UNIVERSITY OF SANTo TOMAS-FACULTY or MEDICINE AND SURGERY Q

MEDICAL BOARD REVIEW 2017 l.\\/ .1

MOCK BOARD EXAMINATION-BIOCHEMISTRY
August 09, 2017, Wednesday
SET A

NAME:
SIGNATURE:

GENERAL INSTRUCTIONS: This questionnaire is composed of 100 items. On the box provided
in the front page of the EXAMINATION ANSWER SHEET, kindly write name and code. All final
answers should be made on the back page of the EXAMINATION ANSWER SHEET provided for.
SHADE SET A. Only Mongol 1 or 2 may be used. Do not leave any blanks as this will be considered
incorrect. Submit your answer sheet. Please be guided accordingly

Choose the best answer

1. Which of the following statements is correct regarding chemical and physical properties of
x carbohydrates?
A. When 2 sugars are said to be mirror images of one another, they are called epimers . .. -' we
8. The reducing property of sugars depend upon the presence of an anomeric carbon atom ,ru ’s ‘
C. Sugar units in polysaccharides are linked by phosphodiester bonds. “W's-r. " " ‘
D. Milk sugar is a disaccharide composed of galactose and glucose ,

-. 2. Which of the following group of amino acids is classified as aliphatic with non polar side
chains? ‘7
A. Valine, leucine , isoleucine
B. Tyrosine, serine, threonine
C. Histidine, tyrosine, glutamine
D. Aspartate, glutamate,lysine
’\

V. 3. In a globular protein such as myoglobin, which group of the following amino acids
would most probably be found in the inten‘or of the protein
A. aspartic acid, lysine , tyrosine
B. lysine, asparagine, glutamic acid
C. valine, leucine , isoleucine
D. arginine, histidine, cysteine

L 4. The peptide with the primary structure .' ala- glu- lys- arg. Which of the following is
' true of the said tetrapetide?
A. there are 4 lonizable groups >
B. the net charge is zero at physiologic pH
C. when separated by electrophoresis at pH 8.6, it will migrate to the cathode
D. all the amino acids in the molecule are dietary essential x

5. The quaternary structure of a protein refers to the:

A. amino acid sequence of the polypeptide i
8. local conformation such as alpha helix or beta pleated sheet 7 0
C. three-dimensional conformation of a polypeptide
D. spatial arrangement of subunits in a protein containing more than one
polypeptide chain
KN
f
6. This glycosaminoglycan consists of repetitive units composed of L-Iduronic acid
k/ and N-Acetyl-D-Galactosamine forms and accumulates in Hurler’s Syndrome:
A. Chondroitin Sulfate
B. Hyaluronic acid
C. Dennatan Sulfate
D. Heparin

UST-FMS MEDICAL BOARD REVIEW 2017 Page 1 of 12

 7. This class of enzymes is NOT c0rrectly paired with its subclass
A. Transferases and hexokinase
B. Lyases and phosphatase
C. Isomerases and mutase ,
D. Ligases and synthase I

8. Comparing the enzyme catalyzed reactions with reactions without enzymes», the
former:
A. increases the energy of activation of the reaction .‘
B. decreases the standard free energy of the overall reaction
C. shifts the equilibrium farther to completion
D. lowers the transition state energy reaching the transition state faster

’\ 9. A compound is known to inhibit a reaction by binding to the enzymes allosteric site. Which
of the following is expected in such type of inhibition?
A. The reaction could be reversed by adding more substrate to the reaction
B. Km increases but the maximum velocity will be the same
C. A noncompetitive type of inhibition is exhibited
D. The inhibitor may be structural analog of the normal substrate

10. The Michaelis Menten constant or Km is equal to the :

A. Substrate concentration when enzyme is fully saturated with the substrate
B. Maximum velocity (Vmax) when the enzyme is half saturated with the substrate
C. Substrate concentration at half maximum velocity
D. Enzyme concentration is equal to the substrate concentration

r 11. Isoenzymes are types of enzymes that :

A. have the same amino acid sequence but catalyze different chemical
.

reactions.
B. differ in amino acid sequence but catalyze the same chemical reaction
C. catalyze opposing chemical reactions at the same reaction rates
D. have identical primary and secondary structures catalyzing the same
r/‘

K— 12. Which of the following is true about coenzymes?

A. all are derived from water soluble vitamins
B. refer to the protein organic portion of the enzyme
C. bind with the apoenzyme to form the holoenzyme

C
D. help enzymes accelerate reactions thru acid base catalysis
13. A patient was diagnosed to have megaloblastic anemia. Which if the following reactions is
expected to inhibited by this condition? i
<1 l 1'.

A. carboxylation
B. transamination
C. methyl group transfer
D. oxidation
{x

(A, 14. In Bioenergetics , an exergonic reaction, which of the following is true? :

' e/ A. requires energy to drive the reaction to completion
8. has a free energy change of less than zero
C. must be coupled to an endergonic in order to proceed

L,
/\ D. is always at equilibrium
15. Oxidative phosphorylation differs from substrate level phosphorylation in which of the
following points?
A. Oxidative phosphorylation 'is the synthesis of energy upon the transfer of high energy
phosphate group to ADP
B. Substrate level phosphorylation occurs exclusively in the cytosol
C. Oxidative phosphorylation is formation of ATP coupled with transfer of electrons along the
Electron Transport Chain
D. Substrate level phosphorylation is characterized by the oxidation of substrate in the
cytoplasm

UST-FMS MEDICAL BOARD REVIEW 2017 Page 2 of 12

~»..- “Wu-s
 16. A patient was found in his car inside his garage in an unconscious state in severe
.. respiratory depression. The car engine was running. He was brought tote emergency room but
i 2 was pronounce dead on arrival. The diagnosis was carbon monoxide poisoning. Carbon
monoxide affects biological oxidation by:
A. uncoupling respiration from phosphorylation.
B. inhibiting cytochrome oxidase
C. tightly binding to complex I of the ETC 7‘
D. dissipating the proton gradient created in the Respiratory Chain

,‘1‘ 17. The activity of most enzymes may be regulated by phosphorylation leading to their
activation or inactivation. This mode of regulation is called:
A. Compartmentation
, B. Proteolytic activation
C. Allosten'c inhibition
D. Covalent modification -'

® 18. By increasing the temperature beyond optimum and decreasing the pH, the reaction
decreases because of all of the following possibilities EXCEPT:
A. there is loss of the normal native state of the enzyme
8. peptide bonds of the enzyme gets destroyed
C. the enzyme’s active site is lost
D. denaturation occurs

D 19. Cellulose in human diets cannot contribute to energy production because cellulose:
A. constitutes a very small percentage of the average diet
B. is highly branched molecule composed of glucose
C. is a heteropolymer composed of fructose and galactose
D. man does not have the enzyme to hydrolyze beta glycosidic bonds of cellulose

L“
20. When glucose is transported into the cell, it immediately undergoes this biochemical process
for its proper utilization as a source of energy:
A. conversion to those phosphates
B. oxidation to pyruvate and acetyl CoA
C. phosphorylation to glucose 6-phosphate
D. recycling of its carbons for nucleic acid synthesis
21. Which statement is true regarding Hexokinase and Glukokinase ?
A. A. Hexokinase has a lower affinity for Glucose compared to Glucokinase
B. Hexokinase is inducible by insulin
C. Glucokinase will phosphorylate glucose molecules more readily than hexokinase
D. Glucokinase is subject to product inhibition by its product Glucose 6-phosphate
C/\ 22. A molecule of glucose when metabolized via the Embden Meyerhoff pathway:
generates 2 molecules of pyruvate because of this enzymatic reaction:
A. phosphofructokinase-l
B. aldolase b
C. phosphotriose isomerase
D. pyruvate kinase
0 23. Skeletal muscles and the erythrocyte produce this product of glycolysis
A. pyruvate
B. acetleoA
C. lactate
D. glucose 6 phosphate

V0) 24. Which of the following reactions is considered the major anaplerotic reaction and an initial
\/ reaction for gluconeogenesis ? . ‘ ‘ ‘ ’.
[lp’inx'ln “Arch”; r-r":\',4'.i.'v}
A. Pyruvate dehydrogenase ‘ I y.
y

air 0‘ 14xka
B. Pyruvate carboxylase - ref '-« MU gnu-vi-nzi’.‘ "
C.Lactate dehydrogenase
D. Pyruvate transaminase

UST-FMS MEDICAL BOARD REVIEW 2017 Page 3 of 12

25. All of the following can contribute to gluconeogenesis , EXCEPT: , .
A. Glycerol We, 1,. g, . My”, ,, . z
B. AcetleoA P‘ ~ 7 1', ,5.

'
In
C. Lactic acid , 3"" ‘ ' " ‘ ‘
D. Dihdroacetone phosphate 2
26. All of the following is of the Citric Acid Cycle, EXCEPT?
A. generates reducing coenzymes NADe‘nd FADHZ for oxidative phosphorylation , F
B. commences with the oxidative decarboxylation of pyruvate to acetleoA - PD ‘0‘
C. generates a molecule of ATP thru substrate level phosphorylation * ‘T " “If
D. final common pathway of intermediary metabolism
27. This reaction of the TCA Cycle is closely associated with Complex II of the Elrectron
Transport Chain: Cm .. 3 .. , -~ i. r. in at Le: Jr ‘3 an ',-
r

A. Malate dehydrogenase \I‘q. yuan ,0 V'A‘v‘yl...

.- '|_r>,n'l.
. '- "v
B. Succinate dehydrogenase (A f
u "1 ~~’ ‘r 7
C. alpha keto glutarate dehydrogenase
’

Lib, {of &v. ~ _‘ . (A 45 Ln,“ 0,, 1...,

D. Isoatrate dehydrogenase rm a; 3; - A *7 r- 4 g n flu. ; c.
28. Which of the following is the effect of insulin on carbohydrate metabolism?
A. promotes glycolysis and complete oxidation to C02 and water
B. stimulates synthesis of glucose from non carbohydrate sources ‘5
C. inhibits glycogenesis \
D. promotes uptake of glucose across the brain and liver tissues <'\ raw 1 WW...
29. The Hexose Monophosphate Shunt provides NADPH + H for: . “k.” 7‘93“ '5
A. nucleic acid synthesis - I . ‘9t. (er’t‘sf
s '1» W
B. fatty acid synthesis ’1'

C. interconversion of hexoses
D. production of ATP when chanelled to the Electron Transport Chain
30 A male student of African descent was prescribed anti malarial medication. Several hours
alter ingestion of the drug, he’developed hemolytic anemia. A defect in this enzyme might have ’
led to his abnormal condition: I‘ '.
."
‘ .u .0 a
1 ~ info‘ i r'
A. Superoxide dismutase n' -
{3. ‘r- ’1‘
A"A

B. Catalase J

C. Glucokinase
D. Glucose 6-phosphate dehydrogenase
31. The Uronic acid pathway is important in metabolism in man because it :
A. is an alternate pathway of glycolysis that provides a greater amount of energy
B. produces activated sugar acids for glycosaminoglycan synthesis and conjugation of
xenobiotics. V 1.1.. 4,: g‘
[3
C. can synthesize vitamin C r not" WW ‘9'“ W‘“ "‘ f ~ ‘ x-'
D. generates metabolites for the synthesis of fats and proteins
32 Epinephrine and glucagon can cause hyperglycemia by which of the following mechanism?
A. breakdown ofmuLCIe glycogen to glucose «‘ r7.» '43,~‘u-» - ‘l .4 (A. PF —‘ “9K A
B. activation of liver glycogen phosphorylase u ' ‘ " .-.."I’ .1
,

C. promoting glycolysis and inhibition of gluconeogenesis ,. picsif?!

D. inactivation of cyclic AMP- dependent protein kinase A. L Pl

33. Glycogen metabolism in the liver differs from that in the muscle because in the liver, "3' BMW
yturlfiL‘
glycogen:f .
2’ :y '1‘» 'l_ 5,."
A. is degraded to provide Glucose 6-P04 for its exclusive use c 'v u '. »
B. is synthesized from Glucose 1-P04
C. maintains blood glucose levels during short periods of fasting
D. stores glucose mainly for glucuronic acid formation

34. Fructose when metabolized by fructokinase , enters the glycolytic cycle as:
A. Fructose 1,6 bisphosphate " "-“' ‘7‘“
B. Fructose 1 phosphate
C. glyceraldehyde 3 phosphate
D. Dihydroxyacetone phosphate

UST-FMS MEDICAL BOARD REVIEW 2017 Page 4 of 12

 35. A chronic alcoholic with liver Cirrhosis was brought to the
hospital in stuporous state
gradually becoming comatous. Initial laboratory exams showed elevated ammonia levels and
Jr lsdecreased blood glucose levels and metabolic acidosis. The primary cause of his mental status
| :
A. failure to convert ammonia into a non toxic form
8. lactic acidemla
C. decreased gluconeogenesis
D. accumulation of ketogenic amino acids

36. The main reaction of the removal of amino group from most amino acids is:
A. transamination /

B. direct deamination . l
o .".a(,‘.“(‘ )I \r‘ t:

C. hydrolytic deamination
D. dehydrative deamination

37. Gamma amino butyric acid (GABA) and histamine are products den‘ved from glutamate and
histidine respectively through the process of:
A. Decarboxylation
“.

B. Deamination
C. Transamination A,
D. Hydroxylation 4*

38. An amino acid can be a source of glucose if the carbon skeletons can be metabolized into
any of the following EXCEPT:
A. acetoacetate
B. pyruvate
C. fumarate
D. oxaloacetate
39. Which of the following amino acids may be synthesized thru transamination?
A. alanine g; . fl); ‘ .. _‘~ -,_ .
B. asparagine ‘ ' l ‘ ' ' ' '
,

'1!
C. lysine \l
i
D. vallne
40. A new born infant was observed to be lethargic with occasional seizures gradually
progressing into coma and eventually death. Initial laboratory findings before death showed
metabolic acidosis with a urine that is characterized as sweet smelling similar to maple syrup.
Metabolism of which group of amino acids is involved with this condition?
A. Sulfur containing amino acids
B. Aromatic amino acids
C. Branched chain amino acids
D. Basic amino acids
41. A patient was seen in the clinic because of skin lesions and diarrhea. The pellagra like
manifestations may be seen in deficiency of this essential amino acid:
A .Phenylalanine
B. Histidine . i
C. Tryptophan m p»! ’ ‘~' W‘ "4P" H ' “6‘ R
D. Lysine i
(3)0

42. Which of the following specialized products is correctly paired'with its amino acid precursor?
A. melanin and tryptophan 1* 1’1I i- b " '3 01'"
B. epinephrine and tyrosine ’
C. melatonin and phenylalanine ,r i ".340 ‘ ' "T'i‘l” Wk"
D. DOPA and leucine 0 (“Pk-hf. m

43. During prolonged starvation which of the following amino acids can contn‘bute most
significantly to ketogenesis? u

.V " \‘ ~
A. Isoleucine - 79' ,1 I; 1.,
1'
.

B. Leucine '~".‘~
b'

C. Valine ’ ir ~,V, i.~' (a.

l. .g‘

D. Alanine v» r'; g.)

' .

UST—FMS MEDICAL BOARD REVIEW 2017 Page 5 of 12

 44. In pheochromocytoma, increased levels oftms d. - / D
\ A. Vanlllyl mandelic acid ' .me‘tabmlte's P-Xpeae -! . ,' I]. l [M
l . I". ,. _ If,
‘ Y!“ ,‘
B. Hydroxyindole acetic acid. ul,v',..,..'i._.
l

C. Formimino glutamlc acid. 3 m.’ v '

.U'ii.
D. Amino adipic acid_ . lg,“r ‘ i
i

C, 45. Which of the following inborn error of metabolism is characterized by mental retardation,
mousey odor of urine, patches of skin and hair deplgmentation 7
A. Homocysteinurla
B. Albinism
I

C. Phenylketonuria ~ , A
D. Alkaptonuria

C: 46. Which of the following is NOT true of bilirubin metabolism?

A. bilirubin is derived from the heme moiety of hemoglobin v
B. unconjugated bilirubin is conjugated in the liver by glucuronyl transferase /
C. conjugated bilirubin is water insoluble bilirubin ~,
D. bilirubin diglucuronide is also called direct bilirubin /

y 47. Which of the the following true of lipid digestion? 31,; .4 H"
\U" A. triacylglycerol is completely hydrolyzed into glycerol and free fatty acids by pancreatic lipase
B. bile salts emulsify lipids for faster digestion and absorption « .
C. dietary lipids are packaged as very low density lipoproteins after digestion 0M1» .' ~ : .
D. products of lonygchain TAG digestion are directly absorbed thru the portal circulation

/“ 48. Steatorrhea occurs in the setting of chronic pancreatitis due to lack of:
k A. Bile salts released from the gall bladder
' B. Insulin from the B cells of the pancreas H
C. Lipase in the intestinal lumen
D. Cholecystokinin released from the enterocytes

49. Which statement best describes the fate of Triacylglycerol molecules stored in adipose ’
_
'3 tissue dun'ng fasting? '
-.. _.—j

A. The stored fatty acids are released from adipose tissue into the plasma as components of 5 1’"
the serum lipoprotein particle, VLDL. . -3 ,i, r a 5 i} ,t..’_,
.

B. Free fatty acids are produced at a high rate in the plasma‘ by the action of lipoprotein lipase 4 u
'"5 ' ( a ,
L, m .- xv s' ‘
on chyomicrons. {92‘ w . I, F. s ’. . ‘ I

C. Glycerol produced by the degradation of triacylglycerol is an important direct source of " "’1",

energy for adipocytes and fibroblasts. r .‘ " “'t ~ -' r‘ . V 5‘

'

D. Hormone-sensitive lipase is phosphorylated and activated by a cAMP-activated protein ~ - l. t I

kinase. ‘
50. In the storage of fatty acids as components of TAGs stored in the adipose: , . AA.
D A. Glycerol P04 is formed by phosphoyrlation of glycerol by glycerol kinaser A 0"" d ' M ‘ W.
8. ATP is required in the transfer of free fatty acids (FFA) to glycerol
C. FFA released from TAGs are transported to the liver, skeletal muscle and
brain where they are used as sources of energy during fasting
D. FFA are released from TAGs by the action of hormone-sensitive lipase
D. 51. An infant, born at 28 weeks of gestation, rapidly gave evidence of respiratory distress as
shown by Lab and x-ray results. Which of the following statements about Respiratory Distress
t..1

A. This is not due to the baby's premature birth.

B. The amount of Type II pneumocytes is fewer than a mature infant.
C. The lecithin/sphingomyelin ratio in the amniotic fluid is likely to be greater than two. ‘1'
D. The concentration of dipalmitoylphosphatidylcholine in the amniotic fluid
would be expected to be lower than that of a full~term baby. t"

UST-FMS MEDICAL BOARD REVIEW 2017 Page 6 of 12

A ‘ . I at
an was found to be milky in appearance. The of
ti|a<?i"_§l'YC'3"0I 'EVE' in excess 0" 2.000 mg/dl (nonnai -. 4—150 mg/dl). The patient was placed
I t supplemented with medium-chain fatty acids.
Particles are most likely responsible for the appearance of the \ .
patient’s plasma? v," ¢ ‘. }. ../_. {Alloy-Ii)me
A. Chyiomicrons._lJ...” ‘ r ,‘

B. Very-low-density iipoproteins ' a‘ P ./ “

C. Low-density-lipoproteinsi'Mm‘7'"
D. High-density-Iipoprotelns. I
\
u

deficiency because they:

53'Medium-Chain fatty adds are given in II'Doprotein lipase
A. provide more fuel than long-chain fatty acids
B. enter directly into the portal blood, and can be metabolized by the liver
C. are activators of lipoprotein lipase
D. are more efficiently packed into serum lipoproteins
l
‘i‘; ’r‘
54. Correct feature of fatty acid synthesis: ,~ V “ W i VIUK‘VW 3' INA-1
A. acetyl CoA carboxylase catalyzes committed step of the pathway (’04 ,1
8. requires NADH + H“ as donor of reducing equivalents for the enzyme Fatty [Ur -
Acid Synthase iv 3! 9 F ii
C. priopionleoA is an intermediate My
"(1.1.
D. major product of de novo synthesis is stearate V! r i J, a

it'd} r f"

55. Fatty acid synthesis differs from fatty acid oxidation in that the former:
A. takes place in the mitochondria \l
8. requires NADH and FADHz i, '4 g t-
C. is favored by a high Insulin/Glucagon ratio
C. is an energy generating process

56. Lipolysis in adipocytes is activated by:

A. Binding of Insulin to specific receptors , /
B. Activation of Lipoprotein Lipase by Apoprotein C-II r' 4‘; ‘v‘ "e- w‘ v-u I! r?» t f1{~ ($0) a! u
C. Epinephrine-stimulated cA'MP activation of the hormone-sensitive lipase
D. Activation of phospholipase A

57. Which statement regarding ketone bodies is correct? F k I w r”! N, 6,.9J

.

A. Ketone bodies cannot pass through the blood brain barrier ‘~‘ L“"’ ‘1" ' .A
‘

B. The liver is unable to use ketone bodies as energy source "‘ V“ fr; " '0“
C. Ketone bodies is packaged in VLDL .
D. Ketone bodies can be produced from glucose “.5 ri'v‘i. AM as;
58. Which lipoprotein synthesized in the liver contains a'high concentration of triacylglycerol
and is cleared from the circulation by. adipose tissue and Imuscle?
A. Chylomicrons *‘T/«‘ (r ’ ‘ " "’ I "' «.- “‘1 ' ‘
B. HDL f HM__JW“'W
V

C. VLDL— “(A (re Cy '

'

D. LDL » L I

59. A 40-year-old woman presents with an LDL serum level of 400 (N.V. < 130), and a
triglyceride level of 170 (recommended level is <150). She is diagnosed with type II familial
hypercholesterolemia. In this disorder, a mutated LDL receptor is formed, such that it cannot
bind to LDL. Which of the following would result? 3
A. Cellular HMG-CoA reductase activity is not inhibited. '7 ~ .1 5!: .d T ‘L l b L w01"“
B. The triglycerides in chylomicrons cannot be degraded. J LDL and; 6;“ A,
C. The VLDL level in the serum increases. Wf
D. The HDL level in the serum increases. 5 W7 0’)

€15..er y 614‘.
UST~FMS MEDICAL BOARD REVIEW 2017 Page 7 of 12
 <04
film. - Clay-’1“: -

i'I. r
’17,“, .l ",

v4 60. Statins are-“competitive inhibitors of HMG-CoA reductase,

which converts HMG-COA to"
A. Mevalonatewni”
B. Isopentenyl pyrophosphate
C. Geranyl pyrophosphate
D. Cholesterol

61. Aspirin is given as an initial treatment for myocardial infarction due to its cardioprotective
effects. As a NSAID, aspin'n inhibits cyclooxygenase activity which is required for the CODVEFSion
of:
A. Thromboxanes from arachidonic acid
B. Leukotn'enes from arachidonic acid
C. Phospholipids from arachidonic acid
D. Arachidonic acid from linoleic acid

A 62. Complete hydrolysis of sphingomyelin yields all of the following products , EXCEPT
“ A.sialicacid — ’0“ ' ‘ 54"
"l
5.1’.

B. ceramide r 5p" 4 T ::
C. phosphate '
D. choline

i 63. Which of the following Inborn error of lipid metabolism is chaarcterized by accumulation of
by GM2 ganglioside? _ . Y . .._r4’(. -I
A. Niemann Pick Disease ” “’5 l ' i3" c

B. Tay Sachs Disease r low; ~ ".» 7

C. Gaucher’s Disease — .m, ,’ -
D. Fabry’s Disease “

64. High serum HDL levels are protective against the development of atherosclerosis because
HDL: __ L 2 _; p: c in'
A. Inhibits cholesterol production by the liver C" ' run 5“ii Vat (I. {.3
B. Inhibits HMG-CoA reductaseisg” ' *""‘bef \n ex» 60! ‘(;\(3
C. Increases LDL production
D. Brings cholesterol esters back to the liver 54"»? .VC w‘r‘s~z‘°~0\ +VBCYF“’{

D 65. A 12-year-old boy presents with fatigue, polydipsia, polyuria, and polyphagia.. He is
diagnosed with type 1 diabetes mellitus, Which one of the following is most likely occurring in
this patient? ,, i Dr
. . . . It1. r .,
A. Increased fatty aCld synthesrs from glucose in liver.;'sm__;“ s Mm“ /,,,gwb- p.
B. Decreased conversion of fatty acids to ketone bodies , b N, 4 k. .T VA
C. Increased stores of tn'acylglycerol in adipose tissuei'g-“u' '
D. Increased production of acetone

D 66. Diabetic cataracts form because of accumulation of this sugar alcohol in the lens of the
eyes: My .I‘W‘J" H ‘1‘";
u. r
l
r‘ ’

‘d' A. Mannitol \‘i'

‘ l s
'

B. Maltitol
C. Xylitol . _
V
Y

D. Sorbitol’ 4m“; “g‘i'r' - .l ‘

'

67. A normal person takes in a high carbohydrate meal and decides to fast thereafter. Which of
/ the following schemes most accurately depicts the order of the metabolic processes in the liver?
A. Glycogen synthesis, lipolysis, gluconeogenesis, glycolysis
B. Glycolysis, glycogen synthesis, lipolysis, glycogenolysis, gluconeogenesis
C. Glycogen synthesis, glycogenolysis, lipolysis, gluconeogenesis
D. Glycolysis, lipolysis, gluconeogenesis, glycogen synthesis

UST—FMS MEDICAL BOARD REVIEW 2017 Page 8 of 12

 r cose and
thiamine which greatly improved the
patient’s level of consciousness alto several hours.
Which enzyme of carbohydrate metabolism
is dependent on Thiamine?
A. Lactic acid dehydrogenase l'fy" m c’r’ -— a

.
1" ‘,

Wm "' Y’i’ "It

B. Glucokinase 0'

C. Pyruvate dehydrogenase
D. Glucose 6-Ph05phatase
g, ii i V
69 In chronic alcoholism, failure of gluconeogenesls
i 1i
\J" occurs as a result of:
A. accumulation of triacyi'glycerois In the liver due
to accelerated fatty acid oxidation
8. excess NADH that inhibits enzymes that generate oxaioacetate in the TCA cycle
C. lack ‘of substrates for the Cori cycle such as lactate, glycerol, and pyruvate 0.. 4 {of
D. shifting of glycolytlc intermediates to the hexose monophosphate shunt i i in i‘, 0/." .

D D I ‘IH it 0“”t‘I
70. In da7 very low carbohydrate-high protein-moderate fat diet, which metabolic response is
expecte .
A. Excess amino acids are chiefly stored in tissue protein.
B. Fasting state in between meals is longer than in other types of diet.
C. Ketoacidosis readily ensues because of excess ketone body formation.
D. Liver remains gluconeogenic and ketogenic in the fed state.

71. In obesity, the accumulation of triacylglerols in adipose cells is a result of:

A. a diminished rate of lactate utilization
B. a low insulin—glucagon ratio 4
C. an exaggerated breakdown of ketone bodies»!
D. an excess of acetyi CoA from pyruvate

it 72. Which of the following metabolic effects is attributed to insulin?

A. Uptake of Glucose into the cells by specific GLUT receptors 1
B. Hydrolysis of Triacylglycerol to Fatty acids and Glycerol
i7 i. L”! do NI
d
05‘
. I;
9'
W

C. Decreased activity of Lipoprotein Lipase

D. Increased rate of beta-oxidation of Fatty acids

D 73. The largest form of stored energy in the body is/are:

A. Glycogen in the muscle
8. Proteins in the skeletal muscle protein
C. Glycogen in the liver
D. Triacylglycerols in the adipose tissue

A 74. The caloric content per gram of fuel is correctly described by this statement:
A. It is the amount of energy obtained from the oxidation of fuel
B. Its value is higher for carbohydrates than fats
C. Its value is higher for protein than carbohydrates and fats
D. Its value is higher in children than adults

(b
75. In formulating a dietary prescription for an average Filipino adult, which of the following
must be observed? l a.» ,J
A.The total energy requirement must be based on the individual actual body
weight W4 i .i‘ Y TE?
B. The acceptab(e distribution for carbohydrates, proteins and fats must be 60%, 15%, and
25% respectively
C.To lose one pound a week we must subtract 100,0,kcal per day from the total
energy requirement 3" "
D.The therrnogenic effect of food must constitute an additional 50% of the basal
energy requirement and physical activity (0/

UST-FMS MEDiCAL BOARD REVIEW 2017 Page 9 of 12

 A '5 'In or der to:
A, 76. There should be adequate amount of calories allotted to carbohydrates and fa
\\ I Ll “ A. Promote absorption of fat soluble vitamins and minerals
\J B. Prevent protein breakdown thru a protein sparing effect
C. Provide enough substrates for gluconeogenesis and glycogenesis
D. Interconvert carbohydrates into fats and vice versa
"L.
A,

‘p 77. A protein food is said to be of high biologic value when:

A. it contains all the essential amino acids
\\

B. its amino acid content is equivalent to that of plant proteins

C. there are equal amounts of essential and dispensable amino acids
D. there is a low ratio of lndispensible to non essential amino acids

78. In nucleotide synthesis , the immediate source of sugar and phosphate comes
p.\ from: r; .5
A. glucose-6 phosphate " ' ‘4‘.%I
" fig.
B. phosphoribosylpyrophosphate ' 05

C. phosphoribosylamine
D. ribose S-phosphate

A 79. In de novo synthesis of nucleotides, which of the following contributes N atom to both
A purine and pyrimidine n‘ng?
A. aspaltate g \
B. glycine ~ f' ‘ " ,'
C. bicarbonate ‘ w r" :~ " ’ "'
D. glutamate (.4 )y‘; p. . u
u

80. 5 year old boy was brought to the clinic because of mental retardation
and self-mutilating tendencies. He was also found to have Hyperuricemia. A
'

diagnosis of Lesch Nyhan Syndrome was given which is characterized by a

defect in this enzyme:
A. Hypoxanthine Guanine phosphoribosyl transferase
B. Xanthine Oxidase
C. Adenosine deaminase / ci D
D. Formyl Transferase

{)3 81. Patients with gout are given allopurinol in order to decrease blood uric acid in
J order to:
A. increase solubility of uric acid and promote its urinary excretion
B. inhibit synthesis of uric acid from pun'ne catabolism
C. further catabolize uric acid to a more soluble and excretable form Von C-w i 'e« if;
D. activate reconversion of urates into purine nucleotide V- (9h. c we (a Pi‘mpvlefl
A 82. Hyperuricemia in patients with Von Gierke’s disease occurs because: 45 ‘7' k.
t " A. increased flux and oxidation of glucose 6 phosphate produces increased ~ (film-o; t C" P T“?
‘I
ribose 5 phosphates L
B. accumulation of glucose-6 phosphate decreases clearance of uric acid .4“ H M P 5" J"
C. of decreased lactate production thru anaerobic glycolysis e;
D. increased NADPH /NADP ratio allosterically activates xanthine oxidase 4‘ n low! 9. f)“ a"
Q a: . .L
A 83. Antifolate drugs e.g 5 fluoro uracil (SFU) are used in cancer thmotherapy by: $\'\houc
A A. inhibiting synthesis of DNA ." Y»; «'5. are. L
i B. alkylating bases in DNA
C. intercalating double stranded DNA
D. denatun'ng DNA r~

84. Which of the following statements is correct about gene expression? ,‘ J

replication in eukaI’Yotes is conservative «6%sz £2 I ‘ v" I . my?
D A. DNA YLani‘di‘ ‘.
B. Reverse transcn'ption in eukaryotes is possible M“,
+0»: c/v'rfl‘r‘
C. Translation is the transfer of genetic information from DNA to RNA
D. The final products of gene’expression are always proteins

UST-FMS MEDICAL BOARD REVIEW 2017 Page 10 of 12

r85. 54“ ridia‘nge In DNA dUe to a point mutation m
not cause any phenotyplc change in
terms of the" protein synthesimd beCause Of this ro 'rtyaY c
9
de:
- ‘ P De ‘ or haracterlstlc of the genetic co
1 A. Unmmy
5’" 7 5.“- * "' ,7" ‘- ’1' 3 Um,“ I! (“9.
3- Memracy
'1
D. Unambiguous

C, 86. Post Transcriptional modifications include which of the following

:
A. removal of exons 1’ 'i i am" .2
8. addition of poly A tail to the 5’ end of mRNA» “:3 ’ p r c.‘
C. 5’ end capping of mRNA with methyguanosine
D.additionofhistones.. zhw‘ I, (
a,» “14
l
40 DNAowW/W“
,r 87. The Lac operon model of gene expression exhibits a type of regulation by:
K“ A. induction -'
B. attenuation
C. co-repression
C. co-induction

88. True of the promoter region of a gene: V” “"‘m ‘9'

A. codes for structural or functional proteins \ ~ i“. (9 Row
B. the start of translation ' " _ 1' ' (m. i . H00 M g
C. site where RNA polymerase binds . U“
D. termination site of transcription AJ‘

\ 89. When the codon AUG is encountered, which of the following takes place during gene
Ger
xpression?
A. replication takes place . . " ‘
B. the first amino acid to
is brought the ribosome for translation Ml ‘ U“ l I who“ M
C. peptide bond formation takes place
D. release of the synthesized protein

A 90. Type of mutation occurs when an adenine base is replaced by a guanine

A Transition
t
8 Transversion
C. Transformation — remix: {:4 Shut mwryt‘V" "Anya; {‘4’ (AI-“J 1"" tad“ 3“
D. Transduction

C/' 91. PS3 , a tumor suppressor gene product exerts its anti-tumor effect by inhibiting
A DNA repair . “I
B. Apoptosis - ‘3“ ' 2'; tall: {Ni ml hr N?!»
4’

C. Cell cycle progression ‘-

D. Photolyase - ygipw‘ r gain!“
\.
A 92. Serum differs from plasma in that serum:
A. is devoid of clotting factors
B. is highly colored in appearance
C. contains red blood cells and other cellular elements
D. is an ultrafiltrate of blood
1.
ri 93. Which of the following is true of hemoglobin? 3‘.
\fi
E D A. a conjugated protein with heme as prosthetic group ‘ . ‘
’ 8. central iron in the fern'c state 6h».- Afi" Tf‘fit‘w Wm ( that a “in” ' "
C. classified as a protoporphyn’n type I List 11),: L‘-
D. a protein that exists in a tertiary level of structure {Pauli i .
O

UST-FMS MEDICAL BOARD REVIEW 2017 Page 11 of 12

 94. Hemoglobin as compared to myoglobin;
\/ A. Hemoglobin has a higher affinity to oxygen
‘ B. Binds to oxygen non cooperatively .
C. has a lower p50 value v s . NW,» 4,11.

v
D. Oxygen dissociation curve is sigmo’ltlal irf shape

(J 95. Which of the following corresponds to shift of Hemoglobin-oxygen dissociation curve to the
right:
A. pH increases
B. stabilization of the R state of Hemoglobin
C. binding of 2,3 bisphosphoglycerate to hemoglobin
D. affinity of hemoglobin to oxygen increases

Q) 96. Dun'ng fetoplacental circulation, the flow of oxygen is from maternal to fetal because fetal
hemoglobin: , . .-.,
A. has a higher p50 value‘than maternal hemoglobin
B. has a lower affinity to 2,3 bisphosphoglyceric acid than maternal hemoglobin
C. binds to oxygen more cooperatively than maternal hemoglobin
D. is a tetrameric molecule while maternal hemoglobin is dimeric ,1.

97. The principal form of carbon dioxide transport in the blood is:
A. Carbamino hemoglobin
.\

g/
B. Carboxyhemoglobin ' L. 43'
C. Bicarbonate ion
D. Carbon dioxide bound to albumin

LA 98. Vitamin K is important in blood coagulation by this molecular effects:

r A. Promoting synthesis of fibrinogen '
B. Gamma carboxylation of Gla-containing coagulation factors } at
C. Polymen‘zation of fibrin monomers ‘ "k
D. Transamidation of fibrin monomers

K
1 5 99 Heparin acts as an anticoagulant by:
A. Inhibiting synthesis of prothrombin
8. Its antithrombin function
C. Preventing polymerization of fibrin Tkmubs'x i'. Pm‘i'wé A» .
D. Cheiating calcium ‘."}‘t>,rr'bw. bH-h AW'W '\‘ “L r

j} 100. Vitamin C promotes wound healing by which of the following mechanisms in maturation of
i ’ collagen in connective tissues: E.
A. Promotes hydroxylation of proline and lysine residues 'Ti” You” “B”
B. Stimulates aldol condensation among tropocollagen molecules ‘
C. Promotes formation of desmosine and isodesmosine cross linkages- ( (a 2+ l h-
0. Formation of triple helix structure of collagen

----THE END---
“*Good luck on your board exam/n'at/o'n***

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