Micronutrients Flashcards
Questions pertaining to vitamins, minerals, water,
You are working with a client who has anemia that is unresponsive to iron
therapy. Which of the following might you recommend to support your efforts?
a. copper
b. zinc
c. copper & zinc
d. none of the above
a. copper
The ________________ of the small intestine secrete the enzyme, ________________, which converts trypsinogen to trypsin.
a. mucosal cells, endopeptidase
b. enterocytes, enterokinase
c. goblet cells, dipeptidase
d. enterocytes, cholecystokinin
b. enterocytes, enterokinase
Metabolism of vitamin B6 to the primary coenzyme form, pyridoxal phosphate, requires the action of what other B vitamin?
a. GSH
b. NAD
c. THF
d. FMN
d. FMN
Which of the following is the most bioavailable form of calcium supplementation?
a. calcium carbonate
b. calcium citrate
c. calcium sulphate
d. calcium phosphate
b. calcium citrate
To absorb folate consumed from green, leafy vegetables, _____.
a. phosphate groups much be removed by the action of alkaline phosphatase
b. glutamate must be transaminated to form alpha-ketoglutarate
c. glutamic acid molecules must be removed
d. glutamic acid molecules must be added
c. glutamic acid molecules must be removed
Pernicious anemia is identified by the _____ test, which involves using radioactive _____.
a. Methylmalonic acid, Vitamin B12
b. RBC folate, folate
c. RBC serum, Vitamin B6
d. Schilling, Vitamin B12
d. Schilling, Vitamin B12
Which of the following may be due to a defect in copper metabolism (found
mainly in young males)?
a. Menkes disease
b. Wilson disease
c. Acrodermatitis enteropathica
d. All of these diseases may be due to such a defect
a. Menkes disease
The vitamin K content in foods is reduced by:
a. alkaline environments
b. tannins
c. pasteurization
d. irradiation
a. alkaline environments
The increased risk of kidney stones with hypercalcemia is typically due to:
a. excess dietary intake of calcium
b. excess supplemental intake of calcium (carbonate form)
c. increased excretion of calcium by the kidneys
d. all of the above
c. increased excretion of calcium by the kidney
Which of the following is NOT a type of carotenoid?
a. beta-carotene and alpha-carotene
b. beta-cryptoxanthin & zeaxanthin
c. lutein
d. glucomannon
d. glucomannon
Carotenoid types:
Beta-carotene Alpha-carotene
Beta-cryptoxanthin Zeaxanthin
Lutein Lycopene
Where is vitamin C mainly absorbed?
a. the duodenum
b. the duodenum and jejenum
c. the jejenum and ileum
d. the ileum
c. the jejenum and ileum
What levels of Vitamin D supplementation and supplementation duration are observed in Vitamin D toxicity?
a. Daily intakes of 20,000 IU or higher for several months b. Daily intakes of 10,000 IU or higher for several months
c. Daily intakes of 5,000 IU
or higher for several months
d. None of the above as Vitamin D toxicity is unlikely.
b. Daily intakes of 10,000 IU or higher for several months
Reference: Gropper, p. 399
Why is colostrum yellow? It has high amounts of:
a. riboflavin
b. Vitamin A
c. niacin
d. antioxidants
b. Vitamin A
Colostrum is a rich source of Vitamin A.
Which nutrient has a synergistic relationship with CoEnzyme Q10 (CoQ10)? A. Vitamin C b. Vitamin A c. Vitamin E d. Vitamin D
c. Vitamin E
What is the normal pH range of serum bicarbonate (HCO3) on an arterial blood gas result?
a. 20-25 mEq/L
b. 22-26 mEq/L
c. 25-27 mEq/L
d. 25-30 mEq/L
b. 22-26 mEq/L
Cheilosis is a symptom of a dietary deficiency of which vitamin?
a. niacin
b. ascorbic acid
c. riboflavin
d. biotin
c. riboflavin
Which amino acid may antagonize the functions of Vitamin B6 and impair the conversion of tryptophan to niacin, when eaten in excess in the diet?
a. lycine
b. arginine
c. leucine
d. methionine
c. leucine
Which one is incorrectly matched?
a. major extracellular cation is sodium/Na+
b. major extracellular anion is bicarbonate/HCO3-
c. major intracellular cation is potassium/K+
d. minor intracellular anion is phosphate ions
e. all of the above are correct
e. all of the above are correct
another key extracellular anion is Chloride (Cl-)
Cations are positive (+); anions are negative (-)
A positive taste test (i.e. suggestive of deficiency) and an alkaline phosphatase
lab of <70 U/L indicate a possible ________________ deficiency.
a. copper
b. iron
c. zinc
d. Vitamin A
c. zinc
Which statement below is incorrect?
a. lutein carotenoids include: beets, kiwi & eggs
b. beta-carotene carotenoids include: salmon & oranges
c. lycopene carotenoids include: tomatoes & watermelon
d. zeaxanthin carotenoids include: orange peppers, eggs & corn
b. beta-carotene carotenoids include: salmon tomatoes & oranges is incorrect.
Beta-carotene carotenoids actually include:
carrots (also have alpha-carotene)
canteloupe, broccoli, squash, peas, spinach
B6-dependent transamination reactions are important in which process?
a. glyconeogenesis
b. gluconeogenesis
c. heme synthesis
d. more than one of the above
b. gluconeogenesis
Plasma buffers act as __________ if plasma pH goes above 7.45, and __________, if plasma goes above 7.35.
a. acids, bases
b. neutralizers, immobiliziers
c. bases, acids
d. bases, neutralizers
a. acids, bases
If serum pH is greater than 7.45, it’s ALKALEMIA, so need an acid to lower pH (need more H+).
If serum pH is lower than 7.45, it’s ACIDEMIA, so need an acid to increase pH (need less H+).
Hypervitamonisis A can be caused by ingesting large amounts of supplemental vitamin A, such as:
a. 10,000 IU daily
b. 15,000 IU daily
c. 50,000 IU daily
d. 72,000 IU daily
c. 50,000 IU daily
Vitamin B1/thiamin is a co-factor for which biochemical reactions?
- Pyruvate dehydrogenase (part of TLCFN)
- Alpha-ketoglutarate dehydrogenase
- Branched-chain alpha-keto acid dehydrogenase
- pyruvate decarboxylase (+Mg)
- transketolase in the PPP (glutathione production; FA & nucleic acid synthesis)
What is the name of the glucose transporter in the liver?
a. GLUT1
b. GLUT2
c. GLUT3
d. GLUT4
b. GLUT2
“2 live” in the liver
Your client is a 35yo female with a diagnosis of iron-deficiency anemia. After 3 months of supplementing with non-heme iron and vitamin C, her iron status has not improved. What other deficiencies might you consider?
a. zinc
b. biotin
c. selenium
d. Vitamin A
d. Vitamin A
Studies with anemic children and women from areas where vitamin A deficiency is endemic, have shown a beneficial effect on Fe status of supplemental vitamin A in addition to Fe supplementation.
Restless leg syndrome can occur with a deficiency of ________________?
a. copper
b. iron
c. zinc
b. iron
Which nutrition assessment method is used to collect dietary info from a community?
a. food frequency questionnaire
b. food diary
c. 24-hour recall
d. food survey
a. food frequency questionnaire
Which classical vitamin deficiency is known for the four Ds: dermatitis, dementia, diarrhea, and death?
a. thiamin
b. niacin
c. biotin
d. folic acid
b. niacin
Supplement of which nutrient may be effective for treating AI thyroiditis and dyslipidemia?
a. folic acid
b. iodine
c. selenium
d. zinc
c. selenium
May improve T4 to T3 conversion.
Antioxidant to support glutathione production.
DNA and RNA are nucleic acids formed from nucleotides. Nucleotides are comprised of which of the following?
a. nitrogenous core+a pentose sugar+phosphate
b. a pyrimidine or purine+ribose or deoxyribose+oxygen
c. nitrogenous core+hexose+phosphate
d. a pyrimidine or purine+ribose or deoxyribose+oxygen
a. nitrogenous core+pentose sugar+phosphate
An individual with hereditary hemochromatosis is typically advised to do all of the following EXCEPT: a. avoid supplemental iron b. avoid alcohol c. supplement with high doses of zinc d. regular phlebotomy
c. supplement with high doses of zinc
What might cause symptoms of blurred vision, nausea and vertigo?
a. Vitamin A deficiency
b. Vitamin A toxicity
c. Vitamin D deficiency
d. Vitamin D toxicity
b. Vitamin A toxicity
In the enzyme methionine synthase, vitamin B12 acts by accepting a _____ group from _____ and donating this group to _____ to form methionine.
a. carbon, methionine, folate
b. methyl, 5-methyltetrahydrofolate, homocysteine
c. methyl, formiminoglutamic acid, succinyl-CoA
d. carbon, serine, glycine
b. methyl, 5-methyltetrahydrofolate, homocysteine
Cuproenzymes are involved in which of the following reactions/processes?
a. energy production
b. iron metabolism
c. antioxidant function
d. all of the above
d. all of the above
All of the following promote the absorption of non-heme iron except:
a. fiber
b. Vitamin C
c. tricarboxylic acids
d. amino acids
a. fiber
How much daily Vitamin C should regular cigarette smokers consumer?
a. 100 mg
b. 125 mg
c. 250 mg
d. 500 mg
b. 125 mg
Pellagra symptoms may appear during B6 deficiency, because this vitamin is required in the process of obtaining niacin from tryptophan.
True or False
True
When the diet is adequate in protein, the body can synthesize niacin from which amino acid?
a. phenylalanine
b. valine
c. tyrosine
d. tryptophan
d. tryptophan
A client presenting with loss of appetite, alopecia, dermatitis, anorexia nervosa, or hyperkeratinization is most likely deficiency in which nutrient?
a. iron
b. magnesium
c. calcium
d. zinc
d. zinc
What is another name for CoQ10?
ubiquinone
Unrefined grains, nuts, beans, seafood and chocolate are all rich in _______.
a. calcium
b. magnesium
c. phosphorous
d. all of the above
b. magnesium
What is the normal pH range of PCO2 (partial pressure of carbon dioxide)?
a. 30-40 mmHg
b. 35-45 mmHg
c. 45-50 mmHg
d. 50-55 mmHg
b. 35-45 mmHg
Remember that the numbers align with blood pH (7.35-7.45) and for PCO2=35-45 mmHg
The following is an appropriate physiologic response to a fall in extracellular fluid (ECF) calcium.
a. A rise in parathyroid hormone (PTH) and a fall in 1,25-OH-D.
b. A fall in parathyroid hormone (PTH) and a rise in 1,25-OH-D.
c. A rise in parathyroid hormone (PTH) and a rise in 1,25-OH-D.
d. A fall in parathyroid hormone (PTH) and a fall in 1,25-OH-D.
e. A rise in parathyroid hormone (PTH) and a rise in 1,25-OH-D.
c, A rise in parathyroid hormone (PTH) and a rise in 1,25 dihydroxyvitamin D.
___________ from nuts, seeds and grains is approximately 50% less absorbable than from other sources.
a. calcium
b. magnesium
c. phosphorous
c. phosphorous
A client comes to see you and is suffering from migraines, insomnia and anxiety. Which mineral(s) may they benefit from supplementing (and/or increasing in the
diet) ?
a. calcium
b. magnesium
c. phosphorous
d. all of the above
b. magnesium
The following condition can result from choline deficiency:
a. Parkinson’s disease
b. NAFLD
c. gout
d. end-stage renal disease
b. NAFLD
Choline defiency contributes towards fat build up in the liver. It can cause muscle damage, liver damage, and NAFLD.
Anthracycline medications (e.g. doxorubicin) and anticonvulsant medications (e.g. valproic acid) inhibit the synthesis of which substance:
a. CoQ10
b. glutathione
c. glycine
d. dopamine
a. CoQ10
Which of the following minerals enhances the response of insulin receptors?
a. zinc
b. chromium
c. selenium
d. vanadium
b. chromium
How much does intracellular fluid (ICF) account for in total body water content?
a. 1/4
b. 1/3
c. 2/3
d. 3/4
c. 2/3
Your client has a disease known as Beriberi. Which of the following foods should he limit?
a. green tea, black tea, shellfish
b. yeast, salmon, pork
c. citrus fruits
d. almonds and spinach
a. green tea, black tea, shellfish
These are thiaminases (and polyphenols) that inhibit absorption of thiamin/Vitamin B1
Ascorbic acid can reduce the oxidized form of vitamin E. Choose the phrase that describes this.
a. Ascorbic acid reduces the tocopheroxy radical to the quinone form; ascorbic acid is oxidized to dehydroascorbic acid
b. Ascorbic acid reduces the hydroquinone form to the quinone form; ascorbic acid is reduced to semi-dehydroascorbic acid.
c. Ascorbic acid reduces the tochopheroxy radical to the tocopherol form; ascorbic acid is oxidized to semi-dehydroascorbate.
c. Ascorbic acid reduces the tochopheroxy radical to the tocopherol form; ascorbic acid is oxidized to semi-dehydroascorbate.
Match these: 1. thiamin diphosphate (TPP)
- flavin adenine dinucleotide (FAD)
- nicotinamide adenine dinucleotide(NAD)
- biotin
- pyridoxal phosphate
a. alanine aminotransferase; impt in a.a. transaminations for facilitating protein synthesis
b. pyruvate dehydrogenase; impt for decarboxylations in carbohydrate catabolism
c. glutathione reductase; impt for RBC antioxidant integrity & a sensitive measure of riboflavin nutriture
d. aldehyde dehydrogenase; impt for catabolism of vitB6 (pyridoxal to pyridoxic acid)
e. acetyl-CoA carboxylase; impt to form malonyl-CoA and commit acetyl-CoA to FA synthesis
- TPP - b. pyruvate dehydrogenase
- FAD - c. glutathione reductase
- NAD - d. aldehyde dehydrogenase
- Biotin - e. acetyl-CoA carboxylase
- pyridoxal phosphate - a. alanine aminotransferase
Vitamin C enhances the absorption of \_\_\_\_\_\_\_\_\_ and inhibits the absorption of \_\_\_\_\_\_\_\_\_ . a. Zinc, copper b. Iron, zinc c. Copper, zinc d. Iron, copper
d. Iron, copper
What is the most tightly regulated ion in the extracellular fluid?
a. magnesium
b. calcium
c. sodium
d. chloride
b. calcium
Which nutrients are need as a co-factor in convertin dopamine to norepinephrine?
a. Vitamin C and copper
b. Vitamin C and zinc
c. Copper and magnesium
d. Magnesium and SAM
a. Vitamin C and copper
Oxalates are found in all of the following except:
a. chard
b. beet greens
c. kale
d. spinach
c. kale
Daily supplementation with multivitamins should be approached cautiously with which of the following populations:
a. alcoholics
b. individuals with Down syndrome
c. elderly individuals
d. smokers
d. smokers
Smokers/former smokers should avoid MVM products with large amts of beta-carotene or VitA because some studies have linked these nutrients to an increased risk of lung cancer in smokers.
A major role for thiamin is:
a. energy transformation
b. blood coagulation
c. collagen formation
d. erythrocyte synthesis
a. energy transformation.
Is blood normally basic or acidic?
a. basic
b. acidic
c. neutral
a. basic
Blood is normally slightly basic, with a normal pH range of about 7.35 to 7.45. Usually the body maintains the pH of blood close to 7.40.
The reason we use equivalents when discussing the RDA for some vitamins is that there are different forms of the vitamin that, by weight, are not equal in terms of vitamin activity—this is due to differences in absorption and/or metabolism.
True or False
True
High circulating levels of homocysteine (i.e., hyperhomocysteinemia) have been implicated in a number of pathologies including cardiovascular disease.
True or False
True
What is another name for sideroblastic anemia? Why does this anemia occur?
Another name for sideroblastic anemia is pyridoxine-responsive anemia.
Occurs when low B6 leads to reduced synthesis of heme (ringed sideroblasts create immature RBC cells due to a defect in protoporphyrin synthesis pathway)
PLP functions as a coenzyme for _____ when alanine enters the liver. Alanine becomes its α-keto acid, _____.
a. transamination, pyruvic acid
b. transamination, α-ketoglutaric acid
c. transmethylation, histidine
d. desulfation, methioninie
a. transamination, pyruvic acid
Which vitamin can lead to a fishy body odor if consumed to toxic levels?
a. folate
b. choline
c. biotin
d. Vitamin B6
b. choline
Choline toxicity: -fishy body odor -excessive salivation -excessive perspiration vomiting.
Folate in foods can only be absorbed in the monoglutamate form; therefore, digestive enzymes called _____ are important for folate nutriture.
a. hydrolases
b. lipases
c. conjugases
d. legumes
c. conjugases
Erythrocyte transketolase activity is an assay to assess the status of:
a. thiamin
b. B6
c. riboflavin
d. B12.
a. thiamin
Which of the following vitamins can gut microbiota synthesize?
a. Vitamin K
b. Biotin
c. Vitamin A
d. A and B only
e. all of the above
d. A and B only
Vitamin D helps our bodies to absorb:
a. Vitamin A
b. Phosphorous
c. Calcium
d. Vitamin K
c. Calcium
Vitamin D is essential for the body to absorb calcium from foods. Without adequate vitamin D levels, the body takes calcium from the bones, weakening them and preventing new bone from being formed. Calcium is critical for many body processes, including proper function of the heart, nerves, and muscles as well as blood clotting.
When plasma calcium concentrations are low, what homeostatic regulatory process takes place to raise calcium levels in the blood?
a. urinary excretion of magnesium decreases
b. osteoclasts are activated to release calcium from the bone
c. calcium absorption in the small intestine decreases
d. all of the above
b. osteoclasts are activated to release calcium from the bone
The answers do not include a. or c. because:
Urinary excretion of CALCIUM (not Mg) decreases.
Calcium absorption in the small intestine increases (not decreases)
Long-term supplementation with the supplement alpha-lipoic acid (ALA) can
increase excretion of which of the following minerals (prompting the
recommendation of its daily supplementation)?
a. copper
b. iron
c. zinc
d. Vitamin A
a. copper
If the pH level of a substance is at an 11.0, is the substance:
a. basic?
b. acidic?
c. neutral?
a. basic?
Folic acid fortification has _____.
a. not caused the decrease in NTDs that was expected
b. had no effect on the number of NTDs in this country
c. caused a greater decrease in NTDs than was expected
d. reduced the number of various NTDs by 11% to 50% in different studies
d. reduced the number of various NTDs by 11% to 50% in different studies
All of the following play a key role in regulating water balance except:
a. adrenal cortex
b. vasopressin
c. Na+/K+ ATPase pump
d. DNA methylation
d. DNA methylation
The anti-coagulent, heparin, interferes with the activation of which nutrient, which is involved in osteoblast function?
a. calcium
b. vitamin D
c. vitamin K
d. magnesium
b. vitamin D
The Tolerable Upper Limit (TUL) for Vitamin A for adults is _________ ug daily and for infants and toddlers is _________ ug daily.
a. 3000, 500
b. 3000, 600
c. 3500, 500
d. 4000, 500
b. 3000, 600
Vitamin A TUL for adults: 3000 ug/d
Vitamin A TUL for infants and children ages 1-3yo:
600 ug/d
On the pH scale, a pH of ______ is neutral.
a. 4.0
b. 5.0
c. 6.0
d. 7.0
d. 7.0
Which of the following functions is related to calcium?
a. nerve transmission and muscle contraction
b. maintaining fluid balance
c. ATP production
d. impt for production of HCl
a. nerve transmission and muscle contraction
Also:
- supports bones and teeth (structure of)
- plays a key role in blood clotting
Antiotensin-convertizing enzymes (ACE) inhibitors can result in all of the following except:
a. increase the excretion of sodium
b. inhibit the absorption of iron
c. inhibit the excretion of potassium
d. increase urinary zinc excretion
a. increase the excretion of sodium
Which carotenoid exhibits the greatest amount of provitamin A activity?
a. alpha-carotene
b. beta-carotene
c. lutein
d. lycopene
b. beta-carotene
Rickets is a bone disorder that occurs in infants and children. It can be caused by a deficiency of:
a. Vitamin D
b. Calcium
c. Phosphate.
d. A and B only
e. All of the above
e. All of the above
Which nutrient plays a role in the synthesis of collagen, catacholamines, serotonin, and tryptophan? A. Vitamin D B. Vitamin B6 C. Vitamin B5 D. Vitamin C
D. Vitamin C