Multiple Choice Questions on Bile Acid Metabolism
1) Most of the plasma proteins are synthesized in the liver. Which of the following plasma protein is not synthesized in the liver?
d) von Willebrand factor
2) Which of the following is not the metabolic function of the liver?
a) Synthesis and assembly of chylomicrons
b) Synthesis and secretion of bile acids
c) Synthesis and breakdown of glycogen
3) Bile acids are conjugated to amino acid or taurine to form bile salts. Which of the following amino acid is utilized for conjugation reaction?
4) Cholic acid and Chenodeoxycholic acid are the primary bile acid synthesized in the liver. The bile acid is converted into secondary bile acids (eg. deoxycholic acid) by
a) Enzymes present in the gall bladders
b) Enzymes present in the duodenum
c) Enzymes produced by exocrine pancreas
d) Bacterial oxidation in the small intestine
5) Which of the following are functions of bile salts except
a) Formation of bile salts decrease the passive absorption in the small intestine
b) Enables active transport of bile salts in the terminal ileum
c) Allows solubilization and elimination of cholesterol
d) Increases emulsification of carbohydrates in the small intestine
6) The bile salt synthesis is subjected to feedback regulation by bile salt reabsorbed from the ileum and recirculated to the liver. Which of the following enzyme is the rate-limiting enzyme of bile acid synthesis?
4) 5-beta isomerase
7) Bile juice secreted by the gallbladder is composed of bile salts, bilirubin, cholesterols. Which
of the following is not true regarding hepatic bile formation?
a) Primary bile salts are predominantly present compared to secondary bile salts.
b) Glycine conjugates predominate in a ratio of approximately 3:1 to 4:1.
c) Free bile acids are normally present in the bile.
d) Bile acids are transported across the canicular surface via carrier-mediated active transport
8) The regulation of bile salt metabolism is mediated via
a) Feedback inhibition of enzyme activity of 7-alpha-hydroxylase
b) Feedback inhibition of enzyme activity of 12-alpha-hydroxylase
c) Bile salt binding to farnesoid X receptor and suppression of 7-alpha-hydroxylase gene expression
d) Bile salt binding to farnesoid X receptor and suppression of 12-alpha-hydroxylase gene expression
9) Enterohepatic circulation of bile salt is responsible for 98% of bile salt recirculation via the portal vein. It involves the following except
a) Passive diffusion of bile salt from hepatocytes
b) Active transport of bile salts from the terminal ileum
c) Carrier-mediated canalicular transport across the membrane
d) Cholecystokinin increases the secretion of bile from the gallbladder
10) The increase in bile salt in plasma and urine is suggestive of
a) Hemolytic jaundice
b) Hepatic jaundice
c) Obstructive jaundice
d) impaired 7-alpha-hydroxylase
Multiple Choice Answers
1- d) von Willebrand factor
2-a) Synthesis and assembly of chylomicrons
4-d) Bacterial oxidation in the small intestine
5-d) Increases emulsification of carbohydrates in the small intestine
7-c) Free bile acids are normally present in the bile
8-c) Bile salt binding to farnesoid X receptor and suppression of 7-alpha-hydroxylase gene expression
9-a) Passive diffusion of bile salt from hepatocytes
10-c) Obstructive jaundice