Basic Knowledge Flashcards
1
Q
When manually monitoring a client's pulse, the trainer counts 17 beats in 6 seconds. Which of the following is the client's heart rate? Select one: a. 85 b. 104 c. 117 d. 170
A
170
2
Q
How many ounces of water should a client consume immediately after exercise for every pound lost? Select one: a. 6 to 12 ounces b. 16 to 24 ounces c. 24 to 32 ounces d. 32 to 48 ounces
A
b. 16 to 24 ounces
3
Q
Which of the following is contraindicated when training a client who is pregnant?
Select one:
a. Fitness assessments should be performed using seated or standing exercises.
b. Stabilization Endurance training should be used during the second and third trimesters
c. Exercise should be done in a supine position after the first trimester.
d. Plyometric training may be done in the first trimester.
A
c. Exercise should be done in a supine position after the first trimester
4
Q
Which of the following terms refers to the elevation of the body’s metabolism after exercise? Select one: a. RER b. EPOC c. HRR d. RPE
A
b. EPOC
5
Q
Which of the following best describes the code of conduct for a fitness professional?
Select one:
a. A set of scientifically proven and evidence-based theories that a fitness professional can apply to specific fitness programs.
b. Guidelines to ensure that all professionals provide the highest level of service and respect for all colleagues, allied professionals, and the general public.
c. A set of records that allow a fitness professional to track his or her own progress career-wise.
d. A set of processes that help a fitness professional determine the number of clients he or she can handle at a given. time
A
b. Guidelines to ensure that all professionals provide the highest level of service and respect for all colleagues, allied professionals, and the general public
6
Q
When talking to a client, conversational techniques that express the purported meaning of what was just heard are referred to as: Select one: a. reflections. b. affirmations. c. compliments. d. judgments.
A
a. reflections.
7
Q
It is lawful for a Certified Personal Trainer who possesses no additional certifications or licensure to do which of the following?
Select one:
a. Massage a client.
b. Apply ultrasound to a client.
c. Design a nutrition plan for a client.
d. Design a cardiorespiratory program for a client.
A
d. Design a cardiorespiratory program for a client.
8
Q
Based on the 2008 Physical Activity Guidelines for Americans, which of the following is the recommended weekly amount of time for moderate-intensity aerobic activity? Select one: a. 75 minutes b. 90 minutes c. 120 minutes d. 150 minutes
A
d. 150 minutes
9
Q
Which of the following muscles is underactive if a client demonstrates an anterior pelvic tilt? Select one: a. Erector spinae b. Psoas c. Latissimus dorsi d. Gluteus maximus
A
d. Gluteus maximus
10
Q
Which of the following is a sign that a client has completed an accurate one-rep maximum bench press estimation test?
Select one:
a. Your client fails after 8-12 repetitions.
b. Your client fails after 1 repetition.
c. Your client fails at 3 to 5 repetitions.
d. Your client fails right before their arms straighten.
A
c. Your client fails at 3 to 5 repetitions.
11
Q
Based on Overhead Squat Assessment findings, if a client exhibits knees moving inward, which flexibility exercise is recommended? Select one: a. Abductor static stretch b. Adductor static stretch c. Piriformis foam roller d. Psoas foam roller
A
b. Adductor static stretch
12
Q
Which of the following is the third step in the Stages of Change model? Select one: a. Action b. Precontemplation c. Contemplation d. Preparation
A
d. Preparation
13
Q
What percent of predicted heart rate maximum is used in zone two of cardiorespiratory training? Select one: a. 56% to 65% b. 66% to 75% c. 76% to 85% d. 86% to 95%
A
c. 76% to 85%
14
Q
A client cannot perform a full prone iso-abs exercise, which of the following would be an appropriate regression?
Select one:
a. Perform prone iso-abs with knees on floor.
b. Perform prone iso-abs with feet on stability ball.
c. Perform a back extension.
d. Perform a stability ball crunch.
A
a. Perform prone iso-abs with knees on floor.
15
Q
Which of the following describes a split routine in a resistance training program?
Select one:
a. It allows for the use of two exercises for antagonistic muscles within one set.
b. It allows for the use of multiple sets for each exercise.
c. It is a way of training that splits the day into two separate workouts.
d. It is a way of training that works different body parts on different days.
A
d. It is a way of training that works different body parts on different days.
16
Q
The client is ready to progress from Phase: Stabilization Endurance to Phase 2. Which of the following best describes the resistance training portion of her new Strength Endurance workout?
Select one:
a. Stabilization exercises with strength supersets
b. Strength with power supersets
c. Power exercises with strength supersets
d. Strength exercises with stabilization supersets
A
d. Strength exercises with stabilization supersets
17
Q
How many times the heart beats per minute and how much blood is being pumped with each beat is known as: Select one: a. Stroke volume b. Heart rate c. Cardiac output d. Expiration
A
c. Cardiac output
18
Q
After completing the Three-Minute Step Test, a 20-year-old male scored in zone 2. What is the correct heart rate range for when he does cardio training? Select one: a. 86% to 95% of HR max b. 76% to 85% of HR max c. 65% to 75% of HR max d. 55% to 60% of HR max
A
b. 76% to 85% of HR max
19
Q
Which of the following is the correct repetition range and tempo for the Stabilization, Strength and Power Phases of the OPT model?
Select one:
a. 12-20/Slow, 1-12/ Moderate, 1-10/Explosive
b. 12-20/Moderate, 1-10/Explosive, 1-12/Slow
c. 1-10/Slow, 12-20/Moderate, 1-12/Explosive
d. 1-10/Moderate,12-20/Slow, 1-12/Explosive
A
a. 12-20/Slow, 1-12/ Moderate, 1-10/Explosive
20
Q
What is a negative side effect associated with the chronic use of a high protein, low carbohydrate diet?
Select one:
a. A high protein diet is typically associated with higher intake of unsaturated fat and fiber which are risk factors for heart disease.
b. A high protein diet will require less water consumption for metabolism than is needed by carbohydrates or fat.
c. A high protein diet will increase glycogen stores which can lead to decreases in performance.
d. A high protein diet will cause the kidneys to work harder to eliminate the increased urea produced.
A
d. A high protein diet will cause the kidneys to work harder to eliminate the increased urea produced.
21
Q
Which of the following is the proper lower extremity position when performing a ball squat? Select one: a. Knee over second toe b. Adduction of the hip c. Pronation of the foot d. Internal rotation of the hip
A
a. Knee over second toe
22
Q
Which of the following is a measuring site of the Durnin–Womersley formula? Select one: a. Calf b. Mid-axillary line c. Subscapular d. Thigh
A
c. Subscapular
23
Q
During an overhead squat assessment, a client demonstrates an excessive anterior pelvic tilt. Which of the following muscles is probably overactive? Select one: a. Bicep femoris b. Piriformis c. Transverse abdominus d. Latissimus dorsi
A
d. Latissimus dorsi
Hip flexor complex
Erector spinae
24
Q
In the Stabilization Endurance Phase, exercises should be performed with which of the following types of intensity? Select one: a. High b. Low c. Maximal d. Moderate
A
b. Low
25
```
Which of the following is an example of a strength level resistance training exercise for legs?
Select one:
a. Multiplanar step-up to balance
b. Single-leg squat
c. Single-leg dead lift
d. Multiplanar dumbbell step-up
```
d. Multiplanar dumbbell step-up
26
```
If a client’s knee moves inward while performing the Single-leg Squat test, this is an indication that which of the following muscles is overactive?
Select one:
a. Adductor longus
b. Vastus medialis oblique
c. Gluteus maximus
d. Piriformis
```
a. Adductor longus
Biceps femoris (short head)
Tensor fasciae latae (TFL)
Vastus lateralis
27
```
Which of the following is a category of subjective information?
Select one:
a. Body composition
b. Cardiorespiratory assessment
c. Medical background
d. Performance assessment
```
c. Medical background
28
```
"From our discussion, I understand that your primary goal is to lose 10 pounds in the next 2 months. Is that correct?” This statement is an example of which of the following?
Select one:
a. Nondirective question
b. Close-ended question
c. Invitational question
d. Probing question
```
b. Close-ended question
close ended are Yes/ no answers and it could be a number
29
When a client practices self-myofascial release, which of the following physiological changes is the goal?
Select one:
a. An increase in joint receptor activity results in an inhibition of muscles around a joint.
b. A decrease in neurotransmitter activity results in the contraction of a muscle.
c. A decrease in muscle spindle activity results in the contraction of a muscle.
d. An increase in Golgi tendon organ activity results in relaxation of a muscle.
d. An increase in Golgi tendon organ activity results in relaxation of a muscle.
GTO is a proprioceptive sensory receptor organ that senses changes in muscle tension. It lies at the origins and insertion of skeletal muscle fibers into the tendons of skeletal muscle.
tendon - muscle to bone
ligament - bone to bone
30
```
A high-protein diet consisting of more than 35% of total caloric intake from protein can potentially lead to which of the following adverse health effects?
Select one:
a. Increased resting heart rate
b. Additional stress on the kidneys
c. Excess belly fat
d. Decreased ATP production
```
b. Additional stress on the kidneys
31
```
Which of the following is part of the marketing mix?
Select one:
a. Prominence
b. Public
c. Place
d. Professionalism
```
c. Place
product, price, place, promotion
32
Which of the following vitamins and minerals are known to have the greatest potential for excess dosage in dietary supplements?
Select one:
a. Vitamin A, vitamin D, iron, and zinc
b. Vitamin B, vitamin C, folic acid, and biotin
c. Beta-Carotene, vitamin E, vitamin K, and niacin
d. Iodine, magnesium, copper, and fluoride
a. Vitamin A, vitamin D, iron, and zinc
33
```
Which of the following muscles is probably underactive when the arms fall forward during an overhead squat?
Select one:
a. Levator scapulae
b. Rhomboids
c. Sternocleidomastoid
d. Upper trapezius
```
b. Rhomboids
Rotator cuff
Middle / lower trapezius
34
```
Which of the following should a trainer determine during the first step in the Ten Steps to Success?
Select one:
a. Weekly session needs
b. Desired annual income Correct
c. Number of clients needed
d. Closing percentage
```
b. Desired annual income Correct
35
```
Which of the following is the system activated at the onset of any activity, regardless of intensity?
Select one:
a. EPOC
b. ATP-PC
c. Oxidative
d. Glycolysis
```
b. ATP-PC
ATP-PC onset of any exercise
Glycolysis 30-50 sec
Oxidative long term anaerobic
36
```
Which of the five principles of goal setting focuses on establishing goals that are challenging but not extreme?
Select one:
a. Attainable
b. Realistic
c. Specific
d. Timely
```
a. Attainable
```
SMART goals
S pecific
M easureable
A ttainable
R ealistic
T imely
```
37
Which of the following should a trainer consider when designing a resistance training program for seniors?
Select one:
a. Progression should be from seated machines to standing exercises, 8 to 10 exercises.
b. Phase 1 of the OPT model should be used for 4 weeks before moving to Phases 2 through 5.
c. Phase 5 of the OPT model is contraindicated for senior clients due to increased safety considerations.
d. Training frequencies should start at 4 to 5 times per week.
a. Progression should be from seated machines to standing exercises, 8 to 10 exercises.
38
Which scenario is a component of the sliding filament theory?
Select one:
a. The result of two Z lines moving closer together.
b. The result of ATP production through aerobic respiration.
c. The pancreas releases glucagon into the bloodstream.
d. The pancreas releases insulin into the bloodstream.
a. The result of two Z lines moving closer together.
39
```
All of the following make up the five kinetic chain checkpoints EXCEPT the
Select one:
a. foot-ankle complex.
b. lumbo-pelvic hip complex.
c. shoulder complex.
d. hand-wrist complex.
```
d. hand-wrist complex.
40
Which of the following should a trainer share with a client regarding carbohydrate intake and weight gain?
Select one:
a. Limit complex carbohydrate intake to prevent weight gain.
b. Excess intake of any macronutrient will cause weight gain.
c. Increase fat intake to offset a decrease in carbohydrates.
d. Increase intake of high glycemic foods.
b. Excess intake of any macronutrient will cause weight gain.
41
Which of the following statements is true concerning client goal setting?
Select one:
a. Clients who are certain about what they want to accomplish are less likely to successfully make life changes.
b. A long-term goal keeps the client motivated for a longer period of time.
c. Setting achievable goals at the lower end of a client’s ability will build more confidence when accomplished.
d. Goals should be consistent with a client’s own ideals and ambitions.
d. Goals should be consistent with a client’s own ideals and ambitions.
42
```
Which of the following occurs at the shoulder while it is moving in the frontal plane?
Select one:
a. Flexion
b. Abduction
c. Extension
d. External rotation
```
b. Abduction
43
```
Which of the following muscles is lengthened in Lower Crossed Syndrome?
Select one:
a. Psoas minor
b. Rectus femoris
c. Erector Spinae
d. Transverse abdominis
```
d. Transverse abdominis
```
Internal oblique
Gluteus medius
Gluteus maximus
Posterior tibialis
Anterior tibialis
```
44
```
To avoid muscle strains, joint pain, and emotional fatigue, which of the following concepts should be implemented?
Select one:
a. Periodization
b. Mechanical specificity
c. Neuromuscular specificity
d. Vertical loading
```
a. Periodization
45
Davis’s law states which of the following?
Select one:
a. A chronically shortened muscle will demonstrate poor neuromuscular efficiency.
b. Soft tissue models along the lines of stress.
c. A tight agonist muscle will decrease neural drive to its functional antagonist.
d. The body will seek the path of least resistance during functional movement patterns.
b. Soft tissue models along the lines of stress.
46
```
To ensure proper front-side mechanics during sprinting, the ankle must be in a position of:
Select one:
a. plantarflexion.
b. eversion.
c. dorsiflexion.
d. inversion.
```
c. dorsiflexion.
47
```
Which of the following types of strength allows the neuromuscular system to perform dynamic eccentric, isometric, and concentric muscle actions in all three planes of motion?
Select one:
a. Postural
b. Structural
c. Functional
d. Neuromuscular
```
c. Functional
Integrated Performance Paradigm
48
```
Which of the following is most useful for assessing an athlete's lower extremity agility and neuromuscular control?
Select one:
a. Shark skill test
b. Davies test
c. Rockport walk test
d. Overhead squat assessment
```
a. Shark skill test
49
```
Under the supervision of which of the following professionals is it appropriate for an adult client to follow an 800-1000 calorie diet?
Select one:
a. Certified Personal Trainer
b. Medical physician
c. Nutritionist
d. Performance Enhancement Specialist
```
b. Medical physician
50
```
When assessing an overhead squat, an indication of relative flexibility due to tightness in the lateral gastrocnemius is:
Select one:
a. the knees moving inward.
b. external rotation of the feet.
c. excessive forward lean.
d. low back arches.
```
b. external rotation of the feet.
51
```
When assessing your clients resting heart rate, what location provides the most accurate measurement?
Select one:
a. Femoral artery
b. Subclavian artery
c. Radial artery
d. Brachial artery
```
c. Radial artery
52
Which of the following statements indicates that your client has successfully implemented a SMART goal?
Select one:
a. “I want to lose weight and trim down.”
b. “I want to build muscle and bulk up.”
c. “I want the ability to climb the stairs without getting winded.”
d. "I want to run a 5k in 45 days."
d. "I want to run a 5k in 45 days."
53
Which of the following movement dysfunctions will create abnormal stress throughout the kinetic chain?
Select one:
a. Over-pronation of the foot
b. Neutrality of the umbo-pelvic-hip complex
c. Patella tracking parallel with the foot
d. Neutrality of the scapulae
a. Over-pronation of the foot
54
```
During which part of the digestive system are protein strands broken down?
Select one:
a. Mouth
b. Stomach
c. Small intestines
d. Esophagus
```
b. Stomach
55
```
In the Maximal Strength Training (MST) phase, what should be the primary emphasis in the client’s program?
Select one:
a. Powerful movements
b. Joint stabilization
c. Increasing hypertrophy
d. Increasing load
```
d. Increasing load
56
```
Which of the following core-training exercises is best for a new client?
Select one:
a. Ball Crunch
b. Front Medicine Ball Oblique Throw
c. Reverse Crunch
d. Prone Iso-ab
```
d. Prone Iso-ab
57
```
When performing a _____, the load should be positioned to resist shoulder extension and scapular retraction.
Select one:
a. standing triceps extension
b. biceps curl
c. standing cable row
d. dumbbell chest press
```
c. standing cable row
58
```
Feedback regarding personal history such as sport, lifestyle, and past medical history would be best described as:
Select one:
a. objective information.
b. subjective information.
c. movement assessment.
d. fitness assessment.
```
b. subjective information.
59
```
Which of the following is an expected systolic blood pressure for a healthy client?
Select one:
a. 80 mm Hg
b. 95 mm Hg
c. 120 mm Hg
d. 135 mm Hg
```
c. 120 mm Hg
120/80
60
```
Which of the following muscles is the synergist when a client is performing a chest press?
Select one:
a. Anterior deltoid
b. Rotator cuff
c. Pectoralis major
d. Levator scapulae
```
a. Anterior deltoid
Synergist- Assist prime mover
61
```
What is the FIRST step a fitness professional should take when coming across an emergency situation that will require CPR?
Select one:
a. Activate the EMS system.
b. Check the scene for hazards.
c. Open the airway.
d. Check for circulation.
```
b. Check the scene for hazards
62
```
A slow and controlled dumbbell chest press performed on a stability ball is an example of what type of specificity?
Select one:
a. Mechanical
b. Balance
c. Metabolic
d. Neuromuscular
```
d. Neuromuscular
Mechanical specificity—the weight and movements placed on the body.
Neuromuscular specificity—the speed of contractions and exercise selection.
Metabolic specificity—the energy demand placed on the body
63
```
Which of the following is the innermost layer of muscular connective tissue?
Select one:
a. Fasciculus
b. Endomysium
c. Perimysium
d. Epimysium
```
b. Endomysium
64
```
A client who has an increased functional capacity to adapt to a stressor is in which of the following stages of the general adaptation syndrome?
Select one:
a. Resistance development
b. Alarm reaction
c. Exhaustion
d. Periodization
```
a. Resistance development
65
```
If a client demonstrates shoulder elevation while performing a cable row exercise, which of the following muscles is considered overactive?
Select one:
a. Rhomboids
b. Sternocleidomastoid
c. Upper trapezius
d. Erector spinae
```
c. Upper trapezius
Sternocleidomastoid
Levator scapulae
66
```
A series of exercises that is performed one after the other, with minimal rest, is referred to as what type of training system?
Select one:
a. Multiple set system
b. Pyramid system
c. Superset system
d. Circuit training system
```
d. Circuit training system
67
```
To maintain certification with NASM, the Certified Personal Trainer must earn:
Select one:
a. 1 CEU within 2 years.
b. 2 CEUs within 2 years.
c. 3 CEUs within 3 years.
d. 3 CEUs within 4 years
```
b. 2 CEUs within 2 years.
68
In which of the following situations should a Certified Personal Trainer refer a client to a medical practitioner?
Select one:
a. When the trainer becomes aware of undiagnosed osteoporosis.
b. When the trainer becomes aware of diagnosed diabetes.
c. When the trainer becomes aware of diagnosed hypertension.
d. When the trainer becomes aware of an undiagnosed allergy.
a. When the trainer becomes aware of undiagnosed osteoporosis.
69
Which of the following is a Power Level balance exercise?
Select one:
a. Single-leg box hop-up with stabilization
b. Single-leg throw and catch
c. Single-leg internal and external rotation
d. Single-leg squat touchdown
a. Single-leg box hop-up with stabilization
70
```
Which of the following is an appropriate intensity when training a client who is obese?
Select one:
a. 20 to 30% of their maximum heart rate
b. 40 to 50% of their maximum heart rate
c. 60 to 70% of their maximum heart rate
d. 85 to 95% of their maximum heart rate
```
c. 60 to 70% of their maximum heart rate
71
A client's maximum heart rate must be established prior to administering the YMCA 3-minute step test. This is achieved by:
Select one:
a. subtracting the client's age from 220.
b. subtracting the client's resting heart rate from 220.
c. subtracting the client's age from 220, then subtracting the client's resting heart rate.
d. subtracting the client's age from 220, then multiplying by 60-90%.
a. subtracting the client's age from 220.
72
```
When a client performs reactive exercises in the Stabilization Level of training, they should hold the landing position for how many seconds before repeating the movement?
Select one:
a. 1 to 2 seconds
b. 3 to 5 seconds
c. 6 to 7 seconds
d. 8 to 10 seconds
```
b. 3 to 5 seconds
73
```
Which of the following should an endurance athlete consume 2-4 hours before exercising to ensure adequate stores of muscle glycogen?
Select one:
a. Baked potato
b. Oatmeal cookie
c. Avocado
d. Spinach
```
a. Baked potato
74
```
Which of the following macronutrients should be consumed in the highest percentage for a healthy diet?
Select one:
a. Carbohydrate
b. Fat
c. Protein
d. Water
```
a. Carbohydrate
75
```
Although quality and brand recognition are important, people ultimately buy personal training services based on the desire to produce a meaningful outcome. Therefore, all buying decisions are based on:
Select one:
a. price.
b. knowledge.
c. pressure.
d. emotion
```
d. emotion
76
```
A client's shoulders elevate during a pulling assessment. Which of the following muscles may be underactive?
Select one:
a. Levator scapulae
b. Latissimus dorsi
c. Sternocleidomastoid
d. Mid and lower trapezius
```
d. Mid and lower trapezius
77
```
The principle that states the body will adapt to the demands that are placed upon it is called the Principle of:
Select one:
a. Periodization.
b. Efficiency.
c. Overload.
d. Specificity.
```
d. Specificity.
Specific adaptation to imposed demands (SAID) principle (principle of specificity)—the body will
specifically adapt to the type of demand placed on it.
78
```
Which of the following ratings of perceived exertion on the Borg Scale would be implemented in a cardio training program for clients wanting to improve their aerobic base?
Select one:
a. 9 to 11
b. 12 to 13
c. 14 to 16
d. 17 to 19
```
b. 12 to 13
79
```
Muscle imbalances can be caused by lack of core strength and poor training techniques. Which concept causes the biceps femoris and piriformis to compensate in a squatting movement?
Select one:
a. Autogenic inhibition
b. Synergistic dominance
c. Arthrokinetic dysfunction
d. Altered reciprocal inhibition
```
b. Synergistic dominance
80
```
Which of the following information is considered objective?
Select one:
a. Occupation
b. Lifestyle behavior
c. Recreational activity
d. Movement assessment
```
d. Movement assessment
81
```
Which one of the following exercises is classified as a balance-strength exercise?
Select one:
a. Single-leg squat touchdown
b. Single-leg lift and chop
c. Single-leg balance and reach
d. Single-leg hop with stabilization
```
a. Single-leg squat touchdown
82
```
The ability to react and change body position, with maximum rate of force production, in all planes of motion, and from all body positions during functional activities is:
Select one:
a. power.
b. speed.
c. quickness.
d. agility.
```
c. quickness.
83
```
When performing a _____, the load must be placed in such a way to resist elbow extension.
Select one:
a. standing triceps extension
b. biceps curl
c. standing cable row
d. dumbbell chest press
```
a. standing triceps extension
84
```
Personal trainers have a maximum of how many seconds to make a good first impression?
Select one:
a. 10 seconds
b. 15 seconds
c. 20 seconds
d. 30 seconds
```
c. 20 seconds
85
Which of the following describes the importance of active listening when engaging with a client?
Select one:
a. Providing the client with the right information.
b. Requiring the client to pay attention.
c. Convincing the client to do something.
d. Seeking a client's perspective.
d. Seeking a client's perspective.
86
```
Which of the following muscles is the prime mover when a client performs a row?
Select one:
a. Latissimus dorsi
b. Posterior deltoid
c. Pectoralis major
d. Pectoralis minor
```
a. Latissimus dorsi
87
```
Which of the following is a primary focus of stabilization training?
Select one:
a. Increased lean body mass
b. Enhanced control of posture
c. Improved peak force
d. Improved prime mover strength
```
b. Enhanced control of posture
88
```
Which of the following muscles is part of the core local stabilization system?
Select one:
a. Transverse abdominis
b. External oblique
c. Latissimus dorsi
d. Pectineus
```
a. Transverse abdominis
```
Transversus Abdominis
Internal Oblique
Lumbar Multifidus
Pelvic Floor Muscles
Diaphram
```
89
```
The Golgi tendon organ is an essential component of static stretching because:
Select one:
a. it increases muscle spindle activity.
b. it results in reciprocal inhibition.
c. it allows muscle fibers to contract.
d. it allows lengthening of the muscle
```
d. it allows lengthening of the muscle
90
```
A client shows signs of obesity, insulin resistance, and hypertension. The combination of these three symptoms are correlated with which of the following disorders?
Select one:
a. Metabolic syndrome
b. Restrictive lung disease
c. Peripheral edema condition
d. Coronary heart disease
```
a. Metabolic syndrome
