Final Flashcards
What urinary porphyrin becomes uniquely elevated in urine due to mercury toxicity? A.) Precoproporphyrin B.) Uroporphyrin I & III C.) Coproporphyrin D.) Protoporphyrin
A
Which of the following toxicants is considered to be iatrogenic? A.) 5-Methylchrysene B.) Acetaminophen C.) Naphthalene D.) D-Lactic acid
B
How does the stimulation of hepatic cytochrome P450 activity by compounds in cigarette smoke illustrate the hormesis model of toxicant effects?
A.) All compounds in cigarette smoke are toxic at all concentrations
B.) Very low doses of a toxic compound can have favorable effects
C.) Cigarette smoke is only toxic under certain dietary conditions
D.) Cytochrome P450 creates non-toxic compounds from most compounds in cigarette smoke
B
Why is oral challenging with DMSA used prior to toxic element testing of urine?
A.) To establish a baseline level before test specimen collection
B.) To normalize for hemoglobin in urine
C.) To demonstrate metallothionein loading status
D.) To increase instrumental sensitivity for mass spectrometric assay
C
Which of the following agents acts to protect enzymes inside of the mitochondria from oxidative damage? A.) Zinc-copper superoxide dismutase B.) Manganese superoxide dismutase C.) Ceruloplasmin D.) Catalase
B
What amino acid is unusually high inside erythrocytes to afford oxidative stress protection? A.) Taurine B.) Threonine C.) Thyroxin D.) Tyrosine
A
Which vitamin sits near the center of the cellular redox potential spectrum? A.) Vitamin A B.) Pantothenic acid C.) Vitamin D D.) Vitamin C
D
Accumulation of which compound tends to produce reductive stress? A.) BH4 B.) NADH C.) NAD D.) GSH
B
Which compound is sometimes used as a biomarker of total body protein oxidative damage? A.) DNA strand breaks B.) Pyroglutamate C.) Uric acid D.) Nitrotyrosine
D
In a patient with multiple signs of oxidative stress, physiological forms of which two micronutrients are needed because they act in tandem directly upon glutathione to achieve the recycling of the oxidized to the reduced form? A.) lysine and taurine
B.) EPA and DHEA
C.) folate and vitamin B12
D.) lipoate and nicotinamide
D
What factor released during sleep adds strong protection against oxidative stress? A.) Melatonin B.) Prostaglandin E2 C.) Serotonin D.) IGF
A
What antioxidant is specifically indicated to be under stress, leading to reduced antioxidant stress response capacity when a patient is found to have elevated pyroglutamate and alpha-hydroxybutyrate? A.) Catalase B.) Trace elements C.) Tocopherols D.) Glutathione
D
Which response shows the three trace elements that are required for the action of superoxide dismutase enzymes? A.) Fe, Mg, Zn B.) Co, Mo, Zn C.) Zn, Ca, Se D.) Cu, Zn, Mn
D
Production of which of the following cell regulators is directly affected by deficiency of iodine? A.) Nitric oxide B.) Serotonin C.) Thyroxin D.) Corticosteroids
C
Production of which of the following cell regulators is directly affected by deficiency of tryptophan? A.) Nitric oxide B.) Thyroxin C.) Serotonin D.) Corticosteroids
C
Production of which of the following cell regulators is directly affected by deficiency of arginine? A.) Nitric oxide B.) Thyroxin C.) Serotonin D.) Corticosteroids
A
Production of which of the following cell regulators is directly affected by excessive consumption of broccoli? A.) Thyroxine B.) Corticosteroids C.) Serotonin D.) Nitric oxide
A
Which of the following is a hormone that is NOT derived from cholesterol? A.) Estrogen B.) Testosterone C.) Cortisol D.) Norepinephrine
D
Which of the following test results is a marker for chronic stress response? A.) Low insulin B.) High estradiol C.) High thyroxin D.) Low sIgA
D
What hormonal abnormality would be suspected in a patient with elevated serum triglycerides, elevated serum LDL cholesterol, obesity and non-alcoholic live disease? A.) Low cortisol B.) Low estrogen C.) Hyperthyroidemia D.) Hyperinsulinemia
D
Which of the following is used to assess risk of cancer from poor regulation of estrogen metabolism? A.) Estradiol/Estriol ratio B.) Pregnenalone/Testosterone ratio C.) 2/16 Hydroxyestrogen ratio D.) Estrone/Estriol ratio
C
Cytokine signaling pathways frequently use which type of chemical reaction to transmit and amplify signals? A.) Dipeptide formation B.) Glutathione reduction C.) Sulfation D.) Phosphorylation
D
The AKT signaling pathway is involved in the initiation of which cellular process? A.) Mitosis B.) Apoptosis C.) Necrosis D.) Secretion
B
Which of the following is true of a laboratory result that lies in the 5th quintile?
A.) Eighty percent or more of the reference population has values less that this result
B.) There are four quintiles above the value for this result.
C.) This result may be presumed to be within normal limits.
D.) According to standard clinical laboratory definitions, this result would necessarily be considered abnormal.
A
A patient with an elevated level of beta-hydroxyisovalerate in urine is a candidate for which nutrient addition? A.) Biotin B.) Vitamin B6 C.) Folic acid D.) Lipoic acid
A
Serum concentrations of which of the following generally is considered to be the best compound for assessing vitamin D status?
A.) 25-Hydroxyvitamin D
B.) 1, 25-Dihydroxyvitamin D Ergosterol
C.) Ergocalciferol
A
Which of the following is a function NOT served by the single carbon pool?
A.) Delivery of reducing equivalents to form BH4
B.) Delivery of formyl groups to form purines
C.) Delivery of methylene groups to form pyrimidines
D.) Delivery of methyl groups to form SAMe
A
Which factor most commonly leads to multiple elevations of essential amino acids in fasting plasma? A.) Vitamin B6 deficiency B.) Vitamin K deficiency C.) Chronic hypochlorhydria D.) High protein diet
A
You would correctly recommend iron supplementation based on finding which abnormality in a patients record? A.) Low serum ferritin B.) Low hair iron C.) High erythrocyte transferrin D.) Low urinary iron
A
Finding very high levels of which element in erythrocytes would be of greatest concern regarding the recent appearance of toxic manifestations in a patient with a history of low urinary selenosugars? A.) Mercury B.) Cadmium C.) Aluminum D.) Lead
A
Metabolic impacts of some toxic elements are sensitively revealed by measuring intermediates in what pathway? A.) Porphyrin synthesis B.) Protein synthesis C.) Bilirubin degradation D.) Methionine catabolism
A
What test result might be used to justify intravenous chelation therapy?
A.) Elevated whole blood lead
B.) Low erythrocyte magnesium
C.) A high Phe/Tyr ration in plasma amino acids
D.) Multiple elevated keto-acids on a urinary organic acid profile
A
Which of the following describes the ultimate event that results in greater intestinal calcium absorption due to the action of vitamin D?
A.) Enterocyte ribosomal synthesis of calbindin is increased B.) Magnesium is displaced from calcium transport channels C.) The amount of absorbable calcium in the gut lumen is increased
D.) The overall activity of enterocyte mitochondrial ATP production is stimulated
A
Which phrase describes the first step in the assimilation of ingested dietary zinc?
A.) Release of bound zinc from food complexes that are denatured by gastric acid
B.) Binding of free zinc to metal ion transporters in enterocyte brush borders
C.) Transfer of ionic zinc to zinc fingers
D.) Metallothionein loading with zinc
A
In the absence of any other laboratory evidence, finding a pattern of strongly elevated serene with low glycine on a plasma amino acid profile would suggest deficiency of which essential nutrient? A.) 5-Methyltetrahydrofolate B.) Thiamin C.) Vitamin C D.) Vitamin D A.) 5-Methyltetrahydrofolate S-Adenoxylmethionine therapy is most likely to be helpful in cases where elevation of which amino acid is found? A.) Phosphoethanolamine B.) Hydroxylysine C.) 3-Methylhistidine D.) Taurine
A
Elevated levels of which compound in plasma is predictive of clinical effects due to insufficient nitric oxide? A.) ADMA B.) SAMe C.) NADPH D.) ACTH
A
Elevated levels of which compound is associated with difficulty in conversion of ammonia to urea? A.) All others shown B.) Ornithine C.) Citrulline D.) Arginine
A
Which of the following is NOT a process that is dependent on the availability of arginine? A.) Porphyrin synthesis B.) Nitric oxide production C.) Urea production D.) Protein synthesis
A
Elevations of which of the following urinary organic acids indicates that a patient has increased turnover of epinephrine?
Vanilmandelate
Which of the following is a urinary organic acid that becomes elevated in a patient due to massive intestinal overgrowth of Lactobacillus acidophillus? A.) D-Lactate B.) D-Arabinitol C.) L-Lactate D.) D-Glucarate
A
Which of the following is a urinary organic acid that becomes elevated as a result of Coenzyme Q10 deficiency? A.) Vanilmandelate B.) Succinate C.) Pyroglutamate D.) D-Lactate
B
