Krok 1 – 2014 Base(Biochemistry)

After consumption of rich food a patient has nausea and heartburn, steatorrhea. This condition might be caused by:

Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination reveals usually hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme:

An infant has apparent diarrhea resulting from improper feeding. One of the main diarrhea effects is plentiful excretion of sodium bicarbonate. What form of acid-base balance disorder is the case?

Examination of a patient suffering from cancer of urinary bladder revealed high rate of serotonin and hydroxyanthranilic acid. It is caused by excess of the following amino acid in the organism:

A mother consulted a doctor about her 5-year-old child who develops erythemas, vesicular rash and skin itch under the influence of sun. Laboratory studies revealed decreased iron concentration in the blood serum, increased uroporphyrinogen I excretion with the urine. What is the most likely inherited pathology in this child?

A 3 year old child with fever was given aspirin. It resulted in intensified erythrocyte haemolysis. Hemolytic anemia might have been caused by congenital insufficiency of the following enzyme:

Blood of a 12 year old boy presents low concentration of uric acid and accumulation of xanthine and hypoxanthine. This child has genetic defect of the following enzyme:

A patient is ill with diabetes mellitus that is accompanied by hyperglycemia of over 7,2 millimole/l on an empty stomach. The level of what blood plasma protein allows to estimate the glycemia rate retrospectively (4-8 weeks before examination)?

A 4 y.o. child with signs of durative proteinic starvation was admitted to the hospital. The signs were as follows: growth inhibition, anemia, edemata, mental deficiency. Choose a cause of edemata development:

Researchers isolated 5 isoenzymic forms of lactate dehydrogenase from the human blood serum and studied their properties. What property indicates that the isoenzymic forms were isolated from the same enzyme?

On some diseases it is observed aldosteronism with hypertension and edema due to sodium retention in the organism. What organ of the internal secretion is affected on aldosteronism?

An experiment proved that UV-radiated cells of patients with xeroderma pigmentosum restore the native DNA structure slower than cells of healthy individuals as a result of reparation enzyme defection. What enzyme helps this process?

A patient presents high activity of LDH1,2, aspartate aminotransferase, creatine phosphokinase. In what organ (organs) is the development of a pathological process the most probable?

While examining the child the doctor revealed symmetric cheeks roughness, diarrhea, disfunction of the nervous system. Lack of what food components caused it?

A 62-year-old female patient has developed a cataract (lenticular opacity) secondary to the diabetes mellitus. What type of protein modification is observed in case of diabetic cataract?

A 53-year-old male patient is diagnosed with Paget’s disease. The concentration of oxyproline in daily urine is sharply increased, which primarily means intensified disintegration of:

Examination of a patient revealed typical presentations of collagenosis. This pathology is characterized by increase of the following urine index:

Untrained people often have muscle pain after sprints as a result of lactate accumulation. This might be caused by intensification of the following biochemical process:

ATP synthesis is totaly blocked in a cell. How will the value of membrane rest potential change?   

Examination of a patient suffering from frequent haemorrhages in the inner organs and mucous membranes revealed proline and lysine being included in collagen fibers. Impairment of their hydroxylation is caused by lack of the following vitamin:

A 20 year old patient complains of general weakness, dizziness, quick fatigability. Blood analysis results: Hb- 80 g/l. Microscopical examination results: erythrocytes are of modified form. This condition might be caused by:

A 48 year old patient complained about intense pain, slight swelling and reddening of skin over the joints, temperature rise up to 38oC. Blood analysis revealed high concentration of urates. This condition might be caused by disturbed metabolism of:

A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will have strengthened concentration in the blood serum?

A patient has an increased pyruvate concentration in blood. A large amount of it is excreted with the urine. What vitamin is lacking in this patient?

Ammonia is a very toxic substance, especially for nervous system. What substance takes the most active part in ammonia detoxication in brain tissues?

A patient has pellagra. Interrogation revealed that he had lived mostly on maize for a long time and eaten little meat. This disease had been caused by the deficit of the following substance in the maize:

Cyanide is a poison that causes instant death of the organism. What enzymes found in mitochondria are affected by cyanide?

A patient with high rate of obesity was advised to use carnitine as a food additive in order to enhance “fat burning”. What is the role of carnitine in the process of fat oxidation?

An experimantal animal that was kept on protein-free diet developed fatty liver infiltration, in particular as a result of deficiency of methylating agents. This is caused by disturbed generation of the following metabolite:

A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found out that the patient lived mostly on cereals and ate too little meat, milk and eggs. What vitamin deficiency is the most evident?

A 46 year old woman suffering from chololithiasis developed jaundice. Her urine became dark-yellow and feces became colourless. Blood serum will have the highest concentration of the following substance:

A 46 year old patient applied to a doctor complaining about joint pain that becomes stronger the day before weather changes. Blood examination revealed strengthened concentration of uric acid. The most probable cause of the disease is the intensified disintegration of the following substance:

It has been found out that one of a pesticide components is sodium arsenate that blocks lipoic acid. Which enzyme activity is impaired by this pesticide?

A 38 year old patient suffers from rheumatism in its active phase. What laboratory characteristic of blood serum is of diagnostic importance in case of this pathology?

A patient with serious damage of muscular tissue was admitted to the traumatological department. What biochemical urine index will be increased in this case?

12 hours after an accute attack of retrosternal pain a patient presented a jump of aspartate aminotransferase activity in blood serum. What pathology is this deviation typical for?

Donor skin transplantation was performed to a patient with extensive burns. On the 8-th day the graft became swollen and changed colour; on the 11-th day graft rejection started. What cells take part in this process?

A 30 y.o. woman had been ill for a year when she felt pain in the area of joints for the first time, they got swollen and skin above them became reddened. Provisional diagnosis is rheumatoid arthritis. One of the most probable causes of this disease is a structure alteration of a connective tissue protein:

Autopsy of a 12-year-old girl revealed: multiple cutaneous hemmorhages (mostly into the skin of buttocks, lower extremities), serous and mucous memrane hemmorhages, cerebral hemmorhages. Adrenal glands show focal necrosis and massive hemmorhages; kidneys show necrotic nephrosis, suppurative arthritis, iridocyclitis, vasculitis. What is the most probable diagnosis?

Examination of a 27-year-old patient revealed pathological changes in liver and brain. Blood plasma analysis revealed an abrupt decrease in the copper concentration, urine analysis revealed an increased copper concentration. The patient was diagnosed with Wilson’s degeneration. To confirm the diagnosis it is necessary to study the activity of the following  enzyme in blood serum:

A patient complains about dyspnea provoked by the physical activity. Clinical examination revealed anaemia and presence of the paraprotein in the zone of gamma-globulins. To confirm the myeloma diagnosis it is necessary to determine the following index in the patient’s urine:

Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin combination should be prescribed in this case?

A drycleaner’s worker has been found to have hepatic steatosis. This pathology can be caused by the disruption of synthesis of the following substance:

As a result of exhausting muscular work a worker has largely reduced buffer capacity of blood. What acidic substance that came to blood caused this phenomenon?

A patient was delivered to the hospital by an emergency team. Objectively: grave condition, unconscious, adynamy. Cutaneous surfaces are dry, eyes are sunken, face is cyanotic. There is tachycardia and smell of acetone from the mouth. Analysis results: blood glucose – 20,1 micromole/l (standard is 3,3-5,5 micromole/l), urine glucose – 3,5% (standard is – 0). What is the most probable diagnosis?

A 62 y.o. woman complains of frequent pains in the area of her chest and backbone, rib fractures. A doctor assumed myelomatosis (plasmocytoma). What of the following laboratory characteristics will be of the greatest diagnostical importance?

A newborn child has convulsions that have been observed after prescription of vitamin B6. This most probable cause of this effect is that vitamin B6 is a componet of the following enzyme:

Nappies of a newborn have dark spots that witness of formation of homogentisic acid. Metabolic imbalance of which substance is it connected with?

Parodontitis is treated with calcium preparations and a hormone that stimulates tooth mineralization and inhibits tissue resorption. What hormone is it?

A child has an acute renal failure. What biochemical factor found in saliva can confirm this diagnosis?

After implantation of a cardiac valve a young man constantly takes indirect anticoagulants. His state was complicated by hemorrhage. What substance content has decreased in blood?

After severe viral hepatitis a 4 year old boy presents with vommiting, occasional loss of consciousness, convulsions. Blood test revealed hyperammoniemia. Such condition is caused by a disorder of the following biochemical hepatic process:

A 50-year-old patient complains about general weakness, appetite loss and cardiac arrhythmia. The patient presents with muscle hypotonia, flaccid paralyses, weakened peristaltic activity of the bowels. Such condition might be caused by:

An 18-year-old patient has enlarged inguinal lymphnodes, they are painless, thickened on palpation. In the area of genital mucous membrane there is a small-sized ulcer with thickened edges and “laquer” bottom of greyish colour. What is the most probable diagnosis?

A patient with suspected diphtheria went through bacterioscopic examination. Examination of throat swab revealed rod-shaped bacteria with volutin granules. What etiotropic preparation should be chosen in this case?

A woman who has been keeping to a clean-rice diet for a long time was diagnosed with polyneuritis (beriberi). What vitamin deficit results in development of this disease?

Removal of gall bladder of a patient has disturbed processes of Ca absorption through the intestinal wall. What vitamin will stimulate this process?

A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and hair, decrease in catecholamine concentration in blood. When a few drops of 5% solution of trichloroacetic iron had been added to the child’s urine it turned olive green. Such alteration are typical for the following pathology of the amino acid metabolism:

Feces of a patient contain high amount of undissociated fats and have grayish-white color. Specify the cause of this phenomenon:

A patient complains of frequent diarrheas, especially after consumption of fattening food, and of body weight loss. Laboratory examination revealed steatorrhea; hypocholic feces. What can be the cause of this condition?

A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess of  glycogene. Glucose concentration in the blood stream is below normal. What is the cause of low glucose concentration?

A 46-year-old female patient consulted a doctor about pain in the small joints of the upper and  lower limbs. The joints are enlarged and shaped like thickened nodes. Serum test revealed an increase in urate concentration. This might be caused by a disorder in metabolism of:

A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination revealed renal calculi. The most probable cause of calculi formation is the strengthened concentration of the following substance:

A 5-year-old child who often fells ill with respiratory diseases has eczematous appearances after consumption of some food products, tendency to prolonged course of inflammatory processes. What kind of diathesis can be suspected in this case?

The greater amount of nitrogen is excreted from the organism in form of urea. Inhibition of urea synthesis and accumulation of ammonia in blood and tissues are induced by the decreased activity of the following liver enzyme:

A 35 y.o. patient who often consumes alcohol was treated with diuretics. There appeared serious muscle and heart weakness, vomiting, diarrhea, AP- 100/60 mm Hg, depression. This condition is caused by intensified excretion with urine of:

After intake of rich food a patient feels nausea and sluggishness; with time there appeared signs of steatorrhea. Blood cholesterine concentration is 9,2 micromole/l. This condition was caused by lack of:

Examination of a man who hadn’t been consuming fats but had been getting enough carbohydrates and proteins for a long time revealed dermatitis, poor wound healing, vision impairment. What is the probable cause of metabolic disorder?

A 44-year-old woman complains of common weakness, heart pain, considerable increase of body weigt. Objectively: moon-like face, hirsutism, AP- 165/100 mm Hg, height – 164 cm, weight – 103 kg; fat is mostly accumulated in the region of neck, upper shoulder girdle, stomach. What is the main pathogenetic mechanism of obesity?

An experimental animal has been given excessive amount of carbon-labeled glucose for a week. What compound can the label be found in?

After a serious viral infection a 3-year-old child has repeated vomiting, loss of consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused changes of biochemical blood indices of this child?

Examination of a patient with frequent hemorrhages from internals and mucous membranes revealed proline and lysine being a part of collagene fibers. What vitamin absence caused disturbance of their hydroxylation?

Albinos can’t stand sun impact – they don’t aquire sun-tan but get sunburns. Disturbed metabolism of what aminoacid underlies this phenomenon?

A nurse accidentally injected a nearly double dose of insulin to a patient with diabetes mellitus. The patient lapsed into a hypoglycemic coma. What drug should be injected in order to help him out of coma?

A biochemical urine analysis has been performed for a patient with progressive muscular dystrophy. In the given case muscle disease can be confirmed by the high content of the following substance in urine:

A patient with continious bronchopneumonia was admitted to the therapeutic department. Antibiotic therapy didn’t give much effect. What medication for improvement of immune state should be added to the complex treatment of this patient?

A patient suffers from hepatic cirrhosis. Examination of which of the following substances excreted by urine can characterize the state of antitoxic function of liver?

Malaria is treated with structural analogs of vitamin B2 (riboflavin). These drugs disrupt the synthesis of the following enzymes in plasmodium:

Vitamin A together with specific cytoreceptors penetrates through the nuclear membranes, induces transcription processes that stimulate growth and differentiation of cells. This biological function is realized by the following form of vitamin A:

Products of some proteins hydrolysis and modification are the biologically active substances called hormones. Lipotropin, corticotropin, melanotropin and endorphins are synthesized in the hypophysis of the following protein:

In patients with the biliary tract obstruction the blood coagulation is inhibited; the patients have frequent haemorrhages caused by the subnormal assimilation of the following vitamin:

A newborn child suffers from milk curdling in stomach, this means that soluble milk proteins (caseins) transform to insoluble proteins (paracaseins) by means of calcium ions and a certain enzyme. What enzyme takes part in this process?

A sportsman was recommended to take a medication that contains carnitine in order to improve his results. What process is activated by carnitine the most?

Human red blood cells do not contain mitochondria. What is the main pathway for ATP production in these cells?

To prevent postoperative bleeding a 6 y.o. child was administered vicasol that is a synthetic analogue of vitamin K. Name post-translational changes of blood coagulation factors that will be activated by vicasol:

A 4 y.o. boy has had recently serious viral hepatitis. Now there are such clinical presentations as vomiting, loss of consciousness, convulsions. Blood analysis revealed hyperammoniemia. Disturbunce of which biochemical process caused such pathological condition of the patient?

During examination of an 11-month-old infant a pediatrician revealed osteoectasia of the lower extremities and delayed mineralization of cranial bones. Such pathology is usually provoked by the deficit of the following vitamin:

Examination of a patient suffering from chronic hepatitis revealed a significant decrease in the synthesis and secretion of bile acids. What process will be mainly disturbed in the patient’s bowels?

Glutamate decarboxylation results in formation of inhibitory transmitter in CNS. Name it: 

In course of histidine catabolism a biogenic amin is formed that has powerful vasodilatating effect. Name it:

Utilization of arachidonic acid via cyclooxigenase pathway results in formation of some bioactive substances. Name them:

After a sprint an untrained person develops muscle hypoxia. This leads to the accumulation of the following metabolite in muscles:

Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation. Name one of them that turns directly into a lactate:

Emotional stress causes activation of hormon-sensitive triglyceride lipase in the adipocytes. What secondary mediator takes part in this process?

A patient diagnosed with carcinoid of bowels was admitted to the hospital. Analysis revealed high production of serotonin. It is known that this substance is formed of tryptophane aminooacid. What biochemical mechanism underlies this process?

A genetics specialist analyzed the genealogy of a family and found that both males and females may have the illness, not across all the generations, and that healthy parents may have ill children. What is the type of illness inheritance?

Analysis of amniotic fluid that was obtained as a result of amniocentesis (puncture of amniotic sac) revealed cells the nuclei of which contain sex chromatin (Barr’s body). What can it be evidence of?

Vitamin B1 deficiency results in disturbance of oxidative decarboxylation of  α-ketoglutaric acid. This will disturb synthesis of the following coenzyme:

A child’s blood presents high content of galactose, glucose concentration is low. There are such presentations as cataract, mental deficiency, adipose degeneration of liver. What disease is it?

According to clinical indications a patient was administered pyridoxal phosphate. What processes is this medication intended to correct?

A 45 y.o. woman suffers from Cushing’s syndrome – steroid diabetes. Biochemical examination revealed: hyperglycemia, hypochloremia. Which of the under-mentioned processes is the first to be activated?

Autopsy of a 46-year-old man revealed multiple brown-and-green layers and hemmorhages on the mucous membrane of rectum and sigmoid colon; slime and some blood in colon lumen; histologically – fibrinous colitis. In course of bacteriological analysis of colon contents S.Sonne were found. What is the most probable diagnosis?

A patient had been ill with bronchial asthma for many years and died from asthmatic fit.
Histologic lung examination revealed: lumen of bronchioles and small bronches contain a lot of mucus with some eosinophils, there is sclerosis of alveolar septums, dilatation of alveole lumen. What mechanism of development of hypersensibility reaction took place?

Those organisms which in the process of evolution failed to develop protection from H2O2 can exist only in anaerobic conditions. Which of the following enzymes can break hydrogen peroxide down?

Desulfiram is widely used in medical practice to prevent alcocholism. It inhibits aldehyde dehydrogenase. Increased level of what metabolite causes aversion to alcochol?

A 1-year-old child with symptoms of muscle involvement was admitted to the hospital. Examination revealed carnitine deficiency in his muscles. What process disturbance is the biochemical basis of this pathology?

A man got poisoned with mushrooms. They contain muscarine that stimulates muscarinic cholinoreceptors. What symptom is typical for poisoning with inedible mushrooms?

Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as the following process is inhibited:

As a result of posttranslative modifications some proteins taking part in blood coagulation, particularly prothrombin, become capable of calcium binding. The following vitamin takes part in this process:

Objective examination of a patient revealed: slender figure, big skull, highly developed frontal region of face, short extremities. What constitutional type is it characteristic for?

A 38-year-old patient died during intractable attack of bronchial asthma. Histologic examination revealed mucus accumulation in bronchial lumen, a lot of fat cells (labrocytes) in the wall of bronches, many of them are in the state of degranulation, there are also a lot of eosinophils. What pathogenesis of bronchial changes is it?

Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. What disorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodies in blood?

A woman with 0 (I) bllod group has born a child with AB blood group. This woman’s husband has A blood group. What genetic interaction explains this phenomenon?

Osteolaterism is charcterized by a decrease in collagen strength caused by much less intensive formation of cross-links in collagen fibrils. This phenomenon is caused by the low activity of the following enzyme:

Depressions and emotional insanities result from the deficit of noradrenalin, serotonin and other biogenic amines in the brain. Their concentration in the synapses can be increased by means of the antidepressants that inhibit the following enzyme:

A 3 year old child with symptoms of stomatitis, gingivitis and dermatitis of open skin areas was delivered to a hospital. Examination revealed inherited disturbance of neutral amino acid transporting in the bowels. These symptoms were caused by the deficiency of the following vitamin:

A 5-month-old boy was hospitalized for tonic convulsions. He has a life-time history of this disease. Examination revealed coarse hair, thinned and fragile nails, pale and dry skin. In blood: calcium – 1,5 millimole/l, phosphor – 1,9 millimole/l. These changes are associated with:

During hypersensitivity test a patient got subcutaneous injection of an antigen which caused reddening of skin, edema, pain as a result of histamine action. This biogenic amine is generated as a result of transformation of the following histidine amino acid:

A patient with suspected diagnosis “progressing muscular dystrophy” got his urine tested. What compound will confirm this diagnosis if found in urine?

Cytogenetic examination of a patient with dysfunction of the reproductive system revealed normal karyotype 46,ХУ in some cells, but most cells have Klinefelter’s syndrome karyotype – 47,ХХУ. Such phenomenon of cell inhomogeneity is called:

An oncological patient had been administered methotrexate. With time target cells of the tumour lost sensitivity to this drug. At the same time the change in gene expression of the following enzyme is observed:

A patient complained about dizziness, memory impairment, periodical convulsions. It was revealed that these changes were caused by a product of decarboxylation of glutamic acid. Name this product:

A sportsman needs to improve his sporting results. He was recommended to take a preparation that contains carnitine. What process is activated the most by this compound?

A doctor examined a child and revealed symptoms of rachitis. Development of this disease was caused by deficiency of the following compound:

Laboratory examination of a child revealed increased concentration of leucine, valine, isoleucine and their ketoderivatives in blood and urine. Urine smelt of maple syrup. This disease is characterized by the deficit of the following enzyme:

A 9-month-old infant is fed with artificial formulas with unbalanced vitamin B6 concentration. The infant presents with pellagral dermatitis, convulsions, anaemia. Convulsion development might be caused by the disturbed formation of:

It was found out that some compounds, for instance fungi toxins and some antibiotics can inhibit activity of RNA-polymerase. What process will be disturbed in a cell in case of inhibition of this enzyme?

When blood circulation in the damaged tissue is restored, then lactate accumulation comes to a stop and glucose consumption decelerates. These metabolic changes are caused by activation of the following process:

During starvation muscle proteins break up into free amino acids. These compounds will be the most probably involved into the following process:

Examination of a patient revealed II grade obesity. It is known that he consumes a lot of sweets and rich food, has sedentary way of life. That’s why anabolic metabolism has the priority in his organism. Which of the following pathways is amphibolic?

Surgical removal of a part of stomach resulted in disturbed absorption of vitamin $B_{12}$, it is excreted with feces. The patient was diagnosed with anemia. What factor is necessary for absorption of this vitamin?

A newborn develops dyspepsia after the milk feeding. When the milk is substituted by the glucose solution the dyspepsia symptoms disappear. The newborn has the subnormal activity of the following enzyme:

Patients who suffer from severe diabetes and don’t receive insulin have metabolic acidosis. This is caused by increased concentration of the following metabolites:

A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D concentration in blood is normal. What is the most probable cause of rickets development?

A patient presents with dysfunction of cerebral cortex accompanied by epileptic seizures. He has been administered a biogenic amine synthetized from glutamate and responsible for central inhibition. What substance is it?

Toxic affection of liver results in dysfunction of protein synthesis. It is usually accompanied by the following kind of dysproteinemia:

A 6 year old child was delivered to a hospital. Examination revealed that the child couldn’t fix his eyes, didn’t keep his eyes on toys, eye ground had the cherry-red spot sign. Laboratory analyses showed that brain, liver and spleen had high rate of ganglioside glycometide. What congenital disease is the child ill with?

In clinical practice tuberculosis is treated with izoniazid preparation – that is an antivitamin able to penetrate into the tuberculosis bacillus. Tuberculostatic effect is induced by the interference with replication processes and oxidation-reduction reactions due to the buildup of pseudo-coenzyme:

A newborn child was found to have reduced intensity of sucking, frequent vomiting, hypotonia. Urine and blood exhibit increased concentration of citrulline. What metabolic process is disturbed?

Dietary intake of a 30 year old nursing woman contains 1000 mg of calcium, 1300 mg of phosphorus and 20 mg of iron per day. It is necessary to change content of these mineral substances in the following way:

Cardinal symptoms of primary hyperparathyroidism are osteoporosis and renal lesion along with development of urolithiasis. What substance makes up the basis of these calculi in this disease?

Study of conversion of a food colouring agent revealed that neutralization of this xenobiotic takes place only in one phase – microsomal oxydation. Name a component of this phase:

A patient had hemorrhagic stroke. Blood examination revealed strengthened kinin concentration.The patient was prescribed contrical. It was administered in order to inhibit the following proteinase:

A 49-year-old driver complains about unbearable constricting pain behind the breastbone irradiating to the neck. The pain arose 2 hours ago. Objectively: the patient’s condition is grave, he is pale, heart tones are decreased. Laboratory studies revealed high activity of creatine kinase and LDH1. What disease are these symptoms typical for?

Plasmic factors of blood coagulation are exposed to post-translational modification with the participation of vitamin K. It is necessary as a cofactor in the enzyme system of  γ-carboxylation of protein factors of blood coagulation due to the increased affinity of their molecules with calcium ions. What amino acid is carboxylated in these proteins?

Pharmacological effects of antidepressants are connected with inhibition of an enzyme catalyzing biogenic amines noradrenaline and serotonine in the mitochondrions of cerebral neurons. What enzyme participates in this process?

An oncological patient was prescribed methotrexate. With the lapse of time target cells of the tumour lost susceptibility to this drug. There is change of gene expression of the folowing enzyme:

A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol – 12,3 mmol/l, total lipids – 8,2 g/l, increased low-density lipoprotein fraction (LDL). What type of hyperlipoproteinemia is observed in the patient?

A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology department. Blood test has revealed hypercalcemia and hypophosphatemia. These changes are associated with abnormal synthesis of the following hormone:

Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL anti-atherogenic action