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CNS NH 2021 > Primer - all sections > Flashcards

Primer - all sections Flashcards

1
Q

Chief cells of the stomach secrete…

Lipase
Pepsinogen
Intrinsic factor
Glycoproteins

A

Lipase

Pepsinogen

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2
Q

Parietal cells of the stomach secrete….

Lipase
Pepsinogen
Intrinsic factor
Glycoproteins

A

Intrinsic factor

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3
Q

Mucous cells of the stomach secrete…

Lipase
Pepsinogen
Intrinsic factor
Glycoproteins and bicarbonate

A

Glycoproteins and bicarbonate

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4
Q

Roles of gastric acid

Destruction of microorgs
Activation of pepsinogen to pepsin
Activation of IF
Denaturation of macromolecules
Faciliation of breakdown of protein and polypeptides by pepsin
A

All of the above

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5
Q

Roles of gastrin

Acts on chief and parietal cells to stimulate HCl and pepsinogen
Stimulates gastric peristalsis

A

Both

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6
Q

Order of small intestine sections

Jejunum, short duodenum, ileum
Short duodenum, jejunum, ileum
Ileum, jejunum, short duodenum

A

Short duodenum, jejunum, ileum

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7
Q

Cholecystokinin stimulates…

Pancreatic secretion of zymogens
Gallbladder contraction
HCl release
A and B

A

A and B

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8
Q

Zymogens are

Active digestive enzymes
Inactive enzyme precursors / -ogens
Another name for bile

A

Inactive enzyme precursors

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9
Q

All of the following are zymogens except

Trypsinogen
Proelastase
Chymotrypsinogen
Procolipase
Procarboxypeptidase A and B
None of the above - all are
A

All are

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10
Q

What is the role of bicarbonate (pancreatic)?

Buffers HCl into strong base
Buffers HCl into weaker acid
Makes HCl into stronger acid

A

Buffers HCl into weaker acid

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11
Q

Salivary amylase works best at what pH?

8-8.5
3-4.5
1.5-3.5
6.75-7

A

6.75-7

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12
Q

Pepsin and lipase work best at what pH?

8-8.5
3-4.5
1.5-3.5
6.75-7

A

1.5-3.5

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13
Q

What are micelles?

Sppherical clusters of bile salts
Collections of lipid soluble dietary subcomponents surrounded by water soluble bile salts

A

Both

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14
Q

T/F: Most of the bile salts excreted into the intestine are reabsorbed in the ileum and the salts are transported back to the liver via enterohepatic circulation.

A

T

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15
Q

Which mechanism of nutrient absorption uses the energy of diffusion through a semi permeable membrane from higher to lower osmotic pressure?

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Osmosis

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16
Q

Which mechanism of nutrient absorption uses hydrostatic pressure to drive the movement of solutes and water through a semipermeable membrane from higher to lower hydrostatic pressure?

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Filtration

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17
Q

Which mechanism of nutrient absorption uses the potential energy created by a difference in nutrient concentration across a membrane to move nutrients from an area of higher to lower concentration?

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Passive diffusion

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18
Q

Which mechanism of nutrient absorption uses the potential energy created by a difference in nutrient concentration across a membrane to move nutrients from an area of higher to lower concentration? Even if attached to a lipid soluble membrane carrier protein?

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Facilitated diffusion

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19
Q

In which mechanism of nutrient absorption does a nutrient move through mucosal cell membranes against a concentration gradient?

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Active transport

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20
Q

Most amino acids are absorbed via…

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Active transport

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21
Q

Most lipid soluble compounds are absorbed via…

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Passive diffusion

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22
Q

Most carbs are absorbed via…

Passive diffusion (simple diffusion)
Facilitated diffusion (carrier-mediated transport)
Osmosis
Active transport (solute pumping)
Filtration
A

Facilitated diffusion

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23
Q

GALT accounts for how much of the total number of immune cells in the body?

10-20%
30-40%
50-60%
80-90%

A

50-60%

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24
Q

GALT provides which immunity via secretion of IgA?

cell-mediated
humoral
both

A

both

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25
Q

Cell mediated immunity is …. while humoral immunity is ….

antibodies via plasma cells…T lymphocytes
T lymphocytes…antibodies

A

B

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26
Q

T/F: Urinary excretion of high lactulose - with normal, hight, or low mannitol - indicates small intestinal permeability

A

T

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27
Q

Glutathione synthesis

A

Homocysteine -> cystathione -> cysteine // cysteine + glutamate -> y-glutamylcysteine // y-glutamylcysteine + glycine -> glutathione

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28
Q

What amino acid is the primary source of fuel for enterocytes?

Glycine
Glutathione
Glutamine
Glutamate

A

Glutamine

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29
Q

Which of the following does glutamine inadequacy not result in?

Thinnig of villi and decreased digestive function
Decreased absorptive function
Loss of intestinal barrier integrity
Increased translocation of antigens and pathogens from lumen into extracellular fluid and blood
None of the above

A

None

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30
Q

Parts / order of the large intestine

Ascending colon > transverse colon > descending colon > sigmoid colon

descending colon > transverse colon > ascending colon > sigmoid colon

Ascending colon > sigmoid colon > descending colon > transverse colon

Ascending colon > descending colon > transverse colon > sigmoid colon

A

Ascending colon > transverse colon > descending colon > sigmoid colon

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31
Q

Which is NOT a major function of the large intestine?

Digest protein
Reabsorb water from digesta
Absorb vitamins produced by intestinal bacteria
Ferment dietary fiber
Elimination
A

Digest protein

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32
Q

T/F: the following are examples of SOLUBLE fiber:

beta glucans, gums, mucilages, pectins, hemicellulose

A

T

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33
Q

T/F: the following are NOT examples of INSOLUBLE fiber:

celluloses, lignins, hemicellulose

A

F

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34
Q

Non fermentable fiber includes which of the following

oat hulls
methylcellulose
wood pulp cellulose
mucilages

A

A, B, C

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35
Q

T/F: Lactobacilli comprise about 50% of all intestinal microflora and ferment dietary fiber carbs to SCFAs

A

F - Bifidobacteria

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36
Q

T/F: Bifidobacteria suppress growth of pathogenic species by maintaining a slightly acidic colonic pH

A

T

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37
Q

Lactobacilli ferment dietary fiber carbohydrates to ____ and SCFAs

A

Lactic acid

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38
Q

Saccharomyces boulardii is / does all except

is antagonistic to candida albicans
stimulates enterocyte secretion of brush border enzymes
relieves constipation
stimulates GALT production and sIgA

A

relieves constipation

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39
Q

Butyrate is metabolized to … within colonocytes

propionate
acetate
acetyl CoA
SCFAs

A

acetyl CoA

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40
Q

Which SCFA is required for the formation and maintenance of tight junctions?

acetate
propionate
butyrate

A

butyrate

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41
Q

In breastfed infants, over ___ of intestinal bacteria consist of Bifidobacterium infantis.

50%
65%
80%
90%

A

90%

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42
Q

Wheat, onion, asparagus, chicory, banana, and artichoke are common sources of prebiotic ____

fructans
oligofructoses
probiotics

A

fructans

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43
Q

T/F: Fructooligosaccharides (FOS) are specifically fermented to SCFAs by Lactobacilli and are converted to lactic acid

A

F - Bifidobacteria and are NOT converted to lactic acid

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44
Q

How does acetylcholine impact digestion?

intestinal smooth muscle contraction
squeezes food and fluids along the GI tract
stimulates release of enzymes
All

A

All

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45
Q

The ability to digest dietary starches and animal fats is minimal until about how old?

4 months
6 months
1 year
5 years

A

6 months

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46
Q

Most iron is transported in the blood via the plasma carrier:

a. heme.
b. erritin.
c. transferrin.
d. albumin.

A

transferrin

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47
Q

A required prerequisite to the digestion of proteins is the HCl-dependent process called:

a. hydrolysis.
b. evaporation.
c. denaturation.
d. distillation.

A

denaturation

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48
Q

The true digestibility of dietary fatty acids is:

a. 65% to 75%.
b. 75% to 85%.
c. 85% to 95%.
d. > 95%.

A

95%

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49
Q

An example of a digestive enzyme secreted from the brush border of microvilli
to help with digestion is:

a. sucrase
b. protease
c. amylase
d. hydrochlaoric acid

A

sucrase

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50
Q

Insulin…

acts to stimulate glucose uptake by GLUT4 transporter in monocytes and adipocytes
acts to stimulate glycogenesis in hepatocytes and myocytes
glycolysis
adipocyte lipoprotein lipase activity (increases triglyceride storage in adipocytes)
amino acid uptake and protein synthesis in the liver and muscle
inhibits glylcogenolysis and gluconeogenesis (decreasing lipolysis of stored triglycerides)

A

ALL

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51
Q

Glucagon

secreted when decreased plasma glucose concentration by a-cells
acts to stimulate hepatic glycogenolysis
stimulates gluconeogenesis from AAs

A

ALL

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52
Q

The formation of GLYCOGEN from GLUCOSE is…

Glycolysis
Glycogenesis
Gluconeogenesis
Glycogenolysis

A

Glycogenesis

when high amount of glucose and ATP present / storage in muscle and liver

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53
Q

The conversion of glycogen (from liver and muscles) is converted to Glucose-1-phosphate then into glucose-6-phosphate during low blood glucose or stress…

Glycolysis
Glycogenesis
Gluconeogenesis
Glycogenolysis

A

Glycogenolysis

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54
Q

The process of synthesizing glucose from non-carb sources with a starting point of pyruvic acid, lactic acid, etc. is called…

Glycolysis
Glycogenesis
Gluconeogenesis
Glycogenolysis

A

Gluconeogenesis

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55
Q

First step in breaking down glucose for energy for cellular metabolism…

Glycolysis
Glycogenesis
Gluconeogenesis
Glycogenolysis

A

Glycolysis

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56
Q

Ghrelin vs leptin

A

ghrelin stimulates food intake / leptin signals satiety

inflammation can cause leptin resistance

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57
Q

Adiponectin

enhances insulin sensitivity
reduces insulin sensitivity
enhances glucose homeostasis
reduces glucose homeostasis
A and C
B and D
A

A and C

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58
Q

T/F: Monosaccharides (in carbs) contain either 5 carbons or 6 carbons

A

T

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59
Q

Common disaccharides (two monos joined together) include all of the following except:

lactose
fructose
maltose
sucrose

A

fructose

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60
Q

Glycogen, starch, and fiber are examples of…

Monosaccharides
Disaccharides
Polysaccharides
Fructose

A

Polysaccharides

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61
Q

___ are composed of monosaccharide units joined together by glycosidic bonds while ____ are long chain oligosaccharides that contain 2+ monosaccharides linked together in a repeating pattern

Polysaccharides, oligosaccharides
Oligosaccharides, polysaccharides
Disaccharides, polysaccharides
Polysaccharides, disaccharides

A

Oligosaccharides, polysaccharides

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62
Q

With AAs, ___ structures are determined by cross-linking of some of the AAs within the proteins, while ___ structures are determined by physico-chemical interactions between the AAs and surrounding water that result in precise folding into characteristic 3d conformations

Primary, secondary
Primary, tertiary
Secondary, tertiary
Tertiary, secondary

A

Secondary, tertiary

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63
Q

All of the following are conditionally essential AAs except…

Arginine
Lysine
Cysteine
Glutamine
Tyrosine
A

Lysine

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64
Q

Essential AAs

A 
Arginine
Histidine
Isoleucine
Leucine
Lysine
Methionine
Phenylalanine
Threonine
Tryptophan
Valine
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65
Q

Non essential AAs

A 
Alanine
Asparagine
Aspartic acid
Cysteine
Glutamic acid
Glutamine
Glycine
Proline
Serine
Tyrosine
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66
Q

BCAAs

A

Isoleucine
Leucine
Valine

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67
Q

T/F: Saturated FA have two double bonds

A

F

no double bonds

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68
Q

The most important MUFA is

stearic acid
palmitic acid
oleic acid
linoleic acid

A

oleic acid

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69
Q

Sources of palmitic acid (saturated FA) include all but:

coconut oil
olive oil
palm oil
palm kernel oil

A

olive oil

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70
Q

Sources of ___ include olive, almond, avocado, peanut, fibert, canola, pecan, and macadamia nut oils

MUFA
SFA
PUFA

A

MUFA

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71
Q

PUFAs contain ____ double bond(s)

one
more than one
more than 3
zero

A

more than one

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72
Q

PUFAs include all but the following:

linoleic acid
linolenic acid
oleic acid
omega 3s - EPA and DHA

A

oleic acid

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73
Q

SCFAs contain ___ carbon atoms while MCFAs contain ___ and LCFA contain ____

<3; 5-10; >14
< 6; 7-12; >14
< 5; 6-14; >16
>6; 7-12; <14

A

< 6; 7-12; >14

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74
Q

T/F: FAs can be classified by the degree of saturation of their carbon atoms OR their chain length.

A

T

also conformation (cis FAs or trans FAs), structural criteria like triglycerides

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75
Q

T/F: Borage, evening primrose, and black current oils are great examples of arachidonic acid while meats and animal products are good examples of GLAs

A

F

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76
Q

Purines and pyrimidines are examples of ___-containing bases in nucleotides

oxygen
carbon
hydrogen
nitrogen

A

nitrogen

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77
Q

Ribonucleosides of RNA

A

adenosine, guanine, cytidine, uridine

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78
Q

Deoxyyribonucleosides of DNA

A

2-deoxyadenosine
…cytidine
…guanosine
…thymidine

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79
Q

Which is produced in the fermentation of carbs and starches and is an important component of beverages?

acetaldehyde
ethanol
methanol
xylitol

A

ethanol

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80
Q

What is the end product of glycolysis?

acetate
pyruvate
butyrate
b-hydroxybutyrate

A

pyruvate

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81
Q

T/F: acetate is a SCFA produced from pyruvatee and during beta-oxidation of FAs

A

T

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82
Q

___ is a dietary organic acid that binds calcium very tightly and is found in many veggies like spinach, beet, greens, parsley.

A

Oxalate

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83
Q

T/F: Lipophilic vitamins require facilitated transport through membranes

A

F - hydrophilic ones do

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84
Q

Decreased plasma glucose levels stimulate ______ secretion by pancreatic alpha cells.

a. Insulin
b. Glucagon
c. Glucocorticoids
d. Epinephrin

A

glucagon

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85
Q

The hormone that is synthesized in adipose tissue and signals satiety is:

a. adiponectin
b. glucagon
c. leptin
d. ghrelin

A

leptin

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86
Q

The C677T base substitution in the gene that synthesizes the enyzyme methyl-
tetrahydrofolate reductase is a genetic abnormality called:

a. a base substitution
b. a genetic anomaly
c. a single nucleotide polymorphism
d. an epigenetic phenomena

A

SNP

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87
Q

The structures of linoleic acid and gamma-linolenic acid differ in their:

a. chain lengths.
b. double bond positions.
c. numbers of double bonds.
d. side chain moieties.

A

number of double bonds

18: 2ω6 - 18 carbon bonds, 2 double bonds, double bond in 6th position
20: 3ω6 - 20 carbon bonds, 3 double bonds, double bond in 6th position

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88
Q 
In the polypeptide chain of a protein, the sequential order of the amino
acids is called the:
a. primary structure.
b. secondary structure.
c. tertiary structure.
d. quaternary structure.
A

primary

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89
Q

Vitamin reserves can become depleted because all vitamins are:

a. synthesized inefficiently.
b. essential nutrients.
c. metabolized quickly.
d. excreted rapidly.

A

essential nutrients

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90
Q

___ like carrageenan, dextrin, lecithin, and xanthan gum are used as thickening agents while ____ are used to hold food constituents together and are especially important with dietary supplements and ___ are used to suspend oily material in water.

Stabilizers, binders, emulsifiers
Emulsifiers, binders, stabilizers
Binders, stabilizers, emulsifiers
Stabilizers, emulsifiers, binders

A

Stabilizers, binders, emulsifiers

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91
Q

Fortification vs nutrification vs enrichment

A

Fortification - addition of nutrients to foods without adding back nutrients lost during processing / nutrient may or may not be present in the original food and can be added in greater amounts than original

Nutrification - makes a food more nutritious

Enrichment - adding nutrients BACK into a food that were lost during processing

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92
Q

Difference between enzyme and coenzyme

A

Unlike an enzyme, a coenzyme
participates in the reaction by either transferring to the reactants an electron, reduced
proton, phosphate, hydroxyl or methyl group or by accepting such a substance from the
reactants, and must be regenerated.

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93
Q

Difference between coenzyme and cofactor

A

Cofactor - nutrient required by enzyme for full activation of the enzyme. Unlike a coenzyme, a cofactor functions as part of the enzyme and is not consumed by the reaction.

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94
Q

Coenzyme A is derived from:

a. Pantothenic acid
b. Pyrodoxine
c. Cobalamin
d. Tetrahydrobiopterin

A

Pantothenic. acid

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95
Q

Glycolysis is considered a/an ___ process

anaerobic
aerobic

A

anaerobic because oxygen isn’t involved

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96
Q

Glycolysis is energy producing or energy consuming?

A

Energy producing

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97
Q

Which cells lack mitochondria and can’t metabolize pyruvate to CO2?

A

Erythrocytes

so pyruvate is converted to lactate

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98
Q

What is the TCA cycle?

A

Metabolic pathway that oxidizes acetate derived from the acatabolism. of FAs, AAs, and carbs to CO2

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99
Q

The TCA cycle is aerobic or anaerobic?

A

aerobic - requires ability to transfer excess electrons to oxygen molecules via mitochondrial cytochromes (ETC) to regenerate NAD+ and FAD

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100
Q

What is the pentose monophosphate shunt?

A

Alternate ppathway of glucose catabolism that is also involved in the biosynthesis of pentose sugars (like ribose) and NADPH2 through the production of ribulose 5P.

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101
Q

What is gluconeogenesis?

A

glucose synthesized de novo from lactate pyruvate or alanine in the liver (90%) and kidney (10%)

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102
Q

T/F: in general gluconeogenesis is the reverse of glycolysis

A

T

However, 3 irreversible glycolytic enzymes (glucokinase,
phosphofructokinase, and pyruvate kinase) must be bypassed via additional enzymatic pathways
that operate only during gluconeogenesis in order to avoid futile cycling.

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103
Q

Pyruvate kinase catalyzes the irreversible conversion. of PEP to pyruvate and needs to be bypassed in two steps. Describe…

HINT: pyruvate –> oxaloacetate –> phosphoenolpyruvate (PEP)

A

Pyruvate –> oxaloacetate (requires acetylCoA to activate pyruvate carboxylase enzyme (pyruvate carboxylase also requires biotin)

oxaloacetate –> PEP (via PEP carboxylase requires 1 molecule of high energy GTP)

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104
Q

Phosophofructokinase catalyzes the irreversible conversion of fructose 6P to fructose 1,6-PP is bypassed by which enzyme?

A

fructose 1,6-biphosphatase

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105
Q

Glucokinaase catalyzes the irreversible formation of glucose. 6-P is bypassed by which enzyme?

A

glucose 6-phosphatase

produces glucose and inorganic phosphate

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106
Q

Alanine cycle

A

pyruvate aminated to produce alanine
alanine deaminated to reform pyruvate
gluconeogenesis produces glucose from pyruvate and glucose circulated to muscle cells

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107
Q

Cori cycle

A

glucose metabolized to pyruvate and then lactate in muscles

lactate is converted back to pyruvate and then glucose (via gluconeogenesis)

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108
Q

Ketones result from the metabolismof:

a. fatty acids.
b. simple sugars.
c. amino acids.
d. complex carbohydrates.

A

fatty acids

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109
Q

Glycolysis is a metabolic process that involves:

a. glycogen synthesis
b. the conversion of glucose to glycogen
c. the conversion of glucose to pyruvate.
d. the conversion of fatty acids to ATP

A

c. the conversion of glucose to pyruvate.

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110
Q

T/F: the effects of nutrients are dose-dependent and unidirectional.

A

F… curvilinear. relationships between intake and. outcome (hormesis)

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111
Q

What is pharmacokinetics vs pharmacodynamic

A

Pharmacokinetics - absorption, distribution, biotransformation and excretion behavior of an ingested. substance

Pharmacodynamics - describes the functions of a nutrient and the relationships between a nutrient’s concentration in a body fluid or at a tissue site and the biological effects of the nutrient

112
Q

Most nutrients exhibit ____ pharmacokinetics

linear
nonlinear

A

nonlinear - limiting the ability to predict potential beneficial or toxic effects of low or high intakes

113
Q

Bioavailability

A

the extent to which an ingested nutrient reachs its site of physiological action

net bioavail - balance of absorption efficiency, rate of delivery to the site of physiologic action, and relative rates of metaboism and excretion prior to arrival at the site of physiologic action

114
Q

Distribution is…

A

dissemination via circulation into interstitial and intracellular fluids

115
Q

About ___ of ingested non fiber carbs and ___ of absorbed. AAs are taken up and metabolized by hepatocyes, preventing deliver to general systemic circulation

10%; 50-80%
40%; 50-80%
80%; 20-40%
100%; 80-100%

A

40%; 50-80%

116
Q

Biotransformation

A

To increase water solubility and facilitate excretion

often called detoxification reactions, classified as phase 1 and 2 reactions

117
Q

Thermal effect of food

A

INCREASE in energy expenditure that results from the metabolic cost of food digestion and the absorption and processing of ingestednutrients (7-10% of. the energy content of the food consumed)

118
Q

Digestion of dietary protein and absorption of the products. of protein digestion releases ___ of the energy contained in proteins

…with carbs

…with fat

A

Protein - 15-30%
Carbs - 6-8%
Fat - 2-3%

119
Q

Dietary protein requirement during first year of life

  1. 8 g/kg body weight
  2. 0 g/kg body weight
  3. 4 g/kg body weight
  4. 7 g/kg body weight
  5. 0 g/kg body weight
A

1.7

120
Q

Dietary protein requirement at 10 y/o

  1. 8 g/kg body weight
  2. 0 g/kg body weight
  3. 4 g/kg body weight
  4. 7 g/kg body weight
  5. 0 g/kg body weight
A

1.0

121
Q

Dietary protein requirement at 20 y/o

  1. 8 g/kg body weight
  2. 0 g/kg body weight
  3. 4 g/kg body weight
  4. 7 g/kg body weight
  5. 0 g/kg body weight
A

0.8

122
Q

Kwashiorkor is chronic ___ deficiency

Fat
Protein
Vitamin C
B6

A

Protein

123
Q

Vitamin required for decarboxylation of alpha keto acids, transketolase reactions, and conversion of carbs to CO2 and energy

B1
B2
B3
B5
B6
A

B1

124
Q

Thiaminase is…

A

enzyme found in raw seafood, decreasing thiamin content of foods

125
Q

Thiamin deficiency is called

A

beriberi

126
Q

Dry vs wet beriberi

A

dry affects nervous system; wet affects heart and circulation

127
Q

Korsakoff syndrome

A

chronic thiamin deficiency plus alcoholism - mental confusion, memory loss, delusions, amnesia or Wernicke disease (apathy, delusion, delirium)

Can appear concurrently as Wernicke-Korsakoff - alcoholic dementia

128
Q

Riboflavin is a precursor for the synthesis of ___ and is required for the function of ETC and other reduction reactions, oxidation of AAs and FAs, among others

FAD
FAD+
NAD
NAD+
NADH
A

FAD

129
Q

Chronic riboflavin deficiency produces all but the following

chelosis
dermatitis
dementia
glossitis
blurred vision
light sensitivity
eczema on face / genitalia
A

dementia

130
Q

A small amount of niacin is synthesized from which AA?

leucine
valine
tryptophan
tyrosine

A

tryptophan

131
Q

Niacin deficiency produces ____

A

pellagra

132
Q

Intake greater than ___ of niacin inhibits VLDL production and may reduce serum total cholesterol

A

1 g

133
Q

T/F: The bioavailability of folate is markedly increased when ingested as synthetic folic acid

A

T

134
Q

Avidin is found in ___ and inhibits absorption of biotin

A

eggs

135
Q

Dry scaly skin, nausea, anorexia, and seborrhea is found in chronic deficiency of what vitamin

A

biotin

136
Q

Burning food syndrome is found with deficiency of what vitamin?

A

B5 / pantotheni acid

137
Q

___ is essential after conversion (to PLP) for protein and AA metabolism, NT synthesis, immune function, hormone synthesis, heme synthesis, remethylation, etc.

A

B6

138
Q

Remethylation refers to ____ to _____ using B6

A

MTFH + homocysteine; THF + methionine

139
Q

Inadequate production of ____ inhibits B12 absorption in the intestine

HCl
protease
intrinsic factor
biotin

A

IF

140
Q

Among the following foods, the nutrient density of vitamin D is greatest in:

a. cheese.
b. salmon.
c. green leafy vegetables.
d. beef.

A

salmon

141
Q

Fat-soluble vitamins are absorbed and then distributed throughout the body to cells via:

a. free fatty acids.
b. lipases.
c. lipoproteins.
d. lymphatics

A

lipases

142
Q

Alkoxyglycerols are found in…

cod liver oil
fish oil
shark liver oil
salmon

A

shark liver oil

143
Q

Allicin vs allicic sulfides

A

Allicin reduces serum total cholesterol concentration and BP; garlic and onions

allicic sulfides have antimutagenic and anticarcinogenic properties that confer some protection against immune and cardiovascular disease, activate liver detox, inhibit cholesterol synthesis, reduce BP, improve immune response, increase resistance to infection and parasites; found in garlic onions leeks challots and chives

144
Q

Arabinogalactans…

A

long, densely-branched polysaccharides; plants (leeks, carrots, radish, pear, maize, wheat, red grape, tomato, ragweed, sorghum, bamboo grass, coconut, echinacea purpurea, curcuma)

may inhibit tumorigenesis and metastasis

145
Q

Beta-glucans are derived from various species of

plants
seeds
mushrooms
animals

A

mushrooms; stimulate phagocytosis and natural killer cell activity

beta d glucans from oats act as soluble dietary fiber

146
Q

Biochanin A

A

water insoluble isoflavone in red clover; weak estrogenic, antioxidant, anticarcinogenic, hypolipidemic properties; may inhibit bone resorption

147
Q

Carotenoids - which form does not exhibit vitamin A activity

alpha
beta
delta
epsilon

A

delta

148
Q

T/F: carrageenans are polysulfated straight-chain galactans derived from red seaweed that are absorbable by human enzymes; may be hypocholesterolemic

A

F - they resist digestion by human enzymes

149
Q

Catechins, with antimicrobial/viral/chemoprotective properties, are found in greatest amounts in which of the two

green tea and black tea
green tea and grape leaves
grape leaves and black tea
seeds and green tea

A

green tea and grape leaves

150
Q

About what percentage of curcuminoids ingested are absorbed?

30%
50%
80%
100%

A

50%

151
Q

Bioflavonoids include…

Flavonoids
Isoflavins
Terpenes
A and B
B and C
A

A and B

152
Q

Flavnoids include

A

Hesperidin, naringin, nobiletin, tageretin, quercitin, rutin, narirutin

1500 flavonoids inhibit estrogen synthesis; potent antioxidants; inhibit cell adhesion, growth factor activity, cell proliferation (atherosclerosis and cancer)

153
Q

Glucomannan is a form of…

A

soluble fiber

154
Q

Glucosinolates are…

A

Found in cruciferous veggies; ppowerful activators of liver and GI detox enzymes, regulate cytokine secretion, inhibit enzymes that pronote tumor growth in liver, breast, colon, stomach, lunch, esophagus

155
Q

I-3-C - converted by stomach acid to ____

A

diindolymethane (DIM) and indole carbazole

156
Q

Isoflavones and lignans act as

phytoestrogens
phytoprogesterone
testosterone
antinutrients

A

phytoestrogens

help protect from breast, uterine, and ovarian cancer

157
Q

Octacosanol may be

hypoglycemic
hypocholesterolemic
antinutrient
anti inflammatory

A

hypocholesterolemic

158
Q

What are phytosterols?

A

Found in soybeans and other plants, inhibit absorption of dietary cholesterol and tumorigenesis in the colon, breast, and prostate

159
Q

Effective antioxidants that stimulate increased glutathione synthesis and expression of glutathione reductase and peroxidases

Protease inhibitors
Proanthocyanidins
Pycnogenol
Saponons

A

Pycogenol

160
Q

Sulforaphane works on…

Phase I
Phase II

A

Phase II - glutathione S-transferase and quinone reductase

161
Q

Quercitin protects ascorbic acid from:

a. oxidation.
b. reduction.
c. dehydrogenation.
d. desaturation.

A

oxidation

162
Q

Beta-glucans are phytonutients that are derived from various mushroom
species and have specific beneficial effects for:
a. cardiovascular disease
b. gastrointestinal symptoms and function
c. immune function
d. auditory function

A

cardiovascular disease

163
Q

Tincture vs extract vs freeze dried

A

tincture - liquid extracts that are not dried
extract - soaking in water or alcohol then evaporated drying
freeze dried - capsules have freeze dried or powdered extracts of whole or plant parts

164
Q

tea vs decoction

A

tea - water based extraction in boiling water

decoction - boiling then straining

165
Q

Aloe vera leaves are rich in what compound

A

1,8-dihydroxyanthacene

166
Q

Which of the following is not true of thalassemia

ineffective erythropoiesis leads to decreased plasma volume
may result in facial deformities
inherited
may result in osteomalacia

A

A

there is increased absorption

167
Q

To be physically active you must get at least

A

20 min of vigorous activity on 3+ days per week OR

30 min of moderate activity on 5+ days per week

168
Q

Sports anemia includes all of the following except

IDA
pernicious anemia
foot strike anemia
hemodilution

A

pernicious anemia

169
Q

omega 3 FAs are most protective against all of the following cancers except

prostate
colon
lung
renal

A

renal

170
Q

Metformin is a common glucose-lowering med for type 2 diabetes. its primary site of action is which organ?

pancreas
adrenal glands
kidneys
liver

A

liver; decreases depatic glucose production and may help IR

171
Q

Digstive enzyme secreted from brush border oof microovilli to aid in digestion:

lactase
HCl
amylase
protease

A

lactase

172
Q

Digstive enzyme secreted from brush border oof microovilli to aid in digestion:

lactase
HCl
amylase
protease

A

lactase

173
Q

Precursor to prostaglandins, thromboxanes, and leukotrienes

ALA
EPA
DHA
Arachidonic Acid

A

arach

174
Q

RDA magnesium for adult women

500 mg/d
400
200
310

A

310

men 400

175
Q

Vitamin with synergistic relationship with coq10

vitamin E
D
A
K

A

E

176
Q

Mineral that enhances use of iron

nickel
selenium
magnesium
zinc

A

nickel

177
Q

iron for pregnant woman

27 mg/d
30
18
8

A

27

178
Q

Primary action of serotonin

regulate blod flow, maintain muscle tone and gastric motor activity
inhibit release of gastric emptying and acid secretion
facilitate secretion and peristalsis
relax the lower esophageal sphincter

A

C

179
Q

iron for girl starting menses

18 mg/d
15
8-10
27

A

15

180
Q

Forms of coq10

ubiquinol and ubiquinone
ubiquinol and L-ubiquinone
ubiquinol
ubiquinone and ubiquinine

A

A

181
Q

All of the following should be avoided in Von Willebrand disease except

vitamin D
vitamin E
gingko biloba
fish oil

A

vitamin D

182
Q

Audited courses are eligible for how many continuing education credits for each semester hour?

12
8
15
10

A

8

183
Q

T/F prealbumin is a good nutritional marker for renal failure

A

F

184
Q

Which is needed in glycogenolysis

B3
B5
B6
B2

A

B6

185
Q

Boiling foods for long periods may leach out which of the following nutrients most

potassium
calcium
phosphorus
magnesium

A

potassium

186
Q

when in excess which of the following minerals increases urinary excretion of calcium

iron
copper
phosphorus
magnesium

A

phosphorus

187
Q

Activation of which lymphocyte plays a major role in atopic dermatitis

th1
th2
b cells
NKCs

A

th2

188
Q

Premature greying nutrients

A

copper and b12

189
Q

cofactor in oxication and synthesis of FAs

A

biotin

190
Q

Nutrition management once oral feeding begins for acute pancreatitis include all of the following except

low fat diet
decreased calories
small meals
adequate protein intake

A

decreased calories

191
Q

All of the following are associated with bulimia nervosa except

diarrhea
salivary gland enlargement
muscle wasting
edema

A

muscle wasting

192
Q

what does aldosterone do?

increases reabsorption of potaassium in kidneys
increases reabsorption of sodium in kidneys
increases secretion of wataer from kidneys
stimulates production of ADH

A

increases reabsorption of sodium in kidneys

193
Q

Which of the following is an end prouct of purine metabolism from food?

nitric acid
uric acid
sulfuric acid
acetic acid

A

uric acid

194
Q

RDA of vitamin C for adult females

1000 mg/d
75
90
2000

A

75

195
Q

Protease inhibitors are commonly found in

dairy products
black and green teas
grains and pseudograins
soybeans and legumes

A

soybeans and legumes

196
Q

Not true of acute hypophosphatemia

may be assoc with vitamin D def
develops over time
may be caused by reduced secretion of PTH
rare condition

A

C

197
Q

Approx ____ mg of dietary tryptophan may produce ___ mg of niacin

30;3
90;1
60; 1
1;90

A

60; 1

198
Q

Leading risk factor for CKD

hypertension
glomerulonephritis
diabetes
amyloidosis

A

diabetes

199
Q

RDA for vitamin D for 75 y/o male

600 IU
800 IU
500 IU
700 IU

A

800

200
Q

Caloric intake during 1st trimester

+350 cal
+450 cal
stays same
+250 cal

A

same

201
Q

T/F: phase angle is a marker for cell health on an electrical bioimpedance analysis

A

T

provides info on the condition of the phospholipid bilayer in the calles

202
Q

DRI is divided into…

A

RDA - recommended dietary allowances
AI - adequate intake
TUL - tolerable upper intake
EAR - estimated average requirements

203
Q

Which of the following DRIs estimates the daily intake of a nutrient that will satisfy the requirement for that nutrient of half of the healthy individuals in a life stage and gender group?

RDA
EAR
AI
TUL

A

EAR

204
Q

Which of the following DRIs estimates the daily intake of a nutrient that will satisfy the requirement for that nutrient of 97-98% of the healthy individuals in a life stage and gender group?

RDA
EAR
AI
TUL

A

RDA

205
Q

Which of the following DRIs estimates the daily intake of a nutrient that will satisfy the requirement for that nutrient of MOST of the healthy individuals in a life stage and gender group when insufficient data is available to estimate an RDA?

RDA
EAR
AI
TUL

A

AI

206
Q

Which of the following DRIs estimates the greatest daily intake of an individual nutrient that is likely to pose no risk of adverse health effects for almost all individuals in the general population?

RDA
EAR
AI
TUL

A

TUL

207
Q

Since 1994 the USRDA was replaced by…

A

Daily Values (DV)

208
Q

DV is based on ___

DRV and RDI - daily reference values and reference daily intakes
DRI and RDA
EAR and RDA
DRV and AI

A

A

209
Q

Current DRVs

total fat
sat fat
cholesterol
total carbs
fiber
protein
A 
fat - 65 g / 30%
sat fat - 20 g / 10%
cholesterol - 300 mg
total carb - 300 g / 60%
fiber - 25 g
protein
*adults - 50 g / 10%
*infants - 14 g
*1-4 - 16 g
*pregnant - 60 g
*lactating - 65 g
*sodium - 2400 mg
*potassium - 3500 mg
210
Q

Current DRVs

total fat
sat fat
cholesterol
total carbs
fiber
protein
A 
fat - 65 g / 30%
sat fat - 20 g / 10%
cholesterol - 300 mg
total carb - 300 g / 60%
fiber - 25 g
protein
*adults - 50 g / 10%
*infants - 14 g
*1-4 - 16 g
*pregnant - 60 g
*lactating - 65 g
*sodium - 2400 mg
*potassium - 3500 mg
211
Q

Nutrient content claims

Calorie free vs low calorie vs reduced calorie

A

Free - < 5 kcal per serving
Low - < 40 kcal
reduced / lite - if 50% or more of cals are from fat, fat must be reduced by 50% cals reduced at least 1/3; contains at least 25% fewer calories per serving

212
Q

Fat free info

A

fat free - < 0.5 g fat per serving
low fat - < 3 g of fat per serving
reduced / less fat - at least 25% less total fat per serving

213
Q

Dietary proteins are of high biological value when they are obtained from:

a. fish, legumes and whole milk.
b. beef, pork and cream cheese.
c. white bread, vegetables and legumes.
d. eggs, chickenmeats and cheddar cheese.

A

d

214
Q

The dietary change that is the most effective in contributing to a decrease in serum
total cholesterol concentration is:

a. decrease on cholesterol intake.
b. a decrease in saturated fat intake.
c. an increase in polyunsaturated fat intake.
d. an increase in monounsaturated fat intake.

A

b

215
Q

The food components that are listed on the Nutrition Facts panel are:

a. sugars, fiber, and potassium.
b. sugars, dietary fiber, and calcium.
c. sugars, dietary fiber, and monounsaturated fat.
d. sugars, magnesium, and B-complex vitamins.

A

b

216
Q

Serum concentration of ___ is indicative of malnutrition in an elderly individual

< 5 g/dL
< 3.5 g/dL
> 5 g/dL
> 3.5 g/dL

A

B

217
Q

Lacto-ovo vegetarian diets vs lacto-vegetarian vs ovo-vegetarian

A

lacto-ovo: allow dairy, eggs, no meat

lacto: allow dairy no eggs no meat
ovo: no dairy, allow eggs

218
Q

The most serious consequence of feeding “double-strength” formula

to an infant is likely to be:

a. sleepiness.
b. colic.

c. mental impairment.
d. dehydration.

A

dehydration

219
Q

Except for when women are pregnant and lactating, the total quantity of nutrients
and calories needed during ____ are greater than at any other stage of the life
cycle.
a. infancy
b. childhood
c. dolescence
d. aging

A

adolescence

220
Q

Digestibility of proteins in vegetarian diets with no animal protein is ____

lower
higher

A

lower
approx 15-25% increase in recommended daily protein intake (approx 1 g.kg body weight) should account for the lower digestibility of the prooteins in strict veg diets

221
Q

Calcium absorption in vegetarians may be ___ efficient than that of calcium in animal-based products

50% less
30% more
20% less
as efficient

A

20% less

222
Q

Supps for vegetarians

A 
Ca
Vitamin D
Iron
Zinc
B12
223
Q

Designs in epidemiology

A

cross sectional
ecological
cohort
case control

224
Q

cross sectional survey

A. examination of correlations between disease status and dietary exposures of several populations or one populatio observed several times
B. contemporaneous determination of disease status (prevalence) and dietary exposure
Cprospective or retrospective observation over time of the occurence of disease (incidence) in subgroupps within a population that have been formed based on degree of exposure to the putative risk factor
D. contemporaneous (using active controls) or retrospective (using historical controls) examination of any relationship between disease status and dietary exposure of individuals matched or paired on the basis of common characterists other than disease status and dietary exposure (sex age nondietary lifestyle factors etc)

A

B

225
Q

ecological

A. examination of correlations between disease status and dietary exposures of several populations or one populatio observed several times
B. contemporaneous determination of disease status (prevalence) and dietary exposure
Cprospective or retrospective observation over time of the occurence of disease (incidence) in subgroupps within a population that have been formed based on degree of exposure to the putative risk factor
D. contemporaneous (using active controls) or retrospective (using historical controls) examination of any relationship between disease status and dietary exposure of individuals matched or paired on the basis of common characterists other than disease status and dietary exposure (sex age nondietary lifestyle factors etc)

A

A

226
Q

Cohort

A. examination of correlations between disease status and dietary exposures of several populations or one populatio observed several times
B. contemporaneous determination of disease status (prevalence) and dietary exposure
Cprospective or retrospective observation over time of the occurence of disease (incidence) in subgroupps within a population that have been formed based on degree of exposure to the putative risk factor
D. contemporaneous (using active controls) or retrospective (using historical controls) examination of any relationship between disease status and dietary exposure of individuals matched or paired on the basis of common characterists other than disease status and dietary exposure (sex age nondietary lifestyle factors etc)

A

C

227
Q

case control

A. examination of correlations between disease status and dietary exposures of several populations or one populatio observed several times
B. contemporaneous determination of disease status (prevalence) and dietary exposure
Cprospective or retrospective observation over time of the occurence of disease (incidence) in subgroupps within a population that have been formed based on degree of exposure to the putative risk factor
D. contemporaneous (using active controls) or retrospective (using historical controls) examination of any relationship between disease status and dietary exposure of individuals matched or paired on the basis of common characterists other than disease status and dietary exposure (sex age nondietary lifestyle factors etc)

A

D

228
Q

Epidemiological studies:

a. identify causative factors
b. are not helpful for public health research
c. are better than cohort studies.
d. are helpful for identifying associations in large populations

A

D

229
Q

Successful treatment for anorexia nervosa most often includes:

a. Family therapy and forced tube feeding.
b. Outpaient nutritional counseling with a registered dietitian.
c. inpatient psychological, nutritional, and medical therapy, often involving
the whole family.

d. Effective psychopharmacological treatment

A

C

230
Q

As a public healthmeasure, chicken
is packed in ice to prevent:

a. Botulism.
b. Perfringens food poisoning.
c. Staphylococcal food poisoning.
d. Salmonella food poisoning.

A

D

231
Q

Which of the following impairs absorption of non heme iron

Carbonates
Oxalates
Phosphates
Fiber from tannins
All
A

All

232
Q

Copper, iron, and zinc have a/an ___ effect

antagonistic
synergistic

A

antagonistic

233
Q

Increases in ____ intake are associated with increased requirements for ____

MUFAs, vitamin C
Omega 3s, vitamin D
PUFAs, vitamin E
PUFAs, vitamin A

A

PUFAs, vitamin E

234
Q

ACE inhibitors and drug-nutrient interactions

A

chelate iron
inhibit urinary potassium excretion
increase urinary zinc excretion

235
Q

Antacids with magnesium decrease absorption of

A

folate

riboflavin

236
Q

Antacids / H2 antagonists inhibit absorption of

A 
calcium
iron
zinc
folate
B12
vitamin D
237
Q

Anthracyclines (chemo treatment) inhibit

A

endogenous synthesis of coq10

238
Q

anticonvulsants…

A

accelerate vitamin D inactivation by liver
decrease ca absorption
increase hepatic accumulation of vitamin A
accelerate metabolic clearance of vitamin C and K
inhibit absorption of biotin, folate, and B12

239
Q

Antidepressants (tricyclic) inhibit action of enzymes requiring

A

coq10

240
Q

MAO inhibitors…

A

increase appetite / carb craving
inhibit actions of enzymes requiring b6
cause sensitivity to tyramine (cheese, piickled stuff, etc.)

241
Q

anti gout meds

A

induce malabsorption of b12

242
Q

betaa blockers

A

chelate dietary ca / prevent its absorption

inhhibit action of enzymes requiring coq10

243
Q

methotrexate

A

inhibiting absorption of folate, b12, ca

244
Q

contraceptives with estrogen

A

inhibit absorption of vitamin A, folate, vitamin C

245
Q

diuretics - potassium sparing

A

inhibit urinary potassium excretion

246
Q

diuretics - potassium depleting

A

increase urinary excretion of thiamin, magnesium, potassium

247
Q

glucocorticoids

A

inhibit ca and folate absorption

248
Q

PPIs

A

inhibit absorption of B12, iron, zinc

249
Q

Use of a thiazide diuretic drugmay produce a low plasma concentration of:

a. calcium.
b. potassium.
c. uric acid.
d. phosphorus.

A

potassium

250
Q

Anti-neoplastic or anti-cancer agents most significantly affect nutritional status by:

a. damaging immune function
b. affecting the intestinal mucosa and reducing nutrient absorption
c. increasing nutrient excretion
d. causing abnormal metabolism

A

B

251
Q

Individuals taking anticonvulsant medications may develop depleted reserves of:

a. folate and vitamin D.
b. thiamin and riboflavin.
c. folate and pantothenic acid.
d. pyridoxine and biotin.

A

A

252
Q

Individuals taking anticonvulsant medications may develop depleted reserves of:

a. folate and vitamin D.
b. thiamin and riboflavin.
c. folate and pantothenic acid.
d. pyridoxine and biotin.

A

A

253
Q

Patients receiving parenteral nutrition must receive all of their nutrients intravenously - this route is called

A

TPN - total parenteral nutrition

254
Q

Contraindications to enteral nutrition are

severe malabsorption
total bowel obstruction
persistent uncontrollable vomiting
tendency to aspiration
ALL
A

ALL

255
Q

Examples of dietary nutrients that are not absorbed directly into the
enterohepatic portal blood system include:
a. amino acids.
b. medium-chain fatty acids.
c. monosaccharides.
d. long-chain fatty acids.

A

D

256
Q 
The hormone responsible for the decrease in gastrointestinal smooth muscle
tone and motility during pregnancy is:
a. estrogen.
b. progesterone.
c. placental lactogen.
d. human chorionic ghonadotropin.
A

B

257
Q

The ingestion of a meal containing large amounts of saturated fat will result in a
transient increase in the serum concentration of:
a. chylomicrons.
b. low-density lipoproteins.
c. high-density lipoproteins.
d. micelles.

A

A

258
Q

The product of enterokinase reactions is:

a. trypsin.
b. chymotrypsin.
c. pepsin.
d. carboxypeptidase.

A

A

259
Q

Most iron is transported in the blood via the plasma carrier:

a. heme.
b. ferritin.
c. transferrin.
d. albumin.

A

C

260
Q 
The organs most active in the synthesis of endogenous cholesterol are the liver
and the:
a. gallbladder.
b. pancreas.
c. adrenal glands.
d. intestinal mucosa.
A

D

261
Q

Lactulose is a carbohydrate that is:

a. absorbed in the small intestine.
b. absorbed in the large intestine.
c. a nonabsorbable laxative.
d. not found in the human diet.

A

C

262
Q

Digested dietary protein is absorbed primarily in the:

a. stomach.
b. duodenum.
c. jejunum.
d. ileum.

A

C

263
Q

Monosaccharides are transported acrossthe placenta from the maternal
circulation to the fetal circulation by the process of:
a. simple diffusion.
b. facilitated diffusion.
c. active transport.
d. pinocytosis.

A

B

264
Q

If a bolus containing 600 mOsm/L enters the jejunum, the net direction of fluid
movement in the intestinal tract will be:
a. from the intestinal lumen to the circulation.
b. from the circulation to the intestinal lumen.
c. longitudinally along the mucosal basement membrane.
d. from the circulation to the lymphoid system.

A

B

265
Q

Excessive production of gas within the intestines may be caused by excessive
colonic bacterial fermentation of unabsorbed:
a. gluten.
b. small peptides.
c. lignin.
d. carbohydrates.

A

D

266
Q

A major intracellular antioxidant is the nutrient:

a. vitamin A.
b. thiamin.
c. glutathione.
d. ascorbic acid.

A

C

267
Q 
A required prerequisite to the digestion of proteins is the HCl-dependent
process called:
a. hydrolysis.
b. evaporation.
c. denaturation.
d. distillation.
A

C

268
Q

The true digestibility of dietary fatty acids is:

a. 65% to 75%.
b. 75% to 85%.
c. 85% to 95%.
d. > 95%.

A

D

269
Q

BMI calc

A 
body weight (kg) / height (meters sq)
BMI should be 19-27 kg/m2
270
Q

waist to hip index

A

women - 0.8 / men - 0.95

271
Q

The rate of urinary excretion of ___ and ___ have been demonstrated to be in proportion to total body muscle mass

creatinine, 3-methyl-histidine
creatinine, BUN
BUN, 3-methyl-histidine

A

A

272
Q

High BUN can indicate ___ while low BUN indicates ____

A

renal failure; presence of liver disease
Blood urea nitrogen (BUN) concentration indicates total body nitrogen
content. Because urea is formed in the liver and is excreted by the kidneys, greatly elevated
BUN concentration indicates renal failure while very low BUN concentration can signal the
presence of liver disease.

273
Q

Which is reflective of body protein reserves?

BUN
Creatinine
Albumin
3-methyl-histidine

A

albumin

concentrations below 5.5 g/dL usually are suggestive of protein malnutrition,
gastrointestinal inflammation, digestive incapacity, edema in extremities, severe acute liver
disease, congestive heart failure, eclampsia of pregnancy, or
extravascular protein loss due to renal dysfunction. Serum albumin concentrations less than
3.5 g/dL often accompany dehydration or hypothyroidism.

274
Q

Symptoms of acidosis

A

ratio less than 1:20

CNS depression, delerium, coma, hyperkalemia, hypercalcemia

275
Q

Symptoms of alkalosis

A

ratio greater than 1:20

CNS exciitation, hyperirritabiity, disorientation, heightened reflex response, hypocalcemia, hypokalemia

CNS NH 2021 (5 decks)

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