En-Metabolism Lipidic
En-Metabolism Lipidic
En-Metabolism Lipidic
a) Taurocholate
b) Glycocholate
c) Calcitriol
d) Corticosteroids
e) Calcitonin.
a) Acetyl co A
b) Acetoacetyl co A
c) Propionyl co A
d) Succinyl co A
e) Malonyl co A
a) Thiolase
b) Thioesterase
c) Thiophorase
d) HMG Co A synthase
e) HMG Co A reductase.
4)- Which out of the following statements best describes about ACAT (Acyl co A
cholesterol acyl transferase) ?
5)- Which out of the following statements is incorrect about bile salts ?
7)- Which of the following lipid lowering drugs act by inhibiting the absorption of dietary
cholesterol ?
a) Statins
b) Ezetimibe
c) Colestipol
d) Clofibrate
e) Cholestyramine
b) LDL receptors for modified LDL (Ox LDL) are not down regulated
9)- A patient presents with very high levels of serum cholesterol. After a series of tests, it is
concluded that the patient has high circulating levels of LDL cholesterol, but has normal
levels of the liver LDL receptor. One possible explanation for this observation is which of
the following?
10)- A patient presents in your office with very high levels of serum cholesterol. He states
that he has tried to follow the diet and exercise regimen you gave him last year. You decide
that this patient would benefit from a drug such as Lipitor (atorvastatin). This class of
drugs is effective in treating hypercholesterolemia because it has what effect?
11)- Free cholesterol can affect cholesterol metabolism in the body by inhibiting cholesterol
biosynthesis. The step at which free cholesterol inhibits its biosynthesis is by inhibiting
which of the following processes?
a) Cyclizing of squalene to form lanosterol
12)- A patient with hereditary type I hyperlipidemia presents with elevated levels of
chylomicrons and VLDL triglycerides in the blood. The main function of the chylomicrons
in circulation is to do which of the following?
13)- The modification to bile salts that increases the working pH range and amphipathic
nature of bile salts is
a) 7α-Hydroxylation
c) Esterification
14)- A 53-year-old male patient with elevated levels of low-density lipoprotein (LDL)
cholesterol, signs of premature cholesterol gallstone disease and substantially elevated
triglycerides visited his physician for a follow-up to check his current status. The patient
had received various statin, HMG-CoA-reductase inhibitors therapies for the past 2 years.
However, after blood work done at this follow-up visit, complications had still not subsided.
This patient has similar problems as two of his siblings.
15)- A patient has been on combination statin and Cholestyramine therapy to lower his
serum cholesterol levels. Prior to any surgery, this patient would be well advised to be
supplemented with which of the following?
a) Vitamin A
b) Vitamin B12
c) Vitamin C
d) Vitamin K
e) Linolenic acid.
17)- A 18-year-old male with sickle-cell anemia develops severe right upper-abdominal
pain radiating to his lower right chest and his right flank 36 hours prior to admission to the
ER. He also reports that his urine is the color of iced tea and his stool now has a light clay
color. On examination, his temperature is slightly elevated, and heart rate is rapid. He is
exquisitely tender to pressure over his right upper abdomen. The sclerae of his eyes are
slightly yellowish in color.
a) A cholesterol-rich gallstone
18) Which of the following compounds directly inhibits the expression of the HMG-CoA
reductase gene?
a) Squalene
b) HMG-CoA
c) Lanosterol
d) Isopentenyl pyrophosphate
e) Cholesterol
19) Which of the following vitamins can be used in high doses to treat
hypercholesterolemia?
a) Niacin
b) Riboflavin
c) Pyridoxine
d) Folic acid
e) Thiamine.
20) A teenage boy presents with moderate to severe epigastric pain. Physical examination
reveals extensive eruptive xanthomas and hepatosplenomegaly. A blood sample reveals
milky plasma. Which of the following is the most likely lipoprotein to be elevated in this
patient ‘s plasma?
a) Chylomicrons
b) Chylomicron remnants
c) HDL
d) IDL
e) LDL
21) – A 25-year-old female was referred to a lipid research center for investigation of
moderate hypertriglyceridemia because the plasma lipid and lipoprotein profiles showed
abnormalities. Both HDL and LDL were more buoyant and showed elevations in TG
content with the mass of TG approximately the same as that of cholesterol. A deficiency in
which of the following is the most likely cause of this patient’ s lipid abnormality?
c) Apoprotein C-II
d) Hepatic lipase
e) Apoprotein B-100
22)- Laboratory results for a patient with uncontrolled Type I diabetes mellitus reveal
hyperglycemia (634 mg/dL) and hypertriglyceridemia (498 mg/dL). The most likely cause
of the hypertriglyceridemia in this patient is which of the following?
Key to answers
1)-e, 2)-a, 3)-e, 4)-c, 5)-d, 6)-b, 7)-b, 8)-b, 9)-a, 10)-e, 11)-c,
12)-b,
13)-d, 14)-c, 15)-d, 16)-d, 17)-d, 18)-e, 19)- a, 20)-a, 21)-d, 22)-c
b) Formation of chylomicrons
Q.2- An 8-year-old boy presents with orange-colored tonsils, a very low HDL levels and an
enlarged liver and spleen. He is diagnosed with Tangier disease. Tangier disease is a disease
of cholesterol transport, such that cholesterol cannot properly exit the cell and form HDL.
Which of the following statements best describes HDL ?
e) It activates ACAT
Q3- In contrast to secondary bile salts, which of the following is not a characteristic of
primary bile salts
Q.4-In the conversion of cholesterol to bile salts, which of the following statements best
describes the process ?
a) Carbon 8 is hydroxylated
Q.5- Which of the following statements best describes low density lipoprotein (LDL) ?
a) It has the most Triacyl glycerol and the least protein
a) Apo A
b) Apo B
c) Apo C II
d) Apo D
e) Apo E
Q.7- Which of the following lipoproteins are the major carriers of Triacyl glycerol ?
Q.8- A 60 -year-old woman presents with chest pain radiating to her left arm. She is
diagnosed with Myocardial infarction and is prescribed a statin medication. Statins inhibit
HMG Co A reductase. How does inhibition of HMG Co A reductase cause lowering of
cholesterol and LDL levels ?
Q.9) -A 35 year-old woman presents with crushing substernal chest pain and shortness of
breath. A coronary artery is occluded due to an atherosclerotic plaque, and she is
diagnosed with having myocardial infarction. Her serum cholesterol level is 700 mg/dl. The
family history is positive for high cholesterol level and she seems to be having familial
hypercholesterolemia. What is the possible biochemical defect in this genetic disorder ?
Q.10)- A 40- year-old man presents with severe pain in the legs upon walking. He is
diagnosed with atherosclerotic plaques in the arteries of his legs. High level of cholesterol
and LDL contribute to the formation of atherosclerosis. Which of the following is digested
to form LDL ?
a) IDL
b) Chylomicrons
c) HDL
d) Cholesteryl esters
e) Cholesterol.
Q.11- A 23-year-old female presents with low red blood cell count, corneal opacities and
kidney insufficiency. She is diagnosed with lecithin: cholesterol acyl transferase (LCAT)
deficiency. In which of the following reactions LCAT is involved ?
b) Hydrolysis of HDL
a) Statin
b) Niacin
c) Folic acid
d) Clofibrate
e) Ezetimibe.
a) only in mitochondria
d) In the lysosomes
Q.14- Which of the following best describes the role of cholesterol ester transfer protein
(CETP) ?
e) It is an activator of LCAT.
Key to Answers-
1)- a, 2)-b, 3)-a, 4)-b, 5)-e, 6)-c, 7)-c, 8)-d, 9)-c, 10)-a, 11)-d,
12)-c
a) Glycerol
c) Acetyl co A
d) Pyruvate
e) Malate.
Q.2- Which of the following supplies the 2 carbon units that are added to the elongation of
fatty acid chain?
a) Acetyl co A
b) Malonyl co A
c) β- Keto acyl co A
d) Glucose
e) Pyruvate.
c) NADPH
d) H2O
a) Glucose-6-P dehydrogenase
b) Pyruvate dehydrogenase
c) Acetyl co A carboxylase
d) Lipoprotein lipase
e) Glycerol kinase.
Q.5- A 45-year-old female presents with severe upper abdominal pain, nausea, and
vomiting. She is diagnosed with Pancreatitis (an inflammation of the pancreas).Her serum
triglyceride level is found to be 3000 mg/dl and is deemed as the cause for Pancreatitis. To
form Triacyl glycerol, which of the following is added to diacyl glycerol?
a) Glycerol
b) Glycerol-3-Phosphate
c) Fatty acyl co A
d) Acetyl co A
e) Succinyl co A.
Q.6- A 35-year-old man presents with yellow xanthomas on his skin and hepatomegaly
(enlarged liver). His Triglyceride level is 1500 mg/dl. He is diagnosed with type V
hyperlipidemia. Triglycerides are primarily synthesized in which of the following tissues?
a) Skeletal muscle
b) Heart muscle
c) Liver
d) Spleen
e) Blood cells.
Q.7- An 18-year-old female is diagnosed as obese. She maintains a sedentary life style and
eats a high-fat, high-sugar diet. Maintenance of this diet and lifestyle has led to lipogenesis
and obesity. Which of the following affects excessive fatty acid synthesis?
Q.8- A 30- year-old pregnant woman has a sugar craving and consumes a hot fudge
sundae. Her serum glucose level increases, which causes release of Insulin. Insulin is known
to increase the activity of acetyl co A carboxylase , the rate limiting enzyme of fatty acid
biosynthesis. Which of the following best describes this regulatory enzyme?
a) It is activated by carboxylation
e) It is activated by malonyl co A.
Q.9- A 16-year-old female presents with xanthomas on her eyelids. She is found to have a
rare genetic deficiency of lipoprotein lipase and is diagnosed with type 1 hyperlipidemia. In
this disorder chylomicrons are abnormally elevated in the serum. In what type of cell are
triacylglycerols packaged in to chylomicrons?
b) Liver cell
c) Muscle cell
d) Heart cell
e) Adipose cell.
Q.10- A 50-year-old, alcoholic male presents with a swollen face, distended abdomen, and
an enlarged fatty liver. Fatty acids react with glycerol-3-P to form triglycerides, which
accumulate to cause fatty liver. The liver has glycerol kinase, while adipose tissue lacks
glycerol kinase. As a result, in adipose tissue, which of the following occurs?
Q.11- A 25-year-old man is brought to the emergency room after a motor vehicle accident.
He has a dislocated hip, rib fractures and a facial laceration. Toxicology screen shows a
high level of ethanol in his blood. Oxidation of ethanol produces acetaldehyde and NADH.
A high level of NADH relative to NAD + slows TCA cycle and promotes the conversion of
which of the following reactions?
c) Citrate to isocitrate
Q.12- A 35-year-old woman presents with flatulence, bloating, and steatorrhea (fat in the
stool). She had been eating large amounts of potato chips that were made using Olestra, a
fat substitute. Normally, dietary triacylglycerol are hydrolyzed in to components that are
reconstructed into triacylglycerols that become a component of chylomicrons. In the
intestinal cell, the initial precursor for fatty acid synthesis is which of the following?
a) Glycerol
b) Glycerol-3-P
d) Phosphatidic acid
e) Acetyl co A.
Q.13- The complete oxidation of odd chain fatty acid produces which of the followings?
a) Acetyl co A only
c) Butyryl co A
d) Palmitoyl co A
e) Propionyl co A only
Q.14- The activation of long chain fatty acids requires which of the following components?
a) 2 ATP
b) 2 ATP and Co A
Q.15- Which of the following statements best describes the β- oxidation of fatty acids?
e) 129 ATP are required for the formation of one mol of Palmitic acid.
Q.16- β- oxidation of long chain fatty acids occurs primarily in which of the following
locations?
a) Cytosol
b) Peroxisomes
c) Mitochondria
d) Endoplasmic reticulum
e) Golgi apparatus.
Q.17- How many carbons are removed from fatty acyl co A in one turn of β- oxidation
spiral ?
a) 1
b) 2
c) 3
d) 4
e) 6
a) ATP
b) NAD +
c) FADH2
d) Acetyl co A
e) Propionyl co A.
a) Cleaves of Co A
d) Generates NADH
e) Generates FADH2
a) Co A
b) CO2
c) H2O
d) Acetyl co A
e) Hydrogen peroxide.
Q.21- A 16-year-old extremely slender girl presents with a body weight that is 35% below
expected. She still feels herself to be obese and severely restricts her food intake. She is
diagnosed with Anorexia Nervosa. In this patient, due to improper dietary intake, the
breakdown of fatty acids is required to provide energy. Which of the following substance is
formed in the first step of the beta oxidation of fatty acids?
a) ATP
b) Co A
c) Fatty acyl co A
d) Carnitine
e) Malonyl co A.
Q.22- A 5-year-old boy presents with altered mental status, heart failure, and muscle
weakness. His serum level of ketones and glucose are abnormally low. He is diagnosed with
primary carnitine deficiency. In which of the following is carnitine directly involved?
c) β-Oxidation
d) ω- Oxidation
e) α- Oxidation.
Q.23- A 10-year-old girl presents with difficult walking, muscle weakness and altered
mental status. She is diagnosed with carnitine acyl transferase deficiency. Carnitine acyl
Transferase-I catalyzes a reaction that produces which of the following?
a) Fatty acyl co A
c) Fatty enoyl co A
d) β- OH- Acyl co A
e) β- Keto acyl co A.
Q.24- An obese, 40-year-old woman, who recently underwent gastric bypass surgery,
presents with severe vomiting due to rapid intake of large quantities of food, which must be
avoided after gastric bypass surgery. She had successfully lost 10 Ib over the last month
after the surgery die to mobilization of fat stores to provide acetyl co A and energy. When
palmitoyl co A is oxidised, how many Acetyl co A are produced?
a)1
b) 10
c) 6
d) 8
e) 4
Q.25- A 16-year-old marathon runner trains by running 15 miles every morning, requiring
a constant supply of ATP. Approximately How many ATP are produced when palmitoyl co
A is oxidized to CO2 and H2O ?
a) 100
b) 129
c) 136
d) 96
Key to answers- 1)-b, 2)-b, 3)-a, 4)-a, 5) –c, 6)-c, 7)-e, 8)-c, 9)-a,
10)-b, 11)- a, 12)- c, 13)- b,
14)- b, 15)- a, 16)- c, 17)- b, 18)- b, 19)- b, 20)- b, 21)-c, 22)-
b 23)- b, 24)-d, 25)-b.