MCQS MODULE 2

1.When should a case of Non-Insulin dependent diabetes mellitus (NIDDM) with a history of diabetes for one year have an ophthalmic examination?
A. As early as feasible
B. After 5 years
C. After 10 years
D. Only after visual symptoms develop

Correct answer : A. As early as feasible

The person may have been diabetic for some time before the diagnosis of NIDDM. Retinopathy may have already occured. Hence, ophthalmological testing should be done as early as possible after diagnosis of NIDDM. If there are no pathologic changes, he should come for review every 6 months / 1 year.

But in case of IDDM (Insulin dependant diabetes mellitus), the patients are diagnosed early in life. There is much less chance of any ophthalmologic disease at the time of diagnosis. Hence ophthalmologic examination is recommended 5 years after the diagnosis of IDDM.

2 Which one of the following would be
expected in pyruvate kinase deficiency?
(A) Increased levels of lactate in the R.B.C
(B) Hemolytic anemia 
(C) Decreased ratio of ADP to ATP in R.B.C
(D) Increased phosphorylation of Glucose to
Glucose-6-phosphate

Which one of the following statements
concerning glucose metabolism is correct?
(A) The conversion of Glucose to lactate occurs
only in the R.B.C
(B) Glucose enters most cells by a mechanism in
which Na+ and glucose are co-transported
(C) Pyruvate kinase catalyses an irreversible
reaction 
(D) An elevated level of insulin leads to a
decreased level of fructose 2, 6-bisphosphate
in hepatocyte

3: Which of the following reactions is unique
to gluconeogenesis?
(A) Lactate Pyruvate
(B) Phosphoenol pyruvate pyruvate
(C) Oxaloacetate phosphoenol pyruvate 
(D) Glucose-6-phosphate Fructose-6-phosphate

4.The synthesis of glucose from pyruvate
by gluconeogenesis
(A) Requires the participation of biotin 
(B) Occurs exclusively in the cytosol
(C) Is inhibited by elevated level of insulin
(D) Requires oxidation/reduction of FAD

5 .The conversion of pyruvate to acetyl CoA
and CO2
(A) Is reversible
(B) Involves the participation of lipoic acid 
(C) Depends on the coenzyme biotin
(D) Occurs in the cytosol

6 Reduced glutathione functions in R.B.Cs
to
(A) Produce NADPH
(B) Reduce methemoglobin to hemoglobin
(C) Produce NADH
(D) Reduce oxidizing agents such as H2O2 

7Phenylalanine is the precursor of
(A) L-DOPA
(B) Histamine
(C) Tyrosine 
(D) Throxine

8.Human heart muscle contains
(A) D-Arabinose
(B) D-Ribose
(C) D-Xylose 
(D) L-Xylose

9.The intermediate n hexose monophos-
phate shunt is
(A) D-Ribulose 
(B) D-Arabinose
(C) D-xylose
(D) D-Lyxose

10.On boiling Benedict’s solution is not
reduced by
(A) Sucrose
(B) Lactose
(C) Maltose
(D) Fructose

11.Most of the metabolic pathways are
either anabolic or catabolic. Which of the
following pathways is considered as
“amphibolic” in nature?
(A) Glycogenesis (B) Glycolytic pathway
(C) Lipolysis
(D) TCA cycle 

12.Transketolase activity is affected in
(A) Biotin deficiency
(B) Pyridoxine deficiency
(C) PABA deficiency
(D) Thiamine deficiency 

13.The following metabolic abnormalities
occur in Diabetes mellitus except
(A) Increased plasma FFA
(B) Increased pyruvate carboxylase activate 
(C) Decreased lipogenesis
(D) Decreased gluconeogenesis

14Morphine can be used in all the following conditions except:
A. Head injury
B. Asthma
C. Hypothyroidism
D. Diabetes

Correct answer : A. Head injury

15.Morphine is contraindicated in head injury for the following reasons:

Causes carbondioxide retention – this in turn increases intracranial tension
Therapeutic doses can cause respiratory depression in head injury patients
Vomiting, miosis and altered mentation caused by morphine can interfere with assessment of neurological status
Morphine should be avoided in those with bronchial asthma as it can precipitate an attack of asthma. But it is not contraindicated. Patients with hypothyroidism are more sensitive to the effects of morphine.

16.When should a case of Non-Insulin dependent diabetes mellitus (NIDDM) with a history of diabetes for one year have an ophthalmic examination?
A. As early as feasible
B. After 5 years
C. After 10 years
D. Only after visual symptoms develop

Correct answer : A. As early as feasible

The person may have been diabetic for some time before the diagnosis of NIDDM. Retinopathy may have already occured. Hence, ophthalmological testing should be done as early as possible after diagnosis of NIDDM. If there are no pathologic changes, he should come for review every 6 months / 1 year.

But in case of IDDM (Insulin dependant diabetes mellitus), the patients are diagnosed early in life. There is much less chance of any ophthalmologic disease at the time of diagnosis. Hence ophthalmologic examination is recommended 5 years after the diagnosis of IDDM.