contributed to the development of gout.
- Laboratory findings include hyperuricemia and scleral icterus.
Defects in Proteins
- A defect in Fibrillin can cause Marfan syndrome.
- A defect in Type III collagen can cause Ehlers-Danlos syndrome.
- A defect in Type II collagen can cause osteogenesis imperfecta.
- A defect in Type I collagen can cause Ehlers-Danlos syndrome.
- A defect in Laminin can cause muscular dystrophy.
Amino Acids
- Isoleucine is an essential amino acid.
- Phenylalanine is an essential amino acid.
- Homogentisic acid is a byproduct of the breakdown of phenylalanine.
- Homocysteine is a byproduct of the breakdown of methionine.
Enzyme Defects
- A defect in AST (Aspartate Transaminase) can cause liver damage.
- A defect in Phenylalanine Hydroxylase can cause phenylketonuria (PKU).
- A defect in Dopamine Hydroxylase can cause Menkes disease.
- A defect in Homogentisate Oxidase can cause albinism.
- A defect in Tyrosinase can cause albinism.
Other Biochemical Defects
- Rubenstein-Taybi syndrome is caused by a defect in the CREB-binding protein (CBP) gene, which affects histone acetyltransferase activity.
- Alzheimer disease is characterized by the accumulation of beta-amyloid and neurotoxic amyloid beta peptide.
- Sickle cell disease is caused by a point mutation that changes glutamate to lysine on the beta-subunit of hemoglobin.
- Hemoglobin S has an increased hydrophobicity compared to normal hemoglobin, leading to the sickled phenotype.
- Phenytoin can cause vitamin D deficiency.
Metabolic Disorders
- Uremia is characterized by the accumulation of urea and other nitrogenous waste products in the blood.
- Porphyria is a group of disorders caused by defects in the heme biosynthetic pathway.
- Gout is caused by the overproduction of uric acid.
- PKU is caused by a defect in phenylalanine hydroxylase, leading to the accumulation of phenylalanine in the blood.
- Carbamoyl Phosphate Synthetase I deficiency is a urea cycle disorder that can cause hyperammonemia.
Toxicology
- Carbon monoxide can bind to hemoglobin, causing carboxyhemoglobin and leading to tissue hypoxia.
- Lead can inhibit heme biosynthesis, leading to anemia and neurological symptoms.
Miscellaneous
- CREB-binding protein (CBP) gene is involved in histone acetyltransferase activity, which helps to expose the promoters of genes.
- Hemin can be used to treat porphyria by increasing the production of heme.
- Glucose can be used to treat porphyria by increasing the production of heme.
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