
Course Introduction
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Course Introduction
Medical Biochemistry explores the chemical processes and substances that are vital to the function and regulation of the human body, with a focus on understanding biochemical pathways, molecular interactions, and metabolism in health and disease. The course covers fundamental topics such as the structure and function of biomolecules, enzyme kinetics, bioenergetics, and the molecular basis of genetic information flow. Emphasis is placed on the clinical relevance of biochemistry, including metabolic disorders, diagnostic biomarkers, and the biochemical mechanisms underlying common diseases. Through lectures, laboratory work, and clinical case studies, students gain an in-depth understanding of how biochemistry informs medical practice and the development of therapeutic interventions.
Recommended Textbook
Principles of Medical Biochemistry 3rd Edition by Gerhard Meisenberg
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Q1) What is the major difference between glycogen and amylose?
A)Glycogen contains only glucose, and amylose contains some fructose in addition to glucose.
B)Glycogen is a storage polysaccharide, and amylose is a structural polysaccharide of the extracellular matrix.
C)Glycogen is branched, and amylose is not.
D)Glycogen contains some linkages, but amylose contains only linkages.
E)Glycogen is stored in the liver, and amylose is stored in skeletal muscle.
Answer: C
Q2) Linkages are important in structural polysaccharides because:
A)They are easily hydrolyzed by glycosidase enzymes.
B)They allow the chains to form compact coils.
C)They cause the chains to exist in an extended form, thus allowing them to form fibers.
D)They cause the chains to absorb more water.
E)They can be formed by any hydroxy group in the monomer, whereas a linkages can be formed only by C-1.
Answer: C
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Q1) Which of the following statements about protein structure is correct?
A)The helix is stabilized primarily by ionic interactions between the side chains of amino acids.
B)Cytoplasmic proteins generally contain disulfide bonds.
C)In comparison with the b-pleated sheet, the a helix is more extended.
D)The denaturation of proteins is in most cases reversible by slow cooling.
E)The tertiary structure of the protein forms before the formation of disulfide bonds.
Answer: E
Q2) Which of the following is true about the tertiary structure of proteins?
A)Disulfide bonds are part of the tertiary structure.
B)Only proteins with more than one polypeptide subunit have a tertiary structure.
C)Proteins with tertiary structure do not contain helix or -pleated sheet.
D)Van der Waals interactions play no role in the tertiary structure.
E)Interactions between hydrophobic amino acid side chains are important for hold the tertiary structure together.
Answer: E
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Q1) The quaternary structure of deoxyhemoglobin is maintained, in part, by which type of bond?
A)Heme-to-heme hydrophobic interactions.
B)Disulfide bonds.
C)Metallic coordination bonds.
D)Hydrogen bonds formed by covalently bound carbohydrate groups.
E)Salt bonds.
Answer: E
Q2) Which of the following statements about hemoglobin is correct?
A)Heme is the cosubstrate for hemoglobin.
B)There are six coordinate bonds formed by Fe+2 in deoxyhemoglobin.
C)Methemoglobin is the functional oxygenated form of hemoglobin.
D)Hemoglobin binds oxygen with lower affinity than myoglobin.
E)Hemoglobin is a tetrameric protein with four identical polypeptide chains.
Answer: D
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Q1) Racemase enzymes interconvert:
A)Epimers.
B)Anomers.
C)Enantiomers.
D)Diasteriomers.
E)Aldoses and ketoses.
Q2) The rate of a typical enzyme-catalyzed reaction:
A)Is independent of pH over a broad range of pH values.
B)Is approximately proportional to the substrate concentration as long as the substrate concentration is much lower than the Michaelis constant (Km).
C)Rises by a factor of about 4 when the temperature is raised by 10° C.
D)Is no longer affected by the enzyme concentration at saturating substrate concentrations.
E)Is virtually independent of the temperature, as long as heat denaturation is avoided.
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Q1) The cleavage of adenosine triphosphate (ATP) to adenosine monophosphate (AMP) + pyrophosphate is said to supply more energy than the cleavage of ATP to ADP + phosphate.Why?
A)ATP ADP + phosphate cleaves a phosphoanhydride bond, and ATP AMP + pyrophosphate cleaves a phosphodiester bond.
B)The cleavage to AMP and pyrophosphate is followed by the degradation of AMP by adenosine deaminase.
C)The cleavage to AMP and pyrophosphate is followed by the degradation of pyrophosphate.
D)ATP ADP + phosphate cleaves a phosphoanhydride bond, and ATP AMP + pyrophosphate cleaves a phosphate ester bond.
E)ATP ADP + phosphate cleaves a phosphate ester bond, and ATP AMP + pyrophosphate cleaves a phosphoanhydride bond.
Q2) Coenzyme A has a very specific function in metabolic pathways.Its task is:
A)Transfer of hydrogen.
B)Transfer of electrons.
C)Attachment of carboxyl groups.
D)Activation of monosaccharides for the synthesis of complex carbohydrates.
E)Activation of organic acids.
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Q1) During DNA replication, the many RNA primers found in the lagging strand must be removed.Which enzyme performs this task in E.coli?
A)RNAse A.
B)Helicase.
C)RNA polymerase II.
D)DNA polymerase I.
E)DNA polymerase III.
Q2) The purpose of the gene products of the lac operon is to ___________.The purpose of the gene products of the trp operon is to ___________.
A)Produce lactose when glucose is low; produce tryptophan when tryptophan is low.
B)Produce lactose when lactose is low; produce tryptophan when glucose is low.
C)Produce lactose when glucose is low; metabolize tryptophan for energy.
D)Metabolize lactose when glucose is low; metabolize tryptophan for energy.
E)Metabolize lactose when glucose is low; produce tryptophan when tryptophan is low.
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Q1) A patient is shown to have a deletion of 500 base pairs within the 3.7-kilobase pair sequence between the promoter of the L-type pyruvate kinase (PK) gene and an erythroid cell-specific enhancer element for the PK gene.What is the most likely outcome of the mutation in erythroid cells?
A)PK will be produced at a higher rate.
B)Transcriptional initiation becomes impossible.
C)There will be no change in the rate of enzyme synthesis.
D)There will be faulty splicing of the transcript.
E)The rate of transcription initiation by transcription factor IIH will be reduced.
Q2) A genetic engineer announces the birth of a baby with an artificial chromosome that carries an extra copy of the gene for telomerase.The gene is engineered with an inducible promoter that causes transcription in response to the insect hormone ecdysone.Why should people with this artificial chromosome want to take ecdysone pills?
A)To reduce the cancer risk.
B)To be resistant to viral infections.
C)To delay aging.
D)To get a high.
E)To cure cancer.
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Q1) In glycoproteins, the terminal position in the oligosaccharide is most commonly occupied by:
A)N-acetylglucosamine.
B)Glucose.
C)Mannose.
D)Iduronic acid.
E)N-acetylneuraminic acid.
Q2) The most promising gene therapy strategy for I-cell disease is to:
A)Introduce an intact copy of the a-L-iduronidase gene.
B)Replace a normal copy of the iduronate sulfatase gene with one containing a nuclear localization signal.
C)Replace the N-acetyl-galactosamine transferase gene with one containing a lysosomal localization signal.
D)Replace a faulty copy of the mannose-6-phosphate transferase gene with a functional copy.
E)Replace all lysosomal enzyme genes.
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Q1) A girl had repeated attacks of pneumonia almost immediately after birth.A blood test taken 3 weeks after birth showed a blood hemoglobin concentration of 4.5% (normal at that age: 15% to 19%).This could possibly be a serious case of:
A)Sickle cell disease or -thalassemia but not -thalassemia.
B) -Thalassemia but not sickle cell disease or -thalassemia.
C)Sickle cell disease or -thalassemia but not -thalassemia.
D)Sickle cell disease but not -thalassemia or -thalassemia.
E) -Thalassemia or -thalassemia but not sickle cell disease.
Q2) Hemoglobin S can be separated from normal hemoglobin A by electrophoresis on paper or cellulose acetate foil.This is possible because hemoglobin S:
A)Is more hydrophilic than hemoglobin A.
B)Is more hydrophobic than hemoglobin A.
C)Has a different number of electrical charges than hemoglobin A.
D)Has a more compact shape than hemoglobin A.
E)Has a different molecular weight than hemoglobin A.
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Q1) Unlike bacteriophage T , l phage is capable of both lytic and lysogenic infection.The lysogenic state is maintained by:
A)Chemical modification of cytosine bases in the viral DNA, forming hydroxymethyl-cytosine.
B)Transcription of the cro gene.
C)Transcription of the gene for the l repressor.
D)Transcription of the xis and cro genes.
E)Exposure of the bacterium to ultraviolet radiation or other DNA-damaging agents.
Q2) The long terminal repeats of the acquired immunodeficiency syndrome (AIDS) virus are recognized by integrase and help direct the incorporation of viral complementary DNA (cDNA) into the genome.What else are they good for?
A)They encode the matrix and core proteins.
B)They form the primer for reverse transcriptase.
C)They encode reverse transcriptase.
D)They encode the proteins required to process gag-pol.
E)They contain the viral promoter region.
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Q1) What are loxP sites, and for which purpose are they used?
A)Cleavage sites for a class of restriction endonucleases that are popular for recombinant DNA studies.
B)Recombination sites that are recognized by a Cre recombinase, used for the targeted excision of genes.
C)Integration sites for retroviral vectors that are used for targeted gene insertion.
D)Sites on RNA that are the target of a selective RNase, used to suppress the expression of genes selectively.
E)Hot spots for homologous recombination, used to introduce genes into the genome by homologous recombination.
Q2) Which of the following is the most plausible recognition site for a restriction endonuclease?
A)A A G C T T.
B)C G A A G C.
C)T G C T G C.
D)A A G G C C.
E)T A C G T A.
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Q1) The fluidity of biological membranes depends on temperature and lipid composition.Because membrane fluidity has to be maintained in an optimal range, you can expect that, in comparison with tropical fish, the biological membranes of cold-water fish have:
A)A higher proportion of polyunsaturated fatty acids.
B)A higher sphingomyelin/lecithin ratio.
C)A higher cholesterol content.
D)A higher content of saturated fatty acids.
E)A higher glycolipid content.
Q2) Of the following compounds, the one that is most likely to diffuse across a lipid bilayer by passive diffusion is:
A)Ethanol.
B)Serum albumin.
C)Glucose.
D)Glycine.
E)Sodium ions.
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Q1) Cells can exchange inorganic ions and small metabolites with neighboring cells in the tissue.This process requires the protein:
A)Vinculin.
B)Dynein.
C)Connexin.
D)Cadherin.
E) -Catenin.
Q2) A bound guanosine triphosphate (GTP) is involved in the reversible assembly of:
A)Thick filaments in skeletal muscle.
B)Keratin filaments in the skin.
C)Actin microfilaments in the cytoplasm of most cells.
D)Microtubules during mitosis.
E)Lamins in the nucleus.
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Q1) Patients with Hurler syndrome (complete deficiency of -L-iduronidase) have mental deficiency in addition to physical deformities, corneal clouding, and valvular heart disease.Their mental deficiency is caused by the accumulation of:
A) -L-iduronic acid.
B)Heparan sulfate.
C)Chondroitin sulfate.
D)Hyaluronic acid.
E)Keratan sulfate.
Q2) A medical student sees the dentist because of sore gums.The dentist also notices small hemorrhagic spots under the student's skin.On questioning, the student says that he subsists mainly on the cookies and coffee that are sold at the campus bookstore.His problems are most likely related to:
A)Reduced synthesis of pre-procollagen chains.
B)Inability to hydroxylate prolyl residues in procollagen.
C)Inability to attach carbohydrate groups to procollagen.
D)Defective collagen crosslinking, resulting from impaired activity of lysyl hydroxylase.
E)Inability to convert pre-procollagen to procollagen.
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Q1) A patient consumes an excessive amount of bicarbonates to treat his heartburn.Which of the following values for total plasma CO and plasma pH are expected as a result? The normal total CO is 22 to 30 mmol, and the normal pH is 7.4.
A)25
B)15
C)45
D)55
E)65
Q2) Heparin inhibits blood clotting by:
A)Binding to fibrinogen and thereby preventing its cleavage by thrombin.
B)Activating tissue-type plasminogen activator.
C)Inhibiting urokinase.
D)Inhibiting the binding of prothrombin to activated platelets.
E)Activating antithrombin III.
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Q1) During the synthesis of steroid hormones, side chain cleavage reactions occur in two biotransformations.These are:
A)Glucocorticoids mineralocorticoids and progestins androgens.
B)Progestins corticosteroids and androgens estrogens.
C)Cholesterol progestins and estrogens androgens.
D)Cholesterol progestins and progestins androgens.
E)Androgens corticosteroids and androgens estrogens.
Q2) Increased activity of the neurotransmitter dopamine at synapses in the mesolimbic dopamine system is known to cause euphoria.Therefore, a good strategy for the development of new euphoriants is to develop drugs that:
A)Inhibit the sodium cotransporter for dopamine in the nerve terminal.
B)Inhibit the transporter that pumps dopamine into synaptic vesicles.
C)Inhibit tyrosine hydroxylase.
D)Induce enhanced expression of catechol-O-methyltransferase (COMT).
E)Block voltage-gated calcium channels in the nerve terminals.
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Q1) Glucagon can induce gene transcription in the liver.How?
A)It is translocated to the nucleus, where it binds to response elements in the regulatory sequences of the genes.
B)It triggers cAMP formation, and cAMP activates genes by binding to the catabolite activator protein.
C)It releases calcium from the ER, which activates protein kinase C in the nucleus.
D)It causes phosphorylation of nuclear transcription factors by protein kinase A.
E)It induces the formation of the second messenger IP3, which activates transcription by binding to nuclear transcription factors.
Q2) Many cytoplasmic enzymes become activated in response to an elevated calcium concentration.In most cases, these effects are mediated by the protein:
A)Calmodulin.
B)Phospholipase A2.
C)Troponin.
D)Calsequestrin.
E)Calcineurin.
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Q1) Progression through the early stages of mitosis requires the phosphorylation of many nuclear proteins, including chromosomal scaffold proteins and the lamins.The cyclin that is most directly involved in these phosphorylations is:
A)Cyclin A.
B)Cyclin B.
C)Cyclin H.
D)Cyclin D.
E)Cyclin E.
Q2) In order to push the cell through the G checkpoint, the cyclin-dependent kinases have to phosphorylate:
A)The p53 protein.
B)The retinoblastoma protein pRb.
C)The MAP kinases.
D)The Ras protein.
E)The Bcl2 protein.
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Q1) The bacterial fermentation of undigested carbohydrates in the colon forms not only gas but also a good deal of:
A)Lactose.
B)Fatty acids.
C)Small organic acids.
D)Urea.
E)Ketone bodies.
Q2) Trypsinogen, chymotrypsinogen, proelastase, procarboxypeptidases, and prophospholipases are all produced as inactive zymogens.Each of these zymogens can be activated by the enzyme ________, and this normally occurs in ________.
A)Enteropeptidase; the duodenal epithelium.
B)Enteropeptidase; the intestinal lumen.
C)Pepsin; the stomach.
D)Chymotrypsin; the pancreas.
E)Trypsin; the intestinal lumen.
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Q1) Which is the most likely regulated step in metabolic pathways?
A)The first reaction in the pathway, regardless of whether it is reversible or irreversible.
B)The first irreversible reaction of the pathway.
C)The first endergonic reaction in the pathway.
D)The last reaction of the pathway.
E)The reaction whose enzyme is present in the highest activity in the cell.
Q2) Which type of regulation is most likely for the regulated enzymes of energy-generating oxidative pathways?
A)Stimulation by adenosine triphosphate (ATP).
B)Stimulation by adenosine diphosphate (ADP).
C)Stimulation by the reduced form of nicotinamide adenine dinucleotide (NADH).
D)Feedback inhibition by carbon dioxide.
E)Inhibition by the substrate of the pathway.
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Q1) A worker in a chemical factory falls into a vat with pentachlorophenol, a wood preservative that uncouples oxidative phosphorylation and that can be absorbed through the skin.Which of the following anomalies can you expect as a result (while the patient is still alive)?
A)Hypothermia (reduced body temperature), because mitochondrial energy generation is impaired.
B)A slowdown of all catabolic pathways, including glycolysis.
C)All redox couples in the respiratory chain will be trapped in the reduced state.
D)Glycogen phosphorylase is activated.
E)ATP can no longer be synthesized from carbohydrates, but ATP synthesis from fatty acids is intact.
Q2) Thiamine deficiency leads not only to the accumulation of pyruvate and lactate but also to the accumulation of:
A)Succinyl-CoA.
B)Oxaloacetate.
C)Malate.
D)Succinate.
E) -Ketoglutarate.
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Q1) A 10-year-old boy has suffered from slowly progressing ataxia (poor motor coordination) since the age of 5.A blood test shows abnormal elevations of alanine and lactic acid levels after an oral glucose load.Partial deficiency of which of the following enzymes or transporters is the most likely cause of the boy's condition?
A)Carnitine-palmitoyl transferase 1.
B)Glucose transporter 4.
C)Pyruvate dehydrogenase.
D)Aldolase B.
E)Glyceraldehyde-3-phosphate dehydrogenase.
Q2) The activation of glucagon receptors turns the liver into a net producer of glucose.Glucagon stimulates a signal transduction pathway in liver involving:
A)SMAD protein phosphorylation.
B)Protein kinase A activation.
C)Calcium pumping into the endoplasmic reticulum.
D)Receptor tyrosine protein kinase activation.
E)Activation of G protein guanosine triphosphatase (GTPase) activity.
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Q1) A patient presents with low blood levels of glucose and ketones in plasma during fasting, accompanied by a high level of plasma free fatty acids.A urine analysis reveals high levels of dicarboxylic acids.The patient is most likely to benefit from:
A)A high-fat diet.
B)A low-fat, high-carbohydrate diet.
C)Low dietary carnitine.
D)A diet rich in essential fatty acids.
E)A high fat, high carbohydrate diet.
Q2) A patient complains about frequent aches and pains in his muscles.A blood test shows increased levels of creatine kinase MM, fatty acids and also myoglobin.A second blood sample, this time taken after an overnight fast, revealed low levels of blood glucose and elevated VLDL.This patient most likely has which of the following conditions?
A)Carnitine-acyl transferase deficiency.
B)Essential amino acid deficiency.
C)Type 1 glycogen storage disease.
D)Acute alcohol toxicity.
E)Elevated insulin levels, which cause hypoglycemia and increased fatty acid mobilization from adipose tissue.
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Q1) A 5-year-old girl presents with hepatosplenomegaly, abnormal bleeding, defects in long bone development, and neurological dysfunction.A liver biopsy reveals an accumulation of glucocerebroside.These symptoms indicate the child is suffering from:
A)Fabry disease.
B)Niemann-Pick disease.
C)Krabbe disease.
D)Gaucher disease.
E)Hurler syndrome.
Q2) The alleles in the ABO blood group system code for:
A)Integral membrane proteins.
B)Glycosyl transferases.
C)Peripheral membrane proteins.
D)Cytoskeletal proteins.
E)Phosphoglyceride-synthesizing enzymes.
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Q1) A 5-year-old boy develops severe stomach pain after eating a big piece of fatty cheesecake.The serum amylase level is found to be mildly elevated.The plasma triglyceride level is 1200 mg/dL, and the total cholesterol level is 220 mg/dL.The parents mention that the child does not like fatty foods at all, but this was the first time he tasted cheesecake.Which apolipoprotein might be deficient in this patient to account for his fat intolerance?
A)A-I.
B)C-II.
C)B-100.
D)C-III.
E)E.
Q2) Cholestyramine can be used for the treatment of hypercholesterolemia, either alone or in combination with a statin.Which enzyme is most immediately affected by cholestyramine treatment?
A)Cholesterol ester transfer protein.
B)Acyl-CoA-cholesterol acyltransferase (ACAT).
C)7-hydroxylase.
D)HMG-CoA reductase.
E)Lecithin-cholesterol acyl transferase (LCAT).
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Q1) A 2-week-old infant presents with vomiting, lethargy, and convulsions without evidence of an infectious process.Laboratory examination reveals hyperammonemia without acidosis.The diagnosis is a hereditary deficiency of N-acetylglutamate synthetase.N-acetylglutamate is an allosteric activator of:
A)Arginase.
B)Carbamoyl-phosphate synthetase I.
C)Arginosuccinate lyase.
D)Ornithine transcarbamoylase.
E)Arginosuccinate synthetase.
Q2) A 2-week-old infant presents with vomiting, lethargy, and convulsions without evidence of an infectious process.Laboratory examination reveals hyperammonemia with alkalosis.Glutamine, citrulline, and arginine levels are found elevated in the blood.The enzyme that is most likely deficient in this patient is:
A)Arginase.
B)Carbamoyl-phosphate synthetase I.
C)Arginosuccinate lyase.
D)Ornithine transcarbamoylase.
E)Arginosuccinate synthetase.
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Q1) Very small quantities of urobilinogen are normally found in the urine.In the clinical laboratory, urinary urobilinogen is useful for differentiating between types of jaundice.Specifically, you have to expect the following levels in patients with acute hepatitis (but without cholestasis), severe hemolysis, and cholestasis (biliary obstruction):
A)Hemolysis: reduced; hepatitis: reduced; cholestasis: elevated.
B)Hemolysis: absent; hepatitis: elevated; cholestasis: absent.
C)Hemolysis: elevated; hepatitis: elevated; cholestasis: elevated.
D)Hemolysis: elevated; hepatitis: elevated; cholestasis: absent.
E)Hemolysis: elevated; hepatitis: reduced; cholestasis: reduced.
Q2) One test that can detect many types of porphyria is the determination of urinary: A)Dihydroorotic acid.
B)Urobilinogen.
C)Stercobilin.
D)Biliverdin.
E)Porphobilinogen.
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Q1) Allopurinol can cure gouty arthritis because it inhibits the enzyme:
A)Adenosine deaminase.
B)Thymidine kinase.
C)Ribonucleotide reductase.
D)Thymidylate synthase.
E)Xanthine oxidase.
Q2) A 4-year-old girl presents in the clinic with megaloblastic anemia and failure to thrive.Orotic acid is demonstrated in blood and urine.Enzyme measurements of white blood cells reveal a deficiency of orotate phosphoribosyl transferase and abnormally high activity of aspartate transcarbamoylase.Which one of the following treatments will reverse all these symptoms?
A)Blood transfusion.
B)White blood cell transfusion.
C)Dietary supplements of phosphoribosylpyrophosphate.
D)Oral thymidine.
E)Oral uridine.
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Sample Questions
Q1) Retinoic acid is a form of vitamin A that is most important as a:
A)Gene regulator.
B)Cofactor for hydroxylation reactions.
C)Constituent of the respiratory chain.
D)Cofactor for oxidative decarboxylation reactions.
E)Coenzyme in many reactions of amino acid metabolism.
Q2) Niacin deficiency causes pellagra.This disease is seen only in patients with a diet that is low in both niacin and:
A)Choline.
B)Creatine.
C)Thiamin.
D)Methionine.
E)Tryptophan.
Q3) Sunlight is good for your bones because:
A)It induces the 25-hydroxylase in the kidneys that makes active calcitriol.
B)It converts 7-dehydrocholesterol to cholecalciferol in the skin.
C)It induces the synthesis of retinol-binding protein in the skin.
D)It carboxylates vitamin K in the skin.
E)It converts tryptophan to niacin in the skin.
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Available Study Resources on Quizplus for this Chatper
15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/35610
Sample Questions
Q1) In Type I diabetes, high levels of ketone bodies are liable to result in acidosis because:
A)The brain consumes very large amounts of acetoacetate.
B)The kidneys excrete large amounts of protonated ketone bodies.
C)The ketone bodies are acids, but the triglycerides from which they are formed are not.
D)Ketone bodies combine with circulating plasma bicarbonate.
E)Ketone bodies increase the urinary excretion of protons.
Q2) When you wake up in the morning, 12 hours after supper, the main source of blood glucose is:
A)Dietary glucose from the intestine.
B)Muscle glycogen.
C)Gluconeogenesis from amino acids.
D)Liver glycogen.
E)Gluconeogenesis from glycerol.
Q3) Mrs.Keller weighs 50 kg and is 1.5 m tall.This means she is considered:
A)Obese.
B)Overweight.
C)Normal.
D)Underweight.
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