
- •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
41. A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess of glycogen. Glucose concentration in the blood stream is below normal. What is the cause of low glucose concentration?
A. Low (absent) activity of glycogene phosphorylase in liver
B. Low (absent) activity of hexokinase
C. High activity of glycogen synthetase
D. Low (absent) activity of glucose 6-phosphatase
E. Deficit of a gene that is responsible for synthesis of glucose 1-phosphaturidine transferase
42. In neonates after birth during 5-6 days develops jaundice. The cause of this disorder is insufficient activity of the following enzyme:
UDP-glucuronyl transferase
Porphobilinogen synthase
Aminolevulinate synthease
Heme oxygenase
Biliverdin reductase
43. In blood of a patient was found an increased content of total bilirubin, in urea were detected bilirubin diglucuronides, absence of stercobilin in feces (acholic stool). What vitamins deficiency can be developed i9n this special case?
D, K, A
B1, B2, B6.
PP, C, U
Biothin and lipoic acid (vitamin N)
P, B15 (pangamic acid).
44. In a patient was recognized congenital liver disease, which is accompanied with high bilirubinemia due to increase in free (nonconjugated) bilirubin. In liver biopsia was detected trace activity of glucuronyl transferase. What disease can be recognized?
Crigler-Najjar syndrome
Gilbert syndrome
Physiological jaundice
Dubin-Johnson syndrome
Wilson disease
45. After a serious viral infection a 3-year-old child has repeated vomiting, loss of consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused changes of biochemical blood indices of this child?
A. Disorder of ammonia neutralization in ornithinic cycle
B. Activated processes of aminoacids decarboxylation
C. Disorder of biogenic amines neutralization
D. Increased purtefaction of proteins in intestines
E. Inhibited activity of transamination enzymes
46. A patient suffering from rheumatism was administered glucocorticoids therapy. What changes in carbohydrate metabolism in liver can be expected?
Stimulation of gluconeogenesis
Stimulation of glycogenesis
Stimulation of glycogen hydrolysis
Stimulation of glycogen phosphorolysis
Increase of glycogen phosphorylase activity
47. A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will have strengthened concentration in the blood serum?
Unconjugated bilirubin
Conjugated bilirubin
Mesobilirubin
Verdoglobin
Biliverdin
48. A 46 year old woman suffering from chololithiasis developed jaundice. Her urine became dark-yellow and feces became colourless. Blood serum will have the highest concentration of the following substance:
Conjugated bilirubin
Unconjugated bilirubin
Biliverdin
Mesobilirubin
Urobilinogen
49. A 4 y.o. boy has had recently serious viral hepatitis. Now there are such clinical presentations as vomiting, loss of consciousness, convulsions. Blood analysis revealed hyperammoniemia. Disturbunce of which biochemical process caused such pathological condition of the patient?
Disturbed neutralization of ammonia in liver
Disturbed neutralization of biogenic amines
Increased putrefaction of proteins in bowels
Activation of aminoacid decarboxylation
Inhibition of transamination enzyms
50. A newborn child was found to have reduced intensity of sucking, frequent vomiting, hypotonia. Urine and blood exhibit increased concentration of citrulline. What metabolic process is disturbed?
A. Ornithinic cycle
B. Tricarboxylic acid cycle
C. Glycolysis
D. Cori cycle
E. Glyconeogenesis
51. In a patient with jaundice it was detected a block in transformation of bilirubin to bilirubin diglucuronide. The concentration of indirect bilirubin in blood was markedly increased. What pathology can be suggested in a patient?
Prehepatic jaundice
Hepatic jaundice
Posthepatic jaundice
Tumor of pancreas and occlusion of bile duct
Addison’s disease
52. In 35 years old patient a jaundice was revealed, as well as fever, bradycardia. Laboratory investigation revealed increase in direct and indirect bilirubin, appearance of direct bilirubin and bile acids in urine, missing of stercobilinogen in feces. What type of jaundice can be expected?
Post-hepatic
Hepatic
Jaundice of neonates type
Gilbert disease
53. Investigation of patient indicated on inflammatory processes in gall bladder, alteration of colloidal stability and high risk of bile stones formation. What substance from listed below favors the formation of bile stones?
Cholesterol
Urates
Phosphates
Oxalates
Lecithine
54. In 14 years old patient a hereditary liver pathology was expected. It was detected high content of direct bilirubin in blood, deposition of melanin in liver due to alteration of bilirubin excretion to bile by liver cells. This state is characteristic to the next disease:
Dubin-Johnson syndrome
Crigler-Najjar syndrome
Gilbert disease
Physiological jaundice
Wilson disease
55. A man is resting after intensive physical effort. Which from different pathways of glucose metabolism is the most active at this time?
Gluconeogenesis from lactate
Glycolysis
Glycogenolysis
Breakdown of glycogen to glucose
Gluconeogenesis from amino acids
56. In a patient suffering from liver cirrhosis concentration of albumin in blood plasma is 15 g/l (normal value 32-55 g/l), prothrombine test – 40 seconds (normal value – 12-20 sec.). To what functional disorder in liver indicate these changes?
Inhibition of protein synthesis
Detoxification function
Excretory function
Production of bile
Secretion of lipoproteins to blood
57. In a patient with toxic damage of liver was revealed low concentration of urea in blood plasma. The cause of this may be the next:
Alteration of ornithine cycle of urea synthesis
Absence of alanil aminotransgferase in liver cells
Deficiency in blood ammonia concentration
Deficiency of CO2 and restriction of urea synthesis
Excess of ammonia, which inhibits enzymes of urea synthesis