nutrition.doc

_ B_11. The major protein involved n the storage or iron is: A. lactoferrin C. transferrin B ferritin D. ferredoxin A_ 12. Iron that has anti-microbial effects thus can protect the newborn: A. lactoferrin C. apoferritin B. ferredoxin D. transferrin B_ 13. The following statement(s) is/are true about iron: A. Cooking of food does not necessarily affect its absorption. B. Low ph is necessary in its absorption C. Much of it is absorbed in the intestines and much is also excreted. All of the above are true D_ 14. Ingested iron is: A. Absorbed by the mucosal cell B. Once absorbed by the mucosal cell, it can be excreted through cellular slough. C. Absorbed, then it could be absorbed by the capillary and trapped by transferrin. D. All of the above are true. 60% _ B_ 15. Protein digestion starts in the: A. Mouth where the amylase can be found. B. Stomach where the acidic environment favors denaturation. C. Intestines where proteolytic enzymes are abundant D. All of the above. _A_ 26. A co-enzyme that can act alternately as an oxidizing and reducing agent is – A. Vitamin C C. Vitamin B2 B. Vitamin B1 D. Vitamin K B_ 46. The freely moving calcium in tissue, extracellular fluid and blood is known as: A. Ionized calcium C. Bound-calcium B. Miscible calcium pool D. All of the above _B_ 47. The vitamin that aids the absorption of calcium and phosphates in the GIT: A. Vitamin A C. Vitamin E B. Vitamin D D. Vitamin K 70% _C_ 48. Iron in the diet is reduced to the ferrous form in the presence of: A. Ferritin C. Gastric acidity B. Antacids D. Calcium _D_ 53. Once formed in the body, cholesterol can give rise to – A. Bile acids C. Steroid hormones B. Vitamin D D. All of the above

1.

An important anti oxidant because it inhibits the formation of nitrosamines during digestion a. retinol b. ascorbic acid c. tocopherol d. retinoic acid e. cobalamin (Harper’s pp640-641)

2.

Deficiency of this may lead to anemia in the prematures due to red blood cell hemolysis a. Vit A b. Vit D c. Vit E d. Vit C e. Vit K (Harper’s pp 647-648)

3.

A cofactor of an important enzyme of the pentose phosphate pathway, transketolase a. Thiamine b. Biotin c. Niacin d. Riboflavin e. Pantothenic acid (Harper’s pp 627)

4.

Functions as a cofactor to a carboxylase that acts on glutamate residues of clotting factor precursor proteins a. Vitamin A b. Vitamin C c. Vitamiin E d. Vitamin K e. Biotin ( Harper’s PP 649)

5.

A polyisoprenoid compound containing a cyclohexenyl ring a. Folic acid b. Pyridoxine c. Ascorbic acid d. Retinol e. Biotin ( Harper’s p 642)

6.

The earliest clinical symptom of Vitamin A deficiency a. defective night vision b. xerophtalmia c. presence of Bitots spots d. Keratomalacia e. Xerosis conjunctivae (Harper’s p 643)

7. This vitamin is important in the regulation of calcium and phosphate metabolism a. Vitamin A b. Vitamin E c. Thiamin d. Folic acid e. Vitamin D ( Harper’s p 645) 8. If a patient exhibits low activity of propionyl CoA carboxylase, therapeutic doses of which of the following might be beneficial? a. carnitine b. pantothenic acid c. biotin d. riboflavin e. niacin ( Harper’s p 635) 9.

Strict vegetarians are susceptible to this kind of vitamin deficiency a. pantothenic acid b. cobalamin c. folacin d. niacin e. pyridoxine ( Harper’s p 635)

10. . Of the following, which is the most potent form of vitamin D? a.ergosterol b.cholecalciferol c.7-dehydrocholesterol d.25-hydroxycholecalciferol e. 1,25-dihydroxycholecalciferol ( Harper’s p 647) _C__87. True regarding basal metabolic rate: A. increased during starvation B. increased in hypothyroidism

C. increased during pregnancy D. increased in old age

_B__88. Manifestation(s) of marasmus: A. edema C. hepatomegaly B. skin and bones appearance D. flag sign E. all of the above _B__89. Function(s) of lipids: A. main source of energy B. maintains integrity of cell membrane C. maintains normal osmotic relations among cellular compartments D. build and repair tissues E. all of the above _B__90. The active part of riboflavin that participates in oxidation/reduction reactions: A. adenine C. phosphoric acid B. isoalloxazine ring D. isopentenyl ring _B__91. This is the major excretory form of vitamin C: A. dehydroascorbic acid C. diketogulonic acid B. oxalic acid D. gulonolactone _B__92. In thiamine deficiency, severe muscle weakness occurs because: A. conversion of pyruvate to lactate does not take place B. conversion of pyruvate to acetyl CoA does not occur C. conversion of pyruvate to oxaloacetate does not take place D. conversion of pyruvate to ATP is blocked _D__93. Microcytic, hypochromic anemia is a deficiency manifestation of: A. Vitamin B6 C. Pantothenic acid B. Vitamin C D. A and B _A__94. This vitamin functions as coenzyme in the major anaphlerotic reaction of the body: A. Biotin C. Folic acid B. Pyridoxine D. Pantothenic acid _B__95. This is a test for folic acid deficiency: A. Tryptophan load test C. Glutamine load test B. Histidine load test D. Tyrosine load test _D__96. This function makes vitamin A anticarcinogenic: A. maintenance of the integrity of the RBC membrane B. maintenance of the integrity of the germinal epithelium C. maintenance of the integrity of mucopolysaccharides D. maintenance of the integrity of the epithelial tissues _B__97. Activation of vitamin D involves: A. a two-step reduction process C. a two-step hydrogenation process B. a two-step hydroxylation process D. a two-step oxidation process _B__98. This pathway can convert glucose to ascorbic acid: A. phosphogluconate pathway C. Embden-Meyerhof pathway B. glucuronic acid pathway D. Pentose phosphate pathway 19. Synthesis of nutritionally nonessential amino acid involves the: A. formation of aspartate from a glycolytic intermediate

B. hydroxylation of phenylalanine to form tyrosine C. interconversion of proline and glutamate via tetrahydrofolate. D. transamination of @ketoisovalerate to valine (Answer: B / Reference A: p. 237, 239, 328 / MPL 60) 26. Deficiency of B complex vitamins can lead to decreased enzymatic activity because derivative of B complex: A. are allosteric effectors for some enzymes. B. are important component of active sites. C. act as co-enzymes of some enzymes. D. are needed to form ribozymes. (Answer: C / Reference A: p. 50 / MPL 60) 58. One of the following is needed in the rate limiting reaction of bile acid synthesis: A. ascorbic acid C. NADH B. Biotin D. succinate (Answer: A / Reference A: p. 226 / MPL 90) 82. The oxidant stress of infection is most likely to trigger the development of: A. cachexia C. marasmus B. kwashiorkor D. 2nd degree malnutrition (Answer: B / Reference: p. 479 / MPL 60) 80. Which of the following is TRUE of micronutrients absorption? A. Gastric intrinsic factor is required for the absopriton of hematopoeitic B vitamins. B. Impaired fat absorption can lead to calcium and fat soluble vitamin malabsorptions. C. Calbindin is vital for the absorption of macrominerals. D. Absorption of iron is strictly regulated by the concentration of intestinal hemosiderin and plasma transferrin. (Answer: B / Reference A: p. 477, 478 / MPL 33) 83. An abnormality in the biliary system of a Filipino is most likely to result in: A. Beri-beri C. Osteomalacia B. Hemorrhagic disorder D. Pellagra (Answer: B / Reference: p. 482 / MPL 33) 84. The importance of sunlight to vitamin D/calcium homeostasis: A. It is the richest source of vitamin D. A. Ultraviolet rays are important for the activation of vitamin D to its functional active form. B. Sunlight is required for the resorption of bone to release calcium in instances of hypocalcemia. C. It participates in photolysis of provitamin D in skin to previtamin D. (Answer: D / Reference A: p. 484 / MPL 60)

85. Inadequate intake of which vitamins/minerals in the maternal diet may result in spina bifida in the newborn: A. Calcium C. Folic acid B. Iron D. Vitamin K (Answer: C / Reference: p. 494 / MPL 90) 86. One of the following is CORRECT of ascorbic acid: A. It is a 6-carbon compound closely related to galactose B. It is a reducing agent and oxygen radical quencher. C. Megadosing of vitamin C has curative effect against common colds. D. Its deficiency state is attributed to deficient elastin formation.. (Answer: B / Reference A: p. 495, 496 / MPL 60) 89. Which vitamin and mineral is involved in blood coagulation? A. Calcitriol and magnesium C. Retinoic acid and potassium B. Menaquinone and calcium D. @ Tocopherol and sodium (Answer: B / Reference A: p. 486, 600 / MPL 90) 90. Hyperhomocysteinemia, a risk factor for cardiovascular disease, is fairly common in the elderly because of inadequate intake or under utilization of: A. B1 and B3 C. B5 and B7 B. B2 and B5 D. B9 and B12 (Answer: D / Reference A: p. 492 / MPL 60) 64. Which of the following vitamins acts as a carrier of carbon dioxide in most carboxylation reactions? A. Thiamine C. Biotin B. Cobalamin D. Folic acid Reference: Murray, R. K., et. al., Illustrated Biochemistry, 26th ed., p. 494. 65. The fat soluble vitamin under current investigation for its cardioprotective properties is: A. Vit. A C. Vit. E B. Vit. D D. Vit. K Reference: Champe, P. C., et. al., Biochemistry, 2nd ed., p. 315. 66. The active form of vitamin D is: A. 7-dehydrocholesterol C. 1,25-dihydrocholecalciferol B. cholecalciferol D. 24,25-dihydroxycholecalciferol Reference: Champe, P. C., et. al, Biochemistry, 2nd ed., p. 335. 67. The effects of vitamin A may include all of the following EXCEPT: A. prevention of anemia. C. the visual cycle

B. serving as an antioxidant D. induction of certain cancers Reference: Champe, P. C. et. al., Biochemistry, 2nd ed., pp. 330-332. 68. This mineral ion is a necessary co-factor in all reactions where ATP participates: A. Cu+2 C. Fe+2 +2 B. Mn D. Mg+2 Reference: Berg, J. M., et. al., Biochemistry, 5th ed., p. 254. 79. Which of the following statements about dietary fibers is/are correct? A. Water soluble fiber helps to lower serum cholesterol in most people. B. Mucilaginous fiber slows the rate of digestion and absorption of carbohydrates. C. Insoluble fiber increases stool bulk and decreases transit time. D. All of the above are correct. Reference: Devlin, F. M, Textbook of Biochemistry with Clinical Correlations, 5th ed., p.1134. 80. A complete replacement of animal protein in the diet by vegetable protein: A. would be expected to have no effect at all on the overall diet. B. would reduce the total amount of food consumed for the same number of calories. C. might reduce the total amount of iron and Vitamin B12 available. D. would be satisfactory regardless of the nature of the vegetable protein used. Reference: Devlin, F. M., Textbook of Biochemistry with Clinical Correlations, 5th ed., p. 1134. 81. Which of the following dietary regimens would be most effective in lowering cholesterol? A. Restrict dietary cholesterol B. Increase the ration of polyunsaturated to saturated fatty acids. C. Restrict cholesterol and increase fiber. D. Restrict cholesterol, increase PUFA/SFA and increase fiber. Reference: Devlin, F. M., Textbook of Biochemistry with Clinical Correlations, 5th ed., p. p.1134. 82. The main source of energy for the brain during prolonged starvation would come from: A. Ketone bodies C. Fatty acids B. Glucose D. Proteins Reference: Champe, P. C., t. al., Biochemistry, 2nd ed., p. 294. 83. In the overall scheme of human metabolism, which organ plays the most important role in caloric homeostasis? A. Brain C. Liver B. Kidney D. Muscle Reference: Champe, P. C., et. al., Biochemistry, 2nd ed., p. 283, 292.

84. In the well-fed state, the following molecules are stored XCEPT: A. Carbohydrates C. Fats B. Proteins D. Ketone bodies Reference: Champe, P. C., et. al., Biochemistry, 2nd ed., pp. 282-289. 85. Survival is possible in starvation because: A. The liver synthesizes glucose from non-carbohydrate sources. B. The brain uses glucose as energy source. C. The muscle proteins are not being continuously broken down for energy source. D. The fats are spared from degradation. Reference: Champe, P. C., et. al., Biochemistry, 2nd ed., pp. 292-294.

86. The high glucagon/insulin ratio seen in starvation: A. promotes mobilization of fatty acids from the adipose tissues. B. stimulates β-oxidation by inhibiting the production of malonyl CoA. C. leads to increased concentration of ketone bodies in the blood. D. All of the above. Reference: Devlin, F. M., Textbook of Biochemistry with Clinical Correlations, 5th ed., p. 724. 87. In the early refed state: A. the fatty acid concentration in the blood rises. B. liver glycogenolysis continues to maintain blood glucose levels. C. liver replenishes its glycogen by synthesis of glucose 6-phophate from lactate. D. glucose being absorbed from the gut is used primarily for fatty acid synthesis by the liver. Reference: Devlin, F. M., Textbook of Biochemistry with Clinical Correlations, 5th ed., p. 726. 88. Increased formation of ketone bodies during starvation is due to: A. increased levels of circulating glucagons. B. decreased formation of acetyl CoA in the liver. C. increased levels of free fatty acids in the serum. D. inhibition of β-oxidation of fatty acids in the liver. Reference: Champe, P. C., et. al. Biochemistry, 2nd ed., p.302. 89. Which of the following is the most important source of blood glucose during the last hours of a 48-hour fast? A. Muscle glycogen C. Liver glycogen

B. Acetoacetate D. Amino acids Reference: Champe, P. C., et. al., Biochemistry, 2nd ed., p. 302. 90. The major cell membrane lipids are: A. Phospholipids C. Lipoproteins B. Cholesterol D. Fatty acids Reference: Murray, R. K., et. al., Illustrated Biochemistry, 26th ed., pp. 41698. Which is NOT a function of cholesterol? A. Synthesis of cell membranes. C. Precursor of steroid hormones. B. Synthesis of Vitamin A. D. Precursor of bile salts. Reference: Murray, R. K., et. al., Illustrated Biochemistry, 26th ed., p. 219. 99. Megaloblastic anemia is caused by lack of: A. Panthothenic acid C. Pyridoxine B. Folic acid D. Ascorbic acid Reference: Champe, P. C., Harvey, R. A., Biochemistry, 2nd ed., p. 326. 100. A smoker who complains of soft swollen gums and loose teeth is deficient in Vitamin C and therefore has impaired: A. hydroxylation of proline. B. hydroxylation of dopamine ß-hydroxylase. C. degradation of tyrosine. D. hydroxylation of bile acids. Reference: Champe, P. C., Harvey, R. A., Biochemistry, 2nd ed., p. 40. 1. Humans MOST easily tolerate a lack of which of the following nutrients? Protein A. Iodine B. Carbohydrate C. Lipid D. Ans Ref. MPL 2.

C Harper’s Biochemistry 24th ed. p. 285-286 0.75

A deficiency in Vitamin B12 causes: Cheilosis A. Beriberi B. Pernicious anemia C. Scurvy D. Ans Ref. MPL

D Harper’s Biochemistry 24th ed. p. 612-613 0.75

3.

Which of the following vitaminswould MOST likely become deficient in a person who develops a completely carnivorous lifestyle? Thiamine A. Niacin B. Cobalamin C. Vitamin C D. Ans Ref. MPL

4.

Fully activated pyruvate carboxylase depends upon the presence of: Malate and Niacin A. Acetyl CoA and Biotin B. Acetyl CoA and Thiamine pyrophosphate C. Oxaloacetate D. Ans Ref. MPL

5.

D Harper’s Biochemistry 24th ed. p. 612-613 0.75

B Harper’s Biochemistry 24th ed. p. 194 0.75

Biotin is involved in which of the following types of reactions? Hydroxlations A. Carboxylations B. Decarboxylations C. Dehydrations D.

Ans B Ref. Harper’s Biochemistry 24th ed. p. 606-607 MPL 0.75 6. Which of the following conditions would primarily produce a functional deficiency of Vitamin K? Coumadin Therapy A. Broad Spectrum antibiotic B. Premature birth C. Lack of red meat in the diet D. Ans Ref. MPL 7.

A Harper’s Biochemistry 24th ed. p. 727 0.75

A 3 month old boy presents with poor feeding & growth, hypotonia, lactic acidemia, and mild acidosis. The pyruvate to lactate ratio is high, and there is decreased conversion of pyruvate to Acetyl CoA. Which of the following may be considered for therapy? Thiamine A. FFA B. Biotin C. Vitamin C D. Ans

A

Ref. MPL 8.

A 2-year old child presents with cough and bronchitis, growth failure, & chronic diarrhea with light-colored foul smelling stools. A deficiency of which vitamin should be considered? Vit B6 A. Vit C B. Vit A C. Vit B1 D. Ans Ref. MPL

9.

Ans

Harper’s Biochemistry 24th ed. p. 183 0.25

C Harper’s Biochemistry 24th ed. p. 614-617 0.25

an infant presents with prominent forehead, bowing of the limbs, broad & tender wrists, swelling at the costochondral junction of the ribs, and irritability. Which of the following treatments is the most appropriate for this patient? Removal of eggs from diet A. Milk & Sunlight exposure B. Diet of baby food containing liver & ground beef C. Diet of baby food containing leafy vegetables D. C

76. Hormonal stimulation of the formation of the second messenger inositol 1,4,5triphosphate (IP3) quickly leads to the release of which other intracellular messenger? A. Calcium C. Prostaglandin B. cAMP D. Thromboxane Reference: pp. 463 MPL 0.33 77. Niacin is not strictly a vitamin since it can be synthesized in the body from this essential amino acid: A. Proline C. Threonine B. Valine D. Tryptophan Reference: pp. 490 MPL 1.0 78. Deficiency of this vitamin causes functional folate deficiency or the so-called “folate trap”: A. Pyredoxine C. Cobalamin B. Riboflavin D. Biotin Reference: pp. 494 MPL 1.0 79. This vitamin is the major lipid-soluble anti-oxidant in cell membranes and plasma lipoproteins: A. A C. E B. D D. K Reference: pp. 486 MPL 1.0

80. This is an intermediate in the synthesis of cholesterol that accumulates in the skin: A. 7 - dehydrocholesterol C. Calcidiol B. Cholecalciferol D. Calcitriol Reference: pp. 484 MPL 0.5 81. Digestion of proteins differ from that of carbohydrates and fats in that: A. Proteins are initially digested in the small intestines B. Digestion of proteins is completed in the stomach C. Most proteolytic enzymes are secreted in their zymogen forms D. The optimum pH in all phases of digestion is in the acidic range Reference: pp. 477 83. Jose after eating a piece of fried chicken, the first enzyme to digest the protein of the chicken meat is: A. Amylase C. Chymotrypsin B. Pepsin D. Trypsin Reference: pp. 477 88. Warfarin is useful as an anticoagulant because it inhibits activation of: A. Factor X C. Platelet activation B. Factor XII D. Thrombin Reference: pp. 604 98. Joel for the past years always have excess caloric intake. Which of the following diseases is NOT associated with overnutirtion? A. Cancer C. Marasmus B. Hypertension D. Type 2 diabetes mellitus Reference: pp. 480 MPL 1.0 99. Vitamin D is required for the intestinal absorption of which of the following minerals? A. Calcium C. Iron B. Magnesium D. Copper Reference: pp. 477 MPL 1.0 100. Alicia always maintain a balanced diet, which substances in her diet is NOT an energy source? A. Carbohydrate C. Fibers B. Lipid D. Lipid Reference: pp. 480