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WorksheetsNDLE 2020 REVIEW EXAM
Total questions: 60
Worksheet time: 2hrs 0mins
A 35 year old patient visited her dermatologist and was given medication to treat her psoriasis. It is characterized as a rapid growth of skin cells presenting with itchy and scaly red patches on the skin. Which vitamin-like substance should be avoided in the diet?
Inositol
Taurine
Carnitine
Choline
J.D. was born with a metabolic disorder called maple syrup urine disease wherein the body has an inability to to metabolize BCAAs. Which among the following are examples of branched chain amino acids?
Isoleucine, Valine
Methionine, Leucine
Leucine, Lysine
Isoleucine, Tryptophan
Which among the following statements is TRUE about vitamin C?
Acts as an antioxidant by donating an oxygen atom to form a stable ascorbyl-free radical
Decreases iron uptake by the duodenum and jejenum through its reaction with non-heme iron
Boosts immunity because of its anti-inflammatory function
Cofactor in the hydroxylation of proline and lysine in collagen synthesis
P.D. has been diagnosed with clinical depression for two years now. One of the medications given by the doctor are monoamine oxidases. Contraindications of the drug include intake of tyramine-rich foods. Which among the following food choices is not contraindicated?
Salami and cheddar sandwich
Samgyupsal with kimchi
Spicy miso ramen with boiled egg
Steak with mashed potatoes
A 72 year old patient diagnosed with a slowly progressive neurologic disorder is taking levodopa every morning as one of her medications. Which among the following statements BEST represents dietary modifications in patients with parkinson’s disease?
Protein intake should be taken during dinner to avoid negative drug-nutrient interactions
Protein intake should be taken in the morning with breakfast to increase absorption of medication
Increased fat intake has no significant effect on levodopa metabolism
Eating egg whites in the morning should be avoided
Ram was raised in a vegetarian family and has a hard time eating out with his high school friends due to the limited options. His mother decided to bring packed lunches to avoid the trouble but is worried about her son lacking the right intake of amino acids. Which of the following BEST describes limiting amino acids in food?
Grains contain ample amounts of methionine but lack lysine
Legumes contain ample amounts of lysine and methionine
Soybeans contain ample amounts of lysine but lacks threonine and tryptophan
Cassava have a high lysine and methionine content
Which among the following statements BEST describes ketone bodies as a result of fatty acid oxidation?
Ketone bodies include acetoacetate, acetone, and hydroxybutyrate synthesized mainly in the kidneys
Higher than normal quantities of ketone bodies in the urine and blood is caused by starvation, high-fat feeding, and severe exercise in the post-absorptive state
Ketone bodies serve as an alternate source of fuel for erythrocytes and skeletal muscle tissue in times of starvation
Continual excretion in quantity of ketone bodies depletes acid reserve causing ketoacidosis
Menkes disease is characterized by kinky hair and growth retardation and reflects a dietary deficiency of which mineral?
Copper
Manganese
Zinc
Iron
Which of the following choices consist entirely of essential amino acids
Tryptophan, Tyrosine, Phenylalanine
Alanine, Lysine, Leucine
Aspartate, Isoleucine, Histidine
Threonine, Arginine, Valine
The following are non-reducing carbohydrates EXCEPT:
Lactose
Maltose
Sucrose
Galactose
Which of the following statements BEST relates to the digestion of carbohydrates?
Digestion starts in the stomach
Amylase aids in the digestion of carbohydrates in the stomach because it is not inactivated by HCl
In lactase deficiency, because of the lack of disaccharidase, lactose cannot be converted into glucose and galactose
There is no digestion of disaccharides and starch once chyme reaches the ileum
Which is found in plant oils?
Beta linolenic acid
Docosahexaenoic acid
Alpha linolenic acid
Eicopentaenoic acid
A 59 year old male consulted his physician for high cholesterol after a lipid profile was taken. He experiences occasional chest pain due to 12 years of Losartan intake and is relieved by rest. The physician referred him to a dietitian who prescribed a diet that included:
Hydrogenated vegetable oil
Corn oil
Mackerel oil
Enriched margarine
Which plasma lipoprotein is synthesized in the liver, contains a high concentration of triglycerides, and is mainly cleared from the circulation by adipose tissue and muscle?
LDL
Chylomicron
VLDL
HDL
Which of the following plays the most important role in determining the serum cholesterol concentrations of individuals?
Heredity
High fat diet
Physical inactivity
Smoking
Which among the following statements DOES NOT describe fructose?
Increased intake leads to increased fatty acid synthesis and raises serum TAG and LDL due to bypassing regulatory steps in glycolysis
Increased intake causes increased formation of uric acid leading to hyperuricemia, which aggravates gout
Deficiency of enzymes that metabolize fructose causes hyperglycemia and diarrhea
It can be made by enzymic isomerization of glucose syrups for food manufacture
Which among the following statements BEST describes carbohydrates?
Inulin is insoluble in water and is used to determine glomerular filtration rate
Dextrins are intermediates in the hydrolysis of starch
Cellulose consists of beta 1-6 bonds explaining why humans cannot digest it due to the lack of the enzyme that hydrolyzes its bond
Ribose is an intermediate in the pentose phosphate pathway
Due to its lack of mitochondria, erythrocytes rely on what biochemical energy pathway for energy?
Glycolysis
Gluconeogenesis
Pentose phosphate pathway
Glycogenolysis
Which of the following statements BEST describes the Kreb’s cycle?
Sequence of reactions in the cytosol that oxidizes acetyl CoA to carbon dioxide and transports coenzymes through the electron transport chain, linked to the formation of ATP
Final common pathway for the oxidation of carbohydrates, lipids, NADH, FADH, and proteins
Deficiency of thiamin allows pyruvate to accumulate causing lactic acidosis
First reaction is the formation of oxaloacetate from acetyl CoA and citrate
Insulin may regulate metabolism by:
Stimulating fat oxidation and inhibiting lipogenesis
Stimulating protein breakdown and inhibiting protein synthesis
Inhibiting muscle glucose uptake and stimulating liver glucose uptake
Inhibiting glycogenolysis and stimulating glycogenesis
The Cori cycle involves the conversion of lactate back to pyruvate. Which organs are capable of this cycle?
Small intestine and smooth muscles
Pancreas and heart
Kidney and skeletal muscles
Liver and skeletal muscles
Diabetes mellitus affects plasma lipids by:
Decreasing levels of VLDL
Decreasing levels of cholesterol
Increased levels of TAG
Increased utilization of chylomicrons
Which is most likely to occur when a patient has a deficiency of vitamin B6?
Hemolytic anemia
Hypoglycemia due to inefficient hepatic glycogenolysis
Inability to convert purine to uric acid
Decreased sensitivity to vitamin D
Which of the following are responses of the body to increased glucagon
Lipogenesis, glucose uptake
Lipolysis, ketogenesis
Guconeogenesis, protein synthesis
Glycogenesis, lipolysis
What BEST describes the weight loss during a ketogenic diet?
Fat has a higher amount of kilocalories per gram than carbohydrates and protein
Body increases stores of glycogen which causes longer satiety and lesser food intake in a day
Low carbohydrate deems considerable amount of gluconeogenesis from amino acids, which is associated with a high ATP cost that must be met by oxidation of fatty acids
Increased free fatty acids metabolized to ketone bodies which is costly in terms of ATP
Maria breastfeeds her 2 month old infant and noticed water stools after feeding. The baby is most likely deficient in what enzyme?
Maltase
Sucrase
Lactase
Trypsin
A.J., a 28 year old architect working in a firm in Taguig had lunch together with her workmates at a nearby restaurant. After 18 hours, she experienced diarrhea. After consult with her physician and lab results were taken, she was diagnosed with having a cholera infection probably from drinking contaminated water. She was prescribed with rest and oral rehydration therapy. Which is true about rehydration through ORS?
Transport of glucose and Na across the intestinal epithelium forces movement of water by osmosis from the lumen of the gut into the intestinal cells
Homemade ORS solutions with NaCl alone will be effective in rehydration
5:1 ratio of water and sodium for homemade ORS
None of the above
High protein intake increases glomerular filtration rate and overworks the kidneys predisposing to renal diseases through the following mechanism:
Amino acids are reabsorbed together with sodium in the kidney through facilitated diffusion causing it to increase GFR
Amino acids decreases insulin sensitivity causing high blood glucose levels and destroying kidney tissue membranes
Excessive amino acids in the gut become unabsorbed causing the kidneys to increase clearance of amino acids through urinary excretion
None of the above
Why is gluten considered a food allergen for patients with celiac disease?
Large peptides may be absorbed intact that are large enough to stimulate antibody formation
Lack of enzymes that breakdown the gliadin portion of gluten
Celiac disease is a food intolerance and not a food allergy
Patients with celiac disease develop an antigens against gluten in the large bowel
T.J., a 60 year old diabetic patient taking oral hypoglycemics combined with insulin for glycemic control sought consult with an RND for dietary advice. His lab results show the following: HbA1C of 7%; blood pressure of 140/90 mmHg; and a fasting plasma glucose of 100 mg/dL. Which among the following goals are unmet?
HbA1C only
HbA1C and fasting plasma glucose
Blood pressure and fasting plasma glucose
Blood pressure and HbA1C
How many percent of nitrogen is in a gram of protein?
15%
16%
17%
18%
A 55 year old male laborer presented with complaints of chronic diarrhea with 12 kilograms of weight loss in the past year with no history of fever, steatorrhea, or fever. Physical exam revealed emaciated man with glossitis, cheilitis, and angular stomatitis with significant pedal edema. Which vitamin is most likely deficient?
Thiamin
Riboflavin
Niacin
Vitamin B6
A 20 month old child was admitted for generalized edema for 2 weeks and was a product of a full-term normal delivery in a local hospital. She was exclusively breastfed for 14 months and was shifted to cow’s milk. At 18 months, she developed periorbital edema and worsening skin lesions, with thin and sparse hair, and was increasingly irritable. Her weight is below the 10th percentile and her height is below the 5th percentile. Hepatomegaly was detected. This is a most likely a case of:
Overall protein and calorie deficiency
Protein deficiency with sufficient calorie intake
Calorie deficiency with sufficient protein intake
Needs more information to determine type of malnutrition
A 45 year old woman was admitted was admitted for jaundice. She was diagnosed with an obstruction of the common bile duct due to stone formation. What will it likely result in?
Vitamin B deficiency
Steatorrhea
Impaired digestion of starch
Pancreatic insufficiency
The following statements are true about Vitamin A, EXCEPT:
Regulation of gene expression and tissue differentiation
Component in visual pigments in the retina
Beta carotene is an antioxidant
Toxicity leads to increased susceptibility to infection
The following statements are true about Vitamin D, EXCEPT:
Cholecalciferol is converted to 25-hydroxycholecalciferol in the kidneys
Has a potent effect in increasing calcium absorption from the intestinal tract
Slight decrease in calcium concentration below normal causes increased formation of activated vitamin D
Promote phosphate absorption by the intestines
G.G., a 32 year old nurse is at risk of thrombosis and is prescribed with warfarin therapy. Which should be avoided in the diet?
Phylloquinone
Tocopherol
Pantothenic acid
Biotin
R.K., a 49 year old jeepney driver has a history of alcoholism for 12 years with poor diet. Neurologic changes became apparent. He was brought by his wife to the hospital and was told that he had Wernicke-Korsakoff syndrome. What is the vitamin that is most likely deficient in the diet?
Thiamin
Riboflavin
Niacin
Vitamin B6
Y.T., a 38 year old librarian diagnosed with pellagra experiences photosensitive dermatitis, diarrhea, and depression. Studies show that niacin deficiency causes this condition. Niacin can be synthesized from what amino acid?
Phenylalanine
Histidine
Tryptophan
Tyrosine
In the Philippines, there is a high incidence of cases of tuberculosis. Patients with this condition are usually prescribed with isoniazid. What vitamin has a negative drug-nutrient interaction with isoniazid?
Vitamin B12
Vitamin B6
Folic acid
Niacin
Vitamin B12 is mostly absorbed in which part of the intestinal tract?
Proximal jejunum
Terminal ileum
Large intestine
Distal duodenum
Pantothenic acid’s central role in metabolism is:
Part of the structure of coenzyme A
Widely distributed in food
Coenzyme in carboxylase reactions
Important in cholesterol transport
Which of the following hormones stimulates pancreatic enzyme secretion and inhibits gastric emptying?
Secretin
Cholecystokinin
Gastrin
Gastric inhibitory peptide
Which of the following enzymes stimulates pancreatic bicarbonate secretion and pepsin secretion?
Secretin
Cholecystokinin
Gastrin
Motilin
L.A., a 25 year old medical student has been diagnosed with chronic gastritis causing destruction of acid-producing parietal cells in the stomach. Which nutrient deficiency is he most likely to experience?
Vitamin C
Vitamin B12
Iron
Calcium
Which of the following nutrients are NOT co-transported with sodium in the intestines?
Glucose
Galactose
Fructose
Amino acids
A 60 year old patient with a history of chronic alcoholism was sent to the OPD for abdominal discomfort and bloatedness. Examination and further testing showed selective destruction of gastric glands. The condition would predispose which of the following?
Gastric hypomotility
Gastric ulcer
Steatorrhea
Anemia
Severe cases of sprue could most likely lead to the following, EXCEPT:
Wasting
Osteomalacia
Inadequate blood coagulation
Microcytic anemia
Defined as a metabolic disorder of increased energy expenditure leading to weight loss greater than that caused by reduced food intake alone:
Anorexia
Cachexia
Inanition
Starvation
Which among the following statements is true about aldosterone?
Increases renal tubular reabsorption of sodium
Decreases excretion of potassium
Excess causes hyperkalemia and muscle weakness
Deficiency causes acidosis
Which among the following statements is true about nutrition of the neonate?
Before birth, the amount of glucose stored in the infants’s body in the form of glycogen is sufficient to supply his/her needs
Appropriate mechanisms allow the infant to use its stored fats and proteins for metabolism until mother’s milk can be provided 2-3 days later
After birth, the fetus derives almost all of its energy from glucose obtained from the mother’s blood
Infant’s weight increases within the first 2-3 days of life
How many irreversible steps are there in glycolysis?
1
2
3
4
M.P., a 30 year old call center agent loves to eat isaw and kwek kwek during his breaks and goes drinking with friends at the bar twice a week. He noticed severe joint pain and was told by his doctor that he had gouty arthritis. Which statement BEST explains this condition?
Uric acid is the end product of purine metabolism and humans lack the enzyme to convert it into a more water soluble substance
Street food is high in uric acid content and alcohol aggravates the gouty arthritis
Tophi deposits in the joints is due to the mainly lack of water intake in the diet
Alcohol disrupts uric acid excretion in the body hence tophi formation in the joints
P.S., a 29 year barista underwent a liver biopsy and revealed that she has a malignant hepatic carcinoma in the left lobe of her liver. Liver function tests also reveals abnormally low levels of plasma proteins. What is likely to happen with low albumin production?
Continuous fibrosis of liver
Generalized edema
Hepatic coma
Vitamin A deficiency
The most common microorganism linked to tooth decay:
Candida albicans
Staphylococcus aureus
Streptococcus mutans
Clostridium perfringens
Delayed gastric emptying is also called:
Receptive relaxation
Hunger pangs
Peristalsis
Gastroparesis
Mr. Harper visited his favorite restaurant after work and ordered a cheeseburger and fries and a milkshake. Assuming he consumed 5 exchanges of carbohydrates, 4 exchanges of medium fat meat, 2 tablespoons of sugar, 2 tablespoons of oil, and 1 slice of cheddar cheese, about how many kilocalories did he consume?
1230 kcal
1266 kcal
1060 kcal
1166 kcal
How many milligrams of sodium is in 2 teaspoons of table salt?
1800 mg
2100 mg
2400 mg
2700 mg
A respiratory quotient of <0.65 indicates:
Starvation
High carbohydrate feeding
High protein feeding
Mixed diet
T.K., a 62 year old male with chronic renal disease stage V is undergoing hemodialysis 3 times a week. What should be the diet appropriate for him?
Increased protein intake
Restricted protein intake
Protein requirement according to age
Similar protein requirement as stage IV
