560E Assmt in Nutr Quiz Questions Flashcards
Which of the following government guidelines in the nutrient intake level sufficient to meet the nutrient requirements of approximately 97% of people in a given sex/age group?
A - Estimated Average Requirement (ERA)
B - Adequate Intake (AI)
C - Tolerable Upper Intake Level
D - Recommended Dietary Allowance (RDA)
D - Recommended Dietary Allowance
AI = assumed to be adequate based on experimentally determined approximations of nutrient intake by a group of healthy people ERA = daily dietary intake estimated to meet needs of 50% of healthy individuals
Nutrient Density
A - refers to high calorie foods
B - allows the nutritional qualities of foods to be easily evaluated
C - is a measure of the weight of a food
D - is an outdated term
B - allows the nutritional qualities of foods to be easily evaluated
expressed in terms of nutrient quantity per 1000kcal
Which of the following phenotypes have been identified with specific genetic polymorphisms?
A - bone loss
B - inflammation
C - blood pressure
D - all of the above
D - all of the above
DRIs were developed to address __________.
Chronic disease risk
DRI = Dietary Reference Intakes
All of the following are major themes in the Dietary Guidelines for American EXCEPT:
A - balancing calories to manage weight
B - foods and nutrients to increase
C - supplement to take for optimal health
D - foods and food components to reduce
C - supplements to take for optimal health is NOT one of the themes
What is the most accurate statement describing the impact of single nucleotide polymorphisms (SNPs) on phenotype?
A - Every chronic disease has a single SNP associated with it
B - Nutrients may alter the action of SNPs
C - Identifying SNPs is the most accurate method to diagnose disease
D - SNPs have no effect on nutrient requirements
B - Nutrients may alter the action of SNPs
A food group that is missing from the MyPlate graphic is__________.
Fat
Which of the following statements is the MOST accurate with regard to using Dietary Reference Intakes (DRIs) and Dietary Guidelines for your clients?
A - An individual who meets the DRI for each nutrient will be certain to be getting optimal amounts of these nutrients
B - The only valid advice for each client is to follow the Dietary Guidelines for Americans developed by the USDA and DHHS
C - Individual variation in nutrient requirements necessitates thorough assessment of each person before offering nutritional advice
D - Dietary Guidelines for Americans should never be used as a basis for nutritional advice
C - Individual variation in nutrient requirements necessitates thorough assessment of each person before offering nutritional advice
The UL for a particular nutrient describes:
The level above which the nutrient has a risk of adverse effects
Nutritional Assessment methods include all of the following EXCEPT:
A - anthropometric
B - biochemical
C - clinical
D - estimation
D - estimation
Which of the following methods would NOT be considered an effective method for measuring dietary intake?
A - 24-hour recall
B - estimation based on weight
C - diet history
D - food diary
B - estimation based on weight
Underreporting and/or overreporting can occur with the 24-hour recall. TRUE or FALSE
TRUE
What is an advantage of the Food record/diary over the 24-hour recall?
IT does not depend on memory
A limitation of the Food Frequency Questionnaires is that it may not represent usual foods or portion sizes chosen by respondents. TRUE or FALSE
TRUE
A strength of the Diet History is:
It assesses usual nutrient intake
A well-known biological marker for verifying reported protein intake is:
analysis of nitrogen in a 24-hour urine specimen
An accurate dietary assessment can be the sole criterion on which to base nutritional recommendations for an individual. TRUE or FALSE
FALSE
The fact that some nutrients are missing from the USDA data base used in computerized dietary analysis systems:
A - can result in falsely low nutrient values when evaluating dietary intake
B - can result in falsely elevated nutrient values when evaluating dietary intake
C - can be corrected by analyzing additional days of intake
D - is not a problem for accurate dietary analysis
A - can result in falsely low nutrient values when evaluating dietary intake
Most high-quality computerized dietary analysis systems contain food composition data from_________.
USDA plus non-USDA sources (such as food manufacturers)
The most important factor in choosing a computerized diet analysis system is ___________.
The nutrient database
The generally accepted normal range for BMI is:
18.5 - 24.9
A waist circumference of 38 inches in an adult female:
A - indicates gynoid obesity
B - indicates an increased risk for Type 2 DM
C - indicates a normal weight
D - indicates a normal BMI
B - indicates increased risk for T2DM
>35 inches in females is high risk and >40 inches in adult males is high risk
A disadvantage of assessing weight with BMI is that _______________.
BMI can be elevated for reasons other than excess fat.
A triceps skinfold measures ___________.
subcutaneous fat
A disadvantage of Bioelectrical impedance is _________.
dehydration will overestimate fat mass
3 factors that contribute to total energy expenditure are:
A - BMR, RMR, physical activity
B - BMR, REE, adaptive thermogenesis
C - BMR, REE, physical activity
D - REE, physical activity, thermic effect of food
D - REE, physical activity, and the thermic effect of food contribute to total energy expenditure
In the article, Fat: an evolving issue, Speakman and O’Rahilly cite evidence that:
A - obesity is primarily a result of decreased activity
B - positive energy balance is the only explanation required to explain the increase in obesity
C - interactions between genes and environment complicate the understanding of causes of obesity
D - genetics has no impact on obesity
C - interactions between genes and environment complicate the understanding of causes of obesity
Determination of body density by under-water weighing allows estimation of _________.
body fat
Which of the following assessments would NOT be indicated on an initial assessment of the obese patient?
A - fasting blood glucose
B - lipid profile
C - serum calcium measurement
D - blood pressure measurement
C - serum calcium measurement
Clinical findings are extremely important in nutritional assessment because, when present, they are specific for a particular nutrient deficiency. TRUE or FALSE
FALSE
The most probably cause of edema in an individual would be:
A - vitamin A deficiency
B - Vitamin C deficiency
C - protein deficiency
D - calcium deficiency
C - protein deficiency
A decrease in taste sensation would most likely indicate a deficiency of _____.
Zinc
During a medical history, Martha indicates that she is a vegan and that she does not take supplements because she cannot swallow pills. What would be the most likely nutrient deficiency for her to have?
Vitamin B12
What is the most likely explanation for a low level of all essential amino acids in a blood specimen?
Inadequate protein digestion
Which of the following would NOT be an indication of bulimia?
A - asymmetrical parotid gland enlargement
B - eating small amounts of food several times a day
C - eating a very large amount of food in a discrete period of time
D - dental erosion
B - eating small amounts of food several times a day
Assessment of aromatic amino acids Phe, Tyr, Trp can provide information regarding:
A - glutathione synthesis
B - collagen synthesis
C - neurotransmitter metabolism
D - muscle catabolism
C - neurotransmitter metabolism
All of the following about serum albumin levels are true EXCEPT:
A - it’s short half-life allows for rapid response to nutritional changes
B - it is not a useful indicator of protein depletion or repletion
C - altered fluid status can affect serum albumin levels
D - low concentrations are associated with increased morbidity and mortality in hospitalized patients
A - it’s short half-life allows for rapid response to nutritional changes
It actually has a very long half-life which causes serum levels to respond very slowly to nutritional change
(Picture of a section of dark hair with a line of white hair running parallel to scalp) - this clinical sign is most likely associated with __________ deficiency.
Protein
The most likely nutrient deficiency in an alcoholic is________.
Thiamin deficiency
Urine is primarily:
A - solute
B - urea
C - uric acid
D - water
D - water
Which of the following would be expected to DECREASE the pH of urine?
A - ingesting antacids
B - allowing the specimen to sit for several hours at room temperature
C - ingesting large quantities of meat
D - ingesting large quantities of fruits and vegetables
C - ingesting large quantities of meat creates acidic urine
The most sensitive indicator of kidney malfunction is:
protein
Ketonuria would be most likely found in:
A - an individual with renal disease
B - an individual on the Atkins diet
C - an individual with well-controlled Type 2 DM
D - a dilute urine
B - an individual on the Atkins diet
Microscopic examining of urine sediment provides the most useful information about:
A - dietary intake
B - metabolic acidosis
C - the urinary system
D - recent drug use
C - the urinary system
Which of the following is present in filtrate, but is normally reabsorbed through the renal tubules, so should NOT be present in urine?
Amino acids / protein
Urine that is pale and colorless would be MOST LIKELY observed:
A - when glucose is positive
B - when bilirubin is positive
C - when leukocyte esterase is postivie
D - in a first morning specimen
A - when glucose is postive
An organic acid is a product of metabolism that can be used to identify nutrient deficiencies. TRUE or FALSE
TRUE
The best assessment of glomerular filtration rate is:
Serum creatinine
In which area has urinary organic acid assessment been the MOST useful?
A - detecting cancer
B - detecting dysbiosis
C - confirming a heart attack
D - detecting a kidney infection
B - detecting dysbiosis
An increase in expired hydrogen after an oral dose of lactose indicates:
A - a lack of intestinal lactase
B - a lack of pancreatic lipase
C - a lack of intestinal peptidase
D - a lack of intrinsic factor
A - a lack of intestinal lactase
Gastric colonization with _________ is strongly correlated with duodenal and gastric ulcers.
Helicobacter pylori
Bacterial overgrowth in the small intestine could be diagnosed by:
A - bacterial count of at least 10 3/ml in an intestinal fluid aspirate
B - excess exhalation of 14CO2 after an oral dose of 14C-xylose
C - achlorhydria
D - positive AGA antibodies
B - excess exhalation of 14CO2 after an oral dose of 14C-xylose
Bacterial fermentation in the large intestine produces beneficial __________
short-chain fatty acids (SCFA)
Inflammation in the mucosa of the small intestine would MOST LIKELY result in compromised production of
disaccharidases
Which symptom would be LEAST likely to occur in an individual with malabsorption?
A - steatorrhea
B - weight gain
C - anemia
D - weight loss
B - weight gain
The most common test used to confirm malabsorption assesses:
Fecal Fat
According to recent research, intestinal hyperpermeability is associated with an increased risk of __________
developing an autoimmune disease
A decreased fecal elastase is most strongly associated with
pancreatic insufficiency
A positive anti-gliadin antibody (AGA) and anti-endomysial antibody (EMA) are nearly 100% diagnostic of
Celiac disease
Consistent blood glucose control in diabetes delays the onset and slows the progression of complications. TRUE or FALSE
TRUE
A fasting plasma glucose value greater than 100mg/dl, but less than 126mg/dl indicates:
impaired fasting glucose
Glycosylated hemoglobin reflects what in regards to blood glucose levels?
an average blood glucose level for the past 8-12 weeks
A BMI greater than 25 would most likely be observed:
A - in all diabetics
B - in a Type 1 diabetic
C - when fasting plasma glucose levels are greater than 200 mg/dl
D - in a Type 2 diabetic
D - in a type 2 diabetic
Ketosis is more likely observed in:
A - type 1 diabetes
B - Syndrome X
C - Type 2 diabetes
D - when glycosylated hemoglobin is below 7%
A - Type 1 diabetes
The lack of insulin in Type 1 diabetes is associated with all of the following EXCEPT:
A - increased protein catabolism
B - dehydration
C - increased glucose use
D - glycosuria
C - increased glucose use
Hyperinsulinemia is associated with weight gain. TRUE or FALSE
TRUE
Every lipoprotein contains all of the following EXCEPT:
A - triglyceride
B - protein
C - cholesterol
D - enzymes
D - enzymes
As an individuals HDL increases, their risk of myocardial infarction:
A - decreases
B - increases
C - remains constant
A - decreases
According to the National Cholesterol Education Program (or ATPIII) the presence of major CHD risk factors will raise the value for LDL cholesterol goals. TRUE or FALSE
FALSE - it would lower the value for LDL goals
Using a functional approach to lower blood pressure, which assessment would be the BEST indicator of successful therapy
A - increased CRP
B - decreased CRP
C - decreased nitric oxide (NO)
D - increased IL-6
B - decreased CRP
A fasting specimen is MOST important for accurate measure of:
A - HDL
B - CRP
C - cholesterol
D - triglyceride
D - triglyceride
According to ATP III, major coronary heart disease risk factors include all of the following EXCEPT:
A - diabetes mellitus
B - current cigarette smoking
C - high levels of chylomicrons in the blood
D - hypertension
C - high levels of chylomicrons in the blood
A relationship has been demonstrated between large VLDL size, small LDL size, small HDL size, and ___________.
Insulin resistance
Which condition would be expected to cause the largest increase in alanine aminotransferase (ALT)?
A - pancreatitis
B - cirrhosis
C - hepatitis
D - obstructive jaundice
C - Hepatitis
Although all of these except for pancreatitis could likely cause large increases…
Although alkaline phosphatase (ALP) is often used as a marker of liver disease, it is also frequently elevated in:
Bone Disease - increased deposition of calcium in bone (hyperparathyroidism, healing fractures, bone tumors)
What is the MOST accurate description of glutathione’s functions?
Antioxidant and component of detoxification mechanisms
Cirrhosis of the liver can cause an increased APTT because
Cirrhosis causes decreased production of coagulation factors
Which of the following test results would MOST likely be observed when blood ammonia levels are elevated?
A - decreased ALP
B - decreased GGT
C - increased ALT
D - decreased ALT
C - increased ALT
The most sensitive indicator of chronic alcohol ingestion is:
GGT
Of the following, the serum elevation of which is most specific for liver dysfunction?
A - ALP
B - bilirubin
C - AST
D - ALT
D - ALT
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:
When liver cells are damaged, they lose the ability to conjugate
Elevated pyroglutamate in urine may indicate depletion of:
glutathione
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 - low urinary orotate
B - high urinary glucarate
C - high urinary orate
D - low urinary glucarate
B - high urinary glucarate
In a normally functioning hypothalamus-pituitary-adrenal (HPA) system, it is expected that increasing cortisol levels would result in:
Negative feedback on the hypothalamus causing decreasing in CRH
and
Negative feedback on the pituitary causing decreasing ACTH
Which of the following conditions would be MOST LIKELY to be associated with decreased activity of the hypothalamic-pituitary-adrenal (HPA) axis?
A - Hyperthyroidism
B - Chronic Fatigue Syndrome
C - Diabetes mellitus
D - Cushing syndrome
B - Chronic Fatigue Syndrome
The most appropriate interpretation of a salivary cortisol is obtained _________.
From specimens collected throughout the day
Of the following choices, what is the MOST likely observation expected with chronic stress?
A - weight loss
B - increased TSH
C - increased salivary cortisol
D - decreased triglycerides
C - increased cortisol
The most biologically active thyroid hormone is:
free T3
The MOST appropriate interpretation of a normal TSH, normal T4, and decreased T3, is:
Decreased conversion of T4 to T3 due to extra-thyroidal factors (deficiencies, liver disease, increased cortisol, increased inflammation, etc)
Antithyroid peroxidase antibodies are closely linked with
hypothyroidism
All of the following are appropriate strategies to suggest to someone with chronically high cortisol levels that appear to be the result of chronic stress EXCEPT:
A - turn off electronic devices such as computers and TV at least one hour before bed to help improve sleep quality and quantity
B - engage in strenuous activity
C - engage in regular moderate activity
D - maintain a healthy diet
B - engage in strenuous activity
The best measurement to assess cellular stores of vitamin C is
leukocyte vitamin C level (WBC)
Which of the following nutrients would have the LEAST effect on a TBARS level?
A - Vitamin E
B - Vitamin B6
C - Coenzyme Q10
D - Vitamin C
B - Vitamin B6
Thiobarbituric acid reactive substances (TBARS) are formed as a byproduct of lipid peroxidation
Which test result would you most expect in an individual that presents with bleeding gums and easy bruising?
decreased plasma ascorbate
The level of serum Vitamin A is an accurate reflection of _____________.
the toxic excess of vitamin A
Functional tests which assess oxidative changes in lipids may be used to assess the status of which nutrient?
Vitamin E
Which of the following conditions or diseases are known to be caused by a deficiency of the same nutrient?
A - hemolytic anemia and megaloblastic anemia
B - osteomalacia and rickets
C - xerophthalmia and breath pentane release
D - kwashiorkor and fibrocystic breast disease
B - osteomalacia and rickets are both from a vitamin D deficiency
Morphological changes in epithelial cells would most likely indicate a deficiency of
Vitamin A
Which of the following is shared by vitamin B12 and folate?
A - both are required for nucleic acid synthesis
B - both are found in significant amounts in green leafy vegetables
C - both require intrinsic factor for absorption
D - both are considered problem nutrients for strict vegetarians
A - both are required for nucleic acid synthesis
Adequate folate intake in women before and during pregnancy can reduce the risk of
spina bifida in a fetus
An expected MCV result for pernicious anemia would be
elevated and above normal
Serum folate levels reflect recent dietary intake. TRUE or FALSE
TRUE
There is an inverse relationship between vitamin B12 and MMA. TRUE or FALSE
TRUE
The most common cause of B12 deficiency is:
A - inadequate intake
B - oral contraceptive use
C - atrophic gastritis
D - multiple pregnancies
C - atrophic gastritis
Which statement is accurate regarding unmetabolized folic acid (UMFA):
A - UMFA is unrelated to genetics
B - Increased UMFA may result from consumption of foods fortified with folic acid
C - Increased UMFA results from eating too many leafy greens
D - There are no risks associated with high levels of UMFA
B - Increased UMFA may result from consumption of foods fortified with folic acid
There is virtually no correlation between serum calcium levels and dietary calcium intake. TRUE or FALSE
TRUE
A low serum calcium level can be best explained by:
A - hyperparathyroidism
B - excessive intake of vitamin D
C - failure to include diary products in the diet
D - hypoalbuminemia
D - hypoalbuminemia
hyperparathyroidism and excessive vitamin D both cause high calcium levels
When measuring serum magnesium lysis of red blood cells will cause a falsely high result. TRUE or FALSE
TRUE
The correct test to perform to determine physiologically active calcium is
ionized calcium
The only way to diagnose osteoporosis and determine risk of future fractures is
a bone mineral density test
Zinc deficiency is most likely present if both _____ and ______ are below expected levels
serum zinc and metallothionen
What is erythrocyte protoporphyrin?
Precursor for hemoglobin synthesis
Which of the following would be expected result in an individual with iron-deficiency anemia?
A - decreased TIBC
B - decreased erythrocyte protophorphyrin
C - decreased transferrin saturation
D - increased MCV
C - decreased transferrin saturation
TIBC is increased
Elevated fecal lactoferrin would be most likely observed in
ulcerative colitis
What are the two best tests to detect iron overload?
TIBC and serum ferritin
What is positive Nitrogen balance
Positive nitrogen balance is associated with periods of growth, hypothyroidism, tissue repair, and pregnancy. This means that the intake of nitrogen into the body is greater than the loss of nitrogen from the body, so there is an increase in the total body pool of protein.
