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Functional Med > Final > Flashcards

Final Flashcards

1
Q

A patient with simultaneous strong elevations of urinary citrate, cis-aconitate, isocitrate and orotate is also likely to be exhibiting which other laboratory abnormality?

A

Ammonemia

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2
Q

Elevation of which compound indicates that inflammatory responses are occurring in the brain?

A

Quinolinic acid

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3
Q

Why would dietary protein intake not be expected to produce elevated levels of amino acids in plasma when the test is done according to usual specimen colection instructions?

A

After more than six hours, amino acids from dietary protein do not affect peripheral blood amino acid concentrations.

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4
Q

A patient with signs consistent with magnesium deficiency that is confirmed by low erythrocyte magnesium is likely to have low status of what other compound with direct effects on magnesium status?

A

glutathione

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5
Q

A patient who had a lab result showing high urinary tricarballylate would be a candidate for which nutrient supplementation?

A

magnesium

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6
Q

Insufficiency of which hormone is associated with impaired conversion of beta carotene to vitamin A?

A

thyroid

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7
Q

When a patient is found to have high levels of LA and GLA, but a low level of DGLA on a plasma fatty acid profile, what specific nutrient intervention is suggested?

A

zinc

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8
Q

Folic acid supplementation is indicated when a LOW result is found for which laboratory test?

A

plasma histidine

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9
Q

Which specific nutrient supplementation is most directly indicated for a patient with a greatly elevated plasma phenylalanine to tyrosine ratio?

A

iron

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10
Q

Which specific nutrient supplementation is most directly indicated for a patient with greatly elevated serum levels of citrulline and ornithine?

A

magnesium

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11
Q

Increased intake of which nutrient is most specifically indicated for a patient with hyperinsulinemia?

A

chromium

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12
Q

When glutathione becomes oxidized in a reaction that removes an oxygen radical, which compound is the co-substrate for the conversion back to reduced glutathione?

A

NADPH

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13
Q

A patient with a low serum transferrin level is a candidate for supplementation of which nutrient?

A

Iron

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14
Q

Aggressive biotin supplementation would be indicated for a patient with which abnormality?

A

High urinary beta-hydroxyisovalerate

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15
Q

Concurrent elevations of urinary L-lactate and pyruvate have been shown to respond favorably to which vitamin supplementation?

A

lipoic acid

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16
Q

Your patient reveals that s/he has been supplementing with high doses of fish oil for years and always cooks with safflower oil and corn oil. Based on this information, what analyte(s) would you suspect might be elevated?

A

lipid peroxides

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17
Q

What compound is a precursor in human cells for tetrahydrobiopterin production?

A

GTP

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18
Q

A patient whose diet contains very low levels of polyphenols may have false negative results for which test?

A

urinary microbial markers

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19
Q

What condition is revealed by finding a large number of 2+ to 4+ results for food-specific IgG4 concentrations in serum?

A

Intestinal hyperpermeability

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20
Q

Measuring breath hydrogen after an oral bolus of glucose is a test used to detect which condition?

A

transitional gut bacterial overgrowth

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21
Q

Why do microbiological culture techniques performed in routine clinical laboratory services fail to detect the large majority of bacteria that occur in stool specimens?

A

the bacteria are strict anaerobes

22
Q

Which food-specific serum antibody class is tested primarily to determine the presence of intestinal hyperpermeability?

A

IgG

23
Q

What region of the normal human intestinal tract has the greatest rate of increase in bacteria populations per inch of transit?

A

ileum

24
Q

Which laboratory abnormality would be the most ominous as a risk factor for a chronic pain patient who has a tendency to overdose her acetaminophen?

A

low plasma methionine

25
Q

Which compound has the unique function of being simultaneously required for the activated methyl-supply system and the glutathione-formation system?

A

homocysteine

26
Q

If glycine is to be administered to support Phase II detoxification, what vitamin also is specifically indicated?

A

pantothenic acid (B5)

27
Q

Which component of biological membranes is most highly susceptible to hydroxyl radical attack?

A

PUFAs

28
Q

What vitamin-derived enzyme cofactor contains pantothenic acid?

A

Coenzyme A

29
Q

Which antioxidant is found in erythrocytes at levels nearly 10 times those found in blood plasma?

A

taurine

30
Q

A defect in which regulatory system is indicated by finding the pattern of very high glutamic acid and very low glutamine in a plasma amino acid profile for a 4 year old boy with severe hyperactivity?

A

SN1-SN2 transporter

31
Q

Dietary deficiency of which vitamin causes the situation known as the “Folate Trap?”

A

Vit B12

32
Q

Which of the following compounds is NOT a tricarboxylic acid?

A

succinate

33
Q

Which laboratory finding tells you that a patient has an increased risk of kidney stone recurrence?

A

low urinary citrate

34
Q

Therapy with which type of drug frequently causes elevation of urinary 5-hydroxyindoleacetate?

A

serotonin reuptake inhibitors

35
Q

Which urinary organic acid profile elevated result would be suspected to have been produced by finding that the patient had consumed a large serving of bananas and black walnuts with her evening meal before the overnight urine specimen collection for the test?

A

5-Hydroxyindoleacetate

36
Q

Use of which specimen for measuring potassium concentration has the strongest scientific support for assessing potassium deficiency?

A

erythrocyte

37
Q

Measuring levels of which serum protein can provide direct information about a patient’s copper status?

A

ceruloplasmin

38
Q

Among the metabolic roles of zinc, which one involves structures called zinc fingers?

A

gene expression

39
Q

If you find mildly elevated urinary methylmalonic acid for a 10-year-old girl with idiopathic polyneuropathy, which laboratory profile would you recommend for confirmation of specific vitamin deficiency?

A

serum Vit B12

40
Q

Which laboratory profile would you recommend to confirm suspicion of biotin deficiency?

A

urinary organic acids

41
Q

Considering the precursor amino acid for thyroid hormone production, which laboratory abnormality would suggest a potential line of specific nutritional therapy for a patient with negative autoimmune thyroid antibodies and chronically low thyroid function that is unresponsive to aggressive supplementation of iodine?

A

Very high plasma Phe/Tyr ratio

42
Q

Which potential intervention for a patient would be reinforced by the following laboratory abnormalities? - low plasma homocysteine, low erythrocyte magnesium, high urinary 8-hydroxy-2’-deoxyguanosine, and low urinary sulfate.

A

N-Acetylcysteine

43
Q

If you were requested to prepare a one day DMSA dosing schedule for a patient, what laboratory profile would you expect to be ordered on that patient?

A

urine toxic elements

44
Q

For a patient who is in a state of strong negative calcium balance, which profile is most likely to show greatly elevated calcium concentration?

A

hair

45
Q

If you had been monitoring a patient’s urinary mercury levels monthly and notice a sudden increase, what kind of treatment procedure would be suspected as a major contributing factor?

A

dental amalgam removal

46
Q

When a patient’s laboratory report shows very low zinc, what other abnormality takes on greatly added significance regarding need for clinical management?

A

elevated blood cadmium

47
Q

A laboratory report that shows a pattern of low range levels for multiple trace elements suggests what underlying physiological failure?

A

insufficient gastric acid output

48
Q

Which laboratory result would provide biochemical confirmation of functional impact from a genetric polymorphism that impairs metabolism of catecholamines?

A

low urinary VMA and HVA

49
Q

Which specific nutrient supplementation is most directly indicated for a patient with greatly elevated urinary quinolinate and very low plasma tryptophan?

A

niacin

50
Q

Based on finding that a patient with greatly elevated homocysteine has normal levels of urinary FIGLU and methylmalonate, which specific vitamin supplementation is likely to result in lower risk for cardiovascular disease?

A

pyridoxine

Functional Med (2 decks)

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