Case 5 Questions 1-10

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Question 1

Which one of the following is the correct description of gluconeogenesis?

  1. A catabolic process where glucose is produced from non carbohydrate sources
  2. An anabolic process where glucose is produced from carbohydrate sources
  3. An anabolic process where glucose is produced from non carbohydrate sources
  4. A catabolic processes where glucose is produced from carbohydrate sources
  5. A catabolic process where glucose is broken down into pyruvate Definition of glycolysis is

The correct answer is option c An anabolic process where glucose is produced from non carbohydrate sources ​

C is correct as the process is anabolic as it builds up
a. This is incorrect as the process is anabolic, not catabolic
b. Incorrect as glyconeogenesis is from a non-carbohydrate source
d. Incorrect as glyconeogenesis is from a non-carbohydrate source
e. This is incorrect, this is the definition of glycolysis

Question 2

What is the first line management for type 2DM?​

  1. Lifestyle advice
  2. Metformin
  3. Insulin
  4. Basal bolus regime
  5. Statin

The correct answer is option a Lifestyle advice

This is correct, to not start medications too early
b. Incorrect, this is the first drug management
c. Incorrect, this is first line for T2DM
d. This is not correct for the treatment of T2DM first line
e. This is to control cholesterol levels

Question 3

During vigorous exercise, the body cannot intake enough oxygen to maintain the respiratory needs of all its muscles in an aerobic state. At this point, anaerobic metabolism begins and this relies on glycolysis for the production of energy, What enzyme is responsible for catalysing the rate limiting step

  1. Hexokinase
  2. Phosphofuctokinase
  3. Aldolase
  4. Phosphoglycerate kinase
  5. pyruvate kinase

The correct answer is option b Phosphofuctokinase

This is correct as the rate limiting step is from phosphofuctokinase to bisphosphofructokinase
a. This catalysises the first step of glycolysis
c. This is the enzyme for the breaking of bisphosphofructokinase
d. This is involved later in glycolysis
e. This catalyses the last stage of glycolysis

Question 4

Which of the following statements correctly describes the properties of oral antiglycaemics?

  1. GLP-1 analogues have a bioavailbility of 93%​
  2. Pioglitazone is contraindicated in patients with a low ejection fraction
  3. Metformin use is associated with recurrent of UTI infections​
  4. Canagliflozin inhibits circulating DPP-4 ​
  5. Linagliptin hahasve low plasma albumin binding.

The correct answer is option b Pioglitazone is contraindicated in patients with a low ejection fraction

This is correct as it can lead to increased risk of heart faliure, oedema and blar cancer
a. Has a bioavailability of 99%, not 93%
c. This would be SGLT2 inhibitors, not metformin
d. This describes linagliptin, not canagliflozin
e. Linagliptin has high plasma albumin binding, not low binding

Question 5

How many molecules of ATP are produced in total from aerobic respiration from one molecule of glucose?​

  1. 32
  2. 34
  3. 36
  4. 38
  5. 40

The correct answer is option d 38

Glycolysis – 2ATP + 2 NADH, Link – 2NADH, Krebs 6NADH, 2FADH, 2 ATP -10*3+2*2+4=38
a. The total production is 38, not 32
b. The total production is 38, not 34
c. This is looking for total production, not net production
e. FADH2 only makes 2 ATP, not 3

Question 6

Which of the following is a function of glucagon?​

  1. Decreased glycogenolysis
  2. Decreased gluconeogenesis
  3. Increased uptake of glucose
  4. Increased lipolysis
  5. Decreased lipolysis

The correct answer is option d Increased lipolysis

Correct as glucagon works to increase level of glucose in the blood
a. Incorrect as this would decrease glucose level further
b. Incorrect as this would decrease glucose level further
c. Incorrect, this would further decrease glucose level
e. It is increasing lipolysis, not decreasing lipolysis

Question 7

Carbon monoxide poisoning is potentially life threatening. What molecule does it bind to to prevent oxidative phosphorylation?​

  1. Haemoglobin
  2. NADH dehydrogenase
  3. ATP synthase
  4. cytochrome C oxidase
  5. FADH2 dehydrogenase

The correct answer is option d cytochrome C oxidase​

Cytochrome C oxidase, also known as complex IV in the ETC, is inhibited which causes a loss of the proton gradient. ATP synthase has no proton driving force and therefore no ATP is produced.
a. CO does inhibit haemoglobin but this would not affect oxidative phosphoritalition
b. CO does not affect NADH dehydrogenase
c. CO does not affect ATP synthase
e. CO does not bind to FAD2 dehydrogenase

Question 8

In anaerobic conditions what is the net production of ATP

  1. 0
  2. 2
  3. 4
  4. 6
  5. 8

The correct answer is option b 2

b is correct as it is a net production and the NADH produced is used to create lactate
a. Incorrect, 2 ATP molecules are created
c. Only 2 ATP molecules are created, not 4
d. Incorrect, NADH does not contribute to ATP production as it is used in creating lactate
This would be the total production in aerobic conditions

Question 9

In aerobic conditions, what is the end product of glycolysis

  1. Protein into glucose
  2. Glucose into fructose
  3. Starch into glucose
  4. Glucose into pyruvate
  5. Glucose into lactic acid

The correct answer is option d Glucose into pyruvate

d is correct as this occurs and then goes into the link reaction
a. Incorrect as this is the definition of glyconeogenesis
b. This is the first stage of glycolysis, not the end
c. This is glycolysis
e. This is the end product of glycolysis in anaerobic conditions

Question 10

s. The number of molecules of pyruvic acid formed from one molecule of glucose at the end of glycolysis is

  1. 0
  2. 1
  3. 2
  4. 3
  5. 4

The correct answer is option c 2

correct as 6 carbons enter the glycolysis, so 6 need to leave, leading to 2 pyruvate
a. Incorrect, it is 2
b. Incorrect, it is 2
d. Incorrect, it is 2
e. Incorrect, it is 2