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560D CLINICAL BIOCHEM FINAL EXAM QUESTIONS WITH 100% VERIFIED ANSWERS
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560D CLINICAL BIOCHEM FINAL EXAMQUESTIONS WITH 100% VERIFIED
ANSWERS
A client with diagnosed iron deficiency anemia comes to you because he
eats meat-based protein and green leafy vegetables but his iron levels
have not increased. What other nutrient is needed to properly absorb
iron?
1.) Vitamin B12
2.) Folic Acid
3.) Intrinsic factor
4.) Vitamin C - ANSWER 4.) Vitamin C
Antacids can reduce the absorption of iron and copper, leading to iron
deficiency anemia because:
1.) Because the antacids bind the metals
2.) Acidic pH increases Fe3+
3.) DMT1 requires co-transport of H+ ions to internalize divalent cations
4.) Stomach acid properly degrades metals - ANSWER 3.) DMT1
requires co-transport of H+ ions to internalize divalent cations
Which of the following factors can increase likelihood of getting iron
deficiency anemia?
1.) Celiac disease
2.) All of these responses
3.) Heavy menstruation
4.) Deficiency of copper - ANSWER 2.) All of these responses
Glucose-6-phosphate dehydrogenase is the enzyme that reduces
.......(a)....... to ____(b)____ as part of the hexose monophosphate shunt
pathway (ie. pentose phosphate pathway). G6PD deficiency can lead to
RBC hemolysis from oxidant stress because ___(b)___ is no longer
available to help recycle glutathione.
,1.) (a) NADPH, (b) NADP+
2.) (a) NADH, (b) NADPH
3.) (a) NADP+, (b) NADPH
4.) (a) NAD+, (b) NADH - ANSWER 3.) (a) NADP+, (b) NADPH
Sickle Cell Anemia is caused by a point mutation leading to a structural
instability of the RBC. What conditions can create increased stress,
leading to increased levels of deoxyhemoglobin and sickle cell crisis?
A: All of these responses
1.) Decreased pH (acidity)
2.) High altitude
3.) Increased 2,3-Bisphosphoglycerate - ANSWER A: All of these
responses
Anemia of chronic disease can be caused from prolonged inflammation
(IL-6, cytokines, infection), which increases level of
__________________ to sequester iron in tissues so germs can't use
the iron to reproduce.
1.) Vitamin B12
2.) Aconitase
3.) Hepcidin
4.) Folic Acid - ANSWER 3.) Hepcidin (Is synthesized by the liver and
controls iron homeostasis).
Sideroblastic anemia is an X-linked condition where the enzyme called
____________________ is mutated, leading to excess iron in the RBC
mitochondria.
1.) Protoporphyrin IX oxidase
2.) NADH methemoglobin reductase
3.) Delta-aminolevulinic acid synthase
4.) Diaphorase I - ANSWER 3.) Delta-aminolevulinic acid synthase (this
is also the enzyme that controls the rate limiting step in heme synthesis)
,Copper-containing ferroxidases called Hephaestin and __________
convert Fe2+ to Fe3+ so it can be safely transported by transferrin in the
bloodstream - ANSWER A: Ferritin (this is an intracellular storage form
of iron)
Which transporter assists in uptake of iron from the intestines?
1.) Divalent metal transporter 1 (DMT1)
2.) Ferritin
3.) Ferrireductase duodenal cytochrome b
4.) Transferrin - ANSWER 1.) Divalent metal transporter 1 (DMT1)
The Bohr effect explains that a decrease in the amount of oxygen
associated with hemoglobin (Hb) due to a reduced affinity of oxygen for
Hb is the result of:
1.) Increased pC02 and increased pH
2.) Increased pCO2 and decreased pH
3.) Decreased pC02 and decreased pH
4.) Decreased pC02 and increased pH - ANSWER 2.) Increased pCO2
and decreased pH
pCO2 (partial pressure of carbon dioxide)
It is important to simultaneously check vitamin B12 and folate levels
because administration of folic acid can mask vitamin B12 deficiency,
leading to neurological demyelination that is often irreparable. The 2
constituents that accumulate in B12 deficiency, one of which
competitively inhibits FA biosynthesis leading to increased myelin sheath
turnover/degradation are:
1.) Succinyl CoA and Methylmalonyl CoA
2.) Methylmalonyl CoA and homocysteine
3.) Acetyl CoA and homocysteine
4.) Succinyl CoA and homocysteine - ANSWER 2.) Methylmalonyl CoA
and homocysteine
Elevations of FIGLU in the urine can indicate:
, 1.) Functional deficiency of vitamin B12
2.) Functional deficiency of histidine
3.) Functional deficiency of glutamate
4.) Functional deficiency of folic acid - ANSWER 4.) Functional
deficiency of folic acid
The folate trap occurs when there is deficient amounts of vitamin B12
and folate gets "trapped" in the form _______________.
1.) 5,10 Methylene-THF
2.) 5-Methyl-THF
3.) THF
4.) 10-Formyl-THF - ANSWER 2.) 5-Methyl-THF
GI conjugase enzymes hydrolyze folate to the monoglutamate form.
What cofactor is needed for this reaction?
1.) Zinc
2.) Vitamin C
3.) Copper
4.) Magnesium - ANSWER 1.) Zinc
Alanine aminotransferase converts alpha-ketoglutarate into glutamate
and alanine into:
1.) Pyruvate
2.) Aspartate
3.) Oxaloacetate
4.) Glutamate - ANSWER 1.) Pyruvate
Folic Acid is composed of: - ANSWER A: Pterin, PABA, Glutamic acid
What cofactor assists aminotransferases like ALT and AST in their ability
to transfer amino groups?
1.) Pyridoxal-5-Phosphate
2.) Vitamin B5
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