
- •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
33. After prolong vomiting and diarrhea in a patient is observed tachycardia, skin dryness, muscular hypotonia and apathia. Such state can be caused by:
Hypomagnesemia
Hypopotassemia
Hyperpotassemia
Hypocupremia
Hypercupremia
34. What disorders of water and mineral metabolism can be expected in a worker, having a job in hot conditions?
Hypoosmolar dehydration
Hyperosmolar dehydration
Cellular hyperhydration
Extracellular hyperhydration
Isotonic hyperhydration
35. In a patient after thyroid gland surgery cramps and convulsions appeared, hyperreflexia and hyperexcitability were observed. Preliminary diagnosis is hypocalcaemia, which may be caused by:
Hypoparathyreosis, induced by extirpation of parathyroid glands
Hyperparathyreosis due to tumor developement from cells of parathyroid gland
Overdose of vitamin E
Overdose of vitamin D
Insulin insufficiency
36. In a patient a development of calcium deposits in soft tissues, stones in urinary ducts are observed. Preliminary diagnosis is hypercalcemia, which may be caused by:
Hyperparathyreosis due to tumor development from cells of parathyroid glands
Vitamin D deficiency
Hypoparathyreosis, induced by injury of parathyroid glands during thyroid gland surgery
Insulin insufficiency
Insulin overproduction
37. Dietary intake of a 30 year old nursing woman contains 1000 mg of calcium, 1300 mg of phosphorus and 20 mg of iron per day. It is necessary to change content of these mineral substances in the following way:
A To increase phosphorus content
B. To increase calcium content
C. To reduce fluorine content
D. To increase iron content
E. To reduce iron content
38. A 35 y.o. patient who often consumes alcohol was treated with diuretics. There appeared serious muscle and heart weakness, vomiting, AP- 100/60 mm Hg, depression. This condition is caused by intensified excretion with urine of:
A. Potassium
B. Sodium
C. Chlorine
D. Calcium
E. Phosphates
39. A 50-year-old patient complains about general weakness, appetite loss and cardiac arrhythmia. The patient presents with muscle hypotonia, flaccid paralyses, weakened peristaltic activity of the bowels. Such condition might be caused by:
A. Hypokaliemia
B. Hypoproteinemia
C. Hyperkaliemia
D. Hypophosphatemia
E. Hyponatremia
Clinical cases and Situational tasks
40. The elderly people (over 60 yr.) of both sexes are at risk for osteoporosis. However, it more predominantly occurs in the post-menopausal women. Explain why.
Answer: The ability to produce calcitriol from vitamin D is decreased with age, particularly in the postmenopausal women. lmmobilized or sedentary individuals tend to decrease bone mass while those on regular exercise tend to increase bone mass. Deficiency of sex hormones (in women) has been implicated in the development of osteoporosis.
41. A patient with the symptoms of irritability, muscular weakness, tachycardia, cardiomegaly and cardiac arrest was delivered to the hospital. What disorders of mineral metabolism can be expected?
Answer: Such symptoms are observed in hypokalemia. Decrease in the concentration of serum potassium is observed due to overactivity of adrenal cortex (Cushing's syndrome), prolonged cortisone therapy, intravenous administration of K+-free fluids, treatment of diabetic coma with insulin, prolonged diarrhea and vomiting.
42. Iron deficiency anemia is the most prevalent nutritional disorder worldover, including the well developed countries (e.g. USA). Several factors may contribute to iron deficiency anemia. These include inadequate intake or defective absorption of iron, chronic blood loss, repeated pregnancies and hookworm infections. Explain why strict vegetarians are more prone for iron deficiency anemia.
Answer: This is due to the presence of inhibitors of iron absorption in the vegetarian foods, besides the relatively low content of iron.
43. Wilson's disease (hepatolenticular degeneration) is a rare disorder of abnormal copper metabolism. Characterize the main manifestations of this disorder.
Answer: Copper is deposited in abnormal amounts in liver and lenticular nucleus of brain. This may lead to hepatic cirrhosis and brain necrosis. Low levels of copper and ceruloplasmin in plasma with increased excretion of copper in urine. Copper deposition in kidney causes renal damage. This leads to increased excretion of amino acids, glucose, peptides and hemoglobin in urine.