Practice Final Qs Flashcards

1
Q

In what situations would you expect the renin angiotensin system to be activated?
A. low blood pressure
B. low extra-cellular fluid volume
C. low plasma Na+
D. all of the above

A

D. all of the above

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2
Q

Which of the following is NOT an environmental factor that influences energy intake?
A. food availability
B. leptin
C. portion sizes
D. dietary diversity
E. food composition

A

B. leptin

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3
Q

Obesity class II is defined as a BMI of…
A. 30-35
B. 35-39.9
C. 40-45
D. >45

A

B. 35-39.9

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4
Q

Why might sugar-sweetened beverages, such as soft drinks, be associated with increased risk
for weight gain?
A. People may drink more soft drinks due to their addictive properties
B. The soft drinks replace water in fluid consumption, making GI tract function slower
C. Soft drinks may replace water consumption, leading to dehydration and
compensatory over eating
D. People are often not aware of the kcal they are drinking, so they do not compensate
by eating less
E. Soft drinks do not contain fiber, which makes the emptying of the GI tract faster

A

D. People are often not aware of the kcal they are drinking, so they do not compensate
by eating less

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5
Q

Which of the following is TRUE:
A. BMI is not used as an indicator for children, as adiposity in childhood does not correlate with adiposity in adulthood
B. BMI-for-age percentiles are used to assess adiposity in childhood, with ≥ 85th percentile considered overweight and ≥ 95th percentile considered obese
C. BMI-for-age percentiles are used to assess adiposity in childhood, with ≥ 75th percentile considered overweight and ≥ 85th percentile considered obese
D. In children under the age of 19 yrs, a BMI of 23 kg/m2 is considered overweight,
regardless of age

A

B. BMI-for-age percentiles are used to assess adiposity in childhood, with ≥ 85th percentile considered overweight and ≥ 95th percentile considered obese

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6
Q

Which of the following are modifiable risk factors for diabetes? Choose all that apply:
A. pre-diabetes
B. age
C. obesity
D. physical inactivity
E. certain ethnicities
F. family history of diabetes

A

A. pre-diabetes
C. obesity
D. physical inactivity

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7
Q

Mr. Rich has had his glycated hemoglobin level measured twice. The doctor said it is significantly elevated. Based on this you would classify Mr Rich as:
A. Having anemia
B. Having coronary heart disease
C. Having diabetes

A

C. Having diabetes

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8
Q

______ are the cells involved in bone formation.
A. osteoclast
B. osteoblast
C. trabecular
D. cortical
E. A & B are correct

A

B. osteoblast

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9
Q

The development of the “fetal origins hypothesis” has been attributed to:
A. Barker
B. Agouti
C. Baker
D. World Health Organization
E. American Society of Obstetrics
F. Health Canada

A

A. Barker

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10
Q

An infant born with a low birth weight….
A. weighs <3.5 kg at birth
B. may be small for its gestational age (SGA)
C. is at decreased risk of death in first year
D. is also preterm (<37 weeks)

A

B. may be small for its gestational age (SGA)

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11
Q

According to the fetal origins of adult disease hypothesis, which of the following
may lead to increased risk of chronic disease in the offspring?
A. maternal deficiency of B vitamins
B. inadequate maternal intake of protein and essential amino acids
C. maternal over-nutrition
D. maternal under-nutrition
E. gestational diabetes
F. all of the above

A

F. all of the above

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12
Q

Which of the following statements is correct?
A. Probiotics are substrates for gut bacterial fermentation.
B. Short-chain fatty acids formed during gut bacterial fermentation affect the brain function
and as such regulate appetite and metabolism.
C. Methyl donor deficient diet leads to dysmorphic small intestinal crypts but does not
affect diversity of gut microbiota.
D. Non-fermentable fiber increases production of short-chain fatty acids by gut bacteria

A

B. Short-chain fatty acids formed during gut bacterial fermentation affect the brain function
and as such regulate appetite and metabolism.

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13
Q

. The leading cause of deaths in Canada is:
A. Heart disease
B. Cancer
C. Diabetes
D. Accident and suicide
E. Respiratory diseases

A

B. Cancer

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14
Q

Which of the following statements appropriately describes the difference between benign and
malignant tumors?
A. Benign tumor cells cannot invade and spread to other parts of the body like malignant
tumor cells do
B. Benign tumor cells cannot proliferate as fast as malignant tumor cells
C. Benign and malignant tumor cells can proliferate and spread to other parts of the body at
a similar rate
D. Only malignant tumor cells bear gene mutations

A

A. Benign tumor cells cannot invade and spread to other parts of the body like malignant
tumor cells do

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15
Q

Vitamin D and _________ complex binds to ____________ and regulates _____________ ,
which is a possible mechanism of protective effects of Vitamin D in cardiovascular disease.
A. Vitamin E, DNA, gene expression
B. receptor, DNA, gene expression
C. receptor, cell surface, cellular uptake
D. Vitamin E, cell surface, cellular uptake

A

B. receptor, DNA, gene expression

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16
Q
  1. Ketogenic diet contains 75% of ___________ and only 5% of ___________ and is approved in
    treatment of ___________.
    A. Fats, carbohydrates, epilepsy
    B. Proteins, carbohydrates, epilepsy
    C. Proteins, carbohydrates, Alzheimer
    D. Fats, proteins, Alzheimer
A

A. Fats, carbohydrates, epilepsy

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17
Q

T/F: Hypertension is a global health concern

A

True

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18
Q

T/F: There is good evidence that sodium intakes are directly related to blood
pressure.

A

True

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19
Q

T/F: Visceral fat is more harmful than subcutaneous fat.

20
Q

T/F: J-shaped association between sodium intake and cardiovascular disease or
death has been shown in many studies.

21
Q

T/F: Obesity increases risk for multiple chronic diseases, including hypertension, type 2 diabetes, heart disease and stroke, some types of cancers, osteoarthritis,
sleep apnea, reproductive problems, gall stones and non-alcoholic fatty liver.

22
Q

T/F: Ghrelin is a peptide that inhibits appetite.

A

False, Ghrelin is a hormone that stimulates appetite, so called “hunger hormone” released by the
stomach.

23
Q

T/F: A high fat diet may be associated with increased risk of type 2 diabetes

A

False, The type of fat (quality of fat) in the diet may be more important than the total amount of fat

24
Q

T/F: Osteoporosis increases risk for fractures, particularly in hip, spine and
leg.

A

False, False – hip, spine and wrist (trabecular bones with fast turnover)

25
T/F: Cortical bone is spongy bone.
False. Trabecular bone = spongy bone
26
T/F: Bone remodeling primarily occurs in childhood and adolescence.
False- occurs throughout lifespan. Bone MODELLING occurs mainly in development.
27
T/F: The fetal origins hypothesis suggests that maternal under/over or imbalanced nutrition in pregnancy can lead to increased risk of low birth weight infants
False: Maternal under/over or imbalanced nutrition may lead to increased risk of chronic disease later in life
28
T/F: Studies on the Dutch famine (Hongerwinter) showed that the timing of nutritional insults during pregnancy do not influence the likelihood of developing chronic disease later in life.
False – does influence. Effects appear to be greatest when nutritional insults occur early in pregnancy (1st trimester)
29
T/F: BRCA1 is an oncogene that drives breast cancer development
False, It is a tumor suppressor gene.
30
T/F: Dietary cholesterol does not seem to have a major influence on serum cholesterol.
True
31
T/F: Stilbenoid polyphenols modify gene expression through epigenetic mechanisms which may explain their anti-oxidant and anti-inflammatory properties.
True
32
T/F: Adding “lean microbes” to mice transplanted with “obese microbes” DOES NOT prevent weight gain.
False, it does prevent weight gain
33
What are the 5 recommendations for prevention of hypertension?
Avoid high sodium diet Increase potassium intake Do not overconsume alcohol Exercise to maintain healthy body weight Apply DASH dietary pattern (Dietary approaches to stop hypertension)
34
The DASH diet is often recommended to reduce blood pressure and decrease risk of hypertension. Describe the 4 characteristics of DASH diet.
DASH dietary pattern (Dietary approaches to stop hypertension): * Emphasizes vegetables, fruits, and fat-free or low-fat dairy products * Includes whole grains, fish, poultry, beans, seeds, nuts, and vegetable oils * Limits sodium, sweets, sugary beverages, and red meats * Consistent with dietary habits associated with reduced risk for chronic conditions such as cancer, heart disease, osteoporosis, etc.
35
Describe two ways in which sodium intake can be measured. For each list one strength and three possible limitations.
Estimating dietary sodium intake: * Dietary estimates (Dietary recalls/records, FFQ) * Urinary sodium excretion (approximates dietary intake, urinary collection at one time point or over 24 hrs) Potential limitations (errors of intake estimation): 1. Dietary sodium * Over/underestimate portion sizes * Missed addition of salt/condiments at table * Differences in sodium content of similar foods * Accurate database for sodium content of foods * Single recall may not be representative of usual intakes 2. Urinary excretion * Medical condition * Incomplete collection * Hydration * High participant burden (may lead to drop-outs) * Differences in losses in sweat & feces * Lab error * Day to day variation * Modifying intake because know being measured
36
Name three factors that might influence an individual’s blood pressure response to a reduced sodium diet.
Sodium “response” depends on: * current blood pressure * age * race * potassium intake * renin-angiotensin-aldosterone system
37
What might be some of the advantages and limitations of using BMI to determine someone’s weight status (healthy, overweight, obese)? What other measures could be used?
Advantages: easy to do, provides quick proxy for adiposity/weight status, does not require special equipment Limitations: does not give measure of weight distribution, may not accurately reflect risk for health problems (eg. An athlete with a high BMI may not actually be at increased risk for disease). Some studies suggest current cutoffs may not be most appropriate (BMI cutoffs not related to mortality). Waist circumference: an alternative measure and better predictor of visceral fat; was shown to correlate with risk of heart disease, hypertension and type 2 diabetes.
38
. How is diabetes diagnosed? (Describe 3 methods)
1. Fasting plasma glucose level 2. Oral glucose tolerance test: within 2 hr post glucose consumption 3. Glycated hemoglobin A1C: reflects blood glucose levels within last 2-3 months
39
. What is a relative risk and what is a 95% confidence interval?
Relative risk (RR): Likelihood that outcome occurs in exposed group compared to unexposed group 95% confidence intervals (CI): a range of values we are fairly sure our true value lies in. RR is statistically significant when CI does NOT include 1.0.
40
Briefly, define diabetes and discuss the differences between type 1 and type 2 diabetes
Diabetes: Metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion, defective insulin action or both  Type 1: autoimmune disease leading to destruction of beta-cells of pancreas, impairs insulin secretion (no, or very little, insulin is produce)  Type 2: insulin resistance/insensitivity – cells do not respond to insulin. May lead to impaired insulin secretion
41
How is osteoporosis diagnosed in postmenopausal women?
Bone density is obtained through DXA (dual energy x-ray absorptiometry) * “T-score” is calculated by comparing the result to the distribution of bone density in healthy young women * If T-score is between -1 and -2.5: osteopenia * If T-score is ≤-2.5: osteoporosis
42
Explain how vitamin D is related to calcium and implications of low vitamin D or low calcium intakes for bone health.
Vitamin D is important for increasing serum calcium levels. Vitamin D a. Increases calcium reabsorption in kidney b. Increases calcium absorption in intestine c. Increases resorption of calcium (demineralization) from bone With inadequate vitamin D intakes, calcium absorption and reabsorption will be lower, and therefore less calcium will be available for bone. With inadequate calcium intakes, vitamin D will “steal” calcium from bone to maintain serum calcium levels. Thus, adequate intakes of both calcium and vitamin D are important for bone health.
43
What is the difference between "developmental plasticity" and "programming"?
Developmental plasticity: particular genotype may produce different phenotypes, depending on environmental exposures  Organs and systems adapt to cues (Epigenetics) Programming: stimuli in early development lead to changes that are permanent (persist across lifespan) (Epigenetics)
44
What is the three-stage process of carcinogenesis? Please list the stages and explain briefly.
1. Initiation: ranges from minutes to days (short) - Cancer causing agent - No DNA repair, impaired regulation of apoptosis 2. Promotion: may last months or even years - Altered DNA leads to changes in gene expression, protein function, etc. - Cell proliferates in uncontrolled way - Alcohol, estrogen in breast tissue, Helicobacter pylori in the stomach, HPV in cervix may act as promoters 3. Progression - Malignant cells invade surrounding tissue and metastasize to other sites
45
. Please define “epigenetics” and list epigenetic components. How does epigenetics differ from genetics?
Epigenetics – stable changes in gene expression that do not involve changing the DNA sequence (no change in genetic code). Components of the epigenome include: DNA methylation, histone covalent modification, chromatin modifying complexes and non-coding RNA mechanisms. Genetics – the DNA code/sequence (eg. sequence of A, C, G & T). Epigenetics can be modified by environmental factors and differs between different cell types and different organs. The genetic code is not altered (except in some cases involving mutation of DNA, for example in cancer), and the genetic code is same in all cells of the body that have DNA.
46
. Please list and briefly describe four main stages of atherosclerotic plaque formation
LDL transport cholesterol to cells. If LDL is not taken up by cells – keeps circulating in blood. The longer LDL circulates in blood, the more likely it is oxidized. Oxidation of LDL is followed by the following steps leading to atherosclerosis development: - uptake by macrophage - foam cell formation - formation of fatty plaques - narrowing of blood vessel (may include rapture of the plaque and thrombus) that can lead to myocardial infarction (MI)
47
T/F: “Diet-Heart Hypothesis is too simplistic to reflect causes of coronary heart disease”. Please briefly justify your answer by defining Diet-Heart hypothesis and listing at least 4 other factors that can OR cannot contribute to coronary heart disease.
Diet-Heart Hypothesis: according to the classic ‘diet‐heart’ hypothesis, high intake of saturated fats and cholesterol and low intake of polyunsaturated fats increase the level of serum cholesterol, which leads to the development of atheromatous plaques. Accumulation of these plaques narrows the coronary arteries, reduces blood flow to the heart muscle and finally leads to myocardial infarction. Factors other than blood cholesterol are important in the etiology of CHD. * Lipoprotein(a) * Saturated fats/PUFA/n-3 fatty acids (fish oils) * Glycemic index * Whole grains/Fiber * Anti-oxidants * Phytochemicals * Vitamin D * Magnesium * Alcohol * B vitamins- folate, B6, B12