4th yr MBBS UoT Lab Medicine 2015 Final Exam MCQ (Dr.

Ashraf)
1. A 49-yr-old male presents for follow-up regarding hypercholesterolemia. He states he is
watching his diet and exercising four times each weeks. His high density lipoprotein
(HDL) has increased from 35 mg/dl to 55 mg/dl. Which enzyme entraps cholesterol
within the HDL particle, allowing cholesterol scavenging from peripheral tissue?
(A) Phosphatidylcholine: cholesterol acyltransferase (PCAT)
(B) Acyl CoA :cholesterol acyltransferase
(C) HMG CoA reductase
(D) Endosomal ATPase.
2. A 41-yr-old BEDOUIN presents to a physician for chest pain. On Eye examination there
is an opaque ring on the lower edge of the Irish and nodular lesions are found on his
Achilles tendon. Which of the following in the hepatocyte cell membrane most likely
defective?
(A) Apo E
(B) Apo B-100 receptor
(C) Lecithin cholesterol acyltransferase
(D) Lipoprotein Lipase
3. A 6-yr-old boy is referred to a specialty clinical because of digestive problem. He often
experiences severe abdominal cramp after eating high fat diet. He is diagnosed with a
genetic defect of lipoprotein Lipase (LPL) deficiency. Which of the following substrate
most likely be elevated in plasma after eating a fatty mean?
(A) LDL
(B) HDL
(C) Chylomicron
(D) Un-esterified fatty acid.
4. Which of the following statement is true regarding cholesterol metabolism?
(A) LDL, transports exogenous cholesterol from peripheral tissue to the liver
(B) HDL, transports cholesterol from peripheral tissue to the liver.
(C) Antioxidant accelerates the oxidation process of LDL.
(D) Cholesterol stores as cholesterol ester on the surface of Lipoprotein.
5. A 45-yr-old new man presents to you for pre-employment health check-up. His blood
cholesterol level is moderately high. Which of the following conditions LEAST LIKELY
be responsible for his high cholesterol level.
(A) Hypothyroidism
(B) Diabetes mellitus
(C) Liver Disease
(D) Peptic Ulcer Disease.
6. An 8-month-old child is brought to a pediatrician because of the mother’s concern about
boy’s tendency to compulsively bite his fingers. On examination, the mother reported she
has noticed yellow-orange crystals in the diapers, but has not mentioned them to anyone.
A genetic defect in which of the following pathways should be suspected?
(A) Aromatic amino acid metabolism
(B) Branched chain amino acid metabolism
 (C) Purine metabolism
(D) Pyrimidine metabolism
7. The Hyperuricemia in Lesch-Nyhan syndrome can be explained on the basis of a
decrease in which regulator of purine biosynthesis?
(A) ATP
(B) GDP
(C) Glutamine
(D) IMP
8. 55 year old man comes to the physician’s office because of a second episode of acute
severe pain in right great toe. Examination shows erythematous, swollen and extremely
tender right 1st metatarsophalangeal joint. After initial intervention patient was
prescribed a drug that reduces the synthesis of uric acid from xanthine. Which of the
enzyme will be inhibited by this enzyme?
(A) Xanthine reductase
(B) Xanthine oxidase
(C) Adenosine deaminase
(D) Ribonucleotide reductase.
9. Which one of the following NOT the secondary cause of hyperuricemia?
(A) Alcohol consumption
(B) Gout due to partial deficiency of HGPRT
(C) Psoriasis
(D) Multiple myeloma
10. Ribose 5-phosphate for nucleotide synthesis is derived from which of the following
metabolic pathway?
(A) Gluconeogenesis
(B) Glycolysis
(C) Glycogenesis
(D) Hexose monophosphate shunt.
11. A 25-yr-old man presents with the complaints of increasing size of head hat, finger ring
and shoes over the period of several months. He also complaints of enlargement of nose
and Jaw size. In Addition, there is intense sweating from enlargement of sweat glands.
Which of the following is the best initial test for this patient.
(A) Serum Growth Hormone
(B) Serum Growth hormone after glucose loading
(C) Serum Insulinlike Growth Factor (IGF)
(D) CT scan of the head
12. A post-partum female presents with sudden onset of fatigue, weight loss and inability to
lactate one week after delivery. Her delivery was complicated with severe postpartum
hemorrhage. Which of the following laboratory finding in serum would you expect in this
patient?
(A) Increase Insulinlike Growth Factor (IGF)
(B) Decrease FSH/LH ratio
(C) Increase Thyroid Stimulating Hormone (TSH)
 (D) Increase Adrenocorticotrophic Hormone (ACTH)
13. A 20-yr-old unmarried woman present to your clinic with the complaints of milk like
product is discharging from her breast. She has been taking anti-psychotic medication
which inhibits pituitary dopamine (D2) receptors for her psychiatric disorder diagnosed 6
months before. Which of the laboratory findings would you expect in this patient’s
serum?
(A) Increase prolactin and Increase Dopamine
(B) Increase Prolactin and Decrease Dopamine
(C) Decrease Prolactin and Increase Dopamine
(D) Decrease Prolactin and Decrease Dopamine
14. Which of the following statement is true?
(A) The posterior pituitary lobe synthesize ADH & Oxytocin
(B) Somatostatin inhibits the Growth hormone
(C) Dopamine stimulates prolactin
(D) IFG1 secretes from Anterior Pituitary
15. An endocrine research laboratory is investigating the regulation of the hypothalamic-
pituitary axis both through pharmacological means and by direct ablation of different
region of brain in monkeys. They found that extremely high doses of chlorpromazine as
well as destruction of the hypothalamus causes the levels of certain hormone to raise.
Levels of which hormone were found to be elevated?
(A) Prolactin
(B) Growth Hormone
(C) Oxytocin
(D) Testosterone