Shaheed Zulfiqar Ali Bhutto Medical University,

Islamabad, 2021

HBS Medical and Dental College, Islamabad

BIOCHEMISTRY DEPARTMENT

[Block 4]

Multiple Choice Questions

1st Professional – Part 2 MBBS Examination, 2021

Tota

l Number of MCQs: 54

Module VII (Gastrointestinal)

Number of MCQs: 22

 Biochemistry of digestive tract (Number of MCQs: 10)

1. Histamine is a physiologically important secretagogue of:

a. Amylase by the salivary glands

b. Gastrin by the stomach
c. Hydrochloric acid by the stomach
d. Hydrolytic enzymes by the pancreas
e. Sodium bicarbonate by the pancreas

2. The contraluminal membranes of small intestinal epithelial cells contain:

 a. Aminopeptidases
b. Carboxypeptidases
c. Disaccharidases
d. Monosaccharidases
e. Sodium potassium adenosine triphosphatase
3. The following property is correct regarding ‘Micelles’:

a. They always consist of only a single lipid specie

b. They are amphiphilic structures having hydrophobic shell and hydrophilic core
c. They are essential for the absorption of vitamins A and K
d. They are formed during lipid digestion, but do not significantly enhance utilization of dietary lipid
e. They are the same as emulsion droplets

4. For the activity of salivary amylase, which of the following is required as an activator:

a. Bicarbonate ions
b. Chloride ions
c. Hydrogen ions
d. Potassium ions
e. Sodium ions

5. Delay in the rate of gastric emptying is due to the action of:

a. Cholecystokinin
b. Enterokinase
c. Gastric lipase
d. Gastrin
e. Pancreozymin

6. The following is the effect of cholecystokinin released from the mucosal cells of jejunum:

a. Rapid release of gastric content into the stomach

b. Release of bicarbonate rich solution from pancreas
 c. Release of bile acids and concentration of gall bladder
d. Release of digestive enzymes from endocrine pancreas
e. Release of glycoproteins from the gall bladder into the stomach

7. The enzyme responsible for the breakdown of triglycerides into fatty acids and monoacylglycerol in
the intestine is:

a. Colipase
b. Hormone sensitive lipase
c. Lipoprotein lipase
d. Pancreatic lipase
e. Phospholipase

8. The following is the function of bile salts in the intestine:

a. Activator of lipase
b. Coalesce lipid particles
c. Cofactor for cholesterol esterase
d. Emulsification of fats
e. Inhibitor of lipid absorption

9. The carboxypeptidase b acts as an exopeptidase and hydrolysis the terminal peptide bonds containing:

a. Glycine and leucine

b. Glycine and valine
c. Leucine and arginine
d. Leucine and isoleucine
e. Lysine and arginine

10. The enzyme collagenase of pancreatic juice hydrolyses collagen present in:

a. Cereals
 b. Eggs
c. Meat
d. Milk
e. Soyabeans

 Bioenergetics and biological oxidation (Number of MCQs: 12)

1. Which of the following complexes couple the transfer of a pair of electrons to pumping of two
hydrogen ions across the inner mitochondrial membrane:

a. Adenosine triphosphate synthase

b. Cytochrome bc1 complex
c. Cytochrome oxidase
d. Reduced nicotinamide adenine dinucleotide dehydrogenase
e. Succinate dehydrogenase

2. Regarding the free energy change, ΔG, which of the following statement is true:

a. Can only be calculated when the reactants and products are present at 1 mol/L concentrations
b. Can only be used to predict spontaneous reactions
c. Is directly proportional to the standard free energy change, ∆Gº'
d. Is equal to minus universal gas constant and temperature in kelvins, – RT, in equilibrium
constant, keq
e. Is equal to zero at equilibrium

3 . The transport of a pair of electrons from Reduced nicotinamide adenine dinucleotide to oxygen via
the electron transport chain produces:

a. Five adenosine triphosphates

b. Four adenosine triphosphates
c. One adenosine triphosphate
d. Three adenosine triphosphates
e. Two adenosine triphosphates

4 . An uncoupler of oxidative phosphorylation is which of the below:

 a. Amobarbital
b. Atractyloside
c. Carboxin
d. Cyanide
e. Dinitrophenol

5. Which of the following statement is true regarding adipose tissue:

a. Brown adipocytes have a large lipid droplet

b. Brown adipose tissue is responsible for production of heat (thermogenesis)
c. Brown adipose tissue is responsible for storage of energy
d. White adipocytes have more mitochondria than brown adipocytes
e. White adipose tissue is responsible for production of heat (thermogenesis)

6. Which of the following statement concerning the components of electron transport chain is correct:

a. All of the components of the electron transport chain are present in large, multi subunit
protein complexes embedded in the inner mitochondrial membrane
b. Cyanide inhibits electron flow, but not proton pumping or adenosine triphosphate synthesis
c. Oxygen directly oxidizes cytochrome c
d. Succinate dehydrogenase directly reduces cytochrome c
e. The electron transport chain contains some polypepide chains coded for by the nuclear
deoxyribonucleic acid and some coded for by maternal deoxyribonucleic acid

7. Which of the following component of the electron transport chain only accepts electrons:

a. Coenzyme Q
b. Cytochrome b
c. Flavin mononucleotide
d. Oxidized nicotinamide adenine dinucleotide
e. Oxygen

8. In the electron transport chain, complex I is comprised of the following:

 a. Adenosine triphosphate synthase
b. Acyl coenzyme A dehydrogenase
c. Coenzyme Q – cytochrome c reducatse
d. Reduced nicotinamide adenine dinucleotide – Coenzyme Q reductase
e. Succinate - Coenzyme Q reducatase

9. Adenosine diphosphate and adenosine triphosphate transport into and out of mitochondria in
oxidative phosphorylation is inhibited by:

a. 2, 4 dinitrophenole
b. Aspirin
c. Atractyloside
d. Oligomycin
e. Thermogenin

10. Which of the following oxidation-reduction systems has highest redox-potential:

a. Ferric ion cytochrome a/Ferrous ion

b. Ferric ion cytochrome b/Ferrous ion
c. Fumarate/succinate
d. Oxidized nicotinamide adenine dinucleotide/reduced nicotinamide adenine dinucleotide
e. Ubiquinone ox/red

11. Following parenteral administration, rotenone can induce vomiting, incoordination, muscle tremors,
clonic convulsions, and respiratory failure. Biochemically, in the presence of rotenone:

a. Cytochrome a is reduced by electron transport

b. Cytochrome a3 is reduced
c. Cytochrome c is reduced
d. Dihydroflavin adenine dinucleotide is oxidized by electron transport
e. Reduced nicotinamide adenine dinucleotide is oxidized by electron transport

12. The phosphate: oxygen (P:O) ratio is defined as:

a. The moles of adenosine triphosphate formed divided by the milligrams of protein

 b. The moles of adenosine triphosphate synthesized divided by the atom equivalents of
oxygen consumed
c. The moles of carbon dioxide produced divided by moles of oxygen consumed
d. The moles of oxygen consumed in presence of adenosine diphosphate divided by the moles of
oxygen consumed in absence of adenosine diphosphate
e. The moles of phosphate consumed divided by moles of oxygen consumed

Module VIII (Renal)

Number of MCQs: 32

 Metabolism of carbohydrates (Number of MCQs: 20)

1. The major disorder associated with the deficiency of the enzyme Glucose - 6 - phosphate of pentose
phosphate pathway is

a. Essential fructosuria
b. Galactosemia
c. Hemolytic anemia
d. Lipid storage diseases
e. Pentosuria

2. The following compound is not a mediator of tricarboxylic acid cycle:

a. Fumarate
b. Malate
c. Oxaloacetate
d. Pyruvate
e. Succinate

3. In gluconeogenesis, a common intermediate in the conversion of glycerol and lactate to glucose is

which of the following:
 a. Glucose - 6 - phosphate
b. Malate
c. Oxaloacetate
d. Phosphoenolpyruvate
e. Pyruvate

4. The end product of glycolysis under anaerobic conditions may be:

a. Acetyl coenzyme A
b. Amino acid
c. Carbon dioxide and water
d. Lactic acid
e. Pyruvic acid

5. Which of the following enzyme is not present in the muscles:

a. Glucose 6-phosphatase
b. Glycogen synthase
c. Hexokinase
d. Lactate dehydrogenase
e. Phosphorylase b

6. After digestion of a piece of cake that contains flour, milk and sucrose as its primary ingredients,
the major carbohydrate products entering the blood will be:

a. Cellulose
b. Fructose and galactose
c. Fructose and glucose
d. Galactose and fructose
e. Glucose, fructose and galactose

7. During starvation, liver glycogen stores are depleted and the following pathway serves for the
production of glucose:
 a. Citric acid cycle
b. Gluconeogenesis
c. Glycogenolysis
d. Glycolysis
e. Pentose phosphate pathway

8. Amongst the allosteric activators of glycolysis in the liver, which of the following is the most
important in maintaining a normal blood glucose level:

a. Acetyl coenzyme A
b. Adenosine triphosphate
c. Fructose 2, 6 - bisphosphate
d. Glucose - 6 – phohphate
e. Nicotinamide adenine dinucleotide

9. Which of the following products is the fate of pyruvate when the reaction is catalyzed by pyruvate
carboxylase:

a. Acetaldehyde
b. Alanine
c. Lactic acid
d. Oxaloacetate
e. Tryptophan

10. A 47 years old obese type two diabetic man presented with polyuria, polydipsia and polyphagia. If
the patient's symptoms are due to a problem at the level of the glucose transporter, which one of the
tissues indicated below will be most affected:

a. Brain
b. Liver
c. Muscle
d. Red blood cells
e. Small intestine

11. Glycogen is converted to glucose - 1 - phosphate by which of the following

enzyme:
 a. Branching enzyme
b. Phosphatase
c. Phosphorylase
d. Translocase
e. Uridine diphosphate glucose transferase

12. Reduced glutathione functions in red blood cells to:

a. Produce large quantities of adenosine triphosphate

b. Produce reduced nicotinamide adenine dinucleotide
c. Produce reduced nicotinamide adenine dinucleotide phosphate
d. Reduce methemoglobin to hemoglobin
e. Reduce oxidizing agents such as hydrogen peroxide

13. Pyruvate dehydrogenase complex and alpha ketoglutarate dehydrogenase

complex require the following for their oxidative decarboxylation:

a. Coenzyme A and lipoic acid

b. Coenzyme A and thiamine pyrophosphate
c. Coenzyme A, thiamine pyrophosphate, nicotinamide adenine dinucleotide, flavin adenine
dinucleotide and lipoic acid
d. Nicotinamide adenine dinucleotide and flavin adenine dinucleotide
e. Nicotinamide adenine dinucleotide, flavin adenine dinucleotide and lipoic acid

14. A regulator of the enzyme glycogen synthase is:

a. 2, 3 bisphosphoglycerate
b. Citrate
c. Lactate
d. Oxaloacetate
e. Pyruvate
15. A child has ingested cyanide from her parent’s garage and is rushed to the emergency room.
Which of the following component of citric acid cycle will be depleted first in this child:

a. Acetyl coenzyme A
b. Aconitase
c. Citrate synthase
d. Cytochrome oxidase
e. Nicotinamide adenine dinucleotide cofactor
16. Galactose is phosphorylated by galactokinase to form:

a. Galactose - 1 – phosphate
b. Galactose - 1, 6 diphosphate
c. Galactose - 6 - phosphate
d. Lactose - 1 - phosphate
e. Lactose - 6 – phosphate

17. In contracting skeletal muscle, sudden elevation of sarcoplasmic calcium concentration will cause:

a. Activation of cyclic adenosine monophosphate – dependent protein kinase A

b. Direct activation of glycogen sythase b
c. Direct activation of phosphorylase kinase b
d. Inactivation of glycogen synthase a
e. Inactivation of phosphorylase kinase a by the action of protein phosphatase - 1

18. Epinephrine and glucagon have which of the following effects on hepatic glycogen metabolism:

a. Both glycogen phosphorylase and glycogen synthase are activated by phosphorylation but at
significantly different rates
b. Both glycogen phosphorylase and glycogen synthase are inactivated by phosphorylation but at
significantly different rates
c. Glycogen phosphorylase is dephosphorylated and active, whereas glycogen synthase is
phosphorylated and inactive
d. Glycogen phosphorylase is inactivated by the resulting rise in calcium, whereas glycogen
synthase is activated
e. Glycogen phosphorylase is phosphorylated and active, whereas glycogen synthase is
phosphorylated and inactive
 19. Regarding citric acid cycle:

a. It produces very little adenosine triphosphate from one mole of glucose

b. It provides precursor for the heme synthesis
c. It occurs exclusively in the cytoplasm
d. Pyruvate enters the cycle directly
e. The total adenosine triphosphate production from this cycle is ten
20. Which of the following is a rate limiting enzyme of gluconeogenesis:

a. Fructose - 1, 6 bisphosphatase
b. Hexokinase
c. Phosphofructokinase I
d. Phosphofructokinase II
e. Pyruvate kinase

 Biochemistry of water and electrolyte imbalance, and acid

base balance
(Number of MCQs: 12)

1. The normal pH of the venous blood and interstitial fluid is:

a. The same as arterial blood

b. More acidic than arterial blood
c. More basic than arterial blood
d. Neutral as compared to arterial blood
e. Not comparable to arterial blood

2. A person was admitted in a diabetic coma. Analysis of the arterial blood gave
the following values; pH: 7.1, PCO 2: 16 millimeters of mercury, HCO3-: 5 millimoles per
liter. The underlying acid-base disorder will be:

a. Metabolic acidosis
b. Metabolic alkalosis
c. Mixed acid base disorder
 d. Respiratory acidosis
e. Respiratory alkalosis

3. The following compound is the most effective buffer system at physiological

pH:

a. Ammonia buffer
b. Bicarbonate buffer
c. Hemoglobin buffer
d. Phosphate buffer
e. Sulphate buffer
4. Which of the following laboratory result indicates compensated metabolic alkalosis:

a. High partial pressure of carbon dioxide, high bicarbonate and high pH

b. High partial pressure of carbon dioxide, normal bicarbonate and low pH
c. Low partial pressure of carbon dioxide, high bicarbonate and low pH
d. Low partial pressure of carbon dioxide, low bicarbonate and low pH
e. Low partial pressure of carbon dioxide, normal bicarbonate and high pH

5. The greatest buffering capacity at physiological pH would be provided by a protein rich in which
of the following amino acid:

a. Aspartic acid
b. Glutamic acid
c. Histidine
d. Leucine
e. Lysine

6. Respiratory acidosis results from:

a. Excessive elimination of bicarbonate

b. Excessive elimination of carbon dioxide
c. Retention of bicarbonate
d. Retention of carbon dioxide
e. Retention of carbon monoxide
7. Insensible loss of body water of normal adult is about:

a. 50 – 100 milliliters
b. 100 – 200 milliliters
c. 300 – 500 milliliters
d. 600 – 1000 milliliters
e. 1500 – 3000 milliliters

8. Anion gap is increased in which of the below condition:

a. Adrenal insufficiency
b. Diabetic ketoacidosis
c. Hypoaldosteronism
d. Pancreatic fistula
e. Ureteral diversion

9. A 23 years old cyanotic amd apneic man found unresponsive following reconstructive knee
surgery and 25 mg of intravenous morphine for pain relief, showed arterial blood gas report; pH:
7.08, pCO2: 80 millimeters of mercury, HCO3-: 22 millimoles per liter. Which of the following
statement will be correct concerning the case:

a. The patient had a high bicarbonate level

b. The patient had a low bicarbonate level
c. The patient had a normal bicarbonate level
d. The patient showed metabolic acidosis
e. The patient showed respiratory acidosis

10. Body water is regulated by the hormone:

a. Adrenocorticotropic hormone
b. Epinephrine
c. Follicle-stimulating hormone
d. Norepinephrine
e. Vasopressin
11. In isotonic contraction of extracellular fluid:

a. Fluid isotonic with plasma is lost

b. Urine output is decreased
c. Urine output is increased
d. Water shifts from extracellular to intracellular compartments
e. Water shifts from intracellular to extracellular compartments

12. A 74 years old woman underwent a left total knee replacement and received 5 liters of 5%
dextrose intravenously. She had the following post-operative results of plasma; Sodium: 117
millimoles per liter, Potassium: 3.7 millimoles per liter and Urea: 3.4 millimoles per liter. She was
most likely suffering from:

a. Post operative hyperkalemia

b. Post operative hypernatremia
c. Post operative hyperuricemia
d. Post operative hypokalemia
e. Post operative hyponatremia