Free Online USMLE Step 1 Questions and Answers 1

7. Biochemists working for a national endocrinology institute are investigating the specifics underlying glucose transport across adipose cell membranes. One of their experiments shows that, in the presence of insulin, D-glucose transport across the plasma membrane of adipocytes is much faster than L-glucose transport. Which of the following transport processes best describes the mechanism for glucose entry into these cells?

A. Simple diffusion
B. Receptor-mediated endocytosis
C. Carrier-mediated transport
D. Primary active transport
E. Co-transport

Correct Answer: C

Answer Explanation:

(Choice A) Simple diffusion refers to the movement of particles along their concentration gradient directly through the cell membrane. Transport of gases (02 and CO2) occurs via simple diffusion, as the membrane is very permeable to small, nonpolar molecules.
(Choice B) Endocytosis allows for cellular uptake through the formation of membrane-bound, typically clathrincoated, vesicles. Uptake of cholesterol by cells occurs by means of receptor-mediated endocytosis (mediated by the LDL receptor).
(Choices D and E) Active transport refers to the movement of a substance against its concentration gradient. This process requires energy as well as transport proteins. In primary active transport, the energy required for transport against the concentration gradient is provided by the hydrolysis of ATP. In secondary active transport, this energy is generated by co-transport of a separate substance down its concentration gradient. Transport of glucose against the concentration gradient occurs via the Na/glucose symporter, which is found in the intestinal and renal tubular epithelium and is used to transfer glucose intracellularly from the lumen.

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8. Researchers lyse human cel ls and isolate a specific messenger RNA template using gel electrophoresis. Reverse transcription polymerase chain reaction is then used to synthesize complementary DNA (cDNA) from the RNA template. Next, the cDNA is modified into an expression vector containing an optimized bacterial promoter, ribosomal binding site, and terminator sequence. After insertion of the vector into appropriate bacterial hosts, the transformed bacteria are cultured in a bioreactor and produce large quantities of a protein containing a domain that binds to a specific DNA sequence. This protein is most likely the receptor for which of the following hormones?

A. Glucagon
B. Growth hormone
C. Insulin
D. Insulin-like growth factor
E. Parathyroid hormone
F. Progesterone

Correct Answer: F

Answer Explanation:

(Choices A and E) Parathyroid hormone and glucagon act on Gs protein-coupled receptors found on the cell membrane. Binding their respective ligands subsequently activates adenylyl cyclase and increases intracellular cyclic AMP concentration.
(Choice B) Growth hormone receptor is a membrane-bound receptor that works via activating the JAK-STAT pathway.
(Choices C and D) The receptors for insulin-like growth factor-1 (IGF-1) and insulin are structurally similar and located at the cell membrane. The intracellular domains of these receptors have intrinsic tyrosine kinase activity, which is activated on ligand binding. Autophosphorylation of the tyrosine residues on the intracellular part of the receptors then triggers downstream signaling.

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9. Succinate dehydrogenase (SDH) is an enzyme complex located within the inner mitochondrial membrane that catalyzes the oxidation of succinate to fumarate. An experiment is conducted to determine if malate alters the rate
of SDH activity. Reaction velocity is measured with and without a fixed quantity of malate as succinate concentration is gradually increased. Obtained results are shown below.

Usmle1 3

Which of the following is the most accurate statement about malate in this experiment?

A. It alters the maximal velocity of the reaction
B. It binds the enzyme at a different site than succinate
C. It covalently binds the enzyme
D. It decreases affinity of the enzyme for succinate
E. It is a competitive inhibitor of the enzyme

Correct Answer: E

Answer Explanation:

(Choice A) Vmax depends on how fast an enzyme can catalyze a reaction when there are enough substrate molecules to fully saturate its active sites. Competitive inhibitors do not affect V max, as higher substrate concentrations are able to overcome the inhibition.
(Choice B) Most competitive inhibitors, such as malate, bind in the substrate-binding pocket. In contrast, most noncompetitive inhibitors bind at allosteric sites, resulting in a conformational change of the enzyme that decreases enzymatic activity and slows the rate of reaction (V max). Noncompetitive inhibition does not change the apparent Km and cannot be overcome with higher substrate concentrations.
(Choice C) Irreversible inhibitors bind to enzymes through strong covalent bonds; this typically renders the enzyme permanently ineffective, decreasing the Vmax.
(Choice D) Competitive inhibitors interfere with substrate binding due to the inhibitor’s own high affinity for the enzyme’s active site. This causes the measured Kn value to increase; however, the actual enzyme affinity for the substrate remains unchanged.

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