Carbohydrate Metabolism — MCQs

Carbohydrate Metabolism Indian Medical PG Practice Questions and MCQs

Question 801: Glycogen storage disorders are primarily classified under which type of disorders?

A. Endocrine disorders
B. Metabolic disorders (Correct Answer)
C. Genetic disorders
D. Lysosomal storage disorders

Explanation: ***Metabolic disorders*** - Glycogen storage disorders involve defects in the enzymes responsible for **glycogen synthesis** or degradation. - These enzymatic defects lead to abnormal accumulation or breakdown of **glycogen**, thus affecting cellular metabolism. *Genetic disorders* - While glycogen storage disorders are **inherited** and thus genetic, their primary classification focuses on the **metabolic pathways** affected. - This category is too broad and refers to the origin, not the specific functional impairment. *Lysosomal storage disorders* - These disorders involve defective lysosomal enzymes leading to the accumulation of various **substrates within lysosomes**. - Glycogen storage disorders primarily involve enzymes in the **cytoplasm** (or sometimes lysosomes for Pompe disease, but the general classification is metabolic). *Endocrine disorders* - Endocrine disorders involve dysfunction of **hormone production** or regulation. - Glycogen storage diseases are disorders of **carbohydrate metabolism** and do not directly involve hormonal imbalance as their primary pathology.

Question 802: A cataract formation in both eyes was discovered in a 1-year-old child during a routine well-child visit, with blood tests showing elevated galactose and galactitol levels. To determine which enzyme might be defective in the child, which intracellular metabolite should be measured?

A. Galactose
B. Fructose
C. Glucose
D. Galactose-1-phosphate (Correct Answer)

Explanation: ***Galactose-1-phosphate*** - An elevation of **galactose-1-phosphate** in a patient with cataracts and elevated galactose and galactitol levels points to a deficiency in **galactose-1-phosphate uridyltransferase (GALT)**, indicating **classic galactosemia**. - The accumulation of **galactose-1-phosphate** is toxic and underlies the severe symptoms of classic galactosemia, including cataracts, liver damage, and intellectual disability. - Measuring this metabolite specifically identifies GALT deficiency and distinguishes it from other enzyme defects in galactose metabolism. *Galactose* - Elevated **galactose** is observed in **galactosemia**, but measuring galactose itself doesn't differentiate between the different enzyme deficiencies (e.g., GALT vs. GALK deficiency). - While elevated, it's the downstream metabolites like **galactose-1-phosphate** that are more specific for diagnosing the enzyme defect in classic galactosemia. *Fructose* - **Fructose** metabolism is distinct from galactose metabolism, and its levels would not be directly affected by defects in galactose-metabolizing enzymes. - Elevated fructose would suggest a different metabolic disorder, such as **hereditary fructose intolerance**, which has different clinical presentations. *Glucose* - **Glucose** levels are not specific for diagnosing enzyme defects in galactose metabolism. - While hypoglycemia can occur in severe galactosemia, measuring glucose doesn't identify which specific enzyme is deficient and is not the primary diagnostic metabolite.

Question 803: Pyruvate can be converted into all of the following in a single step except one.

A. Acetyl CoA
B. Lactate
C. Phosphoenol pyruvate (Correct Answer)
D. Alanine

Explanation: ***Phosphoenol pyruvate*** - The conversion of **pyruvate** to **phosphoenolpyruvate (PEP)** is not a single-step reaction but an energetically unfavorable two-step process in gluconeogenesis, involving **oxaloacetate** as an intermediate. - This conversion requires two enzymes: **pyruvate carboxylase** (to oxaloacetate) and **PEP carboxykinase** (to PEP), hence not a single step. *Alanine* - **Pyruvate** can be directly converted to **alanine** via transamination in a single step, catalyzed by **alanine transaminase**, with the addition of an amino group from glutamate. - This reaction is reversible and plays a key role in the **glucose-alanine cycle**. *Acetyl CoA* - **Pyruvate** is converted to **acetyl CoA** in a single, irreversible step by the **pyruvate dehydrogenase complex**, releasing **carbon dioxide**. - This is a crucial junction connecting glycolysis to the **citric acid cycle** and **fatty acid synthesis**. *Lactate* - **Pyruvate** can be directly reduced to **lactate** in a single step by **lactate dehydrogenase** during anaerobic glycolysis. - This reaction regenerates **NAD+**, essential for continuing glycolysis in the absence of oxygen.

Question 804: What can be prevented by inhibiting aldose reductase in diabetes mellitus?

A. Diabetic nephropathy
B. Diabetic cataract (Correct Answer)
C. Deafness
D. Diabetic neuropathy

Explanation: ***Diabetic cataract*** - **Aldose reductase** is the key enzyme in the **polyol pathway**, which converts glucose to **sorbitol**. - In diabetes, high glucose levels lead to excessive sorbitol accumulation in the **lens**, causing **osmotic stress** and contributing to cataract formation. - **Aldose reductase inhibitors are most effective** in preventing diabetic cataracts, as the lens has limited sorbitol metabolism capacity. *Deafness* - While diabetes can affect **hearing**, the primary mechanism is often related to **microvascular damage** rather than the direct action of aldose reductase. - Aldose reductase inhibition is not a primary strategy for preventing diabetic hearing loss. *Diabetic nephropathy* - This kidney complication of diabetes is primarily caused by **glomerular hypertrophy**, **basement membrane thickening**, and **mesangial expansion**. - While the polyol pathway might play a minor role, it's not the main driver of nephropathy, and aldose reductase inhibitors have not shown significant benefit in preventing it clinically. *Diabetic neuropathy* - The **polyol pathway does contribute** to diabetic neuropathy through sorbitol accumulation in peripheral nerves, causing osmotic stress and **myoinositol depletion**. - However, neuropathy is **multifactorial**, involving **microvascular ischemia**, **oxidative stress**, and **advanced glycation end products (AGEs)**. - While aldose reductase inhibitors have shown **some benefit** for neuropathy, they have had **limited clinical success** compared to their effectiveness in preventing cataracts, making diabetic cataract the **best answer** to this question.

Question 805: Which of the following enzymes catalyzes the rate-limiting irreversible step in glycolysis?

A. Hexokinase
B. Aldolase
C. Pyruvate kinase
D. Phosphofructokinase (Correct Answer)

Explanation: ***Phosphofructokinase*** - **Phosphofructokinase-1 (PFK-1)** catalyzes the phosphorylation of **fructose-6-phosphate** to **fructose-1,6-bisphosphate**, which is an **irreversible** and the **rate-limiting step** in glycolysis. - This enzyme is a major control point in glycolysis, regulated allosterically by several molecules including **ATP**, **AMP**, **citrate**, and **fructose-2,6-bisphosphate**. *Hexokinase* - **Hexokinase** catalyzes the initial phosphorylation of **glucose** to **glucose-6-phosphate**, which is an early irreversible step in glycolysis, but not the rate-limiting one. - This enzyme is inhibited by its product, **glucose-6-phosphate**, providing a feedback mechanism for regulating glucose entry into glycolysis. *Pyruvate kinase* - **Pyruvate kinase** catalyzes the final irreversible step in glycolysis, converting **phosphoenolpyruvate** to **pyruvate**. - While irreversible and a regulatory point, it is not considered the main rate-limiting step for the entire glycolysis pathway. *Aldolase* - **Aldolase** (fructose-1,6-bisphosphate aldolase) catalyzes a reversible step in glycolysis, cleaving **fructose-1,6-bisphosphate** into **dihydroxyacetone phosphate** and **glyceraldehyde-3-phosphate**. - This is not a rate-limiting step and the reaction is reversible.

Question 806: What is the optical rotation of D-glucose during mutarotation?

A. +52.7 (Correct Answer)
B. a +120
C. d +105
D. b -150

Explanation: ***+52.7*** - The **mutarotation** process involves the interconversion between the **α-anomer** (+112°) and **β-anomer** (+18.7°) of D-glucose in aqueous solution. - At **equilibrium**, the mixture contains approximately **36% α-D-glucose** and **64% β-D-glucose**. - The **equilibrium specific rotation** for D-glucose after mutarotation is **+52.7°** (or +52.5°), which is the final stable value reached when both anomers are in equilibrium. - This intermediate value reflects the weighted average of both anomeric forms. *+120* - This value does not correspond to any standard rotation value for D-glucose or its anomers. - Neither the initial α-D-glucose (+112°) nor the equilibrium mixture (+52.7°) has this rotation. *+105* - While this is a positive rotation, it is not the accurate equilibrium specific rotation for D-glucose after mutarotation. - This value does not match the experimentally determined equilibrium rotation of +52.7°. *-150* - This value is a **negative rotation** (levorotatory), which is not characteristic of D-glucose. - D-glucose is a **dextrorotatory** compound at all stages of mutarotation. - This magnitude and sign are completely inconsistent with D-glucose behavior.

Question 807: Which of the following glucose transporters mediates insulin-stimulated glucose uptake?

A. SGLT-1
B. GLUT4 (Correct Answer)
C. GLUT2
D. GLUT1

Explanation: ***GLUT4*** - **GLUT4** is the only glucose transporter that is **insulin-sensitive**, meaning its translocation to the cell membrane is stimulated by insulin, leading to increased glucose uptake. - It is primarily found in **adipose tissue** and **striated muscle (skeletal and cardiac muscle)**, key tissues for insulin's actions. *SGLT-1* - **SGLT-1** (Sodium-Glucose Linked Transporter 1) is a **secondary active transporter** responsible for glucose and galactose absorption in the **small intestine** and reabsorption in the **kidney**. - Its activity is **not directly regulated by insulin**; it couples glucose transport with sodium co-transport. *GLUT1* - **GLUT1** is a **basal glucose transporter** found in nearly all tissues, especially the brain and red blood cells. - It maintains a **constant, low-level glucose uptake** independent of insulin and ensures a continuous supply of glucose to basal metabolic processes. *GLUT2* - **GLUT2** is a **low-affinity, high-capacity transporter** primarily located in the liver, pancreatic beta cells, kidney, and small intestine. - It is crucial for **glucose sensing in the pancreas** and for rapid glucose excretion or storage by the liver, but its activity is **not directly regulated by insulin** for uptake.

Question 808: Which enzyme catalyzes an important rate-limiting step in gluconeogenesis that bypasses the phosphofructokinase-1 reaction of glycolysis?

A. Glucokinase
B. Fructokinase
C. Hexokinase
D. Fructose 1,6-bisphosphatase (Correct Answer)

Explanation: ***Fructose 1,6-bisphosphatase*** - **Fructose 1,6-bisphosphatase** is a key regulatory enzyme in gluconeogenesis, catalyzing the irreversible hydrolysis of fructose 1,6-bisphosphate to fructose 6-phosphate. - This step bypasses the irreversible phosphofructokinase-1 (PFK-1) reaction of glycolysis, making it a critical **rate-limiting and regulatory step** for glucose synthesis. - It is inhibited by AMP and fructose 2,6-bisphosphate, providing important metabolic regulation. *Glucokinase* - **Glucokinase** is an enzyme involved in glycolysis, phosphorylating glucose to glucose-6-phosphate, primarily in the liver and pancreatic beta cells. - Its high Km for glucose means it is active primarily when glucose concentrations are high, acting as a **glucose sensor** rather than a gluconeogenic enzyme. - In gluconeogenesis, **glucose-6-phosphatase** (not glucokinase) catalyzes the final step. *Fructokinase* - **Fructokinase** is an enzyme that phosphorylates fructose to fructose-1-phosphate, mainly in the liver. - It is involved in fructose metabolism, not a direct enzyme in the gluconeogenic pathway for glucose synthesis from non-carbohydrate precursors. *Hexokinase* - **Hexokinase** phosphorylates glucose to glucose-6-phosphate, the first step of glycolysis, in most tissues. - While it initiates glucose breakdown, it does not play a direct role in the synthesis of glucose during gluconeogenesis; rather, **glucose-6-phosphatase** is involved in the final step of gluconeogenesis.

Question 809: Which of the following is not a reducing sugar?

A. Lactose
B. Glucose
C. Fructose
D. Sucrose (Correct Answer)

Explanation: ***Sucrose*** - Sucrose is a **disaccharide** composed of **glucose and fructose** linked by an **α-1,2-glycosidic bond**. - This specific bond involves the **anomeric carbons** of both monosaccharides, rendering them unavailable to open into aldehyde or ketone groups required for reducing sugar activity. *Lactose* - Lactose is a **reducing disaccharide** made of glucose and galactose, having a **free anomeric carbon** on its glucose unit. - This allows it to open into an aldehyde form and act as a reducing agent. *Glucose* - Glucose is a **monosaccharide** and a **reducing sugar** due to its **free aldehyde group** in its open-chain form. - The aldehyde group can be oxidized, allowing glucose to reduce other compounds. *Fructose* - Fructose is a **monosaccharide** that, despite being a **ketose** (containing a ketone group), can isomerize to an **aldose** in alkaline solutions. - This isomerization via the **enediol intermediate** allows it to act as a reducing sugar.

Question 810: Which of the following processes is inhibited by glucagon?

A. Gluconeogenesis
B. Lipolysis
C. Glycogenolysis
D. Glycogenesis (Correct Answer)

Explanation: ***Glycogenesis*** - **Glucagon** is a hormone that counteracts the effects of insulin, primarily to raise **blood glucose levels**. Therefore, it inhibits processes that store glucose, such as **glycogenesis** (the synthesis of glycogen from glucose). - High glucagon levels signal a need for glucose release, thus stopping processes that would remove glucose from the bloodstream. *Glycogenolysis* - **Glycogenolysis** is the breakdown of **glycogen** into **glucose**, which increases blood glucose levels. - **Glucagon** actually **stimulates**, rather than inhibits, glycogenolysis to release stored glucose from the liver. *Gluconeogenesis* - **Gluconeogenesis** is the synthesis of **glucose** from non-carbohydrate precursors (e.g., amino acids, glycerol). - **Glucagon** is a potent **stimulator** of gluconeogenesis, particularly during fasting states, to maintain blood glucose. *Lipolysis* - **Lipolysis** is the breakdown of **triglycerides** into **fatty acids** and **glycerol**, which can be used for energy or as substrates for gluconeogenesis. - **Glucagon** **stimulates** lipolysis in **adipose tissue** to provide alternative fuel sources and precursors for glucose production.

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

Practice Questions

Blood Glucose Regulation

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Diabetes Mellitus: Biochemical Aspects

Practice Questions

Glycosylation and Glycoproteins

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Lactose Intolerance and Galactosemia

Practice Questions

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