BIOCHEMISTRY

Physician’s Licensure Examination

June 2008

1. Amino acids
a. have more than one a-carbon atom
b. cannot participate in covalent bond formation.
c. Only ever have two pKs.
d. Are all chiral, except for glycine.
e. Occur in nature exclusively in the optically active D-form.

2. The pI of a protein is the:

a. pK value of the functional groups attached to the a-carbon.
b. pH value of which it has no charge.
c. pH value at which the protein is generally most soluble.
d. pH value at which its net charge is zero.
e. Net pK value of all the ionizable side chains and R-groups

3. Select the TRUE statement.

a. Secondary structure of a polypeptide is principally responsible for determining its
molecular weight.
b. Tertiary structure of a plypeptide is principally responsible for most of the alpha helical
and beta-pleated sheet motifs it displays.
c. Primary structure of a polypeptide results from methionines being oxidized to disulfide
bonds.
d. Polypeptide domain units are formed by phosphorylation of serines and threonines.
e. The quarternary structure of a protein implies that more than one polypeptide chain
composes that protein.

4. An enzyme in liver which is part of both the glycolytic and gluconeogenic pathways is:
a. glucose 6 phosphatase d. glucokinase
b. PEP carboykinase e. glyceraldehydes 3-phosphate dehydrogenase
c. Fructose 1,6-bisphosphatase

5. Fructose, 26-biphosphate:
a. is required for gluconeogenesis
b. synthesis is stimulated by insulin
c. is increased by cyclic AMP
d. inhibits phosphofructokinase
e. stimulates fructose, 1,6-bisphosphatase

6. Which of the following statements regarding Michaelis-Menten kinetics is TRUE?

a. The Km is the dissociation constant of the enzyme substrate complex.
b. The Km is the concentration of the substrate at Vmax.
c. The Km is measured at high substrate concentration.
d. The Km is the substrate concentration where half of the enzyme is in the form of enzyme
substrate complex.

7. Your patient is a 25 year old male who was admitted to the hospital in a state of starvation. He
had been homeless for several months and become depressed and had not eaten for 4 days.
You start him on a high carbohydrate diet as an attempt to spare protein and restore normal
blood sugar regulation. Which of the following enzymes is most likely to increase in concentration
in his liver?
a. Glucose 6-phosphatase d. Succinate dehydrogenase
b. Glucokinase e. Hexokinase
c. Pyruvate kinase

8. The standard free energy change for a metabolic pathway

a. Is positive for spontaneous pathways.
b. Is inversely proportional to the rate of the overall pathway.
c. Is lower in the presence of the pathway enzymes.
d. Is the sum of all the individual standard free energy values.
e. Depends on the free energy of the rate limiting reaction.

9. The activity of pyruvate dehydrogenase (PDH) decreases

a. as the concentration of acetyl CoA increases.
b. As blood insulin increases.
c. As the concentration of pyruvate increases
d. As the concentration of NADH decreases
e. When the phosphor-enzyme is converted to its dephosphorylated form.

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10. Which enzyme would be impaired in a biotin deficiency.
a. fructose 1,6-bisphosphatase d. pyruvate carboxylase
b. pyruvate kinase e. malate dehydrogenase
c. PEP carboxykinase

11. Which of the following is the correct sequence of carriers in the electron transport chain?
a. NADH/CoQ reductase (R ) cytochrome c ® Co Q ® cytochrome reductase ® cytochrome
oxidase.
b. CoQ ® cytochrome reductase ® cytochrome oxidase ® cytochrome c ® NADH/CoQ
oxidase.
c. NADH/CoQ reductase ® CoQ (R)cytochrome c ® cytochrome oxidase ® cytochrome
reducatse.
d. NADH/CoQ reductase ® cytochrome reudcatse ® cytochrome c R) CoQ ® cytochrome
oxidase.

12. The rate of glycolysis is increased by:

a. Insulin d. NADH
b. ATP e. glucose 6-phosphate
c. Citrate

13. ATP is considered to be the universal source of energy for endergonic reactions but is not the
storage form of energy under physiological conditions. Why?
a. The actual free energy of hydrolysis of ATP is only -11 to -12 kcal.
b. ATP is not located in the cytoplasm where most endergonic reactions occur.
c. The half-life of ATP is too short.
d. The synthesis rate for ATP is not efficient.

14. The viability of red blood cells is critically dependent on glycolysis as a source of energy.
Glycolysis will cease if:
a. The concentration of cAMP is decreased.
b. Phosphofructokinase is activated.
c. Mitochondria are not present in the cell.
d. NADH is not oxidized
e. The concentration of AMP is increased.

15. The first half of glycolysis involves which of the following?

a. ATP synthesis at the substrate level.
b. The incorporation of Pi into a triose phosphate.
c. The reduction of NAD + NADH.
d. The function of 1,3 – biphosphoglycerate.
e. Formation of triose phosphates from a hexose diphosphate.

16. Which statement is CORRECT?

a. Enzymes are small molecules that are heat stable.
b. Enzymes affect rates of reactions in the forward and reverse direction.
c. Enzymes will determine whether a reaction will take place.
d. Enzymes are permanently altered following the conversion of substrate to product.

17. Which of the following is present in the liver, but is absent in muscle?
a. pyruvate carboxylase d.. pyruvate dehydrogenase
b. glycogen synthetase e. glucose 6-phsophatase
c. lactate dehydrogenase

18. When are the concentrations of the conjugate acid and conjugate base equal?
a. When the pH equals the pK.
b. When the pH is 10x the pK.
c. When the pH is 0.1X the pK.
d. When the pH is 7.0
e. When the (H+) is equal to the (OH-)

19. Patients with hemoglobin S are more resistant to malaria because:

a. The protozoa causing malaria is not able to enter the erythrocytes due to an alteration of
the membrane of the erythrocyte.
b. The smaller size and the elongated shape of the erythrocyte prevents the protozoa from
infecting other cells.
c. The half-life of the crythrocyte is decreased in cells containing hemoglobin S resulting in
a decrease level of the protozoa.
d. Hemoglobin S has a higher capacity to bind oxygen which inhibits the action of the
prozoa.

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20. What is the value of D Go’ for the pathway A  B CD?
a. Reaction D Go’
B <> A + 5 kcal/mol
C < == > + 5 kcal/mol
C  > D -15 kcal/mol
b. +5
c. -10
d. -15
e. -20

21. In aerobic glycolysis, NADH in the cytoplasm:

a. Is recycled by lactate dehydrogenase to produce NAD + for glycolysis
b. Reduces dihydroxyacetone phosphate to glycerol phosphate.
c. Reduces malate to oxaloacetate for transport into the mitochondrial matrix.
d. Can be transported into the mitochondrion by an NADH/NAD + antiporter.
e. Acts as a negative allosteric effector for phosphofructokinase.

22. Competitive inhibitors are commonly used in chemotherapy because:

a. the inhibitors decrease the total amount of substrate.
b. The inhibitors alter the enzymes when they bind and decrease the Vmax of the reaction.
c. The inhibitor resembles the structure of the product and inhibit the reaction by negative
feedback.
d. The inhibitor binds only to the active site and increases the Km.

23. The tricarboxylic acid cycle is initiated by the condensation of acetyl – CoA and
a. Malate d. oxaloaccetate
b. Citrate e. HCO3-
c. Pyruvate

24. Gluconcogenesis
a. is favored when insulin concentrations are high.
b. Occurs in the liver
c. Allows skeletal muscle to produce free glucose
d. Is stimulated by high levels of fructose 2,6-bisphosphate
e. Uses acetyl CoA as a substrate

25. Which of the following statements is TRUE? Enzyme catalysis of a chemical reaction.
a. increases the energy of the transition state.
b. Decreases the change in free energy of the reaction.
c. Increases the change in free energy of the reaction.
d. Decreases the change in the free energy of activation.

26. The activity of which enzyme would be expected to increase as the level of insulin increases?
a. Pyruvate dehydrogenase
b. Hexokinase
c. Glucose 6 –phosphatase
d. Fructose 1, 6-biphosphatase
e. PEP carboxykinase

27. Your patient has muscular weakness and degeneration of the optic nerve. Your tentative
diagnosis is Leber’s hereditary optic neuropathy. If this is the correct diagnosis, which of the
following pathways will contain the defect?
a. Tricarboxylic acid cycle
b. Electron transport
c. Glycolysis
d. Gluconeogenesis
e. Pyruvate dehydrogenase multienzyme complex

28. Which of the following statements about enzyme substrate complexes is TRUE?
a. At high substrate concentration the rate of the reaction is first order.
b. The enzyme concentration is higher than the substrate concentration under physiological
conditions.
c. Alteration in the conformation of the enzyme may occur when substrate binds.
d. Increase in enzyme concentration does not affect the rate of the reaction.

29. Which of the following is physiological mechanism for regulating the catalytic activity of enzymes?
a. Increasing the synthesis of the substrate.
b. Covalent modification of tryptophan residues.
c. Phosphorylation of histidine residues in the active site of the enzyme
d. Conformational alteration in the enzyme by binding regulatory proteins.

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30. The synthesis of phosphoenolpyruvate from pyruvate:
a. is the last step in glycolysis
b. is localized only in the cystosol
c. never occurs since the pyruvate kinase reaction is irreversible
d. consumes GTP
e. requires pyruvate kinase

31. Which statement about non-competitive inhibitors is TRUE?

a. Non-competitive inhibitors are not effective at high substrate concentrations.
b. Non-competitive inhibitors affect the Km of the reaction.
c. Non-competitive inhibitors do not bind to the active site of the enzyme.
d. Non-competitive inhibitors do not decrease the free energy of activation.

32. You are the team physician for your local women’s soccer team. Some of your new recruits have
been disabled due to injury for the past four months and are about to start
a. Lactate dehydogenase
b. PEP carboxykinase
c. Transaminase
d. Hexokinase
e. Succinate dehydrogenase

33. The peptide bond:

a. Of a polypeptide chain is involved in the strong covalent bonds of the primary structure,
as well as the weak, noncovalent hydrogen bonding interactions of any secondary
structure.
b. Results from the condensation reaction between the alpha carboxyl group of one amino
acid with the alpha amino group of a second amino acid.
c. Is the fundamental linking unit of amino acids that results in the primary structure of a
polypeptide chain.
d. Results from condensation of any R-groups or side chains of different amino acids with
each other.
e. Results in a somewhat rigid and planar structure.

34. Proteins are more likely to precipitate

a. At their pI value.
b. At non-physiological salt levels.
c. Above their pI value.
d. Under the influence of agents that denature polypeptides by a disruption of weak, non
covalent bonds that are essential for tertiary structure.

35. Glycoproteins contain sugar residues covalently bonded to:

a. lysine
b. threonine
c. leucine
d. asparagines
e. cysteine

36. A patient complained of painful cramps in her legs during exercise. Her patient history also
revealed that she experienced easy fatigability. Which of the following are consistent with these
observation?
a. The patient is diabetic
b. The patient is missing the enzyme glucose -6 –phosphatase
c. The patient may have a defective debranching enzyme.
d. The patient may have a defective muscle phosphorylase.
e. The patient had no liver glycogen.

37. When the arterial blood pH is 7.23, the plasma bicarbonate concentration is 10 meq/liter and the
PCO2 is 25 mm of Hg, (normal ranges: pH 7.35- 7.45; HC03-21-28-PC02 35-45) the acid-base
disturbance is:
a. Uncompensated respiratory acidosis
b. Uncompensated metabolic acidosis
c. Partially compensated metabolic acidosis
d. Compensated metabolic acidosis
e. Partially compensated respiratory acidosis

38. Concerning cholesterol biosynthesis

a. Two squalene units are required.
b. The rate of synthesis is controlled by the rate of production of HMG-CoA.
c. Oxygen is incorporated into the molecule at the C-17 position.
d. NADPH is required for the formation of HMG-CoA.

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 e. HMG-CoA reductase is stimulated by insulin.

39. Facilitated diffusion

a. Requires energy in the form of ATP
b. Can transport a solute against a concentration gradient.
c. Is not subject to competitive inhibition.
d. Displays no specificity
e. Displays saturation kinetics

40. Pernicious anemia is caused by

a. a deficiency of dietary vitamin B12
b. a deficiency of dietary folic acid
c. an excess production of HCL by the parietal cells of the stomach
d. A deficiency of intrinsic factor.

41. How does the cell maintain a higher level of K + than of Na+?
a. The Na + leaks out into the surrounding extracellular fluid.
b. K + is bound to sites inside the cell
c. The body contains less total Na+ than K+, so Na+ is found at a low concentration inside
the cell.
d. Na+ is actively transported out of the cell and K+ actively transported into the cell.
e. Much of the Na + outside the cell is bound to protein, so that no Na + gradient exists
across the cell membrane.

42. In the biosynthesis of purines the first purine derivative formed as:
a. Inosine c. guanosine monophosphate
b. inosine monophosphate d. adenosine monophosphate
e. xantosine monophosphate

43. An amino acid which is both ketogenic and glucogenic is:

a. Tyrosine d. glutamate
b. Alamine e. histidine
c. Leucine

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44. Which one of the following compounds is a COMMON intermediate in ketogenesis and
cholesterogenesis?
a. mevalonic acid d. HMG-CoA
b. acetoacetic acid e. malonyl-CoA
c. succinyl-CoA

45. Hyaluronic acid consists of repeating units of:

a. glucose and fructose
b. glucoronic acid and N-acetylglucosamine
c. galactose and N-acetylgalactosamine
d. glucuronic acid and N-acetylgalactosamine
e. glucoronic acid and N-acetylgalactosamine -4-sulfate

46. Enzyme distribution among tissues

a. Hexokinase d. pyruvate dehydrogenase
b. glucose 6 –phosphatase e. glycogen phosphorylase
c. lactase dehydrogenase

47. The following are true statements about proteins in biological membranes EXCEPT:
a. Proteins in membranes can be attached either peripherally or penetrate, even span, the
lipid bilayer.
b. They are usually asymmetrically distributed on the different sides of the bilayer.
c. They are involved in transport processes through the lipid bilayer without changing sides
(flip-plop) from one side to the other.
d. They are immobile and fixed to the surrounding lipids.
e. Integral proteins usually contain a sequence of hydrophobic amino acids arranged as
alphahelix or beta-sheets.

48. Chronic alcohol intake will elevate the chylomicrons in blood. Which one of the following is a
normal constituent of chylomcirons
a. apoB-100 c. lipoprotein lipase
b. triglycerides d. free fatty acids

49. Which of the following enzymes would show the greatest increase in serum activity in viral
hepatitis?
a. creatine kinase d. 5’ nuleotidase
b. alkaline phosphatase e. acid phosphatase
c. alamine aminotransferase

50. Which of the phospholipids deficient in the lungs of patients with ARDS (acute respiratory
distress syndrome)?
a. Phosphatidylcholine d. cardiolipin
b. Phosphatidylinositol e. sphinagomyelin
c. phosphatidic acid

51. Increased excretion of urobilinogen in the urine is most commonly the result of
a. Hemolysis d. iron
b. erythropoetic porphyria e. bile duct obstruction
c. liver disease such as viral hepatitis

52. Which of the following statements about the pentose phosphate pathway is INCORRECT?
a. N5-methyl tetrahydrofolate (THF) monoglutamate
b. N5, 10-methylene THF
c. N10-formyl THF
d. N5-10-methenyl THF
e. dihydrofolate

53. The “methyl trap” hypothesis states that in the absence of vitamin B12, there is a block in the
further metabolism of
a. ADP d. ATP
b. Magnesium ions e. calcium ions
c. Inorganic phosphate

54. Actin is released from its interaction with myosin by the addition of:
a. ADP d. ATP
b. Magnesium ions e. calcium ions
c. Inorganic phosphate

55. As regards receptors coupled to Gs (stimulatory G protein) and cAMP, which of the following is
FALSE?

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 a. Binding of a hormone to its receptor activates an enzyme which catalyzes the displaces
of GDP with GTP on the alpha Gs subunit.
b. The Gs alpha subunit dissociates from the beta/gamma subunits and activates adenylate
cyclase.
c. Adenylate cyclase catalyzes the conversion of ATP to CAMP.
d. cAMP actiats cAMP dependent protein kinase by binding to the regulatory subunits which
causes dissociation of the regulatory subunits from the cataylitic subunits.
e. The catalytic subunit cAMP dependent protein kinase phosphorylates proteins on serine.

56. The only apoprotein in LDL is:

a. Apo A d. Apo D
b. Apo B-100+ e. Apo-B-48
c. Apo CH

57. For transport across the inner mitochondrial membrane, long chain fatty acids are attached to:
a. coenzyme A d. acyl transferase
b. acyl transacylase e. carnitine
c. phosphatidylethanolamine

58. The activity of lipoprotein lipase is stimulated by:

a. APO A d. APO E
b. APO B- 48 e. APOB-100
c. APO CII

59. A major contributing factor to cataract formation in diabetes may be the accumulation of sorbitol
in the lens. For that to occur, glucose has to interact with:
a. hexokinase and phosphoglucose isomerase
b. fructose dehydrogenase
c. aldose reductase
d. hexokinase and glucose 6 – phosphate dehydrogenase
e. glucose oxidase

60. The sphingolipidoses are a group of diseases involving defective breakdown of ceramides.
Which one of the following is characteristic for a ceramide?
a. an N-linked fatty acid residue.
b. A residue of glycerol
c. A phosphorylcholine residue
d. Three fatty acid residues
e. Contains a thiol

61. The rate-limiting step in the conversion of cholesterol to bile acids is

a. 12 alpha hydroxylation.
b. 7-alpha hydroxyulation
c. 7-beta hydroxylation
d. Conversion to coprostanol

62. Primaquine sensitivity is a result of a defect in the pentose phosphate pathway. Which of the
following is TRUE for the pentose phosphate pathway:
a. It is absent in red blood cells.
b. Its regulated step is catalyzed by glucose-6-phosphate dehydrogenase
c. It channels all glucose carbons into the production of ribose
d. It can provide the cell with NADH needed in the synthesis of fatty acids.
e. One of its function is to maintain cellular glutathione in the oxidized state.

63. Most urinary ammonium ions are derived by the enzymatic hydrolysis of:
a. glutamine c. histamine
b. glutamic acid d. 6-amino purine derivatives

64. The rate-limiting enzyme is cholesterol biosynthesis is:

a. isopentyl pyrophosphate siomerase
b. mevalonate kinase
c. hydroxymethylglutaryl-CoA reducase
d. dimethylallyl transferase
e. squalene synthase

65. Which one of the following enzymes is involved in the hydrolysis of triglycerides found in
chylomicrons?
a. lipoprotein lipase
b. fatty acyl CoA transferase
c. hormone sensitive lipase

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 d. pancreatic lipase
e. cholesterol ester transfer protein

66. A genetic disease characterized by accumulation of excess phenylalanine in the tissues, mental
retardation, and excretion of phenylalanine metabolites in the urine is caused by a deficiency in
a. phenylalanine transaminase d. homogentisic acid oxidase
b. tyrosine transaminase e. phenylalanine decarboxylase
c. phenylalanine hydroxylase

67. The creatine kinase isoenzyme which is characteristic of heart muscle is:
a. the MB isoenzyme c. the BB isoenzyme
b. the MM isoenzyme d. the CK

68. A patient with a deficiency in the enzyme, thioesterase, is unable to release a fully formed fatty
acid from fatty acid synthase. The name for that fatty acid is:
a. arachidonic acid d. palmitic acid
b. an omega 3 fatty acid e. stearic acid
c. octadecanoic acid

69. Which one of the following factors is NOT essential for the conversion of prothrombin to thrombin
in the clot cascade?
a. Ca ion d. Factor V
b. Factor X e. Factor XIII
c. Phospholipid

70. A DNA deletion occurs 1000 bp upstream of the src phtoooncogene, causing it to be activated.
The sequence deleted is probably a(n);
a. Promoter d. silencer
b. Operator e. initiator
c. Enhancer

71. Which of the following is NOT a possible consequence of a single nucleotide deletion in the
coding region of an exon?
a. Change in reading frame
b. Diminution of polyadenylation
c. Deletion of the 5’ splice site.
d. Nothing (i.e., no consequence)
e. Loss of the start codon.

72. Which of the following enyzymes are not used in cDNA cloning?
a. RNA polymerase d. Restriction endonuclease
b. DNA polymerase e. DNA ligase
c. Reverse transcriptase

73. Which statement best describes, “junk” DNA?

a. Some “junk” DNA may have a function
b. It is never transcribed into RNA.
c. It consists of short repeated sequences of DNA.
d. Pseudogenes never have introns.
e. All pseudogenes contain Alu sequences.

74. Which of the following statements is NOT true of PCR?

a. It is useful in the diagnosis of certain genetic disorders.
b. It requires stringent laboratory precautions to ensure its validity.
c. RT-PCR requires the use of the enzyme reverse transcriptase during cDNA synthesis.
d. Use of thermostable DNA polymerases have greatly aided in its usefulness.
e. Only one primer is required.

75. Which of the following proteins can introduce positive supercoils into DNA?
a. Primosome d. Single strand-binding protein
b. DNA ligase e. XPF protein
c. Helicase

76. A mutation that allows read-through of a stop codon during translation is called a
______mutation.
a. Termination d. suppressor
b. Transversion e. silencer
c. amber
77. The gene for albumin is highly expressed in the liver, which of the following is LEAST likely about
the chromatin near the gene?
a. The albumin gene is in a region of euchromatin in liver

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 b. The DNA is highly methylated at pCpG sequences in the region.
c. Histones are less abundant in the region
d. Histones are acetylated in the region.

78. Which of the following is NOT a general feature of enhancers?

a. Distance independence.
b. They are found in prokaryotes and eukaryotes
c. Orientation independence
d. The proteins that bind them generally function as imers.
e. B and C

79. The first three nucleotides of a palindromic restriction endonodcase recognition sequence are 5’-
AAG3”. What is the entire six basepair recognition sequence (both strands)?
a. 5’AAG-3’
3-TTC-5’
b. 5-AAGCTT-3’
3-TTCGAA-5’
c. TTCGAA-5’
5’TTCGAA-3’
d. 5’AAGCTT-3
3’-TTCCTT-5’
e. None of the above

80. You have determined that a strand of DNA is GC-rich. Its complementary strand is:
a. AT-rich
b. Pyrimidine-rich
c. Purine-rich
d. GC rich
e. Cannot determine from the information given.

81. You have incorporated a radioactive “label” into a PCR primer. After 30 cycles
a. only in the original target DNA molecules
b. in 50% of the new DNA molecules
c. interspersed between the parent and child strands of both new DNA molecules
d. in 1005 of the new DNA molecules
e. A and D

82. Which of the following statements is FALSE about eukaryotic chromosome structure?
a. Centromeres contain alphoid repeats.
b. Protein scaffold required for complete compaction
c. High telomerase activity has been associated with some cancers
d. Mitchondrial chromosomes sometimes contain short telomeres.
e. Mitchondrial genes sometimes use a different genetic code.

83. Increased plasma insulin can result in:

a. increased adipocyte adenylate cyclase activity.
b. Decreased hepatocyte glucokinase
c. Decreased hepatocyte glycogen
d. Decreased hormone sensitive lipase activity
e. Decreased hepatocyte pyruvate dehydrogenase activity.

84. All the following substances are potentially mitogenic EXCEPT:

a. Platelet –derived growth factor
b. Insulin
c. Exocrine factors
d. Contact inhibition
e. Steroid hormone

85. A chronic alcoholic is admitted to your service with a blood pH of 7.2. Which of the following
explains this finding?
a. Ethanol is an acid that produces acidosis when consumed in large quantities
b. Ethanol is converted into lactic acid that will lower blood pH.
c. Ethanol elevates the NADH concentration in the liver causing an increased conversion of
pyruvate to lactate.
d. Ethanol decreases the respiratory rate leading to a buildup of CO2 that is converted to
carbonic acid.
e. Ethanol blocks electron transport causing a buildup of NADH and lactate.

86. Which immune response would be considered an immune system dysfunction?

a. Successful vaccination against rabies virus.
b. Organ transplant rejection

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 c. Immune response to influenza virus
d. An autoimmune response
e. Successful vaccination against poliovirus

87. Glucagon plays a homeostatic role by:

a. increasing in response to elevated blood glucose levels and then activating liver glycogen
synthetase.
b. Increasing in response to lowered blood glucose levels and then actiating liver glycogen
phosphorylase
c. Stimulating the release of glucose residues from muscles glycogen during intense
exercise.
d. Activating adenylate cyclase in skeletal muscles cells.
e. Facilitating glucose uptake into skeletal muscle.

88. All of the following are likely to occur after eating a large amount of carbohydrate EXCEPT
a. The synthesis of triacylgylcerol in the liver.
b. The synthesis of glycogen in the liver
c. Increased pentose phosphate pathway activity in liver
d. Release of glycerol from adipose tissue
e. The synthesis and release of VLDL from the liver

89. Which of the following statement is true ABOUT antigen-antibody reactions?

a. They are not involved in allergic responses.
b. They function to identify antigens for subsequent removal from the body.
c. They occur because of the complementary between epitope and parasite.
d. They occur because of complementarity between alpha helices and beta turn structures.
e. They only involve proteins.

90. The enzyme in liver that is stimulated first by glucagons is

a. phosphofructokinase
b. glycogen syntahse
c. hormone sensitive lipase
d. hormone sensitie lipase
e. isocitrate dchydrogenase

91. Which statement below is TRUE about antibodies?

a. Antibodies are normally made against nucleic acids.
b. Antibodies all require-Jchains
c. Antibodies are lipoproteins
d. Antibodies are cytokines produced by plasma cells.
e. All antibodies are composed of heavy chains and light chains.

92. 1,25-dihydroxycholecalciferol (calcitriol)

a. is produced by the liver.
b. Inhibits resoprtion of calcium ions from bone.
c. Promotes intestinal synthesis of a calcium binding protein
d. Reduces absorption of calcium from the kidney
e. Synthesis is reduced by parathyroid hormone.

93. Which of the following is exhibited by diabetics WITHOUT insulin therapy?

a. An increase in the rate of VLDL synthesis by the liver.
b. An increase in the rate of oxidation of fatty acids by the liver.
c. An increase in the rate of protein synthesis in muscle.
d. An increase in the conversion of alanine to pyruvate in skeletal muscle.
e. An increase in the use of acetone as energy by the brain.

94. Your patient has a genetic defect that blocks the synthesis of androstenedione. Which of the
following will also be reduced by this defect?
a. Progesterone d. cortisol
b. Testosterone e. aldosterone
c. Pregnenolone

95. Which of the following statements below if FALSE?

a. Histocompatibility antigens are cell surface protein structures capable of presenting
antigenic fragments to T-cells for specific recognition by T-cells.
b. Class switching changes the immunoglobulin class, but not the paratope.
c. Antibody paratopes result from the juxtaposition six hypervariable regions, three each
from the light chain and the heavy chain variable dominas.
d. B-cells synthesize heavy chains, light cahins and secretory piece.

96. In the fed state:

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 a. glucose is both converted to glycogen and stored in skeletal muscle.
b. Adipose tissue converts triglycerides to glucose
c. Amino acids are transaminated to form ketone bodies.
d. Glycogen stores in liver are depleted
e. Glycogen phosphorylase is in the active form.

97. Which of the following statements is FALSE?

a. immunogenes are normally viewed as foreign by the immune system
b. Antigens are almost always high molecular weight lipids or carbohydrates
c. Antigens can be parts of parasites, bacteria or viruses
d. Epilopes of proteins are generally fie to six amino acids in size.
e. Antigens have small topological features called epitopes

98. Chronic alcohol consumption

a. leads to decreased NADH production in the cytosolo and mitcohondria
b. leads to hypeglycemia because alcohol is converted to glucose.
c. Leads to decreased rates of inactivation of drugs by cytochrome P450
d. Leads to decreased concentration of pyruvate in the liver
e. Leads to increase chylomicron production by the liver

99. All of the statements below about T-cells are TRUE, EXCEPT which one?
a. The major histocompatibility complex class 1 protein is recognized by the CD8 (or T8)
protein of the cytotoxic T-cell
b. The major histocompatibility complex class 1 protein is recognized by the CD8 (or T8)
protein of the cytotoxic T-cell)
c. The T-cell antigen receptor is a heterodimeric protein with variable region domains and
constant region domains.
d. The major histocompatibility complex Class II protein is recognized by the CD4 (or T4)
protein of the helper T-cell.
e. The CD3 complex of the T-cell carries and displays the antigen fragment.

100. Twenty four hours after a meal, the primary source of glucose carbons for the brain is:
a. dietary glucose
b. muscle glycogen
c. glycerol from adipose tissue
d. fatty acids
e. skeletal muscle protein.

11