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Comprehensive

Module by: E. Pennington. E-mail the author

Summary: Final exam for all Carbohydrate and Nitrogen lectures.

Table 1
1. Which of the following molecules CANNOT be excreted by the kidneys as glucuronides?
A. Bile (stercobilin)
B. Progesterone
C. Bilirubin diglucuronide
D. Morphine
E. Thyroid hormone
Table 2
2. Which of the following molecules DOES NOTaccumulate in bloodas a result of a defect in any of the enzymes of the urea cycle?
A. Any of the intermediates of the urea cycle
B. Ammonia in the form of NH4+
C. Glutamine and alanine
D. All the intermediates of glycolysis
3. Which of the following hormones regulates the excretion of both water and sodium counteracting the effects of other water homeostasis hormones?
A. Aldosterone
B. Antidiuretic hormone
C. Cortisol
D. Estrogen
E. Natriuretic peptides
Table 3
4. Which of the following digestive enzymes pairs can break peptide bonds at either terminal end of a polypeptide?
A. Trypsin & chymotrypsin
B. Elastase & collagenase
C. Aminopeptidase and carboxypeptidase
D. Dipeptidase & tripeptidase
E. Enterokinase and Phospholipase A
Table 4
5. Which of the following enzymes pairs can perform autocatalysis once they are activated?
A. Pepsin & trypsin
B. Aminopeptidase & carboxypeptidase
C. Elastase & collagenase
D. Dipeptidase & tripeptidase
E. Chymotrypsin & Phospholipase A
Table 5
6. Which of the following zymogens can help in the screening of gastric disorders?
A. Trypsinogen
B. Pepsinogen
C. Chymotrypsinogen
D. Procollagenase
E. Procarboxypeptidase
Table 6
7. Which of the following disorders can affect the release of pancreatic digestive enzymes into the intestinal lumen?
A. Hartnup disease
B. Cystinuria
C. Cystic fibrosis
D. Atrophic gastritis
E. Duodenal ulcer
Table 7
8. Which of the following mechanisms facilitates the absorption and release of hydrophobic amino acids into the body's cells?
A. Aquaporins
B. Autophagosomes
C. Secondary active transporters
D. Simple diffusion
E. Facilitated diffusion
Table 8
9. Which of the following statements about the degradation of body's proteins is INCORRECT?
A. Proteins for degradation are recognized based on the presence of ubiquiting tags, PEST sequences, N-terminal or oxidized residues.
B. A single ubiquitin isopeptide assigns a regulatory function to a protein but multiple ubiquitin isopeptides targets the protein for degradation.
C. E1 binds and transfer an ubiqutin molecule to E2 and E3 joins the ubiquitin from E2 to the end terminal end of a target protein.
D. Lysosomal proteases break down body' proteins into polypeptides; while, proteasome complexes break them into single amino acids.
E. Binding of N-acetylglucosamine to the active sites of the proteasome inhibits protein degradation and the removal of this molecule facilitates protein degradation.
Table 9
10. Which of the following digestive enzymes pairs can break peptide bonds at either terminal end of a polypeptide?
A. Trypsin & chymotrypsin
B. Elastase & collagenase
C. Aminopeptidase and carboxypeptidase
D. Dipeptidase & tripeptidase
E. Enterokinase and Phospholipase A
Table 10
11. Which of the following enzymes pairs need to be activated via autocatalysis?
A. Pepsin & lysosomal proteases
B. Aminopeptidase & carboxypeptidase
C. Elastase & collagenase
D. Dipeptidase & tripeptidase
E. Chymotrypsin & Phospholipase A
Table 11
12. Which of the following zymogens can help in the screening of some gastrointestinal cancers?
A. Trypsinogen
B. Pepsinogen
C. Chymotrypsinogen
D. Procollagenase
E. Procarboxypeptidase
Table 12
13. Which of the following disorders will not cause a deficiency of essential amino acids due to either the lack of pancreatic digestive enzymes in the intestinal lumen or defective amino acid transporters?
A. Hartnup disease
B. Cystic fibrosis
C. Cystinuria
D. Pancreatitis
   
14. A patient is diagnosed with emphysema. Which of the following enzymes is responsible for the damage to the lungs?
A. Elastase
B. Collagenase
C. Carboxypeptidase
D. Chymotrypsin
E. Trypsin
Table 13
15. Which of the following systems can break body’s proteins into single amino acids?
A. A 19S cap with a 20S proteasome.
B. A 19S cap, 20S proteasome and 11S cap
C. A 20S proteasome with an 11S cap
D. Lysosomal proteases
   
Table 14
16. Which of the following defective enzyme pairs can produce altered branching in the glycogen molecule?
A. Glycogen synthase and glucose-6-phosphatase
B. Musle and liver glycogen phosphorylase
C. Glucorynyl transferase and phosphoglucomutase
D. Glycogenin and alanine aminotransferase
E. Branching and debranching enzymes
Table 15
17. A patient develops kidney failure and skin rashes. A tissue biopsy reveals accumulation of globotriocylceramide. Which of the following defective enzymes can cause Fabry's disease?
A. Acid-beta-glucosidase
B. Alpha-galactosidase A
C. Acid ceramidase
D. Beta-galactosidase-1
E. Galactocerebrosidase
Table 16
18. Which of the following hormones binds beta receptors in both the liver and muscle cells to stimulate glycogenolysis via cAMP signal transduction?
A. Glucagon
B. Epinephrine
C. Cortisol
D. Insulin
E. Aldosterone
Table 17
19. Which of the following molecules would be present in high concentrations in the meconium of neonates or premies with jaundice?
A. Conjugated bilirubin
B. Urobilinogen
C. Stercobilin
D. Unconjugated bilirubin
E. Urobilin
Table 18
20. Which of the following actions stimulates the release of calcium as part of the signal cascade in the liver to activate glycogenolysis and inhibit glycogenesis?
A. Epinephrine binding to beta receptors
B. Epinephrine binding to alpha receptors
C. Glucagon binding to liver receptors
D. Degradation of ATP to AMP
E. Neural impluses on muscle cells
Table 19
21. Which of the following defective enzymes can cause accumulation of both galactose and galactitol?
A. UDP-galactose-4-epimerase
B. Galactokinase
C. Galactose-1-phosphate uridyltransferase
D. Galactose-6-phosphatase
E. Phosphoglucomutase
Table 20
22. Which of the following organ or tissues cells can convert glucose to lactate for spermatogenesis?
A. Muscle cells
B. Renal cells
C. Red blood cells
D. Sertoli cells
E. Astrocytes
Table 21
23. A patient has mental retardation, enlarged liver and skeletal abnormalities. Tissue biopsy reveals accumulation of GM1 gangliosides in neurons. Which of the following defective enzymes can cause GM1 gangliosidosis?
A. Acid-beta-glucosidase
B. Alpha-galactosidase A
C. Acid ceramidase
D. Beta-galactosidase-1
E. Galactocerebrosidase
Table 22
24. A 25 year old female, previously diagnosed with Gilbert's syndrome, has hyperbilirubinemia as a result of eating a very low calorie diet. Which of the following treatments would be effective in dealing with her hyperbilirubinemia?
A. Iron supplements
B. Antiviral drugs
C. Cholecystectomy
D. No treatment
E. Steroid drugs
Table 23
25. Which of the following enzymes converts glucose-1-phosphate into glucose-6-phosphate during glycogen degradation?
A. Glycogen synthase
B. Glycogen phosphorylase
C. Phosphoglucomutase
D. Branching enzyme
E. Debranching enzyme
Table 24
26. Which of the following hormones is important in both the activation and synthesis of the enzymes involved in glycogenesis inside the liver and muscle cells?
A. Glucagon
B. Epinephrine
C. Norepinephrine
D. Vasopressin
E. Insulin
Table 25
27. Which of the following enzymes transfers galactose from UDP-galactose to glucose in the mammary glands?
A. Galactosyl transferase
B. Alpha-lactalbumin
C. Phosphoglucomutase
D. Glucose-6-phosphatase
E. Galactose-1-phosphate uridyltransferase
Table 26
28. Which of the following enzymes can increase the risk of developing cancer and its activity can be blocked with glucaric acid?
A. Hexaminidase A
B. Arylsulfatase A
C. Acid ceramidase
D. Beta-glucuronidase
E. Beta-galactosidase-1
Table 27
29. Which of the following statements BEST describes glycogenesis?
A. Glycogenesis is regulated via three hormones: glucagon, epinephrine and cortisol.
B. The branching enzyme adds 8 -12 glucose molecules to the glycogenin primer.
C. Glycogen synthase adds glucose molecules via alpha-1, 4-O-glycosidic bonds.
D. UDP-glucuronate is the precursor molecule for building the structure of glycogen.
E. Insulin activates the enzymes involved in the release of glucose from glycogen.
Table 28
30. A 35-year old man has the following symptoms: extreme weigh loss, an enlarged liver, right upper quadrant pain and tenderness, and a yellow tinge to his skin especially in the sclera of the eyes. Laboratory test results shows: Urinalysis (dipstick): Urine Urobilinogen: 8 mg/dL (Normal Range: 0.2 - 1 mg/dL)Urine Bilirubin: Present (Measured as positive or negative for presence in urine)Blood Analysis:Alanine aminotransferase (ALT): 50 U/L (Normal Range 5 - 40 U/L)Alkaline Phosphatase(ALP): 110 U/L (Normal Range < 140 U/L)Direct Bilirubin: 0.5 mg/dL (Normal Range 0.1 - 0.3 mg/dL)Indirect Bilirubin: 1.0 mg/dL (Normal Range 0.2 - 0.8 mg/dL)Blood IgM Anti-HAV antibodies: PositiveBlood IgG Anti-HAV antibodies: NegativeProlonged Prothrombin time (PT) even with vitamin K administrationWhich of the following liver disorders is consistent with these laboratory results?
A. Sickle cell anemia
B. Hepatitis A
C. Biliary obstruction
D. Physiological jaundice
E. Pathological jaundice
Table 29
31. Which of the following statements is a common misconception about diabetes insipidus?
A. Central diabetes insipidus is caused by damage to the posterior pituitary.
B. Disease shows high concentration of glucose in both urine and blood.
C. Nephrogenic diabetes insipidus is caused by genetic mutations.
D. Patients can lose up to 16 liters of urine per day causing severe dehydration.
E. Characteristic symptoms include polydipsia for cold water and polyuria.

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