NEET-PG 2013 Practice Questions

Q: Phosphofructokinase-1 occupies a key position in regulating glycolysis and is also subjected to feedback control. Which among the following are the allosteric activators of phosphofructokinase-1?

Fructose 2,6-bisphosphate. ***Fructose 2,6-bisphosphate*** - **Fructose 2,6-bisphosphate** is a potent **allosteric activator** of **phosphofructokinase-1 (PFK-1)**, increasing its affinity for fructose 6-phosphate and overcoming ATP inhibition. - Its synthesis is regulated by **insulin** (stimulating) and **glucagon** (inhibiting), linking glucose availability to glycolytic flux. *2,3-Bisphosphoglycerate (2,3-BPG)* - **2,3-BPG** is an important regulator of **hemoglobin oxygen affinity** in red blood cells. - It is not an allosteric activator of **PFK-1**; its primary role is in oxygen delivery. *Glucokinase* - **Glucokinase** is an **enzyme** in glycolysis, specifically catalyzing the phosphorylation of glucose to glucose 6-phosphate in the liver and pancreatic beta cells. - It is not an allosteric activator of **PFK-1** but rather an upstream enzyme in the pathway. *Phosphoenolpyruvate (PEP)* - **PEP** is an intermediate in glycolysis, formed from 2-phosphoglycerate and converted to pyruvate by pyruvate kinase. - It acts as an **allosteric inhibitor** of phosphofructokinase-1, signaling high energy status and slowing down glycolysis.

Q: Which of the following statements about gluconeogenesis is correct?

Occurs mainly in the liver. ***Occurs mainly in the liver*** - The **liver** is the primary site for **gluconeogenesis**, responsible for maintaining blood glucose levels during fasting. - The kidneys also contribute, especially during prolonged fasting, but to a lesser extent. *It uses exactly the same enzymes as glycolysis in reverse* - While gluconeogenesis shares some enzymes with glycolysis, there are **three irreversible steps in glycolysis** that require different enzymes in gluconeogenesis to bypass them. - Key bypass enzymes include **pyruvate carboxylase**, **phosphoenolpyruvate carboxykinase (PEPCK)**, **fructose-1,6-bisphosphatase**, and **glucose-6-phosphatase**. *It only occurs during fed state when insulin levels are high* - **Gluconeogenesis is activated during fasting or starvation** when blood glucose levels are low, and it is largely **inhibited by high insulin levels**. - Its purpose is to produce new glucose to prevent hypoglycemia, not to store excess glucose. *Fatty acids are the primary substrate for gluconeogenesis* - **Fatty acids cannot be directly converted to glucose** in significant amounts in humans because they are broken down into acetyl-CoA, which cannot be used for net glucose synthesis. - Primary substrates include **lactate**, **amino acids** (from protein breakdown), and **glycerol** (from triglyceride breakdown).

Q: Which of the following tissues relies EXCLUSIVELY on anaerobic glycolysis for ATP production?

Mature RBCs (exclusively anaerobic). ***Mature RBCs (exclusively anaerobic)*** - **Mature red blood cells** lack mitochondria, making them incapable of **oxidative phosphorylation** and thus relying entirely on **anaerobic glycolysis** for ATP. - This pathway produces **2 net ATP** molecules per glucose molecule, which is sufficient for their metabolic needs like maintaining ion gradients. *Skeletal muscle during exercise (anaerobic)* - While skeletal muscle can perform **anaerobic glycolysis** during intense exercise when oxygen supply is limited, it is not an exclusive reliance. - Skeletal muscle also utilizes **aerobic respiration** and **creatine phosphate** for ATP production depending on activity level and oxygen availability. *Cardiac muscle (primarily aerobic)* - **Cardiac muscle** has a very high metabolic demand and is rich in **mitochondria**, relying almost exclusively on **aerobic respiration** for ATP production. - It uses fatty acids, glucose, and lactate as fuel sources, producing a large amount of ATP efficiently with oxygen. *Liver hepatocytes (primarily aerobic)* - **Liver hepatocytes** are highly metabolically active and primarily rely on **aerobic respiration** for ATP production, performing diverse functions such as gluconeogenesis, glycogenolysis, and detoxification. - Although the liver can perform some anaerobic glycolysis under hypoxic conditions, it is not its exclusive or primary mode of ATP synthesis.

Q: The energy for glycogenesis is provided by -

UTP. ***UTP*** - **Uridine triphosphate (UTP)** is essential for **glycogenesis** as it activates glucose by forming **UDP-glucose** from glucose-1-phosphate. - The reaction (Glucose-1-P + UTP → UDP-glucose + PPi) creates a **high-energy intermediate** that drives glycogen synthesis. - The subsequent hydrolysis of pyrophosphate (PPi) makes this activation step **irreversible**, and the energy stored in UDP-glucose is used for **glycosidic bond formation** when glucose is added to the growing glycogen chain. *GTP* - **Guanosine triphosphate (GTP)** is primarily involved in **protein synthesis**, G-protein signaling, and the citric acid cycle. - It is not used for glucose activation in glycogenesis; that role is specific to **UTP**. *GDP* - **Guanosine diphosphate (GDP)** is a product of GTP hydrolysis and functions in regulatory processes. - It does not serve as an energy donor for glycogen synthesis. *AMP* - **Adenosine monophosphate (AMP)** is a low-energy signal molecule that indicates cellular energy depletion. - High AMP levels **inhibit glycogenesis** and activate glycogenolysis through allosteric regulation of key enzymes. - It does not provide energy for anabolic pathways like glycogen synthesis.

Q: Inhibition of glycolysis by increased supply of O2 is called ?

Pasteur effect. ***Pasteur effect*** - The **Pasteur effect** describes the phenomenon where the rate of **glycolysis** is inhibited when **oxygen** is available (aerobic conditions). - This inhibition occurs because **oxidative phosphorylation** is more efficient at generating ATP, leading to reduced reliance on glycolysis for energy production. *Crabtree phenomenon* - The **Crabtree phenomenon** is the opposite of the Pasteur effect, where high concentrations of **glucose** inhibit oxygen consumption in the presence of oxygen. - This is primarily observed in some **cancer cells** and yeast, leading to increased glycolysis even under aerobic conditions. *Lewis phenomenon* - The **Lewis phenomenon** (also known as the hunting reaction) refers to the cyclical vasodilation and constriction of peripheral blood vessels in response to **cold exposure**. - It's a physiological response to protect tissues from **frostbite** and is not related to glycolysis or oxygen supply. *None of the options* - This option is incorrect as the phenomenon described, inhibition of glycolysis by increased O2, is a well-established biochemical process known as the **Pasteur effect**.

Q: Ketone bodies are not used by?

RBC. ***RBC*** - Red blood cells **lack mitochondria**, which are essential organelles for the **oxidation of ketone bodies** (acetoacetate and β-hydroxybutyrate) for energy production. - Their primary energy source is **anaerobic glycolysis** of glucose. *Muscle* - **Skeletal and cardiac muscles** readily utilize **ketone bodies** as an alternative fuel source, especially during prolonged fasting or starvation. - This helps to conserve glucose for other tissues, particularly the brain. *Brain* - The brain can adapt to use **ketone bodies** for energy when glucose supply is limited, such as during prolonged fasting or in cases of uncontrolled diabetes. - This process is crucial for brain function when glucose levels are low. *Renal cortex* - The **renal cortex** is capable of utilizing **ketone bodies** for energy, particularly during starvation. - The kidney is also involved in the **synthesis of glucose** (gluconeogenesis) and the excretion of ketone bodies.

Q: Which of the following substances is not classified as a carcinogen for bladder cancer?

Isopropyl alcohol. ***Isopropyl alcohol*** - Research does not link **isopropyl alcohol** to an increased risk of bladder cancer, making it a non-carcinogenic substance in this context. - It is commonly used as a solvent and antiseptic, but has not shown **urogenic carcinogenicity** in studies. *Phenacetin* - **Phenacetin** is an analgesic that has been associated with an increased risk of bladder cancer, particularly due to its metabolite, which can be nephrotoxic. - Its use has significantly declined due to its carcinogenic effects on the urinary system. *Benzidine* - **Benzidine** is a well-known bladder carcinogen, primarily linked to the dye industry, where exposure has led to increased rates of bladder cancer [1]. - This substance has been implicated in **urothelial carcinoma** due to its mutagenic properties. *Acrolein* - **Acrolein** is a toxic compound that can cause bladder irritation and has been studied for its potential carcinogenic effects related to bladder cancer. - It is released during the combustion of materials and is known to contribute to **chemical injury** in the bladder. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 217-218.

Q: MALT lymphoma is positive for which of the following markers?

CD20. ***CD20*** - MALT lymphoma is a type of **B-cell non-Hodgkin lymphoma**, and CD20 is a **pan B-cell marker consistently expressed** in MALT lymphomas. - CD20 positivity is **crucial for diagnosis** and is the **primary therapeutic target** for anti-CD20 monoclonal antibody therapy (Rituximab). - In diagnostic practice, **CD20 is the most important B-cell marker** for identifying MALT lymphoma and guiding treatment decisions. *CD19* - CD19 is also a **pan B-cell marker** and is **typically positive in MALT lymphoma** along with CD20. - However, in the context of this question, **CD20 is the preferred answer** because it is the **standard diagnostic marker emphasized in clinical practice** and the **primary therapeutic target**. - Both markers are positive, but CD20 has greater **clinical and therapeutic significance** in MALT lymphoma management. *CD43* - CD43 is primarily a **T-cell and myeloid marker**, but can show **aberrant expression in 40-50% of MALT lymphomas**. - While it may be positive in some cases, it is **not a defining B-cell lineage marker** and is not used as a primary diagnostic criterion for MALT lymphoma. - Its variable expression makes it **less reliable** than consistent B-cell markers like CD20. *CD5* - CD5 is typically associated with **T-cells** and certain B-cell lymphomas, particularly **chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)** and **mantle cell lymphoma**. - **MALT lymphoma is characteristically CD5-negative**, which is an important feature for **differentiating it from CD5+ B-cell lymphomas**.

Q: In which condition are Michaelis Gutmann bodies typically seen?

Malakoplakia. ***Malakoplakia*** - **Michaelis-Gutmann bodies** are pathognomonic histological features of malakoplakia, representing calcified concretions containing **iron and calcium** within macrophages. - These are formed around **partially digested bacteria** within defective macrophages, appearing as basophilic inclusions with a "target-like" or "owl's eye" appearance. - Malakoplakia is a chronic granulomatous inflammatory condition most commonly affecting the **urinary tract** (bladder, kidney), but can occur in other organs. *Xanthogranulomatous* - This condition is characterized by an infiltrate of **lipid-laden macrophages** (xanthoma cells, foam cells) and occasional giant cells, but **not** Michaelis-Gutmann bodies. - It most commonly affects the kidney (**xanthogranulomatous pyelonephritis**) and is a destructive inflammatory process with a mass-like appearance. *Pyelonephritis* - Refers to **inflammation of the kidney and renal pelvis**, usually due to bacterial infection (commonly E. coli). - Histologically, it is characterized by acute or chronic inflammatory cells, neutrophil infiltration, and potential abscess formation, **without** Michaelis-Gutmann bodies. *Nail patella syndrome* - This is a **genetic disorder** (autosomal dominant) affecting primarily the **nails, bones** (absent/hypoplastic patella, elbow dysplasia), and sometimes the kidneys (glomerular disease). - It is associated with developmental abnormalities and has **no association** with Michaelis-Gutmann bodies or malakoplakia.

Q: In glomerulus subendothelial deposits are seen in?

MPGN type I (subendothelial deposits). ***MPGN type I*** - **Subendothelial deposits** are a hallmark of MPGN type I, often associated with **immune complex deposition** [1]. - This condition can present with **hematuria**, **proteinuria**, and can be triggered by infections or autoimmune diseases [1]. *Good pasture syndrome* - Primarily involves **anti-GBM antibodies** leading to **glomerulonephritis** and pulmonary hemorrhage, not subendothelial deposits. - Typically, it presents with **crescent formation** in the glomeruli rather than deposits. *MPGN type II* - Characterized by **dense deposit disease**, it features **intramembranous** rather than subendothelial deposits [1]. - It is often associated with **C3 nephritic factor** and does not show classic subendothelial pathology. *IgA nephropathy* - Characterized by **IgA deposits** primarily in the **mesangium**, not subendothelially. - It presents with **hematuria** and recurrent episodes of **macrohematuria**, especially after infections. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 925-927.

Question 1

Phosphofructokinase-1 occupies a key position in regulating glycolysis and is also subjected to feedback control. Which among the following are the allosteric activators of phosphofructokinase-1?

Accepted Answer

Fructose 2,6-bisphosphate

Answer

2,3-Bisphosphoglycerate (2,3-BPG)

Answer

Glucokinase

Answer

Phosphoenolpyruvate (PEP)

Question 2

Which of the following statements about gluconeogenesis is correct?

Accepted Answer

Occurs mainly in the liver

Answer

It uses exactly the same enzymes as glycolysis in reverse

Answer

It only occurs during fed state when insulin levels are high

Answer

Fatty acids are the primary substrate for gluconeogenesis

Question 3

Which of the following tissues relies EXCLUSIVELY on anaerobic glycolysis for ATP production?

Accepted Answer

Mature RBCs (exclusively anaerobic)

Answer

Skeletal muscle during exercise (anaerobic)

Answer

Liver hepatocytes (primarily aerobic)

Answer

Cardiac muscle (primarily aerobic)

Question 4

The energy for glycogenesis is provided by -

Accepted Answer

UTP

Answer

GTP

Answer

GDP

Answer

AMP

Question 5

Inhibition of glycolysis by increased supply of O2 is called ?

Accepted Answer

Pasteur effect

Answer

Crabtree phenomenon

Answer

Lewis phenomenon

Answer

None of the options

Question 6

Ketone bodies are not used by?

Accepted Answer

RBC

Answer

Brain

Answer

Muscle

Answer

Renal cortex

Question 7

Which of the following substances is not classified as a carcinogen for bladder cancer?

Accepted Answer

Isopropyl alcohol

Answer

Acrolein

Answer

Phenacetin

Answer

Benzidine

Question 8

MALT lymphoma is positive for which of the following markers?

Accepted Answer

CD20

Answer

CD19

Answer

CD43

Answer

CD5

Question 9

In which condition are Michaelis Gutmann bodies typically seen?

Accepted Answer

Malakoplakia

Answer

Xanthogranulomatous

Answer

Pyelonephritis

Answer

Nail patella syndrome

Question 10

In glomerulus subendothelial deposits are seen in?

Accepted Answer

MPGN type I (subendothelial deposits)

Answer

Goodpasture syndrome (linear IgG deposits in the basement membrane)

Answer

MPGN type II (intramembranous deposits)

Answer

IgA nephropathy (mesangial IgA deposits)

NEET-PG 2013

Biochemistry

Pathology