BIOC_LB_Q1_ABG_POLARITY_ENZYMES_SICKLE-CELL.pdf

MD 106: BIOCHEMISTRY Quiz 1: ABG | Polarity | Enzymes | Sickle Cell Disease...

MD 106: BIOCHEMISTRY Quiz 1: ABG | Polarity | Enzymes | Sickle Cell Disease CMED 1A | Dr. Adam Espiritu QUESTIONS ANSWERS RATIONALE REFERENCES 1. A compound that is A. is probably held The lipids are a Harper's Illustrated capable of forming together by nonpolar heterogeneous group of Biochemistry (32nd ed). hydrogen bonds with covalent bonds compounds, including p. 206 water _________. B. is probably held fats, oils, steroids, waxes, and together by ionic bonds related compounds. They C. does not dissolve will have the common property with hydrophilic solvents of being (1) relatively D. does not dissolve well insoluble in water and with oil (2) soluble in nonpolar E. None of the above solvents such as ether and chloroform. 2. Given the following A. Isoleucine, leucine, Transmembrane proteins University of Vigo (2023, classification of amino lysine show three molecular May 30). Proteins. Atlas acids, which amino B. Threonine, tyrosine, domains: two hydrophilic and of Plant and Animal acids would most likely tryptophan one hydrophobic. For Histology. be embedded in the C. Alanine, valine, instance, the transmembrane lipid bilayer of a phenylalanine proteins of the plasma membrane? D. Lysine, arginine, membrane proteins have an histidine extracellular, an intra- E. Aspartic acid, glutamic membrane and a cytosolic acid domain. The intra-membrane domain contains sequences of hydrophobic amino acids that are located among the fatty acid chains of the membrane lipids, whereas the extra and intracellular domains contain hydrophilic amino acids. 3.Which of the following A. H-O In molecules containing N-H, Purdue University covalent bonds is the B. C-H O-H or F-H bonds, the large (2023). Hydrogen most polar? C. H-H difference in electronegativity Bonding. D.C-N between the H atom and the E. O-O N, O or F atom leads to a highly polar covalent bond (i.e., a bond dipole).  QUESTIONS ANSWERS RATIONALE REFERENCES 4.Which of the following A. Ethanol, Water, Oil Sucrose is a polar molecule. American Chemical are correctly arranged B. Water, Ethanol, Oil The polar water molecules Society (2023, August according to the solvent C. Oil, Ethanol, Water attract the negative and 16). Why Does Water in which glucose is most D. Ethanol, Oil, Water positive areas on the polar Dissolve Sugar? soluble to least soluble? E. None of the above sucrose molecules which makes sucrose dissolve in water. Ethanol is slightly polar; thus, it can dissolve sucrose but not as well as water. A nonpolar substance like mineral oil does not dissolve a polar substance like sucrose. 5.The following A. Unprotonated form is - Uncharged drugs are more Absorption, distribution, statements is true more lipid soluble and less lipid soluble than charged and clearance. Stringer regarding drugs that are likely to cross biological drugs. A drug tends to pass J.L.(Ed.), (2017). Basic weak acids? membranes. through biological membranes Concepts in B. Protonated form is more if it is uncharged (or Pharmacology: What water soluble and unprotonated). You Need to Know for undergoes better - In alkaline urine, acidic drugs Each Drug Class, 5e. clearance. are more readily ionized. In McGraw Hill. C. Excretion in the urine is acidic urine, alkaline drugs are favored in the protonated more readily ionized. Ionized form. substances (also referred to D. All of the above. as polar) are more soluble in E. None of the above. water so dissolve in the body fluids more readily for excretion. 6.Which of the following ANSWER: B The central structure of heme American Chemical metabolic byproducts of is a porphyrin ring. Bilirubin’s Society (2017, March heme degradation is structure is that of a ring- 27). Bilirubin. least soluble in water? opened porphyrin: a chain of substituted pyrrole and 1,3- dihydro-2H-pyrrol-2-one rings.  QUESTIONS ANSWERS RATIONALE REFERENCES 7.A 67-year-old man A.Carboxyhemoglobinemia The methemoglobinemias are Lippincott's Illustrated presented to the B. Hemoglobin SC disease characterized by "chocolate Reviews: Biochemistry emergency room with a C.Methemoglobinemia cyanosis" (a brownish blue (5th ed.) p.42 1-week history of angina D. Sickle Cell Anemia coloration of the skin and and shortness of breath. E. B-Thalassemia mucous membranes and He complained that his brown-colored blood) as a face and extremities result of the dark-colored had a "blue color". HIs HbM. medical history included chronic stable angina treated with isosorbide dinitrate and nitroglycerin. Blood obtained for analysis was brown colored. Which one of the following is the most likey diagnosis? 8.What is affected in A. Translation of proteins The genetic disorders of Lippincott's Illustrated RBCs in Sickle Cell B. Transport of ions hemoglobin are the most Reviews: Biochemistry Disease? C. Cell membrane common genetic diseases in (5th ed.) p.477 D. Hemoglobin humans. In the case of sickle E. Transcription enzymes cell anemia, the mutation that gives rise to the disease is actually one and the same as the mutation that gives rise to the polymorphism. 9.Sickle cell disease A. Proline, Glutamate Sickle cell disease (SCD) is a Inusa, B. P. D., Hsu, L. results in abnormal B. Glutamate, Proline monogenetic disorder due to a L., Kohli, N., Patel, A., protein formation C. Glutamate, Valine single base-pair point mutation Ominu-Evbota, K., Anie, because of point D. Proline, Valine in the β-globin gene resulting K. A., & Atoyebi, W. mutation in DNA that E. Valine, Proline in the substitution of the amino (2019). Sickle Cell leads to replacement of acid valine for glutamic acid in Disease-Genetics, __ amino acid with __ the β-globin chain. Pathophysiology, Clinical amino acid. Presentation and Treatment. International journal of neonatal screening, 5(2), 20. 10.What is the point of A. A -> T in beta globin Sickle cell anemia is an Lippincott's Illustrated mutation leading to gene example of a genetic Reviews: Biochemistry sickle cell anemia? B. C -> G in beta globin disease caused by a point (5th ed.) p.477 gene mutation…Thus, the A-to-T C. A -> T in alpha globin mutation within a codon of the gene β S globin gene eliminates a D. C-> G in alpha globin cleavage site for the enzyme. gene E. A -> G in alpha and beta globin genes  QUESTIONS ANSWERS RATIONALE REFERENCES 11.Pepsin digests A. Pepsin would be The digestive power of pepsin Britannica, T. Editors of proteins in the stomach denatured in the small is greatest at the acidity of Encyclopaedia (2020, (pH 2) and Trypsin intestine normal gastric juice (pH 1.5– July 3). pepsin. digests proteins in the B. Pepsin works best in 2.5). In the intestine the Encyclopedia Britannica. small intestine (pH 8). acidic environment gastric acids are neutralized Which of the following is C. Trypsin helps in the (pH 7), and pepsin is no true? hydrolysis of proteins longer effective. Deng, Y., Gruppen, H., & D. Trypsin works best in Wierenga, P. A. (2018). basic environment Trypsin from different sources Comparison of Protein E. All of the above is expected to hydrolyze a Hydrolysis Catalyzed by given protein. Bovine, Porcine, and Human Trypsins. Journal of agricultural and food chemistry, 66(16), 4219– 4232. 12.In your home A. Concentration of All of the following choices Worthington Biochemical experiment, which of the enzyme affect enzyme activity except Corporation (2023). following does not affect B. Color of solution color of solution. Introduction to Enzymes. enzyme activity? C. Concentration of substrate Several factors affect the rate D. Temperature at which enzymatic reactions E. A and B proceed - temperature, pH, enzyme concentration, substrate concentration, and the presence of any inhibitors or activators 13.Why does enzyme A. All enzymes only work Active sites are subject to Molnar, C., & Gair, J. activity decreases in in neutral solutions influences of the local (2021). Concepts of solutions B. Enzyme activity remains environment. Increasing the Biology - 1st Canadian with either too high or unchanged in different pH environmental temperature Edition. BCCampus. too low pH. C. The shape of the generally increases reaction active site changes rates, enzyme-catalyzed or D. The shape of the otherwise. However, substrate changes temperatures outside of an E. The concentration optimal range reduce the rate increases and decreases accordingly at which an enzyme catalyzes a reaction. Hot temperatures will eventually cause enzymes to denature, an irreversible change in the 3D shape and therefore the function of the enzyme 14.There is a positive A. inverted At point where all the enzyme Harpers Illustrated correlation between B. Goes the opposite way present is as Enzyme Biochemistry by Rodwell substrate concentration C. Decrease rapidly substrate complex and no free et.al page 78 figure 8-4 and initial rate of D. Decrease slowly enzyme remains available for reaction. However, past E. Plateaus forming more enzyme a point, the enzyme substrate complex, further activity when illustrated increase in substrate cannot in a graph, increase the rate of reaction. becomes_____  QUESTIONS ANSWERS RATIONALE REFERENCES 15.The rate of enzyme A. changes the pH of the Active sites are subject to Molnar, C., & Gair, J. action decreases at system influences of the local (2021). Concepts of higher temperature after B. alters the active site environment. Increasing the Biology - 1st Canadian a certain value because of the enzyme environmental temperature Edition. BCCampus. the increased heat C. neutralizes the acids generally increases reaction ____. and bases in the system rates, enzyme-catalyzed or D. Increases the otherwise. However, concentration of enzymes temperatures outside of an E. decreases the optimal range reduce the concentration of the substrates by cooking it rate at which an enzyme catalyzes a reaction. Hot temperatures will eventually cause enzymes to denature, an irreversible change in the 3D shape and therefore the function of the enzyme. 16.A 18-year-old Respiratory alkalosis uncompensated Vera, M. (2023, student was brought to September 22). Arterial the emergency room Blood Gas Analysis after she fell down Made Easy with Tic-Tac- unconscious while Toe Method. attending the 7 AM Sunday mass. She is noted to be tachycardic (fast heart rate) and tachypneic (fast NORMAL VALUES: breathing). pH: 7.35 – 7.45 (< 7.35 is Acidosis; > 7.45 is Alkalosis) Measurement of arterial blood gas reveals pH pCO2: 35 – 45 mmHg (< 35 is Alkalosis; > 45 is Acidosis) 7.6, PaO2 120 mmHg, HCO3: 22 – 26 mEq/L (26 is Alkalosis) PaCO2 31 mmHg and HCO3 25 mmol/L. What does this mean? 17.A 65-year-old man Metabolic alkalosis uncompensated Vera, M. (2023, had been persistently September 22). Arterial vomiting for 24 hours. Blood Gas Analysis He is brought to the ER Made Easy with Tic-Tac- and appeared to be Toe Method. lethargic and weak. He is noted to have dry mucus membranes and is diagnosed with gastroenteritis and dehydration. NORMAL VALUES: Measurement of arterial pH: 7.35 – 7.45 (< 7.35 is Acidosis; > 7.45 is Alkalosis) blood gas shows pH pCO2: 35 – 45 mmHg (< 35 is Alkalosis; > 45 is Acidosis) 7.5, PaO2 85 mmHg, HCO3: 22 – 26 mEq/L (26 is Alkalosis) PaCO2 40 mmHg and HCO3 34 mmol/L. What acid-base disorder is shown?  QUESTIONS ANSWERS RATIONALE REFERENCES 18.A 40-year-old female Respiratory acidosis uncompensated Vera, M. (2023, patient in the post- September 22). Arterial anesthesia care unit Blood Gas Analysis (PACU), is difficult to Made Easy with Tic-Tac- arouse two hours Toe Method. following surgery. The patient had been administered with Morphine Sulfate thru IV for pain. The respiratory NORMAL VALUES: rate was noted at 9 per pH: 7.35 – 7.45 (< 7.35 is Acidosis; > 7.45 is Alkalosis) minute and pCO2: 35 – 45 mmHg (< 35 is Alkalosis; > 45 is Acidosis) demonstrates shallow breathing. The patient HCO3: 22 – 26 mEq/L (26 is Alkalosis) does not respond to stimuli. The nurse assesses the ABCs (Airway, Breathing, Circulation) and obtains ABG STAT (immediately). Measurement of arterial blood gas shows pH 7.10, PaO2 60 mmHg, PaCO 70 mmHg and HCO3 24 mmol/L. What does this mean? 19. An 8-year-old boy Partially compensated Metabolic Acidosis Vera, M. (2023, was rushed to the September 22). Arterial hospital due to diarrhea Blood Gas Analysis and decreased level of Made Easy with Tic-Tac- consciousness. The Toe Method. patient manifest deep breathing. He is lethargic upon examination and irritable. He appears to NORMAL VALUES: be severely dehydrated pH: 7.35 – 7.45 (< 7.35 is Acidosis; > 7.45 is Alkalosis) with sunken eyes and dry mucous pCO2: 35 – 45 mmHg (< 35 is Alkalosis; > 45 is Acidosis) membranes. His mother HCO3: 22 – 26 mEq/L (26 is Alkalosis) reveals two weeks history of polyuria (frequent urination), polydipsia (frequent thirst) and weight loss. Measurement of arterial blood gas shows: pH 7.0, PaO2 90 mmHg, HCO3 12 mmol/L and PaCO2 23 mmHg. Serum electrolytes results are Na+ 126 mmol/L, K+ 5 mmol/L, and Cl-95 mmol/L. What is your assessment?  QUESTIONS ANSWERS RATIONALE REFERENCES 20.A 60-year-old, Partially compensated Respiratory Acidosis Vera, M. (2023, tricycle driver with a September 22). Arterial history of chronic Blood Gas Analysis obstructive pulmonary Made Easy with Tic-Tac- disease was rushed to Toe Method. the emergency room with increasing difficulty of breathing and a productive cough. His wife claims he has been unwell for three days. NORMAL VALUES: Measurement of arterial pH: 7.35 – 7.45 (< 7.35 is Acidosis; > 7.45 is Alkalosis) blood gas shows: pH pCO2: 35 – 45 mmHg (< 35 is Alkalosis; > 45 is Acidosis) 7.3, PaCO2 68 mmHg, HCO3: 22 – 26 mEq/L (26 is Alkalosis) HCO3 28 mmol/L and Pa02 65 mmHg. How would you interpret this. 21. A 19 y/o mother Fully compensated metabolic acidosis Vera, M. (2023, rushed her 1 y/o infant September 22). Arterial to the ER following Blood Gas Analysis irritability, poor suck, & Made Easy with Tic-Tac- diarrhea for 3 days. The Toe Method. infant’s RR is elevated, & the fontanels are sunken. The ER physician orders ABGs after initial ax. The results from the ABGs NORMAL VALUES: show pH 7.39, paO2 80 pH: 7.35 – 7.45 (< 7.35 is Acidosis; > 7.45 is Alkalosis) mmHg, PaCO2 27 mmHg & HCO3 19 pCO2: 35 – 45 mmHg (< 35 is Alkalosis; > 45 is Acidosis) mmol/L. What does this HCO3: 22 – 26 mEq/L (26 is Alkalosis) mean? 22. A 35 y/o patient who Uncompensated metabolic alkalosis Vera, M. (2023, underwent abdominal September 22). Arterial surgery has NGT. The Blood Gas Analysis nurse noted that the Made Easy with Tic-Tac- NGT is draining a large Toe Method. amount (850 cc in 2 hrs) of coffee ground secretions. The patient is disoriented, hence referred to the attending NORMAL VALUES: surgeon. STAT pH: 7.35 – 7.45 (< 7.35 is Acidosis; > 7.45 is Alkalosis) (immediate) ABGs are ordered. The results pCO2: 35 – 45 mmHg (< 35 is Alkalosis; > 45 is Acidosis) from the ABGs show pH HCO3: 22 – 26 mEq/L (26 is Alkalosis) 7.57, PaO2 85 mmHg, PaCO2 37 mmHg & HCO3 30 mmol/L. What is your answer?  QUESTIONS ANSWERS RATIONALE REFERENCES 23.What is the A. Hyperoxemia oxygenation status of B. Normoxemia the patient in item no. C. Mild Hypoxemia 20? D. Moderate Hypoxemia E. Severe Hypoxemia Pilbeam, S. P., & Cairo, J. (2016, August 16). Improving Oxygenation and Management of Acute Respiratory Distress Syndrome. 24.ABG measurement A. HAGMA Normal: Vera, M. (2023, shows pH7.38, PaO2 65 B. NAGMA pH= 7.35-7.45 September 22). Arterial mmHg, HCO3 24 C. Metabolic Alkalosis HCO3= 22-26 meq/L Blood Gas Analysis mmol/L and PaCO2 41 D. Respiratory Acidosis PCO2= 35-45 mmHg Made Easy with Tic-Tac- mmHg. E. Respiratory Alkalosis Toe Method. Serum electrolytes ABCDE. Normal All values were normal. Serum results are Na+ 140 electrolytes are mmol/L and Cl- 100 not considered because there mmol/L. This is no acid-base imbalance. corresponds to ___? 25.The bicarbonate A. pH= pKa + log buffer systems play a ([HCO3-]/[0.03×PCO2]) role in acid-base B. pH= pKa + log homeostasis. The body ([0.03×PCO2]/ [HCO3-]) can easily interconvert C. pH = -log [HCO3-] the carbonic acid into D. pH= -log [0.03×PCO2] bicarbonate ion or E. None of the choices carbon dioxide to regulate/ maintain the change in hydrogen ion concentration. Identify the equation that represents the relation of carbon dioxide and bicarbonate ions in the maintenance of blood Roy, S. et al. (2021). Severe Hypertriglyceridaemia pH. Leading to Factitious Hypobicarbonataemia. European Journal of Case Reports in Internal Medicine. 26.Which of the Normal anion gap also occurs Lewis, J. L., III (2023, following causes of A. Azetalomide ingestion in early renal failure, July). Metabolic Acidosis. metabolic acidosis has B. Paraldehyde ingestion tubulointerstitial renal disease, MSD Manual a normal anion gap? C. Ketoacidosis and when carbonic anhydrase Professional Version. D. Lactic acidosis inhibitors (e.g., acetazolamide) E. Isoniazid ingestion are taken.  QUESTIONS ANSWERS RATIONALE REFERENCES 27.Of the following A. H20 ∞ H+ + OH- For the reaction above, this Hopkins E, Sanvictores mechanisms, which is В. СНЗСНОНС20Н ∞ states that if more hydrogen T, Sharma S. Physiology, the most important for CHOCHCH2C00- + H+ ions are produced, the Acid Base Balance. the management of the C. C02 + H2O ∞ H2C03 ∞ equation will shift to the left so [Updated 2022 Sep 12]. acid-base status? H++ HCO3- that more reactants are In: StatPearls [Internet]. D. H+ + NH3 ∞ NH4+ formed, and the system can Treasure Island (FL): E.СHЗСООН ∞ СHЗСОО- remain in equilibrium. This is StatPearls Publishing; + Н+ how compensatory pH 2023 Jan-. mechanisms work; if there is a metabolic acidosis present, the kidneys are not excreting enough hydrogen ions and/or not reabsorbing enough bicarbonate. The respiratory system reacts by increasing minute ventilation (often by increasing respiratory rate) and expiring more CO2 to restore equilibrium. 28.What part of nephron A. Glomerulus Bicarbonate is freely filtered at Rajkumar, P., & Pluznick, is responsible for most B. Proximal Convoluted the glomerulus, but ~80% of J. L. (2018). Acid-base of HCO3- reabsorption Tubule this is reabsorbed by the regulation in the renal C. Distal Convoluted proximal tubule proximal tubules: using Tubule novel pH sensors to D. Loof of Henle maintain homeostasis. American Journal of Physiology-Renal Physiology. 29.1st year UNP med A. Drinking soft drinks Saltine crackers (soda Cleveland Clinic (2019, student experience B. Brown bag breathing crackers) have been the family April 5). Ginger Ale and epigastric pain. She C. Soda crackers prescription for upset stomach Saltine Crackers? 5 lacks sleep and didn’t D. Oxygen inhalation (epigastritis) and nausea for Ways to Ease Stomach eat breakfast to study E. Drinking coffee many years as they soak up Pain and Nausea. for the biochem exam. the acid that sits in an empty She is about to take the stomach, which is often the exam at 8am. What source of the irritation. remedy can she take to Additionally, saltine crackers alleviate the epigastric prevent acid from being pain? released in the stomach. 30. Bonus