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CNS Exam > W6 Primer Questions - Metabolic Disorders/Nutr Needs > Flashcards

W6 Primer Questions - Metabolic Disorders/Nutr Needs Flashcards

1
Q

_______ is a defect in the phenylalanine hydroxylase enzyme produces hyperphenylalaninemia.
A. Phenylketonuria
B. MTHFR Mutation
C. None of the above

A

A. Phenylketonuria (PKU)

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2
Q

True/False: Effective nutritional therapy for PKU is based on a diet low in phenylalanine content and high in tyrosine content.
A. True
B. False

A

A. True

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3
Q 
A defect in the enzyme keto acid decarboxylase produces hyperleucinemia is called\_\_\_\_\_
A. PKU
B. Tyrosinemia
C. Maple Syrup Urine Disease
D. Homocystinuria
A

C. Maple Syrup Urine Disease - Chronic hyperleucinemia causes seizures and may be fatal. Effective nutritional therapy is based on a diet low in leucine, isoleucine and valine content.

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4
Q 
\_\_\_\_\_\_\_\_\_\_ Storage Disease type Ia: A defect in the enzyme glucose-6-phosphatase produces fasting hypoglycemia and hepatomegaly. 
A. Protein
B. Carbohydrate
C. Glycogen
D. Fatty acid
A

C. Glycogen - Effective nutritional therapy is based on a diet low in fat content and providing a high intake of complex carbohydrates.

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5
Q

The nutritional history of a child over 3 years may be reflected in the child’s: a. head circumference.

b. weight.
c. height.
d. waist circumference.

A

c. height

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6
Q

The most accurate way to assess micronutrient intake is through the use of a:

a. 24-hour food intake recall questionnaire.
b. 7-day food intake frequency.
c. “food frequency questionnaire.”
d. stool and urine analysis.

A

C. FFQ

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7
Q 
The energy provided by 10mL of an infant formula that contains, per dL, 1g of protein, 3g of carbs, 1mg Ca, 2.5mg P totals:
A. 2.6kcal
B. 5 kcal
C. 6.7 kcal
D. 8.6 kcal
A

C. 6.7 kcal

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8
Q

The amount of food to serve a young child is best determined by the: A. time of day.
B. number of teeth that have erupted.
C. child’s appetite and rate of growth
D. amount of milk the child consumes.

A

C. the child’s appetite and rate of growth

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9
Q

Muscle protein content can be estimated from measurements of: a. serum albumin concentration.

b. mid-chest circumference.
c. urinary creatinine excretion.
d. serum transferrin concentration.

A

c. urinary creatinine excretion

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10
Q 
The minimum urine volume required to excrete a renal solute load of 600 mOsm, when the renal concentrating ability is 1200 mOsm, is:
a. b. c. d.
A. 100 ml. 
B.500 ml. 
C. 750 ml.
D. 1000 ml.
A

B. 500 ml

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11
Q

The metabolite whose serum concentration is the most important to monitor during refeeding of a chronically starved individual is:

a. phosphorus.
b. calcium.
c. cholesterol.
d. urea nitrogen.

A

A. Phosphorus
In refeeding syndrome, chronic whole body depletion of phosphorus occurs. Also, the insulin surge causes a greatly increased uptake and use of phosphate in the cells. These changes lead to a deficit in intracellular as well as extracellular phosphorus. In this environment, even small decreases in serum phosphorus may lead to widespread dysfunction of cellular processes affecting almost every physiological system
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440847/

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12
Q

The breath hydrogen test is a useful diagnostic tool in the identification of individuals suffering from:

a. gluten enteropathy.
b. pancreatitis.
c. lactose intolerance.
d. cystic fibrosis.

A

C. Lactose Intolerance

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13
Q

A useful test to monitor the adequacy of diet and drug therapy in an individual with non-insulin-dependent diabetes mellitus is the:

a. glucose tolerance test.
b. fasting plasma glucose concentration.
c. C - peptide assay.
d. hemoglobin A1c (glycohemoglobin) concentration.

A

D. HgA1c

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14
Q

Protein of the highest biological value is found in foods in the group that includes:

a. meat and eggs.
b. oat bran cereals.
c. apples and raisins.
d. peas and beans.

A

A. meat and eggs

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15
Q

The growth-limiting amino acid in soy protein is:

a. methionine.
b. phenylalanine.
c. cystine.
d. alanine.

A

A. Methionine

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16
Q

Symptoms of magnesium deficiency include:

a. apathy, depression, and fatigue.
b. irritable bowel syndrome.
c. frequent colds and delayed healing.
d. backache and muscle spasms.

A

A. Apathy, depression and fatigue

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17
Q

Experimentally increasing calcium intake may improve measured calcium balance without increasing measured calcium deposition because:

a. the multicompartment theory of calcium metabolism is invalid.
b. increased calcium balance may result from decreased bone resorption.
c. it is possible to increase net calcium balance by >25% without increasing calcium deposition.
d. the circulation serves as a potentially massive sink for dietary calcium.

A

B. increased calcium balance may result from decreased bone resorption.

18
Q

An individual who is 150 cm tall and weighs 90 kilograms has a body mass index of:

a. 20.
b. 30.
c. 40.
d. 50.

A

c. 40

19
Q

According to the National Cholesterol Education Program (NCEP), in an otherwise healthy adult male, a serum total cholesterol concentration greater than 240 mg/dL is considered to be:

a. high.
b. borderline high.
c. desirable.
d. low.

A

A. high

20
Q

A fasting plasma glucose concentration of 180 mg/dL reflects probable:

a. diabetes.
b. glucose intolerance.
c. normal glucose tolerance.
d. hyperinsulinemia.

A

A. diabetes

21
Q

Assessing overall dietary status by hair analysis is:

a. untrustworthy for most nutrients.
b. accurate for most nutrients.
c. independent of hair color.
d. independent of hair length.

A

A. untrustworthy for most nutrients

22
Q

The most accurate and reliable way to assess the macronutrient intake of an individual is through the use of a:

a. 24-hour food intake recall questionnaire.
b. 7-day food intake diary.
c. “food frequency questionnaire.”
d. stool and urine analysis.

A

B. 7 day food intake

23
Q

An increase in the serum concentration of unconjugated bilirubin may be caused by metabolic dysfunction in the:

a. liver.
b. gallbladder.
c. pancreas.
d. kidney.

A

A. liver

24
Q

An individual who is 200 cm tall and weighs 100 kilograms has a body mass index of:

a. 25.
b. 30.
c. 35.
d. 40.

A

A. 25

25
Q

A fasting plasma glucose concentration of 134 mg/dL reflects probable:

a. diabetes.
b. glucose intolerance.
c. normal glucose tolerance.
d. hyperinsulinemia.

A

B. glucose tolerance

26
Q

A fasting plasma glucose concentration of 50 mg/dL may suggest the presence of:

a. diabetes.
b. glucose intolerance.
c. normal glucose tolerance.
d. hyperinsulinemia.

A

D. hyperinsulemia

27
Q

Respiratory Acidosis occurs when:

  • increased blood CO2 concentration in turn elevates plasma H2CO3 concentration
  • decreases the ratio of H2CO3 to HCO3- in plasma to less than 1:20
  • usual cause is pulmonary disease that impairs ability to excrete CO2
A

Primer pg 178

28
Q

Metabolic Acidosis occurs when:

  • alterations in metabolism generate increased amounts of non-volatile organic acids that lower plasma to pH to below 7.35
  • The increased plasma acidity upsets the equilibrium between H2CO3 andHCO3-,increasing the production of H2CO3 and resulting in a ratio of H2CO3 to HCO3- in plasma of less than 1:20
A

primer pg 178

29
Q

Respiratory Alkalosis occurs when:
- increased pulmonary excretion of CO2 causes decreased plasma CO2 concentration, leading to depression of plasma HCO3- concentration

A

Increased excretion of alkaline urine can restore the plasma ratio of H2CO3 to HCO3- to 1:20 and return plasma pH to the normal range.
primer pg 178

30
Q

Metabolic Alkalosis occurs when:
- alterations in metabolism generate increased amounts of alkali, leading to depression of plasma HCO3- concentration, a ratio of H2CO3 to HCO3- in plasma greater than 1:20, decreased plasma CO2 concentration and elevation of plasma pH to above 7.45.

A

primer pg 178

31
Q

Acid-base imbalances occur when plasma pH is either less than 7.35 or great than 7.45
Less than 7.35 is _____
and great than is 7.45 ____
(choices are acidosis/alkalosis)

A

less than 7.35= acidosis

great than 7.45= alkalosis

32
Q

A possible reason for failure of oral rehydration in children is the persistence of:

a. diarrhea
b. salt intake
c. breast feeding
d. vomiting

A

d. vomiting

33
Q

Nutritional support via enteral intubation may be contraindicated in the presence of any of the following conditions except:

a. Congestive heart failure
b. bilateral pedal decubitus ulceration
c. instability of sternal wound
d. pneumonia

A

bilateral pedal decubitus ulceration

34
Q

The infusion of a hypertonic nutrient solution through the jugular or saphenous vein is called:

a. enteral alimentation
b. central parenteral alimentation
c. peripheral parenteral alimentation
d. peridialytic alimentation

A

b. central parenteral alimentation

35
Q

enteral nutrition is nutrition given via:

a. GI intubation
b. I.V.
c. oral route

A

a. GI intubation

36
Q

Parenteral nutrition is given via:

a. I.V.
b. Feeding tube
c. Orally

A

a. I.V

37
Q

The oral glucose tolerance test (OGTT) is used to facilitate the identification of individuals with:

a. diabetes
b. impaired glucose tolerance
c. gestational diabetes
d. all of the above

A

d. all of the above

Primer, p. 174

38
Q

_______ is reflective of body protein reserves:

a. BUN
b. serum albumin
c. serum protein
d rate of urinary excretion of creatinine and 3-methyl-histidine

A

b. Serum albumin concentration is reflective of body protein reserves

Concentrations below 5.5 g/dL 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

Concentrations less than 3.5 g/dL often accompany dehydration or hypothyroidism.

Primer, p. 175

39
Q

What measures are used to estimate cardiovascular status?

a. blood pressure
b. heart rate
c. serum lipid levels
d. all of the above

A

d. all of the above

Blood pressure - status of both heart muscle and the patency of the circulatory system

Heart rate - directly proportional to the effort of pumping blood. (In atherosclerosis, heart rate increases in an effort to pump more oxygen rich blood to the tissues through smaller diameter vessels)

Primer p. 175

40
Q

Mineral/Skeletal Status is assessed via measurement of plasma:

a. calcium
b. phosphorus
c. magnesium
d. vitamin D
e. a and d
f. all of the above

A

f. all of the above

Primer, p. 175

41
Q

Biomarkers of bone resorption include:

a. Serum osteocalcin concentration
b. Serum total and bone alkaline phosphatase activity
c. Serum type I collagen propeptide concentration
d. Urinary pyridinolines excretion rate
e. Urinary hydroxyproline excretion rate
f. Plasma tartrate-resistant acid phosphatase activity
g. a-c
h. d-f
i. all of the above

A

h. d-f

BIOMARKERS OF BONE FORMATION:
Serum osteocalcin concentration, Serum total and bone alkaline phosphatase activity, Serum type I collagen propeptide concentration

BIOMARKERS OF BONE RESORPTION:
Urinary pyridinolines excretion rate, Urinary hydroxyproline excretion rate, Plasma tartrate-resistant acid phosphatase activity

Primer, p. 175

42
Q

Immune system status is most reliably indicated by:

a. total lymphocyte count
b. total neutrophil count
c. total monocyte count
d. total eosinophil count
e. total basophil count

A

a. total lymphocyte count

Because lymphocytes have limited lifetimes and turn over rapidly, their numbers are very dependent on nutritional status

Primer, p. 176

CNS Exam (45 decks)

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