560 E EXTRA

Question 1

Initiation of the atherogenic process may begin in response to some form of endothelial injury. This injury could result from
A. Reduced LDL.
B. Oxidized LDL.
C. Reduced HDL
D. Any of the above.

Answer 1

B. Oxidized LDL.

Question 2

In patients with jaundice, direct hyperbilirubinemia would most likely occur with
A. Gallstones.
B. Hepatitis.
C. Tylenol overdose.
D. Hemolysis

Answer 2

A. Gallstones.

Question 3

Which of the following activities is shared by vitamin B12 and folate?
A. Both are required for nucleic acid synthesis.
B. Both are considered problem nutrients for strict vegetarians.
C. Both are found in significant amounts in green leafy vegetables.
D. Both require intrinsic factor for their release from food proteins.

Answer 3

A. Both are required for nucleic acid synthesis.

Question 4

T/F: An elevation of aspartate aminotransferase (AST) is specific for liver disease.

Answer 4

F

Question 5

A low serum calcium level can best be explained by
A. Hyperparathyroidism.
B. Hypoalbuminemia.
C. Failure to include dairy products in the diet.
D. Excessive intake of vitamin D.

Answer 5

B. Hypoalbuminemia.

Question 6

Anemia is a symptom of ________ poisoning.
A. Mercury.
B. Lead.
C. Cadmium.

Answer 6

B. Lead.

Question 7

Which condition would be expected to cause the largest increase in alanine aminotransferase (ALT)?
A. Cirrhosis.
B. Hepatitis.
C. Pancreatitis.
D. Obstructive jaundice hepatitis.

Answer 7

B. Hepatitis.

Question 8

Which is not a site of inflammation in the presence of obesity?
A. Adipose tissue
B. Liver
C. Spleen
D. Muscle
E. Pancreas

Answer 8

C. Spleen

Question 9

The biggest source(s) of cadmium exposure for people in the general population are
A. Paints.
B. Hair dyes.
C. Cigarette smoke and food.
D. Tap water.

Answer 9

C. Cigarette smoke and food.

Question 10

Digestive enzymes most likely to be diminished in the presence of small intestine mucosal inflammation are
A. Disaccharidases
B. Amylase.
C. Lipase.
D. Pepsin.

Answer 10

A. Disaccharidases

Question 11

When interpreting results from a bone mineral density test
A. The T-score is the most meaningful value.
B. The Z-score is the most meaningful value.
C. A negative score is desirable.
D. The T-score must be compared to serum calcium levels.

Answer 11

A. The T-score is the most meaningful value.

Question 12

Blood mercury levels provide the best information about
A. Recent mercury exposure.
B. Long-term mercury exposure.
C. Metallic mercury exposure.
D. Inorganic mercury exposure.

Answer 12

A. Recent mercury exposure.

Question 13

A decreased hemoglobin would be expected
A. Before iron stores have been depleted.
B. Whenever ferritin values are low.
C. During late stages of iron deficiency.
D. Before erythrocyte protoporphyrin decreases.

Answer 13

C. During late stages of iron deficiency.

Question 14

When measuring serum magnesium
A. Lysis of red blood cells will cause a falsely low result.
B. Lysis of red blood cells will cause a falsely high result.
C. Lysis of red blood cells will have no effect on the result.
D. Lysis of red blood cells is desirable because magnesium is primarily an intracellular ion.

Answer 14

B. Lysis of red blood cells will cause a falsely high result.

Question 15

Phosphorus deficiency
A. Is a large concern in people over 50 years of age.
B. Is rare.
C. Is most common in adolescents.
D. Is associated with large soda consumption.

Answer 15

B. Is rare.

Question 16

Which of the following nutrients would have the LEAST effect on a TBARS level?
A. Vitamin C.
B. Vitamin E.
C. Coenzyme Q.
D. Vitamin B6.

Answer 16

D. Vitamin B6.

Question 17

When Phase I and Phase II liver detoxification pathways are actively working to rid the body of toxins, the most likely observation would be
A. High urinary orotate.
B. Low urinary orotate.
C. High urinary glucarate.
D. Low urinary glucarate.

Answer 17

C. High urinary glucarate.

Question 18

The primary screening method for assessing lead levels is
A. Erythrocyte protoporphyrin.
B. Urinary lead.
C. Blood lead.
D. Bone x-ray.

Answer 18

C. Blood lead.

Question 19

Symptoms of hemochromatosis most often become apparent in males
A. When they are toddlers.
B. Before the age of 18.
C. After age 40.
D. After age 60.

Answer 19

C. After age 40.

Question 20

Zinc deficiency is most likely present if
A. Urinary zinc levels are lower than expected.
B. Serum zinc levels are lower than expected.
C. Serum zinc and metallothionein are both below expected levels.
D. Serum zinc is below expected levels, but metallothionein is above expected levels.

Answer 20

C. Serum zinc and metallothionein are both below expected levels.

Question 21

Increased blood ammonia levels correlate most closely with
A. Decreased alanine aminotransferase (ALT).
B. Increased alanine aminotranserase (ALT).
C. Decreased alkaline phosphatase (ALP).
D. Decreased gamma-glutamyl transpeptidase (GGT).

Answer 21

B. Increased alanine aminotranserase (ALT).

Question 22

What is erythrocyte protoporphyrin?
A. An iron storage protein.
B. An immature red blood cell.
C. An iron binding protein.
D. Precursor for hemoglobin synthesis.

Answer 22

D. Precursor for hemoglobin synthesis.

Question 23

Long-term exposure to cadmium would be most likely to cause
A. Anemia.
B. Fragile bones.
C. Heart attack.
D. Dermatitis.

Answer 23

B. Fragile bones.

Question 24

The best measurement to assess cellular stores of vitamin C is
A. Plasma vitamin C level.
B. Leukocyte vitamin C level.
C. Urinary vitamin C level.
D. Erythrocyte vitamin C level.

Answer 24

B. Leukocyte vitamin C level.

Question 25

T/F: Measuring cadmium in hair and nails is better than measuring urinary cadmium.

Answer 25

False

Question 26

``` The most sensitive indicator of chronic alcohol ingestion is A. GGT. B. AST. C. ALT. D. ALP. ```

Answer 26

A. GGT.

Question 27

Which of the following is true about serum albumin levels? A. Short half-life allows for rapid response to nutritional changes. B. Protein status is the only factor that affects serum concentration. C. Must be measured in the fasting state. D. Dehydration results in increased serum concentration.

Answer 27

D. Dehydration results in increased serum concentration.

Question 28

An expected MCV for pernicious anemia would be A. Below normal. B. Normal. C. Above normal.

Answer 28

C. Above normal.

Question 29

When jaundice is observed in an individual, it is important to differentiate whether the jaundice is primarily a result of direct (conjugated) or indirect (unconjugated) bilirubin. The best explanation for this is: A. When liver cells are damaged, they lose the ability to conjugate. B. When unconjugated bilirubin is increased, this rules out red blood cell damage. C. When unconjugated bilirubin is increased, this confirms obstruction of the extrahepatic ducts. D. Only cirrhosis causes an increase in unconjugated bilirubin.

Answer 29

A. When liver cells are damaged, they lose the ability to conjugate.

Question 30

Which of the following conditions or diseases are known to be caused by a deficiency of the same nutrient? A. Osteomalacia and rickets. B. Xerophthalmia and breath pentane release. C. Kwashiorkor and fibrocystic breast disease. D. Hemolytic anemia and megaloblastic anemia

Answer 30

A. Osteomalacia and rickets.

Question 31

The level of serum vitamin A A. Is never measured. B. Is never an accurate reflection of A status. C. Is an accurate reflection of a toxic excess of vitamin A. D. Is only accurate when performed on a fasting specimen.

Answer 31

C. Is an accurate reflection of a toxic excess of vitamin A.

Question 32

``` Morphological changes in epithelial cells would most likely indicate a deficiency of vitamin A. A. B. D. C. E. D. K. ```

Answer 32

A. A.

Question 33

``` Which of the following compounds provides a major storage reservoir for iron? A. Ferritin. B. Myoglobin. C. Transferrin. D. Hemoglobin. ```

Answer 33

A. Ferritin.

Question 34

``` The lack of insulin in Type 1 diabetes is associated with all of the following except A. Increased protein catabolism. B. Glycosuria. C. Increased glucose use. D. Dehydration. ```

Answer 34

C. Increased glucose use.

Question 35

``` An increase in expired hydrogen after an oral dose of lactose indicates A. Lack of pancreatic lipase. B. Lack of intrinsic factor. C. Lack of intestinal lactase. D. Lack of intestinal peptidase. ```

Answer 35

C. Lack of intestinal lactase.

Question 36

``` A decreased fecal elastase is most strongly correlated with A. Celiac disease. B. Lactose intolerance. C. Pernicious anemia. D. Pancreatic insufficiency. ```

Answer 36

D. Pancreatic insufficiency.

Question 37

Cirrhosis of the liver can cause an increased APTT because A. Cirrhosis causes an increased production of heparin. B. Cirrhosis causes decreased absorption of vitamin K. C. Cirrhosis causes decreased platelet production. D. Cirrhosis causes decreased production of coagulation factors.

Answer 37

D. Cirrhosis causes decreased production of coagulation factors.

Question 38

``` Elevated pyroglutamate in urine may indicate depletion of A. Vitamin K. B. Phase I activity. C. Glutathione. D. Glucaric acid. ```

Answer 38

C. Glutathione.

Question 39

``` Which of the following disorders is strongly correlated with the presence of high blood iron? A. Dermatitis. B. Heart disease. C. Diverticulosis. D. Neural tube defects. ```

Answer 39

B. Heart disease.