1. Insulin signals glucose transport mediated by Glut 4.

Since Yono is suffering from insulin

dependent diabetes mellitus, his doctor cautioned him of insulin overdose. The danger that
could happen to Yono is, he might go into coma because of drop in blood sugar. Too low
blood sugar can be explained as a result of too much uptake of glucose by:

A. Brain cells
B. Liver cells
C. Erythrocytes
D. Brain and liver cells
E. Adipocytes and muscle cells
(E)

2. Without his insulin injection, Yono would feel a weakness especially in the legs. Reason for
the lack of energy is:
A. Decreased gluconeogenesis
B. Decreased glycolysis
C. Decreased ketogenesis
D. Increased pyruvate oxidation
E. Increased glycogenesis
B
3. To compensate for the lack of energy due to defective carbohydrate metabolism, Yono’s
body has to switch to alternative mechanism for his energy need. At an early state of
energy deficiency, the alternative is
A. Increase lipolysis
B. Fatty acid esterification
C. Transamination
D. Proteolysis
E. Ketogenesis
A
4. When Mira overslept one morning during fasting month she just went on without breakfast
knowing that her internal energy store would be sufficient for the day. Initially energy
homeostasis involves glycogenesis and glycogenolysis which are individually regulated by
different key enzymes. Both pathways counter regulate each other controlled by
A. Glucagon
B. Epinephrine
C. ATP
D. Cyclic AMP
E. Ca2+
D
5. Glucose stimulates pancreas β-cells to release insulin. The mechanism underlying this
statement is initiated by entrance of blood glucose into pancreas. ATP obtained from
glucose metabolism will be used to
A. Stimulate Ca2+ flux into pancreas by inhibiting K + extrusion
B. Pump K+ out in exchange for Na+ entering pancreas
C. Pump Ca2+ into pancreatic cells
D. Activate insulin secretion with K+ co transport
E. Activate insulin secretion with Na+ co transport
 A
6. A man suffering from uncontrolled diabetes mellitus was admitted to a clinic. Lab test
indicated a condition of metabolic acidosis. Obviously he could not rely on carbohydrate
metabolism for his energy need and his fat store was almost depleted.
What characteristic would you expect of such a condition?
A. Hypoglycemia
B. Low blood fatty acid
C. Negative nitrogen balance
D. Decreased ketogenesis
E. Decreased lipolysis
C
7. Acid urine can be tested in severe diabetes mellitus or people with high intake of protein.
Acidity of urine is caused by conversion of
A. glutamate to α-ketoglutarate
B. Alanine to glucose
C. Ammonia to urea
D. Cysteine to sulphates
E. Glycine to porphyrin
D
8. Nila, a diabetic patient, fasts one or two days prior to her routine check up with her doctor.
She doesn’t know her blood sugar can be tested by a method that estimates glucose over
past several months. The theoretical aspect of this test is
A. Nonenzymatic glycation of hemoglobin
B. Glucose induced hemolysis
C. Glucose oxidation catalyzed by heme Fe
D. Conjugation of glucose with lipoprotein
E. Conversion of glucose to blood fatty acid
A
9. Mrs. Rada is determined to reduce weight by intensive physical exercise. To be successful
she must exercise vigorously to the extend of consuming calories from
A. Glycolysis
B. Glycogenolysis
C. Citric acid cycle
D. β-oxidation of fatty acid
E. Ketone bodies oxidation
D
10. Hyperglycemia is not the only factor underlying he development of complications of
diabetes. Vascular diseases may develop through interplay of hyperglycemia and a
change in blood lipids such as dyslipidemia characterized by
A. Decreased VLDL and fatty acid
B. Decreased VLDL and HDL
C. Increased HDL and triacylglycerol
D. Increased HDL and VLDL
E. Increased VLDL and decreased HDL
E
11. Fatty acids are oxidized to carbon dioxide and water in the mitochondria of tissues. The
process of β-oxidation produces acetyl-CoA molecules which have to be oxidized in the
 TCA cycle. This process is very dependent upon an adequate supply of metabolite
produced by carbohydrate metabolism to operate in the first step of TCA cycle. The
metabolite needed for this process is
A. Pyruvic acid
B. Succinyl CoA
C. Oxaloacetate
D. Lactic acid
E. Glyceraldehyde-3P
C
12. Fat as higher energy content relative to carbohydrates. Beta oxidation of fatty acids
produces acetyl-CoA to be oxidized to carbon dioxide and water. In excess to this, this
oxidative pathway produces other factors with the potential of producing ATP. These are
A. FMN and FAD
B. FAD and NADP
C. FMNH2 and FADH2
D. FADH2 and NADH
E. FADH2 and NADPH
D
13. A 48 years old male came to the outpatient department with complaints frequently urinates
and easily becomes thirsty and hungry. The physical examination showed that the vital
signs were within normal limit. Body weight = 101 kg, height = 175 cm, waist
circumference = 103 cm.
Based on the data above, what is the most likely underlying mechanism of his complaints?
A. hypercholesterolemia
B. hyperlipidemia
C. hyperglucagonemia
D. hyperinsulinemia
E. hypertrygliceridemia
D