Department of Biochemistry - CHRI

I MBBS 2023-24- 1st Internal Theory Examination - 17/11/2023

Total marks:100 Time: 09.00 AM- 12.00.t-1~1

Section B
Essay :(2xl0=20)
I.A 55 year old uncontrolled Diabetic and obese patient was brought to the emergency department with
complaints of sudden onset chest pain.ECG shows elevated ST segment and T wave inversion.
A. What could be your provisional diagnosis?(})
B.Name the enzymes that can be elevated in this condition?(2)
C.Brief about any two enzymes with its clinical significance(?)
2. Discuss in detail about the definition, classification and clinical significance of different types of
phospholipids.
Short notes:(4x5=20)
3. aFunctions of mitochondria(2.5)
b.Epimerism(2.5)
4. Active transport
5. Isoelectric point and its significance
6. Competitive inhibition
Section C

Essay:(2xl0=20)
7.A 4 year old male child was brought to the OPD with dysmorphic facies and skeletal changes ,delayed
teeth eruption.Examination revealed widening of radius ,chest deformities,rachitic rosary,muscle weakness
and lack of tooth eruption.Investigations show low calcium and phosphorus and vitamin D.
A) What is your diagnosis?(!)
B) Discuss in detail about the RDA,sources·,metabolism,regulation and deficiency manifestations of
Vitamin D(l+l+2+2+3)
8.Discuss in detail about the structural organisation of proteins.Add a note on structure function relationship
using hemoglobin as an example(7+3)
Short notes:(4x5=20) •
\ 9. Types and functions of RNA
\ ~xygen dissociati~n curve
• 11. Heteropolysachharides
\2. Functions of Vitamin A
 Department of Biochemistry - CHRI
I MBBS 2023-24 - II nd Internal Theory _Examination - 19/1/2
024
Total marks: 100 Time: 08.30 AM - 11.30A M·

Section B
Essay :(2x10=20)
1. Discuss in detail about the steps, regulation and significance
of HMP pathway
(4+2+4)
2. A 5 year old boy was brought to the hospital with the complaint
of swelling in the
abdomen. On examination, liver was found to be enlarged (hepat
omegaly); blood
examination showed hypoglycemia, hyperuricemia, hyperlipide
mia, lactic acidosis,
and ketoacidosis. Fasting hypoglycemia does not respond to stimu
lation by adrenaline.
What is your probable diagnosis? (I mark). Discuss in detail
about glycogenolysis
and its regulation.(6+3)
Short notes:(4x5=20)
3. Oral Glucose Tolerance Test(OGTT)
4. Galactosemia
5. Rapaport leubering cycle
6. Phase I Detoxification Reactions

Section C ..
Essay :(2x1 0=20)
7.A 32 year old man was brought to the casu~lty with complaints
for two days. His son mentioned that he had muscle_ weakness
of altered sensorium Q
and a staggering gait in
the· 1ast week. He is a chronic alcoholic and due to his addic
tion he was not having
prope r food for the last few days.
What is your probable diagnosis? (1 mark)
Discuss in detail about the RDA, s?urces, Biochemical functi
ons and deficiency
manifestations of Vitamin Bl (1+1+3+4)
8.Discuss in detail about the RDA, sources, Absorption, Bioch
emical functions and
deficiency manifestations of Vitamin B 12

Short notes:(4x5=20)
9.Folate trap
10.Regulation Of Blood Glucose in the fasting state
11.Pyridoxine
12.Im~unoglobulin
 Department of Biochemistry - CHRI
I MBBS 2023-24-Illrd Internal Theory Exa~!nation - 22/3/2024
Time: 8.30 AM - 11.30PM
Total marks : loo

Section B

Essay :(2xl0=20} • · . · · di
A 21 _Yi Id man presente~ to OPD with complaints of intenmttent mild chest pain sappeared on
!, rest. p:;:i examination Showed multiple xanthomas over elbow, Achilles tendon, fingers, and
buttocks. His biochemical investigations are as follows:
Cholesterol 560 mg/di (<200mg/dl)
TGL 150 mg/di (<150mg/dl)
LDL cholesterol 500 mg/di (<l 30mg/dl)
HDL cholesterol 30mg/dl-(>40 mg/di for men> 50mg/dl for women)
r Family history revealed premature cardiac death of elder brother at the age of 25 years. His thyroid
profile and renal function tests were normal
I a What is the p~obable diagnosis?(lM)
b. Discuss in detail about the metabolism ofLDL & its role in atherosclerosis.(6M)
c. Add a note on any two types ofhyperlipoproteinemia (3M)
2. Discuss in detail about the definition, transport, steps, energetics and regulation
Of beta oxidation of fatty acids. (1+2+4+2+1)
Short notes: 4x5=20
3. Lipid Profi e
4. Ketosi~I r 1
5. Electrophoresis
r,._1 6. a) Fatty liver b) products derived from cholesterol .
c;r <, { r, '? I , \ section C
\ t) '>/ ti~ ,,, "'
t:/ \ 4t>/
Essay:(2xl o'=20)
I

7. An 8 -year old f~male presented with complain

.
of involuntary repeated qiovements in left hand for. past 4
months, which has been progressively worsening over the period of one month. On examination, .she had flat
foot, ectopia lentis and skeletal deformities she also complains of difficulty in vision for pasj 2 years. Baby
is born to consanguineous marriage. Her elder brother died at the age of 4 after few episodes of fits. Blood
investigations revealed high level of serum homocysteine 220 l{ mol/L (normal is <15 l{ moVL).LFT, KFT,

TFT, serum electrolytes results were within normal limits. .

a What is the probable diagnosis?(! mark) J

b. Explain the steps involved in Methionine metabolism. Add a note on transmethylation reactions. (6+3)

8·. Discuss in detail about the electron transport chain complex. Add a note on oxidative
phosphorylation.(6+4)

Short notes:(4x5=20)
9. Products derived from tryptophan
10. De~cri~e and discuss the conunitme~t of lifelong learning a~ an .important part of physician gro.wth
11. Plasma proteins '
12. a. Alkaptonuria
b. Maple syrup urine disease
 Departme nt of Biochemi stry - CHRI
I MBBS 2023-24 - IVth Internal Theory Examinati on - 16/5/2024
Total marks: 100 Time: 8.30 AM - 11.30PM

Section B \
Essay :(2x10=2 0l

1. A 10-year-o ld boy came to the OPD with complain of loss of appetite, early fatique and
lethargy. Mother complained that boy is tried very soon while playing and suffer from
r headache frequently. On examination, nails were flat and pallor was seen. Peripheral smear
showed hypochromic, microcytic picture. ,.
A. What is your probable diagnosis? (1 mark)

B. Discuss in detail about the sources,RDA,digestion and absorption, regulation and

disorders associated with the affected mineral.(1+1+2+2+3)

2. What is the normal blood pH.? Describe in detail about the regulation of body pH.. (1+9)
Short notes:(4x5=20)

3. Hyponatremia

4. Clearance test

5.Cytochrome P450

6.Calcium Homeostasis

Section C

Essay:(2x10=20)

7. A 43 year old man presented to the medicine OPD with complaints of nausea,abdominal
pain and fever. He had yellowish discoloration of sclera.He reported passing yellow urine.
The ultrasoun d abdomen showed stones in gall bladder.
Laborato ry investigations:
Serum bilirubin: 9mg/dl
Conjugated bilirubin: 7.Smg/d l
Unconju gated bilirubin: 1.Smg/d l
AST-SOIU/L ALT-901U/L
ALP-4401U/L
Urine bile salts -positive , Bile pigments -positive (++),UBG -negative
A.What is the probable diagnosi s?(! mark)

B.Explain in detail about the biochem ical investiga tions to different iate different types of
jaundice (9 marks)