Chapter·BiochemistryLysosomal storage diseases

Lysosomal membrane protein disordersDownloads

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1

An 18-month-old girl is brought to the pediatrician’s office for failure to thrive and developmental delay. The patient’s mother says she has not started speaking and is just now starting to pull herself up to standing position. Furthermore, her movement appears to be restricted. Physical examination reveals coarse facial features and restricted joint mobility. Laboratory studies show increased plasma levels of several enzymes. Which of the following is the underlying biochemical defect in this patient?

ACongenital lack of lysosomal formation

BInappropriate protein targeting to endoplasmic reticulum

CFailure of mannose phosphorylation

DInappropriate degradation of lysosomal enzymes

EMisfolding of nuclear proteins

2

A 7-month-old boy is brought by his parents to the pediatrician’s office. His mother says the child has been weakening progressively and is not as active as he used to be when he was born. His condition seems to be getting worse, especially over the last month. He was born at 41 weeks through normal vaginal delivery. There were no complications observed during the prenatal period. He was progressing well over the 1st few months and achieving the appropriate milestones. On examination, his abdomen appears soft with no liver enlargement. The patient appears to be dehydrated and lethargic. The results of a fundoscopic examination are shown in the picture. A blood test for which of the following enzymes is the next best assay to evaluate this patient's health?

AAcid alpha-glucosidase

BHexosaminidase

CSphingomyelinase

DGlucocerebrosidase

EArylsulfatase A

3

An 18-month-old boy of Ashkenazi-Jewish descent presents with loss of developmental milestones. On ocular exam, a cherry-red macular spot is observed. No hepatomegaly is observed on physical exam. Microscopic exam shows lysosomes with onion-skin appearance. What is the most likely underlying biochemical abnormality?

AAccumulation of ceramide trihexoside

BAccumulation of glucocerebroside

CAccumulation of galactocerebroside

DAccumulation of sphingomyelin

EAccumulation of GM2 ganglioside

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