BIOCHEMISTRY PAPER II ANSWER KEY
SECTION A MCQ’S:
1. Fibre delays gastric emptying (C)
2. Maintaining oncotic pressure (B)
3. Uncontrolled cell division due to loss of cell cycle regulation(C)
4. Impaired activation of immune-related genes(A)
5. Decrease in BMR due to reduced muscle mass(A)
6. Dilutional hyponatremia due to fluid retention(B)
7. Impaired replication of mitochondrial DNA(A)
8. Impaired thyroid hormone metabolism(D)
9. Type 2 diabetes(A)
10. Marfan syndrome(B)
11. Nephrotic syndrome (B)
12. Increase intake of red meat, spinach, and fortified cereals(D)
13. IgE-mediated mast cell degranulation (B)
14. Deletion of a critical exon (C)
15. Facilitating blood clot formation(C)
16. Oncogene that promotes uncontrolled cell proliferation(C)
17. Beta-thalassemia trait (B)
18. Blocked elongation of the polypeptide chain(D)
19. Body composition(D)
20. Reduced renal perfusion and impaired glomerular filtration (C)
SECTION B
PART - I
1.a) Diagnosis: Acute gouty arthritis
Biochemical Basis:
Elevated serum uric acid (10.1 mg%) → supersaturation → monosodium urate crystal
deposition in joints
Alcohol increases lactic acid → competes with uric acid for renal excretion → hyperuricemia
b) Normal Lab Values
Serum Uric Acid -3.5–7.2 mg/dL (male)
Blood Sugar - Fasting: 70–110 mg/dL; Postprandial: <140 mg/dl
c) Purine Degradation Pathway:
AMP → Inosine → Hypoxanthine → Xanthine → Uric acid
GMP → Guanosine → Guanine → Xanthine → Uric acid
Key enzymes:
o Adenosine deaminase
o Xanthine oxidase (target of allopurinol)
d) Disorders of Purine Metabolism:
Gout: Uric acid crystal deposition in joints
Lesch-Nyhan Syndrome: HGPRT deficiency → hyperuricemia, self-mutilation
SCID
PART - II
2. Diabetic Ketoacidosis & Metabolic Acidosis
Mechanism: Insulin deficiency → lipolysis → ↑ ketone bodies (acetoacetate, β-
hydroxybutyrate) → ↓ blood pH
Compensation: Hyperventilation (Kussmaul breathing) → ↓ CO₂ → respiratory
compensation for acidosis
3. Epigenetic changes regulate gene activity without altering the DNA sequence. They
modify how genes are read, not the genetic code itself.
DNA Methylation: Adds methyl groups to cytosine → silences genes by blocking
transcription.
Histone Modifications: Acetylation loosens chromatin (activates), deacetylation
tightens it (represses); methylation can do either.
Chromatin Remodeling: Repositions nucleosomes to control access to DNA.
Non-coding RNAs: miRNAs and lncRNAs regulate mRNA stability and recruit
modifiers.
These mechanisms control cell identity, development, and disease states like cancer—making
epigenetics central to modern biology and medicine.
4.
Growth Needs: Children need more protein and energy for rapid development. PEM
causes stunting and irreversible brain deficits.
Immune Impact: Weakens T-cell function, phagocytosis, and mucosal defenses →
higher infection risk.
Cognitive Effects: Impairs neurotransmitter synthesis, myelination, and glucose
supply → poor learning and long-term IQ loss.
Micronutrient Deficiency: Often includes iron, zinc, iodine deficits → worsens
immunity and brain development
5. Sodium Retention & Edema
Mechanism: Na⁺ retention → water retention → ↑ hydrostatic pressure → fluid
extravasation
Heart Failure: ↓ renal perfusion → RAAS activation → Na⁺ retention
Dietary Restriction: Reduces volume overload and edema
.
6. Hallmark: Enables survival despite DNA damage
Mechanisms of apoptosis :
p53 mutation
Overexpression of Bcl-2
Downregulation of death receptors
Inhibition of caspases
PART – III
7. Lifelong learning in medical profession:
Medicine is ever-evolving → need for continuous updating.
Improves clinical competence, evidence-based practice, adaptability to new
technologies, patient safety.
Methods: CME, workshops, self-directed learning, research.
8.
a) Probable diagnosis: Hemolytic transfusion reaction
b) Justification:
Recent transfusion → suggests immune-mediated hemolysis
Indirect hyperbilirubinemia (↑ total, low conjugated) → due to RBC breakdown
Urine bilirubin negative → unconjugated bilirubin is not water-soluble
Indirect Van den Bergh reaction → confirms unconjugated bilirubin elevation
9.
a) Probable diagnosis: Nutritional hypocalcemia
b) Normal serum calcium: 8.5–10.5 mg/dL
c) Calcium homeostasis:
PTH increases serum calcium by bone resorption, renal reabsorption, and activating
vitamin D
Vitamin D enhances intestinal calcium absorption
Calcitonin lowers calcium by inhibiting bone resorption
10.
a) Diagnosis: Hyperthyroidism (likely Graves’ disease)
Justified by ↓TSH, ↑T3/T4, weight loss, tachycardia, goiter, and eye signs
b) Cause of tachycardia:
Increased β-adrenergic receptor sensitivity due to excess thyroid hormones
c) Eye prominence:
Autoimmune inflammation of orbital tissues → exophthalmos
11. a) Buffers:
Plasma: Bicarbonate, proteins, phosphate
Urine: Ammonia, phosphate (2)
b) Anion gap = [Na⁺ + K⁺] – [Cl⁻ + HCO₃⁻]
Normal: 8–12 mEq/L
Helps differentiate causes of metabolic acidosis (2)
c) Diarrhoea causes loss of bicarbonate → leads to normal anion gap metabolic acidosis (1)
12. Diagram: Lac operon & its components
13. Diagram: Ig G Y-shaped structure with:
o Two Fab regions (antigen-binding sites).
o One Fc region (binds to immune cells and complement).
Heavy and light chains connected by disulfide bonds.
Functions of IgG:
Neutralizes toxins and viruses.
Opsonization (enhances phagocytosis).
Activates classical complement pathway.
Crosses placenta → passive immunity to fetus.
14. Diagram: DNA REPLICATION
Direction & Enzymes:
Synthesis: Always 5′ → 3′ direction.
Key Enzymes:
o Helicase: Unwinds DNA.
o Primase: Synthesizes RNA primers.
o DNA Polymerase III: Adds nucleotides.
o Ligase: Seals Okazaki fragments.
o Topoisomerase: Relieves supercoiling.
Leading vs Lagging Strand:
Leading: Continuous synthesis.
Lagging: Discontinuous (Okazaki fragments).
15. Beta Region Plasma Proteins in Electrophoresis
Major Proteins:
Transferrin: Iron transport; ↓ in iron deficiency anemia.
Complement proteins (C3, C4): Immune defense; ↓ in autoimmune diseases.
Beta-lipoproteins: Lipid transport; ↑ in hyperlipidemia.
Fibrinogen (in plasma, not serum): Coagulation; ↑ in inflammation.
Diagnostic Importance:
↑ Beta globulins: Seen in nephrotic syndrome, liver disease.
↓ Transferrin: Chronic illness, malnutrition.
Complement changes: Help diagnose lupus, glomerulonephritis.
16 . Gene sequencing : Gene sequencing is the process of determining the exact order of
nucleotides (A, T, C, G) in a DNA molecule.
Sanger vs NGS:
Feature Sanger Sequencing NGS
Throughput Low High
Read Length Long Short
Cost Expensive per sample Cost-effective for large sets
Time Slow Rapid
Applications Small-scale studies Whole genome, transcriptome
17. Extracellular Matrix (ECM)
Components:
o Collagen: Tensile strength
o Elastin: Elasticity
o Proteoglycans: Hydration
o Fibronectin & Laminin: Cell adhesion
Functions:
o Structural support
o Cell signaling
o Tissue repair
o Barrier to invasion