560 C, E, F, G, H, I, P EXTRA Flashcards by Sara Gibbons

Formation of retinol from beta-carotene requires the presence of what B vitamin?

a. ascorbic acid
b. folic acid
c. pyridoxal phosphate
d. niacin

d. niacin

How well did you know this?

Not at all

Perfectly

Burning feet syndrome is seen with deficiency of?

a. biotin
b. folic acid
c. thiamin
d. pantothenic acid
e. niacin

d. pantothenic acid

How well did you know this?

Not at all

Perfectly

Which mineral is associated with the glucose tolerance factor (GTF)?

a. cobalt
b. copper
c. manganese
d. chromium

D chromium

How well did you know this?

Not at all

Perfectly

Which mineral serves as a cofactor in xanthine oxidase in the metabolism of purines, pyrimidines, and pteridines?

a. molybdenum
b. manganese
c. copper
d. chromium

a. molybdenum

How well did you know this?

Not at all

Perfectly

Which micromineral plays a contributing role in the formation of hydroxyapatite crystals?

a. arsenic
b. selenium
c. fluoride
d. nickel

c. fluoride

How well did you know this?

Not at all

Perfectly

What ultratrace element plays a role in the metabolism of methionine to taurine?

a. boron
b. arsenic
c. vanadium
d. nickel

b. arsenic

How well did you know this?

Not at all

Perfectly

Which element has a positive influence on collagen synthesis and bone mineralization?

a. vanadium
b. nickel
c. arsenic
d. silicon

d. silicon

How well did you know this?

Not at all

Perfectly

Which of the following minerals is essential to the function of glutathione peroxidase?

a. Copper
b. Zinc
c. Iron
d. Manganese
e. Selenium

e. Selenium

How well did you know this?

Not at all

Perfectly

By what mechanism is vitamin C thought to protect bone health?

a. contributing to the integrity of bone collagen
b. carboxylation of osteocalcin and matrix Gla protein
c. buffering for acid-base balance
d. diminishing bone resorption

a. contributing to the integrity of bone collagen

How well did you know this?

Not at all

Perfectly

Which of the microminerals is considered essential for normal brain function?

a. chromium
b. manganese
c. vanadium
d. fluorine

b. manganese

How well did you know this?

Not at all

Perfectly

Which element impairs iodine uptake, causing compensatory goiter in mice?

a. cobalt
b. arsenic
c. nickel
d. boron

b. arsenic

How well did you know this?

Not at all

Perfectly

What ultratrace element has been shown to inhibit Na+/K+-ATPase function and the absorption of amino acids at higher concentrations?

a. vanadium
b. arsenic
c. boron
d. cobalt

a. vanadium

How well did you know this?

Not at all

Perfectly

Measuring cadmium in hair and nails
A. Provides useful information about recent exposure.
B. Provides useful information about past exposure.
C. Is not as useful as urinary cadmium levels.
D. Is more accurate than blood cadmium levels.

C. Is not as useful as urinary cadmium levels.

How well did you know this?

Not at all

Perfectly

Although alkaline phosphatase (ALP) is often used as a marker of liver disease, it is also frequently elevated in
A) kidney disease
B) stroke
C) bone disease
D) pernicous anemia

C) bone disease

How well did you know this?

Not at all

Perfectly

According to the article, A New Perspective on Cardiovascular Disease
A) cardiovascular disease is a result of a normal protective response to chronic insults to endothelium
B) cardiovascular disease could be eradicated with appropriate antioxidant therapy
C) current guidelines from the AHA are the best strategy for identifying cardiovascular risk
D) the most effective strategy for decreasing risk of cardiovascular disease os to lower HDL to below 40 mg/dL

A) cardiovascular disease is a result of a normal protective response to chronic insults to endothelium

How well did you know this?

Not at all

Perfectly

A low serum calcium level can best be explained by
A. Hyperparathyroidism.
B. Hypoalbuminemia.
C. Failure to include dairy products in the diet.
D. Excessive intake of vitamin D.

B. Hypoalbuminemia.

How well did you know this?

Not at all

Perfectly

Excretion of \_\_\_\_\_\_\_\_\_\_\_\_ provides an indicator of muscle protein break down.
A. Glucose.
B. Methionine.
C. Methylhistidine.
D. 3-methylhistidine

D. 3-methylhistidine

How well did you know this?

Not at all

Perfectly

What best explains presence of glucose in urine?
A) it is expected to be present 1-2 hours after meals
B) it is a normal physiological response after drinking one can of soda
C) it occurs when blood glucose exceeds the renal threshold of 160-180 mg/dL
D) it indicates kidney disease

C) it occurs when blood glucose exceeds the renal threshold of 160-180 mg/dL

How well did you know this?

Not at all

Perfectly

In patients with jaundice, direct hyperbilirubinemia would most likely occur with
A. Gallstones.
B. Hepatitis.
C. Tylenol overdose.
D. Hemolysis

A. Gallstones.

How well did you know this?

Not at all

Perfectly

Which of the following nutrients would have the LEAST effect on a TBARS level?
A. Vitamin C.
B. Vitamin E.
C. Coenzyme Q.
D. Vitamin B6.

D. Vitamin B6.

How well did you know this?

Not at all

Perfectly

Which of the following would be an expected result in an individual with iron-deficiency anemia?
A. Decreased TIBC.
B. Increased MCV.
C. Decreased erythrocyte protoporphyrin.
D. Decreased transferrin saturation.

D. Decreased transferrin saturation.

How well did you know this?

Not at all

Perfectly

Determination of body density by under-water weighing allows estimation of
A. BMR.
B. Bone mass.
C. BMI.
D. Body fat.

D. Body fat.

How well did you know this?

Not at all

Perfectly

Elevated blood ammonia is an indicator of
A) severe liver disease
B) kidney disease
C) hemolytic anemia
D) high level of detoxification

A) severe liver disease

How well did you know this?

Not at all

Perfectly

The most biologically active thyroid hormone is
A. T3.
B. Free T3.
C. T4
D. T4.

B. Free T3.

How well did you know this?

Not at all

Perfectly

Which statement is the most accurate? A. It is almost impossible to differentiate B12 and folate deficiency. B. There is an inverse relationship between vitamin B12 and methylmalonic acid. C. There is an inverse relationship between folate and methylmalonic acid. D. Measurement of homocysteine is a more specific indicator of B12 status than methylmalonic acid.

B. There is an inverse relationship between vitamin B12 and methylmalonic acid.

``` A decreased fecal elastase is most strongly correlated with A. Celiac disease. B. Lactose intolerance. C. Pernicious anemia. D. Pancreatic insufficiency. ```

D. Pancreatic insufficiency.

``` What nutrient does not assist the liver in the detoxification of estrogen? A. Folate B. DIM C. Sulforaphane D. Calcium D-Glucarate ```

A. Folate

``` Which brain nutrient should only be used to support sleep if the client has elevated cortisol? A. 5-HTP B. GABA C. Phosphatidylcholine D. Phosphatidyserine ```

D. Phosphatidyserine

``` What nutrient decreases dihydrotestosterone (DHT)? A. Indole-3 carbinol B. Pomegranate C. Saw Palmetto D. Sulforaphane ```

C. Saw Palmetto

``` What tocotrienol isomer has demonstrated the significant cytotoxic effect on human cancer cells? A. Alpha B. Beta C. Gamma D. Delta ```

D. Delta

Which nutrient deficiencies (3) are associated with restless leg syndrome?

Magnesium and vitamin D and Iron (should always be assessed with RLS)

``` A client has calcium oxalate stones. Which supplement will raise pH levels? A. Citrate B. NaCl C. Betaine HCL D. Ammonium sulfate ```

A. Citrate

``` Which nutrient affects the efficacy of B-vitamins in cognitive decline? A. Fish oil B. Evening Primrose Oil C. Olive oil D. Black currant seed oil ```

A. Fish oil

``` Which brain nutrient increases cerebral glucose metabolism in patients with Alzheimer's Disease? A. Phosphatidylserine B. phosphatidylcholine C. Acetyl-l-carnitine D. Glycerophosphpcholine ```

A. Phosphatidylserine

``` Which nutrient would be most appropriate to address peripheral neuropathy symptoms secondary to chemotherapy? A. L-carnitine B. CoQ10 C. Glutamine D. Ginger ```

C. Glutamine

What deficiency can lead to an increase in iron tissue stores and decrease in iron availability?

Copper

``` Which brain nutrient supplies both choline as well as cytidine for the synthesis of phospholipids? A. CDP-choline B. Glycerophosphocholine C. phosphatidylcholine D. Phosphatidylserine ```

A. CDP-choline

What form of vitamin B3 has been used as therapy for osteoarthritis? A. Niacinamide B. Nicotinic acid C. Inositol hexanicotinate

A. Niacinamide

``` Which vitamin is involved in the metabolism of homocysteine and its low serum levels have been associated with hypertension? A. B2 B. B6 C. B12 D. Folate ```

B. B6

``` A client has a microcytic anemia on her CBC. She presents to your office with pale skin, a normal blood pressure, and an elevated pulse. What additional test would you follow up with? A. Ferritin B. Vitamin B12 C. Folate D. Intrinsic factor antibody ```

A. Ferritin

``` What is the best test to assess iodine insufficiency? A. Serum iodine B. 24-hr urine collection C. Hair iodine D. Plasma iodine ```

B. 24-hr urine collection

``` Which heavy metal is not associated with hypertension? A. Pb B. Cad C. Al D. Hg ```

C. Al

``` A 36-year-old female labs reveal a low Hgb 11.8, a low transferrin saturation 18%, and an elevated Ferritin at 124. She has a regular menstrual cycle. What is the cause of anemia? A. Inflammation B. Iron deficiency and Inflammation C. Heavy menstrual bleeding D. Iron deficiency ```

A. Inflammation

What are the serum iron, TIBC, and serum ferritin levels in IDA? A. Low, low, low B. Low, high, low C. Low, low, high

B. Low, high, low

``` Which nutrient improved glutathione levels and decreased fat deposition in patients with NASH? A. N-acetyl-cysteine B. phosphatidylcholine C. Milk Thistle D. Carnitine ```

A. N-acetyl-cysteine

``` Which nutrient can bind to a T-cell receptor and dampen the immune response? A. Quercetin B. N-acetyl-cysteine C. N-acetyle-glucosamine D. Zinc carnosine ```

C. N-acetyle-glucosamine

``` Which mineral deficiency affects relatively young individuals and in a subgroup of Alzheimer's Disease? A. Zinc B. Magnesium C. Calcium D. Selenium ```

A. Zinc

``` Protein _____ calcium reabsorption and phosphorus _____ calcium reabsorption. A. Decreases, decreases B. Decreases, increases C. Increases, increases D. Increases, decreases ```

B. Decreases, increases

What is the temperature "danger zone" for bacterial growth?

5 - 63 degrees C | 41 to 145

``` A dietary imbalance caused by an excess of carbohydrate foods, eventually resulting in protein and mineral deficiencies, can be an adverse effect of a(n) _____ diet. A. Mediterranean B. Anti-inflammatory C. Paleo D. Macrobiotic ```

D. Macrobiotic

``` Your vegetarian client comes to you for help with what food to eat for her fatigue. What nutrient deficiencies do you suspect? (select all that apply) A. Zinc B. Magnesium C. Vitamin B12 D. Iron ```

A. Zinc C. Vitamin B12 D. Iron

What are symptoms of serotonin/tryptophan deficiency?

Depression, Seasonal Affective Disorder, PMS

``` Over time, chronic overeating can eventually cause ______ dopamine (DA) activity and _______ dopamine (DA) sensitivity in the brain. A. Increased, decreased B. Decreased, increased C. Decreased, decreased D. Increased, increased ```

C. Decreased, decreased

Coffee, chocolate, and caffeine are stimulants that __________ dopamine production and _________ uptake. 1. ) increase, decrease 2. ) decrease, decrease 3. ) decrease, increase 4. ) increase, increase

1.) increase, decrease

Chronic overeating can eventually cause _________ dopamine activity and _________ dopamine sensitivity in the brain. 1. ) increased, decreased 2. ) decreased, decreased 3. ) decreased, increased 4. ) increased, increased

2.) decreased, decreased

Your 22 year old male patient has chronic yeast issues manifested as toenail fungus, fatigue, itchy skin, and a white thick coating on his tongue. What foods to you recommend he avoid in his diet? 1. ) White vinegar 2. ) Raw unfiltered apple cider vinegar 3. ) Lemon juice 4. ) Brown rice

1.) White vinegar

According to Michael Pollan, the most important common denominator in sustainable agriculture is __________.

Grass

# Define medium-chain fatty acids. a. Have less than 6 carbon atoms. b. Have 12 or more carbon atoms. c. Have 6 to 10 carbon atoms. d. Have 6 to 12 carbon atoms.

d. Have 6 to 12 carbon atoms.

Which is the least readily utilized type of fatty acid in infants? A. Short-chain fatty acids B. Medium-chain fatty acids C. Long-chain fatty acids

C. Long-chain fatty acids

``` The average daily dietary fiber recommendations are _____ for males and females age 31-50 respectively A. the same at 25 grams B. 35 and 21 grams C. 38 and 25 grams D. 45 and 38 grams E. none of the above ```

C. 38 and 25 grams

``` What fat soluble vitamin is given to infants at birth? A. vitamin A B. vitamin D C. vitamin E D. vitamin K ```

D. vitamin K

``` A simple calculation used to give you a "ballpark" calorie level for weight maintenance is multiplying your body weight by the number A. 13 B. 15 C. 17 D. 25 E. 30 ```

Does soybean-based or cow's milk-based infant formula contribute more to constipation?

Soybean-based

What are the primary proteins in colostrum? X2

Secretory IgA and lactoferrin

Common vitamin/mineral malabsorptions from Gastric bypass?

B12, iron

Benefits of an alkaline diet:

a. Promoting weight loss b. Improving kidney health c. Preventing cancer d. Treating or preventing heart disease e. Improving growth hormone levels f. Improving back pain g. Preventing osteoporosis

Oliguria is:

decreased urine output

Anuria is:

failure of kidneys to make urine

Match the botanical category with its physiological actions: 1. ) Diaphoretic 2. ) Expectorant 3. ) Anti-tussive 4. ) Mucilaginous Choices: 4. ) Form protective coating over pharyngeal mucosa 1. ) Induces perspiration 3. ) Reduce irritability and stimulation of cough receptors above and below the pharynx 2. ) Increase ciliary activity, reduce mucus viscosity, liquefy pulmonary secretions

1. ) Induces perspiration 2. ) Increase ciliary activity, reduce mucus viscosity, liquefy pulmonary secretions 3. ) Reduce irritability and stimulation of cough receptors above and below the pharynx 4. ) Form protective coating over pharyngeal mucosa

Which TWO of the following depend upon vitamin K for their production? a. prostaglandin F2-alpha b. calcitonin c. matrix Gla protein d. osteocalcin e. 7-dehydrocholesterol

c. matrix Gla protein | d. osteocalcin

What is a symptom of a vitamin D toxicity? a. rickets b. hypocalcemia c. hypercalcemia d. osteoporosis

c. hypercalcemia

Cheilosis is a symptom of a dietary deficiency of which vitamin? a. ascorbic acid b. riboflavin c. biotin d. niacin

b. riboflavin

When the diet is adequate in protein, the body can synthesize niacin from which amino acid? a. valine b. phenylalanine c. tyrosine d. tryptophan

d. tryptophan

Which three vitamins are involved in the synthesis of fatty acids? a. biotin, vitamin D, thiamin b. niacin, biotin, pantothenic acid c. riboflavin, B12, folate d. thiamin, riboflavin, niacin

b. niacin, biotin, pantothenic acid

Which non-metal nutrient is associated with Keshan disease, characterized by cardiomyopathy? a. selenium b. molybdenum c. iodine d. zinc

a. selenium

Which of the following minerals plays a major role in regulating body fluid pH? a. sulphur b. calcium c. magnesium d. phosphorus

d. phosphorus

The binding protein that regulates many of the calcium-dependent enzymes is: a. calcitonin b. calmodulin c. globulin d. albumin

b. calmodulin

Which mineral serves as the major intracellular fluid cation? a. chloride b. calcium c. potassium d. sodium

c. potassium

Magnesium absorption may be improved by all of the following except? a. selected carbohydrates b. protein c. phosphorous d. vitamin D

c. phosphorous

Toxicity of which element results in green tongue, diarrhea, and GI cramps? a. silicon b. boron c. vanadium d. nickel

c. vanadium

A well-known biological marker for verifying reported protein intake is A. Analysis of nitrogen in hair B. Analysis of sulfur in a 24-hour urine specimen. C. Analysis of nitrogen in a 24-hour urine specimen. D. Analysis of sulfur in hair.

C. Analysis of nitrogen in a 24-hour urine specimen.

Cirrhosis of the liver can cause an increased APTT because A. Cirrhosis causes an increased production of heparin. B. Cirrhosis causes decreased absorption of vitamin K. C. Cirrhosis causes decreased platelet production. D. Cirrhosis causes decreased production of coagulation factors.

D. Cirrhosis causes decreased production of coagulation factors.

``` Elevated pyroglutamate in urine may indicate depletion of A. Vitamin K. B. Phase I activity. C. Glutathione. D. Glucaric acid. ```

C. Glutathione.

Anemia is a symptom of ________ poisoning. A. Mercury. B. Lead. C. Cadmium.

B. Lead.

``` Which of the following is the most likely explanation for positive nitrites in a urine specimen and observation of white blood cells in urine sediment? A) recent heart attack B) urinary tract infection C) diabetes D) kidney stones ```

B) urinary tract infection

``` What is the most likely reason for a high urine specific gravity? A) dehydration B) urinary tract infection C) compromised kidney function D) overhydration ```

dehydration

``` The best assessment of glomerular filtration rate is A) urine pH B) examination of urinary sediment C) serum creatinine D) urine nitrites ```

C) serum creatinine

``` Elevated blood ammonia is an indicator of A) severe liver disease B) kidney disease C) hemolytic anemia D) high level of detoxification ```

severe liver disease

What are the nutrient needs in a multifetal pregnancy? (more calories?)

450 calories more per day than pre-pregnancy and increased requirements for EFAs (linoleic and alpha-linolenic acid), iron, calcium

What is a sign of inadequate protein intake in preterm infants? (Hint head)

Slow head growth

What congenital abnormality is associated with inadequate vitamin A during pregnancy?

Malformations of the fetal lungs, urinary tract, and heart

What are the nutritional implications of galactosemia? (Need to add? Meet to eliminate?)

Breastfeeding is contraindicated, dairy must be eliminated from diet, and additional calcium, phosphorus, and vitamin D are needed

Which vitamin has been found effective to reduce lung and breathing problems in LBW infants?

Vitamin A

Oxytocin v prolactin role?

Oxy = LETDOWN Pro = stimulate milk productions

``` A vegan or vegetarian diet that is high in phytic acid (found in grains) can inhibit the absorption of which nutrient(s)? A. Calcium B. Iron C. Zinc D. All of these ```

D. All of these

What are causes of dopamine imbalances?

Overeating/binge eating, stimulants, omega-3 deficiency, tyrosine deficiency

What can too little dopamine cause?

- Attention Deficit/Hyperactivity Disorder (ADHD) - Parkinson's dx - Weight gain/increased appetite - Impaired impulse control - Tremor or stiffness of muscles - Risk for addiction - Binge eating - Lethargy and/or hypersomnia - Lack of motivation

``` Protein _____ calcium reabsorption and phosphorus _____ calcium reabsorption. A. Decreases, decreases B. Decreases, increases C. Increases, increases D. Increases, decreases ```

What 3 general factors contribute to food habits?

Food habits are usually defined by social class, ethnics and the regional area in which people live.

What type of anemia involves the following: - Mild to moderate low Hgb - Normal MCV - Normal or increased ferritin - Decreased transferrin saturation - Transferrin receptor level <1 - Increased hepcidin

Anemia of inflammation

``` What energy nutrient is essential for a client with CHF? A. CoQ10 B. Glutamine C. B2 D. B5 ```

A. CoQ10

``` What amino acid will enhance the anti-hypertensive effects of magnesium? A. Gly B. Glu C. Tau D. His ```

C. Tau

``` Which vitamin is involved in the metabolism of homocysteine, and its low serum levels have been associated with hypertension? A. Vitamin B6 B. Vitamin B12 C. Folate D. Vitamin B2 ```

A. Vitamin B6

``` Which nutrient decreases the intestinal absorption of cholesterol? A. Plant sterols B. Red Yeast Rice C. Niacin D. Curcumin ```

A. Plant sterols

What are the serum iron, TIBC, and serum ferritin levels in IDA? A. Low, low, low B. Low, high, low C. Low, low, high

B. Low, high, low

``` Which of the following reduces inflammation by inhibiting NF-kappaB? A. Vitamin E B. Sulfuraphane C. Curcumin D. Green Tea ```

C. Curcumin

``` What does not relax the uterine muscle in dysmenorrhea? A. Cramp bark B. Wild yam C. Ginger D. Raspberry leaf ```

C. Ginger

A. Inflammation

``` Which botanical is not helpful for menopause? A. Black cohosh B. Dong quai C. Red clover D. Chasteberry ```

B. Dong quai

``` Atopic dermatitis is associated with what immunoglobulin? A. IgG B. IgM C. IgE D. IgA ```

C. IgE

``` Which brain nutrient increases cerebral glucose metabolism in patients with Alzheimer's Disease? A. Phosphatidylserine B. phosphatidylcholine C. Acetyl-l-carnitine D. Glycerophosphpcholine ```

A. Phosphatidylserine

``` A client has calcium oxalate stones. Which supplement will raise pH levels? A. Citrate B. NaCl C. Betaine HCL D. Ammonium sulfate ```

A. Citrate

``` Too much of what nutrient can trigger thyroid autoimmunity? A. Selenium B. Tyrosine C. Zinc D. Iodine ```

D. Iodine

``` What is NOT a risk factor for osteoporosis? A. Onset of menopause B. Obesity C. Smoking D. Glucocorticoid use ```

B. Obesity

What is the proposed active constituent or licensed standardized extract? Feverfew

Parthenolide

An anti-inflammatory product called Phlogenzym (marketed in North America as Wobenzym PS) contains several ingredients, one of which is ___________. 1. ) Bromelain 2. ) Evening primrose oil 3. ) Borage oil 4. ) Arnica

1.) Bromelain

Valerian products with a high content of which constituent should not be used due to potential toxicity? 1. ) Valerenic acid 2. ) Acetoxyvalerenic acid 3. ) Valepotriates

3.) Valepotriates

The clinical effects of chasteberry probably depend on modifying the activity of which hormone? 1. ) Progesterone 2. ) Testosterone 3. ) Prolactin 4. ) Estrogen

3.) Prolactin

All of the following side effects have been reported for ginseng. According to our text, which group may have been due to another herb or drug in the ginseng product? 1. ) Increased blood pressure and sleep and gastrointestinal problems 2. ) Breast tenderness, menstrual irregularities, and decreased libido 3. ) Allergic reactions 4. ) Lower levels of blood sugar in diabetics

1.) Increased blood pressure and sleep and gastrointestinal problems

Distinguish between the pharmacological effects of ginkgo biloba and St. John's wort 1. ) Inhibits synaptic reuptake of neurotransmitters 2. ) Upregulates 5-hydroxytryptamine receptors 3. ) Increases tolerance of brain tissue to hypoxia 4. ) Inhibits platelet activation factor (PAF) 5. ) Increases skin response to the effects of UV radiation 6. ) Inhibits age-related decline of choline and alpha-adrenergic receptors Choices: A.) Hypericum perforatum (St. John's Wort) B.) Ginkgo biloba

1. ) Hypericum perforatum 2. ) Hypericum perforatum 3. ) Ginkgo biloba 4. ) Ginkgo biloba 5. ) Hypericum perforatum 6. ) Ginkgo biloba

Which botanical has been found more effective as the whole dried herb than as an ethanolic extract? 1. ) Butterbur 2. ) Willow 3. ) Feverfew 4. ) Boswellin

3.) Feverfew

Match the botanical term with the mechanism of action associated with it in the treatment of digestive tract dysfunction: 1. ) Bitter 2. ) Cholegogue 3. ) Carminative Choices: A.) Relieve bloating and fullness by facilitating gas expulsion B.) Stimulate gastric secretions C.) Promote bile production and emptying of the gallbladder

1. ) Stimulate gastric secretions 2. ) Promote bile production and emptying of the gallbladder 3. ) Relieve bloating and fullness by facilitating gas expulsion

All of the following mechanisms, except one, have been identified for nettle extracts. Which one is NOT a mechanism for nettle extracts? A.) Inhibit prostatic aromatase B.) Anti-inflammatory effects C.) Reduce blood prolactin levels D.) Inhibition of 5-alpha reductase enzyme

C.) Reduce blood prolactin levels

Two of the following mechanisms have been demonstrated for pygeum extracts, one has not. Which one has NOT been demonstrated for pygeum extracts? A.) Inhibition of 5-alpha reductase enzyme B.) Inhibition of aromatase enzyme activity C.) Interactions with sex-hormone-binding globulin (SHBG)

C.) Interactions with sex-hormone-binding globulin (SHBG)

What is the specific part used for pain in? Butterbur A. Bark B. Rhizome C. Leaves

How does hawthorne extract differ pharmacologically from cardiac glycosides such as digitalis? A.) Hawthorne is negatively inotropic yet proarrhythmic B.) Hawthorne is negatively inotropic yet antiarrhythmic C.) Hawthorne is positively inotropic yet antiarrhythmic D.) Hawthorne is positively inotropic yet proarrhythmic

C.) Hawthorne is positively inotropic yet antiarrhythmic

What is the specific part used for pain in? Devil's claw A. Rhizome B. Seeds C. Tuber

``` Which plant part(s) of petasides hybridus was first used for an extract called Ze 339, developed to treat allergic rhinitis? A.) Root and leaf B.) Leaf C.) Root D.) Entire plant ```

B.) Leaf

What is the proposed active constituent or licensed standardized extract? Butterbur

Petadolex

T/f a side effect of kava is dystonia ?

``` What part of the milk thistle plant is the typical source from which silymarin is extracted? A.) Above ground parts B.) Root C.) Seed D.) Leaf ```

C.) Seed

``` Following administration of the radioactive isomer of a certain amino acid, large fractions of the radioactivity was found rapidly and simultaneously to appear in the subjects DNA, RNA, porphyrins, collagen and glutathione. Which amino acid was used? A.) Glycine B.) Arginine C.) Valine D.) Histidine ```

A.) Glycine

``` Which fatty acid source is appropriate for treatment of a patient with ALA and EPA in their upper quintiles and with LA and GLA in their first deciles? A.) Flax oil B.) Primrose oil C.) Fish oil D.) Corn oil ```

B.) Primrose oil

``` S-Adenoxylmethionine therapy is most likely to be helpful in cases where elevation of which amino acid is found? A.) Phosphoethanolamine B.) Hydroxylysine C.) 3-Methylhistidine D.) Taurine ```

A.) Phosphoethanolamine

``` Which factor most commonly leads to multiple elevations of essential amino acids in fasting plasma? A.) Vitamin B6 deficiency B.) Vitamin K deficiency C.) Chronic hypochlorhydria D.) High protein diet ```

A.) Vitamin B6 deficiency

``` A patient with chronic negative calcium balance is expected to have elevated calcium in which specimen type? A.) Erythrocytes B.) Whole blood C.) Unchallenged 24 hr urine D.) Head hair ```

D.) Head hair

In a patient with multiple signs of oxidative stress, physiological forms of which two micronutrients are needed because they act in tandem directly upon glutathione to achieve the recycling of the oxidized to the reduced form? A.) lysine and taurine B.) EPA and DHEA C.) folate and vitamin B12 D.) lipoate and nicotinamide

D.) lipoate and nicotinamide

Which of the following is a function NOT served by the single carbon pool? A.) Delivery of reducing equivalents to form BH4 B.) Delivery of formyl groups to form purines C.) Delivery of methylene groups to form pyrimidines D.) Delivery of methyl groups to form SAMe

A.) Delivery of reducing equivalents to form BH4

``` Which of the following is a urinary organic acid that becomes elevated as a result of Coenzyme Q10 deficiency? A.) Vanilmandelate B.) Succinate C.) Pyroglutamate D.) D-Lactate ```

B.) Succinate

A patient whose diet contains very low levels of polyphenols may have false negative results for which test? A.) Urinary microbial markers B.) Stool sIgA levels C.) Caffeine clearance D.) Schillling test for vitamin B12 absorption

A.) Urinary microbial markers

``` A patient who shows steadily falling levels of erythrocyte arachidonic acid after initial normal levels were found would be suspected of excessive intake of which dietary oil? A.) Fish B.) Borage C.) Coconut D.) Corn ```

A.) Fish

``` What is the principal form of circulating fatty acids in the fasting state? A.) LDL B.) Chylomicrons C.) HDL D.) Free fatty acids ```

A.) LDL

``` Concurrent elevations of urinary L-lactate and pyruvatehave been shown to respond favorably to which vitamin supplementation? A.) Lipoic acid B.) Ascorbic acid C.) Pantothenic acid D.) Folic acid ```

A.) Lipoic acid

Which laboratory finding tells you that a patient has an increased risk of kidney stone recurrence? A.) Low urinary citrate B.) Low urinary zinc C.) Low urinary taurine D.) Low urinary 25-hydroxycholecalciferol

A.) Low urinary citrate

``` A patient with biotin deficiency is likely to show elevated levels of which fatty acid? A.) Nonadecanoic B.) Lignoceric C.) Myristoleic D.) Lauric ```

A.) Nonadecanoic

``` Essential fatty acid deficiency results in rising levels of which fatty acid? A.) Palmitoleic B.) Arachidonic C.) Linoleic D.) Hexacosanoic ```

A.) Palmitoleic

Which phrase describes the first step in the assimilation of ingested dietary zinc? A.) Release of bound zinc from food complexes that are denatured by gastric acid B.) Binding of free zinc to metal ion transporters in enterocyte brush borders C.) Transfer of ionic zinc to zinc fingers D.) Metallothionein loading with zinc

A.) Release of bound zinc from food complexes that are denatured by gastric acid

Among reports in the medical literature, which is the most commonly used specimen for arsenic exposure screening?A.) Urine B.) Serum C.) Whole blood D.) Hair

A.) Urine

Which laboratory abnormality would be the most ominous as a risk factor for a chronic pain patient who has a tendency to overdose her acetaminophen? A.) Low plasma methionine B.) Low serum vitamin D C.) Elevated urinary hydroxymethyglutarate D.) Elevated erythrocyte copper

A.) Low plasma methionine

``` What compound is a precursor in human cells fortetrahydrobiopterin production? A.) GTP B.) Folinic acid C.) Tyrosine D.) Glutamine ```

A.) GTP

``` Which specific compound, appearing at elevated levels in plasma or urine, would best identify a patient who habitually consumes chicken or turkey almost every day? A.) Anserine B.) Carnosine C.) Xanthurenic acid D.) Pipecolic acid ```

A.) Anserine

``` Finding multiple odd-chain fatty acids in erythrocytes means that there is some process causing elevated levels of which compound? A.) Stearate B.) Fumarate C.) Erucate D.) Propionate ```

D.) Propionate

``` Finding very high levels of which element in erythrocytes would be of greatest concern regarding the recent appearance of toxic manifestations in a patient with a history of low urinary selenosugars? A.) Mercury B.) Cadmium C.) Aluminum D.) Lead ```

A.) Mercury

``` A patient with an elevated level of beta-hydroxyisovalerate in urine is a candidate for which nutrient addition? A.) Biotin B.) Vitamin B6 C.) Folic acid D.) Lipoic acid ```

A.) Biotin

In order to rapidly offset acute increases in oxidative stress, homocysteine trans-methylation is inhibited while which pathway is stimulated? A.) Homocysteine trans-sulfuration B.) The SN1-SN2 transporter system C.) Methylation of glycine to form sarcosine D.) Phenylalanine conversion to tyrosine

A.) Homocysteine trans-sulfuration

``` In the absence of any other laboratory evidence, finding a pattern of strongly elevated serene with low glycine on a plasma amino acid profile would suggest deficiency of which essential nutrient? A.) 5-Methyltetrahydrofolate B.) Thiamin C.) Vitamin C D.) Vitamin D ```

A.) 5-Methyltetrahydrofolate

``` Which urinary organic acid profile elevated result would be suspected to have been produced by finding that the patient had consumed a large serving of bananas and black walnuts with her evening meal before the overnight urine specimen collection for the test? A.) 5-Hydroxyindoleacetate B.) 8-Hydroxy-2'-deoxyguanosine C.) Xanthurenate D.) Tricarballylate ```

A.) 5-Hydroxyindoleacetate

``` If glycine is to be administered to support Phase II detoxification, what vitamin also is specifically indicated? A.) Pantothenic acid B.) Vitamin B12 C.) Ascorbic acid D.) Thiamin ```

A.) Pantothenic acid

``` Folic acid supplementation is indicated when a LOW result is found for which laboratory test? A.) Plasma histidine B.) Plasma methionine C.) Urinary pyroglutamate D.) Serum homocysteine ```

A.) Plasma histidine

If a patient is found to be homozygous for SNP that causes lowered activity of the enzyme required for conversion of dopamine to epinephrine, what laboratory report abnormality would show metabolic confirmation of the effect? A.) Low urinary vanilmandelic acid B.) High urinary vanilmandelic acid C.) High urinary 5-hydroxyindoleacetic acid D.) Low urinary pyroglutamic acid

A.) Low urinary vanilmandelic acid

``` When a patient's laboratory report shows very low zinc, what other abnormality takes on greatly added significance regarding need for clinical management? A.) Elevated blood cadmium B.) High erythrocyte magnesium C.) Elevated urinary mercury D.) Low stool predominant bacteria ```

A.) Elevated blood cadmium

``` Which laboratory result would provide biochemical confirmation of functional impact from a genetric polymorphism that impairs metabolism of catecholamines? A.) Low urinary VMA and HVA B.) High urinary VMA and HVA C.) High plasma Phe and low Tyr D.) High urinary picolinic acid ```

A.) Low urinary VMA and HVA

``` What region of the normal human intestinal tract has the greatest rate of increase in bacteria populations per inch of transit? A.) Ileum B.) Duodenum C.) Ascending colon D.) Sigmoid colon ```

A.) Ileum

Which of the following steps in gene expression can be altered by environmental factors? A.) DNA transcription B.) RNA translation C.) Post-translational protein alterations D.) All of the above are correct responses

``` Which of the following is the most abundant PUFA in the average American diet? A.) Linoleic B.) Oleic C.) GLA D.) ALA ```

A.) Linoleic

``` Which antioxidant is found in erythrocytes at levels nearly 10 times those found in blood plasma? A.) Taurine B.) Tocopherol C.) Glutathione D.) Magnesium ```

A.) Taurine

Which ultratrace element, in pharmacological quantities, mimics the action of insulin? a. silicon b. boron c. vanadium d. nickel

c. vanadium

Which is the best measure of vitamin K status? a. INR b. des-γ-carboxyglutamic prothrombin c. prothrombin time d. PTH concentration

c. prothrombin time

Two enzymes that function in the disposal of hydrogen peroxide within cells and tissues are: a. Glutathione peroxidase and superoxide dismutase b. Amine oxidase and glutathione peroxidase c. Catalase and amine oxidase d. Catalase and superoxide dismutase e. Glutathione Peroxidase and catalase

e. Glutathione Peroxidase and catalase

Which vitamin directs cellular differentiation of epithelial cells? a. vitamin E b. riboflavin c. vitamin K d. vitamin A

d. vitamin A

Which micromineral deficiency interferes with vitamin A metabolism by reducing retinol binding protein? a. zinc b. selenium c. iron d. manganese

a. zinc

Which vitamin is associated with improved plasma membrane structure and glucose transport/metabolic control in people with type 2 diabetes? a. A b. D c. E d. K

c. E

Which mineral is associated with the glucose tolerance factor (GTF)? a. cobalt b. copper c. manganese d. chromium

b. copper

Which of the following vitamins has a Tolerable Upper Intake Level established? a. thiamin b. vitamin B6 c. vitamin B12 d. riboflavin

b. vitamin B6

Mr. S. takes warfarin due to his valve replacement surgery. He is an avid gardener and enjoys eating the many green leafy vegetables he grows. You caution Mr. S. to tell his physician about this because the amount of warfarin he takes may need to be _____ a. increased b. decreased

increased