PCM

Question 1

name the deficiency: required for synthesis of opsin and conversion of retinol to retinal; deficiency will compromise visual cycle; may resuult in corneal edema conjunctivitis and xerosis

Answer 1

zinc deficiency

Question 2

name the def: contributes to age-related macular degeneration, leading cause of registered blndess in western pop. _______ lower in smokers. ___________ can’t be synth. by body, dietary intake in green leafy vegetables, orange/yellow fruits and veggies and in breast milk

Answer 2

lutein deficiency

Question 3

name the 3 vitamins required for glutathione

Answer 3

niacin, riboflavin and vitamin C

Question 4

cataracts are more common in what populations?

Answer 4

low income groups
smokers
those exposed to direct sunlight

Question 5

________ important for the integrity of conjunctiva; deficiency results in blockage of sebaceous glands of the eyelids

Answer 5

riboflavin

Question 6

_______ deficiency causes deficiency of the EOMS?

Answer 6

thiamine

Question 7

__________ deficiency causes demyelination of optic nerve (seen in heavy smokers and drinkers, and in tapeworm)

Answer 7

vitamin B12 deficiency

Question 8

disease that has cholesterol deposits within the cornea

Answer 8

familial hypercholesterolemia

Question 9

most rapid period of brain growth occurs from mid gestation at 20 wks to __________ months after birth

Answer 9

18 months

Question 10

the transporter that moves glucose across the BBB is not responsive to what?

Answer 10

insulin

Question 11

__________ ingestion reduces glucose transport into the brain, which contributes to the depressive effect of alcohol on the CNS

Answer 11

alcohol

Question 12

during starvation, brain adapts to use of ketone bodies derived from fat breakdown for energy, by inducing what?

Answer 12

by inducing a ketone body transporter across the BBB

Question 13

ketones can be elevated by ___________ diet, used by some to treat seizures as they are believed to reduce neuronal excitability esp. in children

Answer 13

ketogenic diet (high in fat)

Question 14

_______ proteins are resistant to digestion

Answer 14

most

Question 15

how many essential amino acids are there?

Answer 15

9

Question 16

energy used in protein synthesis accounts for ________ % of basal metabolic rate

Answer 16

12%

Question 17

there is no functional store of ________

Answer 17

amino acids

Question 18

the carbon skeleton of amino acids is converted to what two things with release of ATP (esp. in liver)

Answer 18

CO2 and water

Question 19

term that provides an indication of how BG levels change after ingesting different carbs

Answer 19

glycemic index

Question 20

name foods with high glycemic index

Answer 20

bread
rice
bananas
glucose
sucrose
soft drinks
raisins
honey

Question 21

low glycemic index

Answer 21

apples
grapefruit
peaches
plums
beans
milk
yogurt
ice cream
fructose
tomato soup

Question 22

____________ in large intestine is acted upon by bacterial flora, process of fermentation releases short-chain fatty acids

Answer 22

soluble fiber

Question 23

proprionic and acetic acids are metabolized in the ________

Answer 23

liver

Question 24

_____________ is used by gut colonocytes as an essential source of energy

Answer 24

butyric acid

Question 25

multiplication of the bacteria flora has what effect on stools?

Answer 25

increases bulk and water content

Question 26

________ reaches the colon unchanged and is not fermented by bacteria

Answer 26

insoluble fiber

Question 27

what is the function of insoluble fiber?

Answer 27

to hold water

Question 28

insoluble fiber together with _____________, the intra-colonic mass is greater and leads to increased peristaltic action which increases speed of movement of the colon contents

Answer 28

large bacterial mass

Question 29

monosaccharides do not require __________ prior to absorption in the small intestine

Answer 29

digestion

Question 30

name the 3 sugar alcohols that are used as sweetening agents in the food industry

Answer 30

sorbitol mannitol xylitol

Question 31

what are the 2 valuable properties of sugar alcohols?

Answer 31

1. absorbed from the gut and metabolized to glucose more slowly, delaying the rise in BG 2. not fermented by mouth bacteria, fewer dental carries; seen in chewing gum

Question 32

term for maladaptive pattern of use w/i a 12 month period manifested by one or more of the following: failure to fulfill major role obligations, use in physically dangerous situations, related legal probs, continued use despite persistent social or personal probs

Answer 32

substance abuse disorder

Question 33

substance dependence disorder dx: maladaptive use leading to 3 or more of the following in a 12 month period (name them)

Answer 33

``` tolerance withdrawal larger amount of substance unable to cut down time spent to obtain substance impaired performance use despite physical and psychological problems ```

Question 34

definition: implies permanent structural changes have taken place in the brain

Answer 34

substance addiction

Question 35

dependence implies ___________ changes

Answer 35

reversible

Question 36

if drug is addictive then it must have the ability to facilitate the ___________ system

Answer 36

dopaminergic-glutamatergic system

Question 37

the change with synaptic plasticity results in increased sensitivity to environmental or ___________ triggers which can overwhelm the pt's motivated conscious desire to abstain

Answer 37

endogenous

Question 38

what do you ask about first when taking a substance abuse history?

Answer 38

ask about socially acceptable first such as caffeine and nicotine

Question 39

what does RAPS4 stand for?

Answer 39

``` Remorse Amnesia Performance Interference Starter/eye opener (more sensitive than CAGE) ```

Question 40

with early intervention technique what is the classic intervention?

Answer 40

to make pt overcome past denial in order for pt to realize their problem

Question 41

what is an example of biochemical feedback intervention?

Answer 41

malmo GGT study

Question 42

the Malmo GGT study screened what pts for increased GGT levels?

Answer 42

moderate drinkers

Question 43

Monthly GGT test for these pts with moderate drinking instead of heavy drinking- successful in ___% fewer days sick or absent from work, ____% fewer hospitalization days and ___% lower mortality in the 4 yr follow up periods

Answer 43

80% 60% 50%

Question 44

what % of people in the US experience an episode of depression in their lifetime

Answer 44

10%

Question 45

what is the ratio of women to men with depression?

Answer 45

2:1 due to increased incidence during the reproductive yrs

Question 46

once established, depression recurs in men and women with _________ frequency

Answer 46

equal

Question 47

regarding depression: after 1st episode __% of pts experience recurrence within 2 yrs unless on maintenance treatment; after 3rd episode, the rate of recurrence is ____%

Answer 47

50% 90%

Question 48

bipolar pts experience more freq. episodes of _____ than mania or hypomania

Answer 48

depression

Question 49

After any bipolar episode, the risk of recurrence increases from ____% at 1 yr to 90% at 3 yrs if mood stabilizing treatment is not continued

Answer 49

50%

Question 50

bipolar disorder may be revealed when ______ or ____ is started for major depression, during first few wks of treatment

Answer 50

SSRI or SNRI

Question 51

what are the 3 major categories of symptoms for PTSD?

Answer 51

intrusion arousal avoidance

Question 52

most typical PTSD for females?

Answer 52

rape or family violence

Question 53

most typical PTSD etiology for males?

Answer 53

PTSD after combat or accidence

Question 54

what is the status of urinary cortisol and NE in pts with PTSD?

Answer 54

low urinary cortisol and high NE

Question 55

are men or women more likely to develop PTSD?

Answer 55

women

Question 56

symptoms for somatoform disorders must begin prior to age _____

Answer 56

30 yrs

Question 57

what is a screening test for somatoform disorders? also: often have comorbidities and family hx

Answer 57

PHQ13

Question 58

what is the ratio of men to women with body dysmorphic disorder?

Answer 58

EQUAL