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Here is your 100-MCQ Exam Paper based exactly on your syllabus. Distribution: Module I (25 Qs), Module II (25 Qs), Module III (35 Qs), Module IV (15 Qs).

BASICS OF BIOCHEMISTRY — 100 MCQ EXAM PAPER

Total Questions: 100 | Time: 2.5 Hours | Each correct answer: 1 mark | No negative marking

MODULE – I: NUTRITION (Q. 1–25)

1. The calorific value of 1 gram of carbohydrate is:
  • A) 4 kcal
  • B) 9 kcal
  • C) 7 kcal
  • D) 5.65 kcal
✓ Answer: A
2. The calorific value of 1 gram of fat is:
  • A) 4 kcal
  • B) 5.65 kcal
  • C) 9 kcal
  • D) 7 kcal
✓ Answer: C
3. The calorific value of 1 gram of protein is:
  • A) 9 kcal
  • B) 4 kcal
  • C) 7 kcal
  • D) 2 kcal
✓ Answer: B
4. Nitrogen balance is said to be POSITIVE in:
  • A) Starvation
  • B) Pregnancy and growth
  • C) Burns
  • D) Marasmus
✓ Answer: B
5. In a normal healthy adult, nitrogen balance is:
  • A) Positive
  • B) Negative
  • C) Zero (equilibrium)
  • D) Fluctuating
✓ Answer: C
6. Respiratory Quotient (RQ) is defined as:
  • A) Volume of O₂ consumed / Volume of CO₂ produced
  • B) Volume of CO₂ produced / Volume of O₂ consumed
  • C) O₂ consumed / Total calories
  • D) CO₂ / Total nitrogen excreted
✓ Answer: B
7. The RQ for a pure carbohydrate diet is:
  • A) 0.7
  • B) 0.8
  • C) 1.0
  • D) 1.2
✓ Answer: C
8. The RQ for fat is approximately:
  • A) 0.7
  • B) 0.85
  • C) 1.0
  • D) 1.3
✓ Answer: A
9. The RQ for protein is approximately:
  • A) 0.7
  • B) 0.82
  • C) 1.0
  • D) 1.2
✓ Answer: B
10. Basal Metabolic Rate (BMR) is defined as the energy expenditure:
  • A) During maximum physical activity
  • B) At rest, in a post-absorptive state, in a thermoneutral environment
  • C) After a full meal
  • D) During sleep only
✓ Answer: B
11. BMR is highest in:
  • A) Elderly females
  • B) Children and young adults
  • C) Obese adults
  • D) Post-menopausal women
✓ Answer: B
12. Harris-Benedict equation is used to calculate:
  • A) Anion gap
  • B) Osmolality
  • C) Basal Metabolic Rate
  • D) Creatinine clearance
✓ Answer: C
13. Which vitamin is essential for carbohydrate metabolism as a cofactor in pyruvate decarboxylation?
  • A) Vitamin B12
  • B) Vitamin B1 (Thiamine)
  • C) Vitamin C
  • D) Vitamin D
✓ Answer: B
14. Scurvy is caused by deficiency of:
  • A) Vitamin A
  • B) Vitamin B12
  • C) Vitamin C
  • D) Vitamin K
✓ Answer: C
15. Rickets in children is caused by deficiency of:
  • A) Vitamin A
  • B) Vitamin B6
  • C) Vitamin C
  • D) Vitamin D
✓ Answer: D
16. Which of the following is a fat-soluble vitamin?
  • A) Vitamin B1
  • B) Vitamin B12
  • C) Vitamin C
  • D) Vitamin K
✓ Answer: D
17. Night blindness is associated with deficiency of:
  • A) Vitamin D
  • B) Vitamin A
  • C) Vitamin E
  • D) Vitamin K
✓ Answer: B
18. Essential fatty acids include:
  • A) Palmitic acid and stearic acid
  • B) Linoleic and alpha-linolenic acid
  • C) Oleic acid and lauric acid
  • D) Arachidic acid and behenic acid
✓ Answer: B
19. The most important mineral involved in oxygen transport in blood is:
  • A) Calcium
  • B) Zinc
  • C) Iron
  • D) Magnesium
✓ Answer: C
20. Proteins are the primary source of:
  • A) Energy storage
  • B) Nitrogen in the body
  • C) Ketone bodies
  • D) Bile acids
✓ Answer: B
21. Parenteral nutrition is indicated when:
  • A) The patient refuses oral feeding
  • B) The gastrointestinal tract is non-functional
  • C) Weight loss exceeds 2 kg
  • D) BMI is above 25
✓ Answer: B
22. Total Parenteral Nutrition (TPN) is administered via:
  • A) Intramuscular route
  • B) Central or peripheral venous catheter
  • C) Nasogastric tube
  • D) Rectal suppository
✓ Answer: B
23. Which of the following is NOT a component of a standard TPN solution?
  • A) Glucose
  • B) Amino acids
  • C) Lipid emulsions
  • D) Whole blood
✓ Answer: D
24. Kwashiorkor is primarily caused by deficiency of:
  • A) Total caloric intake
  • B) Dietary protein
  • C) Vitamin C
  • D) Iron
✓ Answer: B
25. Iodine deficiency leads to:
  • A) Rickets
  • B) Scurvy
  • C) Goitre
  • D) Pellagra
✓ Answer: C

MODULE – II: ACID-BASE BALANCE, WATER & ELECTROLYTE BALANCE (Q. 26–50)

26. The Henderson-Hasselbalch equation for bicarbonate buffer is:
  • A) pH = pKa + log [HCO₃⁻] / [H₂CO₃]
  • B) pH = pKa – log [HCO₃⁻] / [H₂CO₃]
  • C) pH = pKa × [HCO₃⁻] / [H₂CO₃]
  • D) pH = [HCO₃⁻] / [H₂CO₃]
✓ Answer: A
27. The normal arterial blood pH range is:
  • A) 7.0 – 7.2
  • B) 7.35 – 7.45
  • C) 7.5 – 7.6
  • D) 6.9 – 7.1
✓ Answer: B
28. The most important buffer system in the blood is:
  • A) Phosphate buffer
  • B) Protein buffer
  • C) Bicarbonate buffer
  • D) Ammonia buffer
✓ Answer: C
29. Normal arterial pCO₂ is:
  • A) 25–30 mmHg
  • B) 35–45 mmHg
  • C) 50–60 mmHg
  • D) 15–20 mmHg
✓ Answer: B
30. Normal plasma HCO₃⁻ concentration is:
  • A) 10–12 mEq/L
  • B) 22–26 mEq/L
  • C) 30–35 mEq/L
  • D) 5–8 mEq/L
✓ Answer: B
31. Respiratory acidosis is characterized by:
  • A) Decreased pCO₂ and increased pH
  • B) Increased pCO₂ and decreased pH
  • C) Decreased pCO₂ and decreased pH
  • D) Normal pCO₂ and increased HCO₃⁻
✓ Answer: B
32. Metabolic alkalosis is compensated by:
  • A) Hyperventilation (increased CO₂ excretion)
  • B) Hypoventilation (CO₂ retention)
  • C) Increased renal HCO₃⁻ excretion only
  • D) No compensation occurs
✓ Answer: B
33. The anion gap is calculated as:
  • A) [Na⁺] – ([Cl⁻] + [HCO₃⁻])
  • B) [Na⁺] + [K⁺] – [Cl⁻]
  • C) [Cl⁻] – [HCO₃⁻]
  • D) [Na⁺] – [K⁺]
✓ Answer: A
34. The normal anion gap is:
  • A) 1–3 mEq/L
  • B) 8–12 mEq/L
  • C) 20–25 mEq/L
  • D) 30–40 mEq/L
✓ Answer: B
35. Diabetic ketoacidosis causes:
  • A) High anion gap metabolic acidosis
  • B) Normal anion gap metabolic acidosis
  • C) Metabolic alkalosis
  • D) Respiratory alkalosis
✓ Answer: A
36. In metabolic acidosis, compensation occurs by:
  • A) Renal retention of HCO₃⁻
  • B) Hyperventilation to decrease pCO₂
  • C) Hypoventilation to increase pCO₂
  • D) Increased aldosterone secretion
✓ Answer: B
37. Respiratory alkalosis is caused by:
  • A) Hypoventilation
  • B) Chronic obstructive pulmonary disease
  • C) Hyperventilation
  • D) Renal failure
✓ Answer: C
38. The pH at which an arterial blood gas sample is considered acidotic is:
  • A) Below 7.35
  • B) Above 7.45
  • C) Exactly 7.40
  • D) Below 7.0 only
✓ Answer: A
39. Which electrolyte is the principal cation in intracellular fluid?
  • A) Sodium (Na⁺)
  • B) Calcium (Ca²⁺)
  • C) Potassium (K⁺)
  • D) Magnesium (Mg²⁺)
✓ Answer: C
40. Which electrolyte is the principal cation in extracellular fluid?
  • A) Potassium (K⁺)
  • B) Sodium (Na⁺)
  • C) Chloride (Cl⁻)
  • D) Bicarbonate (HCO₃⁻)
✓ Answer: B
41. Normal serum sodium concentration is:
  • A) 100–110 mEq/L
  • B) 135–145 mEq/L
  • C) 150–160 mEq/L
  • D) 120–130 mEq/L
✓ Answer: B
42. Hyperkalemia is characterized by serum potassium greater than:
  • A) 3.5 mEq/L
  • B) 4.0 mEq/L
  • C) 5.5 mEq/L
  • D) 6.5 mEq/L
✓ Answer: C
43. The kidneys regulate acid-base balance primarily through:
  • A) Excreting CO₂
  • B) Reabsorption of HCO₃⁻ and excretion of H⁺
  • C) Producing carbonic anhydrase
  • D) Secreting aldosterone
✓ Answer: B
44. The blood gas parameter that reflects metabolic component of acid-base balance is:
  • A) pCO₂
  • B) pO₂
  • C) HCO₃⁻ (bicarbonate)
  • D) Hemoglobin
✓ Answer: C
45. Chloride shift (Hamburger phenomenon) refers to:
  • A) Cl⁻ exchange for HCO₃⁻ across RBC membrane for CO₂ transport
  • B) Cl⁻ loss in urine during acidosis
  • C) Renal reabsorption of chloride
  • D) Cl⁻ movement into mitochondria
✓ Answer: A
46. Serum osmolality is calculated as:
  • A) 2[Na⁺] + Glucose/18 + BUN/2.8
  • B) [Na⁺] + [K⁺] + Glucose
  • C) [Na⁺] × 2 + Urea
  • D) [HCO₃⁻] / pCO₂
✓ Answer: A
47. Normal serum potassium concentration is:
  • A) 1.5–2.5 mEq/L
  • B) 3.5–5.0 mEq/L
  • C) 6.0–7.5 mEq/L
  • D) 8.0–10.0 mEq/L
✓ Answer: B
48. In hyponatremia, serum sodium falls below:
  • A) 145 mEq/L
  • B) 135 mEq/L
  • C) 120 mEq/L
  • D) 110 mEq/L
✓ Answer: B
49. The body fluid compartment that contains approximately 2/3 of total body water is:
  • A) Extracellular fluid
  • B) Intracellular fluid
  • C) Plasma
  • D) Interstitial fluid
✓ Answer: B
50. Carbonic anhydrase inhibitor (acetazolamide) causes:
  • A) Respiratory alkalosis
  • B) Metabolic alkalosis
  • C) Metabolic acidosis
  • D) Respiratory acidosis
✓ Answer: C

MODULE – III: CLINICAL CHEMISTRY, NORMAL VALUES & INTERPRETATION (Q. 51–85)

51. Serum creatinine is primarily used to assess function of:
  • A) Liver
  • B) Kidney
  • C) Pancreas
  • D) Heart
✓ Answer: B
52. Normal serum creatinine in adults is approximately:
  • A) 0.1–0.5 mg/dL
  • B) 0.6–1.2 mg/dL
  • C) 2.0–3.0 mg/dL
  • D) 5.0–7.0 mg/dL
✓ Answer: B
53. Creatinine clearance is used as an estimate of:
  • A) Hepatic blood flow
  • B) Glomerular filtration rate (GFR)
  • C) Tubular secretion only
  • D) Urinary protein loss
✓ Answer: B
54. Blood Urea Nitrogen (BUN) is elevated in:
  • A) Liver failure
  • B) Hemolytic anemia
  • C) Renal failure
  • D) Hypothyroidism
✓ Answer: C
55. The normal BUN:creatinine ratio is:
  • A) 1:1
  • B) 5–10:1
  • C) 10–20:1
  • D) 30–40:1
✓ Answer: C
56. Which is the most sensitive liver function test for early hepatocellular damage?
  • A) Alkaline phosphatase (ALP)
  • B) Alanine aminotransferase (ALT/SGPT)
  • C) Gamma GT
  • D) Bilirubin
✓ Answer: B
57. AST (SGOT) to ALT (SGPT) ratio >2:1 is characteristic of:
  • A) Viral hepatitis
  • B) Alcoholic liver disease
  • C) Obstructive jaundice
  • D) Fatty liver
✓ Answer: B
58. Conjugated (direct) bilirubin is elevated in:
  • A) Hemolytic anemia
  • B) Obstructive jaundice
  • C) Neonatal physiological jaundice
  • D) Gilbert syndrome
✓ Answer: B
59. Normal total serum bilirubin is:
  • A) 0–0.2 mg/dL
  • B) 0.2–1.2 mg/dL
  • C) 2.0–5.0 mg/dL
  • D) 5.0–10.0 mg/dL
✓ Answer: B
60. Prothrombin time (PT) is used to assess:
  • A) Platelet function
  • B) Extrinsic coagulation pathway (liver synthetic function)
  • C) Renal function
  • D) Fibrinolysis
✓ Answer: B
61. Alpha-fetoprotein (AFP) is a tumor marker primarily elevated in:
  • A) Prostate cancer
  • B) Colon cancer
  • C) Hepatocellular carcinoma
  • D) Cervical cancer
✓ Answer: C
62. PSA (Prostate Specific Antigen) is a tumor marker for:
  • A) Liver cancer
  • B) Prostate cancer
  • C) Ovarian cancer
  • D) Lung cancer
✓ Answer: B
63. CA-125 is a tumor marker used for:
  • A) Breast cancer
  • B) Ovarian cancer
  • C) Colorectal cancer
  • D) Thyroid cancer
✓ Answer: B
64. CEA (Carcinoembryonic Antigen) is primarily associated with:
  • A) Hepatocellular carcinoma
  • B) Colorectal cancer
  • C) Prostate cancer
  • D) Melanoma
✓ Answer: B
65. The FIRST cardiac marker to rise after acute myocardial infarction is:
  • A) CK-MB
  • B) Troponin I
  • C) Myoglobin
  • D) LDH
✓ Answer: C
66. Cardiac Troponin I or T is preferred over CK-MB because:
  • A) It rises faster
  • B) It is more cardiac-specific and remains elevated longer
  • C) It is cheaper to measure
  • D) It is only elevated in MI
✓ Answer: B
67. CK-MB (Creatine Kinase-MB isoenzyme) peaks at approximately:
  • A) 1–2 hours post-MI
  • B) 12–24 hours post-MI
  • C) 72–96 hours post-MI
  • D) 7–10 days post-MI
✓ Answer: B
68. In diagnostic enzymology, isoenzymes are:
  • A) Identical enzymes from different species
  • B) Different molecular forms of the same enzyme catalyzing the same reaction
  • C) Enzymes activated by the same cofactor
  • D) Enzymes inhibited by the same drug
✓ Answer: B
69. LDH-1 (LD1) isoenzyme elevation with LD1 > LD2 ("flipped pattern") suggests:
  • A) Liver disease
  • B) Pulmonary embolism
  • C) Myocardial infarction
  • D) Renal failure
✓ Answer: C
70. Alkaline phosphatase (ALP) is elevated in all EXCEPT:
  • A) Obstructive jaundice
  • B) Bone disease (Paget's disease)
  • C) Hyperparathyroidism
  • D) Hypoparathyroidism
✓ Answer: D
71. Normal fasting blood glucose is:
  • A) Less than 70 mg/dL
  • B) 70–99 mg/dL
  • C) 100–125 mg/dL
  • D) Above 126 mg/dL
✓ Answer: B
72. Diabetes mellitus is diagnosed when fasting plasma glucose is:
  • A) ≥ 100 mg/dL on one occasion
  • B) ≥ 126 mg/dL on two separate occasions
  • C) ≥ 110 mg/dL once
  • D) ≥ 140 mg/dL once
✓ Answer: B
73. In a standard Oral Glucose Tolerance Test (OGTT), the glucose load given is:
  • A) 50 g
  • B) 75 g
  • C) 100 g
  • D) 25 g
✓ Answer: B
74. A 2-hour post-OGTT plasma glucose of ≥ ___ mg/dL confirms diabetes:
  • A) 140 mg/dL
  • B) 160 mg/dL
  • C) 200 mg/dL
  • D) 180 mg/dL
✓ Answer: C
75. HbA1c reflects average blood glucose over the past:
  • A) 1–2 weeks
  • B) 2–4 weeks
  • C) 2–3 months
  • D) 6 months
✓ Answer: C
76. Normal serum total cholesterol in adults (desirable) is:
  • A) Less than 200 mg/dL
  • B) 200–240 mg/dL
  • C) Greater than 240 mg/dL
  • D) Less than 150 mg/dL
✓ Answer: A
77. Which lipoprotein is considered "bad cholesterol"?
  • A) HDL
  • B) LDL
  • C) VLDL
  • D) Chylomicrons
✓ Answer: B
78. Normal fasting serum triglycerides are less than:
  • A) 100 mg/dL
  • B) 150 mg/dL
  • C) 200 mg/dL
  • D) 250 mg/dL
✓ Answer: B
79. Normal specific gravity of urine is:
  • A) 1.000–1.005
  • B) 1.010–1.030
  • C) 1.035–1.050
  • D) 1.050–1.070
✓ Answer: B
80. Proteinuria of > 3.5 g/day is characteristic of:
  • A) Urinary tract infection
  • B) Nephrotic syndrome
  • C) Prerenal azotemia
  • D) Diabetes insipidus
✓ Answer: B
81. Glucose appears in the urine (glucosuria) when blood glucose exceeds the renal threshold of approximately:
  • A) 100 mg/dL
  • B) 126 mg/dL
  • C) 180 mg/dL
  • D) 240 mg/dL
✓ Answer: C
82. Ketonuria is seen in:
  • A) Nephrotic syndrome
  • B) Diabetic ketoacidosis and starvation
  • C) Hepatitis
  • D) Urinary tract infection
✓ Answer: B
83. Bence-Jones proteins in urine are characteristic of:
  • A) Glomerulonephritis
  • B) Multiple myeloma
  • C) Diabetes mellitus
  • D) Wilson's disease
✓ Answer: B
84. Urobilinogen in urine is ABSENT in:
  • A) Viral hepatitis
  • B) Hemolytic jaundice
  • C) Complete obstructive jaundice
  • D) Cirrhosis
✓ Answer: C
85. Myoglobinuria (dark/red urine) is seen in:
  • A) Rhabdomyolysis
  • B) Porphyria
  • C) Obstructive jaundice
  • D) Nephrotic syndrome
✓ Answer: A

MODULE – IV: RADIOISOTOPES (Q. 86–100)

86. A radioisotope is defined as:
  • A) A stable element used in X-rays
  • B) An unstable isotope of an element that spontaneously emits radiation
  • C) A synthetic molecule used in MRI
  • D) A chemical used to stain tissues
✓ Answer: B
87. The unit of radioactivity is:
  • A) Becquerel (Bq) or Curie (Ci)
  • B) Joule (J)
  • C) Gray (Gy)
  • D) Sievert (Sv)
✓ Answer: A
88. Half-life of a radioisotope is:
  • A) Time taken for its radioactivity to double
  • B) Time taken for 50% of radioactive atoms to decay
  • C) Time taken to emit all its radiation
  • D) Time for full biological clearance
✓ Answer: B
89. The radioisotope most commonly used in thyroid function studies is:
  • A) ¹⁴C (Carbon-14)
  • B) ³²P (Phosphorus-32)
  • C) ¹³¹I (Iodine-131)
  • D) ⁵¹Cr (Chromium-51)
✓ Answer: C
90. Radioimmuno assay (RIA) is based on:
  • A) Competition between labeled and unlabeled antigen for antibody binding
  • B) Direct measurement of enzyme activity
  • C) Electrophoresis of proteins
  • D) Colorimetric reaction
✓ Answer: A
91. ⁵¹Cr (Chromium-51) is used to measure:
  • A) GFR
  • B) Red blood cell lifespan
  • C) Thyroid uptake
  • D) Bone density
✓ Answer: B
92. The ALARA principle in radiation protection stands for:
  • A) Absolute Limit And Radiation Allowance
  • B) As Low As Reasonably Achievable
  • C) Absorbed Level After Radiation Assessment
  • D) Annual Limit for Radiation Activity
✓ Answer: B
93. Which type of radiation has the GREATEST penetrating power?
  • A) Alpha (α) particles
  • B) Beta (β) particles
  • C) Gamma (γ) rays
  • D) Neutrons (in comparison to α and β only)
✓ Answer: C
94. Alpha particles are stopped by:
  • A) Lead shielding
  • B) A sheet of paper
  • C) Concrete walls
  • D) Water only
✓ Answer: B
95. Which radioisotope is used to label compounds in metabolic pathway studies (carbon tracer)?
  • A) ¹³¹I
  • B) ⁹⁹ᵐTc (Technetium-99m)
  • C) ¹⁴C (Carbon-14)
  • D) ³²P (Phosphorus-32)
✓ Answer: C
96. ⁹⁹ᵐTc (Technetium-99m) is the most widely used radionuclide in nuclear medicine because:
  • A) It has a very long half-life of 100 years
  • B) It has a short half-life (6 hours) and emits pure gamma rays
  • C) It emits alpha particles
  • D) It is cheap and easy to store
✓ Answer: B
97. Radiation sickness (acute radiation syndrome) is caused by:
  • A) Chronic low-dose exposure
  • B) Acute whole-body exposure to high doses of ionizing radiation
  • C) Inhalation of non-radioactive gases
  • D) Consumption of radioactive food in small amounts
✓ Answer: B
98. In the LFT clinical chart, the pattern of predominantly UNCONJUGATED hyperbilirubinemia suggests:
  • A) Obstructive jaundice
  • B) Cholestasis
  • C) Pre-hepatic (hemolytic) jaundice
  • D) Hepatocellular carcinoma
✓ Answer: C
99. In the RFT chart, a markedly elevated serum creatinine with low GFR and anemia suggests:
  • A) Acute prerenal failure
  • B) Chronic renal failure (CKD)
  • C) Urinary tract infection
  • D) Hepatorenal syndrome
✓ Answer: B
100. In diagnostic enzymology, the enzyme gamma-glutamyl transferase (GGT) is most specifically elevated in:
  • A) Acute myocardial infarction
  • B) Bone disorders
  • C) Alcoholic liver disease and biliary obstruction
  • D) Skeletal muscle disease
✓ Answer: C

ANSWER KEY SUMMARY

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2C22B42C62B82B
3B23D43B63B83B
4B24B44C64B84C
5C25C45A65C85A
6B26A46A66B86B
7C27B47B67B87A
8A28C48B68B88B
9B29B49B69C89C
10B30B50C70D90A
11B31B51B71B91B
12C32B52B72B92B
13B33A53B73B93C
14C34B54C74C94B
15D35A55C75C95C
16D36B56B76A96B
17B37C57B77B97B
18B38A58B78B98C
19C39C59B79B99B
20B40B60B80B100C
Coverage Summary:
  • Module I – Nutrition: Q 1–25 (Calorific values, RQ, BMR, vitamins, minerals, parenteral nutrition)
  • Module II – Acid-Base & Electrolytes: Q 26–50 (Henderson-Hasselbalch, buffers, blood gas, anion gap, electrolytes)
  • Module III – Clinical Chemistry: Q 51–85 (RFT, LFT, tumor markers, cardiac markers, enzymology, lipid profile, GTT, urine analysis)
  • Module IV – Radioisotopes: Q 86–100 (Definitions, half-life, applications, hazards, RIA, clinical charts)
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