Amino Acid Metabolism — MCQs

Amino Acid Metabolism Indian Medical PG Practice Questions and MCQs

Question 531: An increase in glutamine levels in the cerebrospinal fluid (CSF), blood, and urine is indicative of a deficiency in which enzyme?

A. Carbamoyl Phosphate Synthetase I (CPS-I) (Correct Answer)
B. Arginase
C. Ornithine transcarbamylase (OTC)
D. Argininosuccinate synthetase

Explanation: ***Carbamoyl Phosphate Synthetase I (CPS-I)*** - A deficiency in **Carbamoyl Phosphate Synthetase I (CPS-I)**, the first enzyme in the urea cycle, blocks the conversion of ammonia and bicarbonate into carbamoyl phosphate. - This leads to severe **hyperammonemia**, which is detoxified by glutamine synthetase, causing marked elevation of **glutamine in CSF, blood, and urine**. - **Key distinguishing feature**: CPS-I deficiency causes isolated hyperammonemia with elevated glutamine but **NO orotic aciduria**, unlike OTC deficiency. - This is the most proximal urea cycle defect, presenting with the purest pattern of glutamine elevation without other metabolite abnormalities. *Ornithine transcarbamylase (OTC)* - **OTC deficiency** is the most common urea cycle disorder and also causes severe hyperammonemia with elevated glutamine. - However, it leads to accumulation of carbamoyl phosphate, which diverts into the pyrimidine synthesis pathway, resulting in **elevated urinary orotic acid**. - **Key differentiator**: The presence of orotic aciduria distinguishes OTC from CPS-I deficiency—both have elevated glutamine, but only OTC has elevated orotic acid. *Argininosuccinate synthetase* - A deficiency causes **citrullinemia**, characterized by markedly elevated **citrulline** in blood and urine. - While hyperammonemia and secondary glutamine elevation occur, the **hallmark finding is elevated citrulline**, which makes this diagnosis distinct from isolated glutamine elevation. *Arginase* - Arginase deficiency leads to accumulation of **arginine** in blood and urine, causing **hyperargininemia**. - This deficiency presents with progressive spasticity, growth retardation, and intellectual disability, with **elevated arginine** being the distinguishing metabolite rather than isolated glutamine elevation.

Question 532: In Cystinuria, which of the following amino acids is not affected by the reabsorption defect?

A. Arginine
B. Ornithine
C. Citrulline (Correct Answer)
D. Lysine

Explanation: ***Citrulline*** - **Citrulline** is the correct answer because it is **not a dibasic amino acid** and does not share the same renal tubular transporter as the affected amino acids. - In cystinuria, the defect involves the **rBAT-b0,+AT transporter system**, which specifically transports **cystine** and **dibasic amino acids** (ornithine, arginine, lysine) - remembered by the mnemonic **COAL**. - Citrulline uses a **different transport mechanism** and therefore its reabsorption remains **normal** in cystinuria. *Lysine* - **Lysine** is one of the four amino acids affected in cystinuria (part of the COAL group). - Being a **dibasic amino acid**, its reabsorption is **impaired**, leading to increased urinary excretion. - This is **incorrect** as the question asks for the amino acid NOT affected. *Arginine* - **Arginine** is a **dibasic amino acid** whose reabsorption is significantly reduced in cystinuria. - It is part of the COAL group and shows **elevated urinary concentration** in affected individuals. - This is **incorrect** as arginine IS affected by the reabsorption defect. *Ornithine* - **Ornithine** is another **dibasic amino acid** included in the COAL group. - Its renal tubular reabsorption is **defective** in cystinuria, resulting in increased urinary excretion. - This is **incorrect** as ornithine IS affected by the transport defect.

Question 533: Tyrosinemia Type I is caused due to deficiency of which enzyme?

A. Homogentisate 1,2-dioxygenase
B. Fumarylacetoacetate hydrolase (Correct Answer)
C. Tyrosine aminotransferase
D. 4-hydroxyphenylpyruvate dioxygenase

Explanation: ***Fumarylacetoacetate hydrolase*** - **Tyrosinemia Type I**, also known as **hereditary tyrosinemia type 1 (HT1)**, is an **autosomal recessive** metabolic disorder caused by a deficiency of the enzyme **fumarylacetoacetate hydrolase (FAH)**. - This enzyme is crucial for the final step in the **tyrosine degradation pathway**, leading to the accumulation of toxic metabolites like fumarylacetoacetate and succinylacetone. *Tyrosine aminotransferase* - Deficiency of **tyrosine aminotransferase** causes **Tyrosinemia Type II**, a distinct disorder from Type I. - Type II tyrosinemia primarily affects the eyes and skin, presenting with **corneal ulcers** and painful **hyperkeratotic plaques**. *Homogentisate 1,2-dioxygenase* - Deficiency of **homogentisate 1,2-dioxygenase** leads to **alkaptonuria (black urine disease)**, a rare metabolic disorder. - This condition involves the accumulation of **homogentisic acid**, which causes dark urine, **ochronosis** (bluish-black pigmentation of connective tissues), and severe arthropathy. *4-hydroxyphenylpyruvate dioxygenase* - Deficiency of **4-hydroxyphenylpyruvate dioxygenase** results in **Tyrosinemia Type III**, another rare form of tyrosinemia. - This type is typically milder, often presenting with **neurological symptoms** such as intellectual disability and seizures, but without the severe liver and kidney damage seen in Type I.

Question 534: What is the scientific name for the neurotransmitter serotonin?

A. 5-hydroxytryptamine (5-HT) (Correct Answer)
B. N-methylphenylamine
C. 3-Methoxytyramine
D. Phenethylamine

Explanation: ***5-hydroxytryptamine (5-HT)*** - **Serotonin** is the common name for the neurotransmitter **5-hydroxytryptamine**, often abbreviated as **5-HT**. - It plays a crucial role in regulating mood, appetite, sleep, and other physiological and behavioral functions. *N-methylphenylamine* - **N-methylphenylamine** is not the chemical name for serotonin. - This compound is a **synthetic amine** and does not serve as a well-known neurotransmitter in the human body. *3-Methoxytyramine* - **3-Methoxytyramine** is a **dopamine metabolite** and a trace amine, not serotonin. - It is typically formed from dopamine through the action of **catechol-O-methyltransferase (COMT)**. *Phenethylamine* - **Phenethylamine** is a **trace amine** that can act as a neuromodulator, but it is not serotonin. - It is known for its stimulant effects and is found in some foods like chocolate.

Question 535: What is the limiting amino acid in cereals?

A. Methionine
B. Tryptophan
C. Lysine (Correct Answer)
D. Cysteine

Explanation: ***Lysine*** - **Lysine** is the **first limiting amino acid in cereals** (wheat, rice, corn), meaning it is present in the lowest proportion relative to the body's needs. - This deficiency can impact **protein synthesis** if cereals are the sole or primary protein source without supplementation. - Complementing cereals with **legumes** (rich in lysine but low in methionine) provides complete protein nutrition. *Methionine* - **Methionine** is typically the limiting amino acid in **legumes**, not cereals. - It works with cysteine to provide **sulfur-containing amino acids** essential for various metabolic processes. - This is why cereal-legume combinations (rice and lentils, corn and beans) are nutritionally complementary. *Tryptophan* - **Tryptophan** is an essential amino acid, but it is generally **not the primary limiting amino acid in cereals**. - While corn can be relatively low in tryptophan, **lysine deficiency is more significant** across cereal grains. - It is a precursor to **serotonin** and **niacin**. *Cysteine* - **Cysteine** is a non-essential amino acid, meaning the body can synthesize it from methionine. - While important for protein structure and function, it is **not considered a limiting amino acid** since it can be produced endogenously.

Question 536: Which of the following compounds is not formed with the involvement of glycine?

A. Purines
B. Glutathione
C. Thyroxine (Correct Answer)
D. Heme

Explanation: ***Thyroxine*** - **Thyroxine** (and other thyroid hormones) are derived from the amino acid **tyrosine**. - Their synthesis involves iodination and coupling reactions of tyrosine residues within the protein **thyroglobulin**. *Heme* - **Glycine** is a direct precursor for the initial step in **heme synthesis**. - It condenses with **succinyl CoA** to form α-amino-β-ketoadipate, which then decarboxylates to form δ-aminolevulinate (ALA). *Purines* - **Glycine** contributes part of its structure to the **purine ring**. - Specifically, the **nitrogen at position 7** and the **carbons at positions 4 and 5** of the purine ring are derived from glycine. *Glutathione* - **Glutathione** is a tripeptide composed of three amino acids: **glutamate**, **cysteine**, and **glycine**. - **Glycine** is the C-terminal amino acid of glutathione and is essential for its structure and function as an antioxidant.

Question 537: Coenzyme for phenylalanine hydroxylase is?

A. Tetrahydrofolate
B. Pyridoxal phosphate
C. S-adenosyl methionine
D. Tetrahydrobiopterin (Correct Answer)

Explanation: ***Tetrahydrobiopterin*** - **Tetrahydrobiopterin (BH4)** is an essential coenzyme for aromatic amino acid hydroxylases, including **phenylalanine hydroxylase (PAH)**. - PAH converts **phenylalanine** to **tyrosine**, and deficiencies in BH4 or PAH itself lead to *phenylketonuria (PKU)*. *Tetrahydrofolate* - **Tetrahydrofolate (THF)** is a coenzyme derived from **folic acid** and is primarily involved in **one-carbon metabolism**, including **purine** and **pyrimidine synthesis**, and various amino acid interconversions. - It does not directly act as a coenzyme for phenylalanine hydroxylase. *Pyridoxal phosphate* - **Pyridoxal phosphate (PLP)**, a derivative of **vitamin B6**, is a crucial coenzyme for many enzymes involved in **amino acid metabolism**, particularly in **transamination**, **decarboxylation**, and side-chain cleavage reactions. - It is not the coenzyme for phenylalanine hydroxylase. *S-adenosyl methionine* - **S-adenosyl methionine (SAM)** is a major **methyl donor** in various biochemical reactions, important for the synthesis of **neurotransmitters**, **hormones**, and **phospholipids**. - While essential for many metabolic pathways, it is not involved as a coenzyme for phenylalanine hydroxylase.

Question 538: Which amino acid is not involved in transamination?

A. Alanine
B. Aspartate
C. Lysine (Correct Answer)
D. Histidine

Explanation: ***Lysine*** - **Lysine** cannot undergo transamination because it lacks the structural requirements for typical transaminase enzymes. - While lysine has both an **α-amino group** and an **ε-amino group**, its metabolic pathway involves **oxidative deamination** rather than transamination. - Along with **threonine**, lysine is one of only two amino acids that do not participate in transamination reactions. *Alanine* - **Alanine** is a major substrate for transamination, readily converting to pyruvate via **alanine transaminase (ALT)**. - This reaction involves the transfer of its **α-amino group** to an α-keto acid, typically α-ketoglutarate, forming glutamate. *Aspartate* - **Aspartate** is actively involved in transamination, converting to oxaloacetate via **aspartate transaminase (AST)**. - Its **α-amino group** is easily transferred to α-ketoglutarate, forming glutamate. *Histidine* - **Histidine** can undergo transamination, though less commonly cited as a primary substrate compared to aspartate and alanine. - It can transfer its **α-amino group** to an α-keto acid, leading to the formation of imidazolepyruvate.

Question 539: In phenylketonuria, which substance should be restricted in the diet?

A. Tyrosine
B. Phenylalanine (Correct Answer)
C. Maize
D. None of the options

Explanation: ***Phenylalanine*** - **Phenylketonuria (PKU)** is a genetic disorder where the body cannot effectively metabolize **phenylalanine** due to a deficiency in the enzyme **phenylalanine hydroxylase**. - Restricting dietary phenylalanine is crucial to prevent the accumulation of toxic byproducts that can lead to severe neurological damage and developmental delays. *Tyrosine* - Tyrosine is normally synthesized from phenylalanine. In PKU, this conversion is impaired. - While phenylalanine must be restricted, tyrosine supplementation is often necessary for individuals with PKU, as it becomes a conditionally essential amino acid. *Maize* - Maize (corn) is a carbohydrate-rich food and does not contain high levels of phenylalanine that would necessitate its restriction in PKU. - Dietary management in PKU focuses on regulating protein intake, as phenylalanine is an amino acid found in proteins. *None of the options* - This option is incorrect because phenylalanine must be strictly restricted in the diet of individuals with phenylketonuria to manage the condition effectively. - Without dietary restriction, the accumulation of phenylalanine can lead to severe and irreversible neurological damage.

Question 540: Pyridoxine is required in -

A. Glycolysis
B. TCA cycle
C. Glycogenesis
D. Transamination (Correct Answer)

Explanation: ***Transamination*** - **Pyridoxal phosphate (PLP)**, the active form of pyridoxine (vitamin B6), is an essential **coenzyme for aminotransferases (transaminases)** - Transamination reactions involve the transfer of an **amino group** from an amino acid to a keto acid, which is crucial for amino acid metabolism - This is the classic biochemical function of vitamin B6 and a frequently tested concept *Glycolysis* - Glycolysis is a metabolic pathway that breaks down glucose into pyruvate - Key cofactors for glycolysis include **NAD+ and ATP**, not vitamin B6 - Does not require pyridoxine as a coenzyme *TCA cycle* - The **TCA cycle (Krebs cycle)** is a central metabolic pathway for energy production - Uses enzymes that require cofactors such as **NAD+, FAD, and Coenzyme A** (derived from pantothenic acid) - Pyridoxine is not directly involved as a coenzyme in TCA cycle reactions *Glycogenesis* - Glycogenesis is the process of synthesizing **glycogen from glucose** - Primarily involves enzymes like **glycogen synthase** and **branching enzyme** - Requires **UTP and glucose-1-phosphate**, not pyridoxine

Practice by Chapter

Protein Digestion and Absorption

Practice Questions

Transamination and Deamination

Practice Questions

Urea Cycle

Practice Questions

Disorders of Urea Cycle

Practice Questions

Metabolism of Individual Amino Acids

Practice Questions

Inborn Errors of Amino Acid Metabolism

Practice Questions

Phenylketonuria and Alkaptonuria

Practice Questions

Homocystinuria and Methionine Metabolism

Practice Questions

Synthesis of Biologically Important Compounds from Amino Acids

Practice Questions

Nitrogen Balance

Practice Questions

Ammonia Metabolism and Toxicity

Practice Questions

One-Carbon Transfer Reactions

Practice Questions

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