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5. 0 Біохімія 1




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47

A 48 year old patient complained about intense pain, slight swelling and reddening of skin

over the joints, temperature rise up to $38^oC$. Blood analysis revealed high

concentration of urates. This condition might be caused by disturbed metabolism of:

A Purines

B Collagen

C Cholesterol

D Pyrimidines

E Carbohydrates


48

A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will have

strengthened concentration in the blood serum?

A Unconjugated bilirubin

B Conjugated bilirubin

C Mesobilirubin

D Verdoglobin

E Biliverdin


49

A patient has an increased pyruvate concentration in blood. A large amount of it is

excreted with the urine. What vitamin is lacking in this patient?

A $B_1$

B $E$

C $B_3$

D $B_6$

E $B_2$


50

Ammonia is a very toxic substance, especially for nervous system. What substance takes

the most active part in ammonia detoxication in brain tissues?

A Glutamic acid

B Lysine

C Proline

D Histidine

E Alanine


51

A patient has pellagra. Interrogation revealed that he had lived mostly on maize for a long

time and eaten little meat. This disease had been caused by the deficit of the following

substance in the maize:

A Tryptophan

B Tyrosine

C Proline

D Alanine

E Histidine


52

Increased production of thyroidal hormones $T_3$ and $T_4$, weight loss, tachycardia,

psychic excitement and so on present on thyrotoxicosis. How do thyroidal hormones effect

energy metabolism in the mitochondrion of cells?

A Disconnect oxidation and oxidated phosphorylation

B Activates phosphorylation of substance

C Stops phosphorylation of substance

D Stops respiratory chain

E Activates oxidated phosphorylation


53

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?

A Transport of FFA (free fatty acids) from cytosol to the mitochondria

B Transport of FFA from fat depots to the tissues

C It takes part in one of reactions of FFA beta-oxidation

D FFA activation

E Activation of intracellular lipolysis


54

An experimantal animal that was kept on protein-free diet developed fatty liver infiltration, in

particular as a result of deficiency of methylating agents. This is caused by disturbed

generation of the following metabolite:

A Choline

B DOPA

C Cholesterol

D Acetoacetate

E Linoleic acid


55

A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found

out that the patient lived mostly on cereals and ate too little meat, milk and eggs. What

vitamin deficiency is the most evident?

A Nicotinamide

B Calciferol

C Folic acid

D Biotin

E Tocopherol


56

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:

A Conjugated bilirubin

B Unconjugated bilirubin

C Biliverdin

D Mesobilirubin

E Urobilinogen


57

A 46 year old patient applied to a doctor complaining about joint pain that becomes

stronger the day before weather changes. Blood examination revealed strengthened

concentration of uric acid. The most probable cause of the disease is the intensified

disintegration of the following substance:

A Adenosine monophosphate

B Cytidine monophosphate

C Uridine triphosphate

D Uridine monophosphate

E Thymidine monophosphate


58

A 42-year man suffering from gout has increased level of urinary acid in the blood.

Allopurinol was prescribed to decrease the level of urinary acid. Competitive inhibitor of

what enzyme is allopurinol?

A Xanthinoxidase

B Adenosinedeaminase

C Adeninephosphoribosiltransferase

D Hypoxantinphosphoribosiltransferase

E Guaninedeaminase


59

A 38 year old patient suffers from rheumatism in its active phase. What laboratory

characteristic of blood serum is of diagnostic importance in case of this pathology?

A C-reactive protein

B Uric acid

C Urea

D Creatinine

E Transferrin


60

Patient experienced increased susceptibility of the skin to the sunlight. His urine after some

time became dark-red. What is the most likely cause of this?

A Porphyria

B Hemolytic jaundice

C Albinism

D Pellagra

E Alkaptonuria


61

A patient with serious damage of muscular tissue was admitted to the traumatological

department. What biochemical urine index will be increased in this case?

A Creatinine

B Common lipids

C Glucose

D Mineral salts

E Uric acid


62

12 hours after an accute attack of retrosternal pain a patient presented a jump of aspartate

aminotransferase activity in blood serum. What pathology is this deviation typical for?

A Myocardium infarction

B Viral hepatitis

C Collagenosis

D Diabetes mellitus

E Diabetes insipidus


63

Donor skin transplantation was performed to a patient with extensive burns. On the 8-th

day the graft became swollen and changed colour; on the 11-th day graft rejection started.

What cells take part in this process?

A T-lymphocytes

B Erythrocytes

C Basophils

D Eosinophils

E B-lymphocytes


64

A 30 y.o. woman had been ill for a year when she felt pain in the area of joints for the first

time, they got swollen and skin above them became reddened. Provisional diagnosis is

rheumatoid arthritis. One of the most probable causes of this disease is a structure

alteration of a connective tissue protein:

A Collagen

B Mucin

C Myosin

D Ovoalbumin

E Troponin


65

Autopsy of a 12-year-old girl revealed: multiple cutaneous hemmorhages (mostly into the

skin of buttocks, lower extremities), serous and mucous memrane hemmorhages, cerebral

hemmorhages. Adrenal glands show focal necrosis and massive hemmorhages; kidneys

show necrotic nephrosis, suppurative arthritis, iridocyclitis, vasculitis. What is the most

probable diagnosis?

A Meningococcemia

B Epidemic typhus

C Periarteritis nodosa

D Systemic lupus erythematosus

E Radiation sickness


66

Examination of a 27-year-old patient revealed pathological changes in liver and brain.

Blood plasma analysis revealed an abrupt decrease in the copper concentration, urine

analysis revealed an increased copper concentration. The patient was diagnosed with

Wilson’s degeneration. To confirm the diagnosis it is necessary to study the activity of the

following enzyme in blood serum:

A Ceruloplasmin

B Carbonic anhydrase

C Xanthine oxidase

D Leucine aminopeptidase

E Alcohol dehydrogenase


67

A patient complains about dyspnea provoked by the physical activity. Clinical examination

revealed anaemia and presence of the paraprotein in the zone of gamma-globulins. To

confirm the myeloma diagnosis it is necessary to determine the following index in the

patient’s urine:

A Bence Jones protein

B Bilirubin

C Haemoglobin

D Ceruloplasmin

E Antitrypsin


68

As a result of exhausting muscular work a worker has largely reduced buffer capacity of

blood. What acidic substance that came to blood caused this phenomenon?

A Lactate

B Pyruvate

C 1,3-bisphosphoglycerate

D 3-phosphoglycerate

E -


69

A patient was delivered to the hospital by an emergency team. Objectively: grave condition,

unconscious, adynamy. Cutaneous surfaces are dry, eyes are sunken, face is cyanotic.

There is tachycardia and smell of acetone from the mouth. Analysis results: blood glucose -

20,1 micromole/l (standard is 3,3-5,5 micromole/l), urine glucose - 3,5\% (standard is - 0).

What is the most probable diagnosis?

A Hyperglycemic coma

B Hypoglycemic coma

C Acute heart failure

D Acute alcoholic intoxication

E Anaphylactic shock


70

Profuse foam appeared when dentist put hydrogen peroxide on the mucous of the oral

cavity. What enzyme caused such activity?

A Catalase

B Cholinesterase

C Acetyltransferase

D Glucose-6-phosphatdehydrogenase

E Methemoglobinreductase


71

A 62 y.o. woman complains of frequent pains in the area of her chest and backbone, rib

fractures. A doctor assumed myelomatosis (plasmocytoma). What of the following

laboratory characteristics will be of the greatest diagnostical importance?

A Paraproteinemia

B Hyperalbuminemia

C Proteinuria

D Hypoglobulinemia

E Hypoproteinemia


72

A newborn child has convulsions that have been observed after prescription of vitamin

$B_6$. This most probable cause of this effect is that vitamin $B_6$ is a componet of the

following enzyme:

A Glutamate decarboxylase

B Pyruvate dehydrostase

C Netoglubarate dehydromine

D Aminolevulinate synthase

E Glycogen phosphorylase


73

Nappies of a newborn have dark spots that witness of formation of homogentisic acid.

Metabolic imbalance of which substance is it connected with?

A Thyrosine

B Galactose

C Methionine

D Cholesterine

E Tryptophane


74

Pathological changes of the liver and brain were revealed in a 27-year-old patient.The

copper concentration is abruptly decreased in blood plasma and increased in the urine.

Wilson's disease was diagnosed. Activity of what enzyme in the blood serum should be

examined to prove diagnisis?

A Ceruloplasmin

B Carboanhydraze

C Xanthioxidase

D Leucinamineopeptidaze

E Alcoholdehydrogenaze


75

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


76

An 18-year-old patient has enlarged inguinal lymphnodes, they are painless, thickened on

palpation. In the area of genital mucous membrane there is a small-sized ulcer with

thickened edges and "laquer" bottom of greyish colour. What is the most probable

diagnosis?

A Syphilis

B Tuberculosis

C Lepra

D Trophic ulcer

E Gonorrhea


77

Concentration of pyruvate is increased in the patient's blood, the most of which is excreted

with urine. What avitaminosis is observed in the patient?

A Avitaminosis $В_1$

B Avitaminosis $E$

C Avitaminosis $В_3$

D Avitaminosis $B_6$

E Avitaminosis $В_2$


78

Carnitine including drug was recomended to the sportsman for improving results. What

process is activated most of all with help of carnitine?

A Transport of fatty acids to the mitochondria

B Synthesis of steroid hormones

C Synthesis of ketone bodies

D Synthesis of lipids

E Tissue respiration


79

A patient with suspected diphtheria went through bacterioscopic examination. Examination

of throat swab revealed rod-shaped bacteria with volutin granules. What etiotropic

preparation should be chosen in this case?

A Antidiphtheric antitoxic serum

B Bacteriophage

C Diphtheria antitoxin

D Eubiotic

E Interferon


80

Patient with diabetes mellitus experienced loss of consciousness and convulsions after

injection of insulin. What is the result of biochemical blood analysis for concentration of the

sugar?

A 1,5 mmol/L

B 8,0 mmol/L

C 10,0 mmol/L

D 3,3 mmol/L

E 5,5 mmol/L


81

A woman who has been keeping to a clean-rice diet for a long time was diagnosed with

polyneuritis (beriberi). What vitamin deficit results in development of this disease?

A Thiamine

B Ascorbic acid

C Pyridoxine

D Folic acid

E Riboflavin


82

Removal of gall bladder of a patient has disturbed processes of $Ca$ absorption through

the intestinal wall. What vitamin will stimulate this process?

A $D_3$

B $PP$

C $C$

D $B_{12}$

E $K$


83

A 63-year-old woman developed signs of rheumatoid arthritis. Increase of which indicated

blood values level could be helpful in proving diagnosis?

A Additive glycosaminoglycans

B Lipoproteids

C Acid phosphatase

D General cholesterol

E R-glycosidase


84

A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and

hair, decrease in catecholamine concentration in blood. When a few drops of 5\% solution

of trichloroacetic iron had been added to the child’s urine it turned olive green. Such

alteration are typical for the following pathology of the amino acid metabolism:

A Phenylketonuria

B Alkaptonuria

C Tyrosinosis

D Albinism

E Xanthinuria


85

A patient complains of frequent diarrheas, especially after consumption of fattening food,

and of body weight loss. Laboratory examination revealed steatorrhea; hypocholic feces.

What can be the cause of this condition?

A Obturation of biliary tracts

B Mucous membrane inflammation of small intestine

C Lack of pancreatic lipase

D Lack of pancreatic phospholipase

E Unbalanced diet


86

On the empty stomach in the patients blood glucose level was 5,65 mmol/L, in an hour

after usage of sugar it was 8,55 mmol/L, in a 2 hours - 4,95 mmol/L. Such indicators are

typical for:

A Healthy person

B Patient with hidden diabetes mellitus

C Patient with insulin-dependent diabetes mellitus

D Patient with non-insulin dependent diabetes mellitus

E Patient with tireotoxicosis


87

A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess

of glycogene. 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


88

A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination

revealed renal calculi. The most probable cause of calculi formation is the strengthened

concentration of the following substance:

A Uric acid

B Cholesterol

C Bilirubin

D Urea

E Cystine


89

A 65-year-old suffering from the gout man complains of the pain in the kidney's region. On

ultrasonic examination the renal calculi were revealed. As a result of what process were

they formed?

A Decay of purine nucleotides

B Protein catabolism

C Ornithine cycle

D Heme decay

E Restoration of cysteine


90

A 5-year-old child who often fells ill with respiratory diseases has eczematous appearances

after consumption of some food products, tendency to prolonged course of inflammatory

processes. What kind of diathesis can be suspected in this case?

A Exudative-catharral

B Hemmorhagic

C Arthritism

D Lymphohypoplastic

E Asthenic

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