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First Aid USMLE Step 1: Biochemistry Questions with Detailed Verified Answers (100% Correct Answers) /Already Graded A+

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What is a nucleoside? What is a nucleotide? Which are the purines? Which are the pyrimidines? Ans: Side = base + (deoxy)ribose [sugar] Tide = base + (deoxy)ribose [sugar] *Which are the purines?* "pure as gold" = Adenosine, Guanosine *Which are the pyrimidines?* "CUT the pyramid" = Cytosine, Uracil, Thymine In the nucleotide synthesis pathway, describe how purine synthesis differs from pyrimidine synthesis. Fr the following drugs, describe how they interfere with purine or pyrimidine synthesis. Leflunomide Methotrexatem Trimethoprim and Pyrimethamine 5-Fluorouracil 2 Exampromax - Stuvia US2025/2026 Approved By: Exampromax - Stuvia US 6-Mercaptopurine Mycophenolate and Ribavirin Hydroxyurea Ans: *Disrupt pyrimidine synthesis* *Leflunomide: *inhibits dihydroorate dehydrogenase *Methotrexatem Trimethoprim and Pyrimethamine 5-Fluorouracil*: inhibit dihydrofolate reductase, resulting in decreased dTMP in humans, bacteria and protozoa respectively. *Disrupt purine synthesis* *6-Mercaptopurine* (6-MP): and its prodrug azathioprine inhibit de novo purine synthesis *Mycophenolate and Ribavirin*: inhibit inosine monophosphate dehydrogenase *Disrupt purine and pyrimidine synthesis* *Hydroxyurea*: inhibits nucleotide reductase Adenosine deaminase deficiency *metabolic deficiency:* *symptoms:* Ans: *metabolic deficiency:* - absence of adenosine deaminase resulting in increased dATP which is toxic to lymphocytes - one of the major causes of autosomal recessive SCID *symptoms:* Lesch-Nyhan Syndrome *pattern of inheritance*: 3 Exampromax - Stuvia US2025/2026 Approved By: Exampromax - Stuvia US *metabolic deficiency:* *symptoms:* Ans: *pattern of inheritance*: - x-linked recessive *metabolic deficiency:* - defective purine salvage due to absence of HGPRT which converts hypoxanthine to IMP and guanine to GMP - this results in excess uric acid production and de novo purine synthesis *symptoms:* remember *HGPRT* - Hyperuricemia - Gout - Pissed off (aggression

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2024/2025
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1 Exampromax - Stuvia US 2025/2026


First Aid USMLE Step 1: Biochemistry Questions with
Detailed Verified Answers (100% Correct Answers)
/Already Graded A+
What is a nucleoside?


What is a nucleotide?


Which are the purines?


Which are the pyrimidines?
Ans: Side = base + (deoxy)ribose [sugar]
Exampromax - Stuvia US
Approved By:




Tide = base + (deoxy)ribose [sugar]


*Which are the purines?*
"pure as gold" = Adenosine, Guanosine


*Which are the pyrimidines?*
"CUT the pyramid" = Cytosine, Uracil, Thymine

In the nucleotide synthesis pathway, describe how purine synthesis differs
from pyrimidine synthesis.


Fr the following drugs, describe how they interfere with purine or
pyrimidine synthesis.


Leflunomide
Methotrexatem Trimethoprim and Pyrimethamine
5-Fluorouracil

, 2 Exampromax - Stuvia US 2025/2026

6-Mercaptopurine
Mycophenolate and Ribavirin
Hydroxyurea
Ans: *Disrupt pyrimidine synthesis*
*Leflunomide: *inhibits dihydroorate dehydrogenase
*Methotrexatem Trimethoprim and Pyrimethamine
5-Fluorouracil*: inhibit dihydrofolate reductase, resulting in decreased
dTMP in humans, bacteria and protozoa respectively.


*Disrupt purine synthesis*
*6-Mercaptopurine* (6-MP): and its prodrug azathioprine inhibit de novo
purine synthesis
Exampromax - Stuvia US
Approved By:




*Mycophenolate and Ribavirin*: inhibit inosine monophosphate
dehydrogenase


*Disrupt purine and pyrimidine synthesis*
*Hydroxyurea*: inhibits nucleotide reductase

Adenosine deaminase deficiency
*metabolic deficiency:*
*symptoms:*
Ans: *metabolic deficiency:*
- absence of adenosine deaminase resulting in increased dATP which is
toxic to lymphocytes
- one of the major causes of autosomal recessive SCID


*symptoms:*

Lesch-Nyhan Syndrome
*pattern of inheritance*:

, 3 Exampromax - Stuvia US 2025/2026

*metabolic deficiency:*
*symptoms:*
Ans: *pattern of inheritance*:
- x-linked recessive


*metabolic deficiency:*
- defective purine salvage due to absence of HGPRT which converts
hypoxanthine to IMP and guanine to GMP
- this results in excess uric acid production and de novo purine synthesis


*symptoms:*
Exampromax - Stuvia US




remember *HGPRT*
- Hyperuricemia
Approved By:




- Gout
- Pissed off (aggression)
- Retarded (intellectual disability)
- DsyTonia

Describe the processing of hmRNA to form an mRNA. Where does this
process occur?
Ans:

What is the function of the following polymerases:


RNA Polymerase I
RNA Polymerase II
RNA Polymerase III
Ans:

What is the splicing process of pre-mRNA?

, 4 Exampromax - Stuvia US 2025/2026


What is the name for antibodies against spliceosomal snRNPs and what
disease are they highly specific for?


What disease are anti-UI RNP antibodies associated with?
Ans: *What is the splicing process of pre-mRNA?*


*What is the name for antibodies against spliceosomal snRNPs and what
disease are they highly specific for?*
- antibodies to spliceosomal snRNPS (aka *anti-SMITH antibodies) are
highly specific for SLE
Exampromax - Stuvia US




*What disease are anti-UI RNP antibodies associated with?*
Approved By:




- mixed connective tissue disease

For the following types of collagen, name the tissues in which they are most
commonly found/important and any relevant diseases in which they are
altered.


Type I
Type II
Type III
Type IV
Ans:

Osteogenesis imperfecta
*pattern of inheritance*:
*mutation:*
*symptoms:*

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