Exam Qs

Question 1

3 nutrients useful in treatment of type 2 diabetes

Answer 1

Cinnamon, chromium and zinc - improve glycemic control

Magnesium - improves insulin sensitivity

Question 2

2 things to do which may prevent progression of RA?

Answer 2

Repair leaky gut - check for food allergies/sensitivities

Modulate immune dysfunction

Control inflammation

Initiate Mediterranean diet

Question 3

5 reasons a women may not fall pregnant?

Answer 3

PID

Endometriosis

Toxic effects of tobacco & drugs

Advanced age

Incorrect timing of intercourse

Inadequate diet associated with extreme loss or weight gain

Question 4

2 causes of ADHD?

Answer 4

Food sensitivities

Nutrient deficiencies

Lead toxicity

Question 5

3 factors which lead to poor nutrition in elderly?

Answer 5

Chewing difficulties - dental problems

GIT disturbances

Adverse reactions from medications

Alzheimer’s/dementia

Question 6

2 drinks which decrease bone density?

Answer 6

Carbonated - increases acid load due to phosphoric acid

Caffeine - decreases intestinal absorption of calcium

Alcohol - increases risk of hip fracture

Question 7

3 foods high in purines?

Answer 7

Beef

Organ meats

Mussels

Yeast

Question 8

5 benefits of regular exercise?

Answer 8

Improves CV status

Reduced body weight

Relieves stress

Improves insulin sensitive

Reduces inflammation

Increases mitochondrial no. & function

Question 9

Prostate affected by which 2 hormones and how do they stimulate growth?

Answer 9

Testosterone and oestrogen

Imbalance of these contribute to increased DHT which increases prostatic cell proliferation

Question 10

4 clinical features of PCOS?

Answer 10

Hirsutism

Insulin resistance

Infertility

Amennorhea

Acne

Question 11

3 dietary patterns which contribute to development of kidney stones?

Answer 11

Low fibre

High alcohol

High oxalate foods

High refined carbohydrates / fat / animal protein

Question 12

Why would avoiding high oxalate foods be advisable for someone who has or has had kidney stones?

Examples of food.

Answer 12

Oxalic acid can pass through intestinal wall into blood and enter kidneys where it can combine with calcium

Chocolate, spinach, strawberries

Question 13

5 causes / contributing factors of MS?

Answer 13

Poor regulatory control of inflammation

Autoimmunity

Genetic predisposition

Viral or bacterial infection

Allergies - milk & gluten

Nutrient deficiencies - D, B12, B6, zinc, magnesium, omega 3’s etc

Question 14

Gene associated with Rheumatoid arthritis?

Answer 14

HLA DR4

Question 15

What B vitamin should be tested for in someone who has recently been diagnosed with MS and why?

Answer 15

B12
B12 often low in MS
B12 deficiency causes demyelination and could accelerate the disease process

Question 16

2 test you would consider for someone with family history of BPH and prostate symptoms?

Answer 16

Prostate specific antibody

Testosterone and DHT

Question 17

2 ways indole-3-carbinol may protect against cancer?

Answer 17

Inhibits HPV

Increases apoptosis rate

Question 18

How may carbohydrate loading be beneficial in preparation for a marathon?

Answer 18

Endurance activities require aerobic respiration - typically using glycogen
Carbohydrate loading promotes glycogen depletion, which promotes glycogen synthesis, increasing glycogen storage capacity

Question 19

2 examples of lifestyle changes in the MEND protocol and rationale behind them.

Answer 19

Sleep - 8 hours per night = support HPA axis

Reduce stress - yoga/meditation = support HPA axis and reduce cortisol

Question 20

Which part of the brain is destroyed in PD and how much is destroyed before the disease is detected?

Answer 20

Substantia nigra

60-70%

Question 21

Why is it important to eat 1-2 hours after exercise?

Answer 21

First 45 mins after exercise optimal for utilising glycogen synthesis, if too long passes mussels decrease their insulin sensitivity and become insulin resistant for up to 16 hours

Question 22

Strain of probiotic used for childhood allergy?

Answer 22

L. Rhammosus GG

Question 23

What 5 nutrients are of concern during pregnancy and why?

Answer 23

1. Vit A - high levels of synthetic retinol (active vit A) in doses 15,000IU+ shown to have teratogenic effects (birth defects)
2. Folate - DNA synthesis and cell replication, deficiency in pregnancy linked to maternal megaloblasic anaemia and fetal neural tube defects
3. Iron - additional iron needed to expand maternal red cell mass and to supply fetal and placental tissues, iron deficiency anaemia is common 30mg RDA in pregnancy
4. EFA’s - especially DHA needed for fetal CNS growth and development, better pregnancy outcomes in mums who take DHA
5. Calcium - major component of bone, higher need in pregnancy to construct fetal tissues, especially in the 3rd trimester, RDA 1000mg. Hormonal adaptations and increased intestinal absorption ensure mother and baby get what they need

Question 24

Causative factors involved in kidney stones.

Answer 24

Diet high in purines - aids formation or uric acid stones
Low fibre, high refined carbohydrates, vitamin D enriched foods, soft drinks all contribute to the formation of calcium containing kidney stones. Excess salt increases urinary excretion of calcium.
Dehydration

Question 25

4 hormones made from cholesterol

Answer 25

Testosterone
Oestrogen
Progesterone
DHEA

Question 26

How is cranberry helpful in UTI’s?

Answer 26

Benzoic and quinic acid metabolise hippuric acid which prevents bacterial adhesion to bladder wall. Proanthocyanins envalop E.coli preventing it from binding to epithelial cells of bladder

Question 27

3 examples of why aromatase enzyme may be increased?

Answer 27

Increased age
Increased insulin
Increased alcohol consumption

Question 28

State the roles of the following thyroid nutrients: tyrosine, iodine, zinc, selenium, copper.

Answer 28

Tyrosine and iodine - thyroid hormone formation
Zinc and copper - conversation of T4 - T3
Selenium - thyroid hormone synthesis, activation and metabolism

Question 29

Daily extra calories in pregnancy?

Answer 29

100-300

Question 30

2 reasons why glucosamine supplementation helps OA?

Answer 30

1. fundamental building block of connective tissue and other important components of joints
2. It stimulates collagen synthesis
3. Inhibits enzymes which destroy cartilage

Question 31

4 positive functions of DHEA?

Answer 31

1. Stimulates and strengthens immune system by improving resistance to microbes
2. Decreases cravings
3. Slows natural again process or calls and organs
4. Improves metabolism

Question 32

How might the hygiene hypothesis explain asthma development?

Answer 32

Excessive use of cleaning agents and spending less time outside playing in the earth is depriving the immune system of its ‘learning tools’ against various antigens in early life. Natural antigens stimulate TH1 response, asthma and other atopic conditions are T2 dominant. TH2 immune response is dominant in those raised in sanitary conditions encouraging asthma.

Question 33

Describe effect of stress on conversion of T4 to T3?

Answer 33

Inhibit enzyme which converts T4 to T3, more T4 is then shunted towards rT3 causing increased levels, when someone has excess rT3 they display hypothyroid symptoms.

Question 34

How is breast milk production affected by stress?

Answer 34

Stress can adversely affect a womans milk supply, via the down regulation of milk production due to increased levels of dopamine which inhibits prolactin synthesis.