Examples of Krok 1 tests

117. An untrained person who has not been practicing physical exercises for a long time complains of a muscle pain as a result of intensive manual work. What is the probable reason of the pain syndrome?

1. Accumulation of lactate in muscles

2. Decreasing of lipids level in muscles

3. Increased disintegration of muscle proteins

4. Accumulation of creatinine in muscles

5. Increase of ATP level in muscles

118. The high speed sprint causes a feeling of pain in skeletal muscles of untrained people that occurs due to lactate accumulation. The activation of what biochemical process is it resulting from?

1. Glycolysis

2. Gluconeogenesis

3. Pentose phosphate pathway

4. Lipogenesis

5. Glycogenesis

119. A 7-year-old girl manifests obvious signs of anemia. Laboratory tests showed the deficiency of pyruvate kinase activity in erythrocytes. The disorder of what biochemical process is a major factor in the development of anemia?

1. Anaerobic glycolysis

2. Deamination of amino acids

3. Tissue respiration

4. Oxidative phosphrylation

5. Breaking up of peroxides

120. The intake of aspirin by a 3-year-old child with a fever caused marked erythrocytes hemolysis. The inherited deficiency of what enzyme could be the cause of the hemolytic anemia development?

A. Glucosо-6-phosphate dehydrogenase.

B. Glucose-6-phosphatase.

C. Glycogen phosphorylase.

D. Glycerol-phosphate dehydrogenase.

E. γ-Glutaminyl transferase.

121. A 2-year-old boy has the increase of liver and spleen sizes detected and eye cataract present. The total sugar level in blood is increased, but glucose tolerance is within the normal range. The inherited disturbance of the metabolism of what substance is the cause of the indicated state?

A. Galactose.

B. Fructose.

C. Glucose.

D. Maltose.

E. Saccharose.

122. A newborn child had dyspepsia phenomena (diarrhea, vomiting) detected after feeding with milk. After additional feeding with glucose the morbid symptoms disappeared. The insufficient activity of what enzyme that takes part in the carbohydrates breakdown causes the indicated disorders?

A. Lactase.

B. Amylase.

C. Saccharase.

D. Isomaltase.

E. Maltase.

123. A newborn child with the signs of cataract, growth and mental retardation, who manifested vomiting and diarrhea, was brought to an emergency clinic. A presumptive diagnosis of galactosemia was made. The deficiency of what enzyme occurs in case of this disease?

A. Galactose-1-phosphate uridyl transferase.

B. Glucokinase.

C. UDP-galactose-4-epimerase.

D.Hexokinase.

E. Glucose-6-phosphate dehydrogenase

124. A cataract and fatty degeneration of the liver develop in the conditions of high galactose and low glucose level in blood. What disease do these symptoms testify to?

A. Galactosemia.

B. Diabetes mellitus.

C. Lactosemia.

D. Steroid diabetes.

E. Fructosemia.

125. In a patient are manifested symptoms of intoxication with arsenic compounds. What metabolic process is damaged taking into account that arsenic containing substances inactivate lipoic acid?

A. Oxidative decarboxylation of pyruvate

B. Fatty acids biosynthesis

C. Neutralization of superoxide anions

D. Coupling of oxidation and phopsphorylation

E. Microsomal oxidation

126. In a weak apathic infant an enlarged liver was detected, which in investigation of biopcia pieces showed an excess of glycogen. Blood glucose concentration is under the normal value. What may be the cause of this disease?

1. Lowered activity of glycogen phosphorylase in a liver

2. Lowered activity of glycogen synthase

3. Lowered activity of glucose 6-phosphate isomerase

4. Lowered activity of glucokinase

5. Deficiency of gene responsible for synthesis of glucose 1-phosphate uridyl transferase

127. During biochemical investigation of blood in a patient was detected hypoglycemia in fasting condition. Investigation of liver bioptates revealed the failure of glycogen synthesis. What enzyme deficiency may cause such status?

1. Glycogen synthase

2. Phosphorylase

3. Aldolase

4. Fructose bis-phosphatase

5. Pyruvate carboxylase

128. In an infant with point mutations in genes the absence of glucose 6-phosphatase, hypoglycemia and hepatomegalia were revealed. What disease is characterized by these symptoms?

1. Gierke disease

2. Adison disease

3. Parkinson disease

4. Cori disease

5. Mac Ardle disease

129. In a patient a lowering in ability to physical load was revealed, while in skeletal muscles the glycogen content was increased. The decrease in activity of what enzyme may cause this condition?

1. Glycogen phosphorylase

2. Phosphofructokinase

3. Glucose 6-phosphate dehydrogenase

4. Glycogen synthase

5. Glucose 6-phosphatase

130. What biochemical process is stimulated in the liver and kidneys of a patient exhausted by starvation?

A. Gluconeogenesis.

B. Synthesis of urea.

C. Synthesis of bilirubin.

D.Formation of hippuric acid.

E. Synthesis of uric acid.

131. Under Girke's glycogenosis the conversion of glucoso-6-phosphate into glucose is disturbed, which results excessive glycogen accumulation in liver and kidneys. The deficiency of what enzyme is the cause of the disease?

A. Glucoso-6-phosphatase.

B. Glycogen synthase.

C. Phosphorylase.

D. Hexokinase.

E. Aldolase.

132. A child is sluggish and inert. His liver is enlarged. The liver biopsy showed the excess of glycogen. The concentration of glucose in blood plasma is below the normal range. What is the cause of the glucose level decrease in blood?

A. Reduced (or absent) activity of glycogen phosphorylase in the liver

B. Reduced (or absent) activity of hexokinase.

C. High activity of glycogen synthase

D. Reduced (or absent) activity of glucose-6-phosphatase.

E. Deficiency of the gene, which is responsible for the synthesis of glucose-1-phosphate uridine transferase.

133. The major process responsible for maintaining blood glucose in 4 hours after last meal is:

1. Glycogenolysis

2. Glycolysis

3. The pentose phosphate pathway

4. Gluconeogenesis

5. Glycogenesis

134. The major process responsible for maintaining blood glucose in 40 hours after last meal is:

1. Gluconeogenesis

2. Glycolysis

3. Glycogenolysis

4. The pentose phosphate pathway

5. Glycogenesis

135. A 46-year-old woman complains of dryness in the oral cavity, thirst, frequent urination, general weakness. Biochemical research of the patient's blood showed hyperglycemia and hyperketonemia. Sugar and ketone bodies are revealed in the urine. Diffuse changes in myocardium are marked on the electrocardiogram. Make an assumptive diagnosis of the illness.

A. Diabetes insipidus.

B. Alimentary hyperglycemia.

C. Acute pancreatitis.

D. Diabetes mellitus.

E. Ischemic cardiomyopathy.

136. A patient was admitted to a hospital in comatous state. The accompanying mates explained that the patient loss his consciousness during the training on the last stage of marathon distance. What coma type can be recognized?

1. Hypoglycemic

2. Hyperglycemic

3. Hypovolemic

4. Hypothyroid

5. Hepatic

137. A patient addressed to physician with complaints on permanent thirst. In laboratory investigation it was revealed hyperglycemia, polyuria and increased content of 17-ketosteroids in urine. What disease is the most probable?

1. Steroid diabetes

2. Insulin dependent diabetes mellitus

3. Addison disease

4. Glycogenosis of the 1 type

5. Myxoedema

138. A 38-year-old man is receiving treatment for schizophrenia in hospital. Fhe initial levels of glucose, ketone bodies and urea in the blood are within the normal range. Shock therapy put into practice by regular insulin injections resulted in the development of the comatose state which improved the clinical status of the patient. What is the most probable cause of insulin coma?

A. Hypoglycemia.

B. Dehydratation of tissues.

C. Metabolic acidosis.

D. Ketonemia.

E. Hyperglycemia.

139. In a 57-year-old patient, suffering from diabetes mellitus, ketoacidosis has been developed. Biochemical background of this status is decrease in utilization of acetyl-CoA due to a deficiency of:

1. Oxaloacetate

2. 2-oxoglutarate

3. Glutamate

4. Aspartate

5. Succinate.

140. In patients’ blood glucose level is over the renal threshold, polyuria is observed, as well as acidosis and ketonuria. What disease can be suggested?

A. Diabetes mellitus

B. Starvation

C. Hypercorticism

D. Addison disease

E. Hyperthyreosis

141. In a patient a hyperglycemia, ketonuria, polyuria and glucosuria were revealed. What disorders of acid-base equilibrium can be expected in this conditions?

A. Metabolic acidosis

B. Respiratory alkalosis

C. Metabolic alkalosis

D. Respiratory acidosis

E. Normal acid-base equilibrium

142. A 58 years old woman, in a heavy state, cloudy consciousness, dry skin, cyanosis, an odor of spoiled apples from mouth were revealed. Blood glucose level – 15,1 mmol/l, in urine – 3,5 %. This state is caused by:

A. Hyperglycemic coma

B. Hypoglycemic coma

C. Anaphylactic shock

D. Uremic coma

Hypovolemic coma

143. By consumption of fresh milk in kid developed disorders of digestive tract. Consumption of other sugar-containing food-stuffs did not cause similar disorders. Genetically determined insufficiency of what enzyme can be considered in this case?

1. Lactase

2. Phosphoglucomutase

3. Glycogen synthetase

4. Hexokinase

5. Glucose-6 phosphate isomerase

144. A 45-year-old woman does not have any symptoms of insulin dependent diabetes mellitus but testing on an empty stomach showed the increase of the blood glucose level (7.5 mM/l). What additional laboratory test needs to be done to substantiate the diagnosis?

A. Determination of tolerance to glucose.

B. Determination of ketone bodies concentration in the urine.

C. Determination of rest nitrogen level in the blood.

D. Determination of tolerance to glucose on an empty stomach.

E. Determination of glycosylated hemoglobin level.

145. A condition called diabetic ketoacedosis is caused by a lack of insulin leading to a build-up of ketoacids. Excessive ketone bodies are formed by the biochemical imbalance in uncontrolled or poorly managed diabetes. Which compounds are called ketone bodies?