Файл: Fsbei he northWestern State Medical University named after I. I. Mechnikov Ministry of Healthcare of the Russian Federation.doc

Тest 2

CHOOSE THE CORRECT ANSWER:

Type I glycogenosis - Girke's disease can be detected by using stress test with:

а) with glucose

b) glucagon

c) disaccharide

d) dexamethasone

e) ischemic load

Тest 3

CHOOSE THE CORRECT ANSWER:

The process of carbohydrate metabolism ensuring the stability of the antioxidant system is:

а) glycolysis

b) glycogen synthesis

c) pentose phosphate cycle

d) glycogen breakdown

e) aerobic oxidation of glucose

Тest 4

CHOOSE THE CORRECT ANSWER:

The cause of type I glycogenosis - Girke's disease is congenital deficiency of the enzyme

а) liver phosphorylases

b) muscle phosphorylases

c) phosphofructokinase

d) glucose - 6 - liver phosphatases

e) glycogen branching enzyme

Тest 5

CHOOSE ALL CORRECT ANSWERS

The terminal oxidation chain blockers are:

а) 2,4 dinitrophenol b) barbiturates c) carbon monoxide

d) cyanides e) thyroxine
Тest 6

CHOOSE ALL CORRECT ANSWERS

The disconnectors of the terminal oxidation chain are:

а) 2,4 dinitrophenol b) barbiturates c) carbon monoxide

d) cyanides e) thyroxine

Тest 7

CHOOSE ALL CORRECT ANSWERS

Glucose-tolerant test can be used for

а) detecting malabsorption of glucose

b) diagnosis of type 1 glycogenosis (Girke's disease)

c) detection of impaired glucose tolerance

d) diagnosis of carbohydrate digestion disorders

e) monitoring the effectiveness of the treatment of diabetes

Тest 8

CHOOSE ALL CORRECT ANSWERS

Compensation for diabetes is achieved through the following mechanisms:

а) maintaining the pH of the blood due to the work of blood buffer systems

b) elimination of excess glucose through the kidneys

c) a decrease in the synthesis of ammonium salts

d) excretion of ketone bodies through the kidneys, lungs, skin

e) an increase in the synthesis of ammonium salts
Тest 9

MATCH THE CORRESPONDENCE

(each answer can be used one or more times)

1) insulin dependent diabetes mellitus 2) insulin non-dependent diabetes mellitus

а) glucosuria b) hyperglycemia c) the content of "C" peptide in the blood is normal or increased d) polyuria e) the content of "C" peptide in the blood is below normal f) weakness

Тest 10

CHOOSE THE CORRECT ANSWER

The results of glucose tolerance test are:

Glucose levels

Before loading ­4.5 mmol / l

1 hour after loading ­ 6.2 mmol / l

2 hours after loading ­ 4.8 mmol / l

mean:

а) the norm

b) impaired glucose tolerance

c) malabsorption

d) indicate disorders in the digestion of carbohydrates
Тest 11

CHOOSE THE CORRECT ANSWER

The results of glucose tolerance test are:

Glucose levels

Before loading 5,0 mmol/l

1 hour after loading 12,5 mmol/l

2 hours after loading 9 mmol/l

mean:

а) the norm

b) impaired glucose tolerance

c) malabsorption

d) indicate disorders in the digestion of carbohydrates
Тest 12

FILL IN THE GAPS ОТВЕТ:

Hyperketonemia and ketoria in diabetes mellitus and (or) carbohydrate starvation is associated with a decrease in the speed of the metabolic process, which is called ___________ .

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Тest 13

CHOOSE THE CORRECT ANSWER

The results of glucose tolerance test are:

Glucose levels

Before loading 3,3 mmol/l

1 hour after loading 3,8 mmol/l

2 hour after loading 3,5 mmol/l

mean:

а) the norm

b) impaired glucose tolerance

c) malabsorption

d) indicate disorders in the digestion of carbohydrates

Тest 14

FILL IN THE GAPS ОТВЕТ

Symptoms such as polyuria, thirst, dry mouth, polydipsia, weakness, itchy skin, hyperglycemia, ketonemia, glucosuria, ketonuria, are characteristic of __________________.

Тest 15.

FILL IN THE GAPS ОТВЕТ

The accumulation of ketone bodies in the blood without a pH shift is called ________________ ;with a shift in pH to the acidic side ­ _______________

KEYS

1. c 2. b 3. c 4. d 5. bcd 6. аe 7. аce 8. аbde

9. 1-аbdef 2- аbdcf 10. а 11. b 12. TCAC 13 c 14. diabetes mellitus 15. ketonemia, ketoacidosis

Topic 15 Test in Biological Chemistry. Section: “Chemistry and carbohydrate metabolism. Regulation of carbohydrate metabolism. Signal molecules. Hormones”.
1. Classification of carbohydrates. The most important monosaccharides, structure and properties (glucose, fructose, galactose). The most important derivatives of monosaccharides formed during oxidation, reduction, phosphorylation, amination, acetylation. Their biological role.

2. The most important disaccharides: sucrose, lactose, maltose.

3. Homopolysaccharides: starch, glycogen, fiber. Their features, structures, chemical properties and biological role.

4. Digestion of carbohydrates in the gastrointestinal tract. Enzymes involved in the digestion of carbohydrates, their distribution in the digestive juices, types of bonds broken down by each enzyme.

5. Glycogen exchange. The mechanism of glycogen synthesis, enzymes of this process, hormonal regulation.

6. The breakdown of glycogen. Features of this process in the liver and muscles. The mechanism of glycogen mobilization. Write the necessary reactions. Enzymes. Hormonal regulation.

7. Anaerobic decomposition of carbohydrates: glycolysis and glycogenolysis (process reactions, enzymes, coenzymes). Stages of glycolysis. The mechanism of ATP formation during anaerobic decomposition of carbohydrates is substrate phosphorylation. Energy balance and biological role of glucose anaerobic oxidation. Regulation of hormones.

8. Gluconeogenesis. Write reactions that bypass the irreversible glycolysis reactions. Key gluconeogenesis enzymes. The biological role of this process. Regulation of hormones.

9. Aerobic dichotomous oxidation of glucose. Stages Biological role.

10. Oxidative decarboxylation of PVA (pyruvic acid). Pyruvate oxidase system: enzymes, coenzymes, vitamins, inhibitors. Ways of pyruvate formation in the cell. The reasons for the change in the concentration of PVA in the blood and urine, the diagnostic value of the indicator in the practice of a medical doctor.

11. The tricarboxylic acid cycle. Tricarboxylic acid cycle reactions, enzymes, coenzymes. Energy-supplying reactions TCAC. TCAC flow conditions. Inhibitors of this metabolic process. The biological role of TCAC in metabolism.

12. The formation of oxaloacetate.

13. The NADH + H⁺, FAD2H, formed during aerobic oxidation of glucose. Shuttle mechanism of hydrogen transfer from the cytoplasm to mitochondria (glycerolphosphate and malaspartate).

14. The structure of FAD and NAD⁺, their role in metabolism.

15. Tissue breathing. Structural organization and characterization of the components of the respiratory chain (electron transfer chain). Biological role.

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16. The mechanism of oxidative phosphorylation and its biological role. Mitchell's theory. Localization of three conjugation points of oxidation and phosphorylation in the respiratory chain.

17. The amount of ATP formed in the respiratory chain per oxygen atom 'with a complete and shortened respiratory chain.

18. Inhibitors of the respiratory chain and oxidative phosphorylation. Oxidative phosphorylation uncouplers, examples.

19. Energy balance of aerobic oxidation of glucose.

20. The role of ATP in the body. The definition of "macroergic connection."

21. Apotomic decomposition of carbohydrates. The pentose phosphate cycle and its biological role. Write reactions to the stage of pentosis formation.

22. The mechanisms of action of signaling molecules. Types of signaling molecules. The mechanisms of interaction of hormones with the cell. Two types of cellular reception: intracellular (direct) and membrane (mediated).

23. Characterization of the direct intracellular receptor.

24. Types of membrane receptors. The structure of the membrane (mediated) type of receptor. Types of secondary intermediaries.

25. Adenylate cyclase, phosphatidylinositol, Ca⁺⁺ ways signal transmission.

26. Insulin receptor and growth factor receptors. Structure, mechanism of functioning. Internalization of the cell receptor, the biological role of this process.

27. Neurohumoral regulation. The structure and place of synthesis of insulin, glucagon, adrenaline, glucocorticoids, ACTH, growth hormone, thyroxine. Effect on carbohydrate metabolism and changes in blood glucose levels. Methods for assessing the hormonal status of the body.

28. Pituitary hormones, structure, role in the body, clinical manifestations of hypo and hyperfunction in childhood and in adults.

29. Thyroid hormones, structure, role in the body, by what type of reception does thyroxine act? Clinical manifestations of hypo and hyperfunction in childhood and in adults. Endemic goiter, causes, how the content of thyroxine and thyroid stimulating hormone in the blood changes.

30. The biological significance of blood glucose. Ways of entry glucose into the blood. Ways to use glucose in tissues. Mechanisms for regulating blood glucose. Norm. Hyperglycemia: its types, causes of development; hypoglycemia, its causes. Glucosuria, types of glucosuria.

31. Methods for the determination of glucose in the blood (comparative characteristics of the methods). The diagnostic value of the indicator in the practice of a medical doctor.

32. The levels of regulation of carbohydrate metabolism. Metabolic (cellular) regulation. Allosteric regulation of the activity of key enzymes of dichotomous aerobic breakdown of glucose by end metabolites according to the principle of negative feedback.

33. Regulation of the activity of carbohydrate metabolism enzymes by changing the concentration of secondary intermediaries by the example of the breakdown and synthesis of glycogen.

34. The role of the liver and kidneys in the regulation of blood glucose. The biological meaning of the existence of the renal threshold.

35. Disorders of carbohydrate metabolism:

- violation of the digestion and absorption of carbohydrates in the small intestine, what loading tests are used for diagnosis,

- glycogenosis, causes, what loading tests are used for diagnosis,

- for what diagnostic purposes is the determination of amylase in urine used

- diabetes mellitus: what metabolic disorders are characteristic for diabetes mellitus, which tests are used for diagnosis,

what tests are used to diagnose types of diabetes, what types of tests are used to diagnose latent forms of diabetes,

-hypovitaminosis В₁, В₂, В₃ (PP), leading to impaired carbohydrate metabolism, in which processes of carbohydrate metabolism are these vitamins used,

- in what pathology of carbohydrate metabolism can hemolytic anemia occur, which enzyme activity should be determined before treatment with drugs with the properties of oxidizing agents.

Topic 16. Testing of practical skills acquired during laboratory work in the semester
The student must be able to

1. 
   Explain the molecular mechanisms of maintaining homeostasis under various influences of internal and external factors.
   
2. 
   Explain the molecular mechanisms of metabolic disorders, arising from some hereditary and acquired diseases, applying knowledge of the main ways of the conversion of carbohydrates in the human body.
   
3. 
   Explain the therapeutic effects of certain drugs using knowledge of the molecular processes and structures that are the target of these drugs.
   
4. 
   Evaluate data on the chemical composition of biological fluids to characterize the norm and signs of the disease.
   

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The student must have the following practical skills:

1. 
   Work with pipettes of various volumes and automatic dispensers
   
2. 
   Calculate concentrations of substances used
   
3. 
   Filter samples
   
4. 
   Quantify vitamin C in the urine (titrometric using indicators)
   
5. 
   Work on the photocolorimeter
   
6. 
   Determine the activity of alanine aminotransferase
   
7. 
   Determine the serum cholinesterase activity
   
8. 
   Determine the amylase activity of urine
   
9. 
   Determine blood glucose.
   
10. 
    Work with pipettes of various volumes and automatic dispensers
    
11. 
    Conduct a calculation of the concentrations of substances used
    
12. 
    Filter samples
    
13. 
    Quantitatively determine of vitamin C in urine (titrometric using indicators)
    
14. 
    Work with the photocolorimeter
    
15. 
    Determine the alanine aminotransferase activity
    
16. 
    Determine the serum cholinesterase activity
    
17. 
    Determine the amylase activity of urine
    
18. 
    Determine blood glucose.
    
19. 
    Assess and interpret the biochemical laboratory research data (total protein and protein fractions, glucose, pyruvate, lactate, ketone bodies in the blood and urine, amylase activity and glucose-6-phosphate dehydrogenase in the blood) with the aim of using them in the diagnosis of various diseases .
    

CONTENTS

Topic Digestion of carbohydrates in the gastrointestinal tract. Glycogen exchange. Practical work ­ quantitative determination of amylase in urine. (Kuleba V.A.)……………………..…
Topic Dichotomous breakdown of glucose. Gluconeogenesis. Metabolism of pyruvic acid. (Sokolova E.A., Beishebaeva Ch. R.).......................................................................................
Topic: Aerobic dichotomous decomposition of carbohydrates. Biological oxidation. (Smertina M.N.)………………………………………………………............................……
Topic Signal molecules, mechanisms of action. Hormones, chemical nature of the determination methods. Pituitary and thyroid hormone (Pavlova R.N.) ……………………
Topic Regulation of carbohydrate metabolism. Quantitative determination of glucose in the blood. (Makarova M.N., Pavlova R.N.)….………………………………………………….
Topic Disruption of carbohydrate metabolism (Astratenkova I.V., Ivanova L.V.).…….....

Topic Test in Biological Chemistry. Section "Chemistry and carbohydrate metabolism. Regulation of carbohydrate metabolism. Signal molecules. Hormones” (Pavlova RN, Antonova Zh.V.) ……………………………………......................................………………
Topic Testing of practical skills acquired during laboratory studies in the semester (Pavlova R.N.) …

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