Carbohydrate Metabolism — MCQs

Carbohydrate Metabolism Indian Medical PG Practice Questions and MCQs

Question 731: Which of the following is required for proper effects of Insulin?

A. Chromium (Correct Answer)
B. Selenium
C. Copper
D. Iron

Explanation: ***Chromium*** - **Chromium** is an essential trace mineral that plays a crucial role in enhancing the action of **insulin** by promoting its binding to cell receptors. - It is a key component of **glucose tolerance factor (GTF)**, which helps cells absorb glucose more efficiently. *Selenium* - **Selenium** is an antioxidant and is involved in thyroid hormone metabolism and immune function, but it does not directly facilitate insulin action. - While important for overall health, it has no known direct requirement for the proper effects of insulin. *Copper* - **Copper** is involved in various enzymatic reactions, iron metabolism, and connective tissue formation, but it is not directly required for insulin's proper function. - High levels of **copper** can even negatively impact glucose metabolism in some contexts. *Iron* - **Iron** is essential for oxygen transport in hemoglobin and myoglobin, as well as for many enzymatic processes, but it does not directly enhance insulin sensitivity or action [1]. - Both **iron deficiency** and **iron overload** can indirectly affect metabolic health but do not directly influence insulin's effects in the same way chromium does [2].

Question 732: Glycemic index is defined as:

A. Measure of the change in blood glucose following ingestion of protein.
B. Measure of the change in blood glucose following ingestion of fat.
C. Measure of glucose control over a period of time.
D. Measure of the change in the blood glucose following ingestion of carbohydrate. (Correct Answer)

Explanation: ***Measure of the change in the blood glucose following ingestion of carbohydrate.*** - The **glycemic index (GI)** specifically quantifies how much a **carbohydrate-containing food** raises blood glucose levels compared to a reference food (e.g., pure glucose or white bread). - It helps categorize foods based on their immediate impact on **blood sugar**. *Measure of the change in blood glucose following ingestion of protein.* - Protein intake can affect blood glucose, but its impact is much less direct and immediate than carbohydrates, and it's not what the **glycemic index** measures. - While protein can stimulate insulin release, it doesn't cause a rapid, significant rise in blood glucose in the same way carbohydrates do. *Measure of the change in blood glucose following ingestion of fat.* - **Dietary fats** have a minimal direct impact on blood glucose levels; their primary role is energy storage and membrane structure. - Fat can slow down gastric empting and carbohydrate digestion, indirectly affecting the rise in blood glucose, but it is not what the **glycemic index** directly measures. *Measure of glucose control over a period of time.* - Measures like **HbA1c** (glycated hemoglobin) assess average blood glucose control over a longer period (e.g., 2-3 months). - The **glycemic index** is a measure of the acute, post-prandial (after meal) blood glucose response to a specific food.

Question 733: Which of the following is NOT a function of glycosaminoglycans?

A. Lubrication of joints
B. Wound healing process
C. Anticoagulant activity
D. Transport of lipids in the bloodstream (Correct Answer)

Explanation: ***Transport of lipids in the bloodstream*** - Glycosaminoglycans (GAGs) generally do not play a direct role in the **transport of lipids** in the bloodstream. Lipid transport is primarily mediated by **lipoproteins** (e.g., chylomicrons, VLDL, LDL, HDL). - While some GAGs might interact with lipoproteins in the extracellular matrix, their fundamental role is not lipid transport but rather structural and signaling functions. *Lubrication of joints* - This is a well-established function of GAGs, particularly **hyaluronic acid**, which contributes to the **viscoelastic properties of synovial fluid**, reducing friction in joints. - Hyaluronic acid helps maintain the **hydration** and **shock-absorbing capacity** of articular cartilage. *Wound healing process* - Glycosaminoglycans, especially **hyaluronic acid** and **heparin sulfate**, are crucial in **wound healing** processes, where they modulate inflammation, cell migration, and tissue remodeling. - They provide a **scaffold for cell proliferation** and differentiation in the wound bed. *Anticoagulant activity* - **Heparin**, a highly sulfated glycosaminoglycan, is a potent **anticoagulant** that works by activating **antithrombin III**, thereby inhibiting various coagulation factors like thrombin. - Other GAGs, like **heparan sulfate** found on cell surfaces, also exhibit mild anticoagulant properties.

Question 734: Which of the following is not a substrate for gluconeogenesis?

A. Leucine (Correct Answer)
B. Lactate
C. Propionate
D. Glycerol

Explanation: ***Leucine*** - **Leucine** is an exclusively **ketogenic amino acid**, meaning its breakdown products can only be converted into **ketone bodies** or fatty acids, not glucose. - It does not have a carbon skeleton that can be directly converted into **pyruvate** or **oxaloacetate**, which are key intermediates in gluconeogenesis. *Lactate* - **Lactate** is a major substrate for gluconeogenesis, particularly during exercise or fasting. - It is converted to **pyruvate** by **lactate dehydrogenase**, and pyruvate can then enter the gluconeogenic pathway. *Propionate* - **Propionate** is a fatty acid with an odd number of carbon atoms, primarily derived from the catabolism of odd-chain fatty acids or from bacterial fermentation in the colon. - It can be converted into **succinyl CoA**, an intermediate of the citric acid cycle, which can then be used for gluconeogenesis. *Glycerol* - **Glycerol**, released during the breakdown of triglycerides, is an important substrate for gluconeogenesis. - It is phosphorylated to **glycerol-3-phosphate**, which is then oxidized to **dihydroxyacetone phosphate (DHAP)**, an intermediate in glycolysis and gluconeogenesis.

Question 735: Which of the following processes primarily utilizes lactate produced anaerobically?

A. Cori cycle (Correct Answer)
B. Gluconeogenesis
C. TCA cycle
D. Glycolysis

Explanation: ***Cori cycle*** - The **Cori cycle** (lactic acid cycle) involves the transport of **lactate** produced during anaerobic metabolism in muscles to the liver. - In the **liver**, this lactate is then converted back to **glucose** via gluconeogenesis, which can be returned to the muscles. *Gluconeogenesis* - **Gluconeogenesis** is the synthesis of glucose from non-carbohydrate precursors, one of which is lactate. - While it uses lactate, it is only one component of the broader **Cori cycle**, which describes the inter-organ cooperation. *Glycolysis* - **Glycolysis** is the metabolic pathway that breaks down glucose into pyruvate, which can then be converted to lactate under anaerobic conditions. - This process *produces* lactate but does not *utilize* it, acting upstream of lactate production. *TCA cycle* - The **TCA cycle** (Krebs cycle) is a central part of aerobic respiration that oxidizes acetyl-CoA to produce ATP, NADH, and FADH2. - It does not directly utilize lactate; instead, lactate is typically converted to pyruvate before potentially entering the TCA cycle under aerobic conditions.

Question 736: What is the respiratory quotient of carbohydrates?

A. 0.5
B. 0.8
C. 0.75
D. 1 (Correct Answer)

Explanation: ***Option: 1 (Correct Answer)*** - The **respiratory quotient (RQ)** is the ratio of **carbon dioxide produced to oxygen consumed** during metabolism. - For carbohydrates, complete oxidation yields equal moles of CO2 and O2, resulting in an **RQ of 1.0**. - Example: C6H12O6 + 6O2 → 6CO2 + 6H2O, giving RQ = 6CO2/6O2 = 1.0 - This value reflects that carbohydrates are highly oxygenated molecules, requiring less external oxygen for their oxidation relative to the CO2 produced. *Option: 0.5* - An RQ of 0.5 is not observed for any major macronutrient during complete oxidation. - This value would imply significantly lower CO2 production relative to O2 consumption, which doesn't match any physiological substrate metabolism. *Option: 0.8* - An RQ of approximately 0.8 is characteristic of a **mixed diet** or the average value sometimes cited for **protein metabolism**. - Protein RQ typically ranges from 0.8-0.85, as proteins require more oxygen for their oxidation compared to the CO2 produced. - The exact RQ can vary depending on the specific amino acids being metabolized. *Option: 0.75* - An RQ around 0.7-0.75 may represent **fat-predominant metabolism** or a mixed diet with fats and carbohydrates. - Pure **fat metabolism** has an RQ of approximately **0.7**, as fats require substantial oxygen for oxidation due to their lower oxygen content relative to carbon and hydrogen. - Fats contain many C-H bonds and few C-O bonds, necessitating more oxygen for complete combustion.

Question 737: Enzyme deficient in Hers disease -

A. Muscle phosphorylase
B. Liver phosphorylase (Correct Answer)
C. Acid maltase
D. Debranching enzyme

Explanation: ***Liver phosphorylase*** - Hers disease, also known as Glycogen Storage Disease Type VI, is specifically caused by a deficiency of **liver phosphorylase**. - This enzyme is crucial for the breakdown of **glycogen in the liver**, leading to an inability to release glucose into the bloodstream during fasting. *Muscle phosphorylase* - Deficiency of **muscle phosphorylase** (myophosphorylase) causes **McArdle disease** (Glycogen Storage Disease Type V), which primarily affects muscle energy. - Patients typically present with exercise intolerance, muscle pain, and cramps, not the hepatic symptoms seen in Hers disease. *Acid maltase* - Deficiency of **acid maltase** (also known as alpha-glucosidase) is responsible for **Pompe disease** (Glycogen Storage Disease Type II), a lysosomal storage disorder. - This enzyme deficiency leads to glycogen accumulation in lysosomes in various tissues, including muscle, liver, and heart, causing muscle weakness and cardiomyopathy. *Debranching enzyme* - A deficiency in the **debranching enzyme** (amylo-1,6-glucosidase) causes **Cori disease** or **Forbes disease** (Glycogen Storage Disease Type III). - This results in the accumulation of abnormally structured glycogen with short outer branches in the liver, muscle, and heart.

Question 738: Which of the following statements about NADP is correct?

A. Involved in fatty acid oxidation
B. Involved in HMP shunt (Correct Answer)
C. Involved in glycolysis
D. Acts as a coenzyme form of Riboflavin

Explanation: ***Involved in HMP shunt*** - **NADPH**, the reduced form of NADP+, is primarily generated in the **hexose monophosphate shunt (HMP shunt)**, specifically during the oxidative phase. - The NADPH produced in the HMP shunt is crucial for **reductive biosynthesis** reactions and maintaining the **redox balance** of the cell. *Acts as a coenzyme form of Riboflavin* - **NADP is derived from Niacin (Vitamin B3)**, not Riboflavin (Vitamin B2). - **Flavin adenine dinucleotide (FAD)** and **flavin mononucleotide (FMN)** are the coenzyme forms of Riboflavin. *Involved in glycolysis* - **NADP is not directly involved in glycolysis**; instead, **NAD+** is the primary coenzyme that accepts electrons in glycolysis, specifically during the oxidation of glyceraldehyde-3-phosphate. - While some enzymes in glycolysis can interact with NADP+ under specific conditions, its main role is not within the glycolytic pathway. *Involved in fatty acid oxidation* - **Fatty acid oxidation (beta-oxidation)** primarily utilizes **NAD+** and **FAD** as electron acceptors. - **NADP+** is not a direct participant in the electron transport chain during fatty acid breakdown.

Question 739: Most important carbohydrate store for maintaining blood glucose homeostasis -

A. Blood glucose
B. Glycogen in adipose tissue
C. Hepatic glycogen (Correct Answer)
D. None of the options

Explanation: ***Hepatic glycogen*** - The liver contains **100-120g of glycogen**, which is the most crucial carbohydrate store for **maintaining blood glucose homeostasis**. - **Hepatic glycogen** can be mobilized and released as glucose into the bloodstream to supply all body tissues, especially during fasting. - Although muscle glycogen is quantitatively larger (~400-500g), it cannot contribute to blood glucose as muscle lacks glucose-6-phosphatase. - The liver's unique ability to release free glucose makes hepatic glycogen the **most metabolically important** carbohydrate store. *Blood glucose* - **Blood glucose** (~5g total in circulation) represents carbohydrates available for immediate energy, not a storage form. - This is far too small to be considered a major carbohydrate reserve. *Glycogen in adipose tissue* - **Adipose tissue** primarily stores **fat (triglycerides)**, with negligible glycogen content. - Adipose tissue plays virtually no role in carbohydrate storage. *None of the options* - This is incorrect because **hepatic glycogen** is indeed the most important carbohydrate store for glucose homeostasis.

Question 740: Fructose intolerance is due to deficiency of which enzyme?

A. Aldolase B (Correct Answer)
B. Aldolase A
C. Fructokinase
D. Triokinase

Explanation: ***Aldolase B*** - **Hereditary fructose intolerance** is a genetic disorder caused by a deficiency in the enzyme **aldolase B**. - This deficiency leads to an accumulation of **fructose-1-phosphate** in the liver, kidneys, and small intestine, causing **hypoglycemia**, **vomiting**, and **liver damage** upon exposure to fructose. *Fructokinase* - A deficiency in **fructokinase** causes **essential fructosuria**, a benign metabolic disorder. - This condition is asymptomatic because **fructose** simply accumulates in the blood and urine without causing significant clinical problems. *Triokinase* - **Triokinase**, also known as **glycerol kinase**, is involved in glycerol metabolism, converting glycerol to **glycerol-3-phosphate**. - Its deficiency is not directly linked to fructose intolerance and typically presents with **hyperglycerolemia**. *Aldolase A* - **Aldolase A** is one of the three aldolase isoenzymes (A, B, and C) and is primarily involved in **glycolysis**, specifically in the breakdown of **fructose-1,6-bisphosphate**. - A deficiency in aldolase A can lead to **hemolytic anemia** and **myopathy**, not directly fructose intolerance.

Practice by Chapter

Carbohydrate Chemistry and Classification

Practice Questions

Glycolysis: Reactions and Regulation

Practice Questions

Gluconeogenesis: Reactions and Regulation

Practice Questions

Glycogen Metabolism: Synthesis and Breakdown

Practice Questions

Glycogen Storage Diseases

Practice Questions

Pentose Phosphate Pathway

Practice Questions

Metabolism of Fructose and Galactose

Practice Questions

Disorders of Fructose and Galactose Metabolism

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Blood Glucose Regulation

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Diabetes Mellitus: Biochemical Aspects

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Glycosylation and Glycoproteins

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Lactose Intolerance and Galactosemia

Practice Questions

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