M5 F

Question 1

In the electrophoretic pattern below, which of the following is demonstrated?

M spike
Polyclonal increase
A1 anti-trypsin deficiency
B-y bridge of cirrhosis

Answer 1

B-y bridge of cirrhosis

Question 2

Which of the following is the largest contributor to plasma oncotic pressure?
Small molecules (e.g., glucose, amino acids, vitamins, etc.)
Large proteins found in plasma
Cations and artons in plasma
Red blood cells white blood cells

Answer 2

Large proteins found in plasma

Question 3

Which of the following best explains nitrogen balance?
Positive nitrogen balance is an anabolic state that exists when nitrogen intake exceeds nitrogen output.
Greater intake of nitrogen than their loss as net protein synthesis proceeds is common among pregnant women, and adults recovering from a major illness.
Excessive tissue destruction is a catabolic state that is characterized by more nitrogen elimination.
Autosomal pathway degrades extracellular and some intracellular proteins.
1,3
1,2,3
2,4
2,3,4

Answer 3

1,2,3

Question 4

Which of the following proteins is responsible for nearly 80% of the colloid osmotic pressure of the intravascular fluid?
beta globulins
gamma globulins
albumin
alpha globulins

Answer 4

albumin

Question 5

Which of the following statements is not true?
When a person has a high BMI, their adipocytes generate more adiponectin, a hormone associated with obesity.
Fetal fibrinogen supports the placental attachment to the uterus.
Elevated values for CK, normal troponin, and normal CKMB suggest that the myocardial damage occurred more than 1 day ago.
Leakage of CSF can be determined using the immunological marker B-trace protein in the blood.
1,2,3,4
2,3,4
1,2,3
1,3,4

Answer 5

1,2,3

Question 6

Which of these refers to chemical bonds that are established when an amino acid’s carboxyl group is attached to the amino group of another amino acid?
Hydrogen bond
Peptide bond
lonic bond
Glycosidic bond

Answer 6

Peptide bond

Question 7

Maple Syrup Urine Disease is associated with the absence or lack of which of the following enzymes?
a-ketoacid decarboxylase
Phenylalanine hydroxylase
Isovaleryl-CoA dehydrogenase
Homogentisate oxidase

Answer 7

a-ketoacid decarboxylase

Question 8

MSUD is characterized by which of the following urinary amino acids?
Leucine, Isoleucine, & Valine
Cystine & cysteine
Phenylalanine
Tyrosine

Answer 8

Leucine, Isoleucine, & Valine

Question 9

A 75-year-old patient staying in a nursing home had a blood extraction laboratory testing revealing elevated Tau protein and suppressed amyloid Beta 42. How would you interpret these results?
The patient is not suffering from Alzheimer’s disease, no further testing is needed.
The patient’s dementia is most likely due to Alzheimer’s disease, additional testing should be done.
The dementia is more likely due to a cause other than Alzheimer’s disease, further testing should be requested.
The patient is definitely suffering from Alzheimer’s disease, and the results should be immediately reported to the physician.

Answer 9

The patient’s dementia is most likely due to Alzheimer’s disease, additional testing should be done.

Question 10

Which of the following hormones aids in controlling protein catabolism?
Insulin
Testosterone
Glucagon
Growth Hormone

Answer 10

Glucagon

Question 11

Which of the following statements best explains why Cystatin C is regarded as a new sensitive endogenous serum indicator for glomerular filtration rate?
It is an adhesive glycoprotein synthesized in the liver hepatocytes that strengthens the nephrons.
The glomerulus freely filters it, and the proximal tubular cells almost entirely reabsorb and catabolize cystatin C.
It is composed of an N-terminal collagen-like domain & a C-terminal globular domain that helps the kidney to perform its filtering system.
It functions as a protease inhibitor and is not dependent on muscle mass, gender, age, or ethnicity to protect the kidney.

Answer 11

The glomerulus freely filters it, and the proximal tubular cells almost entirely reabsorb and catabolize cystatin C.

Question 12

Which of the following conditions indicate/s a negative nitrogen balance?
1. malnutrition
2. convalescence from major illness
3. extensive burns
4. massive blood loss
1,2,4
1,2,3
1,3,4
2,3,4

Answer 12

1,3,4

Question 13

Which of the following is a glycoprotein that transports iron in the bloodstream and delivers it to various tissues?
troponin
transferrin
immunoglobulin
myoglobin

Answer 13

transferrin

Question 14

Which of the following is an example of transport proteins?
Dehydrogenase
Immunoglobulin
Myoglobin
Hemoglobin

Answer 14

Hemoglobin

Question 15

How would you interpret the result of a patient with an increased concentration of cross-linked C telopeptide?
There is decreased bone turnover rate such as in menopausal and pregnant women.
Calcium is released from bone tissue to the circulation in response to the rapid osteoclasts breakdown.
There is suppressed bone resorption to promote the movement of minerals from the bone marrow to the circulation.
There is an effective response to antiresorptive therapy which helps in the restoration of bones.

Answer 15

Calcium is released from bone tissue to the circulation in response to the rapid osteoclasts breakdown.

Question 16

The presence of Bence Jones protein is an indicator of which disease?
Multiple Myeloma
Diabetes
Nephritis
Nephrotic Syndrome

Answer 16

Multiple Myeloma

Question 17

In the direct method for the measurement of globulin levels, which amino acid reacts with glyoxylic acid to produce a purple color?
methionine
tyrosine
Tryptophan
Threonine
arginine

Answer 17

Tryptophan

Question 18

Which of the following is the screening test for amino acid analysis?
TLC
Electrophoresis
HPLC
MS/MS

Answer 18

TLC

Question 19

Which of the following statements describes the fibrous proteins?
1. form long protein filaments or subunits
2. asymmetrical and usually inert
3. symmetrical
4. soluble in water
5. water insoluble
1,2,4
1,3,4
1,2,5
1,3,5

Answer 19

1,2,5

Question 20

Where does protein digestion begin?
Duodenum
Mouth
Stomach
Liver

Answer 20

Stomach

Question 21

A 32-year-old male comes to a physician complaining of joint pains and pigmentation of the sclera of his eyes. Upon examination in the laboratory, his urine turned black upon the addition of ferric chloride. Which aminoacidopathy is strongly associated with the patient’s condition?
Maple Syrup Urine Disease
Citrullinemia
Alkaptonuria
Isovaleric acidemia

Answer 21

Alkaptonuria

Question 22

All of the following statements about the Biuret Method are correct EXCEPT?
It is the IFCC-recommended method for protein determination
Amino acids & dipeptides will form a violet-colored chelate with this method.
The absorbance of the colored chelate formed is measured at 540 nm.
A blue-colored solution indicates a negative biuret test.

Answer 22

Amino acids & dipeptides will form a violet-colored chelate with this method.

Question 23

Correctly arrange the following steps involved in the digestion of proteins.
1. Endopeptidases cleave protein in their internal sites and exopeptidases cleave one AA from the carboxyl terminus of the polypeptide
2. Secretin hormone stimulate the pancreas to produce protein-free electrolyte solution rich in bicarbonate
3. Breaking down of proteins into large polypeptides
4. Releases proteolytic enzymes by the pancreas once chyme reaches the duodenum
5. Release of pepsin and pepsinogen activation by stimulation of pepsin and gastric acidity
6. Gastrin hormone stimulates the secretion of pepsinogen and HCI
3,4,6, 5, 2,1
5,6,3,4,1,2
1,2,5,6,3,4
6,2,3,5,4,1

Answer 23

5,6,3,4,1,2

Question 24

Which of the following is the major contributory factor to why amino acids are uniquely different from each other?
The R-group is attached to its central alpha carbon.
The amino groups are removed from them and transferred to acceptor keto-acids.
The ability of some amino acids that can be both ketogenic and glucogenic.
Their release from the normal breakdown of body proteins.

Answer 24

The R-group is attached to its central alpha carbon.

Question 25

What precipitation reagent is used to detect albumin, globulins, and Bence-Jones proteins at low concentrations, and is the differential screening urine protein test for monoclonal light chain diseases?
Benzethonium
SSA
None of the choices is correct.
TCA

Answer 25

None of the choices is correct.

Question 26

Which of the following is true regarding Type 1 Citrullinemia?
1. It results in excessive accumulation of nitrogen
2. It is caused by a deficiency or absence of the enzyme argininosuccinate synthetase
3. It caused by mutations in the SLC25A13 gene
4. It is caused by a lack the enzyme argininosuccinate acid lyase
1,2
1
1,2,3
1,3,4

Answer 26

1,2

Question 27

Which of the following statements is incorrect?
1. Deaminase catalyzes the removal of an amino group from a molecule, this process happens in the human liver.
2. Alanine are non-essential glucogenic amino acids that are converted to pyruvate through the addition of an amino group.
3. Polypeptides are linear polymers composed of amino acids linked together by peptide bonds, this polymerization is a hydrolytic reaction.
4. Leucine and lysine are essential amino acids that can generate ketone bodies
2,3
1,4
1,2,3
2,3,4

Answer 27

1,2,3

Question 28

Which of the following is an abnormal cerebrospinal fluid (CSF) finding?
A protein level of less than 0.5 g/L
A glucose level that is less than 50% of the plasma glucose level
A cell concentration of 0-5 cells/μL
All of the choices is correct.

Answer 28

A protein level of less than 0.5 g/L

Question 29

Doctor Ho ordered a Guthrie test for a microcephalic infant to check for a genetic disorder related to an amino acid disorder. Upon testing the infant’s blood on a filter paper on agar plates with Bacillus subtilis, a bacterial growth with a halo is seen surrounding the filter paper fifteen minutes later. To confirm the diagnosis, Dr. Ho ordered the sample to be run with HPLC and found out that the patient has a markedly increased phenylalanine blood concentration. Which of the following statements best describes the condition of the infant?
The patient has PKU due to the absence of PAH, resulting in an increased phenylalanine concentration in the blood.
A positive Guthrie test and confirmed HPLC test indicate MSUD due to PAH deficiency. Hence, phenylalanine will be deposited in the patient’s blood.
The Guthrie test is used to screen patients’ blood for ketones and phenylalanine, while HPLC is the gold standard for quantifying ketones and phenylalanine concentrations in the blood.
B and C are correct

Answer 29

The patient has PKU due to the absence of PAH, resulting in an increased phenylalanine concentration in the blood.

Question 30

The Henderson Hasselbalch equation explains the relationship between what constants?
pH and pKa
POH and pKa
pH and pOH
pH and log pKa

Answer 30

pH and pKa