Past Quiz Questions Flashcards
in a patient with iron deficiency anemia, a clinician would expect which biochemical markers to be low?
ferritin
transferrin saturation
a patient with low hematocrit, high MCV, and normal cobalamin concentration has …
macrocytic anemia
which micronutrient has a sensitive biomarker, meaning the concentration in blood, serum, or plasma is reflective of total body pools?
folate
you are interested in evaluating the calcium intake and status of your patient
what biochemical marker would be most appropriate to measure
24-hour urinary calcium excretion
what marker would you use to help evaluate folate status in a woman with questionable folate intake who is trying to become pregnant?
erythrocyte folate concentration
erythrocyte transketolase activity coefficient is considered the best marker of
thiamin status
what is the best way to assess niacin status
by measuring urinary end products of niacin metabolism
briefly outline/describe the three stages of iron deficiency
list at least two markers that will be low, normal, or elevated for each of the three stages
tissue depletion: decreased ferritin
functional deficiency without anemia: decreased serum ferritin, decreased transferrin saturation, increased erythrocyte protoporphyrin/ZPP, increased serum transferrin receptor
microcytic anemia: decreased hemoglobin and hematocrit, decreased MCV
A physician is concerned about zinc status of a recently admitted patient. The physician asks you if serum zinc is a sensitive marker of zinc status. What do you tell him/her? In your answer, provide a brief definition of what is meant by “sensitive”.
Serum zinc is not a sensitive marker. A sensitive marker is able to correctly reflect the stores that are in the body. In the case of serum zinc, when zinc levels in the body are so low that a deficiency is present, it will be reflected in the labs. However, if the labs are within normal levels but slightly high or low, it is not super reflective of the body stores.
For this reason, a 24-hour urinary collection would be a better indicator of zinc status to determine body stores.
what is the best biochemical marker of vitamin D status
serum 25(OH)D
pale conjunctivae is associated with a deficiency of
iron
a patient with a history of lactose intolerance reports he has been trying to follow a ketogenic diet. He eats a lot of red meat and chicken plus a variety of vegetables including peppers and leafy green vegetables. He also eats nuts and uses butter and vegetable oils liberally. He reports he does not eat bread or other grains, dairy, fruit or fish. Based on this dietary pattern, the patient could be deficient in which of the following nutrients?
riboflavin and calcium
a patient who follows an overly processed American diet that contains red and white meats, processed breads and cereals, cheese and fruit juice with little whole grains, nuts, legumes, vegetables, and fish/seafood might have suboptimal status of …
fiber and magnesium
perifollicular hemorrhages or petechiae may be a sign of
vitamin C deficiency
comment on while it is important to assess the food matrix and cooking techniques when assessing the status of calcium, zinc, iron, and other minerals
It is important to ask your client what methods they are using to prepare and cook their foods, as different methods can change the absorption of micronutrients.
For example, soaking and sprouting certain foods can help increase the absorption of zinc.
what is the bioavailable form of niacin
NADH
what is the bioavailable form of vitamin B6
pyrodoxal phosphate
what is the bioavailable form of vitamin E
alpha tocopherol
what is the bioavailable form of pantothenic acid
coenzyme A
what is the bioavailable form of riboflavin
FADH
what is the bioavailable form of folate
tetrahydrofolate
__ are found in nuts, whole grains, and certain vegetables including swiss chard, spinach, beet greens, sweet potato, and cocoa
they bind many divalent ions including calcium, magnesium, and iron and decrease their absorption
oxalates
dermatitis, diarrhea, and dementia are signs of a
niacin deficiency
the physiological and biochemical effects of a drug or a combination of drugs are termed __ whereas the movement of a drug through the body by absorption, distribution, and excretion is termed __
pharmacodynamics, pharmakinetics
chelation reactions between certain drugs and medications cause
decreased amount of mineral available for absorption
decreased absorption and action of the drug/medication
which of the following is not an example of pharmacogenomics?
a) Those with glucose-6-phosphate dehydrogenase deficiency are sensitive to hemolytic anemia after consuming fava beans, aspirin or high doses of vitamins C and K
b) Tetracycline is more likely to be ineffective in teenagers who drink a lot of milk
c) Asian Individuals are more likely to have low activity of hepatic acetyl transferase than Caucasians
d) Different activities of cytochrome P450 enzymes can influence drug effectiveness or risk of side effects
e) all of the above are examples
f) None of the above are example
b) Tetracycline is more likely to be ineffective in teenagers who drink a lot of milk
which statement is true concerning the anti-osteoporosis drug Fosamax (and other bisphosphatates)?
A) The medication should not be taken with milk or mineral water because it decreases its action
B) The medication should not be taken with iron supplements because it prevents iron from being absorbed
C) The medication should be taken in the morning on an empty stomach, about 30-60 minutes before breakfast
D) The medication must be taken with folacin, the reduced form of folic acid, to prevent macrocytic anemia
C) The medication should be taken in the morning on an empty stomach, about 30-60 minutes before breakfast
Grapefruit juice cannot be taken with a number of specific medications including certain central-nervous system drugs, immunosuppressants, cardiovascular drugs and lipid-lowering medications. The reason for this is because a component (furanocoumarin) in grapefruit and Seville oranges_____.
inhibits a specific CYP450 isoenzyme in the intestinal wall that decreases metabolism of these drugs and leads to increased blood concentrations of the drug and possibly toxic effects
Patients on the Parkinson’s drug Levodopa should be instructed to __, particularly in the more advanced stages of this disease
consume protein mostly in the evening meal to ensure optimal absorption of the medication
A hospital patient had a serum albumin concentration of 2.9 mg/dL. The patient is stabilized and adequately hydrated. If the physician prescribes Warfarin at the standard dose, this patient ___.
May be at risk for drug toxicity
GFR is lower in women compared to men. These physiological difference can account for sex-related differences in drug clearance. T/F?
true
Please list two other differences between men and women that may account for sex-related differences in drug metabolism and/or drug distribution
Women typically have lower body weight/fat and volume distribution. This means that at the same dosage, the woman might have higher concentrations when compared to a male because she is smaller in general. This could lead to drug toxicity or stronger effects than predicted.
Women also have decreased activity of cytochrome CYP450 enzymes, specifically CYP3A4. This means that they do not have as many active enzymes to metabolize the drug and inactivate it in the GI tract. This could lead to higher concentrations in the blood, and it could result in toxicity.
