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Clinical Biochemistry — Protein biochemistry Quiz

Total questions: 85

Worksheet time: 43mins

Name
Class
Date
1.

A patient on a strict vegetarian diet develops muscle wasting and fatigue. Which of the following best explains this condition?

a)

Negative nitrogen balance

b)

Positive nitrogen balance

c)

Nitrogen equilibrium

d)

Increased urea excretion

e)

Reduced ammonia detoxification

2.

A burn patient requires increased protein intake for recovery. Which of the following best represents his metabolic state?

a)

Positive nitrogen balance

b)

Negative nitrogen balance

c)

Nitrogen equilibrium

d)

Ammonia excess

e)

Protein catabolism decrease

3.

A man with liver cirrhosis has elevated blood ammonia. Which of the following pathways is primarily impaired?

a)

Urea cycle

b)

Glycolysis

c)

Beta-oxidation

d)

TCA cycle

e)

Electron transport chain

4.

A child presents with edema and a distended abdomen due to protein deficiency. Which of the following best describes this condition?

a)

Kwashiorkor

b)

Marasmus

c)

Obesity

d)

Cachexia

e)

Hyperproteinemia

5.

A patient with chronic renal failure has high blood urea nitrogen (BUN). Which of the following explains this finding?

a)

Decreased urea excretion

b)

Increased urea synthesis

c)

High protein diet

d)

Urea cycle defect

e)

Hepatic coma

6.

After prolonged fasting, which of the following becomes the main source of glucose?

a)

Amino acid catabolism

b)

Fatty acid oxidation

c)

Glycogenolysis

d)

Ketone utilization

e)

Cholesterol breakdown

7.

A genetic defect in carbamoyl phosphate synthetase I leads to accumulation of which compound?

a)

Ammonia

b)

Urea

c)

Creatinine

d)

Aspartate

e)

Citrulline

8.

A patient consumes excessive protein supplements. Which of the following will most likely increase in the blood?

a)

Urea

b)

Glucose

c)

Ketone bodies

d)

Bilirubin

e)

Lactate

9.

A neonate with hyperammonemia is diagnosed with an enzyme defect in the urea cycle. Which of the following is the most likely consequence?

a)

Reduced excretion of nitrogen

b)

Enhanced amino acid synthesis

c)

Decreased gluconeogenesis

d)

Increased protein synthesis

e)

Elevated urea in urine

10.

During starvation, which of the following occurs to maintain glucose levels?

a)

Muscle protein breakdown increases

b)

Protein synthesis increases

c)

Urea synthesis decreases

d)

Amino acid oxidation stops

e)

Fat oxidation ceases

11.

A marathon runner shows increased plasma alanine levels post-race. This is mainly due to which of the following?

a)

Muscle protein breakdown

b)

Fat oxidation

c)

Glycogen storage

d)

Ketone production

e)

Ammonia detoxification

12.

A patient with liver dysfunction exhibits confusion due to elevated ammonia. Which treatment would best help reduce this?

a)

Lactulose

b)

Insulin

c)

Vitamin D

d)

Cortisol

e)

Adrenaline

13.

A high-protein diet may cause which of the following changes in renal function?

a)

Increased urea excretion

b)

Decreased urine formation

c)

Decreased ammonia production

d)

Reduced filtration rate

e)

Proteinuria

14.

A low BUN level in blood is most likely due to which of the following?

a)

Liver failure

b)

Renal failure

c)

High protein intake

d)

Starvation

e)

Muscle injury

15.

A trauma patient in ICU shows rapid weight loss despite adequate calorie intake. Which of the following processes is increased?

a)

Protein catabolism

b)

Lipogenesis

c)

Amino acid synthesis

d)

Glucose storage

e)

Ketone synthesis inhibition

16.

In a patient with protein-energy malnutrition, plasma albumin is reduced. Which of the following is a clinical consequence?

a)

Edema

b)

Polyuria

c)

Fever

d)

Bradycardia

e)

Hypertension

17.

A defect in arginase leads to accumulation of which metabolite?

a)

Arginine

b)

Urea

c)

Citrulline

d)

Aspartate

e)

Ornithine

18.

A malnourished patient with marasmus shows loss of subcutaneous fat. Which of the following is preserved?

a)

Serum albumin

b)

Body fat

c)

Muscle protein

d)

Urea excretion

e)

Nitrogen intake

19.

After protein ingestion, amino acids enter the liver. Which of the following is their immediate metabolic fate?

a)

Transamination

b)

Ketone synthesis

c)

Cholesterol formation

d)

Glycogen synthesis

e)

Protein degradation

20.

A patient with severe hepatic dysfunction accumulates ammonia. Which of the following amino acids plays a major role in its transport?

a)

Glutamine

b)

Serine

c)

Glycine

d)

Lysine

e)

Tyrosine

21.

Following a high-protein meal, which of the following enzymes is most active?

a)

Transaminase

b)

Lipase

c)

Amylase

d)

Lactase

e)

Kinase

22.

A person undergoing intense exercise develops muscle fatigue due to increased ammonia production. Which organ detoxifies it?

a)

Liver

b)

Muscle

c)

Kidney

d)

Brain

e)

Pancreas

23.

A child with phenylketonuria lacks an enzyme responsible for converting phenylalanine to which amino acid?

a)

Tyrosine

b)

Glycine

c)

Alanine

d)

Serine

e)

Cysteine

24.

A protein-deficient diet impairs wound healing mainly due to reduced synthesis of which protein?

a)

Collagen

b)

Actin

c)

Myosin

d)

Elastin

e)

Fibrinogen

25.

A patient with a high-protein diet and normal renal function will show an increase in which of the following?

a)

Urea excretion

b)

Bilirubin

c)

Ammonia accumulation

d)

Glucose reabsorption

e)

Ketone production

26.

Which of the following is the primary element distinguishing proteins from carbohydrates and lipids?

a)

Nitrogen

b)

Carbon

c)

Hydrogen

d)

Oxygen

e)

Sulfur

27.

Which of the following represents a fibrous protein?

a)

Collagen

b)

Albumin

c)

Hemoglobin

d)

Myoglobin

e)

Insulin

28.

Which of the following is a globular protein?

a)

Hemoglobin

b)

Keratin

c)

Collagen

d)

Elastin

e)

Fibrin

29.

Which of the following is an example of a conjugated protein?

a)

Hemoglobin

b)

Albumin

c)

Collagen

d)

Keratin

e)

Insulin

30.

Which of the following bonds stabilize secondary protein structure?

a)

Hydrogen bonds

b)

Ionic bonds

c)

Peptide bonds

d)

Disulfide bonds

e)

Hydrophobic bonds

31.

Which of the following structures is lost during protein denaturation?

a)

Secondary and tertiary

b)

Primary only

c)

Quaternary only

d)

Peptide bonds

e)

All levels

32.

Which of the following amino acids is essential?

a)

Lysine

b)

Alanine

c)

Glycine

d)

Serine

e)

Proline

33.

Which of the following amino acids is nonessential?

a)

Alanine

b)

Leucine

c)

Valine

d)

Isoleucine

e)

Lysine

34.

Which of the following statements about essential amino acids is correct?

a)

Must be obtained from diet

b)

Synthesized in the body

c)

Stored in the liver

d)

Formed from urea

e)

Produced during fasting

35.

Which of the following best describes nitrogen balance in healthy adults?

a)

Nitrogen intake equals nitrogen loss

b)

Nitrogen intake exceeds loss

c)

Nitrogen loss exceeds intake

d)

No nitrogen excretion

e)

Ammonia replaces urea

36.

Which of the following indicates positive nitrogen balance?

a)

Growth period

b)

Starvation

c)

Infection

d)

Trauma

e)

Liver failure

37.

Which of the following indicates negative nitrogen balance?

a)

Prolonged illness

b)

Growth

c)

Pregnancy

d)

Recovery

e)

Exercise

38.

Which of the following organs is the main site of urea synthesis?

a)

Liver

b)

Kidney

c)

Muscle

d)

Brain

e)

Pancreas

39.

Which of the following is the main nitrogen excretory product in humans?

a)

Urea

b)

Ammonia

c)

Uric acid

d)

Creatinine

e)

Nitrate

40.

Which of the following intermediates links urea cycle and TCA cycle?

a)

Fumarate

b)

Oxaloacetate

c)

Citrate

d)

Malate

e)

Aspartate

41.

Which of the following enzymes initiates the urea cycle?

a)

Carbamoyl phosphate synthetase I

b)

Arginase

c)

Ornithine transcarbamoylase

d)

Argininosuccinate synthetase

e)

Aspartate aminotransferase

42.

Which of the following is required for activation of carbamoyl phosphate synthetase I?

a)

N-acetylglutamate

b)

ATP

c)

FAD

d)

NADH

e)

Biotin

43.

Which of the following amino acids carries ammonia to the liver?

a)

Glutamine

b)

Serine

c)

Glycine

d)

Cysteine

e)

Tyrosine

44.

Which of the following amino acids is glucogenic and ketogenic?

a)

Isoleucine

b)

Alanine

c)

Glycine

d)

Aspartate

e)

Serine

45.

Which of the following amino acids forms serotonin?

a)

Tryptophan

b)

Tyrosine

c)

Phenylalanine

d)

Methionine

e)

Cysteine

46.

Which of the following amino acids is the precursor of thyroid hormones?

a)

Tyrosine

b)

Phenylalanine

c)

Tryptophan

d)

Serine

e)

Cysteine

47.

Which of the following indicates high BUN?

a)

Renal failure

b)

Liver failure

c)

Low protein diet

d)

Overhydration

e)

Anemia

48.

Which of the following indicates low BUN?

a)

Liver disease

b)

Renal disease

c)

Dehydration

d)

High protein intake

e)

Fever

49.

Which of the following tests evaluates renal function through protein metabolism?

a)

Blood urea nitrogen

b)

Creatinine clearance

c)

Serum uric acid

d)

Urine ketone bodies

e)

Plasma ammonia

50.

Which of the following disorders involves defective collagen synthesis?

a)

Scurvy

b)

Kwashiorkor

c)

Marasmus

d)

Gout

e)

Diabetes

51.

Which of the following amino acids forms melanin?

a)

Tyrosine

b)

Tryptophan

c)

Methionine

d)

Alanine

e)

Glycine

52.

Which of the following is true about albumin?

a)

Maintains plasma oncotic pressure

b)

Serves as an enzyme

c)

Functions as a receptor

d)

Acts as a hormone

e)

Stores oxygen

53.

Which of the following protein classes includes immunoglobulins?

a)

Protective

b)

Structural

c)

Contractile

d)

Transport

e)

Storage

54.

Which of the following is a transport protein?

a)

Hemoglobin

b)

Collagen

c)

Actin

d)

Keratin

e)

Fibrin

55.

Which of the following represents a derived protein?

a)

Peptone

b)

Albumin

c)

Collagen

d)

Keratin

e)

Casein

56.

Which of the following amino acids contains sulfur?

a)

Methionine

b)

Valine

c)

Alanine

d)

Glycine

e)

Serine

57.

Which of the following bonds is formed between amino acids?

a)

Peptide bond

b)

Hydrogen bond

c)

Disulfide bond

d)

Ionic bond

e)

Glycosidic bond

58.

Which of the following processes converts amino acids to energy?

a)

Deamination

b)

Transamination

c)

Amination

d)

Condensation

e)

Hydroxylation

59.

Which of the following occurs during transamination?

a)

Transfer of amino group

b)

Removal of amino group

c)

Conversion to ammonia

d)

Oxidation of carbon skeleton

e)

ATP formation

60.

Which of the following amino acids is the main donor of amino groups?

a)

Glutamate

b)

Alanine

c)

Glycine

d)

Tyrosine

e)

Serine

61.

Which of the following best describes the amino acid pool?

a)

Total free amino acids available in body fluids

b)

Stored amino acids in liver

c)

Dietary amino acids only

d)

Protein-bound amino acids

e)

Plasma-bound amino acids

62.

Which of the following factors increases amino acid pool?

a)

Protein breakdown

b)

Lipid synthesis

c)

Glycogen storage

d)

Ketone production

e)

Fat oxidation

63.

Which of the following enzymes removes the amino group from glutamate?

a)

Glutamate dehydrogenase

b)

Transaminase

c)

Decarboxylase

d)

Synthetase

e)

Kinase

64.

Which of the following components is produced in the final step of the urea cycle?

a)

Urea

b)

Ornithine

c)

Fumarate

d)

Citrulline

e)

Aspartate

65.

Which of the following best defines amphoteric nature of proteins?

a)

Acts as acid and base

b)

Only acidic

c)

Only basic

d)

Nonionic

e)

Neutral

66.

Which of the following statements about dietary protein is correct?

a)

Provides essential amino acids

b)

Provides glucose only

c)

Provides fatty acids

d)

Lacks nitrogen

e)

Is energy neutral

67.

Which of the following reflects the biological value of a protein?

a)

Proportion of absorbed nitrogen retained

b)

Caloric value

c)

Fat content

d)

Iron composition

e)

Peptide length

68.

Which of the following amino acids forms nitric oxide?

a)

Arginine

b)

Glycine

c)

Alanine

d)

Methionine

e)

Tryptophan

69.

Which of the following is the first step of amino acid catabolism?

a)

Transamination

b)

Urea formation

c)

Deamination

d)

Oxidation

e)

Reduction

70.

Which of the following conditions results from excessive protein catabolism?

a)

Negative nitrogen balance

b)

Positive nitrogen balance

c)

Nitrogen equilibrium

d)

Reduced BUN

e)

Protein anabolism

71.

Which of the following disorders shows increased serum globulins?

a)

Chronic infection

b)

Liver failure

c)

Nephrotic syndrome

d)

Starvation

e)

Malnutrition

72.

Which of the following is a function of structural proteins?

a)

Provide support to tissues

b)

Transport gases

c)

Act as enzymes

d)

Regulate hormones

e)

Store energy

73.

Which of the following is the clinical significance of serum albumin measurement?

a)

Indicator of nutritional status

b)

Marker for infection

c)

Test for carbohydrate metabolism

d)

Marker for lipid metabolism

e)

Indicator of enzyme deficiency

74.

Which of the following represents the simplest amino acid?

a)

Glycine

b)

Alanine

c)

Serine

d)

Valine

e)

Cysteine

75.

Which of the following represents the main form of nitrogen excretion in urine?

a)

Urea

b)

Creatine

c)

Ammonia

d)

Uric acid

e)

Peptides

76.

Which of the following plasma proteins is responsible for maintaining oncotic pressure of blood?

a)

Albumin

b)

Globulin

c)

Fibrinogen

d)

Ceruloplasmin

e)

Transferrin

77.

Which of the following plasma proteins acts as a carrier for thyroxine and bilirubin?

a)

Albumin

b)

Fibrinogen

c)

Haptoglobin

d)

Transferrin

e)

Globulin

78.

Which of the following plasma proteins increases markedly during inflammation?

a)

C-reactive protein

b)

Albumin

c)

Prealbumin

d)

Myoglobin

e)

Ferritin

79.

Which of the following proteins is primarily involved in blood clot formation?

a)

Fibrinogen

b)

Albumin

c)

Transferrin

d)

Immunoglobulin G

e)

Ceruloplasmin

80.

Which of the following represents a simple protein composed only of amino acids?

a)

Albumin

b)

Hemoglobin

c)

Glycoprotein

d)

Lipoprotein

e)

Metalloprotein

81.

Which of the following plasma proteins binds free hemoglobin in the blood?

a)

Haptoglobin

b)

Transferrin

c)

Albumin

d)

Fibrinogen

82.

Which of the following best explains hypoalbuminemia in liver disease?

a)

Decreased hepatic synthesis of albumin

b)

Increased renal loss of protein

c)

Increased gastrointestinal absorption

d)

Decreased urea formation

e)

Increased albumin catabolism in muscle

83.

Which of the following proteins functions as a major iron transport protein in plasma?

a)

Transferrin

b)

Ceruloplasmin

c)

Ferritin

d)

Albumin

e)

Haptoglobin

84.

Which of the following findings is expected in nephrotic syndrome?

a)

Decreased albumin and increased α2-globulin

b)

Increased albumin and decreased β-globulin

c)

Increased γ-globulin and albumin

d)

Decreased α1-globulin and normal albumin

e)

Increased fibrinogen and prealbumin

85.

Which of the following plasma proteins carries copper and prevents its toxicity?

a)

Ceruloplasmin

b)

Transferrin

c)

Haptoglobin

d)

Albumin

e)

Fibrinogen

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