CHNI NUTRITION REVIEW 2000Mock Board Examination

Nutritional Biochemistry and Clinical Dietetics

I. Nutritional Biochemistry

1. The combination of processes by which the living organism receives and utilizes the materials needed to maintain its function and for the growth and renewal of its components:

a. Metabolism b. Absorption c. Nutrition d. Digestion

2. Any substance which can be used in the body’s metabolic processes:a. Metabolite b. Nutrient c. Vitamin d. Nucleic acid

3. The passage of product of digestion through the intestinal mucosa into the blood and lymph system:a. Digestion b. Excretion c. Absorption d. Metabolism

4. All the physical and chemical changes which food undergoes in the body to make it absorbable:a. Digestion b. Mastication c. Absorption d. Ingestion

5. The formation of glycogen from several glucose units is an example of:a. Anabolism c. Metabolismb. Catabolism d. None of the above

6. To prevent ketosis, an individual must consume at least ____ grams of dietary carbohydrates daily:a. 100 b. 45 c. 50 d. 75

7. All of the following are accusations against simple sugars except:a. Sugar causes misbehaviour in childrenb. Sugar promotes cancerc. Sugar causes heart diseasesd. Sugar causes obesity

8. All processes add to the level of glucose in the blood except:a. Glycogenolysis c. Intestinal absorptionb. Glycogenesis d. Gluconeogenesis

9. Glycogenesis is:a. Utilization of glucoseb. Breakdown of glycogen to glucosec. Synthesis of glucose from non-glucose sourcesd. Formation of glycogen in liver and muscles

10. The term glycemic effect of food includes the following descriptions except:a. How quickly blood glucose returns to normalb. How high blood glucose rises after a mealc. How quickly glucose is absorbed after eatingd. How long glucose is elevated after a meal

11. Chemical breakdown of energy-giving nutrients:a. Absorption c. Oxidationb. Metabolism d. Reduction

12. Major site of absorption of food and absorption of nutrientsa. Large intestines c. Liverb. Small intestines d. Stomach

13. The major classes of lipids are:a. Phospholipids, glycerol, polyunsaturated fatty acidsb. Sterols, phospholipids, lecithinc. Omega 3 fatty acids, omega 6 fatty acids, glycerold. Triglycerides, phospholipids, sterols

14. Sources of glucose except for:a. Monosaccharides, disaccharidesb. Glycogenc. Fatd. Amino acids

15. The second aerobic stage of carbohydrate metabolism which take place in the mitochondriaa. Oxidative decarboxylation c. Glycolysisb. Oxidative phosphorylation d. Hexose monophosphate shunt

16. The exchange of oxygen, nutrient, and waste products takes place in:a. Arteries b. Veins c. Capillaries d. B & C

17. Sucrase acts on sucrose to produce:a. Glucose and galactose c. Glucose and fructoseb. Glucose d. Maltose

18. The degree to which an ingested nutrient gets absorbed and is available to the bodya. Bioassay c. Biologic valueb. Bioavailability d. None of the above

19. An algal polysaccharide used as a thickening agent to many processed foodsa. Pectin c. Celluloseb. Carageenan d. Hemicellulose

20. A noncellulose polysaccharide found in fruits and composed of units of a galactose derivativea. Cellulose c. Carageenanb. Pectin d. Hemicellulose

21. Intermediate product of starch hydrolysisa. Glycogen b. Dextrin c. Glucose d. None of the above

22. Amino acids may be classified according to the following except:a. Use b. pH c. Essentiality d. Metabolic pathway

23. The process of removing the amino group from an amino acida. Transamination b. Deamination c. Ketone bodies generation d. Urea cycle

24. All are dietary carbohydrates except:a. Mucilages b. Glycogen c. Starch d. Pectins

25. The decomposition of one glucose molecule produces:

a. 38 molecules of ATP c. 48 molecules of ATPb. 46 molecules of ATP d. None of the above

26. It is called the “feasting hormone” because its release is enhanced by a high blood glucose levela. Epinephrine b. Insulin c. Thyroxine d. Glucagon

27. The most variable component of energy expenditure:a. Thermic effect of food c. Basal/resting energy expenditureb. Physical activity d. None of the above

28. A noncariogenic sugar alcohol absorbed less rapidly as glucose and often used in sugarless chewing gum

a. Xylitol b. mannitol c. Sorbitol d. None of the above

29. Large lipids such as monoglycerides and long-chain fatty acids must first merge into _____ prior to absorption and transport

a. Micelles b. Chylomicron c. LDL d. HDL

30. Fatty acids concentrated in animal foods such as chicken, pork, and dairy products and in palm and coconut oil

a. Monounsaturated fatty acids c. Polyunsaturated fatty acidsb. Saturated fatty acids d. None of the above

31. Transport form of fat in the body after digestion and absorptiona. Micelles b. Bile c. Cholesterol d. Chylomicrons

32. Before their release into the lymph, lipids combine witha. Bile acids b. Carbohydrates c. Proteins d. Secretin

33. Polyunsaturated fatty acid predominating in the dieta. Oleic acid b. Arachidonic acid c. Linolenic acid d. Linoleic acid

34. The end product of anaerobic phase of glucose metabolisma. Acetyl CoA c. Carbon dioxide and waterb. Pyruvate and lactic acid d. All of the above

35. An omega-3 fatty acid which plays a major role in retinal function and brain development is now believed to be essential for infants

a. Alpha-linolenic acid (ALA) c. Decosahexaenoic acid (DHA)b. Eicosapentaenoic acid (EPA) d. None of the above

36. These are lipoproteins made primarily by liver cells to transport lipids to various tissues in the bodya. HDL b. LDL c. VLDL d. Chylomicron

37. A nutritionally omega-3 fatty acid concentrated in fish oils and shellfisha. Linoleic & Linoleic b. EPA & DHA c. EPA d. DHA & linoleic

38. Coenzyme required in oxidative decarboxylationa. Biotin b. B12 c. TPP d. Pyridoxal phosphate

39. It is important in lipid metabolism carrying long-chain fatty acids to the mitochondria for beta-oxidationa. Carnitine b. Lecithin c. Cholesterol d. Cephalin

40. It does not contain cholesterola. Peanut butter b. Cheese c. Fish d. Lean meat

41. If bile is not released into the small intestines, it would imnpair the digestion and absorption of a. Fat b. Carbohydrates c. Minerals d. Proteins

42. Simplesse, formulated from egg white or milk protein, gives only 1-2kcal/g and is used in reduced-fat and fat-free foods like salad dressings, cheeses, & frozen desserts. This synthetic lipid is an example of a

a. Structured lipid c. Fat substitute/replacerb. Medium chain triglyceride d. None of the above

43. Synonymous to Krebs cyclea. Citric acid cycle b. Glycolysis c. Tricarboxylic acid cycle d. Aerobic pathway

44. The reactions in which electrons are removed from a moleculea. Condensation b. Oxidation c. Deamination d. Transamination

45. It is a series of proteins that serve as electron “carriers”a. Gluconeogenesis c. Tricarboxylic acid cycleb. Adenosine phosphate d. Oxidative phosphorylation

46. End product of glycolysis of 2 glucose moleculesa. Acetyl CoA b. 2 pyruvic acid c. 4 acetyl CoA d. 4 pyruvic acid

47. The principal nitrogen-excretion product of metabolisma. Ammonia b. Ammonium c. Creatinine d. Urea

48. The carbon compound used as the starting material of the TCAa. Acetyl CoA b. Pyruvate c. Glycerol d. Carbon dioxide

49. It is defined as the nonphysiological regulation of eatinga. Hunger b. Satiety c. Appetite d. Density

50. Hormone that facilitates the breakdown of glycogen to glucosea. Androgen b. Aldosterone c. Parathyroid d. Epinephrine

51. A product of carbohydrate metabolism used for muscular contractiona. Acetic acid b. Lactic acid c. Pyruvic acid d. Succinic acid

52. All factors may affect BMR except a. Muscle mass b. Body temperature c. Hunger d. Age

53. An average sedentary individual expends roughly ___ of his/her total caloric intake on physical activitya. 15% b. 25% c. 30% d. 35%

54. Brown fat differs from yellow fat since it contains morea. Ribosomes b. Cytoplasm c. Lysosomes d. Mitochondria

55. A good source of carbohydrate and proteina. Cornstarch b. Honey c. Soybeans d. Molasses

56. During the fasting stage, one of the following occurs:a. Glycogen breakdown c. protein synthesisb. Glycogen synthesis d. fat synthesis

57. Pathway followed by NH2 after oxidative deaminationa. Purine and uric acid synthesis c. Ketogenesisb. Urea detoxification d. Fat synthesis

58. It needs further digestion before it can be absorbed in the blooda. Galactose b. sucrose c. fructose d. glucose

59. One of the following can use glucose only for energy in normal conditionsa. Liver b. muscle c. kidneys d. brain and nervous system

60. Nutrient/s with a protein-saring effecta. Carbohydrates b. fat c. vitamin d. both a & b

61. The ration between caloric content and the nutrient composition in a fooda. Glycemic index c. nutrient adequacyb. Nutrient density d. energy density

62. Inactive precursors of enzymesa. Apoenzymes b. coenzymes c. zwitterions d. zymogens

63. Amino acids lacking in a protein is calleda. Non-essential amino acid c. limiting amino acidb. Essential amino acid d. neutral amino acid

64. A protein source that does not contain cholesterola. Cheese b. rice c. tuna fish d. roast beef

65. Based on NPU values, the body uses most efficiently the protein in a. Peanuts (NPU=43) c. chicken (NPU=73)b. Soybeans (NPU=61) d. milk (NPU-82)

66. Source of complete proteina. Rice b. egg c. monggo d. vegetables

67. Amino acids derived from the digestion of food proteinsa. Exogenous amino acids c. neutral amino acidsb. Endogenous amino aicds d. essential amino acids

68. The amino acid precursor of tyrosine both neeses in the formation of thyroxine and epinephrinea. Methionine b. tryptophan c. phenylalanine d. glycine

69. A reduced blood albumin level leads toa. Dehydration b. acidosis c. edema d. alkalosis

70. Amino acid which combines with many toxic substances converting them to harmless forms which are then secreted

a. Glycine b. methionine c. tryptophan d. phenylalanine

71. A person who east fish but not land-based animals is a/ana. Vegetarian c. ovolactopollovegetarianb. ovolactovegetarian d. pescovegetarian

72. When blood insulin levels are high, one of the following occurs:a. Fat synthesis c. glycogen breakdownb. Glucose synthesis d. protein breakdown

73. Ammonia is detoxified when the liver converts it toa. Urea b. ketones c. creatinine d. nitrogen

74. NPU is a measure to testa. Protein digestibility c. the amount of protein eatenb. The percentage of nitrogen absorbed d. the protein utilized by the body

75. Of the macronutrients needed by man, the most important is:a. Protein b. carbohydrates c. water d. fat

76. Excess dietary protein isa. Excreted directly in the urineb. Broken down for energy or used to synthesize glucose and fatc. Stored in the bodyd. None of the above

77. Another name for vasopressin isa. Aldosterone b. anti-diuretic hormone c. renin d. angiotensin

78. Fat-soluble vitamins which need protein carriers for their utilizationa. Vits. A & D b. Vits. A & E c. Vits. D & K d. Vits. A & K

79. Ketosis may occura. When there is inadequate carbohydrate in the dietb. During infectionsc. When there is too much fat in the dietd. When there in inadequate protein in the diet

80. Body water is lost mainly througha. Urine b. feces c. lungs d. insensible perspiration

81. Human need for water varies with1. Level of physical activity2. Age3. Environmental temperature4. Body weight

a. 1 & 3 b. 1, 3 & 4 c. 2, 3 & 4 d. 1, 2 & 3

82. Water/fluid balance is maintained by thea. kidney b. hypothalamus c. a & b d. none of the above

83. Adult requirement for watera. 1.5L/1000kcal b. 2L/1000kcal c. 1L/1000kcal d. 2.5L/1000kcal

84. A purple pigment in the rod cells involved in the coversion of light energy into nerve impulses in the retina

a. Opsin b. rhodopsin c. iodopsin d. none of the above

85. Organix essential nutrients required in small amounts by the bodya. Minerals b. water c. carbohydrates d. vitamins

86-90 A= 1, 2, 3 B= 1, 3 C=2, 4 D=4 E=All

86. Vitamin B121. Participates in the conversion of homocysteine to methionine2. Contains cobalt3. When injected into patient with pernicious anemia, overcomes the lack of intrinsic factor4. Can be obtained from peas and carrots

A B C D E

87. Vitamin K1. Plays an essential role in preventing thrombosis2. Decreases the coagulation time in newborn infants with hemorrhagic disease3. Is present in high concentration in cow’s milk or breast milk4. Is synthesized by intestinal bacteria

A B C D E

88. Vitamin A 1. Can be enzymically formed from dietary beta-carotene2. Is transported from the intestine to the liver by chylomicrons3. Is the light absorbing portion of rhodopsin4. Is phosphorylated an dephosphorylated during the visual cycle

A B C D E

89. Alpha-tocopherol1. Functions mainly as an antioxidant2. Deficiency is commonly found in adults3. Requirements increase with the amount of PUFA in the diet4. Is found if high concentrations in whole grains and cereals

A B C D E

90. Which of the following statements about niacin is/are true?1. Forms part of the structure of NADP2. Derived from the degradation of tryptophan3. Involved as a ofactor in oxidation-reduction reactions4. Constituent of FAD

A B C D E

91. The increase in basal metabolism per degree Fahrenheit rise in body temperaturea. 5% b. 7% c. 10% d. 8%

92. Vitamin D1. Increases absorption of calcium from the intestine2. Is not required in the diet of individuals exposed to sunlight3. Is not really a vitamin since its active form can be synthesized by humans4. Opposes the effect of PTH

A B C D E

93. Symptoms of ariboflavinosisa. Cheilosis, glossitis, photophobiab. Diarrhea, dermatitis, depressionc. Cheilosis, dermatitis around nose, glossitisd. Cheilosis, glossitis, petechiae

94. First signs of VADa. Keratinization b. Bitot’s spot c. keratomalacia d. nightblindness

95. Preformed, biologicall active Vitamin Da. 1,25 dihydroxycholecalciferol c. 7-derhydrocholesterolb. 25 hydroxycholecalciferol d. cholecalciferol

96. Vitamins that can be synthesized by the body’s intestinal bacteria excepta. Riboflavin b. biotin c. folate d. pyridoxine

97. Another term for nightblindnessa. Xerophthalmia b. keratomalacia c. nyctalopia d. conjunctival

xerosis

98. The need for B1 increases in the following conditions excepta. With increased alcohol consumptionb. With increased energy/caloric intakec. With increased fat consumptiond. During pregnancy and lactation

99. Called the food pipea. Trachea b. epiglottis c. esophagus d. none of the above

100. Most stable of all vitamins, resistant to heat, light, air, acid & alkalia. Vit. C b. Vit. B2 c. Vit. B3 d. Vit. B1

101. The following are properties of fat-soluble vitamins excepta. Most need protein carriers c. needed in the daily dietb. Tend to reach toxic levels d. less readily excreted

102. Other names of Vit. B12 excepta. Anti-pernicious factor c. citrovorum factorb. Erythrocyte maturation factor d. animal protein factor

103. Food constituents which enhance Ca absorptiona. Oxalates & phytates c. both A & Bb. Vits C & D d. none of the above

104. Chracterized by microcytic, hypochromic anemiaa. Iron deficiency b. B6 deficiency c. A & B d. folate & B12

105. B vitamins that help cells to dividea. Niacin & B12 b. thiamin & riboflavin c. folate & biotin d. folate & B12

106. Functions of electrolytes except a. Creation of osmotic pressure c. Maintenance of normal fluid balanceb. Maintenance of acid-base balance d. maintenance of normal immune system

107. A B vitamin active in amino acid metabolism because of its ability to transfer amino groupsa. B2 b. B12 c. B6 d. B1

108. The effect of an adequate intake of lactosea. Enhanced calcium absorptionb. Increased Vit. D activityc. Decrease pH in the ileumd. A & C onlye. All of the above

109. It needs glycoprotein, the intrinsic factor for its absorptiona. B6 b. B12 c. biotin d. pantothenic acid

110. Also known as tocopherola. Vit. D b. Vit. K c. Vit. E d. Vit. A

111. Erythrocyte hemolysis is a sign ofa. Folate deficiency b. iron deficiency c. Vit. E deficiency d. Vit. B12 deficiency

112. Mineral component of antioxidant enzyme superoxide dismutasea. Se b. Fe c. Cu d. Zn

113. Functions as coenzymes in the breakdown of fat energy productiona. B2 b. B3 c. B12 d. B1

114. Fat-soluble vitamins obtained from non-food sourcea. Vits D & K b. Vits D & E c. Vits K & A d. Vits E & A

115. Nutrients which interfered with Vit. A utilizationa. Zn b. Fe c. protein d. Vit. E

116. Factors favouring non-heme iron absorption excepta. Vit. C b. MFP c. Zn d. increased acidity

117. Also known as pteroylglutamic acid (PGA)a. Folate b. B6 c. B12 d. pantothenic acid

118. In general, fresh fruits and vegetables area. High in K but low in Na c. High in Na but low in Kb. High in K and Na d. Low in K and Na

119. Extracellular ions which are first lost by sweating, bleeding or renal/fecal excretiona. K & Cl b. Na & Cl c. Na & K d. Na & Mg

120. The most abundant mineral in the bodya. Na b. K c. Ca d. P

121. B vitamins whose requirements are dependent on a person’s energy intake

a. Thiamine and niacin c. riboflavin and folateb. Thiamine and riboflavin d. thiamine and biotin

122. Part of coenzyme A, important in energy metabolisma. Biotin b. pantothenic acid c. thiamine d. cyanocobalamin

123. When blood Ca levels fall too low, the ograns systems which raise the low Ca levels area. Intestines, stomach, kidneys c. intestines and kidneysb. Intestines, kidneys, and bones d. stomach and bones

124. The following are good source of Ca excepta. Milk and milk products c. bean curd (tofu), greens (broccoli)b. Sardines with bones “dilis” d. butter and cream

125. Clay eating is known asa. Geophagia b. pagophagia c. pica d. none of the above

126. The body’s first line of defence against changes in the acid-base balance of body fluidsa. The kidneys b. buffer systems c. lungs d. antioxidants

127. A component of biotin, thiamine and the hormone insulina. Zn b. S c. Fe d. Co

128. Keshan disease, characterized by heart enlargement and insufficiency is associated witha. Fe deficiency b. Zn deficiency c. Se deficiency d. I deficiency

129. Mineral component of glutathione peroxidase which prevents free radical formationa. Fe b. Se c. Zn d. Cu

130. A trace mineral which helps maintain glucose homeostasisa. Fe b. Mn c. Cr d. Zn

II. Clinical Dietetics

131. The fluid needs of an adult whose body weight is 56kg is approximatelya. 1500ml b. 2000ml c. 2500ml d. 3000ml

132. The common method of tube feeding administration area. Bolus, continuous drip c. bolus, gravity dripb. Bolus, continuous drip, intermittent drip d. all of the above

133. Risk assessment CHD includes measurements of blood lipids such as:a. Total cholesterol,TG c. HDL-C, TGb. LDL-C, total cholesterol d. all of the above

134. The recommended intake for MUFA in the diet is approximatelya. 30% of total kcal c. up to 10% total kcalb. Less than 7% of total kcal d. up to 15% of total kcal

135. Estrogen Replacement Therapt (ERT) in post-menopausal women is one method of reducing the risk for

a. Duodenal cancer b. breast cancer c. ovarian cancer d. osteoporosis

136. Flatulence, cramps of diabetes, may be some unpleasant side effects upon the initiation ofa. Fiber restricted diet b. high fiber diet c. soft diet d. elemental diet

137. Chronic diarrhea may be accompanied by a number of nutritional deficiencies due to losses ofa. Na & K b. vitamins and minerals c. protein d. all of the above

138. Body measurements which are more reliable assessment tools in person with edema or ascitesa. Weight, MAC b. MAC, triceps skinfold c. weight, TSF d. all of the above

139. This type of supplement has shown good results in reducing encephalopathy and in improving nitrogen and energy balance

a. Vegetable, casein-based protein supplementsb. Aromatic amino acids supplementsc. Branched chain amino acid supplementsd. Phenylalanine supplements

140. When metabolically stressed patients are given diets with excessive calories, this could result in overfeeding, excess carbon dioxide production and other related complications such as

a. Excessive weight gain c. immediate weaning from mechanical ventilationb. Respiratory insufficiency d. all of the above

141. A patient with gout and urecemia will benefit from which diet prescriptiona. Low purine, adequate protein, 3 liters waterb. Low purine, 15g/protein/kBW, low alcoholc. Low purine, high CHO, adequate protein, low fatd. Low purine, 1 g protein/kBW, calorie restricted

142. Choose the best re-feeding schedule for anorexia nervosaa. Start with 800-1200kcal and increase by 5-10kcal/kg/day every 3-5 daysb. Start with 800-1200kcal then rapidly increase to 70-100 kcal/kg/dayc. Start with 800-1200 kcal once the patient is taking 30 kcal/kg/dayd. Start with 800-1200kcal and gradually increase by 10-29 kcal/day