Part I: Definition: Define the following terms or phrases and write your answers on the space

provided for you (1 Mark each).

1. Severely Combine Immunodeficiency Disease (SCID)

2. Maple Syrup Urine Disease (MSUD)
3. Endergonic reaction
4. Asymmetric carbon atom
5. Transamination
6. Coeliac disease

ANSWERS

1.Severely Combined Immunodeficiency Disease (SCID): A genetic disorder causing a

severely weakened immune system, making individuals highly prone to infections.

2. Maple Syrup Urine Disease (MSUD): An inherited condition that prevents breakdown of
certain amino acids, leading to sweet-smelling urine and serious health issues.

3. Endergonic Reaction: A chemical reaction that requires energy input, resulting in products
with higher energy than the reactants.

4. Asymmetric Carbon Atom: A carbon atom bonded to four different groups, creating chiral
molecules that exist as mirror images.

5. Transamination: A process where an amino group is transferred from one amino acid to a
keto acid, forming new amino acids.

6. Coeliac Disease: An autoimmune disorder where gluten intake damages the small intestine,
leading to nutrient malabsorption.

Part II: Multiple Choice Questions: (1 Mark each).

1
__C____1. If a cell were to contain 100% nonfunctional mitochondria, what would be the net ATP yield
that would be produced from 1molecule of glucose?

A. 1ATP C. 2ATP
B. 4 ATP D. 0ATP

__C__2. During electron transport, protons are pumped out of the mitochondria matrix at each of the
major sites except for;
A. Complex I C. Complex II
B. Complex III D. Complex IV

___B_3. An uncoupler of oxidative phosphorylation such as Dinitrophenol;

A. Inhibit respiration and ATP synthesis
B. Allows electron transport to proceed without ATP synthesis
C. Inhibits respiration without impairment of ATP synthesis
D. Act as a competitive inhibitor of NAD+- requiring reactions in the mitochondria

__C__4. An 18-year-old girl presents with a lack of secondary sexual characteristics, such as age
appropriate pubic hair growth and breast development. Her history reveals she has never started menses.
She is diagnosed with 17- hydroxylase deficiency. The levels of various steroid hormones in her serum
are found to be abnormal. Steroid hormones are most directly derived from which one of the following?
A. Acetyl CoA C. Cholesterol
B. Fatty acids D. Oleic acid

___A__5. Which one of the following tissues can metabolize glucose, fatty acids, and ketone bodies for
ATP production?
A. Liver C. Muscle
B. Brain D. Red blood cells

_A___6. An 18-year-old woman presents with xanthomas on her eyelids and is found to have a rare
genetic deficiency of lipoprotein lipase. She is diagnosed with type I hyperlipidemia. In this disorder,
chylomicrons are abnormally elevated in the serum. In which cell or tissue does triacylglycerol packaging
into chylomicrons occur?
A. Intestinal epithelial cell C. Liver cell
B. Muscle cell D. Adipose cell

__B___7. Insulin has many direct effects on various cell types from such tissues as muscle, fat, liver, and
skin. Which of the following cellular activities is decreased following exposure to physiologic
concentrations of insulin?
A. Plasma membrane transfer of glucose C. Glucose oxidation
B. Gluconeogenesis D. Lipogenesis

__D___8. Similarities between carbamoyl phosphate synthetase I and carbamoyl phosphate synthetase II
include which ONE of the following?

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 A. Carbon source C. Intracellular location
B. Regulation by N-acetyl glutamate D. Nitrogen source

___A__9. After several weeks of chemotherapy in the form of methotrexate, a cancer patient’s tumor
begins to show signs of resistance to treatment. Which of the following mechanisms is most likely to
explain the tumor's methotrexate resistance?

A. Overproduction of dihydrofolate reductase

B. Overproduction of xanthine oxidase
C. Deficiency of PRPP synthase
D. Deficiency of thymidine kinase

___C__10. Which tripeptide has a major role in protection against reactive oxygen species?
A. Insulin C. Glutathione
B. Carnitine D. Creatine

___C__11. Which of the following antioxidants has the primary role as chain-breaking antioxidant in the
lipid phase of plasma membrane?
A. Ascorbic acid C. Vitamin E
B. Ubiquinone D. Glutathione

___D__12. A 4-month-old boy presents with frequent episodes of weakness, accompanied by sweating
and feelings of dizziness. Physical examination is remarkable for palpably enlarged liver and kidneys.
Laboratory tests reveal hypoglycemia and lactic acidemia. The patient is diagnosed with an enzyme
deficiency of glucose 6-phosphatase, which is normally only expressed in which of the following?
A. Liver and muscle C. Liver and brain
B. Liver and adipose tissue D. Liver and kidney

__A___13. A 57-year-old alcoholic man with chronic pancreatitis is admitted to the hospital for
treatment. The absorption of which one of the following vitamins may be affected with pancreatitis?
A. Vitamin B12 (cobalamin) C. Folic acid
B. Vitamin B2 (riboflavin) D. Vitamin D

___A__14. A biochemistry graduate student isolates all the enzymes of the TCA cycle and adds OAA and
acetyl CoA, including the appropriate energy precursors, cofactors, and water. Which of the following
will not be a direct product of his experiment?
A. ATP C. GTP
B. NADH D. FADH2

__B___15. A 38-year-old man gets bloated and has episodes of diarrhea after eating his favorite ice
cream. It also occurs when he consumes yogurt, cheese, and other milk-containing products. The patient
lacks the ability to cleave which one of the following glycosidic bonds?
A. Glucose-α (1→4) glucose
B. Glucose-α (1→2) fructose
C. Galactose-β (1→4) glucose
D. Glucose-α (1→6) glucose

__C___16. A 55-year-old man suffers from cirrhosis of the liver. He has been admitted to the hospital
several times for hepatic encephalopathy. His damaged liver has compromised his ability to detoxify

3
ammonia. Which of the following amino acids can be used to fix ammonia and thus transport and store
ammonia in a nontoxic form?

A. Aspartate C. Glutamate
B. Histidine D. Cysteine

__D___17. A 57-year-old man with a long history of alcohol abuse comes to the emergency room with
symptoms of confusion and heptomegaly on examination. The patient also has a flapping tremor at the
wrist (asterixis). He is diagnosed with hepatic encephalopathy, which can be partially treated with a diet
of branched-chain amino acids. Which of the following sets of amino acids would you suggest?

A. Tryptophan, phenylalanine, tyrosine

B. Aspartate, glutamate, asparagine
C. Glycine, alanine, serine
D. Valine, leucine, isoleucine

___A__18. You are in the laboratory and are trying to understand the interaction between lovastatin and
HMG-CoA reductase. Analyses reveal that the Vmax of the reductase is unchanged in the absence or
presence of the statin, yet the Km is increased. Lovastatin is most likely functioning as which of the
following?

A. Competitive inhibitor C. Noncompetitive inhibitor

B. Feedback inhibitor D. Irreversible inhibition

___B__19. A 25-year-old man is intubated in the intensive care unit. He is being treated for an
overwhelming infection. Through a gastric tube, he is being fed proteins that are broken down to amino
acids. When his dietary nitrogen intake exceeds his excreted nitrogen, this is most accurately called which
of the following?

A. Negative nitrogen balance

B. Positive nitrogen balance
C. Nitrogen balance
D. An anabolic state

___A__20. In the nursery, an infant with blond hair and blue eyes is noted to have a mousy odor to his
urine upon diaper changes. As is mandated by the state, all infants are screened for multiple inborn errors
of metabolism, and he is found to have phenylketonuria (PKU). The cells of this child are unable to
convert phenylalanine to which one of the following?

A. Tyrosine C. Serine
B. Tryptophan D. Histidine

___D__21. In diabetes mellitus, glucagon levels are………………….

4
 A. Elevated due to high insulin
B. Lowered due to high conversion to glucose
C. Lowered due to low insulin
D. Elevated and not suppressed by carbohydrate loading

___A__22. Nitrogen atoms of urea are contributed by …………………..

A. Ammonium and aspartate

B. Ammonium and glutamate
C. Ammonium and glutamine
D. Ammonium and asparagine

____A_23. Which amino acids are only ketogenic?

A. Leucine and lysine

B. Leucine and isoleucine
C. Isoleucine and lysine
D. Glycine and lysine

___A__24. One of the following bonds occur between charged amino acid residues in a protein.

A. Electrostatic Interactions.
B. Hydrophobic interactions.
C. Van der waals forces.
D. Hydrogen bonds.

___B__25. Enzymes increase the rates of reaction by:

A. Increasing the free energy of activation.

B. Decreasing the energy of activation.
C Changing the equilibrium constant of the reaction.
D Increasing the free energy change of the reaction.

___B__26. Dopamine carboxylase catalyzes…………………………..

A. Dopamine to Norepinephrine
B. Dopa to Dopamine
C. Norepinephrine to epinephrine
D. Tyrosine to Dopa

__C___27. Which one of the following enzymes is common to both glycolysis and gluconeogenesis?
A. Pyruvate kinase.
B. Hexokinase.
C. Phosphoglycerate kinase.
D. Fructose-1,6-bisphosphatase.

___B__28. The end product of fatty acid synthesis is ………………

5
 A. Stearate
B. Palmitate
C. Linoleate
D. Arachidonate

___A__.29. Substrates required for hemoglobin biosynthesis are:

A. Acetate and glycine

B. Glycine and fumaric acid
C. Lysine and succinate
D. Succinic acid and glycine

___A__30. High energy compounds include all the following except ……………..

A. Esters.
B. Phosphate anhydride.
C. Enol phosphates (phosphoenol pyruvate).
D. Thioesters.

___C__31. Liver glycogen contributes to the maintenance of glucose but not muscle glycogen. Which of
the following enzymes is absent in the muscles?

A. Glycogen phosphorylase
B. Hexokinase
C. Glucose-6-phosphatase
D. Debranching enzyme

___D__32. Which of the following statements regarding TCA cycle is true?

A. It is an anaerobic process.
B. It occurs in cytosol.
C. It contains no intermediates for Gluconeogenesis.
D. It is amphibolic in nature.

___D__33. The first molecule produced in the citric acid cycle is:

A. Acetyl CoA.
B. Oxaloacetate.
C. ATP.
D. Citrate.

___B__34. An enzyme that catalyzes the conversion of an aldose sugar to a ketose sugar would be
classified as one of the………………..

A. Transferases.
B. Isomerases
C. Oxidoreductases

6
 D. Hydrolases

___B__35. Cori’s cycle transfers……………….

A. Glucose from muscles to liver

B. B. Lactate from muscles to liver
C. Lactate from liver to muscles
D. Pyruvate from liver to muscles

____B_36. Dietary triacylglycerols are absorbed from the intestinal lumen after hydrolysis mainly as:

A. Fatty acids and glycerol.

B. Fatty acids and two monoacylglycerol.
C. Fatty acids and α, β-diglyceride.
D. Acyl-CoA and glycerol.

___C__37. Which of the statements regarding enzymes is false?

A. Enzymes are proteins that function as catalysts.

B. Enzymes are specific.
C. Enzymes provide activation energy for reactions.
D. Enzyme activity can be regulated

___A__38. When (S) is equal to Km, which of the following conditions exist?

A. Half the enzyme molecules are bound to substrate

B. The velocity of the reaction is equal to Vmax
C. The velocity of the reaction is independent of substrate concentration
D. Enzyme is completely saturated with substrate

__A___39. One of the following is wrong about Urea?

A. Urea is synthesized in the kidney.

B. Urea is produced by most terrestrial vertebrates.
C. Urea’s nitrogen atoms come from ammonia and aspartate.
D. Urea’s carbon atom comes from bicarbonate.

___B__40. During each cycle of β-oxidation of FA, all the following compounds are generated,
except……………….

A. NADH
B. H2O
C. FADH2

7
 D. Acetyl-CoA

___B__41. A drug which prevents uric acid synthesis by inhibiting the enzyme xanthine oxidase is
(A) Aspirin
(B) Allopurinol
(C) Colchicine
(D) Probenecid

___A__42. Milk is deficient in which vitamins?

(A) Vitamin C
(B) Vitamin A
(C) Vitamin B2
(D) Vitamin K

___C__43. Milk is deficient of which mineral?

(A) Phosphorus
(B) Sodium
(C) Iron
(D) Potassium

__B___44. HDL is synthesized and secreted from

(A) Pancreas\
(B) Liver
(C) Kidney
(D) Muscle

__D___45. Oxidation of which substance in the body yields the most calories
(A) Glucose
(B) Glycogen
(C) Protein
(D) Lipids

___A__46. Two sugars which differ from one another only in configuration around a single carbon atom
are termed
(A) Epimers
(B) Anomers
(C) Optical isomers
(D) Stereoisomers

__D___47. Reduced glutathione functions in R.B.Cs to

(A) Produce NADPH
(B) Reduce methemoglobin to hemoglobin
(C) Produce NADH
(D) Reduce oxidizing agents such as H2O2

___D__48. A disaccharide linked by α-1-4 Glycosideic linkages is

(A) Lactose

8
(B) Sucrose
(C) Cellulose
(D) Maltose

___A__49. The intermediate in hexose monophosphate shunt is

(A) D-Ribulose
(B) D-Arabinose
(C) D-xylose
(D) D-Lyxose

___A__50. Familial hypertriaacylglycerolemia is associated with

(A) Over production of VLDL
(B) Increased LDL concentration
(C) Increased HDL concentration
(D) Slow clearance of chylomicrons

___C__51. The amino acid that undergoes oxidative deamination at significant rate is
(A) Alanine
(B) Aspartate
(C) Glutamate
(D) Glutamine

___C__52. Apolipoprotein B-48 is synthesized in

(A) Adipose tissue
(B) Liver
(C) Intestine
(D) Liver and intestine

___D__53. Nascent chylomicron receives apolipoproteins C and E from

(A) VLDL remnant
(B) VLDL
(C) LDL
(D) HDL
__A___54. Deficiency of vitamin D causes
(A) Ricket and osteomalacia
(B) Tuberculosis of bone
(C) Hypothyroidism
(D) Skin cancer

___D__55. Increased glucose consumption increases the dietary requirement for

(A) Pyridoxine
(B) Niacin
(C) Biotin
(D) Thiamin

__B___56. Cholesterol is transported from liver to extra hepatic tissues by

(A) Chylomicrons
(B) VLDL
(C) HDL

9
(D) LDL

__B__57. Which of the following is required as a reductant in fatty acid synthesis?

(A) NADH
(B) NADPH
(C) FADH2
(D) FMNH2

__B___58. Urea clearance test is used to determine the

(A) Glomerular filtration rate
(B) Renal plasma flow
(C) Ability of kidney to concentrate the urine
(D) Measurement of tubular mass

___C__59. Creatinine EDTA clearance is a test to measure

(A) Renal plasma flow
(B) Filtration fraction
(C) Glomerular filtration rate
(D) Tubular function

___A__60. An increase in serum unconjugated bilirubin occurs in

(A) Hemolytic jaundice
(B) Obstructive jaundice
(C) Nephritis
(D) Glomerulonephritis

Part III: Matching Questions

Column A Column B

1. Glucose 6-phospahte deficiency F A. Lactose

2. Fluorouracil D B. Amino Acid Transporter
3. Milk Sugar A C.
4. Pancrease G D. Thymidylate Synthase

10
5. Hartnup’s disease B E.
6. F. Hemolytic Anemia
7. G. Amylase
8. H.

1. **Glucose 6-phosphate deficiency** → **F. Hemolytic Anemia**

(This deficiency can lead to hemolytic anemia due to oxidative stress on red blood cells.)

2. **Fluorouracil** → **D. Thymidylate Synthase**

(Fluorouracil inhibits thymidylate synthase, an enzyme involved in DNA synthesis.)

3. **Milk Sugar** → **A. Lactose**

(The sugar found in milk is lactose.)

4. **Pancreas** → **G. Amylase**

(The pancreas produces amylase, an enzyme that helps digest carbohydrates.)

5. **Hartnup’s disease** → **B. Amino Acid Transporter**

(Hartnup’s disease is related to defective transport of certain amino acids.)

Part IV. Short answer questions: Give brief and clear answers for the following questions.

1. Ammonia toxicity occurs when the ammonia content in the blood supersedes the
liver's capacity to eliminate it. Discuss the mechanism of ammonia toxicity in the brain? (2
marks)

11
Ammonia toxicity occurs when excess ammonia crosses the blood-brain barrier, leading to
astrocyte swelling and disruption of neurotransmitter balance.

Elevated ammonia levels result in increased glutamate and decreased gamma-aminobutyric acid
(GABA), causing excitotoxicity and altered neuronal function.
This can lead to symptoms such as confusion, lethargy, and in severe cases, coma.

2. Describe the factors which influence the rate of enzyme action (2marks)

Substrate Concentration: Higher concentrations typically increase reaction rates until saturation is
reached.
Temperature: Enzyme activity generally increases with temperature up to an optimal point, beyond
which activity declines due to denaturation.
pH: Each enzyme has an optimal pH; deviations can reduce activity or denature the enzyme.

Enzyme Concentration: Increasing enzyme concentration usually enhances the reaction rate,
assuming substrate availability.

3. The incomplete lipid profile laboratory test result of your patient is:

Total cholesterol-250mg/dl, HDL-70mg/dl and TAG- 250mg/dl.

Using Friedewald equation Find;

i. VLDL

ii. LDL

iii. From the result of (ii), is your patient at the risk of Atherosclerosis

ANSWER
Given:
● Total Cholesterol: 250 mg/dl
● HDL: 70 mg/dl
● TAG: 250 mg/dl
Using the Friedewald equation:
i. VLDL
VLDL=TAG5=2505=50 mg/dlVLDL=5TAG=5250=50 mg/dl
ii. LDL
LDL=Total Cholesterol−HDL−VLDLLDL=Total Cholesterol−HDL−VLDL
LDL=250−70−50=130 mg/dlLDL=250−70−50=130 mg/dl
iii. Atherosclerosis Risk
An LDL level of 130 mg/dl is considered borderline high. This indicates a potential risk for
atherosclerosis, especially if other risk factors (such as hypertension, diabetes, or family
history) are present. Regular monitoring and lifestyle modifications are advisable.

12
 ANSWERS

1. **C. 2 ATP**
Without functional mitochondria, only anaerobic glycolysis can yield 2 ATP from 1
molecule of glucose.
2. **C. Complex II**
Protons are not pumped out of the mitochondrial matrix at Complex II.
3. **B. Allows electron transport to proceed without ATP synthesis**
An uncoupler like Dinitrophenol permits electron transport but prevents ATP synthesis.
4. **C. Cholesterol**
Steroid hormones are directly derived from cholesterol.
5. **A. Liver**
The liver can metabolize glucose, fatty acids, and ketone bodies for ATP production.
6. **A. Intestinal epithelial cell**
Triacylglycerol packaging into chylomicrons occurs in intestinal epithelial cells.
7. **B. Gluconeogenesis**
Insulin decreases gluconeogenesis in various tissues.
Here are the precise answers to your multiple choice questions, double-checked for accuracy:

8. **D. Nitrogen source**

Both carbamoyl phosphate synthetase I and II utilize ammonia as a nitrogen source.

9. **A. Overproduction of dihydrofolate reductase**

Tumor resistance to methotrexate is often due to the overproduction of dihydrofolate reductase,
which reduces the drug's effectiveness.
13
10. **C. Glutathione**
Glutathione plays a major role in protecting against reactive oxygen species.

11. **C. Vitamin E**

Vitamin E acts as a chain-breaking antioxidant in the lipid phase of the plasma membrane.

12. **D. Liver and kidney**

Glucose 6-phosphatase is expressed in the liver and kidney, which is crucial for
gluconeogenesis and glycogenolysis.

13. **A. Vitamin B12 (cobalamin)**

Chronic pancreatitis can affect the absorption of Vitamin B12 due to impaired digestive
enzyme function.

14. **A. ATP**

ATP is not a direct product of the TCA cycle; instead, GTP, NADH, and FADH2 are
produced.

15. **C. Galactose-β (1→4) glucose**

The inability to cleave the galactose-β (1→4) glucose bond indicates lactose intolerance, as it
aHere are the precise answers to your multiple choice questions, double-checked for accuracy:

16. **C. Glutamate**

Glutamate can fix ammonia and transport it in a nontoxic form as glutamine.

17. **D. Valine, leucine, isoleucine**

Branched-chain amino acids (BCAAs) include valine, leucine, and isoleucine, which can help
in managing hepatic encephalopathy.

14
18. **A. Competitive inhibitor**
Lovastatin increases the Km (decreases affinity) while leaving the Vmax unchanged, indicating
it acts as a competitive inhibitor of HMG-CoA reductase.

19. **B. Positive nitrogen balance**

When dietary nitrogen intake exceeds excreted nitrogen, it is most accurately called a positive
nitrogen balance.

20. **A. Tyrosine**

In phenylketonuria (PKU), the cells are unable to convert phenylalanine to tyrosine due to a
deficiency in the enzyme phenylalanine hydroxylase.ffects the digestion of lactose in dairy
products.
Here are the precise answers to your multiple choice questions, double-checked for accuracy:

21. **D. Elevated and not suppressed by carbohydrate loading**

In diabetes mellitus, glucagon levels are elevated and are not effectively suppressed by
carbohydrate intake.

22. **A. Ammonium and aspartate**

The nitrogen atoms of urea are contributed by ammonium and aspartate during the urea cycle.

23. **A. Leucine and lysine**

Leucine and lysine are the only amino acids that are purely ketogenic.

24. **A. Electrostatic Interactions**

Electrostatic interactions occur between charged amino acid residues in a protein.

25. **B. Decreasing the energy of activation**

15
 Enzymes increase the rates of reaction by decreasing the energy of activation.

26. **B. Dopa to Dopamine**

Dopamine carboxylase catalyzes the conversion of Dopa to dopamine.

27. **C. Phosphoglycerate kinase**

Phosphoglycerate kinase is common to both glycolysis and gluconeogenesis.
_28. The end product of fatty acid synthesis is ………………
A. Stearate
B. Palmitate
C. Linoleate
D. Arachidonate

_____.29. Substrates required for hemoglobin biosynthesis are:

A. Acetate and glycine
B. Glycine and fumaric acid
C. Lysine and succinate
D. Succinic acid and glycine

_____30. High energy compounds include all the following except ……………..
A.Esters.
B.Phosphate anhydride.
C. Enol phosphates (phosphoenol pyruvate).
D.Thioesters.

_____31. Liver glycogen contributes to the maintenance of glucose but not muscle glycogen.
Which of the following enzymes is absent in the muscles?
A. Glycogen phosphorylase

16
B. Hexokinase
C. Glucose-6-phosphatase
D. Debranching enzyme

_____32. Which of the following statements regarding TCA cycle is true?

A.It is an anaerobic process.
B.It occurs in cytosol.
C.It contains no intermediates for Gluconeogenesis.
D.It is amphibolic in nature.

_____33. The first molecule produced in the citric acid cycle is:
A.Acetyl CoA.
B.Oxaloacetate.
C.ATP.
D.Citrate.
Here are the precise answers to your multiple choice questions, double-checked for accuracy:

34. **B. Isomerases**

An enzyme that catalyzes the conversion of an aldose sugar to a ketose sugar is classified as an
isomerase.

35. **B. Lactate from muscles to liver**

Cori's cycle transfers lactate from muscles to the liver, where it is converted back to glucose.

36. **B. Fatty acids and two monoacylglycerol**

Dietary triacylglycerols are absorbed from the intestinal lumen mainly as fatty acids and two
monoacylglycerols after hydrolysis.

17
37. **C. Enzymes provide activation energy for reactions**
This statement is false; enzymes lower the activation energy required for reactions, rather than
providing it.

38. **A. Half the enzyme molecules are bound to substrate**

When (S) is equal to Km, half of the enzyme molecules are bound to the substrate.

39. **A. Urea is synthesized in the kidney**

This statement is wrong; urea is synthesized in the liver, not the kidney.
Here are the precise answers to your multiple choice questions, double-checked for accuracy:

40. **B. H2O**

During each cycle of β-oxidation of fatty acids, NADH, FADH2, and Acetyl-CoA are
generated, but not H2O.

41. **B. Allopurinol**

Allopurinol is a drug that prevents uric acid synthesis by inhibiting xanthine oxidase.

42. **A. Vitamin C**

Milk is deficient in Vitamin C.

43. **C. Iron**

Milk is typically deficient in iron.

44. **B. Liver**

HDL (High-Density Lipoprotein) is synthesized and secreted from the liver.

45. **D. Lipids**

18
 Oxidation of lipids yields the most calories compared to glucose, glycogen, or protein.

46. **A. Epimers**

Two sugars that differ only in configuration around a single carbon atom are termed epimers.

47. **D. Reduce oxidizing agents such as H2O2**

Reduced glutathione functions in red blood cells to reduce oxidizing agents like hydrogen
peroxide (H2O2).

48. **D. Maltose**

Maltose is a disaccharide linked by α-1-4 glycosidic linkages.

49. **A. D-Ribulose**

D-Ribulose is an intermediate in the hexose monophosphate shunt.

50. **A. Over production of VLDL**

Familial hypertriacylglycerolemia is associated with the overproduction of VLDL (Very Low-
Density Lipoprotein).

51. **C. Glutamate**

Glutamate undergoes oxidative deamination at a significant rate.

52. **C. Intestine**

Apolipoprotein B-48 is synthesized in the intestine.

53. **D. HDL**

Nascent chylomicrons receive apolipoproteins C and E from HDL (High-Density Lipoprotein).

19
54. **A. Ricket and osteomalacia**
Deficiency of vitamin D causes rickets in children and osteomalacia in adults.
Here are the precise answers to your multiple choice questions, double-checked for accuracy:

55. **D. Thiamin**

Increased glucose consumption increases the dietary requirement for thiamin (vitamin B1), as
it is a cofactor for enzymes in glucose metabolism.

56. **B. VLDL**

Cholesterol is transported from the liver to extrahepatic tissues by VLDL (Very Low-Density
Lipoprotein).

57. **B. NADPH**

NADPH is required as a reductant in fatty acid synthesis.

58. **A. Glomerular filtration rate**

The urea clearance test is used to determine the glomerular filtration rate (GFR).

59. **C. Glomerular filtration rate**

Creatinine clearance is a test used to measure the glomerular filtration rate (GFR).

60. **A. Hemolytic jaundice**

An increase in serum unconjugated bilirubin occurs in hemolytic jaundice due to the
breakdown of red blood cells.

20