1. The patient presented with shortness of breath, coughing and chest tightness. Laboratory tests showed elevated CKMB. This suggests the diagnosis of myocardial infarction. Isoenzymes are variants of enzymes that catalyze the same chemical reaction but have different structures, properties or molecular forms. Two relevant enzyme isoenzymes and their clinical significance are discussed.
2. Vitamin B12 is obtained from animal sources and supplements. It is absorbed in the intestine through binding to intrinsic factor and transported to the liver. It acts as a coenzyme in DNA synthesis and fatty acid and amino acid metabolism. Deficiency causes megaloblastic anemia and neurological problems due to impaired DNA synthesis. Vegans are
1. The patient presented with shortness of breath, coughing and chest tightness. Laboratory tests showed elevated CKMB. This suggests the diagnosis of myocardial infarction. Isoenzymes are variants of enzymes that catalyze the same chemical reaction but have different structures, properties or molecular forms. Two relevant enzyme isoenzymes and their clinical significance are discussed.
2. Vitamin B12 is obtained from animal sources and supplements. It is absorbed in the intestine through binding to intrinsic factor and transported to the liver. It acts as a coenzyme in DNA synthesis and fatty acid and amino acid metabolism. Deficiency causes megaloblastic anemia and neurological problems due to impaired DNA synthesis. Vegans are
1. The patient presented with shortness of breath, coughing and chest tightness. Laboratory tests showed elevated CKMB. This suggests the diagnosis of myocardial infarction. Isoenzymes are variants of enzymes that catalyze the same chemical reaction but have different structures, properties or molecular forms. Two relevant enzyme isoenzymes and their clinical significance are discussed.
2. Vitamin B12 is obtained from animal sources and supplements. It is absorbed in the intestine through binding to intrinsic factor and transported to the liver. It acts as a coenzyme in DNA synthesis and fatty acid and amino acid metabolism. Deficiency causes megaloblastic anemia and neurological problems due to impaired DNA synthesis. Vegans are
Rajiv Gandhi University of Health Sciences, Karnataka
MBBS Phase – I Degree Examination
Biochemistry -Model Paper I QP Code- Max Marks: 100 Marks Time - 3 hrs Answer all questions. Draw diagrams wherever necessary I. Long Essay 2X10=20 marks 1. A 57 year old man was brought to the emergency with a history of 12 hours shortness of breath, coughing and tightness in the chest region. The symptoms appeared suddenly. His past medical history is significant for diabetes mellitus and hypertension. He is a known smoker and alcoholic. At the time of admission his B.P was 180/100 mm of Hg. The laboratory tests showed CKMB as 45 IU / L (reference Range 5-25 IU/L). a) Suggest the probable diagnosis? (1 Mark) b) Define isoenzymes. (1Mark) c) Discuss different isoenzyme forms of any two relevant enzyme along with their characteristics, and clinical significance (8 marks)
2. Discuss Vit B12 with respect to the following
a) Dietary sources and RDA. (2Marks) b) How is it absorbed from the intestine? (2 Marks) b) Biochemical role as coenzyme (2 marks) c) Deficiency manifestations and their biochemical basis. (3 Marks) d) Why vegans develop Vit B12 deficiency (1 Mark)
II. Write Short Essays 10X5=50
marks 3. What are Phospholipids? Mention the composition and function of any four of lipids. (1+4) 4. Mention the reference range of HDL cholesterol (HDL-C). Justify the role of HDL-C as scavenger of cholesterol illustrating the metabolic pathway. (1+4) 5. Define oxidative phosphorylation.. Explain the Chemiosmotic theory of oxidative phosphorylation with suitable diagram. (1+4) 6. A 25 yrs old type 1 Diabetic patients presented with hypertension, dry mucous membrane and poor skin turgor. On examination the patient was tachypneic and his breath had fruity odour. His blood investigations showed RBS - 550mg/dL, pH- 7.25, pCO2 - 38 mmHg, HCO3- - 16 mEq/L A) Suggest the acid base disorder (1) B) Explain the causes, biochemical abnormalities and compensatory mechanisms in this acid base disorder. (2) C) What is anion gap and how do you relate anion gap in this case. (2) 7. A 12 year old girl came with h/o of distension of abdomen and complained of frequent episodes of weakness, sweating and pallor that subsided on eating . O/E significant findings showed hepatomegaly. Blood examination revealed Fasting Plasma Glucose-40mg/dL, Triglycerides- Increased, Lactic acid- Increased, Uric acid- Increased and Ketone bodies- Increased a) Suggest the probable diagnosis (0.5 Mark) b)Name the deficient enzyme in this case (0.5 Mark) c) Outline the reactions of the affected pathway in this case (2 Marks) b) Analyze the reason for increased lactic acid and uric acid levels in this case. (2 Marks) 8. Mention the reference range of serum calcium. Explain the regulation of blood calcium level. (1+4) 9. Compare and contrast Marasmus and Kwashiorkor. 10. Explain the anapleurotic reactions of TCA cycle . (5) 11. Explain the synthesis of ketone bodies. Justify the role of ketone bodies as alternate source of energy. (3+2) 12. Discuss Oral Glucose Tolerance Test (GTT) under the following headings: Indications, contraindications, procedure and interpretation of oral GTT. (1+1+1+2)
III. Short Answers 10X3= 30 marks
13. Draw a neat labelled diagram of Mitochondria and Name any two mitochondrial disorders.(2+1) 14. Enumerate the any six components of ECM 15. Explain the protein sparing action of carbohydrates in the body. 16. Mention the Biological Reference Range in the serum for the following analytes a) Na b) K c) Cl- d) ca e) Phosphorus f) Bicarbonate 17. List any 3 functions each of copper and zinc . 18. Discuss the relationship between Vit E and selenium 19. Digoxin, a cardio tonic drug inhibits which transport pump in the membranes. Explain the mechanism of this pump. 20. Mention the role of lipases involved in the digestion of lipids 21. Define osmolality. Mention the reference range of plasma osmolality. 22. Mention the therapeutic significance of competitive inhibition citing three examples.