PGI BOARD REVIEW – BIOCHEMISTRY 2021

In general, methylation of DNA regulates gene expression by:

A. Reducing it
B. Increasing it
C. Promoting the activity of euchromatin
D. Decreasing the amount of heterochromatin
ANSWER: A

Which of the following mutations is MOST likely to be lethal?

A. deletion of three nucleotides (corresponding to one codon)
B. insertion of one nucleotide
C. substitution of adenine for cytosine
D. substitution of cytosine for guanine
ANSWER: B
Which of the following nucleotide base is NOT present in codons?
A. adenine
B. guanine
C. uracil
D. thymine
ANSWER: D

Drugs that target thymidylate synthase only works in humans/eukaryotes; will not work
against those with only RNA.

The tetracycline drugs prevent the binding of amino acyl tRNAs to the A site of the bacterial
ribosome. This will result in:
A. inhibition of bacterial replication
B. bacterial cell lysis
C. inhibition of initiation of translation
D. inhibition of transcription
ANSWER: C

CENTRAL DOGMA

DNA replication – fluoroquinolones (DNA gyrase)

mRNA transcription – rifampicin
translation – ribosomes

1. Initiation – tRNA synthetase  Tetracyclines

2. Peptide formation – macrolides, chloramphenicol (peptide bond formation)
3. Prevent assembly of the translation complex – Aminoglycosides, Clindamycin
A newly launched antibiotic is credited with inhibiting the bacterial helicase which then stops the
synthesis of proteins in bacterial systems. At what stage of protein synthesis does the antibiotic
act?
A. replication
B. transcription
C. translation
D. reverse transcription
ANSWER: A
A 50/M diagnosed with gout has not been improving despite a low-purine diet. He is started on
Allopurinol. How will this drug reduce his uric acid levels?
A. The drug serves as a non-purine inhibitor of xanthine oxidase
B. The drug reduces the expression of xanthine oxidase
C. The drug’s metabolite renders xanthine oxidase no longer functional
D. The drug allosterically inhibits the action of xanthine oxidase
ANSWER: C

COMPETITIVE INHIBITOR – FEBUXOSTAT

ALLOPURINOL – initially competitive, xanthine oxidase will act on it  OXYPURINOL 
SUICIDE INHIBITOR of xanthine oxidase
URICASES (Rasburicase, Pegloticase)
- Tumor lysis syndrome

A human disorder attributed to a mutation leading to reduced DNA repair activity is:
A. Lesch Nyhan Syndrome
B. Xeroderma pigmentosum
C. Tay Sach’s disease
D. Albinism – melanin comes from tyrosine
ANSWER: B
A two-year-old boy is exhibiting developmental delay and is noted to incessantly bite his lips and
fingers. Orange-colored grains of sand-like material are found on his diapers. The child
has inability to metabolize which one of the following molecules?
A. uric acid
B. adenine
C. thymine
D. hypoxanthine (and guanine)

HGPRT – hypoxanthine guanine phosphoribosyl transferase  Inosine monophosphate

ANSWER: D

The importance of Methotrexate in cancer treatment is attributed to its capacity to inhibit this
enzyme in actively dividing cells:
A. aspartate transcarbamylase
B. dihydrofolate reductase
C. thymidylate synthase
D. PRPP synthase
ANSWER: B
MTX – Rheumatoid arthritis, psoriasis (diffuse), choriocarcinoma, medical tx for ectopic
pregnancy

Hereditary Orotic Aciduria is characterized by severe anemia, growth retardation, and high
levels of orotic acid in the urine. It is produced by deficiency of enzymes related with:
A. synthesis of pyrimidine nucleotides
B. catabolism of pyrimidine nucleotides
C. synthesis of purine nucleotides
D. catabolism of purine nucleotides
ANSWER: A
Purine – Inosine  AMP, GMP
Pyrimidine – Uracil  Cytosine; Thymine is synthesized separately
The anemia in a patient with Hereditary Orotic Aciduria is most likely of which type?
A. Iron deficiency
B. Hemolytic
C. Megaloblastic
D. Sideroblastic
ANSWER: C

Types of anemia
1. Excessive loss of RBCs  IDA
2. Hemolysis – increased destruction (increased exposure to OXIDATIVE SPECIES)
3. Decreased production – bone marrow
AIP – ALA crosses the BBB  false neurotransmitter  neuropsychiatric
PCT – skin deposition  photosensitivity

What genes actively promote cancers?

A. oncogenes
B. tumor suppressor genes
C. proto-oncogenes
D. anti-oncogenes
ANSWER: A

All of the following DNA sequences are possible sites that restriction endonucleases will
recognize EXCEPT:
A. TTCGAA AT CG
B. TCCGA
C. GCTAGC
D. AGCT
ANSWER: B

Which of the following does NOT code for a tumor suppressor protein?
A. p53
B. Her2/Neu
C. APC
D. RB
ANSWER: B
A 27-year-old woman is seen for a lump on her breast that she palpated on self-breast
examination. History reveals that her mother and her aunt both had breast and ovarian cancer.
Given this presentation, you suspect that the patient may have mutation in which of the
following genes involved in maintenance of the integrity of DNA?
A. p53
B. BRCA1
C. Ras
D. Rb
ANSWER: B

A 34/F with major depressive disorder overdoses herself with paracetamol. This drug is
extensively metabolized in the liver; with excess, a highly toxic metabolite is formed and the rate
of how fast it can be conjugated is limited by the availability of glutathione. The currently used
“antidote” for this is actually a drug that replenishes the active amino acid of glutathione. This
amino acid is _____________.
a. Glutamate
b. Methionine
c. Cysteine
d. Glycine
ANSWER: C
Patients with Alzheimer and Parkinson disease arise from accumulation of misfolded proteins
within neurons leading to their death and degeneration of specific or diffuse parts of the brain. In
these disorders, which level of the peptide structure is pathologic?
a. Primary
b. Secondary
c. Tertiary
d. Quaternary
ANSWER: C

Primary – PEPTIDE BONDS

Secondary – HYDROGEN BONDS
Tertiary – Hydrogen bonds, covalent bonds, salt bridges, hydrophobic interactions
Quaternary – interactions of multiple subunits

In people with Huntington disease, the huntingtin gene has trinucleotide repeats (CAG) where
this segment occurs more than 30 and up to 120 times. This leads to coding of an abnormal and
erroneous protein that is degraded forming clumps that accumulates in the neurons of the
caudate nucleus leading to subsequent degeneration and atrophy. These patients will have
involuntary movements and early onset of dementia as a consequence. In this disorder, which
level of the peptide structure is pathologic?
 a. Primary
b. Secondary
c. Tertiary
d. Quaternary
ANSWER: A

A patient with chronic hemolytic anemia has the following peripheral blood smear. The abnormal
RBC structure or element most likely functions as a:

a. Membrane transporter
b. Cytoskeletal protein
c. Oxygen carrier
 d. Enzyme
ANSWER: B

Ankyrin, spectrin

Which of the following type of anemia will most likely occur in a patient with an undiagnosed
colon cancer leading to blood-tinged stools?
a. Iron deficiency anemia
b. Megaloblastic anemia
c. Sideroblastic anemia
d. Hemolytic anemia – (+) reticulocytosis
ANSWER: A
A 50-year-old patient consults regarding fatty liver. His latest AST and ALT are twice elevated.
You explain that these are enzymes become elevated in the blood when hepatocytes die,
releasing them into the circulation. These enzymes are important in amino acid metabolism
as they interconvert aspartate and alanine into:
a. Oxaloacetate and pyruvate
b. Lactate and glutamate
c. Succinate and alpha ketoglutarate
d. Citrate and methylmalonate
ANSWER: A
Which of the following patients may have falsely low creatinine levels where a normal value
may actually mask an abnormally high value?
a. A 48-year-old diabetic female
b. A middle-aged male body builder
c. A young professional on strict ketogenic diet
d. An elderly female with low BMI and osteoporosis
ANSWER: D

Negative nitrogen balance occurs in which of the following states or conditions?

a. Cancer – WARBURG PHENOMENON
b. Renal failure
c. Pregnancy
d. Diabetic patients
ANSWER: A
CANCER CELLS rely on glucose
Express a lot glucose receptors

AEROBIC GLYCOLYSIS – 2 ATP ~100 ATP

KREBS CYCLE, ETC – 30-32 ATP

Glucose goes down

LIVER COMPENSATES via gluconeogenesis

Requires ATP – Free fatty acids
Substrates: Lactate, glycerol, glucogenic amino acids

Albumin-to-globulin ratio may be decreased in which of the following states or conditions?

a. Leukemia  Increased levels of globulins
b. Malnutrition  decreased protein
c. Renal failure – muscle wasting  dec albumin
d. Cirrhosis  dec protein and albumin synthesis in the liver
ANSWER: A

A:G Decreased when Albumin is decreased OR Increased in Globulin fraction

Increased ratio when globulin is decreased

The urea cycle is most significantly upregulated when this amino acid is present in significant
elevated quantities in the hepatocyte:
a. Arginine
b. Glutamate
 c. Aspartate
d. Alanine
ANSWER: B

Glutamine  Glutamate + NH4+  alpha ketoglutarate + NH4+

Type 1 Hyperammonemia – CPS I – most fatal

Type 2 Hyperammonemia – OTC – most common

Which of the following amino acids is not significantly required in the brain for neurotransmitter
production?
a. Phenylalanine – only converted to tyrosine in the liver
b. Tyrosine – Dopamine, NE, Epi Arginine - NO
c. Tryptophan - Serotonin
d. Histidine - Histamine
ANSWER: A
 Decarboxylases – Vitamin B6

A 26-year-old female suffers from pulmonary embolism. This is traced to elevation of the pro-
thrombotic molecule homocysteine in her blood. Levels of this metabolite may be reduced when
we supplement her with _________________. These would facilitate the enzymes converting
homocysteine to other molecules.
a. Vitamin B1, B2
b. Vitamin B3, B6
c. Vitamin B6, B12
d. Vitamin B1, B12
ANSWER: C
In a diabetic patient undergoing ketosis, muscle mass and proteins are catabolized to generate
amino acids that may be converted in the liver into ketone bodies which the rest of the body can
utilize for ATP production. Which of the following is one such amino acid?
a. Valine
b. Proline
c. Isoleucine
d. Glutamine
ANSWER: C

IPTTT (isoleucine, phenylalanine, tryptophan, tyrosine, threonine) – both glucogenic and

ketogenic
Except
Lysine-Leucine (purely ketogenic)

The carbon skeletons of Isoleucine, Methionine and Valine may be used in the TCA cycle to
replenish ATP provided that the patient does not have deficiencies of:
a. Riboflavin, Ascorbate
b. Thiamine, Pyridoxin
c. Biotin, Cobalamin
d. Niacin, Thiamine
 ANSWER: C

A 6-month-old baby girl has been having difficulty meeting the appropriate developmental
milestones. After an extensive workup, she was diagnosed of a mutation in the gene encoding
for the protein crystallin. This defect most likely led to decreased visual acuity. Which of the
following mechanisms is likely associated with her condition?
a. Corneal clouding
b. Impaired Vitamin A turnover in the retina
c. Retinal hyperpigmentation
d. Opacities in the lens
 ANSWER: D

CONGENITAL CATARACTS

What is the most likely mechanism causing corneal transparency to be compromised in the
following figure?

a. Chronic hypoxia
b. Deficiency of Vitamin C
c. Deficiency of Vitamin A
d. Deposition of AGEs from hyperglycemia
ANSWER: C

Vitamin A – RETINOIC ACID

 Vitamin A – supplemented in patient with poor wound healing or massive wounds/burns
In measles – re-epithelialize the respiratory tract

Vitamin C – collagen
Zinc – DNA and transcription
Zinc is needed by many oxidases (expressed by WBCs to fight pathogens)

These cells mediate the isomerization of trans-retinol to cis-retinol, and thus regeneration of
functional retinoids, to allow continuous perception of color vision:
a. Rod cells
b. Cone cells
c. Muller cells
d. Hepatocytes
ANSWER: C

A 24-year-old male chugs down an energy drink containing aspartame. As he tastes the
beverage, which of the following mechanisms is facilitated?
a. Combinatorial (used in olfaction) processing in the insular cortex – taste center
b. Activation of epithelial sodium channels (ENaCs)
c. Depolarization of cells leading to calcium ion influx
d. Activation of gustducin and rise in intracellular calcium concentration
Glutamate – UMAMI

ANSWER: D

A 49-year-old man suffered a heart attack and subsequent cardiac arrest. He was successfully
revived after 8 minutes of CPR but remained unresponsive all this time. While under intensive
care and monitoring, he is noted to manifest involuntary jerking of his arms and legs every few
minutes. This is most likely due to?
 a.Neurons being unable to generate ATP from the TCA cycle
b.Excess glutamate which astrocytes are unable to take up effectively
c.Decreased GABA production as glutamine formation from glutamate is prioritized
d.Accumulation of cytokines and other inflammatory molecules in the brain from
decreased excretion  UREMIC encephalopathy
ANSWER: B

Neurons die  they release GLUTAMATE  seizures (excitotoxicity)

A 40-year-old man, unconscious from an alcoholic binge, was brought to the ER and was found
to be hypoglycemic. He was given intravenous glucose but became acidotic afterwards. He
should have also received ________.
a. Vitamin B1
b. Vitamin B6
c. Vitamin B12
d. Vitamin C

ANSWER: A
A patient with chronic hypertension and untreated diabetes complains of worsening insomnia.
He also complains of a persistent bitter or metallic taste. His symptoms are most likely due to?
a. Neurons being unable to generate ATP from the TCA cycle
b. Excess glutamate which astrocytes are unable to take up effectively
c. Decreased GABA production as glutamine formation from glutamate is prioritized
d. Accumulation of cytokines and other inflammatory molecules in the brain from
decreased excretion
ANSWER: D

The so-called “runner’s high” or the “feel good feeling” after an intensive work-out may be due to
the activation of the ventral tegmental area by:
a. Norepinephrine
b. Substance P
c. Endorphins
d. Serotonin
ANSWER: C

An example of a neurotransmitter imbalance leading to psychiatric disorders is excess

activation of adrenergic receptors with diminished activation of serotonergic receptors.
This imbalance most likely describes which disorder?
a. Schizophrenia – inc dopamine
b. Major depression disorder – dec serotonin, NE, dopamine
c. Generalized anxiety disorder – dec serotonin, inc NE
d. Attention deficit and hyperactivity disorder (ADHD) – dec NE
ANSWER: C
A patient with known substance abuse disorder presents in the ER with altered sensorium.
Assessment of his pupils revealed the finding as shown. The drug he most likely abused at the
present is:

a. Benzodiazepines
b. Amphetamines
c. Phencyclidine
d. Opioids
ANSWER: B

The pathway leading to the synthesis of the neurotransmitters coming from the pointed
structures require the following micronutrients, EXCEPT?
 a. Vitamin B6
b. Vitamin B3
c. Iron
d. Copper

Fe, Cu – hydroxylases, participate with Vitamin C

ANSWER: B

Which diet is most ideal to prescribe to a patient with essential hypertension, controlled with one
drug?
a. Low-fat
b. Low-salt, low-fat
c. Low-calorie
d. Low-protein, low-salt
ANSWER: B

Which diet is most ideal to prescribe to a 35-year-old male, obese patient with Type 2 DM but
without hypertension?
a. Ketogenic diet
b. Low-salt, low-fat
c. Low-calorie
d. Low-protein, low-salt
ANSWER: C

A 35-year-old female with dyslipidemia asks if drinking coconut oil regularly is beneficial for her
condition. Which of the following is the most accurate statement or advice?
a. Coconut oil is rich in MUFAs
b. Coconut oil is rich in PUFAs
c. Coconut oil is rich in saturated fatty acids – 12-carbon sat fat
d. Coconut oil is rich in very-long chain trans-fatty acids
ANSWER: C
Central OBESITY  CVS disease because of inflammation
Visceral fat – admixed with macrophages  TNF alpha, leptin

The ideal diagnostic test or procedure to catch the onset of renal disease in diabetics is:
a. OGTT (every 6 months)
b. Regular HbA1c (every 3 months)
c. Routine urinalysis (every 3 months)
d. 24-hour urine collection – detect microalbuminuria – 30-300
ANSWER: D

In the general population, obesity significantly accelerates the risk for the following metabolic
disorders, EXCEPT:
a. Osteoporosis OSTEOARTHRITIS
 b. Steatohepatitis – fatty liver  hepatitis
c. Ischemic heart disease
d. Peripheral arterial occlusive disease
e. No option is an exception
ANSWER: A

In the following scenarios, there is significantly increased activity of pyruvate carboxylase

(RLS of GLUCONEOGENESIS requiring BIOTIN) in the liver. Which of them is the exception?
a. Sepsis
b. Multiple physical injuries
c. 70% TBSA Burns
d. Disseminated cancer
e. No option is an exception
ANSWER: E

HYPERCATABOLIC STATES – sepsis, trauma, burns, complicated surgeries

 Liver – GLUCONEOGENESIS 90% Liver, 10% kidneys (goes to 50% in fasted)

The 18:6 intermittent fasting is a theoretically good option for those who want to slim down but is
not sustainable for many patients. The basis for this diet is how long the body of an otherwise
healthy adult would consume which of the following?
a. Peripheral fat
b. Visceral fat
c. Hepatic glycogen
d. Muscle glycogen
ANSWER: C

HEPATIC Glycogen – 18-24 hours (16 hours - Schwartz)

Muscle glycogen – cannot be exported to the blood

The maintenance of blood glucose through hepatic gluconeogenesis in patients with severe
infections depend on the following substrates, EXCEPT:
a. Fatty acids – they help by giving ATP through beta-oxidation  acetyl-CoA  Krebs
cycle
b. Glycerol
c. Lactate
d. Alanine
e. No option is an exception
ANSWER: A

Succinyl-CoA:3-ketoacid CoA transferase (SCOT) is an important enzyme for:

a. Conversion of fatty acids to ketones in the liver
b. Production of ketones in the liver
c. Conversion of ketones to usable substrates in tissues
d. Conversion of acetoacetate to acetone for excretion
ANSWER: C
The key metabolic interconnections between the liver and the skeletal muscle to maintain blood
sugar rely on 2 cycles. Which of the following enzymes is NOT involved in these?
a. Alanine aminotransferase
b. Pyruvate carboxylase
c. Glycogen phosphorylase
d. Lactate dehydrogenase
ANSWER: C

Which of the following amino acids will not be able to contribute in the maintenance of blood
sugar even in hypercatabolic states?
a. Isoleucine
b. Valine
c. Leucine
d. Tryptophan
e. Tyrosine
ANSWER: C

Which electrolytes are minimized in the diet of a patient with advanced renal disease?
a. Potassium
b. Sodium and potassium
c. Potassium and phosphorus
d. Sodium, phosphorus, uric acid
ANSWER: C

Phosphates – calcium  VASCULAR CALCIFICATION

In general, drinking alcoholic beverages promote development of gout or trigger gouty flares.
Which of the following statements is most accurate?
a. Hard spirits are rich in purines, hence increasing production of uric acid
b. Wine generates by-products that enter the purine synthesis pathway
c. Beer is rich in malt which inhibits the excretion of uric acid through the kidneys
d. All alcoholic beverages interfere with the excretion of uric acid
ANSWER: D

Ethanol – cause gout

Reduce excretion of uric acid
Beer – malt  glycolysis  pentose phosphate pathway  riboses  increased purine
production

The drug pegloticase, given for refractory gout, is best described by which of the following
statements?
a. It downregulates the production of xanthine oxidase to slow down uric acid production
b. It is a competitive inhibitor of the enzyme xanthine oxidase
c. It is a suicide inhibitor of the enzyme xanthine oxidase
d. It acts as a uricase, an enzyme that converts uric acid into allantoin
ANSWER: D

Zinc is a critical mineral in the enzyme system of white blood cells to fight off pathogens. What
type of enzymatic reactions would zinc most likely participate in?
a. Transfer of methyl or acetyl groups
b. Transfer of glucuronide molecules
c. Oxidative reactions
d. Hydrolysis of covalent bonds
ANSWER: C

Biotin deficiency will most significantly compromise which pathway?

a. Purine synthesis
b. Fatty acid oxidation
c. Glycogen synthesis
d. Gluconeogenesis
ANSWER: D

VOMIT pathway
Fatty acid synthesis (Acetyl-CoA carboxylase)

Which of the following immunosuppressive drugs interferes with the pyrimidine synthesis
pathway, specifically inhibiting dihydroorotate dehydrogenase?
a. Mycophenolate - inosine production (purine synthesis)
b. Methotrexate
c. Leflunomide – 2nd line drug for Rheumatoid arthritis
d. Tacrolimus – inhibits T cells
ANSWER: C

Where in the noradrenergic neurons are dopamine converted into norepinephrine?

a. Mitochondria
b. Endoplasmic reticulum
c. Secretory granules
d. Cytoplasm
ANSWER: C

Deficiency of which mineral can lead to treatment-resistant iron deficiency anemia?

a. Zinc
b. Selenium
c. Copper
d. Magnesium
ANSWER: C

Which of the following lipoproteins has the highest levels of triacylglycerol in a normal person?
A. Chylomicron remnants
B. Chylomicrons
C. LDLs
D. VLDLs
Answer: B

The regulation of cholesterol synthesis primarily occurs at which enzymatic site?

A. 3-hydroxy-3-methylglutaryl CoA synthase
B. 3-hydroxy-3-methylglutaryl CoA lyase
C. 3-hydroxy-3-methylglutaryl CoA reductase
D. 3-methyl-3-hydroxylglutaryl CoA oxidase
Answer: C

The key regulatory enzyme of fatty acid synthesis is:

A. Fatty acid synthase
B. Acetyl CoA carboxylase
C. Citrate synthase
D. Malonyl transacylase
Answer: B

Deficiency of biotin will result in decreased formation of which of the following?

A. acyl carrier protein
B. malonyl CoA
C. phosphatidic acid
D. ceramide
Answer: B

Which of the following statements is TRUE regarding cholesterol metabolism:

A. Cholesterol synthesis is limited to the liver and intestines.
B. Dietary cholesterol is obtained mostly from plant sources.
C. All 27 carbon atoms of cholesterol are derived from acetyl-CoA.
D. The enzyme system of cholesterol synthesis is present in the mitochondria.
Answer: C

In terms of cell communication, what do bacterial pathogens such as cholera and anthrax have
in common?
A. They destroy the receptors for key signaling molecules
B. They prevent the production of key signaling molecules
C. They alter the chemical structure of key signaling molecules
D. They block the normal functioning of signal transduction mechanisms
Answer: D

Which one of following statements about the fed state is correct?

A. There is decreased secretion of glucagon
B. Ketone bodies are synthesized in liver
C. Plasma glucose is maintained by gluconeogenesis
D. There is increased glycogenolysis in the liver and muscle
Answer: A

Which of the following statement is TRUE when comparing the metabolic milieu that is occurring
in untreated type1 DM and that of a starving patient?
A. During starvation, brain utilizes ketones in the absence of glucose
B. Ketoacidosis occurs both in type 1 DM and starving patients
C. Glycogen is absent in type 1 DM because of the absence of insulin
D. Muscle proteins are conserved both in type 1 diabetic and starving patient
Answer: A

The preferred fuel of the skeletal muscle during prolonged aerobic exercise is/are:
A. Fatty acids
B. Ketones
C. Amino acids
D. Glucose
Answer: D

The preferred fuel of the cardiac myocytes during routine or day-to-day activities is/are:
A. Fatty acids
B. Ketones
C. Amino acids
D. Glucose
Answer: D

A biochemical reaction would occur spontaneously if

A. The delta-H is negative, while the delta-S is positive
B. Both delta-H and delta-S are negative, with delta-S having a much greater magnitude
C. The delta-H is positive, while the delta-S is negative
D. Both delta-H and delta-S are positive, with delta-H having a much greater magnitude
ANSWER: A

Which one of the following uses molecular oxygen as a hydrogen acceptor?

A. Cytochrome c oxidase
B. NADH dehydrogenase
C. Succinate dehydrogenase
D. CoQH2-cytochrome c reductase
ANSWER: A

This enzyme represents the most important control site or step in the mammalian glycolytic
pathway.
A. Hexokinase
B. Phosphofructokinase-1
C. Pyruvate kinase
D. Phosphoglycerate kinase
ANSWER: B

Pyruvate becomes substrate for which enzyme under aerobic conditions?

A. Pyruvate kinase
B. Lactate dehydrogenase
C. Pyruvate dehydrogenase
D. Glyceraldehyde 3-phosphate dehydrogenase
ANSWER: C

During the FED state, which of the following is activated as an indirect result of insulin release?
A. Phosphorylase kinase
B. cAMP dependent protein kinase
C. Glycogen phosphorylase
D. Protein phosphatase
ANSWER: D

The enzyme that catalyzes the rate-limiting step of the Krebs cycle is
A. Isocitrate dehydrogenase
B. Alpha-ketoglutarate dehydrogenase
C. Succinate dehydrogenase
D. Malate dehydrogenase
ANSWER: A

Which of the following dehydrogenases in the Krebs cycle does not generate the reduced form
of NAD+ that is brought to the electron transport chain?
A. Succinate dehydrogenase
B. Isocitrate dehydrogenase
C. Malate dehydrogenase
D. Alpha-ketoglutarate dehydrogenase
ANSWER: A

The pentose phosphate pathway as the source of NADPH is particularly important for
erythrocytes (RBCs) because in these cells, NADPH participates in/as
A. Reduction of oxidized glutathione to protect against superoxides
B. Detoxification of xenobiotics with the use of cytochrome P450
C. Reducing agent in the biosynthesis of neurotransmitters
D. Generation of superoxides for lysing or damaging invading bacteria
ANSWER: A

Sorbitol does not cause osmolysis in this tissue because of the presence of the enzyme sorbitol
dehydrogenase, which converts it to fructose, thus preventing sorbitol accumulation.
A. Peripheral nerves
B. Lens
C. Renal glomeruli
D. Seminal vesicles
ANSWER: D

The so-called Alcohol Flush Reaction is common among Asians/Southeast Asians. The
reaction is the result of an accumulation of acetaldehyde after ingestion of alcoholic beverages.
Since acetaldehyde is toxic, this syndrome has been associated with an increased risk of
esophageal cancer in those who drink. Accumulation of this metabolite is due to deficiency in
what enzyme?
A. Alcohol dehydrogenase
B. Glucose 6-phosphate dehydrogenase
C. Aldehyde dehydrogenase
D. UDP-galactose epimerase
ANSWER: C

During pregnancy, there is an increased demand for folate, necessitating supplementation.

Folate deficiency during pregnancy can result in which of the following?
A. Neural tube defects
B. Cleft lip or cleft palate
C. Limb amputations
D. Muscular dystrophy
ANSWER: A

Niacin is technically not a vitamin because we can actually synthesize it in our bodies. We will,
however, need 60 mg of this amino acid from our diet in order to synthesize 1 mg of niacin.
A. Tryptophan
B. Threonine
C. Tyrosine
D. Methionine
ANSWER: A

This is described as encephalopathy and psychosis among alcoholics due to thiamine

deficiency.
A. Shoshin beriberi
B. Dry beriberi
C. Wernicke-Korsakoff syndrome
D. Pellagra
ANSWER: C

The choices below feature four of the 5 cofactors of the pyruvate dehydrogenase complex.
Which cofactor-vitamin precursor pair is erroneous?
A. TPP, Vitamin B1
B. NAD+, Vitamin B3
C. FAD, Vitamin B2
D. CoA-SH, Vitamin B6
ANSWER: D

Which of the following water-soluble vitamin deficiency and clinical scenario pair is erroneous?
A. Vitamin B6 deficiency; patient on isoniazid (anti-TB medication)
B. Vitamin B5 deficiency; situations of famine and war (severe malnutrition)
C. Vitamin B1 deficiency; chronic alcoholism
D. Vitamin B7 deficiency; body-builder taking 8-10 raw egg whites a day
E. Vitamin B9 deficiency; megaloblastic anemia with neurologic manifestations
ANSWER: E

Which of the following lipids is not normally seen in mammalian membranes?

A. Triacylglycerol
B. Phosphoglyceride
C. Sphingomyelin
D. Cholesterol
ANSWER: A

Which of the following would have the highest permeability through the cell’s lipid bilayer?
A. Metal cations
B. Glucose
C. Water
D. Amino acids
ANSWER: C

Which characteristic of a drug would be best to enable it to reach its target cell?
A. Electrostatic polarity
B. Molecular size
C. Straight-chain structure
D. Hydrophobicity
ANSWER: D

Why is glycine the most abundant amino acid seen in collagen?

A. Only the R group of glycine fits in the central core of collagen
B. Only glycine can form intramolecular desmosine cross-links
C. Collagen can synthesize glycine, which can also form hydroxylated bonds with proline
D. Only glycine can form peptide linkages with hydroxylated amino acid
ANSWER: A

Where is fibronectin found?

A. In the microtubules during cell division
B. In the actin and myosin filaments of muscles
C. Outside the plasma membrane of cells
D. In histones to anchor with DNA fragments
ANSWER: C
A protein engineer desires to alter the active site of chymotrypsin so that it can cleave peptide
bonds to the carboxy-terminal side of aspartyl and glutamyl residues. The protein engineer will
most likely succeed if he replaces valine at the active site with this amino acid:
A. Phenylalanine
B. Glycine
C. Proline
D. Lysine
ANSWER: D

Which of the following is incorrect?

A. Enzymes increase the activation energy required in a reaction
B. Enzymes are not destroyed during a chemical reaction
C. The presence of an enzyme has no effect on the Delta G
D. Alteration of the active site affects enzyme function
ANSWER: A

Which of the following best explains the mechanism of action of enzymes in the coagulation
cascade to regulate its activity?
A. Covalent modification
B. Partial proteolysis
C. Compartmentalization
D. Epigenetic activation
ANSWER: B

The form of vitamin A that can bind to nuclear receptors which can then binds to specific DNA
response elements thus affecting gene transcription
A. beta-carotene
B. retinol
C. retinoic acid
D. retinaldehyde
ANSWER: C

Which of the following reaction requires the presence of vitamin K?

A. gamma-carboxylation of glutamyl residues
B. hydroxylation of proline to hydroxyproline
C. transketolase reaction
D. oxidative decarboxylation of branched-chain ketoacids
ANSWER: A

A 55-year old man previously diagnosed with cirrhosis developed signs and symptoms of
ammonia intoxication. Treatment included administration of an intestinal antibiotic. What vitamin
has to be given to avoid the development of complication secondary to the treatment?
A. Vitamin B12
B. Vitamin K
C. Vitamin C
D. Vitamin B6
ANSWER: B

The presence of this mineral in drinking water can prevent the development of dental caries
A. fluoride
B. copper
C. magnesium
D. chromium
ANSWER: A

As a component of glutathione peroxidase, it plays a role in the protection against oxidative

damage
A. cobalt
B. selenium
C. iron
D. chromium
ANSWER: B

What accounts for the surface tension and the solvent power of water?
A. The presence of hydrogen
B. The presence of oxygen
C. The presence of hydrogen bonds
D. The absence of carbon
ANSWER: C

pOH is defined as:

A. the negative logarithm of hydrogen ion concentration
B. 14 minus pH
C. A measure of the dissociation constant of water
D. the pressure exerted by the hydroxyl ion in solution
ANSWER: B

A 25-year-old male came to emergency room because of 4 days of fever, headache, body and
joint pains. Which among the immunoglobulins is most likely elevated in this patient, if this is a
systemic viral infection such as dengue fever?
A. IgM
B. IgG
C. IgA
D. IgE
ANSWER: A