A 6 year old boy was taken to the hospital

by his mother with complaints of

decreased vision in the night. The doctor
suspected a possible vitamin A deficiency.
Describe in detail the sources, RDA ,
functions and deficiency manifestation of
deficient nutrient. What other clinical
features, the doctor has to look for in
this case ,how deficiency is confirmed
and what advice should be given
(1+1+3+3+2) =10
 A 72 year old woman consulted the doctor for
tiredness , muscle aches and difficulty in standing up.
On investigation the following are found.
low - serum Calcium 08 mg/dL (9-11)
Low- serum phosphate 02 mg/dL (2.5-4.3)
High- Para thyroid hormone 138 ng/L (20-65)
High- alkaline phosphatase 763 U/L (<250)
Low- 25- hydroxy vit D 05 μg/L (> 75)
Name the probable deficient nutrient. Describe in
detail the sources, RDA ,Metabolism, functions and
deficiency manifestations of that nutrient.
(1+1+1+2+3+2) =10
A patient was brought to the hospital with
peripheral edema , Tachycardia . On
examination the doctor found enlargement
of the heart and high output congestive
heart failure.
Write in detail about the sources, RDA ,
other clinical features , biochemical
functions of the suspected deficient
nutrient. Write how the deficiency is
diagnosed and treated.
(1+1+1+4+2+1) =10
A patient from an area where corn based diets
are eaten was brought to the hospital with
skin lesions , gastrointestinal and neurological
symptoms .
I) What is the probable diagnosis? and how do
you confirm the diagnosis?
II) write in detail about clinical presentation of
the above patient , Biochemical functions and
RDA of the deficient nutrient .
(1+2+2+4+1) = 10
• A female patient was admitted in the hospital with
fatigue, dyspnoea and palpitations . On
examination she was found to be pale and
tachycardia is present. Her hemoglobin
concentrations are low and the MCV is higher .
Bone marrow examination showed Megaloblastic
picture.
what is the probable diagnosis ?
write about the biochemical functions,
Biochemical basis of deficiency manifestations and
biochemical diagnosis and treatment of the
nutrient deficiency
(2+ 3 +1+ 2+ 1+ 1 ) = 10
 A 67 year old woman consulted her doctor for
tiredness and paraesthesiae in her feet as well as
for anaemia . On examination , there was sensory
peripheral neuropathy . Her Blood test results are
Hb - 8 g/L , MCV - 102 fL
vit B12 – 90 ng/L , Folate – 2.8 μg/L
Parietal antibodies -strongly positive
What is the probable diagnosis ?
write about the sources , absorption, RDA ,
biochemical functions , deficiency disease and
its diagnosis, of the nutrient
(2+1+1+1+2+1+2) =10
 A patient came with a complaint of delayed wound
healing , easy bruising and bleeding gums . On
examination she was found to be anemic and
osteoporotic.
What is the probable diagnosis ? Write the
Biochemical basis for the signs and symptoms .
Write about the sources , RDA and Lab diagnosis of
the deficiency of the deficient nutrient .
Give the reason why that nutrient can not be
synthesized in humans.
List the condition in which this nutrient is shown to
be beneficial
(2+3+ 1+1+ 1 +1+1) = 10
 A 25 yr old man presented to emergency
department with a chest pain of more
than 24 hour duration with shortness of
breath. ECG showed ST segment
elevation & T wave inversion.
What is the probable diagnosis ?
List the enzymes and isoenzymes whose
levels are elevated ?
write in detail about the isozymes used in
the diagnosis of the above condition.
(2+2+6) = 10
A 40 year old obese female presented with
severe abdominal pain & vomiting following a
heavy meal the previous night with pain
radiating to back, relieved on bending forward.
Her blood & urine samples were sent for
enzymatic analysis.
What is the probable diagnosis ?
Which enzymes are elevated ?
write in detail about the clinical applications of
enzymes .
(2+2+ 6) = 10
 A 45 yr old man presented to the Outpatient
department with severe abdominal pain following a
bout of alcohol the previous night. He is chronic
alcoholic with a history of similar complaints before.
His blood & urine samples were sent for enzymatic
analysis.
What is the probable diagnosis ?
List enzymes whose levels are elevated in this disease
List various other enzymes and isoenzyme analyses
used to assess Liver function
Write in detail about clinical enzymology
(2+2+ 6) = 10
 A 40 yr old male presented to out patient
department with c/o sudden onset, severe pain &
redness in his great toe since morning. His blood
samples sent for investigations & were found to be
containing ⇧ uric acid levels. He was suggested to
take Analgesics & Allopurinol.
What is the probable diagnosis ?
What is mechanism of action of
Allopurinol in reducing the uric acid levels?
Classify enzyme inhibition with suitable Examples ,
write how different classes are identified using
substrate conc X velocity & LB plots. (2+2+3+3) =10
 A 45 yr old male, chronic alcoholic presented to
emergency department with blurred vision,
vomiting, dizziness, abdominal pain & convulsions
following consumption of alcohol one hr before.
His blood samples where found to be positive for
methanol and he was given ethanol.
What is the probable diagnosis?
What is mechanism of action of ethanol in
counteracting effects of methanol?
Write in detail about enzyme inhibition
(2+2 +6) =10
 A 10 yr old female child presented with c/o
fever since 5 days with associated pain
abdomen, vomiting, loss of appetite. O/E
child had jaundice & hepatomegaly. Her
blood samples where sent for investigations.
What is the probable diagnosis
Which liver enzyme panel should be
investigated?
Write about the isoenzyme forms & clinical
significance of these enzymes.
(2+2+6) = 10
 A 70 yr old male patient presented with
gradually progressive jaundice, loss of
appetite, recurrent itching & passing pale
stools since 2 months and dark yellow colored
urine. He has a previous h/o gall stones 3 yr
back.
What is the probable diagnosis ?
Which liver enzyme panel should be analysed ?
Write about the isoenzyme forms & clinical
significance of these enzymes
(2+2+6) =10