Krok 1 Medicine

5.0 Biochemistry

1
Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination usually
reveals hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme:
A Glycogen phosphorylase
B Glucose 6-phosphate dehydrogenase
C α-amylase
D γ-amylase
E Lysosomal glycosidase

2
Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination usually
reveals hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme:
A Glycogen phosphorylase
B Glucose 6-phosphate dehydrogenase
C α-amylase
D γ-amylase
E Lysosomal glycosidase

3
A 46-year-old female patient has continuous history of progressive muscular (Duchenne's) dystrophy.
Which blood enzyme changes will be of diagnostic value in this case?
A Creatine phosphokinase
B Lactate dehydrogenase
C Pyruvate dehydrogenase
D Glutamate dehydrogenase
E Adenylate cyclase

4
Protective function of saliva is based on several mechanisms, including the presence of enzyme that
has bactericidal action and causes lysis of complex capsular polysaccharides of staphylococci and
streptococci. Name this enzyme:
A Lysozyme
B α-amylase
C Oligo-1,6-glucosidase
D Collagenase
E β-glucuronidase

5
Protective function of saliva is based on several mechanisms, including the presence of enzyme that
has bactericidal action and causes lysis of complex capsular polysaccharides of staphylococci and
streptococci. Name this enzyme:
A Lysozyme
B α-amylase
C Oligo-1,6-glucosidase
D Collagenase
E β-glucuronidase
 6
In the process of hemoglobin catabolism iron is released and then as a part of special transport protein
is returned to the bone marrow, to be used again for hemoglobin synthesis. Name this transport
protein:
A Transferrin
B Transcobalamin
C Haptoglobin
D Ceruloplasmin
E Albumin

7
The process of metabolism in the human body produces active forms of oxygen, including superoxide
anion radical О2-. This anion is inactivated by the following enzyme:
A Superoxide dismutase
B Catalase
C Peroxidase
D Glutathione peroxidase
E Glutathione reductase

8
Malaria is treated with structural analogs of vitamin B2 (riboflavin). These drugs disrupt the synthesis
of the following enzymes in plasmodium:
A FAD-dependent dehydrogenase
B Cytochrome oxidase
C Peptidase
D NAD-dependent dehydrogenase
E Aminotransferase

9
A pregnant woman with several miscarriages in anamnesis is prescribed a therapy that includes
vitamin preparations. What vitamin facilitates carrying of a pregnancy?
A Alpha-tocopherol
B Folic acid
C Cyanocobalamin
D Pyridoxal phosphate
E Rutin

10
Collagenosis patients typically present with connective tissue destruction processes. The presence of
these processes can be confirmed by the increase in:
A Blood oxyproline and oxylysine
B Blood creatine and creatinine
C LDH-isoenzyme activity in the blood
D Transaminase activity in the blood
E Blood urates

11
A 53-year-old male patient is diagnosed with Paget's disease. The concentration of oxyproline in daily
urine is sharply increased, which primarily means intensified disintegration of:
A Collagen
B Keratin
C Albumin
D Hemoglobin
E Fibrinogen

12
A 53-year-old man is diagnosed with Paget's disease. Concentration of oxyproline in daily urine is
sharply increased, which primarily means intensified disintegration of:
A Collagen
B Keratin
C Albumin
D Hemoglobin
E Fibrinogen

13
A child with point mutation presents with absence of glucose 6-phosphatase, hypoglycemia, and
hepatomegaly. What pathology are these signs characteristic of?
A Von Gierke's disease (Glycogen storage disease type I)
B Cori's disease (Glycogen storage disease type III)
C Addison's disease (Primary adrenal insufficiency)
D Parkinson's disease
E McArdle's disease (Glycogen storage disease type V)

14
Untrained people often have muscle pain after sprints as a result of lactate accumulation. This can be
caused by intensification of the following biochemical process:
A Glycolysis
B Gluconeogenesis
C Pentose phosphate pathway
D Lipogenesis
E Glycogenesis

15
Blood test of the patient revealed albumine content of 20 g/l and increased activity of lactate
dehydrogenase isoenzyme 5 (LDH5). These results indicate disorder of the following organ:
A Liver
B Kidneys
C Heart
D Lungs
E Spleen

16
A patient presents with acute attack of cholelithiasis. Laboratory examination of the patient's feces
will show the following in this case:
A Negative reaction to stercobilin
B Positive reaction to stercobilin
C Connective tissue
D Partially digested cellulose
E Starch granules
 17
Cyanide is a poison that causes instant death of the organism. What enzymes found in mitochondria
are affected by cyanide?
A Cytochrome oxidase (aa3)
B Flavin enzymes
C Cytochrome В5
D NAD+-dependent dehydrogenase
E Cytochrome P-450

18
Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL
anti-atherogenic action?
A They remove cholesterol from tissues
B They supply tissues with cholesterol
C They are involved in the breakdown of cholesterol
D They activate the conversion of cholesterol to bile acids
E They promote absorption of cholesterol in the intestine

19
Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL
anti-atherogenic action?
A They remove cholesterol from tissues
B They supply tissues with cholesterol
C They are involved in the breakdown of cholesterol
D They activate the conversion of cholesterol to bile acids
E They promote absorption of cholesterol in the intestine

20
A 46-year-old woman suffering from cholelithiasis developed jaundice. Her urine became dark
yellow, while feces are light-colored. What substance will be the most increased in concentration in
the blood serum in this case?
A Conjugated bilirubin
B Unconjugated bilirubin
C Biliverdine
D Mesobilirubin
E Urobilinogen

21
An infant born prematurely 2 days ago presents with yellow coloring of skin and mucosa. Such a
condition in the infant is caused by temporary deficiency of the following enzyme:
A UDP-glucuronyl transferase
B Aminolevulinate synthase
C Heme oxygenase
D Heme synthetase
E Biliverdine reductase

22
It has been found out that one of a pesticide components is sodium arsenate that blocks lipoic acid.
Which enzyme activity is impaired by this pesticide?
A Pyruvate dehydrogenase complex
B Microsomal oxidation
C Methemoglobin reductase
D Glutathione peroxidase
E Glutathione reductase

23
It has been determined that one of a pesticide components is sodium arsenate that blocks lipoic acid.
Enzyme activity can be impaired by this pesticide. Name this enzyme:
A Pyruvate dehydrogenase complex
B Microsomal oxidation
C Methemoglobin reductase
D Glutathione peroxidase
E Glutathione reductase

24
It has been found out that one of a pesticide components is sodium arsenate that blocks lipoic acid.
Which enzyme activity is impaired by this pesticide?
A Pyruvate dehydrogenase complex
B Microsomal oxidation
C Methemoglobin reductase
D Glutathione peroxidase
E Glutathione reductase

25
A 50-year-old woman diagnosed with cardiac infarction has been delivered into an intensive care
ward. What enzyme will be the most active during the first two days?
A Aspartate aminotransferase
B Alanine aminotransferase
C Alanine aminopeptidase
D LDH4
E LDH5

26
A 42-year-old man with gout presents with high content of uric acid in blood. The patient was
prescribed allopurinol to lower the concentration of uric acid. Allopurinol is a competitive inhibitor
of the following enzyme:
A Xanthine oxidase
B Adenosine deaminase
C Adenine phosphoribosyltransferase
D Hypoxanthine phosphoribosyltransferase
E Guanine deaminase

27
A traumatology unit received a patient with crushed muscular tissue. What biochemical indicator of
urine will be raised in this case?
A Creatinine
B Total lipids
C Glucose
D Mineral salts
E Uric acid
 28
A 30-year-old woman first developed pain, swelling, and skin redness in the area of joints about a
year ago. Provisional diagnosis is rheumatoid arthritis. One of the likely causes of this disease is
change in the structure of the following connective tissue protein:
A Collagen
B Mucin
C Myosin
D Ovalbumin
E Troponin

29
A patient consulted a doctor with complaints of dyspnea occurring after physical exertion. Physical
examination revealed anemia, paraprotein was detected among gamma globulins. What value should
be determined in the patient's urine to confirm the diagnosis of myeloma?
A Bence Jones protein
B Bilirubin
C Hemoglobin
D Ceruloplasmin
E Antitrypsin

30
A dry-cleaner's worker has been found to have hepatic steatosis. This pathology can be caused by
disruption of synthesis of the following substance:
A Phosphatidylcholine
B Tristearin
C Urea
D Phosphatidic acid
E Cholic acid

31
A drycleaner's worker has been found to have hepatic steatosis. This pathology can be caused by the
disruption of synthesis of the following substance:
A Phosphatidylcholine
B Tristearin
C Urea
D Phosphatidic acid
E Cholic acid

32
A drycleaner's worker has been found to have hepatic steatosis. This pathology can be caused by the
disruption of synthesis of the following substance:
A Phosphatidylcholine
B Tristearin
C Urea
D Phosphatidic acid
E Cholic acid

33
A 16-year-old adolescent is diagnosed with hereditary UDP (uridine diphosphate)
glucuronyltransferase deficiency. Laboratory tests revealed hyperbilirubinemia caused mostly by
increased blood content of the following substance:
A Unconjugated bilirubin
B Conjugated bilirubin
C Urobilinogen
D Stercobilinogen
E Biliverdine

34
A 16-year-old adolescent is diagnosed with hereditary UDP (uridine diphosphate)
glucuronyltransferase deficiency. Laboratory tests revealed hyperbilirubinemia caused mostly by
increased blood content of the following substance:
A Unconjugated bilirubin
B Conjugated bilirubin
C Urobilinogen
D Stercobilinogen
E Biliverdine

35
During removal of the hyperplastic thyroid gland of a 47-year-old woman, the parathyroid gland was
damaged. One month after the surgery the patient developed signs of hypoparathyroidism: frequent
convulsions, hyperreflexia, laryngospasm. What is the most likely cause of the patient's condition?
A Hypocalcemia
B Hyponatremia
C Hyperchlorhydria
D Hypophosphatemia
E Hyperkalemia

36
During removal of the hyperplastic thyroid gland of a 47-year-old woman, the parathyroid gland was
damaged. One month after the surgery the patient developed signs of hypoparathyroidism: frequent
convulsions, hyperreflexia, laryngospasm. What is the most likely cause of the patient's condition?
A Hypocalcemia
B Hyponatremia
C Hyperchlorhydria
D Hypophosphatemia
E Hyperkalemia

37
Prior to glucose utilization in cells it is transported inside cells from extracellular space through
plasmatic membrane. This process is stimulated by the following hormone:
A Insulin
B Glucagon
C Thyroxin
D Aldosterone
E Adrenalin

38
After implantation of a cardiac valve a young man systematically takes indirect anticoagulants. His
state was complicated by hemorrhage. What substance content has decreased in blood?
A Prothrombin
B Haptoglobin
C Heparin
D Creatin
E Ceruloplasmin

39
Feces of a patient contain high amount of undissociated fats and have grayish-white color. Specify the
cause of this phenomenon:
A Obturation of bile duct
B Hypoactivation of pepsin by hydrochloric acid
C Hypovitaminosis
D Enteritis
E Irritation of intestinal epithelium

40
A 46-year-old female patient consulted a doctor about pain in the small joints of the upper and lower
limbs. The joints are enlarged and shaped like thickened nodes. Serum test revealed an increase in
urate concentration. This might be caused by a disorder in metabolism of:
A Purines
B Carbohydrates
C Lipids
D Pyrimidines
E Amino acids

41
A 7-year-old child in the state of allergic shock caused by a bee sting has been delivered into an
emergency ward. High concentration of histamine was observed in blood. Production of this amine
was the result of the following reaction:
A Decarboxylation
B Hydroxylation
C Dehydrogenation
D Deaminization
E Reduction

42
To an emergency ward a 7-year-old child was delivered in the condition of allergic shock caused by a
bee sting. High concentration of histamine is observed in blood. Production of this amine is the result
of the following reaction:
A Decarboxylation
B Hydroxylation
C Dehydrogenation
D Deaminization
E Reduction

43
A 65-year-old man suffering from gout complains of pain in his kidneys. Ultrasonic examination
revealed kidney stones. A certain substance in increased concentration can cause kidney stones
formation. Name this substance:
A Uric acid
B Cholesterol
C Bilirubin
D Urea
E Cystine
 44
Nitrogen is being excreted from the body mainly as urea. When activity of a certain enzyme in the
liver is low, it results in inhibition of urea synthesis and nitrogen accumulation in blood and tissues.
Name this enzyme:
A Carbamoyl phosphate synthetase
B Aspartate aminotransferase
C Urease
D Amylase
E Pepsin

45
Nitrogen is being excreted from the body mainly as urea. When activity of a certain enzyme in the
liver is low, it results in inhibition of urea synthesis and nitrogen accumulation in blood and tissues.
Name this enzyme:
A Carbamoyl phosphate synthetase
B Aspartate aminotransferase
C Urease
D Amylase
E Pepsin

46
People, who for a long time remained in hypodynamic state, develop intense pain in the muscles after
a physical exertion. What is the most likely cause of this pain?
A Accumulation of lactic acid in muscles
B Intensive breakdown of muscle proteins
C Accumulation of creatinine in muscles
D Decreased content of lipids in muscles
E Increased content of ADP in muscles

47
A patient with jaundice has high total bilirubin that is mainly indirect (unconjugated), high
concentration of stercobilin in the feces and urine. The level of direct (conjugated) bilirubin in the
blood plasma is normal. What type of jaundice can be suspected?
A Hemolytic
B Parenchymal (hepatic)
C Mechanical
D Neonatal
E Gilbert's disease

48
A biochemical urine analysis has been performed for a patient with progressive muscular dystrophy.
In the given case muscle disease can be confirmed by the high content of the following substance in
urine:
A Creatine
B Porphyrin
C Urea
D Hippuric acid
E Creatinine
 49
A patient suffering from gout was prescribed allopurinol. What pharmacological property of
allopurinol provides therapeutic effect in this case?
A Competitive inhibition of xanthine oxidase
B Acceleration of nitrogen-containing substances excretion
C Acceleration of pyrimidine nucleotides catabolism
D Deceleration of pyrimidine nucleotides salvage
E Acceleration of nucleic acids synthesis

50
A patient suffers from hepatic cirrhosis. What substance excreted in urine should be analyzed to
characterize the antitoxic function of liver?
A Hippuric acid
B Ammonium salts
C Creatinine
D Uric acid
E Amino acids

51
Blood of the patients with diabetes mellitus shows increased content of free fatty acids. Name the
most likely cause of this:
A Increased activity of adipose triglyceride lipase
B Accumulation of palmitoyl-CoA in cytosol
C Activation of ketone bodies utilization
D Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis
E Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase

52
Blood of the patients with diabetes mellitus shows increased content of free fatty acids. Name the
most likely cause of this:
A Increased activity of adipose triglyceride lipase
B Accumulation of palmitoyl-CoA in cytosol
C Activation of ketone bodies utilization
D Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis
E Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase

53
Patients with bile duct obstruction typically present with inhibited blood clotting and develop
hemorrhages due to insufficient assimilation of vitamin:
AK
BA
CD
DE
EC

54
Human red blood cells contain no mitochondria. What is the main pathway for ATP production in
these cells?
A Anaerobic glycolysis
B Aerobic glycolysis
C Oxidative phosphorylation
D Creatine kinase reaction
E Cyclase reaction

55
Human red blood cells do not contain mitochondria. What is the main pathway for ATP production in
these cells?
A Anaerobic glycolysis
B Aerobic glycolysis
C Oxidative phosphorylation
D Creatine kinase reaction
E Cyclase reaction

56
During intensive muscle work there is a large amount of ammonia produced in the muscles. What
amino acid plays the main role in the transportation of ammonia to the liver and participates in
gluconeogenesis reactions?
A Alanine
B Arginine
C Lysine
D Ornithine
E Aspartate

57
Along with normal hemoglobin types there can be pathological ones in the organism of an adult.
Name one of them:
A HbS
B HbF
C HbA1
D HbA2
E HbO2

58
Along with normal hemoglobin types there can be pathological ones in the organism of an adult.
Name one of them:
A HbS
B HbF
C HbA1
D HbA2
E HbO2

59
Emotional stress causes activation of hormon-sensitive triglyceride lipase in the adipocytes. What
secondary mediator takes part in this process?
A Cyclic adenosine monophosphate
B Cyclic guanosine monophosphate
C Adenosine monophosphate
D Diacylglycerol
E Ions of Са2+
 60
A patient has been diagnosed with alkaptonuria. Choose an enzyme that can cause this pathology
when deficient:
A Homogentisic acid oxidase
B Phenylalanine hydroxylase
C Glutamate dehydrogenase
D Pyruvate dehydrogenase
E Dioxyphenylalanine decarboxylase

61
A 40-year-old woman with Cushing's disease presents with steroid diabetes. On biochemical
examination she has hyperglycemia and hypochloremia. What process activates in the first place in
such patients?
A Gluconeogenesis
B Glycogenolysis
C Glucose reabsorption
D Glucose transportation into a cell
E Glycolysis

62
A 40-year-old woman suffers from Cushing's disease - steroid diabetes. On biochemical examination
she has hyperglycemia and hypochloremia. What process activates in the first place in such patients?
A Gluconeogenesis
B Glycogenolysis
C Glucose reabsorption
D Glucose transport to the cells
E Glycolysis

63
Those organisms which in the process of evolution failed to develop protection from H2O2 can exist
only in anaerobic conditions. Which of the following enzymes can break hydrogen peroxide down?
A Peroxidase and catalase
B Oxygenase and hydroxylase
C Cytochrome oxidase, cytochrome B5
D Oxygenase and catalase
E Flavin-dependent oxidase

64
During regular check-up a child is detected with interrupted mineralization of the bones. What
vitamin deficiency can be the cause?
A Calciferol
B Riboflavin
C Tocopherol
D Folic acid
E Cobalamin

65
During regular check-up a child is determined to have interrupted mineralization of the bones. What
vitamin deficiency can be the cause?
A Calciferol
B Riboflavin
C Tocopherol
D Folic acid
E Cobalamin

66
Neutralization of xenobiotics and active endogenous metabolites often occurs via introduction of an
oxygen atom into the substrate molecule. What process occurs as the result?
A Hydroxylation
B Decarboxylation
C Transamination
D Phosphorilation
E Deaminization

67
Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as the following
process is inhibited:
A Gluconeogenesis
B Glycolysis
C Glycogenolysis
D Lipolysis
E Proteolysis

68
During intensive physical exertion, one of the energy sources for the working muscles is glucose
produced as the result of gluconeogenesis. This process is the most intensive in the following organ:
A Liver
B Brain
C Lungs
D Muscles
E Stomach

69
A 39-year-old female patient with a history of diabetes was hospitalized in a precomatose state for
diabetic ketoacidosis. This condition had been caused by an increase in the following metabolite level:
A Acetoacetate
B Citrate
C Alpha-ketoglutarate
D Malonate
E Aspartate

70
Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They change the
level of nearly all neurotransmitters in synapses, with the following neurotransmitter being the
exception:
A Acetylcholine
B Noradrenaline
C Adrenaline
D Dopamine
E Serotonin
 71
Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They change the
level of nearly all neurotransmitters in synapses, with the following neurotransmitter being the
exception:
A Acetylcholine
B Noradrenaline
C Adrenaline
D Dopamine
E Serotonin

72
Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They change the
level of nearly all neurotransmitters in synapses, with the following neurotransmitter being the
exception:
A Acetylcholine
B Noradrenaline
C Adrenaline
D Dopamine
E Serotonin

73
The key reaction of fatty acid synthesis is production of malonyl-CoA. What metabolite is the source
of malonyl-CoA synthesis?
A Acetyl-CoA
B Succinyl-CoA
C Acyl-CoA
D Malonate
E Citrate

74
Ketosis develops in the patients with diabetes mellitus, as the result of activation of fatty acids
oxidation processes. What acid-base imbalance can result from accumulation of excessive ketone
bodies in the blood?
A Metabolic acidosis
B Metabolic alkalosis
C No imbalance occurs
D Respiratory acidosis
E Respiratory alkalosis

75
Depression and emotional disturbances result from the lack of noradrenaline, serotonin, and other
biogenic amines in the brain. Their content in the synapses can be increased through administration of
antidepressants that inhibit the following enzyme:
A Monoamine oxidase
B Diamine oxidase
C L-amino acids oxidase
D D-amino acid oxidase
E Phenylalanine 4-monooxygenase

76
A patient with homogentisuria has signs of arthritis, ochronosis. In this case, the pain in the joints is
associated with the deposition of:
A Homogentisates
B Urates
C Phosphates
D Oxalates
E Carbonates

77
A hereditary disease - homocystinuria - is caused by disturbed transformation of homocysteine into
methionine. Accumulated homocysteine forms its dimer (homocystine) that can be found in urine.
What vitamin preparation can decrease homocysteine production?
A Vitamin B12
B Vitamin C
C Vitamin B1
D Vitamin B2
E Vitamin PP

78
A 2-year-old child presents with acute psychomotor retardation, vision and hearing impairment, sharp
enlargement of the liver and spleen. The child is diagnosed with hereditary Niemann-Pick disease.
What genetic defect is the cause of this disease?
A Sphingomyelinase deficiency
B Glucose 6-phosphatase deficiency
C Amylo-1,6-glucosidase deficiency
D Acid lipase deficiency
E Xanthine oxidase deficiency

79
A patient with hereditary hyperammonemia due to a disorder of ornithine cycle has developed
secondary orotaciduria. The increased synthesis of orotic acid is caused by an increase in the following
metabolite of ornithine cycle:
A Carbamoyl phosphate
B Citrulline
C Ornithine
D Urea
E Argininosuccinate

80
During hypersensitivity skin test a patient received an allergen subcutaneously, after which the patient
developed skin redness, edema, and pain due to histamine action. This biogenic amine is produced as
the result of the following transformation of histidine amino acid:
A Decarboxylation
B Methylation
C Phosphorilation
D Isomerization
E Deaminization

81
A patient presents with steatorrhea. This disorder can be linked to disturbed supply of the intestine
with the following substances:
A Bile acids
B Carbohydrates
C Tripsin
D Chymotrypsin
E Amylase

82
Cytochrome oxidase is a hemeprotein that is an end component of the mitochondrial respiratory
chain. What reaction is catalyzed with this enzyme?
A Transfer of reduced equivalents to molecular oxygen
B Cytochrome synthesis
C Transfer of reduced equivalents to ubiquinone
D Cytochrome splicing
E Adenosine triphosphate synthesis

83
A 49-year-old male patient with acute pancreatitis was likely to develop pancreatic necrosis, while
active pancreatic proteases were absorbed into the blood stream and tissue proteins broke up. What
protective factors of the body can inhibit these processes?
A α2-macroglobulin, α1-antitrypsin
B Immunoglobulin
C Cryoglobulin, interferon
D Ceruloplasmin, transferrin
E Hemoplexin, haptoglobin

84
It is known that in catecholamine metabolism a special role belongs to monoamine oxidase (MAO).
This enzyme inactivates mediators (noadrenalin, adrenalin, dopamine) by:
A Oxidative deamination
B Adjoining amino groups
C Removing methyl groups
D Carboxylation
E Hydrolysis

85
A patient, who has been subsisting exclusively on polished rice, has developed polyneuritis due to
thiamine deficiency. What substance is an indicator of such avitaminosis, when it is excreted with
urine?
A Pyruvic acid
B Malate
C Methylmalonic acid
D Uric acid
E Phenyl pyruvate

86
A patient, who has been subsisting exclusively on polished rice, has developed polyneuritis due to
thiamine deficiency. What substance is an indicator of such avitaminosis, when it is excreted with
urine?
A Pyruvic acid
B Malate
C Methylmalonic acid
D Uric acid
E Phenyl pyruvate

87
When blood circulation in the damaged tissue is restored, lactate accumulation stops and glucose
consumption decelerates. These metabolic changes are caused by activation of the following process:
A Aerobic glycolysis
B Anaerobic glycolysis
C Lipolysis
D Gluconeogenesis
E Glycogen biosynthesis

88
When blood circulation in the damaged tissue is restored, lactate accumulation stops and glucose
consumption decelerates. These metabolic changes are caused by activation of the following process:
A Aerobic glycolysis
B Anaerobic glycolysis
C Lipolysis
D Gluconeogenesis
E Glycogen biosynthesis

89
It is known that pentose-phosphate pathway actively functions in the erythrocytes. What is the main
function of this metabolic pathway in the erythrocytes?
A Counteraction to lipid peroxidation
B Activation of microsomal oxidation
C Neutralization of xenobiotics
D Oxidation of glucose into lactate
E Increase of lipid peroxidation

90
A sick child presents with high content of phenyl pyruvate in urine (normally it is practically absent).
Blood phenylalanine level is 350 mg/L (norm - 15 mg/L). What disease are these symptoms
characteristic of?
A Phenylketonuria
B Albinism
C Tyrosinosis
D Alkaptonuria
E Gout

91
In investigation of serum proteins various physical and physicochemical methods can be used. In
particular, serum albumins and globulins can be separated by the method of:
A Electrophoresis
B Polarography
C Dialysis
D Spectrography
E Refractometry

92
A 4-year-old child with hereditary renal lesion has signs of rickets; vitamin D concentration in blood
is normal. What is the most probable cause of rickets development?
A Impaired synthesis of calcitriol
B Increased excretion of calcium
C Hyperfunction of parathyroid glands
D Hypofunction of parathyroid glands
E Lack of calcium in food

93
Inherited diseases, such as mucopolysaccharidoses, manifest in metabolic disorders of connective
tissue, bone and joint pathologies. The sign of this disease is the excessive urinary excretion of the
following substance:
A Glycosaminoglycans
B Amino acids
C Glucose
D Lipids
E Urea

94
Diseases of respiratory system and circulatory disorders impair the transport of oxygen, thus causing
hypoxia. Under these conditions the energy metabolism is carried out by anaerobic glycolysis. As a
result, the following substance is generated and accumulated in blood:
A Lactic acid
B Pyruvic acid
C Glutamic acid
D Citric acid
E Fumaric acid

95
A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine citrulline
are very high. What metabolic process is disturbed?
A Ornithine cycle
B Tricarboxylic acid cycle
C Glycolysis
D Gluconeogenesis
E Cori cycle

96
Leading symptoms of primary hyperparathyroidism are osteoporosis and renal damage resulting in
urolithiasis development. What substances are the basis of uroliths in such cases?
A Calcium phosphate
B Uric acid
C Cystine
D Bilirubin
E Cholesterol

97
Patients with erythropoietic porphyria (Gunther's disease) have teeth that fluoresce with bright red
color when subjected to ultraviolet radiation; their skin is light-sensitive, urine is red-colored. What
enzyme can cause this disease, when it is deficient?
A Uroporphyrinogen III cosynthase
B Uroporphyrinogen I synthase
C Delta-aminolevulinate synthase
D Uroporphyrinogen decarboxylase
E Ferrochelatase

98
A doctor was addressed by a 30-year-old man. There is a probability of the patient being
HIV-positive. To clarify the diagnosis the doctor proposed to perform polymerase chain reaction. The
basic process in this kind of investigation is:
A Gene amplification
B Transcription
C Genetic recombination
D Genomic mutation
E Chromosome mutation

99
One of the causes of pernicious anemia is disturbed synthesis of transcorrin - Castle's intrinsic factor -
by the parietal cells of the stomach. What substance is called Castle's extrinsic factor?
A Cobalamin
B Folic acid
C Pyridoxine
D Riboflavin
E Biotin

100
Symptoms of pellagra (vitamin PP deficiency) is particularly pronounced in patients with low protein
diet, because nicotinamide precursor in humans is one of the essential amino acids, namely:
A Tryptophan
B Threonine
C Arginine
D Histidine
E Lysine

101
One of the factors that cause obesity is the inhibition of fatty acids oxidation due to:
A Low carnitine content
B Impaired phospholipid synthesis
C Excessive consumption of fatty foods
D Choline deficiency
E Lack of carbohydrates in the diet

102
One of the factors that cause obesity is inhibition of fatty acids oxidation due to:
A Low level of carnitine
B Impaired phospholipid synthesis
C Excessive consumption of fatty foods
D Choline deficiency
E Lack of carbohydrates in the diet

103
Congenital pyruvate carboxylase deficiency causes physical and mental retardation in children and
leads to early death. It is characterized by lactic acidemia, lactaciduria, and a number of metabolic
disorders. Among others, inhibition of the following occurs:
A Citric acid cycle and gluconeogenesis
B Glycolysis and glycogenolysis
C Glycogenesis and glycogenolysis
D Lipolysis and lipogenesis
E Pentose-phosphate pathway and glycolysis

104
Streptomycin and other aminoglycosides prevent the joining of formyl-methionyl-tRNA by bonding
with the 30S ribosomal subunit. This effect leads to disruption of the following process:
A Translation initiation in procaryotes
B Translation initiation in eucaryotes
C Transcription initiation in procaryotes
D Transcription initiation in eucaryotes
E Replication initiation in procaryotes

105
For biochemical diagnostics of myocardial infarction it is necessary to measure activity of a number
of enzymes and their isoenzymes. What enzymatic test is considered to be the best to prove or disprove
the diagnosis of infarction in the early period after the chest pain is detected?
A Creatine kinase isoenzyme CK-MB
B Creatine kinase isoenzyme CK-MM
C LDH1 lactate dehydrogenase isoenzyme
D LDH2 lactate dehydrogenase isoenzyme
E Aspartate aminotransferase cytoplasmic isoenzyme

106
A newborn baby has numerous hemorrhages. Blood coagulation tests reveal increased prothrombin
time. The child is most likely to have a disorder of the following biochemical process:
A Production of gamma-carboxyglutamate
B Conversion of homocysteine to methionine
C Conversion of methylmalonyl CoA to succinyl CoA
D Degradation of glutathione
E Hydroxylation of proline

107
A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results:
cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l, increased low-density lipoprotein fraction (LDL). What
type of hyperlipoproteinemia is observed in the patient?
A Hyperlipoproteinemia type IIa
B Hyperlipoproteinemia type I
C Hyperlipoproteinemia type IIb
D Hyperlipoproteinemia type IV
E Cholesterol, hyperlipoproteinemia

108
A 67-year-old man consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol -
12,3 mmol/l, total lipids - 8,2 g/l, increased low-density lipoprotein fraction (LDL). What type of
hyperlipoproteinemia is observed in the patient?
A Hyperlipoproteinemia type IIa
B Hyperlipoproteinemia type I
C Hyperlipoproteinemia type IIb
D Hyperlipoproteinemia type IV
E Cholesterol, hyperlipoproteinemia

109
After an extended treatment with sulfanamides a patient has developed macrocytic anemia.
Production of active forms of the following vitamin is disrupted in such a condition:
A Folic acid
B Thiamine
C Riboflavin
D Pyridoxine
E Cyanocobalamin

110
A patient is diagnosed with glucocerebroside lipidosis (Gaucher's disease) that manifests as
splenomegaly, liver enlargement, affected bone tissue, and neuropathies. What enzyme of complex
lipid catabolism is deficient, thus causing this disease?
A Glucocerebrosidase
B Hexosaminidase
C Sphingomyelinase
D β-galactosidase
E Hyaluronidase

111
Steatosis is caused by the accumulation of triacylglycerols in hepatocytes. One of the mechanisms of
this disease development is a decrease in the utilization of VLDL neutral fat. What lipotropics prevent
the development of steatosis?
A Methionine, B6, B12
B Arginine, B2, B3
C Alanine, B1, PP
D Valine, B3, B2
E Isoleucine, B1, B2

112
A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin lipidosis
(Niemann-Pick disease). In this condition synthesis of the following substance is disrupted:
A Sphingomyelinase
B Glycosyltransferase
C Sphingosine
D Ceramides
E Gangliosides

113
A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin lipidosis
(Niemann-Pick disease). In this condition the synthesis of the following substance is disturbed:
A Sphingomyelinase
B Glycosyltransferase
C Sphingosine
D Ceramides
E Gangliosides
 114
Decarboxylation of glutamate induces production of gamma-aminobutyric acid (GABA)
neurotransmitter. After breakdown, GABA is converted into a metabolite of the citric acid cycle, that
is:
A Succinate
B Citric acid
C Malate
D Fumarate
E Oxaloacetate

115
A 36-year-old female patient has a history of B2-hypovitaminosis. The most likely cause of specific
symptoms (epithelial, mucosal, cutaneous, corneal lesions) is the deficiency of:
A Flavin coenzymes
B Cytochrome A1
C Cytochrome oxidase
D Cytochrome B
E Cytochrome C

116
A therapeutist has an appointment with a 40-year-old patient complaining of recurrent pain attacks in
his hallux joints and their swelling. Urine analysis revealed its marked acidity and pink colour. What
substances can cause such changes in the urine?
A Uric acid salt
B Chlorides
C Ammonium salts
D Calcium phosphate
E Magnesium sulfate

117
A therapeutist has an appointment with a 40-year-old patient complaining of recurrent pain attacks in
his hallux joints and their swelling. Urine analysis revealed its marked acidity and pink color. What
substances can cause such changes in urine?
A Uric acid salt
B Chlorides
C Ammonium salts
D Calcium phosphate
E Magnesium sulfate

118
A 30-year-old man with diabetes mellitus type I was hospitalized. The patient is comatose.
Laboratory tests revealed hyperglycemia and ketonemia. What metabolic disorder can be detected in
this patient?
A Metabolic acidosis
B Metabolic alkalosis
C Respiratory acidosis
D Respiratory alkalosis
E Acid-base balance is normal
 119
A 30-year-old man with diabetes mellitus type I was hospitalised. The patient is comatose. Laboratory
tests revealed hyperglycemia and ketonemia. What metabolic disorder can be detected in this patient?
A Metabolic acidosis
B Metabolic alkalosis
C Respiratory acidosis
D Respiratory alkalosis
E Normal acid-base balance

120
Exophthalmus observed during thyrotoxicosis is caused by accumulation of highly water-binding
substances within the retrobulbar tissues. Name these substances:
A Glycosaminoglycans
B Cholesterol
C ATP
D Kreatine
E Phospholipids

121
Disruption of nerve fiber myelinogenesis causes neurological disorders and mental retardation. These
symptoms are typical for hereditary and acquired alterations in the metabolism of:
A Sphingolipids
B Neutral fats
C Higher fatty acids
D Cholesterol
E Phosphatidic acid

122
An infant, who was on synthetic formula feeding, developed signs of vitamin B1 deficiency. What
reactions does this vitamin take part in?
A Keto acids oxidative decarboxylation
B Amino acids transamination
C Amino acids decarboxylation
D Proline hydroxylation
E Redox reactions

123
A child has a history of hepatomegaly, hypoglycemia, seizures, especially on an empty stomach and
in stressful situations. The child is diagnosed with Gierke disease. This disease is caused by the genetic
defect of the following enzyme:
A Glucose-6-phosphatase
B Amyloid-1,6-glycosidase
C Phosphoglucomutase
D Glycogen phosphorylase
E Glucokinase

124
A 28-year-old patient undergoing treatment in the pulmonological department has been diagnosed
with pulmonary emphysema caused by splitting of alveolar septum by tissular tripsin. The disease is
cased by the congenital deficiency of the following protein:
A α1-proteinase inhibitor
B α2-macroglobulin
C Cryoglobulin
D Haptoglobin
E Transferrin

125
A 28-year-old patient undergoing treatment in a pulmonological department has been diagnosed
with pulmonary emphysema caused by splitting of alveolar septum by tissular tripsin. The
disease is caused by the congenital deficiency of the following protein:
A α1-proteinase inhibitor
B α2-macroglobulin
C Cryoglobulin
D Haptoglobin
E Transferrin

126
A patient, who has been suffering for a long time from intestine disbacteriosis, has increased
hemorrhaging caused by disruption of posttranslational modification of blood-coagulation
factors ІІ, VІІ, ІХ, and Х in the liver. What vitamin deficiency is the cause of this condition?
AК
B В12
C В9
DС
EР

127
A patient with signs of osteoporosis and urolithiasis has been admitted to an endocrinology
department. Blood test revealed hypercalcemia and hypophosphatemia. These changes are associated
with abnormal synthesis of the following hormone:
A Parathyroid hormone
B Calcitonin
C Cortisol
D Aldosterone
E Calcitriol

128
A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology
department. Blood test has revealed hypercalcemia and hypophosphatemia. These changes are
associated with abnormal synthesis of the following hormone:
A Parathyroid hormone
B Calcitonin
C Cortisol
D Aldosterone
E Calcitriol

129
Activation of a number of hemostatic factors occurs through their joining with calcium ions. What
structural component allows for adjoining of calcium ions?
A Gamma-carboxyglutamic acid
B Gamma-aminobutyric acid
C Gamma-oxybutyric acid
D Hydroxyproline
E Monoamine-dicarboxylic acids

130
Lymphocytes and other cells of our body synthesize universal antiviral agents as a response to viral
invasion. Name these protein factors:
A Interferon
B Interleukin - 2
C Cytokines
D Interleukin - 4
E Tumor necrosis factor

131
Corticosteroid hormones regulate the adaptation processes of the body as a whole to environmental
changes and ensure the maintenance of internal homeostasis. What hormone activates the
hypothalamo-pituitary-adrenal axis?
A Corticoliberin
B Somatoliberin
C Somatostatin
D Corticostatin
E Thyroliberin

132
In cancer patients who have been continuously receiving methotrexate, the target cells of tumor with
time become insensitive to this drug. In this case, gene amplification of the following enzyme is
observed:
A Dihydrofolate reductase
B Thiaminase
C Deaminase
D Thioredoxin reductase
E-

133
Pancreas is known as a mixed gland. Endocrine functions include production of insulin by beta cells.
This hormone affects metabolism of carbohydrates. What is its effect on the activity of glycogen
phosphorylase (GP) and glycogen synthase (GS)?
A It inhibits GP and activates GS
B It activates both GP and GS
C It inhibits both GP and GS
D It activates GP and inhibits GS
E It does not affect the activity of GP and GS

134
Pancreas is known as a mixed gland. Endocrine functions include production of insulin by beta cells.
This hormone affects the metabolism of carbohydrates. What is its effect upon the activity of glycogen
phosphorylase (GP) and glycogen synthase (GS)?
A It inhibits GP and activates GS
B It activates both GP and GS
C It inhibits both GP and GS
D It activates GP and inhibits GS
E It does not affect the activity of GP and GS
 135
Fructosuria is known to be connected with inherited deficiency of fructose 1-phosphate aldolase.
What product of fructose metabolism will accumulate in the organism resulting in toxic action?
A Fructose 1-phosphate
B Glucose 1-phosphate
C Glucose 6-phosphate
D Fructose 1,6-biphosphate
E Fructose 6-phosphate

136
Cholesterol content in blood serum of a 12-year-old boy is 25 mmol/l. Anamnesis states hereditary
familial hypercholesterolemia caused by synthesis disruption of receptor-related proteins for:
A Low-density lipoproteins
B High-density lipoproteins
C Chylomicrons
D Very low-density lipoproteins
E Middle-density lipoproteins

137
Cholesterol content in blood serum of a 12-year-old boy is 25 mmol/l. Anamnesis states hereditary
familial hypercholesterolemia caused by synthesis disruption of receptor-related proteins for:
A Low-density lipoproteins
B High-density lipoproteins
C Chylomicrons
D Very low-density lipoproteins
E Middle-density lipoproteins

138
A 50-year-old inpatient during examination presents with glucosuria and blood glucose of 3.0
mmol/L, which are the most likely to be caused by:
A Renal disorder
B Diabetes insipidus
C Myxedema
D Essential hypertension
E Pellagra

139
A 50-year-old inpatient during examination presents with glucosuria and blood glucose of 3,0 mmol/l,
which are the most likely to be caused by:
A Renal disorder
B Diabetes insipidus
C Myxedema
D Essential hypertension
E Pellagra

140
Obesity is a common disease. The aim of its treatment is to lower content of neutral fats in the body.
What hormon-sensitive enzyme is the most important for intracellular lipolysis?
A Triacylglycerol lipase
B Protein kinase
C Adenylate kinase
D Diacylglycerol lipase
E Monoacylglycerol lipase

141
A patient is diagnosed with cardiac infarction. Blood test for cardiospecific enzymes activity was
performed. Which of the enzymes has three isoforms?
A Creatine kinase
B Lactate dehydrogenase
C Aspartate transaminase
D Alanine transaminase
E Pyruvate kinase

142
During examination of a teenager with xanthomatosis the family history of hypercholesterolemia is
revealed. What transportable lipids are increased in concentration in case of such a disease?
A Low-density lipoproteins
B Chylomicrons
C Very low-density lipoproteins
D High-density lipoproteins
E Intermediate-density lipoproteins

143
A 7-year-old child presents with marked signs of hemolytic anemia. Biochemical analysis of
erythrocytes determined low concentration of NADPH and reduced glutathione. What enzyme is
deficient in this case leading to the biochemical changes and their clinical manifestations?
A Glucose-6-phosphate dehydrogenase
B Hexokinase
C Fructokinase
D Pyruvate kinase
E Lactate dehydrogenase

144
Biochemical analysis of an infant's erythrocytes revealed evident glutathione peroxidase deficiency
and low concentration of reduced glutathione. What pathological condition can develop in this infant?
A Hemolytic anemia
B Pernicious anemia
C Megaloblastic anemia
D Sicklemia
E Iron-deficiency anemia

145
Coenzym A participates in numerous important metabolic reactions. It is a derivative of the following
vitamin:
A Pantothenic acid
B Thiamine
C Niacin
D Calciferol
E Ubiquinone
 146
An 8-year-old girl presents with signs of disturbed twilight vision. This condition is caused by the
deficiency of vitamin:
AA
BE
CD
DK
EF

147
A young family came for a genetic counseling to identify the father of their child. The husband insists
that the child does not resemble him at all and cannot possibly be his. Polymerase chain reaction
method for person identification is based on the following:
A Gene amplification
B Nucleotide deletion
C Genetic recombination
D Missense mutation
E Transduction

148
A 25-year-old young man came to the doctor complaining of general weakness, rapid fatigability,
irritability, reduced working ability, and bleeding gums. What vitamin is likely to be deficient in this
case?
A Ascorbic acid
B Riboflavin
C Thiamine
D Retinol
E Folic acid

149
A patient with diabetes mellitus suffers from persistently nonhealing surgical wound, which is a sign
of disrupted tissue trophism. What is the cause of such disorder?
A Disruption of protein metabolism regulation
B Hypoglycemia
C Ketonemia
D Increased lipid catabolism
E Anemia

150
Vascular endothelium is characterized by high metabolic activity and synthesizes vasoactive
substances. Among these substances there is a potent vasodilator synthesized from L-arginine. Name
this vasodilator:
A Nitrogen oxide
B Histamine
C Bradykinin
D Acetylcholine
E Adrenaline