MIDTERM Flashcards
What is the physiological origin of the alkaline tide?
Stomach acid production
The Heidelberg capsule is a device that was developed for clinical assessment of what function?
A. Small intestine residence time
B. Gastric acid output
C. Pancreatic enzyme output
D. Bile flow
B. Gastric acid output
Why is the flow of amino acids and vitamins from the gut to the liver not accompanied by dietary fatty acids?
A. Rates of fatty acid absorption are more distal in the stomach
B. Fatty acids are transferred into the lymphatic flow
C. Absorbed fatty acids are incorporated directly in VLDL
B. Fatty acids are transferred into the lymphatic flow
What is the long-term major difference in prognosis between a positive IgE response and positive IgG4 response
A. No food avoidance is needed for IgG4 reactions
B. Only short-term food avoidance is needed for IgE reactions
C. IgG4-reactive patients may resume eating reactive foods when the gut is healed
D. There are no differences in management
C. IgG4-reactive patients may resume eating reactive foods when the gut is healed
Which type of food-specific antibody is able to both block IgE responses and persist for many days as a multi-antigen-binding complex?
A. IgG4
B. IgG1
C. IgG2
D. IgG3
A.
High fecal fatty acids can arise from lack of which digestive function?
A. Bile acid secretion
B. Adequate stomach residence time
C. Carbohydrate malabsorption
D. Immune barrier dysfunction
A. Bile acid secretion
Which biomarker can be used to assess chronic elevated intestinal permeability?
A. sIgA
B. Isobutyrate
C. IgG4
D. IgGE
C. IgG4
In which class of immunoglobulin are the transmembrane Fc. regions not joined by disulfide bonds?
A. IgE
B. IgA
C. IgM
D. IgG
D
General insufficient secretion of pancreatic enzymes leads to which metabolic outcome?
A. Low fecal fats
B. Low polyunsaturated fatty acids in the plasma
C. Low gastric pH
D. Low vitamin B12
B
In what anatomical region of the gut does the most rapid increase in commensal bacteria growth occur?
A. Ileum
B. Cecum
C. Transverse colon
D. Sigmoid colon
B
What unique metabolic product of desulfovibrio pinger is thought to confer cardiovascular disease protection?
A. Chondroitin
B. Acetate
C. Vibrio antigen
D. Hydrogen sulfide
D.
Why are mealtime habits so important for achieving a healthy gut micro biome that resists challenges from pathogens and occasional food indiscretions?
A. They allow much more robust growth of Lactobacillus
B. Such habits improve digestive function and GI residence time
C. Anxiety while eating raises cortisol to very high levels
D. They allow the stomach to empty faster, lowering caloric load
B.
What target has the greatest mid-range levels in the healthy population?
A. Bifidobacter
B. Clostridium
C. Faecalibacterium
D. Fusobacterium
B.
**Which target can confer protection against intestinal inflammatory responses when it is present at normal levels?
A. Prevotella
B. E. Coli
C. Bactericides
D. Faecalibacterium prausnitzii
D.
** Which best describes the effect of robust, balanced growth of normal commensal bacteria on most intestinal pathogens
A. Stimulation of pathogen growth
B. Suppression of growth and pathogenicity
C. Higher rates of pathogen DNA mutations
D. Hyperimmune states and inflammation
B
** The single archaeon found in appreciable levels in most healthy people requires the presence of what substrate for growth?
A. Hydrogen
B. Methanol
C. Amylose
A
**What advantage is gained by reporting bacteria levels in units per microgram of feces?
The results can read as simple integer values
** Why is robust growth needed for normal high-abundance commensal bacteria to reach levels that sustain a healthy gut microbiome?
Most of the them must pass into the anaerobic cecum before active growth can begin
What best describes fecal material in people with a healthy gut microbiome?
Large, soft logs
**Which of the following factors does not impact alpha-tocopherol levels
A. Canola oil
B. Almonds
C. Fat malabsorption
D. Hyperglycemia
A
Which compound is measured as a laboratory test for vitamin K deficiency?
A. 7-Dehydrocholesterol
B. Under Carboxylated osteocalcin
C. Dehydroascorbic acid
D. Sepiapterin
B.
Assessment of vitamin D deficiency is done by measuring serum levels of what compound?
A. Calcitriol
B. Previtmain D3
C. 25-Hydroxyvitamin D
D. 1,25-Dihydroxyvitamin D
C
A patient can have normal serum vitamin B12, but still show elevated urinary MMA because:
A. The folate trap prevents proper methylation
B. Vitamin B12 promotes the formation of methylmalonate
C. Methylmaonate causes anemia from folic acid deficiency
D. Methylmalonate metabolism requires intra-cellular activity of vitamin B12
D.
Which vitamin insufficiencies can indicate elevated branched-chain keto acids in urine?
A. B-complex
B. Antioxidants
C. Cholecalciferol
D. Ascorbate
A.
** Why is it incorrect to speak of a “folic acid” deficiency
A. Folic acid is not commonly found in many food sources
B. Folic acid is highly toxic
C. Folic acid is not a naturally occurring nutrient
D. Human tissues can synthesize folic acid
C.
Dysbiosis is a risk factor for all of the following nutrient depletions, except:
A. Vitamin B12
B. Vitamin D
C. Vitamin K2
D. Biotin
B.
Plasma levels of which compounds becomes elevated as a sign of failure in the methyl group supply pathways?
A. Homocysteine
B. Glycine
C. Betaine
D. Glycine
A.
Supplementation of which conditionally essential nutrient would be indicated is laboratory testing showed blood sugar dysregulation, and low levels of lactate and pyruvate?
A. Ubiquonoine
B. Threonine
C. Glycine
D. Alpha-lipoid acid
D.
Human tissue production of which conditionally essential nutrient consumes the greatest fraction of daily active methyl groups?
A. Carnitine
B. Creatine
C. Ubiquinone
D. Lipoic acid
B.
Mitochondrial deficiency of which compound is considered a cause of chronic oxidative stress due to the generation of superoxide radicals?
A. Choline
B. Glycine
C. Ubiquinone
D. Creatine
C.
Which of the following compounds participates in fatty acid transport across the mitochondria membranes?
A. Choline
B. Carnitine
C. Ubiquinone
D. Creatine
B.
Finding low levels of which amino acid in plasma is a marker of potential poor methylation status?
A. Aspartate
B. Proline
C. Glycine
D. Glutamine
C.
What compound is produced as a immediate product when methyltransferase enzymes carry out their reactions?
A. NADPH
B. SAH
C. Hydroxylated fatty acid
D. Alpha-ketoisovalerate
B.
A person with insufficient ability to synthesize carnitine is likely to have elevated levels of which biomarker?
A. Citrate
B. Suberate
C. Methylmalonate
D. Alpha-Hydroxyisovalerate
B.
** What organ failure most directly causes multiple low trace elements to be found in the blood and urine
A. Pancreas
B. Liver
C. Stomach
D. Kidney
C.
Which mineral is integral in immune function as well as GI integrity?
A. Iron
B. Selenium
C. Zinc
D. Magnesium
C.
** Why does direct testing of calcium in body fluids fail to reveal nutritional status?
A. Strong mechanisms assure ionic calcium levels in calcium deficiencies
B. Other elements interfere with the measurement of calcium in body fluids
C. Calcium presents at levels too low to detect in body fluids
D. Calcium levels in body fluids change too rapidly to allow interpretations of calcium balance
A.
Which of the following is NOT useful for assessing iron status?
A. Total iron binding capacity
B. Serum ferritin
C. Transferrin saturation
D. Hair iron concentration
D.
Finding high levels of serum ferritin in an indication of what condition?
A. Copper deficiency
B. Copper excess
C. Iron deficiency
D. Iron excess
D.
A patients which chronic negative calcium balance is expected to have elevated calcium in which specimen?
A. Unchallenged 24 hr urine
B. Whole blood
C. Head hair
D. Erythrocytes
C.
What amino acid accounts for the high metal ion binding capacity of metallothionein?
A. Methionine
B. Glutamic acid
C. Cysteine
D. Histidine
C.
Which amino acid is converted into a neurotransmitter by two sequential hydroxylation reactions requiring tetrahyobiopterin as a cofactor?
A. Glutamic acid
B. Tryptophan
C. Valine
D. Phenylalanine
D.
A pattern of elevated essential amino acids is an early sign of deficiency of what vitamin?
A. Vit A
B. Vit C
C. B12
D. B6
D.
Which medical condition is often found in patients with elevated plasma asymmetric dimethylarginine?
A. Chronic fatigue
B. Maldigestion
C. Hypertension
D. Food allergies
C.
What metabolic process creates the largest demand for amino acids?
A. Neurotransmitter synthesis
B. Hepatic detoxification
C. Protein synthesis
D. Hydrochloric acid production
C.
Which amino acid is a substrate for competing reactions that lead to either a compound that supplied a methyl group or to a compound that supplies protection from oxidative stress?
A. Taurine
B. Homocysteine
C. Asparagine
D. Proline
B
Elevations in the following group of compounds is associated with depletions in vitamins B1, B2, B3, B5, and lipoic acid but NOT B6
A. Branches chain ketoacids
B. GABA
C. Sacrosanct
D. BCAAs
A.
What amino acid is implicated in the balance of both the urea and nitric oxide cycles?
A. Homocysteine
B. Glutamine
C. Arginine
D. Lysine
C.
** What is the principal metabolic outcome of the glycine cleavage system?
A. Protein synthesis
B. Inhibition of the pathway that leads to heme synthesis
C. Generation of 5-10-methylene THF
D. Regeneration of tetrahydrobiopterin
C.
** What fatty acid is part of the structure of the most active endocannbinoids?
AA
DHA 22:6n3 is ?
Docasanhexaenoic acid
Which omega 3 fatty acid tends to become persistently low in patients using fish oil supplements?
ALA (or DGLA)