Section III – Bioenergetics

1. Which one of the following statements about the free energy

Change (ΔG) in a biochemical reaction is CORRECT?
A. If ΔG is negative, the reaction proceeds spontaneously with A
loss of free energy.
B. In an exergonic reaction, ΔG is positive.
C. The standard free energy change when reactants are present
In concentrations of 1.0 mol/L and the pH is 7.0 is Represented
as ΔG0
D. In an endergonic reaction, ΔG is negative.
E. If ΔG is 0, the reaction is essentially irreversible.
2. If the ΔG of a reaction is zero:
A. The reaction goes virtually to completion and is essentially
Irreversible.
B. The reaction is endergonic.
C. The reaction is exergonic.
D. The reaction proceeds only if free energy can be gained.
E. The system is at equilibrium and no net change occurs.
3. ΔG0’ is defined as the standard free energy charge when:
A. The reactants are present in concentrations of 1.0 mol/L.
B. The reactants are present in concentrations of 1.0 mol/L At pH
7.0.
C. The reactants are present in concentrations of 1.0 mmol/L At
pH 7.0.
D. The reactants are present in concentrations of 1.0 μmol/L.
E. The reactants are present in concentrations of 1.0 mol/L At pH
7.4.
4. Which of the following statements about ATP is CORRECT?
A. It contains three high energy phosphate bonds.
B. It is needed in the body to drive exergonic reactions.
C. It is used as an energy store in the body.
D. It functions in the body as a complex with Mg2+.
E. It is synthesized by ATP synthase in the presence of
Uncouplers such as UCP-1 (thermogenin).

5. Which one of the following enzymes uses molecular oxygen as a

Hydrogen acceptor?
A. Cytochrome c oxidase
B. Isocitrate dehydrogenase
C. Homogentisate dioxygenase
D. Catalase
E. Superoxide dismutase
6. Which one of the following statement about cytochromes is
INCORRECT?
A. They are hemoproteins that take part in oxidation-reduction
Reactions.
B. They contain iron which oscillates between Fe3+ and
Fe2+During the reactions they participate in.
C. They act as electron carriers in the respiratory chain in
Mitochondria.
D. They have an important role in the hydroxylation of steroids In
the endoplasmic reticulum.
E. They are all dehydrogenase enzymes.
7. Which one of the following statement about cytochromes P450 is
INCORRECT?
A. They are able to accept electrons from either NADH or NADPH.
B. They are found only in the endoplasmic reticulum.
 C. They are monooxygenase enzymes.
D. They play a major role in drug detoxification in the liver.
E. In some reactions they work in conjunction with Cytochrome
b5.
8. As one molecule of NADH is oxidized via the respiratory chain:
A. 1.5 molecules of ATP are produced in total.
B. 1 molecule of ATP is produced as electrons pass through
Complex IV.
C. 1 molecule of ATP is produced as electrons pass through
Complex II.
D. 1 molecule of ATP is produced as electrons pass through
Complex III.
E. 0.5 of a molecule of ATP is produced as electrons pass Through
complex I.
9. The number of ATP molecules produced for each molecule of
FADH2 Oxidized via the respiratory chain is:
A. 1
B. 2.5
C. 1.5
D. 2
E. 0.5
10. A number of compounds inhibit oxidative phosphorylation—the
Synthesis of ATP from ADP and inorganic phosphate linked to
Oxidation of substrates in mitochondria. Which of the following
Describes the action of oligomycin?
A. It discharges the proton gradient across the mitochondrial Inner
membrane.
B. It discharges the proton gradient across the mitochondrial Outer
membrane.
 C. It inhibits the electron transport chain directly by binding to one
Of the electron carriers in the mitochondrial inner membrane.
D. It inhibits the transport of ADP into, and ATP out of, the
Mitochondrial matrix.
E. It inhibits the transport of protons back into the Mitochondrial
matrix through ATP synthase.
11. A number of compounds inhibit oxidative phosphorylation—the
Synthesis of ATP from ADP and inorganic phosphate linked to
Oxidation of substrates in mitochondria. Which of the following
Describes the action of an uncoupler?
A. It discharges the proton gradient across the mitochondrial Inner
membrane.
B. It discharges the proton gradient across the mitochondrial Outer
membrane.
C. It inhibits the electron transport chain directly by binding to One
of the electron carriers in the mitochondrial inner Membrane.
D. It inhibits the transport of ADP into, and ATP out of, the
Mitochondrial matrix.
E. It inhibits the transport of protons back into the mitochondrial
Matrix through the stalk of the primary particle.
12. A student takes some tablets she is offered at a disco, and
without Asking what they are she swallows them. A short time
later she Starts to hyperventilate, and becomes very hot. What is
the most Likely action of the tablets she has taken?
A. An inhibitor of mitochondrial ATP synthesis
B. An inhibitor of mitochondrial electron transport
C. An inhibitor of the transport of ADP into mitochondria to Be
phosphorylated
D. An inhibitor of the transport of ATP out of Mitochondria Into the
cytosol
 E. An uncoupler of mitochondrial electron transport and Oxidative
phosphorylation
13. The flow of electrons through the respiratory chain and the
Production of ATP are normally tightly coupled. The processes Are
uncoupled by which of the following?
A. Cyanide
B. Oligomycin
C. Thermogenin
D. Carbon monoxide
E. Hydrogen sulphide
14. Which of the following statements about ATP synthase is
INCORRECT?
A. It is located in the inner mitochondrial membrane.
B. It requires a proton motive force to form ATP in the Presence
of ADP and Pi.
C. ATP is produced when part of the molecule rotates.
D. One ATP molecule is formed for each full revolution of the
Molecule.
E. The F1Subcomplex is fixed to the membrane and does not
Rotate.
15. The chemiosmotic theory of Peter Mitchell proposes a
Mechanism for the tight coupling of electron transport via the
Respiratory chain to the process of oxidative phosphorylation.
Which of the following options is NOT predicted by the theory?
A. A proton gradient across the inner mitochondrial Membrane
generated by electron transport drives ATP Synthesis.
B. The electrochemical potential difference across the inner
Mitochondrial membrane caused by electron transport is Positive
on the matrix side.
C. Protons are pumped across the inner mitochondrial Membrane as
electrons pass down the respiratory chain.
D. An increase in the permeability of the inner mitochondrial
Membrane to protons uncouples the processes of electron
Transport and oxidative phosphorylation.
E. ATP synthesis occurs when the electrochemical potential
Difference across the membrane is discharged by Translocation of
protons back across the inner Mitochondrial membrane through
an ATP synthase Enzyme.
Section IV – Metabolism of Carbohydrates

1. Which of the following is a definition of glycemic index?

A. The decrease in the blood concentration of glucagon after
Consuming the food compared with an equivalent amount Of
white bread.
B. The increase in the blood concentration of glucose after
Consuming the food.
C. The increase in the blood concentration of glucose after
Consuming the food compared with an equivalent amount Of
white bread.
D. The increase in the blood concentration of insulin after
Consuming the food.
E. The increase in the blood concentration of insulin after
Consuming the food compared with an equivalent amount Of
white bread.
2. Which of the following will have the lowest glycemic
index?
A. A baked apple
B. A baked potato
C. An uncooked apple
D. An uncooked potato
E. Apple juice
3. Which of the following will have the highest glycaemic
index?
A. A baked apple
B. A baked potato
C. An uncooked apple
D. An uncooked potato
E. Apple juice
4. A blood sample is taken from a 50-year-old woman after an
Overnight fast. Which one of the following will be at a
higher Concentration than after she had eaten a meal?
A. Glucose
B. Insulin
C. Ketone bodies
D. Nonesterified fatty acids
E. Triacylglycerol
5. A blood sample is taken from a 25-year-old man after he
has Eaten three slices of toast and a boiled egg. Which one
of the Following will be at a higher concentration than if
the blood Sample had been taken after an overnight fast?
A. Alanine
B. Glucagon
C. Glucose
D. Ketone bodies
E. Nonesterified fatty acids
6. A blood sample is taken from a 40-year-old man has been
fasting Completely for a week, drinking only water. Which
 of the following Will be at a higher concentration than
after a normal overnight fast?
A. Glucose
B. Insulin
C. Ketone bodies
D. Nonesterified fatty acids
E. Triacylglycerol
7. Which one of following statements about the fed and
fasting Metabolic states is correct?
A. In the fasting state glucagon acts to increase the activity of
Lipoprotein lipase in adipose tissue.
B. In the fasting state, glucagon acts to increase the synthesis Of
glycogen from glucose.
C. In the fed state insulin acts to increase the breakdown of
Glycogen to maintain blood glucose.
D. In the fed state there is decreased secretion of insulin in Response
to increased glucose in the portal blood.
E. Ketone bodies are synthesized in liver in the fasting state, And the
amount synthesized increases as fasting extends Into starvation.
8. Which one of following statements about the fed and
fasting Metabolic states is correct?
A. In the fed state muscle can take up glucose for use as a Metabolic
fuel because glucose transport in muscle is Stimulated in response
to glucagon.
B. In the fed state there is decreased secretion of glucagon in
Response to increased glucose in the portal blood.
C. In the fed state, glucagon acts to increase the synthesis of
Glycogen from glucose.
D. Plasma glucose is maintained in starvation and prolonged Fasting
by gluconeogenesis from ketone bodies.
E. There is an increase in metabolic rate in the fasting state.
9. Which one of following statements about the fed and
fasting Metabolic states is correct?
A. In the fasting state muscle synthesizes glucose from amino Acids.
B. In the fed state adipose tissue can take up glucose for Synthesis of
triacylglycerol because glucose transport in Adipose tissue is
stimulated in response to glucagon.
C. Ketone bodies are synthesized in muscle in the fasting state, And
the amount synthesized increases as fasting extends Into
starvation.
D. Ketone bodies provide an alternative fuel for red blood cells In the
fasting state.
E. Plasma glucose is maintained in starvation and prolonged Fasting
by gluconeogenesis from fatty acids.
10. Which one of following statements about the fed and
fasting Metabolic states is correct?
A. In the fasting state adipose tissue synthesizes glucose from The
glycerol released by the breakdown of triacylglycerol.
B. In the fasting state adipose tissue synthesizes ketone bodies.
C. In the fasting state the main fuel for red blood cells is fatty Acids
released from adipose tissue.
D. Ketone bodies provide the main fuel for the central nervous
System in the fasting state.
E. Plasma glucose is maintained in starvation and prolonged Fasting
by gluconeogenesis in the liver from the amino Acids released by
the breakdown of muscle protein.
11. Which one of following statements about the fed and
fasting Metabolic states is correct?
A. Fatty acids and triacylglycerol are synthesized in the liver in The
fasting state.
B. In the fasting state the main fuel for the central nervous System is
fatty acids released from adipose tissue.
C. In the fasting state the main metabolic fuel for most tissues
Comes from fatty acids released from adipose tissue.
D. In the fed state muscle cannot take up glucose for use as a
Metabolic fuel because glucose transport in muscle is Stimulated
in response to glucagon.
E. Plasma glucose is maintained in starvation and prolonged Fasting
by gluconeogenesis in adipose tissue from the Glycerol released
from triacylglycerol.
12. A 25-year-old man visits his GP complaining of
abdominal Cramps and diarrhea after drinking milk. What
is the most likely Cause of his problem?
A. Bacterial and yeast overgrowth in the large intestine
B. Infection with the intestinal parasite Giardia lamblia
C. Lack of pancreatic amylase
D. Lack of small intestinal lactase
E. Lack of small intestinal sucrase-isomaltase
13. Which one of following statements about glycolysis
and Gluconeogenesis is correct?
A. All the reactions of glycolysis are freely reversible for
Gluconeogenesis.
B. Fructose cannot be used for gluconeogenesis in the liver Because
it cannot be phosphorylated to fructose-6-Phosphate.
C. Glycolysis can proceed in the absence of oxygen only if Pyruvate is
formed from lactate in muscle.
D. Red blood cells only metabolize glucose by anaerobic Glycolysis
(and the pentose phosphate pathway).
E. The reverse of glycolysis is the pathway for gluconeogenesis In
skeletal muscle.
 14. Which one of following statements about the step in
glycolysis Catalyzed by hexokinase and in gluconeogenesis
by glucose 6-phosphatase is correct?
A. Because hexokinase has a low Km its activity in liver Increases as
the concentration of glucose in the portal Blood increases.
B. Glucose-6-phosphatase is mainly active in muscle in the Fasting
state.
C. If hexokinase and glucose-6-phosphatase are both equally Active
at the same time there is net formation of ATP from ADP and
phosphate.
D. Liver contains an isoenzyme of hexokinase, glucokinase, Which is
especially important in the fed state.
E. Muscle can release glucose into the circulation from its Glycogen
reserves in the fasting state.
15. Which one of following statements about this step in
glycolysis Catalyzed by phosphofructokinase and in
gluconeogenesis by Fructose 1,6-bisphosphatase is correct?
A. Fructose 1,6-bisphosphatase is mainly active in the liver in The fed
state.
B. Fructose 1,6-bisphosphatase is mainly active in the liver in The fed
state.
C. If phosphofructokinase and fructose 1,6-bisphosphatase are Both
equally active at the same time, there is a net Formation of ATP
from ADP and phosphate.
D. Phosphofructokinase is inhibited more or less completely By
physiological concentrations of ATP.
E. Phosphofructokinase is mainly active in the liver in the Fasting
state.
 16. Which one of the following statements about glucose
metabolism In maximum exertion is correct?
A. Gluconeogenesis from lactate requires less ATP than is Formed
during anerobic glycolysis.
B. In maximum exertion pyruvate is oxidized to lactate in Muscle.
C. Oxygen debt is caused by the need to exhale carbon dioxide
Produced in response to acidosis.
D. Oxygen debt reflects the need to replace oxygen that has Been
used in muscle during vigorous exercise.
E. There is metabolic acidosis as a result of vigorous exercise.
17. Which one of following statements is correct?
A. Glucose-1-phosphate may be hydrolyzed to yield free Glucose in
liver.
B. Glucose-6-phosphate can be formed from glucose, but not From
glycogen.
C. Glucose-6-phosphate cannot be converted to glucose 1-
phosphate in liver.
D. Glucose-6-phosphate is formed from glycogen by the Action of
the enzyme glycogen phosphorylase.
E. In liver and red blood cells, glucose-6-phosphate may enter Into
either glycolysis or the pentose phosphate pathway.
18. Which one of following statements about the
pyruvate Dehydrogenase multienzyme complex is correct?
A. In thiamin (vitamin B1) deficiency, pyruvate formed in Muscle
cannot be transaminated to alanine.
B. In thiamin (vitamin B1) deficiency, pyruvate formed in Muscle
cannot be carboxylated to oxaloacetate.
C. The reaction of pyruvate dehydrogenase involves Decarboxylation
and oxidation of pyruvate, then formation Of acetyl CoA.
D. The reaction of pyruvate dehydrogenase is readily Reversible, so
that acetyl CoA can be used for the synthesis Of pyruvate, and
hence glucose.
E. The reaction of pyruvate dehydrogenase leads to the Oxidation of
NADH to NAD+, and hence the formation of ~2.5 × ATP per mol of
pyruvate oxidized.
19. Which one of following statements about the pentose
phosphate Pathway is correct?
A. In favism red blood cells are more susceptible to oxidative Stress
because of a lack of NADPH for fatty acid synthesis.
B. People who lack glucose-6-phosphate dehydrogenase Cannot
synthesize fatty acids because of a lack of NADPH In liver and
adipose tissue.
C. The pentose phosphate pathway is especially important in Tissues
that are synthesizing fatty acids.
D. The pentose phosphate pathway is the only source of NADPH for
fatty acid synthesis.
E. The pentose phosphate pathway provides an alternative to
Glycolysis only in the fasting state.
20. Which one of following statements about glycogen
metabolism is Correct?
A. Glycogen is synthesized in the liver in the fed state, then Exported
to other tissues in low density lipoproteins.
B. Glycogen reserves in liver and muscle will meet energy
Requirements for several days in prolonged fasting.
C. Liver synthesizes more glycogen when the hepatic portal Blood
concentration of glucose is high because of the Activity of
glucokinase in the liver.
D. Muscle synthesizes glycogen in the fed state because Glycogen
phosphorylase is activated in response to insulin.
E. The plasma concentration of glycogen increases in the fed State.
21. Which one of following statements about
gluconeogenesis is Correct?
A. Because they form acetyl CoA, fatty acids can be a substrate For
gluconeogenesis.
B. If oxaloacetate is withdrawn from the citric acid cycle for
Gluconeogenesis then it can be replaced by the action of Pyruvate
dehydrogenase.
C. The reaction of phosphoenolpyruvate carboxykinase is Important
to replenish the pool of citric acid cycle Intermediates.
D. The use of GTP as the phosphate donor in the
Phosphoenolpyruvate carboxykinase reaction provides a Link
between citric acid cycle activity and gluconeogenesis.
E. There is a greater yield of ATP in anaerobic glycolysis than The
cost for synthesis of glucose from lactate.
22. Which one of following statements about
carbohydrate Metabolism is correct?
A. A key step in the biosynthesis of glycogen is the formation Of
UDP-glucose.
B. Glycogen can be broken down to glucose-6-phosphate in Muscle,
which then releases free glucose by the action of The enzyme
glucose-6-phosphatase.
C. Glycogen is stored mainly in the liver and brain.
D. Insulin inhibits the biosynthesis of glycogen.
E. Phosphorylase kinase is an enzyme that phosphorylates the
Enzyme glycogen phosphorylase and thereby decreases Glycogen
breakdown.
23. Which one of following statements about glycogen
metabolism is Correct?
A. Glycogen synthase activity is increased by glucagon.
B. Glycogen phosphorylase is an enzyme that can be activated By
phosphorylation of serine residues.
C. Glycogen phosphorylase cannot be activated by calcium Ions.
D. cAMP activates glycogen synthesis.
E. Glycogen phosphorylase breaks the α1-4 glycosidic bonds By
hydrolysis.
24. Which one of following statements about glucose
metabolism is Correct?
A. Glucagon increases the rate of glycolysis.
B. Glycolysis requires NADP+.
C. In glycolysis, glucose is cleaved into two three carbon
Compounds.
D. Substrate level phosphorylation takes place in the electron
Transport system.
E. The main product of glycolysis in red blood cells is Pyruvate.
25. Which one of following statements about metabolism
of sugars is Correct?
A. Fructokinase phosphorylates fructose to fructose-6-Phosphate.
B. Fructose is an aldose sugar like glucose.
C. Fructose transport into cells is insulin dependent.
D. Galactose is phosphorylated to galactose-1-phosphate by
Galactokinase.
E. Sucrose can be biosynthesized from glucose and fructose in The
liver.
26. In glycolysis, the conversion of 1 mol of fructose 1,6-
bisphosphate to 2 mol of pyruvate results in the formation
of:
A. 1 mol NAD+ and 2 mol of ATP
B. 1 mol NADH and 1 mol of ATP
C. 2 mol NAD+ and 4 mol of ATP
D. 2 mol NADH and 2 mol of ATP
E. 2 mol NADH and 4 mol of ATP
27. Which of the following will provide the main fuel for
muscle Contraction during short-term maximum exertion?
A. Muscle glycogen
B. Muscle reserves of triacylglycerol
C. Plasma glucose
D. Plasma nonesterified fatty acids
E. Triacylglycerol in plasma very low density lipoprotein
28. The disaccharide lactulose is not digested, but is
fermented by Intestinal bacteria, to yield 4 mol of lactate
plus 4 protons. Ammonium (NH4+) is in equilibrium with
ammonia (NH3) in The bloodstream. Which of the
following best explains how Lactulose acts to treat
hyperammonemia (elevated blood Ammonium
concentration)?
A. Fermentation of lactulose increases the acidy of the Bloodstream
so that there is more ammonium and less Ammonia is available to
cross the gut wall.
B. Fermentation of lactulose results in acidification of the gut
Contents so that ammonia diffuses from the bloodstream into The
gut and is trapped as ammonium that cannot cross back.
C. Fermentation of lactulose results in acidification of the gut
Contents so that ammonia produced by intestinal bacteria is
Trapped as ammonium that cannot diffuse into the Bloodstream.

D. Fermentation of lactulose results in an eightfold increase in The

osmolality of the gut contents, so that there is more Water for
ammonia and ammonium to dissolve in, so that Less is absorbed
into the bloodstream.
 E. Fermentation of lactulose results in an eightfold increase in The
osmolality of the gut contents, so that there is more Water for
ammonia and ammonium to dissolve in, so that More will diffuse
for the bloodstream into the gut.

Section V – Metabolism of Lipids

1. Which one of the following statements concerning fatty

acid Molecules is CORRECT?
A. They consist of a carboxylic acid head group attached to a
Carbohydrate chain.
B. They are called polyunsaturated when they contain one or More
carbon-carbon double bonds.
C. Their melting points increase with increasing unsaturation.
D. They almost always have their double bonds in the
cisConfiguration when they occur naturally.
E. They occur in the body mainly in the form of free (nonesterified)
fatty acids.
2. Which one of the following is NOT a phospholipid?
A. Sphingomyelin
B. Plasmalogen
C. Cardiolipin
D. Galactosylceramide
E. Lysolecithin
3. Which one of the following statements about gangliosides
is INCORRECT?
A. They are derived from galactosylceramide.
B. They contain one or more molecules of sialic acid.
C. They are present in nervous tissue in high concentrations.
D. The ganglioside GM1 is the receptor for cholera toxin in The
human intestine.
E. They function in cell-cell recognition.
4. Which one of the following is a chain-breaking antioxidant?
A. Glutathione peroxidase
B. Selenium
C. Superoxide dismutase
D. EDTA
E. Catalase
5. After they are produced from acetyl-CoA in the liver,
ketone Bodies are mainly used for which one of the
following processes?
A. Excretion as waste products
B. Energy generation in the liver
C. Conversion to fatty acids for storage of energy
D. Generation of energy in the tissues
E. Generation of energy in red blood cells
6. The subcellular site of the breakdown of long chain fatty
acids to Acetyl-CoA via β-oxidation is:
A. The cytosol
B. The matrix of the mitochondria
C. The endoplasmic reticulum
D. The mitochondrial intermembrane space
E. The Golgi apparatus
7. Carnitine is needed for fatty acid oxidation BECAUSE:
A. It is a cofactor for acyl-CoA synthetase, which activates Fatty acids
for breakdown.
B. Long chain acyl-CoA (“activated fatty acids”) need to enter The
mitochondrial matrix to be oxidized, but cannot cross The outer
 mitochondrial membrane. Transfer of the acyl Group from CoA to
carnitine enables translocation to occur.
C. Long chain acyl-CoA (“activated fatty acids”) need to enter The
mitochondrial matrix to be oxidized, but cannot cross The outer
mitochondrial membrane. Transfer of the acyl Group from CoA to
carnitine enables translocation to occur.
D. Long chain acyl-CoA (“activated fatty acids”) need to enter The
mitochondrial intermembrane space to be oxidized, but Cannot
cross the inner mitochondrial membrane. Transfer Of the acyl
group from CoA to carnitine enables Translocation to occur.
E. It prevents the breakdown of long chain fatty acyl CoA in The
mitochondrial intermembrane space.
8. The breakdown of one molecule of a C16 fully saturated
fatty Acid (palmitic acid) by β-oxidation lead to the
formation of:
A. 8 FADH2, 8 NADH and 8 acetyl CoA molecules
B. 7 FADH2, 7 NADH and 7 acetyl CoA molecules
C. 8 FADH2, 8 NADH and 7 acetyl CoA molecules
D. 7 FADH2, 8 NADH and 8 acetyl CoA molecules
E. 7 FADH2, 7 NADH and 8 acetyl CoA molecules
9. Malonyl CoA, the first intermediate in fatty acid synthesis,
is an Important regulator of fatty acid metabolism
BECAUSE:
A. Its formation from acetyl CoA and bicarbonate by the Enzyme
acetyl CoA carboxylase is the main rate-limiting Step in fatty acid
synthesis.
B. It prevents entry of fatty acyl groups into the matrix of the
Mitochondria because it is a potent inhibitor of carnitine
Palmitoyl transferase-I.
C. It prevents entry of fatty acyl groups into the matrix of the
Mitochondria because it is a potent inhibitor of carnitine
Palmitoyl transferase-II.
D. It prevents entry of fatty acyl groups into the matrix of the
Mitochondria because it is a potent inhibitor of
carnitineacylcarnitine translocase.
E. It inhibits the synthesis of fatty acyl CoA.
10. Α-Linolenic acid is considered to be nutritionally
essential in Humans BECAUSE:
A. It is an ω3 fatty acid.
B. It contains three double bonds.
C. In humans double bonds cannot be introduced into fatty Acids
beyond the Δ9 position.
D. In humans double bonds cannot be introduced into fatty Acids
beyond the Δ12 position.
E. Human tissues are unable to introduce a double bond in The Δ9
position of fatty acids.
11. Inactivation of acetyl CoA carboxylase is favored
WHEN:
A. Cytosolic citrate levels are high.
B. It is in a polymeric form.
C. Palmitoyl CoA levels are low.
D. The tricarboxylate transporter is inhibited.
E. It is dephosphorylated.
12. Which one of the following eicosanoids is synthesized
from Linoleic acid via the cyclooxygenase pathway?
A. Prostaglandin E1 (PGE1)
B. Leukotriene A3 (LTA3)
C. Prostaglandin E3 (PGE3)
D. Lipoxin A4 (LXA4)
E. Thromboxane A3 (TXA3)
13. Which one of the following enzymes is inhibited by
the Nonsteroidal anti-inflammatory drug (NSAID) aspirin?
A. Lipoxygenase
B. Prostacyclin synthase
C. Cyclooxygenase
D. Thromboxane synthase
E. Δ6 desaturase
14. Which one of the following is the major product of
fatty acid Synthase?
A. Acetyl-CoA
B. Oleate
C. Palmitoyl-CoA
D. Acetoacetate
E. Palmitate
15. Fatty acids are broken down by repeated removal of
two carbon Fragments as acetyl CoA in the β-oxidation
cycle, and Synthesized by repeated condensation of acetyl
CoAs until a long Chain saturated fatty acid with an even
number of carbons is Formed. Since fatty acids need to be
broken down when energy is Short supply and synthesized
when it is plentiful, there are Important differences
between the two processes which help cells To regulate
them efficiently. Which one of the following Statements
concerning these differences is INCORRECT?
A. Fatty acid breakdown takes place inside mitochondria, While
synthesis occurs in the cytosol.
B. Fatty acid breakdown uses NAD+ and produces NADH, While
synthesis uses NADPH and produces NADP.
C. Fatty acyl groups are activated for breakdown using CoA And for
synthesis using acyl carrier protein.
D. Transport across the mitochondrial membrane of fatty acyl
Groups and acetyl CoA is required for fatty acid breakdown And
synthesis, respectively.
E. Glucagon promotes fatty acid synthesis and inhibits fatty Acid
breakdown.
16. Hormone sensitive lipase, the enzyme which
mobilizes fatty acids From triacylglycerol stores in adipose
tissue is inhibited by:
A. Glucagon
B. ACTH
C. Epinephrine
D. Vasopressin
E. Prostaglandin E
17. Which one of the following best describes the action
of Phospholipase C?
A. It releases the fatty acyl chain from the sn-2 position of a
Phospholipid.
B. It cleaves a phospholipid into its phosphate-containing Head
group and a diacylglycerol.
C. It releases the head group of a phospholipid, leaving Phosphatidic
acid.
D. It releases the fatty acyl chain from the sn-1 position of a
Phospholipid.
E. It releases the fatty acyl chains from the sn-1 and sn-2 Positions of
a phospholipid.
18. Tay Sachs disease is a lipid storage disease caused by
a genetic Defect in deficiency which one of the following
enzymes:
A. Β-Galactosidase
B. Sphingomyelinase
C. Ceramidase
D. Hexosaminidase A
E. Β-Glucosidase
19. Which of the plasma lipoproteins is best described as
follows: Synthesized in the intestinal mucosa, containing a
high Concentration of triacylglycerol and responsible for
the transport Of dietary lipids in the circulation?
A. Chylomicrons
B. High-density lipoprotein
C. Intermediate density lipoprotein
D. Low-density lipoprotein
E. Very low density lipoprotein
20. Which of the plasma lipoproteins is best described as
follows: Synthesized in the liver, containing a high
concentration of Triacylglycerol and mainly cleared from
the circulation by Adipose tissue and muscle?
A. Chylomicrons
B. High-density lipoprotein
C. Intermediate density lipoprotein
D. Low-density lipoprotein
E. Very low density lipoprotein
21. Which of the plasma lipoproteins is best described as
follows: Formed in the circulation by removal of
triacylglycerol from very Low density lipoprotein, contains
cholesterol taken up from High-density lipoprotein delivers
cholesterol to extrahepatic Tissues?
A. Chylomicrons
B. High-density lipoprotein
C. Intermediate density lipoprotein
D. Low-density lipoprotein
E. Very low density lipoprotein
22. Which of the following will be elevated in the
bloodstream about 2 hours after eating a high-fat meal?
A. Chylomicrons
B. High-density lipoprotein
C. Ketone bodies
D. Nonesterified fatty acids
E. Very low density lipoprotein
23. Which of the following will be elevated in the
bloodstream about 4 hours after eating a high-fat meal?
A. Chylomicrons
B. High-density lipoprotein
C. Ketone bodies
D. Nonesterified fatty acids
E. Very low density lipoprotein
24. Which one of the following processes is NOT involved
in the Efflux of cholesterol from extrahepatic tissues and its
delivery to The liver for excretion by HDL?
A. Efflux of cholesterol from tissues to pre-β HDL via ABCA1.
B. Esterification of cholesterol to cholesteryl ester by LCAT to Form
HDL3.
C. Transfer of cholesteryl ester from HDL to VLDL, IDL, and LDL by
the action of cholesteryl ester transfer protein (CETP).
D. Efflux of cholesterol from tissues to HDL3 Via SR-B1 and ABCG1.
E. Selective uptake of cholesteryl ester from HDL2 By the liver Via
SR-B1.
25. Which one of the following statements concerning
chylomicrons Is CORRECT?
A. Chylomicrons are made inside intestinal cells and secreted Into
lymph, where they acquire apolipoproteins B and C.
B. The core of chylomicrons contains triacylglycerol and
Phospholipids.
C. The enzyme hormone sensitive lipase acts on chylomicrons To
release fatty acids from triacylglycerol when they are Bound to
the surface of endothelial cells in blood Capillaries.
D. Chylomicron remnants differ from chylomicrons in that They are
smaller and contain a lower proportion of Triacylglycerol and a
higher proportion of cholesterol.
E. Chylomicrons are taken up by the liver.
26. Which one of the following statements concerning
the Biosynthesis of cholesterol is CORRECT?

A. The rate-limiting step is the formation of 3-hydroxy 3-

methylglutaryl-CoA (HMG-CoA) by the enzyme HMG-CoA
synthase.
B. Synthesis occurs in the cytosol of the cell.
C. All the carbon atoms in the cholesterol synthesized Originate from
acetyl-CoA.
D. Squalene is the first cyclic intermediate in the pathway.
E. The initial substrate is mevalonate.
27. The class of drugs called statins have proved very
effective against Hypercholesterolemia, a major cause of
atherosclerosis and Associated cardiovascular disease.
These drugs reduce plasma Cholesterol levels by:
A. Preventing absorption of cholesterol from the intestine.
B. Increasing the excretion of cholesterol from the body via
Conversion to bile acids.
C. Inhibiting the conversion of 3-hydroxy-3-methylglutarylCoA to
mevalonate in the pathway for cholesterol Biosynthesis.
D. Increasing the rate of degradation of 3-hydroxy-3-Methylglutaryl
CoA reductase.
E. Stimulating the activity of the LDL receptor in the liver.
28. Which of the following statements about bile acids
(or bile salts) Is INCORRECT:
A. Primary bile acids are synthesized in the liver from Cholesterol.
B. Bile acids are needed for the breakdown of fats by Pancreatic
lipase.
C. Secondary bile acids are produced by modification of Primary bile
acids in the liver.
D. Bile acids facilitate the absorption of the products of lipid
Digestion in the jejunum.
E. Bile acids are recirculated between the liver and the small
Intestine in the enterohepatic circulation.
29. A 35-year-old man with severe hypercholesterolemia
has a family History of deaths at a young age from heart
disease and stroke. Which of the following genes is likely to
be defective?
A. Apolipoprotein E
B. The LDL receptor
C. Lipoprotein lipase
D. PCSK9
E. LCAT
30. The recently discovered protein, proprotein
convertase Subtilisin/kexin type 9 (PCSK9), has been
identified as a Potential target for antiatherogenic drugs
BECAUSE:
 A. It decreases the number of LDL receptors exposed at the Cell
surface, thus LDL uptake is lowered and blood Cholesterol levels
rise.
B. It inhibits the binding of apoB to the LDL receptor, thus Blocking
uptake of the lipoprotein and raising blood Cholesterol levels.
C. It increases the absorption of cholesterol from the intestine.
D. It prevents the breakdown of cholesterol to bile acids in the Liver.
E. It increases the synthesis and secretion of VLDL in the Liver,
leading to increased LDL formation in the blood.
Section VI – Metabolism of Proteins & Amino Acids

1. Select the one of the following statements that is NOT

CORRECT:
A. Δ1-Pyrroline-5-carboxylate is an intermediate both in the
Biosynthesis and in the catabolism of L-proline.
B. Human tissues can form dietarily nonessential amino acids From
amphibolic intermediates or from dietarily essential Amino acids.
C. Human liver tissue can form serine from the glycolytic
Intermediate 3-phosphoglycerate.
D. The reaction catalyzed by phenylalanine hydroxylase
Interconverts phenylalanine and tyrosine.
E. The reducing power of tetrahydrobiopterin derives Ultimately
from NADPH.
2. Identify the metabolite that does NOT serve as a precursor
of a Dietarily essential amino acid:
A. Α-Ketoglutarate
B. 3-Phosphoglycerate
C. Glutamate
D. Aspartate
E. Histamine
3. Select the one of the following statements that is NOT
CORRECT:

A. Selenocysteine is present at the active sites of certain Human

enzymes.
B. Selenocysteine is inserted into proteins by a Posttranslational
process.
C. Transamination of dietary α-keto acids can replace the Dietary
essential amino acids leucine, isoleucine, and Valine.
D. Conversion of peptidyl proline to peptidyl-4-hydroxyproline Is
accompanied by the incorporation of oxygen into succinate.
E. Serine and glycine are interconverted in a single reaction in Which
tetrahydrofolate derivatives participate.
4. Select the CORRECT answer:The first reaction in the
degradation of most of the protein amino Acids involves
the participation of:
A. NAD+
B. Thiamine pyrophosphate (TPP)
C. Pyridoxal phosphate
D. FAD
E. NAD+ And TPP
5. Identify the amino acid that is the major contributor to the
Transport of nitrogen destined for excretion as urea:
A. Alanine
B. Glutamine
C. Glycine
D. Lysine
E. Ornithine
 6. Select the one of the following statements that is NOT
CORRECT:
A. Angelman syndrome is associated with a defective Ubiquitin E3
ligase.
B. Following a protein-rich meal, the splanchnic tissues Release
predominantly branched-chain amino acids, which Are taken up
by peripheral muscle tissue.
C. The rate of hepatic gluconeogenesis from glutamine Exceeds that
of any other amino acid.
D. The L-α-amino oxidase-catalyzed conversion of an Α-amino acid to
its corresponding α-keto acid is Accompanied by the release of
NH4+.
E. Similar or even identical signs and symptoms can be Associated
with different mutations of the gene that Encodes a given
enzyme.
7. Select the one of the following statements that is NOT
CORRECT:
A. PEST sequences target some proteins for rapid degradation.
B. ATP and ubiquitin typically participate in the degradation Of
membrane-associated proteins and other proteins with Long half-
lives.
C. Ubiquitin molecules are attached to target proteins via Non-α
peptide bonds.
D. The discoverers of ubiquitin-mediated protein degradation
Received a Nobel Prize.
E. Degradation of ubiquitin-tagged proteins takes place in the
Proteasome, a multi-subunit macromolecule present in all
Eukaryotes.
 8. For metabolic disorders of the urea cycle, which statement
is NOT CORRECT:
A. Ammonia intoxication is most severe when the metabolic Block in
the urea cycle occurs prior to the reaction Catalyzed by
argininosuccinate synthase.
B. Clinical symptoms include mental retardation and the Avoidance
of protein-rich foods.
C. Clinical signs can include acidosis.
D. Aspartate provides the second nitrogen of Argininosuccinate.
E. Dietary management focuses on a low-protein diet ingested As
frequent small meals.
9. Select the one of the following statements that is NOT
CORRECT:
A. One metabolic function of glutamine is to sequester Nitrogen in a
nontoxic form.
B. Liver glutamate dehydrogenase is allosterically inhibited by ATP
and activated by ADP.
C. Urea is formed both from absorbed ammonia produced by Enteric
bacteria and from ammonia generated by tissue Metabolic
activity.
D. The concerted action of glutamate dehydrogenase and Glutamate
aminotransferase may be termed Transdeamination.
E. Fumarate generated during biosynthesis of Argininosuccinate
ultimately forms oxaloacetate in Reactions in mitochondria
catalyzed successively by Fumarase and malate dehydrogenase.
10. Select the one of the following statements that is
NOT CORRECT:
A. Threonine provides the thioethanol moiety for biosynthesis Of
coenzyme A.
B. Histamine arises by decarboxylation of histidine.
 C. Ornithine serves as a precursor of both spermine and Spermidine.
D. Serotonin and melatonin are metabolites of tryptophan.
E. Glycine, arginine, and methionine each contribute atoms For
biosynthesis of creatine.
11. Select the one of the following statements that is
NOT CORRECT:
A. Excreted creatinine is a function of muscle mass, and can Be used
to determine whether a patient has provided a Complete 24-hour
urine specimen.
B. Many drugs and drug catabolites are excreted in urine as Glycine
conjugates.
C. The major nonprotein metabolic fate of methionine is Conversion
to S-adenosylmethionine.
D. The concentration of histamine in brain hypothalamus Exhibits a
circadian rhythm.
E. Decarboxylation of glutamine forms the inhibitory
Neurotransmitter GABA (γ-aminobutyrate).
12. What distinguishes the routes by which each of the
following Amino acids appears in human proteins:
5-Hydroxylysine
Γ-Carboxyglutamate
Selenocysteine
5-Hydroxylysine and γ-carboxyglutamate represent examples of
posttranslational modification of peptidyl lysyl and peptidyl glutamyl
residues, respectively. By contrast,Selenocysteine is incorporated into
proteins cotranslationally, in the same way as the other 20 common
protein amino acids. The process is complex, and involves the unusual
tRNA termed tRNAsec.
 13. What evolutionary advantage might be gained by the
fact that Certain amino acids are dietarily essential for
human subjects?
Biosynthesis of the amino acids that are dietarily essential for humans
requires multiple reactions. Since human diets typically contain
adequate amounts of these amino acids, loss of the genes that can
encode these “unnecessary” enzymes and the lack of need to expend
the energy required to copy tthemprovide an evolutionary advantage
14. What explanation can you offer to explain that
metabolic defects That result in the complete absence of
the activity of glutamate Dehydrogenase have not been
detected?
Since glutamate dehydrogenase plays multiple central roles in
metabolism, its complete absence would unquestionably be fatal.
15. Which of the following is NOT a hemoprotein?
A. Myoglobin
B. Cytochrome c
C. Catalase
D. Cytochrome P450
E. Albumin
16. A 30-year-old man presented at clinic with a history
of intermittent Abdominal pain and episodes of confusion
and psychiatric Problems. Laboratory tests revealed
increases of urinary Δ-aminolevulinate and
porphobilinogen. Mutational analysis Revealed a mutation
in the gene for uroporphyrinogen I synthase
(porphobilinogen deaminase). The probable diagnosis was:
A. Acute intermittent porphyria.
B. X-linked sideroblastic anemia.
C. Congenital erythropoietic porphyria.
D. Porphyria cutanea tarda.
E. Variegate porphyria.
17. Select the one of the following statements that is
NOT CORRECT:
A. Bilirubin is a cyclic tetrapyrrole.
B. Albumin-bound bilirubin is transported to the liver.
C. High levels of bilirubin can cause damage to the brains of
Newborn infants.
D. Bilirubin contains methyl and vinyl groups.
E. Bilirubin does not contain iron.
18. A 62-year-old female presented at clinic with intense
jaundice, Steadily increasing over the preceding 3 months.
She gave a History of severe upper abdominal pain,
radiating to the back, And had lost considerable weight.
She had noted that her stools Had been very pale for some
time. Lab tests revealed a very high Level of direct bilirubin,
and also elevated urinary bilirubin. The Plasma level of
alanine aminotransferase (ALT) was only slightly Elevated,
whereas the level of alkaline phosphatase was markedly
Elevated. Abdominal ultrasonography revealed no
evidence of Gallstones. Of the following, which is the most
likely diagnosis?
A. Gilbert syndrome
B. Hemolytic anemia
C. Type 1 Crigler-Najjar syndrome
D. Carcinoma of the pancreas
E. Infectious hepatitis.
 19. Clinical laboratories typically use diazotized sulfanilic
acid to Measure serum bilirubin and its derivatives. What is
the physical Basis that permits the laboratory to report
results to the physician In terms of these two forms of
bilirubin?
The assay takes advantage of the different water solubility of
unconjugated and conjugated bilirubin. Two assays are conducted, one
in the absence and a second in the presence of an organic solvent,
typically methanol. The highly polar glucuronic acid groups of
conjugated bilirubin convey water solubility that insures that it will
react with the colorimetric reagent even in the absence of any added
organic solvent. Data from an assay conducted in the absence of added
methanol, termed “direct bilirubin,” is bilirubin glucuronide. A second
assay conducted in the presence of added methanol measures total
bilirubin, ie, both conjugated and unconjugated bilirubin.The difference
between total bilirubin and direct bilirubin, reported as “indirect
bilirubin,” is unconjugated bilirubin
20. What signals the synthesis of heme to take place?
The biosynthesis of heme from succinyl-CoA and glycine occurs only
when the availability of free iron signals the potential for synthesis of
heme. Regulation targets the first enzyme of the pathway, δ-
aminolevulinate synthase (ALA synthase) rather than a subsequent
reaction. This conserves energy by avoiding wasting a coenzyme A
thioester.

Reference: HARPER’S ILLUSTRATED BIOCHEMISTRY 30th edition