Lipid Metabolism — MCQs

Lipid Metabolism Indian Medical PG Practice Questions and MCQs

Question 691: Which of the following is not a phospholipid ?

A. Lecithin
B. Plasmalogen
C. Cardiolipin
D. Ganglioside (Correct Answer)

Explanation: ***Ganglioside*** - Gangliosides are a type of **glycosphingolipid** because their structure includes a ceramide (a sphingoid base linked to a fatty acid) and a carbohydrate portion with one or more **sialic acid** residues, but no phosphate group. - They are primarily found in **nerve cell membranes** and are crucial for cell-cell recognition and signaling, differentiating them from phospholipids which contain a phosphate group. *Lecithin* - Lecithin, specifically **phosphatidylcholine**, is a common phospholipid characterized by a **phosphate group** and a **choline head group** attached to a diacylglycerol backbone. - It plays vital roles in cell membrane structure and function and is an important emulsifier. *Plasmalogen* - Plasmalogens are a class of phospholipids characterized by a **vinyl ether linkage** at the *sn*-1 position of the glycerol backbone, instead of the typical ester linkage found in other phospholipids. - They retain the defining **phosphate group** that classifies them as phospholipids. *Cardiolipin* - Cardiolipin is a unique phospholipid composed of **two phosphatidic acid moieties** connected by a glycerol molecule, resulting in four fatty acid chains and two phosphate groups. - It is predominantly found in the **inner mitochondrial membrane**, essential for mitochondrial function.

Question 692: Albumin is the primary transport protein in blood for which of the following substances?

A. Free fatty acids (FFA) (Correct Answer)
B. Thyroxine
C. Steroid
D. Calcium

Explanation: ***Free fatty acids (FFA)*** - **Albumin is the PRIMARY and MAJOR transport protein for free fatty acids** in the bloodstream, with each albumin molecule having **6-7 high-affinity binding sites** for FFAs. - This binding is essential for transporting water-insoluble fatty acids from **adipose tissue** (during lipolysis) to peripheral tissues for **β-oxidation and energy production**. - In the context of lipid metabolism, albumin-FFA transport is the **most quantitatively significant** and physiologically important binding function. - **Clinical relevance:** Impaired albumin levels directly affect FFA transport capacity. *Thyroxine* - While albumin does bind thyroid hormones, **thyroxine-binding globulin (TBG)** is the **primary carrier** (~70% of T4), followed by transthyretin (~15%). - Albumin binds only ~10-15% of circulating T4 with **low affinity**, serving as a secondary reserve. - TBG has **much higher affinity** for thyroid hormones than albumin. *Steroid* - Steroids are primarily transported by **specific binding globulins**: **corticosteroid-binding globulin (CBG)** for cortisol and **sex hormone-binding globulin (SHBG)** for testosterone/estrogen. - While albumin binds ~10-20% of steroids, it is a **secondary carrier** with lower affinity than the specific globulins. *Calcium* - Although ~40-45% of plasma calcium is albumin-bound (important for calcium homeostasis), this is a **passive binding function** rather than active transport. - Albumin's role with calcium is primarily **buffering** rather than the dedicated transport function it provides for FFAs. - In the context of **lipid metabolism** and **transport proteins**, FFA binding is the hallmark function of albumin.

Question 693: Which of the following is not an androgen?

A. 17α-hydroxyprogesterone (Correct Answer)
B. Testosterone
C. Dihydrotestosterone
D. Androstenedione

Explanation: ***17α-hydroxyprogesterone*** - This is a **progesterone derivative** and an intermediate in the synthesis of androgens and corticosteroids, but it does **not possess significant androgenic activity** itself. - Its primary role is as a precursor, rather than a direct androgen. *Testosterone* - **Testosterone** is the **primary male sex hormone** and a potent androgen, responsible for the development of male secondary sexual characteristics. - It plays crucial roles in muscle mass, bone density, libido, and erythropoiesis. *Dihydrotestosterone* - **Dihydrotestosterone (DHT)** is a potent androgen, formed from testosterone by the enzyme 5α-reductase. - DHT is responsible for the development of external male genitalia during fetal development and contributes to prostate growth and male pattern baldness in adults. *Androstenedione* - **Androstenedione** is a **weak androgen** and an important **precursor hormone** in the biosynthesis of testosterone and estrogens. - It is produced in the adrenal glands and gonads, serving as an intermediate step in steroidogenesis.

Question 694: Concentration of which is inversely related to the risk of coronary heart disease?

A. VLDL
B. LDL
C. HDL (Correct Answer)
D. None of the options

Explanation: ***HDL*** - **High-density lipoprotein (HDL)** is known as "good cholesterol" because it helps remove excess cholesterol from the arteries and transport it back to the liver for excretion. - Higher levels of HDL are generally associated with a **lower risk of coronary heart disease (CHD)**, hence the inverse relationship. *VLDL* - **Very low-density lipoprotein (VLDL)** carries triglycerides and cholesterol and is considered an independent risk factor for CHD when present in high concentrations. - High VLDL levels are associated with an **increased risk of CHD**, not an inverse relationship. *LDL* - **Low-density lipoprotein (LDL)** is often referred to as "bad cholesterol" because it contributes to plaque buildup in arteries (**atherosclerosis**). - High levels of LDL are strongly associated with an **increased risk of CHD**, indicating a direct, not inverse, relationship. *None of the options* - This option is incorrect because HDL clearly demonstrates an **inverse relationship** with the risk of coronary heart disease.

Question 695: Apolipoprotein E is rich in

A. Methionine
B. Lysine
C. Histidine
D. Arginine (Correct Answer)

Explanation: ***Arginine*** - **Apolipoprotein E (apoE)** is notably rich in **basic amino acids**, with **arginine** being particularly abundant. - The high content of **positively charged arginine residues** is critical for apoE's ability to bind to negatively charged lipid surfaces and interact with receptors such as the **LDL receptor** and **LDL receptor-related protein (LRP)**. - This arginine-rich composition is a defining characteristic of apoE and is essential for its role in **lipid metabolism** and **receptor-mediated lipoprotein uptake**. *Lysine* - While apoE does contain **lysine** (another basic amino acid), it is **arginine** that is particularly abundant and functionally emphasized. - Both lysine and arginine contribute positive charges, but **arginine residues** are specifically highlighted in apoE's **receptor binding domains** and are more characteristic of this apolipoprotein. *Histidine* - **Histidine** is also a **basic amino acid**, but it is not present in the same high proportions as **arginine** in apoE. - Its pKa (~6.0) is closer to physiological pH, meaning its charge state can vary, making it less consistently positive than arginine or lysine in biological contexts. - Histidine is not a defining feature of apoE's amino acid composition. *Methionine* - **Methionine** is a **sulfur-containing, nonpolar amino acid**, not a basic amino acid. - It does not contribute to the positive charge characteristic of apoE. - Its role in proteins is typically structural or as the initiator of protein synthesis (as the first amino acid), but it is not relevant to apoE's receptor-binding properties.

Question 696: Which of the following statements about LDL is false?

A. More dense than chylomicron
B. Transports maximum amount of lipid (Correct Answer)
C. Contains maximum cholesterol
D. Smaller than VLDL

Explanation: ***Transports maximum amount of lipid*** - This statement is false because **chylomicrons**, not LDL, are primarily responsible for transporting the **maximum amount of dietary lipids** (triglycerides) from the intestines to various tissues. - While LDL does transport lipids, its primary role is to deliver **cholesterol** to cells, and it contains a lower proportion of triglyceride compared to chylomicrons and VLDL. *More dense than chylomicron* - This statement is true; **LDL is denser than chylomicrons** because it has a higher protein-to-lipid ratio. - **Chylomicrons** are the least dense lipoproteins due to their very high triglyceride content. *Smaller than VLDL* - This statement is true; **LDL is smaller than VLDL** (Very Low-Density Lipoprotein). - VLDL particles are larger and contain more triglycerides, which are gradually removed, leading to the formation of smaller LDL particles. *Contains maximum cholesterol* - This statement is true; **LDL contains the highest proportion of cholesterol** (specifically, **cholesterol esters**) among the lipoproteins. - This characteristic makes LDL the primary carrier for delivering cholesterol to peripheral tissues.

Question 697: Which of the following lipoproteins is most strongly associated with an increased risk of cardiovascular diseases and is commonly referred to as "bad cholesterol"?

A. VLDL
B. Chylomicron
C. Lp (a)
D. LDL (Correct Answer)

Explanation: ***LDL*** - **Low-density lipoprotein (LDL)** is commonly referred to as "bad" cholesterol because elevated levels are the **primary driver** of atherosclerotic plaque buildup in arterial walls. - LDL particles transport cholesterol from the liver to peripheral tissues; when present in excess, they infiltrate the arterial intima and undergo oxidative modification, triggering inflammatory responses that lead to atherosclerosis. - **Clinical significance:** LDL cholesterol is the primary target of lipid-lowering therapy in cardiovascular disease prevention. *VLDL* - **Very low-density lipoprotein (VLDL)** primarily transports endogenously synthesized **triglycerides** from the liver to peripheral tissues. - While elevated VLDL levels do contribute to cardiovascular risk (particularly through conversion to small, dense LDL particles), it is not the primary lipoprotein targeted in cardiovascular risk assessment. *Chylomicron* - **Chylomicrons** transport **dietary lipids** (triglycerides and cholesterol) from the intestines to tissues after meals. - They are rapidly cleared from circulation (half-life of 5-10 minutes) and are typically not present during fasting, making their contribution to chronic atherosclerotic plaque formation minimal. *Lp(a)* - **Lipoprotein(a) [Lp(a)]** is structurally similar to LDL but contains an additional apolipoprotein(a) molecule, which has homology to plasminogen and may interfere with fibrinolysis. - While Lp(a) is an independent cardiovascular risk factor, it is less commonly measured in routine clinical practice, and **LDL remains the cornerstone lipoprotein** for cardiovascular risk stratification and management.

Question 698: Krabbe's disease is due to deficiency of ?

A. Sphingomyelinase
B. Beta galactocerebrosidase (Correct Answer)
C. Hexosaminidase
D. Arylsulfatase

Explanation: ***Beta galactocerebrosidase*** - Krabbe's disease is specifically caused by a deficiency of **beta-galactocerebrosidase**, leading to the accumulation of toxic substances in the brain [1]. - This disease predominantly affects the **myelin sheath**, resulting in severe neurological deterioration [1]. *Arylsulfatase* - Deficiency of **arylsulfatase** is associated with **metachromatic leukodystrophy**, not Krabbe's disease. - Symptoms and pathology differ significantly, primarily affecting **sulfatides** rather than galactocerebrosides. *Sphingomyelinase* - A deficiency of **sphingomyelinase** is linked to **Niemann-Pick disease**, characterized by splenomegaly and liver involvement. - This condition does not involve the same neurological deterioration seen in Krabbe's disease. *Hexosaminidase* - Hexosaminidase deficiency is associated with **Tay-Sachs disease**, primarily affecting the **GM2 gangliosides** [2]. - This results in different clinical manifestations, such as **cherry-red spots** and progressive neurodegeneration, rather than the symptoms of Krabbe's disease [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1304-1305. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, p. 161.

Question 699: Which is the first steroid intermediate formed in the conversion of cholesterol to steroid hormones?

A. Glucocorticoid
B. Mineralocorticoid
C. Estradiol
D. Pregnenolone (Correct Answer)

Explanation: ***Pregnenolone*** - **Pregnenolone** is the **first steroid intermediate** formed from **cholesterol** in steroidogenesis - The conversion occurs in mitochondria via the **cholesterol side-chain cleavage enzyme (P450scc/CYP11A1)** - This is the **rate-limiting step** in steroid hormone biosynthesis - From pregnenolone, all other steroid hormones are subsequently synthesized *Progesterone* - Progesterone is the **second intermediate**, formed from pregnenolone - It serves as a precursor for glucocorticoids, mineralocorticoids, and androgens - Not the first intermediate from cholesterol *Glucocorticoid* - Glucocorticoids (e.g., cortisol) are **end products**, not intermediates - Formed several steps downstream from cholesterol via pregnenolone and progesterone *Mineralocorticoid* - Mineralocorticoids (e.g., aldosterone) are **end products**, not intermediates - Synthesized from progesterone through multiple enzymatic steps *Estradiol* - Estradiol is a **late-stage product** synthesized from androgens - Requires aromatase enzyme for conversion from testosterone - Multiple steps removed from the initial cholesterol conversion

Question 700: Which protein hormone is often referred to as the 'guardian angel against obesity' due to its role in regulating metabolism?

A. Adiponectin (Correct Answer)
B. Fibronectin
C. High-Density Lipoprotein (HDL)
D. Insulin

Explanation: ***Adiponectin*** - **Adiponectin** is a hormone secreted by **adipose tissue** that plays a crucial role in regulating glucose and fatty acid metabolism, increasing **insulin sensitivity**, and decreasing inflammation. - Its levels are inversely correlated with body fat percentage; individuals with obesity tend to have lower adiponectin levels, leading to its nickname as the 'guardian angel against obesity'. *Fibronectin* - **Fibronectin** is a glycoprotein involved in cell adhesion, growth, migration, and differentiation, and is a key component of the **extracellular matrix**. - It does not primarily function in metabolic regulation or body weight control, unlike adiponectin. *High-Density Lipoprotein (HDL)* - **HDL** is a type of lipoprotein that transports cholesterol from peripheral tissues back to the liver, a process known as **reverse cholesterol transport**. - While beneficial for cardiovascular health, HDL is a lipid-carrying particle, not a protein hormone, and its primary role is not in metabolic regulation or direct obesity prevention. *Insulin* - **Insulin** is a peptide hormone produced by the pancreas that regulates carbohydrate and fat metabolism, primarily by facilitating glucose uptake from the blood into cells. - While essential for metabolism, high levels of insulin in the context of insulin resistance can contribute to obesity, rather than act against it.

Practice by Chapter

Lipid Classification and Chemistry

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Fatty Acid Oxidation

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Ketone Body Metabolism

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Fatty Acid Synthesis

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Metabolism of Triacylglycerols

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Phospholipid Metabolism

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Cholesterol Metabolism and Biosynthesis

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Bile Acids and Bile Salts

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Lipoprotein Metabolism and Transport

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Dyslipidemias and Atherosclerosis

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Prostaglandins and Eicosanoids

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Fatty Liver and Lipotropic Factors

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