DAVAO MEDICAL SCHOOL FOUNDATION

COLLEGE OF MEDICINE
DEPARTMENT OF BIOCHEMISTRY

LIPID CHEMISTRY / LIPID METABOLISM

OBJECTIVE:
A. The students must be able to describe the chemical nature and properties
of the different types of lipids and relate them to their cellular functions

B. The students must understand the biosynthesis and catabolism of the

commonly occurring lipid in human cells and explain the biochemical
basis of diseases associated with abnormalities in lipid transport and
metabolism

1. Of the following lipoproteins, which one is inversely related to the incidence of

coronary atherosclerosis?
a. chylomicron
b. high density lipoprotein
c. intermediate lipoprotein
d. low density lipoprotein
e. very low density lipoprotein
( HARPER’s 25th ch 27 pp 268-271)

2. . In the shuttle of mitochondrial acetyl coenzyme A to the cytosol for fatty acid
synthesis, in which step generates NADPH?
a. oxaloacetate + acetyl coenzyme A  citrate
b. oxaloacetate  malate
c. malate  pyruvate
d. pyruvate  oxaloacetate
e. citrate _ coenzyme A  oxaloacetate _ acetyl coenzyme A
( Harper’s ch 24 pp238-239)

3. The lipoprotein that serves to transport triacylglycerol from the liver to the
different extrahepatic tissues:
a. chylomicrons
b. high density lipoproteins
c. intermediate density lipoproteins
d. low density lipoproteins
e. very low density lipoproteins
(Harper’s Ch 27 p 268-271)

4. . Which of the following apolipoproteins serves as inhibitor of

lecithin:cholesterol acyltransferase (LCAT)?
a. apolipoprotein A-II
b. apolipoprotein A-IV
c. apolipoprotein B-48
d. apolipoprotein C-I
e. apolipoprotein C-II
( Harper’s ch 27 pp 270-271)
5. . In the following steps in ketone bodies metabolism, NADH is generated in:
a. acetoacetate  acetone
b. acetoacetate  beta hydroxybutyrate
c. acetoacetyl coenzyme A + acetyl coenzyme A  HMG coenzyme A
d. beta hydroxybutyrate  acetoacetate
e. HMG coenzyme A  acetoacetate + acetyl coenzyme A
( Harper’s ch 24 p 244-245)

6. Human body synthesize cholesterol de novo from acetyl coenzyme A.

Cholesterol synthesis occurs in which of the following organelles?
a. cytosol
b. endoplasmic reticulum
c. golgi apparatus
d. mitochondria
e. ribosomes
( Harper’s ch 28 p285)

7. . Among the following apolipoproteins, which one serves as lipid transfer

protein?
a. apolipoprotein A-IV
b. apolipoprotein B-100
c. apolipoprotein C-III
d. apolipoprotein D
e. apolipoprotein E
( Harper’s ch 27 p 271)

8. Among the following conditions, which one is characterized by pathologic

accumulation of galactocerebroside in the affected tissues.
a. Farber's Disease
b. Fabry's Disease
c. Gaucher's Disease
d. Krabbe's Disease
e. Metachromatic Leukodystrophy
( Harper’s ch 27 p 267t)

9. . Which of the lipoproteins has the highest triacylglycerol content?

a. chylomicrons
b. high density lipoproteins
c. intermediate density lipoproteins
d. low density lipoproteins
e. very low density lipoproteins
(Harper’s Ch 27 p 268-271)

10. . Ketone bodies maybe synthesized from fatty acids by which of the following
organs or cells?
a. skeletal muscle
b. liver
c. kidney
d. erythrocytes
e. brain
(Harper’s ch 24 p242)
11. Spontaneous decarboxylation of acetoacetate results in the formation of:
a. acetone
b. acetyl coenzyme A
c. 3-hydroxybutyrate
d. malonyl coenzyme A
e. propionate
( Harper’s ch 24 p 242-243)

12. Which of the lipoproteins has the highest total lipid content?
a. chylomicrons
b. high density lipoproteins
c. intermediate density lipoproteins
d. low density lipoproteins
e. very low density lipoproteins
( Harper’s p 268)

13. The major site of fatty acid synthesis:

a. mammary gland
b. liver
c. kidney
d. brain
e. adipose tissue
(Harper’s ch 23 p 230-231)

14. Of the following lipoproteins, which one is elevated in Type I Hyperlipidemia?

a. chylomicrons
b. high density lipoproteins
c. intermediate density lipoproteins
d. low density lipoproteins
e. very low density lipoproteins
(Harper’s Ch 27 p 268-271)

15. Of the following lipids, which one is accumulated is tissues of patient with
Tay-Sach’s Disease?
a. ceramide trihexoside
b. galactocerebroside sulfate
c. ganglioside
d. glucoceberoside
e. sphingomyelin
(Harper’s p 267)

16. In the separation of plasma lipoprotein by electrophoresis on agarose gel,

which fraction is located closest to the negative pole?
a. chylomicrons
b. HDL
c. LDL
d. VLDL
e. Triglycerides
(Harper’s Ch 27 p 268-271)

17. During uncontrolled diabetes mellitus or starvation, which of the following

organs utilizes ketone bodies as much as 75% for its energy substrate?
a. Heart
b. Brain
c. Kidney
d. Skeletal muscles
( harper’s ch 29 p 301)
18. In the biosynthesis of fatty acids, what is the compound that transports the
acetate group out of the mitochondria into the cytoplasm
a. pyruvate
b. malate
c. citrate
d. acyl carnitine
e. acyl coenzyme A
(Harper’s ch 23 p 236)

19. Activation of medium chain and short fatty acids occurs in the
a. Ribosomes
b. Mitochondrial matrix
c. Golgi apparatus
d. Endoplasmic reticulum
e. Cytosol
(Harper’s pp 238-239)

20. The committed step in fatty acid synthesis is the formation of

a. Acetyl coenzyme A
b. Acetyl acyl carrier protein
c. Malonyl coenzyme A
d. Malonyl acyl carrier protein
( Harper’s Ch 23 pp 230)

B. Carbohydtrate chemistry/ Carbohydrate metabolism

OBJECTIVES:
a) The student must be able to describe adequately the chemical properties
of carbohydrates and relate them to their cellular function

b) The students must describe the interrelationships between the various

pathways of carbohydrate metabolism and explain the biochemical basis
of diseases resulting from impairment of carbohydrate metabolism

1. a D glucose and a L glucose are

a. Anomers
b. Epimers
c. Tautomers
d. Enantiomers
(Berg et al BIOCHEMISTRY 5TH ED p 296)

2. This sugar derivative is produced by the reduction of the carbonyl group on a

monosaccaharide
a. sorbitol
b. glucoronic acid
c. glycoside
d. gluconic acid
( Harper’s Ch 15 p 153)
3. Of the following hexoses, which is a constituent of glycolipids and
glycoproteins?
a. glucose
b. galactose
c. fructose
d. xylulose
( Harper’s ch 56 p 676-677)

4. Which of the following glycosaminoglycans are found in large amount in

cartilages
a. Dermatan sulfate
b. Keratan sulfate
c. Choindroitin sulfate
d. Heparan sulfate
e. Hyaluronic acid
( Harper’s Ch 57 p 704)

5. The compound that is the probable causative factor in the development of

cataract in patients with diabetes mellitus
a. Dulcitol
b. Fructose 1-phosphate
c. galactose 1-phosphate
d. glucose 1-phosphate
e. sorbitol
( Harper’s p 228-229)

6. The glycogen storage disease resulting from the deficiency of muscle

phosphorylase
a. Pompe’s disease
b. McArdle’s disease
c. Her’s disease
d. Forbe’s disease
e. Andersen’s disease
(Harper’s ch 20 p 206t)

7. What is the major energy source for spermatozoa in seminal fluid?

a. Fructose
b. galactose
c. glucose
d. ketone bodies
e. xylulose

8. A patient is diagnosed as having von Gierke’s disease is likely to exhibit which

of the following clinical manifestations
a. an enlarged liver
b. hyperglycemia
c. hypolipidemia
d. hypouricemia
(Harper’s Ch 36 p 397)

9. This enzyme is common to both glycolysis and gluconeogenesis

a. Glyceraldehyde 3-phosphate dehydrogenase
b. glucose 6-phosphatase
c. pyruvate kinase
d. pyruvate carboxylase
(Harper’s p 194/211)
10. In humans, liver glycogen stores are adequate up to how many hours
without support from gluconeogenesis?
a. 4 hours
b. 12 hours
c. 24 hours
d. 48 hours
(Harper’s pp214-217)

C. BIOENERGETICS and BIOLOGICAL OXIDATION

OBJECTIVES:
1. The students must understand the energy transformations known
to occur in cells

1. The net ATP generated in the complete oxidation of beta-hydroxybutyrate is:

a. 12 ATPs
b. 23 ATPs
c. 26 ATPs
d. 36 ATPs
e. 129 ATPs
(Harper’s chapter 24)

2. The number of NADPH required in complete synthesis of one (1) mole of

palmitic acid
a. 7
b. 8
c. 12
d. 14
e. 16
(Harper’s chapter 23)

3. Major source of ATP in aerobic organisms

a. direct phosphorylation
b. substrate level phosphorylation
c. ATP adenylation
d. Oxidative phosphorylation
(Harper’s ch 14 p137)

4. The primary pathway for the oxidation of glucose

a. Embden Myerhoff pathway
b. Sorbitol pathway
c. Tricarboxylic acid pathway
d. Pentose phosphate pathway
(Harper’s ch 17 p 173)

5. In the complete oxidation of one (1) mole of palmitic acid to CO2 and H2O, the
total number of ATP generated is
a. 12
b. 24
c. 36
d. 129
e. 131
(Harper’s Ch 23)
6. Synonymous with Kreb’s cycle
a. Pentose phosphate pathway
b. Citric acid cyle
c. Oxidative phosphorylation
d. Embden myerhoff pathway
(Harper’s ch 18 p 182f)

7. Anaerobic glycolysis produces how many moles of ATP per mole of glucose?
a. 2
b. 6
c. 8
d. 12
e. 24
(Harper’s ch 19 p 190-191)

8. Rate limiting enzyme and the major regulatory enzyme in glycolysis

a. triose phosphate isomerase
b. glyceride 3-phosphate dehydrogenase
c. phosphofructokinase
d. aldolase
(Harper’s p 191/194)

9. Enzyme that links glycolysis and the citric acid cycle

a. Pyruvate dehydrogenase
b. Isocitrate dehydrogenase
c. Alpha-ketoglutarate dehydrogenase
d. Succinate dehydrogenase
(Harper’s ch 29 pp 298…)

10. Oxidative phosphorylation is carried out by respiratory assembly located in

a. mitochondrial matrix
b. inner mitochondrial membrane
c. endoplasmic reticulum
d. cytosol
( Harper’s pp 126/ 137….)

D. Protein and amino acid chemistry/ metabolism

OBJECTIVES:
1. The student must be able to describe the chemical structure
and properties of proteins and amino acids

2. The student must be able to understand the principles of amino

acid and protein metabolism so they can relate and apply such
knowledge to the study of human health and diseases

1. Which of the following amino acid functional group pairs is not correct
a) arginine:guanidine
b) histidine:imidazole
c) phenylalanine: hydroxyphenyl
d) tryptophan : indole
e) cysteine : sulfhydryl
(Harper’s p 29)
2.Helical formation or Helix is a characteristic of what protein structure?
a. primary
b. secondary
c. tertiary
d. quaternary
e. all of the above
(Harper’s p 49)

3. Which of the following amino acids serve as the major mode of disposing
ammonia from the brain?
a. alanine
b. glutamine
c. threonine
d. serine
e. valine
(Harper’s p 308/317)

4. Among the following amino acids, which one is converted to pyruvate through
transamination reaction?

a. alanine
b. methionine
c. threonine
d. valine
( Harper’s pp315-316)

5. Which of the following amino acids is convertible to pyruvate by direct

deamination?
a. alanine
b. cysteine
c. glycine
d. serine
e. threonine

6.The amino acid precursor of catecholamines:

a. glycine
b. proline
c. threonine
d. tryptophan
e. tyrosine
( Harper’s p 354)

7. Among the following amino acids, which one is purely ketogenic?

a. isoleucine
b. leucine
c. phenylalanine
d. threonine
e. tryptophan
( Harper’s Chapter 4)
8. Urea is the major pathway of nitrogen excretion in humans. It is synthesized in
the:
a. brain
b. intestine
c. kidney
d. liver
e. skeletal muscle
( Harper’s pp315…)

9. Among the intermediates in urea cycle, which one provides the linkage of urea
cycle and the citric acid cycle?
a. Alpha ketoglutarate
b. aspartate
c. fumarate
d. malate
e. oxaloacetate
(Harper’s pp319-321)

10. The following amino acid is GLYCOGENIC ONLY

a. aspartate
b. isoleucine
c. leucine
d. lysine
e. tyrosine
( Harper’s Chapter 4)

11. Disorder of amino acid metabolism characterized by “Maple Syrup urine

odor”:
a. Alkaptonuria
b. Isovaleic Acidemia
c. Menke’s Disease
d. Phenylketonuria

12. What is the Isoelectric pH of albumin?

a. 4.2
b. 4.7
c. 4.9
d. 5.2
e. 5.7

13. The main mode of linkage in primary protein structure is

a. hydrogen bonds
b. peptide bonds
c. salt bonds
d. covalent disulfide bonds
e. van der waals
(Harper’s p 49)

14. Which of the following amino acids contain indole functional group?
a. Arginine
b. Histidine
c. Phenylalanine
d. Tryptophan
e. Tyrosine
(Harper’s p 29)
15. A biochemical technique used to separate molecules based on both size and
charge
a. gel electrophoresis
b. spectrophotometry
c. ultracentrifugation
d. paper chromatography
( Harper’s P48/53)

16. Which of the following enzymes funnel amino nitrogen from glutamate to
urea?
a. glutamate transaminase
a. alanine transaminase
b. amino acid oxidase
c. glutamate dehydratase
d. glutamate dehydrogenase
(Harper’s pp319-321)

17Amino acid precursor of serotonin

a. alanine
b. aspartate
c. tryptophan
d. methionine
e. tyrosine

18. The metabolism of the following amino acid leads to the production of small
amounts of nicotinic acid in humans
a. cysteine
b. methionine
c. serine
d. tryptophan
e. valine
( Harper’s chapter 42)

19. A metabolite of the following amino acid is a substrate for branched-chain

keto-acid dehydrogenase
a. arginine
b. lysine
c. methionine
d. proline
e. valine
( Harper’s chapter 4)

20. Which of the following is a non essential amino acid?

a. leucine
b. tyrosine
c. lysine
d. methionine
e. valine
( Harper’s chapter 4)

D. Nucleic acid chemistry/metabolism/ Genetics

OBJECTIVES:
1. The student should be able to describe the structural organization
of nucleosides, nucleotides and nucleic acids and relate them to
their cellular functions
 2. The students should discuss and understand the
biochemical basis of diseases resulting from impairment in
the biosynthetic and catabolic pathways of purine and
pyrimidine nucleotide metabolism

1. The most abundant free nucleotide in mammalian cells

a. Adenosine diphosphate
b. Cyclic AMP
c. Adenosine triphosphate
d. Adenosine monophosphate
e. Phosphoadenosine phosphosulfate
( HARPER’S 25th p. 379)

2. A purine analog which is widely used in the treatment of gout

a. aspirin
b. azathioprine
c. allopurinol
d. 5-iododeoxyuridine
e. 5-flourouracil
(HARPER’S CH 35 p-382)

3. Okasaki fragments are

a. short non coding DNA segments
b. short DNA fragments attached to RNA primers during replication
c. produced when histone biosynthesis is inhibited
d. mitochondrial DNA fragments complexed with histones
(HARPER’S CH 38 p- 424)

4. RNA and DNA diifer from each other , in that:

a. in DNA, the nucleotides run 5’ to 3’ direction
b. in RNA, the sugar is linked to the base by an N-glycosidic linkage
c. In RNA, the sugar is D-ribose
d. in DNA, thymine is found instead of uracil
( HARPER’S CH 37 p 406)

5. Detection of purines and pyrimidines can be done because of their strong

absorption of UV light at this wavelength
a. 260nm
b. 650 nm
c. 400nm
d. 600 nm
(HARPER’S p-290)

6. In genetic diseases, the primary defect resides in this organelle

a. endoplasmic reticulum
b. nucleus
c. cytoplasm
d. mitochondria
( HARPER’S CH 63 P-813)
7. A PURINE BASE
a. cytosine
b. guanine
c. uracil
d. thymine
( HARPER’s ch 37 p 402)

8. Serves as the carrier of genetic information to the site of protein synthesis

a. mRNA
b. tRNA
c. rRNA
d. snRNA
(HARPER’s ch37 p 407)

9. A synthetic nucleotide analog which exhibits antiviral activity useful in the

treatment of herpetic keratitis
a. azathioprine
b. 5-iododeoxyuridine
c. cytarabine
d. mercaptopurine
( HARPER’s p 383)

10. Nucleotide derivative that acts as “ secondary messenger”

a. ATP
b. ADP
c. c-AMP
d. c-GMP
e. GTP
( HARPER’s CH 35 p-380)

E. ENZYMES

OBJECTIVES:

1. The students must appreciate hoe protein structures of enzymes

have been specifically designed to allow the catalytic action of
enzymes in metabolic reactions

2. The students must understand the role of enzymes in metabolic

regulation and their importance as diagnostic aids and therapeutic
tools

1. Two constants are always measured whenever an enzyme is characterized.

These are:
a. K1 and Km
b. Km and Vmax
c. Q10 and Vo
d. Vmax and Q10
e. Vo and K1
(Harper’s pp 95 ff )
2. Group of enzymes that catalyze the addition or removal of water, ammonia or
carbon dioxide to double bonds:
a. hydrolases
b. isomerases
c. ligases
d. lyases
e. oxidoreductases

3. Nonfunctional serum enzyme that is diagnostic of obstructive liver diseases.

A. acid phosphatase
B. alanine aminotransferase
C. alkaline phosphatase
D. aspartate aminotransferase
E. ceruloplasmin

4. Carbonic anhydrase requires which metal ion as cofactor

a. iron
b. zinc
c. magnesium
d. copper
e. sodium,

5. In the effects of substrate concentration on reaction velocity, when substrate

concentration is low
a. the reaction velocity is zero order
b. the reaction velocity is first-order
c. the reaction velocity is second order
d. the reaction velocity is mixed order

6. Which of the following is the target enzyme of an anti inflammatory drug,

aspirin?
a. xanthine oxidase
b. transpeptidase
c. HMG CoA reductase
d. Cyclooxygenase
e. Monoamine oxidase

7. Effect of uncompetitive inhibitors to the Maximum velocity (Vmax) and

Michaelis constant (Km)
a. Vmax - none : Km – increases
b. Vmax – decreases : Km – decreases
c. Vmax – decreases : Km - none
d. Vmax – decreases : Km- increases
e. Vmax – increase : Km – none
(Harper’s pp 95 ff )

8. The quantitative value of the Michaelis constant or Km, is a measure of

a. the optimum condition present in the cell
b. relative affinity between the substrate and enzyme
c. the velocity of the biochemical reaction
d. the concentration of the enzyme present
(Harper’s pp 95 ff )
9. This enzyme is valuable in the diagnosis of metastatic carcinoma of the
prostate gland.
a. ceruloplasmin
b. alkaline phosphatase
c. lactate dehydogenase
d. acid phosphatase
e. aspartate aminotransferase

10. A group of enzymes that join two molecules along with breakdown of a
pyrophosphate (P-P) bond
a. ligase
b. isomerase
c. lyase
d. transferase

F. HORMONES/ Hormone actions

OBJECTIVES:
1. The students must understand the structures, properties and
the roles of hormones in the maintenance of normal body
metabolism

1. Among the following hormones, which one possess anti-inflammatory effect

mediated through the inhibitory effect on arachidonic acid release?
a. adrenaline
b. glucagon
c. glucocorticosteroid
d. insulin
e. thyroxine

2. Of the following, which is a C-19 steroid?

a. cholic acid
b. cortisol
c. estradiol
d. progesterone
e. testosterone
( Harper’s 577-578)

3. . Which of the following hormones is aromatic?

a. aldosterone
b. cortisol
c. estradiol
d. progesterone
e. testosterone
( Harper’s p 577)

4. In the synthesis of estradiol which of the following hormone is its immediate

precursor?
a. androstenedione
b. corticosterone
c. pregnenolone
d. progesterone
e. testosterone
( Harper’s pp599-601)
5. Site of aldosterone secretion in the adrenal cortex:
a. zona fasciculata
b. zona granulosa
c. zona intima
d. zona pellucida
e. zona reticularis

6. Which of the following is a C-24 steroid?

a. chenodeoxycholic acid
b. cortisol
c. estradiol
d. progesterone
e. testosterone
(Harper’s p 292)

7. Of the following hormones, which one is an essential requirement for

triacyglycerol synthesis in the adipose tissue?
a. adrenaline
b. cortisol
c. glucagon
d. insulin
e. thyroxine
(Harper’s p246)

8. In the adipose tissue, which of the following hormones enhances the synthesis
of lipoprotein lipase?
a. cortisol
b. epinephrine
c. glucagons
d. insulin
e. progesterone
( Harper’s p 246)

9. The urinary metabolite used in the diagnosis of Adrenal Pheochromocytoma:

a. hydroxyindoleacetic acid (HIAA)
b. hydroxytryptamine
c. hydroxytryptophan
d. normetanephrine
e. vanillylmandelic acid (VMA)
(Harper’s p 593)

10. . Which of the following is a C-18 steroid?

f. chenodeoxycholic acid
g. cortisol
h. estradiol
i. progesterone
j. testosterone
( Harper’s p577)
E. VITAMINS AND MINERALS
OBJECTIVES:
1. The students must understand clearly the nutritional aspects of
vitamins
and minerals and appreciate their role in the maintenance of normal
body functions

2. The students must correlate the clinical disorders that will result from
the deficiency and excesses of these vitamins with their metabolic roles
in the body.

1. An important anti oxidant because it inhibits the formation of

nitrosamines during digestion
a. retinol
b. ascorbic acid
c. tocopherol
d. retinoic acid
e. cobalamin
(Harper’s pp640-641)

2. Deficiency of this may lead to anemia in the prematures due to red

blood cell hemolysis
a. Vit A
b. Vit D
c. Vit E
d. Vit C
e. Vit K
(Harper’s pp 647-648)

3. A cofactor of an important enzyme of the pentose phosphate pathway,

transketolase
a. Thiamine
b. Biotin
c. Niacin
d. Riboflavin
e. Pantothenic acid
(Harper’s pp 627)

4. Functions as a cofactor to a carboxylase that acts on glutamate

residues of clotting factor precursor proteins
a. Vitamin A
b. Vitamin C
c. Vitamiin E
d. Vitamin K
e. Biotin
( Harper’s PP 649)

5. A polyisoprenoid compound containing a cyclohexenyl ring

a. Folic acid
b. Pyridoxine
c. Ascorbic acid
d. Retinol
e. Biotin
( Harper’s p 642)
6. The earliest clinical symptom of Vitamin A deficiency
a. defective night vision
b. xerophtalmia
c. presence of Bitots spots
d. Keratomalacia
e. Xerosis conjunctivae
(Harper’s p 643)

7. This vitamin is important in the regulation of calcium and phosphate

metabolism
a. Vitamin A
b. Vitamin E
c. Thiamin
d. Folic acid
e. Vitamin D
( Harper’s p 645)

8. If a patient exhibits low activity of propionyl CoA carboxylase, therapeutic

doses of which of the following might be beneficial?
a. carnitine
b. pantothenic acid
c. biotin
d. riboflavin
e. niacin
( Harper’s p 635)

9. Strict vegetarians are susceptible to this kind of vitamin deficiency

a. pantothenic acid
b. cobalamin
c. folacin
d. niacin
e. pyridoxine
( Harper’s p 635)

10. . Of the following, which is the most potent form of vitamin D?

a.ergosterol
b.cholecalciferol
c.7-dehydrocholesterol
d.25-hydroxycholecalciferol
e. 1,25-dihydroxycholecalciferol
( Harper’s p 647)