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pH, Amino Acids, Proteins - MARIAM NIKOLASHVILI

Total questions: 40

Worksheet time: 7mins

Name
Class
Date
1.

A patient with pH 7.1, low bicarbonate, and compensatory hyperventilation most likely has:

a)

Metabolic acidosis

b)

Respiratory acidosis

c)

Metabolic alkalosis

d)

Respiratory alkalosis

e)

Normal acid–base balance

2.

Which condition is caused by excessive vomiting?

a)

Metabolic acidosis

b)

Metabolic alkalosis

c)

Respiratory acidosis

d)

Respiratory alkalosis

e)

Mixed acidosis

3.

A patient with COPD and elevated pCO2 with low blood pH is most likely suffering from:

a)

Metabolic acidosis

b)

Respiratory acidosis

c)

Respiratory alkalosis

d)

Mixed alkalosis

e)

Metabolic alkalosis

4.

Which parameter decreases when an acid is strong?

a)

Ka

b)

pKa

c)

Buffer capacity

d)

Hydrogen ion concentration

5.

Which is not a cause of respiratory alkalosis?

a)

Hyperventilation

b)

High altitude

c)

Fever

d)

COPD

e)

Anxiety

6.

During compensation for metabolic acidosis, respiration:

a)

Decreases

b)

Increases

c)

Remains unchanged

d)

Stops intermittently

7.

Which amino acid is not chiral?

a)

A. Alanine

b)

B. Glycine

c)

C. Serine

d)

D. Threonine

e)

E. Valine

8.

Branched-chain amino acids include:

a)

Leucine, Isoleucine, Valine

b)

Lysine, Arginine, Histidine

c)

Alanine, Glycine, Proline

d)

Phenylalanine, Tyrosine, Tryptophan

e)

Aspartate, Glutamate, Glutamine

9.

Which amino acid introduces kinks in alpha helices?

a)

Valine

b)

Proline

c)

Alanine

d)

Serine

e)

Cysteine

10.

Tertiary structure of proteins is stabilized by all except:

a)

Disulfide bridges

b)

Hydrogen bonds

c)

Peptide bonds

d)

Ionic bonds

e)

Hydrophobic interactions

11.

Denaturation of proteins involves loss of:

a)

Primary structure

b)

Secondary and tertiary structures

c)

Peptide bonds

d)

Amino acid sequence

e)

Covalent linkages

12.

Infectious prions cause:

a)

Alzheimer’s disease

b)

Creutzfeldt–Jakob disease

c)

Methemoglobinemia

d)

Marfan Syndrome

e)

Scurvy

13.

Which amino acid is unique to collagen?

a)

Proline

b)

Hydroxyproline

c)

Tyrosine

d)

Alanine

e)

Glycine

14.

The most life-threatening complication of Marfan syndrome is:

a)

Joint dislocation

b)

Lens dislocation

c)

Aortic aneurysm

d)

Mitral valve prolapse

e)

Pulmonary embolism

15.

Which structure is responsible for elasticity of elastin?

a)

Glycine

b)

Desmosine

c)

Alanine

d)

Lysine

e)

Valine

16.

Prolonged intake of β-aminopropionitrile (a lysyl oxidase inhibitor) can lead to:

a)

Increased collagen crosslinking

b)

Decreased elastin crosslinking

c)

Enhanced bone formation

d)

Increased hemoglobin synthesis

17.

Myoglobin differs from hemoglobin by:

a)

Being tetrameric

b)

Having a hyperbolic O₂ curve

c)

Transporting CO₂

d)

Showing cooperative binding

e)

Binding 4 oxygen molecules

18.

The iron in heme normally exists in which oxidation state?

a)

Fe⁰

b)

Fe⁺

c)

Fe²⁺

d)

Fe³⁺

e)

Fe⁴⁺

19.

HbF has a higher affinity for oxygen than HbA because it:

a)

Binds more CO₂

b)

Binds less 2,3-BPG

c)

Is tetrameric

d)

Contains β chains

e)

Is oxidized

20.

The T (tense) state of hemoglobin has:

a)

High oxygen affinity

b)

Low oxygen affinity

c)

Denatured chains

d)

Reduced heme iron

e)

Increased pH

21.

Cooperative binding means:

a)

O₂ binds independently to each subunit

b)

Binding of one O₂ increases affinity for the next

c)

O₂ binds more tightly to deoxy-Hb

d)

2,3-BPG decreases binding

e)

pH has no effect of Hb and O2 binding

22.

The Bohr effect describes the influence of:

a)

Temperature on O₂ binding

b)

pH and CO₂ on O₂ affinity

c)

Enzyme concentration

d)

Blood buffer concentration

e)

Iron content within the body

23.

Increasing 2,3-BPG levels will:

a)

Shift O₂ curve to left

b)

Shift O₂ curve to right

c)

Increase O₂ affinity

d)

Cause alkalosis

e)

Prevent CO binding

24.

Which form of Hb cannot bind oxygen?

a)

Carbaminohemoglobin

b)

Methemoglobin

c)

Oxyhemoglobin

d)

Deoxyhemoglobin

e)

HbF

25.

Methemoglobinemia results from oxidation of:

a)

Fe2+ to Fe3+

b)

Fe3+ to Fe2+

c)

Heme to bilirubin

d)

Porphyrin ring cleavage

e)

Vitamin C deficiency

26.

Common cause of acquired methemoglobinemia:

a)

Vitamin B12 deficiency

b)

Nitrate or benzocaine exposure

c)

Iron overload

d)

Oxygen therapy

e)

Diabetes Mellitus type 2

27.

Infants are more susceptible to methemoglobinemia because:

a)

A. Fetal Hb has less 2,3-BPG

b)

B. NADH-methemoglobin reductase is immature

c)

C. They have more RBCs

d)

D. Their lung capacity is larger compared to adults

e)

E. Their heme is mainly made from Fe3+

28.

What is an antidote for severe methemoglobinemia:

a)

Vitamin C

b)

Methylene blue

c)

Glucose

d)

Oxygen therapy only

e)

Iron Supplements

29.

Carbon monoxide binds to hemoglobin:

a)

At CO₂ binding sites

b)

At O₂ binding sites

c)

At β-globin chains

d)

Irreversibly only

30.

CO binding to Hb shifts O₂ dissociation curve:

a)

Right

b)

Left

c)

Downward

d)

Upward

e)

No change

31.

A patient with cherry-red skin, headache, and confusion after furnace exposure likely has:

a)

Anemia

b)

CO poisoning

c)

Methemoglobinemia

d)

Hypoventilation

e)

Cyanosis

32.

The most effective immediate management of CO poisoning:

a)

Methylene blue

b)

Hyperbaric oxygen therapy

c)

Iron chelation

d)

Vitamin B₆

e)

Rest in bed

33.

Chronic smokers have increased levels of:

a)

Oxyhemoglobin

b)

Carboxyhemoglobin

c)

Methemoglobin

d)

Fetal Hb

e)

Myoglobin

34.

HbA1C is used clinically to monitor:

a)

Iron deficiency anemia

b)

Diabetes mellitus

c)

Liver disease

d)

Sickle cell presence within blood

e)

Hemophilia

35.

A patient with cyanosis unresponsive to oxygen therapy but responsive to methylene blue likely has:

a)

CO poisoning

b)

Methemoglobinemia

c)

Sickle cell disease

d)

Anemia

e)

Asthma

36.

Excess 2,3-BPG production helps adaptation to:

a)

Hypoxia

b)

Alkalosis

c)

CO poisoning

d)

Hyperglycemia

e)

Hypoglycemia

37.

During exercise, Hb affinity for O2 decreases due to:

a)

Decrease in temperature

b)

Decrease in CO2

c)

Increase in temperature and H+

d)

Increase in pH

e)

Decrease in 2,3-BPG

38.

22-year-old tall, thin man with long limbs presents with lens dislocation and an aortic root aneurysm. Which of the following best explains the underlying molecular defect?

a)

Collagen type I gene mutation

b)

Fibrillin-1 gene mutation

c)

Elastin overproduction

d)

Defective lysyl oxidase

e)

Vitamin C Deficiency

39.

In Marfan Syndrome, which of the following is least likely to be seen?

a)

Aortic dissection

b)

Pectus excavatum

c)

Hyperextensible joints

d)

Blue sclera

e)

Lens dislocation

40.

A child presents with bleeding gums, delayed wound healing, and perifollicular hemorrhages. Which laboratory finding is most consistent with this condition?

a)

Decreased serum copper

b)

Decreased lysine hydroxylation

c)

Increased plasma calcium

d)

Decreased hemoglobin production

e)

Elevated proline hydroxylase activity

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