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EXAMINATION OCTOBER 2024 (SUPPLEMENTARY EXAM)
FIRST MBBS
BIO-CHEMISTRY (PAPER - I) (NEW)- LEVEL 3
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[Time: As Per Schedule][Max. Marks: 100]
Instructions:
Seat No:
1. Fill up strictly the following details on your answer book
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a. Name of the Examination : FIRST MBBSb. Name of the Subject : BIO-CHEMISTRY (PAPER - I) (NEW) -
LEVEL 3
c. Subject Code No : 2406000101030701
2. Sketch neat and labelled diagram wherever necessary.
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3. Figures to the right indicate full marks of the question.4. All questions are compulsory.
Student's Signature
Section A
Q.1 Multiple choice questions. (20 out of 20)
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20x1=201. A 42 year old obese man admitted in emergency due recurrent
abdominal pain. Ultrasonographic examination revealed the presence
of numerous gall bladder stones. Initially he was treated with
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chenodeoxy cholic acid. The rational for this initial treatment is thatthis compound:
a) Inhibits Cholesterol synthesis
b) Interferes with the enterohepatic circulation.
c) Inhibits bile acid synthesis
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d) Increases cholesterol solubility in bile2. A 9-year young girl had a history of abdominal pain. One day due to
severe pain she was taken to tertiary care health center. After clinical
examination, blood was drawn, and the plasma appeared milky, with
the triacylglycerol level >1500 mg/dl (normal levels up to 150
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mg/dl). Which of the following proteins most likely to be deficient inthis patient.
a) Apoprotein C-II
c) Apoprotein B-48
b) Apoprotein B-100
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d) Apoprotein C-I3. Na+- glucose transport is an example of
a) Facilitated diffusion
c) Primary active transport
b) Secondary active transport
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d) Secondary passive transport2406000101030701
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4. Which of the following has strongest tendency to gain electrons?
a) Oxygen
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c) FADb) Coenzyme Q
d) Cytochrome c
5. A shift in oxygen dissociation curve to the left can occur due to
a) Metabolic alkalosis
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c) Diabetes mellitusb) Anemia
d) Ascending to high altitudes
6. All of the following increases fatty acid synthesis, EXCEPT
a) Phosphorylation of Acetyl CoA carboxylase
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b) High level of ATPc) High level of Acetyl CoA
d) Insulin
7. Which of the following diseases results from deficient production of
free radicals?
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a) Alzheimer's disease c) Amyotrophic lateral sclerosisb) Chronic glomerulonephritis d) Chronic granulomatous disease
8. Which one of the reactions listed replenishes a TCA cycle
intermediate?
a) Heme Synthesis
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c) Transamination of oxaloacetateb) Carboxylation of pyruvate d) carboxylation of acetyl CoA
9. A firefighter is brought to the emergency room (ER) from the scene
of a fire complaining of headaches, weakness, confusion, and
difficulty in breathing. His skin and mucous membranes appear very
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pink. The causative agent of these symptoms inhibits electrontransport and oxidative phosphorylation by which one of the
following mechanisms?
a) Uncoupling of electron transport and phosphorylation
b) Combining with NADH dehydrogenase
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c) Combining with coenzyme Qd) Combining with cytochrome oxidase
10. What is true about Basal Metabolic rate (BMR)?
a) Increase in old age
c) Increased during exercise
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b) Similar for males and femaled) low in hyperthyroidism
11. A 25-year-old male is treated with an antibiotic for a urinary tract
infection. A week later he presents to the emergency department with
jaundice and complaints of dark urine. His past medical history is
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unremarkable Which of the following test will confirm thediagnosis?
a) Sickling test.
c) Hb electrophoresis
b) G6PD levels in RBCs d) Pyruvate Kinase levels in RBCs
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12. If a person had not eaten for a week, other than drinking alcohol, the
disruption in the glucose-alanine cycle is occurring at which one of
the following steps?
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a) Pyruvate to oxaloacetate in the liverb) Pyruvate to alanine in the muscle
c) PEP to 2-phosphoglycerate in the liver
d) Alanine to pyruvate in the liver
13. A man presents to the ER with an elevated temperature, sweats, and
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increased rate of breathing. He had been spraying insecticide andaccidentally inhaled some of the poison. Using the insecticide on
cultured cells, it was demonstrated that the rate of oxygen
consumption by the cells was much greater than in the absence of the
compound. This drug is acting most like which one of the following?
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a) Carbon monoxidec) Rotenone
b) Dintrophenol
d) Cyanide
14. A medical student in exam hall begins nervously hyperventilating
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and then faints. You make him breath in a paper bag and he recovers.If you have drawn and analyze the blood sample when he was fainted
you would have expected to see
a) Decreased pH, Decreased blood pCO2
b) Increased pH, Increased blood pCO2
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c) Increased pH, Decreased blood pCO2d) Decreased pH, Increased blood pCO2
15. A 50-years old female obese was recently diagnosed with coronary
artery disease was advised to increase green leafy vegetables intake
in her diet. All of the following are the beneficial effects of that diet,
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EXCEPTa) Dietary fibers increase glycemic index.
b) Dietary fibers decrease absorption of bile acids and increase
production of bile acids.
c) Sitosterol present in the diet decreases cholesterol absorption
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d) Dietary fibers retain water in feces and increase stomach fullness.16. True about Iron absorption are all EXCEPT
a) Patients are advised to take iron tablet with lemon water
b) Hepcidin will inhibit Divalent Metal Ion transporter 1 on luminal
surface of intestinal mucosal cells
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c) Patients are advised not to take iron tablet with glass of milk.d) In the blood iron is re-oxidize to ferric state by ceruloplasmin.
17. False statement about ion channels is
a) Voltage gated calcium channels are responsible for release of
acetyl choline from nerve endings.
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b) Amelogenin, a calcium channel opens in phosphorylated state isuseful in formation of calcium hydroxyapatite crystals.
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c) A ligand gated Sodium channel is responsible for generation of
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action potential in postsynaptic nerves.d) Voltage gated calcium channels remove cytosolic calcium and
maintain low cytosolic calcium levels in muscles.
18. In individuals with iodine deficiency, which one of the following is
most likely?
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a) TSH levels are elevated and directly stimulate growth of thethyroid gland to a very large size.
b) Synthesis of the Na+, K+-ATPase is increased.
c) Mono- and di-iodinated thyroid hormone molecules are produced
and elevated levels of these derivatives compensate for the
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deficiency.d) Tissue utilization of oxygen is increased.
19. In Wilson's disease
a) Copper fails to be excreted in the bile
b) Copper level in plasma is decreased
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c) Ceruloplasmin level is increasedd) Intestinal absorption of copper is decreased
20. All are true about regulation of sodium and water balance, EXCEPT
a) Hypovolemia stimulates thirst
b) Expansion of ECF inhibits aldosterone secretion
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c) Hypo-osmolality stimulates ADH secretiond) Low blood pressure stimulates Aldosterone secretion
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Section B
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Q.2 Long Answer Questions (2 out of 3)
2x10=20
1. Enumerate the causes of fatty liver and explain how these causes lead to
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fatty liver formation (5). Explain how fatty liver progresses to cirrhosisof the liver (3). Write a note on lipotropic factors (2).
2. Describe hormonal regulation of blood glucose (3). Explain why
polyuria, polydipsia, and polyphagia are seen in diabetes mellitus (3).
Describe the biochemical basis of the formation of ketoacidosis in
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diabetes mellitus (3). How diabetic ketoacidosis differs from starvationketoacidosis (1).
3. Write a complete reaction that links glycolysis to Krebs cycle (2).
Describe the significance of the Krebs cycle in detail (8).
Q.3 Short Answer Questions (10 out of 11)
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10x2=201. Explain why excess lipoprotein (a) is atherogenic.
2. Why cataracts and hepatomegaly are seen in galactosemia?
3. Write at least four differences between hexokinase and glucokinase.
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4. Explain why fasting hypoglycemia and hyperuricemia are seen in
type-1 glycogen storage disease.
5. Draw the Cori's cycle and write its significance.
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6. Write types of vesicular transport mechanisms with suitableexamples.
7. Why are premature babies prone to acute respiratory distress
syndrome?
8. Calcium level in blood is increased by parathyroid hormone.
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Explain.9. Write the causes and clinical features of iron deficiency anemia.
10. The Rapoport-Leubering cycle is beneficial for RBCs. Justify.
11. Oral iron treatment should be supplemented with ascorbate and
tocopherol. Why?
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Section C
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Q.4
Short Answer Questions (4 out of 5)
4x5=20
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1. Describe free radical formation and its effects on our body.
2. Describe the liver function tests based on synthetic and excretory
functions.
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3. Describe phase-II detoxification reactions.4. Describe the roles and responsibilities of a physician in the health-care
system.
5. Describe digestion and absorption of fat.
Q.5 Clinical Cases (2 out of 2)
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2x10=201. A 9-month-old boy was brought to the pediatric clinic by his mother, who
was a daily labourer from a poor family in a rural area. She reported to the
attending pediatrician that he was exhausted and fatigued. When further
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enquired, she revealed that she was previously breastfeeding but had tostop to return to work. She had three more children. To feed all of them
she had to dilute her formula with water to make formula to serve all of
them. After a physical examination, he was diagnosed with Marasmus
(severe malnutrition). As per the hospital's policy, he was provided with a
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dietary kit with all the nutrients.1. Write the types of protein-energy malnutrition given by WHO. (2)
2. Enlist at least four conditions that cause protein energy malnutrition. (2)
3. Write at least four biochemical alterations of protein energy
malnutrition. (2)
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4. Explain mutual supplementation by a suitable example. (2)5. What is positive and negative nitrogen balance? Mention in which
conditions you will observe a positive nitrogen balance and which
conditions you will observe a negative nitrogen balance (2)
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[5 of 6]2. A male patient age 45 years was asked to go for an oral glucose tolerance
test (OGTT) to confirm his diabetic status. His OGTT values are given
below, go through it and answer the questions
Sample No.
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Time (minutes) S. GlucoseUrine
(both serum &
(mg/dl)
sugar
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urine)1
0 (fasting)
182
Positive
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230
250
Positive
3
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60330
Positive
4
90
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275Positive
5
120
190
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Positive1. Write instructions given to patient before undergoing OGTT? (2)
2. Write interpretation of OGTT results of this patient? (2)
3. Write normal reference range of fasting blood sugar, random blood
sugar and post- prandial blood sugar? (2)
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4. Why sugar is detected in all the urine samples? (2)5. Write the name and principle of the test by which sugar is detected
in urine. (2)
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