THE MINISTRY OF PUBLIC HEALTH OF UKRAINE

ZAPOROZHYE STATE MEDICAL UNIVERSITY

COLLECTED TESTS
FOR PREPARATION TO LICENSING EXAMINATION
“KROK 1” on BIOCHEMISTRY

FOR STUDENTS OF MEDICAL AND

PHARMACEUTICAL DEPARTMENTS

ZAPOROZHYE 2012

1
 Properties and Functions of Proteins & Enzymes
1. Succinate dehydrogenase catalyses the dehydrogenation of succinate. Malonic
acid HOOC-CH2-COOH is used to interrupt the action of this enzyme. Choose
the inhibition type:
A. Allosteric
B. Competitive
C. Non-competitive
D. Dephosphorylation
E. Limited proteolysis
2. The conjugated protein necessarily contains special component as a nonprotein
part. Choose the substance that can't carry out this function:
A. Glucose
B. HNO3
C. Thiamine pyrophosphate
D. ATP
E. AMP
3. Only one factor can influence the charge of amino acid radicals in the active
centre of enzyme. Name this factor:
B. The presence of a competitive inhibitor
C. Temperature
D. Pressure
E. pH medium
F. The surplus of a product

Metabolism of Carbohydrates
1. A 45 y.o woman suffers from Cushing`s syndrome (steroid diabetes).
Biochemical examination revealed hyperglycemia, hyperchloremia in this
patient. Which of the processes below is the first to be activated?
A. Gluconeogenesis
B. Glucose reabsorption
C. Glycogenolysis
D. Glycolysis
E. Glucose transport to the cell
2. A 7-year-old girl has signs of anemia. Laboratory examination revealed pyruvate
kinase deficiency in the erythrocytes. What process disturbance plays the main
role in anemia development?
A. Tissue respiration
B. Oxidative phosphorylation
C. Peroxide decomposition
D. Amino acids desamination
E. Anaerobic glycolysis
3. Patient with diabetes mellitus experienced loss of consciousness and
convulsions after an injection of insulin. What might be the result of
biochemical blood analysis for concentration of sugar?

2
 A. 3,3 mmol/L
B. 10.0 mmol/L
C. 8,0 mmol/L
D. 1,5 mmol/L .
E. 5,5 mmol/L
4. A child’s blood presents high content of galactose, glucose concentration is low.
There are such presentations as cataract, mental deficiency, adipose
degeneration of liver. What disease is it?
A. Diabetes melluitis
B. Steroid diabetes
C. Fructosemia
D. Lactosemia
E. Galactosemia
5. A child has got galactosemia. Concentration of glucose in blood has not
considerably changed. Deficiency of what enzyme caused this illness?
A. Phosphoglucomutase
B. Amylo-l,6-glucosidase
C. Galactokinase
D. Galactose-1-phosphate uridyltransferase
E. Hexokinase
6. The gluconeogenesis is activated in the liver after intensive physical trainings
.What substance is utilized in gluconeogenesis first of all in this case:
A. Glucose
B. Glutamate
C. Alanine
D. Lactate
E. Pyruvate
7. A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a
significant amount of glycogen. Glucose concentration in the blood stream is
below normal. What is the cause of low glucose levels:
A. Low {absent} activity of hexokinase
B. High activity of glycogen synthetase
C. Deficit of gene that is responsible for the synthesis of glucose 1-
phosphate uridine transferase
D. High activity of glycogen phosphorylase in liver
E. Low {absent} activity of glucose 6-phosphatase

Metabolism of Lipids
1. An experimental animal has been given excessive amount of carbon labeled
glucose for a week. In what compound can the label be found?
A. Phenylalanine
B. Methionine
C. Palmitic acid
D. Vitamin A
E. Arachidonic acid

3
2. After intake of food rich in fats a patient feels nausea and sluggishness; with
time there appeared signs of steatorrhea. Blood cholesterol concentration is 9,2
micromole/L. This condition was caused in the intestine by lack of:
A. Phospholipids
B. Chylomicrons
C. Fatty acids
D. Bile acids
E. Amino acids
3. A patient has disturbed absorption of fat digestion products. It might have been
caused by a deficit of those components in the small intestine cavity:
A. Bile acids
B. Bile pigments
C. Lipolytic enzymes
D. Sodium ions
E. Lipid soluble vitamins
4. Examination of cell culture got from a patient with lysosomal pathology
revealed accumulation of great quantity of lipids in the lysosomes. What of the
following diseases is this disturbance typical for?
A. Gout
B. Phenylketonuria
C. Wilson disease
D. Tay-Sachs disease
E. Galactosemia
5. A 1 y.o. child with symptoms of muscle affection was admitted to the hospital.
Examination revealed carnitine deficiency in muscles. Biochemical base of this
pathology is disturbed process of:
2+
A. Regulation of Ca level in mitochondria
B. Transporting of fatty acids to the matrix of mitochondria
C. Actin and myosin synthesis
D. Lactic acid utilization
E. Substrate phosphorylation
6. A sportsman was recommended to take a medication that contains carnitine in
order to improve his results. What process is activated by carnitine the most?
A. Synthesis of steroid hormones
B. Fatty acids transport to mitochondrions
C. Tissue respiration
D. Synthesis of ketone bodies
E. Synthesis of proteins
7. The patient with diabetes mellitus has been delivered in hospital in the state of
unconsciousness. Arterial pressure is low. The patient has acidosis. Point
substances, which accumulation in the blood results in these manifestations:
A. Ketone bodies
B. Monosaccharides
C. Cholesterol esters
D. High fatty acids

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 E. Amines
8. Synthesis of phospholipids is disordered under the liver fat infiltration. Indicate
which of the following substances can enhance the process of methylation
during phospholipids synthesis?
A. Glucose
B. Citrate
C. Methionine
D. Glycerin
E. Ascorbic acid

Metabolism of Proteins and Amino Acids

1. Ammonia is a very toxic substance, especially for the nervous system. What
substance takes the most active part in ammonia detoxification in the brain
tissue?
A. Lysine
B. Glutamic acid
C. Histidine
D. Proline
E. Alanine
2. Labeled by radioisotope amino acids alanine and tryptophan were administrated
to a mouse in order to study the localization of protein synthesis in cells.
Around what organelles in the cell the accumulation of labeled amino acids will
be observed?
A. Agranular endoplasmic reticulum
B. Golgi apparatus
C. Ribosomes
D. Cell nucleus
E. Lysosomes
3. In course of histidine catabolism a biogenic amine is formed that has powerful
vasodilatating effect. Name it:
A. Noradrenalin
B. Dioxyphenylalanine
C. Serotonin
D. Dopamine
E. Histamine
4. Nappies of a newborn have dark spots that witness the presence of homogentisic
acid oxidation product. Choose the substance whose metabolic disorder is
associated with accumulation of homogentisic acid in the organism:
A. Cholesterol
B. Galactose
C. Tyrosine
D. Tryptophan
E. Methionine
5. Glutamate decarboxylation results in the formation of inhibitory transmitter in
CNS. Name it:
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 A. Glutathione
B. Gamma amino butyric acid
C. Serotonin
D. Histamine
E. Asparagine
6. A 4 y.o. boy has had recently serious viral hepatitis. Now there are such clinical
symptoms as vomiting, unconsciousness, fits. There is hyperammoniemia in
patient, too. Disturbance of which biochemical process caused such
pathological condition of the patient?
A. Increased putrefaction of proteins in bowels
B. Inhibition of transamination enzymes
C. Disturbed neutralization of ammonia in the liver
D. Activation of amino acid decaboxylation
E. Disturbed neutralization of biogenic amines
7. According to clinical indications a patient was administered pyridoxal
phosphate. What process is this medication intended to correct?
A. Desamination of purine nucleotide
B. Synthesis of purine and pyrimidine bases.
C. Transamination and decarboxylation of amino acids
D. Protein synthesis
E. Oxidative decarboxylation of ketoacids
8. A 4 y.o. child with signs of durative proteinic starvation was admitted to the
hospital. The signs were as follows: Growth inhibition, anemia, oedema, mental
deficiency. Choose the cause of oedema development:
A. Reduced synthesis of lipoproteins
B. Reduced synthesis of glycoproteins
C. Reduced synthesis of hemoglobin
D. Reduced synthesis of globulins
E. Reduced synthesis of albumins
9. A patient diagnosed with carcinoma of bowels was admitted to the hospital.
Analysis revealed high production of serotonin. It is known that this substance
is formed of tryptophan amino acid. What biochemical mechanism underlies
this process?
A. Formation of paired compounds
B. Decarboxylation
C. Transamination
D. Microsomal oxidation
E. Desamination
10. Albinos can't stand sun impact – they don't require sun-tan but get sunburns.
Disturbed metabolism of what amino acid underlies this phenomenon?
A. Histidine
B. Phenylalanine
C. Tryptophan
D. Glutamic acid
E. Methionine

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11. Cerebral trauma caused the increase of ammonia formation. What amino acid
takes part in removal of ammonia from cerebral tissue?
A. Tryptophan
B. Lysine
C. Glutamic acid
D. Valine
E. Туrosine
12. A patient diagnosed with carcinoid of bowels was admitted to the hospital.
Analysis revealed high production of serotonin. It is known that this substance
is formed of tryptophan amino acid. What biochemical mechanism underlies
this process?
A. Decarboxylation
B. Microsomal oxidation
C. Transamination
D. Desamination
E. Formation of paired compounds
13. Low level of albumins and fibrinogen was detected in the patient's blood.
Decreased activity of what organelle in the hepatocyte can most probably cause
it?
A. Golgi complex
B. Agranular endoplasmatic reticulum
C. Lysosomes
D. Mitochondrions
E. Granular endoplasmatic reticulum
14. Different functional groups can be presented in the structure of L-amino acid
radicals. Identify the group that is able to form ester bond:
A. -OH
B. -CONH2
C. -SH
D. -NH2
E. -CH3
15. After a serious viral infection a 3-year-old child has repeated vomiting, loss of
consciousness, convulsions. Examination revealed hyperammoniemia. What
may have caused changes of biochemical blood indexes of this child?
A. Activated processes of amino acids decarboxylation
B. The increased putrefaction of proteins in intestines
C. The inhibited activity of enzymes for transamination
D. Disorder of ammonia neutralization in ornithine cycle
E. Disorder of biogenic amines neutralization

Metabolism of Chromoproteins
1. A patient who suffers from congenital erythropoietic porphyria has skin
photosensitivity. The accumulation of what compound in the skin cells can
cause it?
A. Uroporphyrinogen I

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 B. Uroporphyrinogen II
C. Protoporphyrin
D. Coproporphyrinogen III
E. Heme
2. A denaturation of proteins can be found in some substances. Specify the
substance that is used for the incomplete denaturation of hemoglobin:
A. Sulfuric acid
B. Nitric acid
C. Toluene
D. Sodium hydroxide
E. Urea
3. A patient is ill with diabetes mellitus that is accompanied with hyperglycemia of
over 7,2 millimole/L on an empty stomach. The level of what blood plasma
protein can estimate the hyperglycemia rate retrospectively {4-8 weeks before
examination}?
A. C-reactive protein
B. Ceruloplasmin
C. Fibrinogen
D. Albumin
E. Glycosylated haemoglobin
4. Examination of initial molecular structure revealed substitution of the glutamic
acid by valine. What inherited pathology is it typical for?
A. Minkowsky-Shauffard disease
B. Hemoglobinosis
C. Thalassemia
D. Favism
E. Sickle-cell anemia
5. A 48 y.o. patient was admitted to the hospital with complaints about weakness,
irritability, sleep disturbance. Objectively: skin and scleras are yellow. In blood:
conjugated bilirubin, cholamia. Feces are acholic. Urine is of dark colour
(bilirubin). What jaundice is it?
A. Hemolytic
B. Gilbert’s syndrome
C. Mechanic (obstractive)
D. Crigler-Najjar syndrome
E. Parenchymatous

Metabolism of Nucleoproteins
1. A doctor administered Allopurinol to a 26-year-old young man with the
symptoms of gout. What pharmacological action of Allopurinol ensures
therapeutical effect?
A. By inhibiting uric acid formation
B. By general analgetic effect
C. By increasing uric acid excretion
D. By general anti-inflammatory effect

8
 E. By inhibiting leucocyte migration into the joint
2. In some regions of South Africa there is a spread sickle-shaped cell anemia, in
which erythrocytes have shape od a sickle as a result of substitution of
glutamine by valine in the hemoglobin molecule. What is the cause of this
disease?
A. Gene mutation
B. Disturbance of mechanisms of genetic information realization
C. Genomic mutations
D. Crossingover
E. Transduction
3. Nowadays about 50 minor bases have found in the t-RNA structure besides the
main four nitrogenous bases. Choose the minor nitrogenous base:
A. Dihydrouracil
B. Cysteine
C. Uracil
D. Adenine
E. Cytosine
4. RNA that contains AIDS virus penetrated into a leukocyte and by means of
reverse transcriptase forced a cell to synthesize a viral DNA. This process is
based upon:
A. Reverse transcription
B. Convariant replication
C. Operon depression
D. Operon repression
E. Reverse translation
5. Methotrexate (structural analogue of the folic acid which is competitive inhibitor
of the dihydrofolatreductase) is prescribed for treatment of the malignant
tumour. On which level does methotrexate hinder synthesis of the nucleic
acids?
A. Reparation
B. Mononucleotide synthesis
C. Replication
D. Processing
E. Transcription
6. RNA-polymerase B (II) is blocked due to amanitin poisoning (poison of death-
cup). What process is disturbed?:
A. Primer synthesis
B. Synthesis of t-RNA
C. Reverse transcription
D. Synthesis of m-RNA
E. Maturation of m-RNA
7. An experiment proved that UV-radiated cells of patients with xeroderma
pigmentosum restore the native DNA structure slower than cells of healthy
individuals as a result of reparation enzyme defection. What enzyme helps this
process?
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 A. DNA polymerase III
B. DNA gyrase
C. RNA ligase
D. Endonuclease
E. Primase
8. A 42-year-old man suffering from gout has increased level of uriс acid in blood.
Allopurinol was prescribed to decrease the level of uriс acid. Competitive
inhibitor of what enzyme is allopurinol?
A. Adenosine deaminase
B. Hypoxanthine phosphoribosiltransferase
C. Xanthine oxidase
D. Guanine deaminase
E. Adenine phosphoribosiltransferase

Biochemistry of Hormones
1. A patient is followed up in an endocrinological dispensary on account of
hyperthyroidism. Weight loss, tachycardia, finger tremor are accompanied with
hypoxia similar symptoms – headache, fatigue, eye flicker. Find out the result
for the influence of high level of thyroid hormones on tissue respiration causing
the development of hypoxia similar symptoms:
A. Specific binding of active centers of respiratory enzymes
B. Intensification of respiratory enzymes synthesis
C. Competitive inhibition of respiratory enzymes
D. Inhibition of respiratory enzymes synthesis
E. Uncoupling of oxidation and phosphorylation
2. A 2 y.o child has convulsions as a result of reduced concentration of calcium
ions in the blood plasma. It is caused by the reduced function of:
A. Adrenal cortex
B. Pineal gland
C. Parathyroid glands
D. Hypophysis
E. Thymus
3. A patient who suffers from pneumonia has high body temperature. What
biologically active substances play the leading part in origin of this
phenomenon?
A. Leukotrienes
B. Histamine
C. Serotonin
D. Bradykinin
E. Interleukin
4. Examination of a patient revealed hyperkalaemia and hyponatraemia. Low
secretion of which hormone may cause such changes?
A. Aldosterone
B. Parathyroid hormone
C. Atrial natriuretic peptide

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 D. Cortisol
E. Vasopressin
5. Inhabitants of territories with cold climate have high content of an adaptive
thermoregulatory hormone. What hormone is it?
A. Glucagon
B. Insulin
C. Cortisol
D. Thyroxin
E. Somatotropin
6. A 44-year-old woman complains of common weakness, heart pain, increase of
body weight. Objectively: moon-like face, hirsutism, AP- 165/100 mm Hg,
height -164 cm, weight -103 kg; fat is mostly accumulated in the region of
neck, upper shoulder girdle, stomach. What is the main pathogenic mechanism
of obesity?
A. Decreased production of glucagon
B. Decreased production of thyroid hormones
C. Increased production of mineral corticoids
D. Increased production of insulin
E. Increased production of glucocorticoids
7. Utilization of arachidonic acid via cyclooxygenase pathway results in formation
of some bioactive substances. Name them:
A. Biogenic amines
B. T3 and T4
C. Somatomedins
D. Insulin-like growth factors
E. Prostaglandins
8. Patient with diabetes mellitus experienced loss of consciousness and
convulsions after an injection of insulin. What might be the result of
biochemical blood analysis for concentration of sugar?
A. 3,3 mmol/L
B. 10.0 mmol/L
C. 8,0 mmol/L
D. 1,5 mmol/L
E. 5,5 mmol/L
9. The intake of oral contraceptives containing sex hormones inhibits secretion of
the hypophysial hormones. Secretion of which of the indicated hormones is
inhibited while taking oral contraceptives?
A. Thyrotropic
B. Somatotropic
C. Oxytocin
D. Follicle-stimulating
E. Vasopressin
10. A 2-year-old child experienced convulsions because of calcium ions
concentration decrease in the blood plasma. Function of what structure is
decreased?
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 A. Pineal gland
B. Thymus
C. Hypophysis
D. Adrenal cortex
E. Parathyroid glands
11. Some diseases reveal symptoms of aldosteronism with hypertension and edema
due to sodium retention in the organism. What organ of the internal secretion is
affected on aldosteronism?
A. Hypophysis
B. Testicle
C. Ovaries
D. Pancreas
E. Adrenal glands
12. A man after 1,5 liter blood loss has suddenly reduced diuresis. The increased
secretion of what hormone caused this diuresis alteration?
A. Vasopressin
B. Corticotrophin
C. Cortisol
D. Parathormone
E. Natriuretic
13. A 2-year-old child experienced convulsions because of calcium ions
concentration decrease in the blood plasma. Function of what structure is
decreased?
A. Pineal gland
B. Thymus
C. Hypophysis
D. Adrenal cortex
E. Parathyroid glands
14. The formation of a secondary mediator is obligatory in membrane-intracellular
mechanism of hormone action. Point out the substance that is unable to be a
secondary mediator:
A. Diacylglycerol
B. cAMP
C. Inositol-3,4,5-triphosphate
2+
D. Ca
E. Glycerol
15. A 19-year-old female suffers from tachycardia in rest condition, weight loss,
excessive sweating, exophtalmos and irritability. What hormone would you
expect to find elevated in her serum?
A. ACTH
B. Mineralocorticoids
C. Cortisol
D. Insulin
E. Thyroxine

12
16. Secretion of what gastrointestinal hormones will be primarily decreased as a
result of duodenum removal?
A. Neurotensin
B. Gastrin and histamine
C. Cholecystokinin and secretin
D. Gastrin
E. Histamine
17. A person has reduced diuresis, hypernatremia, hypokalemia. Hypersecretion of
what hormone can cause such changes?
A. Adrenalin
B. Aldosterone
C. Vasopressin
D. Auricular sodiumuretic factor
E. Parathormone
18. Testosterone and its analogs increase the mass of skeletal muscles that allows
to use them for treatment of dystrophy. Due to interaction of the hormone with
what cell substrate is this action caused?
A. Membrane receptors
B. Chromatin
C. Ribosomes
D. Proteins-activators of transcription
E. Nuclear receptors
19. Periodic renal colics attacks are observed in a woman with primary
hyperparathyroidizm. Ultrasonic examination revealed small stones in the
kidneys. What is the most plausible reason of the stones's formation?
A. Hyperphosphatemia
B. Hypercalcemia
C. Hypercholesterinemia
D. Hyperuricemia
E. Hyperkalemia
20. There is only one hormone among neurohormones which refers to the
derivatives of amino acids according to classification. Point out it:
A. Melatonin
B. Vasopressin
C. Oxytocin
D. Thyroliberin
E. Somatotropin
21. Parents of a 10 y.o. boy consulted a doctor about extension of hair-covering,
growth of beard and moustache, low voice. Intensified secretion of which
hormone must be assumed?
A. Of oestrogen
B. Of progesterone
C. Of somatotropin
D. Of testosterone
E. Of cortisol
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22. Thyrotoxicosis leads to increased production of thyroidal hormones Tз and T4,
weight loss, tachycardia, psychic excitement and so on. How do thyroidal
hormones influence energy metabolism in the mitochondrion of cells?
A. Stop respiratory chain
B. Activate oxidative phosphorylation
C. Stop substrate phosphorylation
D. Activate substrate phosphorylation
E. Disconnect oxidation and oxidative phosphorylation
23. Kidneys of a man under examination show increased resorbtion of calcium
ions and decreased resorbtion of phosphate ions. What hormone causes this
phenomenon?
A. Vasopressin
B. Hormonal form D3
C. Thyrocalcitonin
D. Aldosterone
E. Parathormone

Biochemistry of nutrition. Vitamins.

1. Examination of a patient with frequent hemorrhages from internals and mucous
membranes revealed proline and lysine being a part of collagen fibers. What
vitamin absence caused disturbance of their hydroxylation?
A. Vitamin A
B. Thiamine
C. Vitamin K
D. Vitamin E
E. Vitamin C
2. Examination of a man who hadn’t been consuming fats but had been getting
enough carbohydrates and proteins for a long time revealed dermatitis, poor
wound healing, vision impairment. What is the probable cause of metabolic
disorder?
A. Lack of vitamins PP, H
B. Lack of oleic acid
C. Lack of linoleic acid, vitamins A, D, E, K.
D. Lack of palmitic acid
E. Low caloric value of diet
3. A patient who has been strictly keeping to a certain diet for 10 days went
through examination of respiratory coefficient. It was determined that it was
equal 1. What diet has the patient been keeping to?
A. With domination of proteins and fat
B. With domination of fat and carbohydrates
C. With domination of proteins and carbohydrates
D. Mixed
E. With domination of carbohydrates

14
4. A woman who has been keeping to a clean-rice diet for a long time was
diagnosed with polyneuritis (beriberi). What vitamin deficit results in
development of this disease?
A. Folic acid
B. Thiamine
C. Ascorbic acid
D. Riboflavin
E. Pyridoxine
5. A 30-year-old woman was diagnosed with insufficiency of exocrine function of
pancreas. Hydrolysis of what nutrients will be disturbed?
A. Proteins, fats, carbohydrates
B. Fats, carbohydrates
C. Proteins, carbohydrates
D. Proteins, fats
E. Proteins
6. A patient suffers from vision impairment – hemeralopia (night blindness). What
vitamin preparation should be administered the patient in order to restore his
vision?
A. Pyridoxine
B. Retinol acetate
C. Vicasol
D. Thiamine chloride
E. Tocopherol acetate
7. There is disturbed process of Ca2+ absorption through intestinal wall after the
removal of gall bladder in patient:
A. K
B. C
C. D3
D. PP
E. B12
8. A 6 y.o child was administered vicasol to prevent postoperative bleeding.
Vicasol is a synthetic analogue of vitamin K. Name post-translation changes of
blood coagulation factors that will be activated by vicasol:
A. Carboxylation of glutamic acid residues
B. Polymerization
C. Partial proteolysis
D. Glycosylation
E. Phosphorylation of serine radicals
9. Most participants of Magellan expedition to America died from avitaminosis.
This disease declared itself by general weakness, subcutaneous hemmorhages,
falling of teeth, gingival hemmorhages. What is the name of this avitaminosis?
A. Biermer's anemia
B. Polyneuritis (beriberi)
C. Pellagra
D. Rachitis

15
 E. Scurvy
10. A patient with hypochromic anemia has splitting hair and loss of hair,
increased nail bottling and taste alteration. What is the mechanism of the
development of these symptoms?
A. Deficiency of vitamin B12
B. Decreased production of thyroid hormones
C. Deficiency of vitamin A
D. Decreased production of parathyrin
E. Deficiency of iron-containing enzymes
11. The structural analogue of vitamin B2 is administered (acriсhine) in a case of
enterobiasis. The disorder of which enzyme synthesis is caused by this
medicine in microorganisms?
A. NAD-dependent dehydrogenases
B. Cytochrome oxidases
C. FAD-dependent dehydrogenases
D. Peptidases
E. Aminotransferases
12. A patient who was previously ill with mastectomy as a result of breast cancer
was prescribed radiation therapy. What vitamin preparation has marked
radioprotective action caused by antioxidant activity?
A. Tocopherol acetate
B. Riboflavin
C. Folic acid
D. Ergocalciferol
E. Thiamine chloride
13. There is an inhibited coagulation in the patients with bile ducts obstruction,
bleeding due to the low level of absorption of vitamin. What vitamin is in
deficiency?
A. K
B. E
C. D
D. A
E. Carotene
14. After intake of rich food a patient feels nausea and sluggishness; with time
there appeared signs of steatorrhea. Blood cholesterol concentration is 9.2
mmole/l. That condition was caused by lack of:
A. Chylomicrons
B. Fatty acids
C. Phospholipids
D. Bile acids
E. Triglycerides
15. Concentration of pyruvate is increased in the patient's blood, the most of which
is excreted with urine. What avitaminosis has the patient?
A. Avitaminosis B1
B. Avitaminosis B2
16
 C. Avitaminosis E
D. Avitaminosis B9
E. Avitaminosis B3
16. Pyruvate concentration in the patient's urine has increased 10 times from
normal amount. What vitamin deficiency can be the reason of this change:
A. Vitamin B6
B. Vitamin A
C. Vitamin E
D. Vitamin C
E. Vitamin B1
17. Hydroxylation of endogenous subrates and xenobiotics requires a donor of
protons. Which of the following vitamins can play this role?
A. Vitamin C
B. Vitamin E
C. Vitamin P
D. Vitamin A
E. Vitamin B6
18. A 2-year-old child has got intestinal dysbacteriosis, which results in
hemorrhagic syndrome. What is the most likely cause of hemorrhage of the
child?
A. Activation of tissue thromboplastin
B. PP hypovitaminosis
C. Fibrinogen deficiency
D. Vitamin K insufficiency
E. Hypocalcemia
19. A 10-year-old girl often experiences acute respiratory infections with multiple
hemorrages in the places of clothes friction. Hypovitaminosis of what vitamin is
in this girl organism?
A. A
B. B2
C. B1
D. B6
E. С
20. A patient complains of frequent diarrheas, especially after consumption of
fattening food and of the body weight loss. Laboratory examination revealed
steatorrhea; hypocholic feces. What can be the cause of this condition?
A. Mucous membrane inflammation of small intestine
B. Obturation of biliary tracts
C. Lack of pancreatic phospholipase
D. Lack of pancreatic lipase
E. Unbalanced diet

Biochemistry of the Liver. Xenobiotic metabolism

1. A patient with symptoms of acute alcohol poisoning was brought to the hospital.
What carbohydrates metabolism changes are typical for this condition?
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 A. The anaerobic glucose metabolism predominates in muscles
B. The gluconeogenesis is increased in the liver
C. The breakage of glycogen is increased in the liver
D. The gluconeogenesis velocity in the liver is decreased
E. The anaerobic breakage of glucose is increased in muscles
2. Desulfiram is widely used in medical practice to prevent alcoholism, it inhibits
aldehyde dehydrogenase. Increased level of what metabolite causes aversion
to alcohol?
A. Acetaldehyde
B. Ethanol
C. Malonyl aldehyde
D. Propionic aldehyde
E. Methanol
3. In course of metabolic process active forms of oxygen including superoxide
anion radical are formed in the human body. By means of what enzyme is this
anion inactivated?
A. Catalase
B. Glutathione reductase
C. Peroxidase
D. Superoxide dismutase
E. Glutathione peroxidase
4. A patient suffers from hepatic cirrhosis. Examination of which of the following
substances excreted by urine can characterize the state of antitoxic function of
liver?
A. Uric acid
B. Сreatinine
C. Ammonium salts
D. Hippuric acid
E. Amino acids
5. A patient with encephalopathy was admitted to the neurological in patient
department. There was revealed a correlation between increasing of
encephalopathy and substances absorbed by the bloodstream from the
intestines. What substances that are formed in the intestines can cause
endotoxemia?
A. Indole
B. Ornithine
C. Acetacetate
D. Butyrate
E. Biotin

Biochemistry of Muscular & Connective Tissues

1. A 30 y.o. woman had been ill for a year when she felt pain in the area of joints
for the first time, they got swollen, and skin above them became reddened.
Provisional diagnosis is rheumatoid arthritis. One of the most probable causes
of this disease is a structure alteration of a connective tissue protein:
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 A. Ovoalbumin
B. Collagen
C. Myosin
D. Troponin
E. Mucin
2. Increased fragility of vessels, enamel and dentine destruction resulting from
scurvy are caused by disorder of collagen maturation. What stage of
procollagen modification is disturbed under this avitaminosis?
A. Hydroxylation of proline
B. Detaching of N-ended peptide
C. Formation of polypeptide chains
D. Glycosylation of hydroxylysine residues
E. Removal of C-ended peptide from procollagen
3. A patient with serious damage of muscular tissue was admitted to the trauma
department. What biochemical urine index will be increased in this case?
A. Creatinine
B. Common lipids
C. Uric acid
D. Glucose
E. Mineral salts

Biochemistry of blood and kidney

1. 12 hours after an acute attack of retrosternal pain a patient presented a jump of
aspartate aminotransferase activity in blood serum. What pathology is this
deviation typical for?
A. Viral hepatitis
B. Diabetes insipidus
C. Collagenosis
D. Diabetes mellitus
E. Myocardial infarction
2. A patient who had been working hard under condition of elevated temperature
of the environment has now a changed quantity of blood plasma proteins. What
phenomenon is the case?
A. Absolute hyperproteinemia
B. Relative hyperproteinemia
C. Absolute hypoproteinemia
D. Disproteinemia
E. Paraproteinemia
3. 62 y.o. woman complains of frequent pains in the area of her chest and
backbone, rib fractures. A doctor assumed myelomatosis (plasmocytoma).What
of the following laboratory characteristics will be of the greatest diagnostic
importance?
A. Proteinuria
B. Hypoproteinemia
C. Hypoglobunemia

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 D. Hyperalbuminemia
E. Paraproteinemia
4. Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids.
What disorders of acid-base equilibrium may be caused by excessive
accumulation of ketone bodies in blood?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
Any changes won't happen
5. A 63-year-old woman developed symptoms of rheumatoid arthritis. Their
increase of which blood values indicators could be most significant in proving
the diagnosis?
A. R-glycosidase
B. Acid phosphatase
C. Lipoproteins
D. General cholesterol
E. Additive glycosaminoglycans
6. Marked increase of activity of MB-forms of CPK (creatinephosphokinase) and
LDH-1 was revealed by examination of the patient's blood. What is the most
probable pathology?
A. Myocardial infarction
B. Hepatitis
C. Pancreatitis
D. Rheumatism
E. Cholecystitis
7. There is high activity of LDH1,2 , aspartate aminotransferase, creatine
phosphokinase in the blood of patient. In what organs (tissues) the development
of pathological process is the most probable?
A. In the heart muscle {initial stage of myocardium infraction}
B. In skeletal muscle {dystrophy, atrophy}
C. In kidneys and adrenals
D. In liver and kidneys
E. In connective tissue
8. The high level of Lactate Dehydrogenase (LDH) isozymes concentration
showed the increase of LDH-1 and LDH-2 in a patient’s blood plasma. Point
out the most probable diagnosis.
A. Diabetes mellitus
B. Skeletal muscle dystrophy
C. Myocardial infarction
D. Acute pancreatitis
E. Viral hepatitis
9. Analysis of blood serum of a patient revealed the increase of alanine
aminotransferase and aspartate aminotransferase levels. What cytological
changes can cause such a situation?
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 A. Disturbance of genetic apparatus of cells
B. Cellular breakdown
C. Disorder of enzyme systems of cells
D. Disturbance of cellular interrelations
E. Disturbed energy supply of cells
10. A worker has decreased buffer capacity of blood due to exhausting muscular
work. The influx of what acid substance in the blood can cause this symptom?
A. 3-phosphoglycerate
B. 1,3-bisphosphoglycerate
C. Lactate
D. α-ketoglutarate
E. Pyruvate
11. Blood sampling for bulk analysis is recommended to be performed on an
empty stomach and in the morning. What changes in blood composition can
occur if to perform blood sampling after food intake?
A. Reduced contents of erythrocytes
B. Increased contents of erythrocytes
C. Increased contents of leukocytes
D. Increased plasma proteins
E. Reduced contents of thrombocytes
12. A 34-year-old patient was diagnosed with chronic glomerulonephritis 3 years
ago. Edema has developed within the last 6 months. What caused the edema?
A. Liver dysfunction of protein formation
B. Hyperosmolarity of plasma
C. Proteinuria
D. Hyperproduction of vasopressin
E. Hyperaldosteronism
13. Examination of a 43 y.o. anephric patient revealed anemia symptoms. What is
the cause of these symptoms?
A. Folic acid deficit
B. Vitamin B12 deficit
C. Reduced synthesis of erythropoietins
D. Enhanced destruction of erythrocytes
E. Iron deficit
14. A 55 y.o. women consulted a doctor about having continuous cyclic uterine
hemorrhages for a year, weakness, dizziness. Examination revealed skin pallor.
Hemogram: Hb – 70 g/L, erythrocytes-3.2 x 1012/L, color index – 0.6;
leukocytes – 6.0 x 109/L, reticulocytes – 1%, erythrocyte hypochromia. What
anemia is it?
A. Iron-deficiency anemia
B. B12-folate-deficiency anemia
C. Hemolytic anemia
D. Aplastic anemia
E. Chronic posthemorrhagic anemia

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