HEME BIOSYNTHESIS & CATABOLISM

1. T/F
a) Glycine is required for heme biosynthesis.
b) The reaction catalysed by ALA synthase is the rate limiting
step of heme biosynthesis.
c) Fe3+ inhibits heme biosynthesis.
d) ALA accumulates in plasma in lead poisoning.
e) Iron is removed from heme and excreted from the body.
f) Reduction of biliverdin produces bilirubin.
g) Haemolytic anaemia increases urinary urobilinogen.
h) Urobilinogen is formed in the liver.
i) In obstructive jaundice serum conjugated bilirubin level is
increased.
j) Bilirubin is water soluble.
k) Bilirubin glucuronidase is impaired in physiological jaundice.
l) Exposure to light is beneficial for infants with physiological
jaundice.
m) Rh incompatibility leads to jaundice.
n) Kernicterus is a complication of neonatal jaundice.
o) Dark stools is a feature of haemolysis.
p) Bilirubin excretion in the urine is a feature of haemolytic
anaemia.
q) Pale stools is a feature of infective hepatitis.

r) In infective hepatitis hyerbilirubinaemia is caused by

unconjugated bilirubin.
s) Transcription of ALA synthase gene is repressed by heme.
t) Administration of cytochrome P450 dependent drugs leads to
increased synthesis of heme.
u) Conjugated bilirubin is increased in haemolytic jaundice.
v) ALA levels in plasma are elevated in lead poisoning.
w) Bilirubin is conjugated via its propionic acid groups.
x) Sulphonamides can displace bilirubin from its binding site to
albumin.
y) Unconjugated bilirubin appears in urine.
z) Hepatic UDP glucuronyl transferase is a cytosolic enzyme.
aa) Canalicular excretion is the rate limiting step in the
metabolism of bilirubin.
bb) Bilirubin glucuranoid is formed in the urine of patient
having hemolytic jaundice.
cc) Succinyl CoA is needed for synthesis of heme.
dd) Bilirubin is converted to UDP- bilirubin during conjugation
process.
ee) Bilirubin is transported bound to albumin.
ff) Plasma conjugated bilirubin level is increased in
physiological jaundice.
gg) Vandenberg reaction is used to detect urobilin in urine.
hh) Urobilinogen is produced in the liver.

ii) Urobilin level in urine is increased in extra hepatic

cholestasis.
jj) UDP-glucuranoyl transferase deficiency leads to jaundice.
kk) Phototherapy of yellow babies results in the formation of
water soluble products of bilirubin.
ll) The rate limiting step of haem biosynthesis occurs in the
cytosol.
mm)The last three steps of haem biosynthesis occur in the
cytosol.
nn) Haem biosynthesis is inhibited by glucose.
oo) Erythroid specific ALA synthase gene is expressed at a
higher rate than hepatic gene encode in X chromosome.
pp) Lead poisoning leads to an increase of ALA due to increased
activity of ALA synthase.
qq) ALA dehydrogenase? is inhibited by Pb.
rr) Total bilirubin concentration in blood is measured by indirect
Vandenburg test.
ss) Most of haem is synthesized in the liver.
tt)Bilirubin is a very effective antioxidant.
uu) Succinate is used in haem biosynthesis.
vv) Porphyrias are caused by defect in haem synthesis.
ww) Lead inhibits haem biosynthesis.
xx) Exposure to sunlight is useful in treatment of physiological
jaundice in new born.
yy) Conjugated bilirubin is increased in cholelistasis.

zz) Dark coloured urine seen in infective hepatitis is due to

increased urobilin.
aaa) ALA synthase action is the regulatory step in heme
biosynthesis.
bbb) Rate of uptake of haem in bile synthesis is different from
hepatocyte to hepatocyte.
ccc) Lead poisoning leads to decreased protoporphyrin inRBCs.
ddd) Salicylates decrease binding of bilirubin to albumin.
eee) Urinary urobilinogen excretion increased in haemolytic
jaundice.
fff) Citric acid cycle provides building blocks for haem
synthesis.
2. TOF regarding heam biosynthesis
a) majorly occur in mature erythrocytes
b) in lead poisoning ALA dehydrogenase is inhibited.
c) jaundice in newborns is treated with blue fluorescent light
d) bilirubin is is excreted as urobilinogen in faceal flora
e) in heamolytic jaundice serum bilirubin is elevated