- •Section I Control of the initial level of knowledge. Biochemical constituents of the cell. Methods of biochemical investigations.
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •77. Discribe the method, shown at the picture below:
- •78. Discribe the method, shown at the picture below:
- •Section іі Enzymes, structure and classification. Regulation of metabolism
- •Е. Whatever part of polypeptide chain of enzyme molecule.
- •Substrate concentration at which reaction rate is half maximal
- •The second enzyme has higher affinity to substrate
- •Competitive
- •Examples of Krok 1 tests
- •Cysteine
- •B. Amylase
- •Peptidases
- •Enteropeptidase
- •Clinical cases and Situational tasks
- •Section ііi Metabolic pathways and bioenergetics. Tricarboxylic acid cycle. Biological oxidation and oxidative phopshorylation
- •1. When atp forms amp:
- •B. Protons
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •Section іv Structure and metabolism of carbohydrates
- •19. Chose the reaction of glycolysis catalyzed by an enzyme phosphofructokinase:
- •A. Liver
- •Examples of Krok 1 tests
- •Acetoacetate, β-hydroxybulyrate, and acetone
- •Clinical cases and Situational tasks
- •Section іv Structure and metabolism of lipids
- •Examples of Krok 1 tests
- •143. A patient with high rate of obesity was advised to use carnitine as a food additive in order to enhance "fat burning". What is the role of carnitine in the process of fat oxidation?
- •144. Lipids are obvious energetic material for the body. What is the main pathway of fatty acids metabolism in mitochondria?
- •Clinical cases and Situational tasks Situational tasks
- •179. The patient is observed an allocation of undigested fat in the faeces. What are the possible causes for this?
- •184. Free cholesterol can affect cholesterol metabolism in the body by inhibiting cholesterol biosynthesis. By which step free cholesterol can inhibit its biosynthesis?
- •186. Explain the mechanism of phospholipids breakdown, shown at the scheme below:
- •Section VI Structure and metabolism of amino acids
- •B. Amylase
- •Examples of Krok 1 tests
- •112. According to clinical indications a patient was administered pyridoxal phosphate. What processes is this medication intended to correct?
- •Clinical cases and Situational tasks
- •145. In a patient 10 g of urine per day is excreted. Evaluate this result.
- •151. Skin color is the aggregate result of the expression of a number of genes modified by ethnic origin and genetic inheritance. What can cause the hypopigmentation?
- •Section VII Principles of molecular biology and molecular genetics
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •108. List and describe properties of the genetic code.
- •113. Fill in the blanks.
- •114. Put the numbers of the enzymes on their place in the picture. Using arrows indicate the direction of replication and direction of synthesis of leading and lagging strands.
- •Section VIII Molecular mechanisms of hormone action on target cells. Biochemistry of hormonal regulation
- •Examples of Krok 1 tests
- •78. For analgesia, a certain substance which imitates the physiological properties of morphine but is synthesized inside the human brain can be used. Name this substance.
- •80. A patient suffering from rheumatism was administered glucocorticoid therapy. What changes in carbohydrate metabolism in liver can be expected?
- •88. In blood of a patient a hypercalcemia, hypophosphatemia, in urine – hyperphosphaturia is observed. What is a possible cause of this state?
- •90. In 13 years old girl a hypotension and polyuria is observed. Preliminary diagnosis – diabetes insipidus. It is caused by deficiency of:
- •93. Signaling via prostanoids begins by interaction of the prostanoid with its receptor. The receptor involved is usually located in which part of the cell?
- •Clinical cases and Situational tasks
- •97. In 13 years old girl a hypotension and polyuria is observed. Preliminary diagnosis – diabetes insipidus. Which hormone deficiency can cause this disease?
- •99. The thyroid hormones t3 and t4 are synthesized in the follicular cells of the thyroid gland. From which of the following essential amino acids are the thyroid hormones synthesized?
- •101. Name types of signalling:
- •Section IX Biochemistry of the nervous tissue
- •С. Ketone bodies
- •24. What compound may be used by the cns cells after extensive physical exercises and prolonged starvation?
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •114. Describe the structure of a synapse and explain how it operates?
- •Section X Biochemistry of the Muscular tissue
- •D. Glycogenolysis in muscles
- •С. Fatigue faster compared to the red fibers
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •Section XI Biochemistry of nutrition
- •1. Note substance, which activates pepsinogen to pepsin:
- •2. Chose the enzyme which plays an important role in production of hydrochloric acid by parietal cells of gastric mucosa glands:
- •3. Which of the following is not a function of the pancreas?
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •62. The clinical and laboratory examination of the patient evaluated the presence of the lactic acid in his gastric juice. What does it indicate? What should be recommended to the patient?
- •69. Discribe the mechanism of hydrochloric acid production shown at the picture:
- •Section XII Functional role of water soluble and fat soluble vitamins in metabolism and providement of cell functions
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •100. A deficiency in thiamine (vitamin b1) would most likely lead to which clinical manifestations?
- •Section XIII Biochemistry and pathobiochemistry of blood
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •89. The blood clotting cascade in humans is represented in the picture below. Using this scheme answer the following questions:
- •Section XIV Functional and clinical biochemistry of liver tissue. Biotransformation of xenobiotics and endogenous toxic compounds
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •Section XV Water and mineral metabolism
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •Section XVI Functional role of kidneys in urinogenesis. Normal and pathological constituents of urine
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •Section XVII Biochemical constituents of connective tissue
- •Examples of Krok 1 Tests
- •Clinical cases and Situational tasks
- •34. Patient with burn disease is at the risk of formation of blood clots in blood vessels. What glycosaminoglycan may be used to prevent formation of blood clots?
- •Section XVIII Biochemistry of saliva and tooth tissue
- •Examples of Krok 1 tests
- •Clinical cases and Situational tasks
- •Section XIX. Biochemical reactions
- •References:
Examples of Krok 1 tests
50. The intensive muscular work induced the significant decrease of the buffer capacity of the blood of the worker. Which metabolite induced this condition?
А. Lactate
В. 1,3-Diphosphoglycerate
С. а-Ketoglutarate
D. 3-Phosphoglycerate
Е. Pyruvate
51. A patient suffering from progressive muscular dystrophy was administered the biochemical examination of urea. The presence of the large amount of what compound in urea can confirm the muscular pathology in this patient?
А. Creatine
В.Hippuric acid
С. Porphyrins
D. Urea
Е. Creatinine
52. Hepatitis, myocardial infarction induce an acute increase of alanine- and aspartate aminotransferase in patient’s blood? What is the cause of the increase of these enzymes?
A.The damage of cell membrane and passage of the enzymes to blood
B. Increased rate of amino acid synthesis in tissues
C. Increased rate of amino acids breakdown in tissues
D. Lack of pyridoxin
E. Increase of the enzyme activity by the hormones
53. Skeletal muscles and myocardium use different blood compounds as the substrates of oxidation. Which of the following compounds is utilized in myocardium but is not used by skeletal muscles?
А.Lactate
В. Glucose
С. Glycogen
D. Fatty acids
Е. Ketone bodies
54. Muscular tissue is capable to contract. This is provided by the presence of:
А. Actin and myosin
В. Fibrinogen
С. Creatinine
D. Thrombin
Е. Hemoglobin
55. A 40 year old man ran 10 km within 60 minutes. Which changes of the energetic metabolism will occur in his muscles?
A.The rate of fatty acids oxidation will increase
B. Proteolysis will increase
C. Gluconeogenesis will increase
D. Glycogenolysis will increase
E. Glycolysis will increase
56. McArdle's disease is characterized by the following clinical signs: excessive glycogen accumulation in muscles, progressive myopathy, manifested by painful seizures after muscular work, myoglobulinuria. At the same time the lactate content in blood is not changed or decreased. The lack of what enzyme of glycogen metabolism causes this disease?
А. Glycogen phosphorylase
В. Adenilate cyclase
С. Glycogen synthase
D. Kinase of phosphorylase
Е. Protein kinase
57. Normal value of this protein marker in health makes up 80 ng/l. In myocardial infarction its concentration is acutely increased within first 2 hours and then gets significantly decreased due to excretion with urea. Name this protein.
А. Myoglobin
В. Tropomyosin
С. Actin
D. Hemoglobin
Е. Myosin
58. The deficiency of myoadenilate desaminase, the enzyme catalizing irreversible desamination of AMP to IMP induces fast fatigue during physical exercises as well as delayed onset muscle soreness and muscular pain. This myopathy is caused by:
А. The disturbance of purins metabolism
В. Accessive accumulation of fatty acids
С. Insufficient carnitine content
D. The disturbance of glycogen metabolism
Е. The changes of the number of mitochondrias, their size and internal structure
59. The oxidation of noncarbohydrate compounds (mainly fatty acids) provides 65-70% of energetic needs of the myocard. Which of the free fatty acids is the most easily oxidized in heart muscle?
А.Oleic acid
В.Palmitic acid
С.Stearic acid
D.Arachidonic acid
Е.Linolic acid
60. Which of the following clinical signs are not typical for the muscular tissue pathology?
А.Glucosuria
В.Myoglobulinuria
С.Creatinuria
D.Decrease of cAMP
Е.Significant decrease of the content of carnosine and anserine
61. Myofibrillar proteins are the proteins providing muscular contractions. Which of the following proteins exert ATP-ase activity?
А.Myosin
В.Actin
С.Troponin T
D. Troponin I
Е. Troponin С
62. The changes of the cytoplasm concentration of calcium ions are the main biochemical regulator of the muscular contraction and relax. What component of the troponin system is activated by the increased calcium concentration?
А.Troponin C
В.Myosin
С. Actin
D.Troponine T
Е.Troponin I
63. In long-term rhythmic muscular work ATP in muscles is synthesized by means of oxidation of:
А.Lipids
В.Lactate
С.Glucose
D.Aminoacids
Е.Glycogen
64. The contraction of the smooth muscles when the calcium concentration increases up to 10µm is significantly different from the analogic process in the barred muscles and is initiated by means of bonding of calcium to:
А.Calmodulin
В.Actin
С.Myosin
D.Troponin С
Е. Troponin І
65. The excessive intake of vitamin A is accompanied by increased membrane permeability or membrane destruction with the release of the acid proteases and acid phosphatase from the lysosomes, The excretion of what muscular cells metabolite is indicative for their damage?
А.Creatine
В.Lactate
С.Pyruvate
D.Creatinine
Е.Glucose
66. What effect of magnium ions on the muscular tissue causes the wide use of the magnium-containing drugs in clinical practice?
А.Decreases calcium concentration
В.Activates troponin complex
С.Increases calcium concentration
D. Enhances the nervous impulses transfer in the synapses
Е.Increases ATP and phosphate concentration
67. The muscular sarcoplasm contains proteins, which belong to different heterogeneal fractions: myogenous fraction contains enzymes of glycolysis and tissue respiration enzymes, myoalbuminum and myoglobinum, the main function of which are:
А.Oxygen deposition
В. Initiation of muscular contractions
С.Initiation of muscular relaxing
D.Calmodulin activation
Е.Troponin C activation
68. After short distance run untrained people develop delayed onset muscle soreness, resulting from lactate accumulation in muscles. The enhanced activity of what biochemical process in the organism may be associated with this condition?
А.Glycolysis
В.Glycogenesis
С.Penthosophosphate pathway
D.Gluconeogenesis
Е.Lipogenesis
69. The large quantity of the MB-form of creatine kinase isof orms evaluated in the blood of patient with destructive changes of the muscular tissue. What is the most evident diagnosis?
А.Myocardial infarction
В. Muscular atrophy
С.Muscular dystrophy
D.Polymyositis
С.Duchenne disease
70. A 1 year child got to clinic with the signs of muscular involvement. The examination evaluated carnitine deficiency in muscles. The disturbance of what process is the biochemical background for this pathology?
А.Тhe fatty acids transport to mitochondrias
В.Regulation of Ca2+ level in mitochondrias
C. Substrate phosphorylation
D.Lactate utilization
Е.Actin and myosin synthesis
71. A 46-year-old female has been suffering from progressive myodystrophy Duchenne's disease) for a long time, the change of catalytic activity of what flood enzyme proves to be a diagnostic test for the disease?
A. Creatine kinase.
B. Lactate dehydrogenase.
C. Pyruvate dehydrogenase.
D. Glutamate dehydrogenase.
E. Adenylate kinase.