Test Bank for Lippincott Illustrated Reviews: Pharmacolo
q q q q q q
gy 8th Edition by Karen Whalen|
q q q q q
KNOW qTHIS:q-
qANSWERqqq1)qRNAqisqsusceptibleqtoqalkalineqhydrolysis,qwhereasqDNAqisqnot.
2)qUnderqalkalineqconditions,qtheqhydroxylqgroupqcanqactqasqaqnucleophileqandqattackqth
eqphosphodiesterqlinkageqbetweenqadjacentqnucleotides,qbreakingqtheqlinkageqandqlea
dingqtoqtheqtransientqformationqofqaqcyclicqnucleotide.q
3)qAsqthisqcanqoccurqatqeveryqphosphodiesterqlinkageqinqRNA,qhydrolysisqofqtheqRNAqwil
lqoccurqdueqtoqtheseqreactions.qAsqDNAqlacksqtheq2′-
hydroxylqgroup,qthisqreactionqcannotqoccur,qand
DNAqisqveryqstablequnderqalkalineqconditions.
Symptomsqofqadenosineqdeaminaseqdeficiency:q-
qANSWERqqq1)qHistoryqofqchronicqdiarrheaqandqmultipleqpneumonias
2)qTheqchestqX-rayqshowsqaqpneumonia,qbutqalsoqrevealsqanqabnormallyqsmallqthymus.q
3)qBloodqworkqshowsqaqdistinctqlackqofqcirculatingqlymphocytes.q
*HereqyouqhaveqnoqworkingqBqorqTqcells*
*qThisqdisorderqleadsqtoqanqaccumulationqofqdeoxyadenosineqandqS-
adenosylhomocysteine,
whichqareqtoxicqtoqimmatureqlymphocytesqinqtheqthymus.*
4)qTheqmostqlikelyqinheritedqenzymaticqdefectqinqthisqchildqleadsqtoqanqinabilityqtoqalterqaq
purineqnucleotideqatqpositionq6qofqtheqringqstructureq(whereqdeaminationqoccursqandqisqr
eplacedqwithqaqcarbonylqgroup)
InosineqandqWobblingq-qANSWERqqqInosineqisqaqwobbleqbaseqpairqformer,qhavingqthe
abilityqtoqbaseqpairqwithq*adenine,quracil,qorqcytosine*
KNOW qTHIS:q-qANSWERqqqLactaseqwillqsplitqtheqβ-1,4qlinkageqbetween
galactoseqandqglucoseqinqlactose.q
Theqlactoseqthusqpassesqunmetabolizedqtoqtheqbacteriaqinhabitingqtheqgut,qandqtheirqme
tabolismqofqtheqdisaccharideqleadsqtoqtheqobservedqsymptoms.q
Combiningqtwoqsugarsqinqaqdehydrationqreactionqcreatesqaqglycosidicqbond.q
AddingqaqsugarqtoqtheqnitrogenqofqaqnitrogenousqbaseqalsoqcreatesqanqN-
glycosidicqbond.
,KNOW qTHIS:q-
qANSWERqqqTheqalphaqcarbonqdeterminesqwhetherqtheqaminoqacidqisqinqtheqDqorqLqconfi
guration
*Manyqbiochemicalqcompoundsq(includingqdrugs)qareqonlyqactiveqasqeitherqtheqDqorqLqis
omer.*
Yourqpatientqhasqaqmechanicalqheartqvalveqandqisqchronicallyqanemicqdueqtoqdamageqto
qredqbloodqcellsqasqtheyqpassqthroughqthisqvalve.qOneqofqtheqsignalsqthatqtargetqdamage
dqredqbloodqcellsqforqremovalqfromqtheqcirculationqisqtheqpresenceqofqphosphatidylserine
qinqtheqouterqleafletqofqtheqredqcellqmembrane.qPhosphatidylserineqisqanqintegralqpartqofq
cellqmembranesqandqisqnormallyqfoundqinqtheqinnerqleafletqofqtheqredqcellqmembrane.qThi
sqflip-
flopqofqphosphatidylserineqbetweenqmembraneqleafletsqexposesqwhichqpartqofqtheqphos
phatidylserineqto
theqenvironment?
(A)qTheqheadqgroup
(B)qFattyqacids
(C)qSphingosine
(D)qGlycerol
(E)qCeramideq-qANSWERqqqA.
Thus,qwhenqaqphospholipidqflqip-
flqopsqacrossqtheqmembrane,qtheqheadqgroupqwillqalwaysqendqupqfacingqtheqaqueousqen
vironment.
Aqcoupleqhasqhadqfiveqchildren,qallqofqwhoqexhibitqshort
stature,qeyelidqdroop,qandqsomeqdegreeqofqmuscleqweaknessqandqhearingqlossq(someqs
evere,qsomeqmild).qTheqmotherqalsoqhasqsuchqproblems,qalthoughqatqaqmildqlevel.qTheqf
atherqhasqnoqsymptoms.qTheqmutationqthatqafflictsqtheqchildrenqmostqlikelyqresidesqinqD
NAqfoundqinqwhichqintracellularqorganelle?
(A)qMitochondria
(B)qPeroxisome
(C)qLysosome
(D)qEndoplasmicqreticulum
(E)qNucleusq-qANSWERqqqA.
Theqmotherqandqchildrenqareqexperiencingqtheqeffectsqofqaqmitochondrialqdisorder.
*Theyqkeyqhereqisqthatqallqofqtheqkidsqhaveqtheqissueqandqtheqmotherqasqwellqbutqtheqfath
erqshowsqnoqsymptoms*
Thereqareqmultipleqmitochondrialqdisordersqassociatedqwithqmuscularqdystrophy:
q
1)qKearns-Sayerqsyndrome(thisqcase)
2)qLeighqsyndromeq(non-X-linked)
3)qPearsonqsyndrome
,4)qMitochondrialqDNAqdepletionqsyndrome
5)qMitochondrialqencephalomyopathy
Membraneqformationqoccurs,qinqpart,qdueqtoqlowqlipidqsolubilityqinqwaterqdueqtoqprimarilyq
whichqofqtheqfollowing?
(A)qHydrogenqbondqformationqbetweenqlipidsqandqwater
(B)qCovalentqbondqformationqbetweenqlipidsqandqwater
(C)qAqdecreaseqinqwaterqentropy
(D)qAnqincreaseqinqwaterqentropy
(E)qIonicqbondqformationqbetweenqlipidsqandqwaterq-qANSWERqqqD.
Cageqformingqdecreasesqwaterqentropy,qwhichqis
unfavorable,qandqthisqleadsqtoqtheqhydrophobicqeffect,qinqwhichqtheqlipidqmoleculesqallqc
omeqtogetherqsuchqthatqonlyqoneqlargeqcageqneedsqtoqbeqformedqaboutqtheqlipidqmolecu
les,qratherqthanqmanyqsmallqcagesqaboutqeachqindividualqlipidqmolecule.q
Theqlipidsqdoqnotqformqcovalentqorqionicqbondsqwithqwater,qand,qasqmentionedqabove,qlip
idsqinqwaterqleadsqtoqaqdecreaseqinqwaterqentropyq(whichqisqunfavorable),qratherqthanqan
qincreaseqinqtheqentropyqofqwaterq(whichqwouldqbeqaqfavorableqevent).
KNOW qTHIS:q-
qANSWERqqqPrecipitationqofquricqacidqoccursqinq"cold"qareasqofqtheqbody,qsuchqasqtheqgr
eatqtoe.
Aqsingle-strandedqDNAqmoleculeqcontainsq20%A,q25%T,
30%G,qandq25%C.qWhenqtheqcomplementqofqthisqstrand
isqsynthesized,qtheqTqcontentqofqtheqresultingqduplexqwill
beqwhichqoneqofqtheqfollowing?
(A)q20%
(B)q22.5%
(C)q25%
(D)q27.5%
(E)q30%q-qANSWERqqqB.
Forqtheqentireqduplexqthen,qtheqTqcontent
isqtheqaverageqofq25%qandq20%,qorq22.5%qforqtheqduplex.qTheq[A]qinqtheqduplexqwillqalso
qbeq22.5%q(again,qsinceq[A]q=q[T]),qandqtheqconcentrationsqofq[G]qandq[C]qwillqeachqbeq27
.5%qforqtheqduplex.
KNOW qTHIS:q-qANSWERqqqTheqglycosylationqofqhemoglobinqprimarilyqoccursqonqtheqN-
terminalqvalineqresiduesqofqtheqβqchainsq(whichqcontainqaqfreeqaminoqgroup).
TheqrateqofqdegradationqofqnonmodifiedqhemoglobinqandqHbA1cqareqtheqsame.
KNOW qTHIS:q-
qANSWERqqq1)qInqorderqtoqmakeqaqxenobioticqmoreqsoluble,qaqhydrophilicqgroupqneedsqt
oqbeqadded
toqtheqxenobiotic.q
, 2)qGlucuronicqacidq(glucoseqwithqaqcarboxylicqacidqatqpositionq6qinsteadqofqanqalcoholqgr
oup)qisqaqhydrophilicqmolecule.
3)qGlucuronicqacidqisqaddedqtoqtheqxenobioticqatqpositionq1,qusingqtheqactivatedqinterme
diateqUDPqglucuronate.
EarlyqclinicalqsignsqofqCreutzfeldt-Jakobqdisease:q-qANSWERqqq1)qMoodqchanges
2)qMinorqlossqofqmemory
3)qDecreasedqmotorqskills
Causedqbyqaqmisfoldedqprionqprotein,qleadingqtoqproteinqaggregatesqinqtheqbrain.q
Thisqpatientqwillqprobablyqdieqwithinq1qyear.q
Thereqisqnoqcurrentqtreatmentqforqtheqdisease.q
Asqtheqdiseaseqprogresses,qheqwillqprobablyqdevelopqblindness,qinvoluntaryqmovement
s,qandqsevereqdeteriorationqofqmentalqfunction.
KNOW qTHIS:q-
qANSWERqqqBisphosphonatesqdecreaseqboneqresorptionqbyqtheqosteoclasts,qtherebyqst
rengtheningqtheqbone,qevenqwithqtheqdefectiveqcollagenqmolecule.
Youqareqvisitedqbyqaq40-year-
oldqfemaleqpatientqcomplainingqofqweightqloss,qnumbnessqinqtheqhandsqandqfeet,qfatigue
,qandqdifficultyqswallowing.qPhysicalqexam
notesqanqenlargedqtongue,qenlargedqliver,qaqrubbery
feelingqaroundqtheqjoints,qandqbruisingqaroundqthe
eyes.qAqboneqmarrowqbiopsyqshowsqanqabnormal
stainingqofqdenaturedqproteinq(seeqbelow).qThese
denaturedqproteinsqareqmostqlikelyqtoqbeqwhichqofqthe
following?
(A)qAntibodyqlightqchains
(B)qCollagen
(C)qFibrillin
(D)qAlbumin
(E)qTransaminasesq-qANSWERqqqA.
*Theqpatientqisqexhibitingqtheqsymptomsqofqprimaryqamyloidosis*
Primaryqamyloidosisq-
qANSWERqqq1)qAqproteinqfoldingqdiseaseqinqwhichqimmunoglobulinqlightqchainsqareqimpr
operlyqprocessedqandqcannotqbeqdegraded.q
2)qTheseqproteinsqthenqformqfibrilsqinqtissues,
whichqareqinsoluble.qThisqdisruptsqtheqnormalqfunctionqofqtheqtissue,qandqmanyqtissuesq
canqaccumulateqtheseqfibrils.
q q q q q q
gy 8th Edition by Karen Whalen|
q q q q q
KNOW qTHIS:q-
qANSWERqqq1)qRNAqisqsusceptibleqtoqalkalineqhydrolysis,qwhereasqDNAqisqnot.
2)qUnderqalkalineqconditions,qtheqhydroxylqgroupqcanqactqasqaqnucleophileqandqattackqth
eqphosphodiesterqlinkageqbetweenqadjacentqnucleotides,qbreakingqtheqlinkageqandqlea
dingqtoqtheqtransientqformationqofqaqcyclicqnucleotide.q
3)qAsqthisqcanqoccurqatqeveryqphosphodiesterqlinkageqinqRNA,qhydrolysisqofqtheqRNAqwil
lqoccurqdueqtoqtheseqreactions.qAsqDNAqlacksqtheq2′-
hydroxylqgroup,qthisqreactionqcannotqoccur,qand
DNAqisqveryqstablequnderqalkalineqconditions.
Symptomsqofqadenosineqdeaminaseqdeficiency:q-
qANSWERqqq1)qHistoryqofqchronicqdiarrheaqandqmultipleqpneumonias
2)qTheqchestqX-rayqshowsqaqpneumonia,qbutqalsoqrevealsqanqabnormallyqsmallqthymus.q
3)qBloodqworkqshowsqaqdistinctqlackqofqcirculatingqlymphocytes.q
*HereqyouqhaveqnoqworkingqBqorqTqcells*
*qThisqdisorderqleadsqtoqanqaccumulationqofqdeoxyadenosineqandqS-
adenosylhomocysteine,
whichqareqtoxicqtoqimmatureqlymphocytesqinqtheqthymus.*
4)qTheqmostqlikelyqinheritedqenzymaticqdefectqinqthisqchildqleadsqtoqanqinabilityqtoqalterqaq
purineqnucleotideqatqpositionq6qofqtheqringqstructureq(whereqdeaminationqoccursqandqisqr
eplacedqwithqaqcarbonylqgroup)
InosineqandqWobblingq-qANSWERqqqInosineqisqaqwobbleqbaseqpairqformer,qhavingqthe
abilityqtoqbaseqpairqwithq*adenine,quracil,qorqcytosine*
KNOW qTHIS:q-qANSWERqqqLactaseqwillqsplitqtheqβ-1,4qlinkageqbetween
galactoseqandqglucoseqinqlactose.q
Theqlactoseqthusqpassesqunmetabolizedqtoqtheqbacteriaqinhabitingqtheqgut,qandqtheirqme
tabolismqofqtheqdisaccharideqleadsqtoqtheqobservedqsymptoms.q
Combiningqtwoqsugarsqinqaqdehydrationqreactionqcreatesqaqglycosidicqbond.q
AddingqaqsugarqtoqtheqnitrogenqofqaqnitrogenousqbaseqalsoqcreatesqanqN-
glycosidicqbond.
,KNOW qTHIS:q-
qANSWERqqqTheqalphaqcarbonqdeterminesqwhetherqtheqaminoqacidqisqinqtheqDqorqLqconfi
guration
*Manyqbiochemicalqcompoundsq(includingqdrugs)qareqonlyqactiveqasqeitherqtheqDqorqLqis
omer.*
Yourqpatientqhasqaqmechanicalqheartqvalveqandqisqchronicallyqanemicqdueqtoqdamageqto
qredqbloodqcellsqasqtheyqpassqthroughqthisqvalve.qOneqofqtheqsignalsqthatqtargetqdamage
dqredqbloodqcellsqforqremovalqfromqtheqcirculationqisqtheqpresenceqofqphosphatidylserine
qinqtheqouterqleafletqofqtheqredqcellqmembrane.qPhosphatidylserineqisqanqintegralqpartqofq
cellqmembranesqandqisqnormallyqfoundqinqtheqinnerqleafletqofqtheqredqcellqmembrane.qThi
sqflip-
flopqofqphosphatidylserineqbetweenqmembraneqleafletsqexposesqwhichqpartqofqtheqphos
phatidylserineqto
theqenvironment?
(A)qTheqheadqgroup
(B)qFattyqacids
(C)qSphingosine
(D)qGlycerol
(E)qCeramideq-qANSWERqqqA.
Thus,qwhenqaqphospholipidqflqip-
flqopsqacrossqtheqmembrane,qtheqheadqgroupqwillqalwaysqendqupqfacingqtheqaqueousqen
vironment.
Aqcoupleqhasqhadqfiveqchildren,qallqofqwhoqexhibitqshort
stature,qeyelidqdroop,qandqsomeqdegreeqofqmuscleqweaknessqandqhearingqlossq(someqs
evere,qsomeqmild).qTheqmotherqalsoqhasqsuchqproblems,qalthoughqatqaqmildqlevel.qTheqf
atherqhasqnoqsymptoms.qTheqmutationqthatqafflictsqtheqchildrenqmostqlikelyqresidesqinqD
NAqfoundqinqwhichqintracellularqorganelle?
(A)qMitochondria
(B)qPeroxisome
(C)qLysosome
(D)qEndoplasmicqreticulum
(E)qNucleusq-qANSWERqqqA.
Theqmotherqandqchildrenqareqexperiencingqtheqeffectsqofqaqmitochondrialqdisorder.
*Theyqkeyqhereqisqthatqallqofqtheqkidsqhaveqtheqissueqandqtheqmotherqasqwellqbutqtheqfath
erqshowsqnoqsymptoms*
Thereqareqmultipleqmitochondrialqdisordersqassociatedqwithqmuscularqdystrophy:
q
1)qKearns-Sayerqsyndrome(thisqcase)
2)qLeighqsyndromeq(non-X-linked)
3)qPearsonqsyndrome
,4)qMitochondrialqDNAqdepletionqsyndrome
5)qMitochondrialqencephalomyopathy
Membraneqformationqoccurs,qinqpart,qdueqtoqlowqlipidqsolubilityqinqwaterqdueqtoqprimarilyq
whichqofqtheqfollowing?
(A)qHydrogenqbondqformationqbetweenqlipidsqandqwater
(B)qCovalentqbondqformationqbetweenqlipidsqandqwater
(C)qAqdecreaseqinqwaterqentropy
(D)qAnqincreaseqinqwaterqentropy
(E)qIonicqbondqformationqbetweenqlipidsqandqwaterq-qANSWERqqqD.
Cageqformingqdecreasesqwaterqentropy,qwhichqis
unfavorable,qandqthisqleadsqtoqtheqhydrophobicqeffect,qinqwhichqtheqlipidqmoleculesqallqc
omeqtogetherqsuchqthatqonlyqoneqlargeqcageqneedsqtoqbeqformedqaboutqtheqlipidqmolecu
les,qratherqthanqmanyqsmallqcagesqaboutqeachqindividualqlipidqmolecule.q
Theqlipidsqdoqnotqformqcovalentqorqionicqbondsqwithqwater,qand,qasqmentionedqabove,qlip
idsqinqwaterqleadsqtoqaqdecreaseqinqwaterqentropyq(whichqisqunfavorable),qratherqthanqan
qincreaseqinqtheqentropyqofqwaterq(whichqwouldqbeqaqfavorableqevent).
KNOW qTHIS:q-
qANSWERqqqPrecipitationqofquricqacidqoccursqinq"cold"qareasqofqtheqbody,qsuchqasqtheqgr
eatqtoe.
Aqsingle-strandedqDNAqmoleculeqcontainsq20%A,q25%T,
30%G,qandq25%C.qWhenqtheqcomplementqofqthisqstrand
isqsynthesized,qtheqTqcontentqofqtheqresultingqduplexqwill
beqwhichqoneqofqtheqfollowing?
(A)q20%
(B)q22.5%
(C)q25%
(D)q27.5%
(E)q30%q-qANSWERqqqB.
Forqtheqentireqduplexqthen,qtheqTqcontent
isqtheqaverageqofq25%qandq20%,qorq22.5%qforqtheqduplex.qTheq[A]qinqtheqduplexqwillqalso
qbeq22.5%q(again,qsinceq[A]q=q[T]),qandqtheqconcentrationsqofq[G]qandq[C]qwillqeachqbeq27
.5%qforqtheqduplex.
KNOW qTHIS:q-qANSWERqqqTheqglycosylationqofqhemoglobinqprimarilyqoccursqonqtheqN-
terminalqvalineqresiduesqofqtheqβqchainsq(whichqcontainqaqfreeqaminoqgroup).
TheqrateqofqdegradationqofqnonmodifiedqhemoglobinqandqHbA1cqareqtheqsame.
KNOW qTHIS:q-
qANSWERqqq1)qInqorderqtoqmakeqaqxenobioticqmoreqsoluble,qaqhydrophilicqgroupqneedsqt
oqbeqadded
toqtheqxenobiotic.q
, 2)qGlucuronicqacidq(glucoseqwithqaqcarboxylicqacidqatqpositionq6qinsteadqofqanqalcoholqgr
oup)qisqaqhydrophilicqmolecule.
3)qGlucuronicqacidqisqaddedqtoqtheqxenobioticqatqpositionq1,qusingqtheqactivatedqinterme
diateqUDPqglucuronate.
EarlyqclinicalqsignsqofqCreutzfeldt-Jakobqdisease:q-qANSWERqqq1)qMoodqchanges
2)qMinorqlossqofqmemory
3)qDecreasedqmotorqskills
Causedqbyqaqmisfoldedqprionqprotein,qleadingqtoqproteinqaggregatesqinqtheqbrain.q
Thisqpatientqwillqprobablyqdieqwithinq1qyear.q
Thereqisqnoqcurrentqtreatmentqforqtheqdisease.q
Asqtheqdiseaseqprogresses,qheqwillqprobablyqdevelopqblindness,qinvoluntaryqmovement
s,qandqsevereqdeteriorationqofqmentalqfunction.
KNOW qTHIS:q-
qANSWERqqqBisphosphonatesqdecreaseqboneqresorptionqbyqtheqosteoclasts,qtherebyqst
rengtheningqtheqbone,qevenqwithqtheqdefectiveqcollagenqmolecule.
Youqareqvisitedqbyqaq40-year-
oldqfemaleqpatientqcomplainingqofqweightqloss,qnumbnessqinqtheqhandsqandqfeet,qfatigue
,qandqdifficultyqswallowing.qPhysicalqexam
notesqanqenlargedqtongue,qenlargedqliver,qaqrubbery
feelingqaroundqtheqjoints,qandqbruisingqaroundqthe
eyes.qAqboneqmarrowqbiopsyqshowsqanqabnormal
stainingqofqdenaturedqproteinq(seeqbelow).qThese
denaturedqproteinsqareqmostqlikelyqtoqbeqwhichqofqthe
following?
(A)qAntibodyqlightqchains
(B)qCollagen
(C)qFibrillin
(D)qAlbumin
(E)qTransaminasesq-qANSWERqqqA.
*Theqpatientqisqexhibitingqtheqsymptomsqofqprimaryqamyloidosis*
Primaryqamyloidosisq-
qANSWERqqq1)qAqproteinqfoldingqdiseaseqinqwhichqimmunoglobulinqlightqchainsqareqimpr
operlyqprocessedqandqcannotqbeqdegraded.q
2)qTheseqproteinsqthenqformqfibrilsqinqtissues,
whichqareqinsoluble.qThisqdisruptsqtheqnormalqfunctionqofqtheqtissue,qandqmanyqtissuesq
canqaccumulateqtheseqfibrils.
