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NUTR 4320 MIDTERM QUESTIONS WITH VERIFIED ACCURATE ANSWERS, Exams of Nursing

United States International UniversityNursing

NUTR 4320 MIDTERM QUESTIONS WITH VERIFIED ACCURATE ANSWERS

Typology: Exams

2025/2026

Available from 04/16/2026

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NUTR 4320 MIDTERM QUESTIONS WITH VERIFIED
ACCURATE ANSWERS
What are the structures that increase surface area in the SI? - Answers - kerckring
folds, villi, microvilli
What make up the mucosa? - Answers - The epitheliael cell barrier and the lamina
propria , got some goblet cells too
Where are mature epi cells found in the small intestine vs stem cells? - Answers -
mature- villi
stem- crypts
What are the 4 layers of the small intestine? - Answers - mucosa, submucosa,
muscularis externa, serosa
Does the colon have villi? - Answers - No only crypts
what makes up lactose? - Answers - glucose and galactose
what makes up sucrose? - Answers - fructose and glucose
what makes up maltose? - Answers - glucose and glucose
what bond links sugar molecules? - Answers - glycosidic
what two borders must be crossed in the intestine to get to the blood stream? - Answers
- apical and basolateral
Glucose and galactose cross the _________ border via ____________ by active
trasnport using 2 _____ moleucles - Answers - apical
SGLT1
2Na+
Fructose crosses the apical membrane of enterocytes via _______________ and the
basolateral membrane via _____________. - Answers - GLUT5
GLUT2
How does fructose, glucose, and galactose get from the SI to the blood? - Answers -
glucose and galactose cross the apical membrane via SGLT1 by active transport using
2 Na molecules and then into the blood via facilitated diffusion using GLUT2
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Download NUTR 4320 MIDTERM QUESTIONS WITH VERIFIED ACCURATE ANSWERS and more Exams Nursing in PDF only on Docsity!

NUTR 4320 MIDTERM QUESTIONS WITH VERIFIED

ACCURATE ANSWERS

What are the structures that increase surface area in the SI? - Answers - kerckring folds, villi, microvilli What make up the mucosa? - Answers - The epitheliael cell barrier and the lamina propria , got some goblet cells too Where are mature epi cells found in the small intestine vs stem cells? - Answers - mature- villi stem- crypts What are the 4 layers of the small intestine? - Answers - mucosa, submucosa, muscularis externa, serosa Does the colon have villi? - Answers - No only crypts what makes up lactose? - Answers - glucose and galactose what makes up sucrose? - Answers - fructose and glucose what makes up maltose? - Answers - glucose and glucose what bond links sugar molecules? - Answers - glycosidic what two borders must be crossed in the intestine to get to the blood stream? - Answers

  • apical and basolateral Glucose and galactose cross the _________ border via ____________ by active trasnport using 2 _____ moleucles - Answers - apical SGLT 2Na+ Fructose crosses the apical membrane of enterocytes via _______________ and the basolateral membrane via _____________. - Answers - GLUT GLUT How does fructose, glucose, and galactose get from the SI to the blood? - Answers - glucose and galactose cross the apical membrane via SGLT1 by active transport using 2 Na molecules and then into the blood via facilitated diffusion using GLUT

Fructose uses GLUT5 instead of SGLT what is fructose malabsorption? How does it differ from hereditary fructose intolerance?

  • Answers - You have low expression of the SLC2A5 gene which causes one to not have a lot of GLUT in fructose intolerance you dont have the liver enzyme Aldolase B which means you get a build up of F1P which can lead to death of liver cells What are the two types of lactose intolerance? - Answers - Primary lactase deficiency= loss of lactase expression after weaning ( IRREVERSIBLE) Seconddary lactase deficiency= loss of lactase expression due to GI mucosal injury EG: injury from celiac disease or IBD (REVERSIBLE) What is gastroenteritis? - Answers - infectious diarrhea wherein sufficient degrees of muscoal damage reduces the quantity of lactase enzymes in the SI Low lactase activity can be caused by which 3 mechanisms? - Answers - 1) low lactase gene expression
  1. low lactase protein expression
  2. low lactase enzyme activity why do certan populations tend to have a higher prevalence of lactose intolerance? - Answers - SNP in the MCM6 gene causes lactase persistance in european and white populations typical SNPs are associated with: Intron 13 of MCM6 C>T intron 9 of MCM6 G>A In afriance and asian populations SNPs are associated with intron 13 of MCM6 T>G, C>G, G>C What are 2 TFs that activate LCT transcription level? - Answers - Cdx HFN-1a What is the relevance of PDX-1? - Answers - It inhibits Cdx2 and HNF-1a which would lead to a decreased expression of the lacatse gene What happens if lactose reaches the colone? - Answers - microbiota ferments the non- digested lactose in the colon and what ever is not fermented is lost in the feces. As it is fermented there is gas --> H2, CO2 and CH4 produced and acids--> lactic acid, acetic acid, propionic and butyric How may carbon are each of these acids?

slows the release of food in the SI giving the ensyme an optimal amount of time for it to do its job What do the symptoms of LI depend on? - Answers - level of remaining lactase enzyme acitivity amount of lactose consumed at a time GI transit time ability of the colon microbiota to ferment lactose composition of colon microbiota what is the ideal transit time through the GI tract? stomach--> SI---> COlon - Answers - slow slow fast what are some stratagies to improve LI? - Answers - adjust the amount of lactose consumed at a time drink milk with a meal or a snack to slow gastric emptying choose your dairy wisely what is the difference between pre and probiotics in terms of LI? - Answers - probiotics- are live microbial supplements that beneficially affect the host by changing the intestinal microbial balance prebiotics are non-digestable food ingrediants that encourage the growth and activity of favourable intestinal bacteria what is osteoporosis? - Answers - a skeletal disorder characteriszed by compromised bone strength predisposing a person to an increased risk of fracture

  • low BMD and microarchitectural deterioration what is the reccomended clinical analysis for diagnosising osteroporosis? - Answers - Dual X-ray absorptiometry !what are risk factors for osteoporosis? - Answers - female old deceased physical activity and decreased bone cquisition renal dysfunction malnutrition vit d deficiency where is calcium stored in the body? - Answers - 99% in the bones and in the teeth, with the remaining 1% in ECF explain calcium absorption, reabsorption and resorption - Answers - absorption: occurs in the SI as we absorb Ca form the diet

reabsorption occurs in the kidney where calcium can be exreted in the urine or reabsorbed back into the blood when calcium levels are low resorption: occurs in the bone, involves breaking down the bone structure to release calcium Describe the roles of PTH. - Answers - this is the first response to low calcium levelsm secreted by the parathyroid gland, this hormone serves to increase blood calcium

  • stimulates production of calcitriol in the kidney (which activates 1-hydroxylase enzyme)
  • stimulates resorption of bone
  • maximizes tubular reabsorption of calcium in the kidney explain the roles of cacitriol - Answers - this is the 2nd response to low blood calcium, it is an active metabolite of VIt D which is made in the kidney
  • stimulates resorption of bone
  • facilitates absorption of calcium from SI
  • maximizes tubular reabsorption of calcium in the kidney explain the roles of calcitonin - Answers - this is a hormone that responds to high blood calcium and acts to decrease it
  • supresses tubular reabsorption of calcium in the kidney
  • inhibits bone resorption what are some ways in which calcitrioal can influence disease processeses? - Answers
    • decreases B and T cell activation
  • decreases antigen presenting cell maturation
  • decreases inflammatory cytokine production
  • inhibits Th17 cell activation and Il-17 secretion
  • stimulates antimicrobial protein secretion describe the two way calcium is absorbed across the SI - Answers - across the basolateral Ca2+ transport A) sodium calcium exchanger ( 3Na in nd 1 Ca out) B) Calcium Pump (Ca out, H+ in ** requires ATP) across the apical boarder
  1. passive diffusion
  2. calcium channel : TRPv What shuffles Ca from the intracellular stores to mito and ER? - Answers - calbindin what happens when you have a FHH mutation in the CaSR? - Answers - the body is not sensitive to changes in blood calcium levels so you always have sustained levels of PTH secretion what are the two types of bone? - Answers - cortical/compact ~80% of bone mass
  1. proteolytic enzymes degrade the bone matrix
  2. TRAP proteins are secreted and move along the bone surface to continue the breakdown of bone what are some stimulators of bone resorption? - Answers - inflammatory cytokines eg: TNFa, IL6 and PGE growth factors RANKL bound to RANK PTH what are some inhibitors of bone resorption? - Answers - IL IFNy calcitonin what are some stimulators of bone formation? - Answers - IGFs BMP Estrogen (OPG) what are some effects consuming n-6 PUFAs could have on bone resorption? - Answers - decreasesOPG secretion and increases RANKL secretion stimulates RANK expression on osteoclasts inhibits osteoclast apoptosis--> continued activity of mature osteoclasts what are some effects of consuming n-3 PUFAs? - Answers - - increase Ca pump epression on epi cell barrier
  • decrease NFkB activation and TNFa secretion
  • decrease STAT3 activation and IL-6 secretion
  • decrease RANKL secretion decrease M-CSF secretion
  • Increase IGF
  • precursos for non-inflammatory eicosanoids what are some mechanisms in which plant polyphenols work to reduce bone resorption? - Answers - - supress NFkB and this decreases TNFa secretion
  • inhibit RANKL
  • inhibit osteoclastogenesis
  • inhibit COX-2 which ecreases PGE2 synthesis
  • stimulate OPG stimulate RUNx2 which stimulates preosteoblasts into osteoblasts
  • upregulate growth factors what are some ways in which soy-isoflavones reduce bone resorption? - Answers - function as phytoestrogens which bind to the estrogen receptor
  • can synthesize vitamin D to increase estrogen receptor expression on osteoblasts
  • stimulate the expression of 1-a-hydroxylase in the kidney
  • increase OPG and reduce RANK-L
  • increase osteoclast apoptosis
  • decrease inflammatory cytokine production
  • stimulate osteoblast maturation via upregulation of RUNx in a human intervention trial done with soy isoflavones what two results did they see? - Answers - - increased bone mineral density in the umbar spine and femur
  • higher intakes is associated with lower risk of fractures what enzyme do obese women produce in the AT post menopause? - Answers - aromatase is obesity a protectant against osteoporosis? - Answers - At the beginning you do have some bone mass increasing to accomodate the greater load on the bone but this plateaus and eventually you cannot match the increases in fat mass you may tend to see fewer hip and spine injuries because there is some added protection with the fat but you do see increased leg and ankle fractures What are some of the adverse effects associated with obesity and bone status? - Answers - inflammatory cytokines TNFa and IL6 are produced in obese AT which can stimulate osteoclast activity leading to increased bone resorption
  • 25 - hydroxyvitamin D levels are commonly reduced in obese individuals (this is.a precursor for calcitriol)
  • serum PTH levels are commonly high in obesity which can have an adverse effect on bone
  • adipoctes and osteoblasts share a common progenitor cell (mesenchymal stem cells) which therefore if there is an increased nuber of adipocytes there is a reduced number of osteoblasts from this cellular pool how do you classify metaboiic syndrome? - Answers - someone who has one of the following:
  • T2D
  • impaired glucose toleance
  • imparied glucose fasting
  • insulin resistance and 2 of the following
  • high BP
  • dyslipidemia
  • high waist circumference
  • microalbuminuria Why is celiac disease associated with nutrient malabsorption? - Answers - Celiac disease is associated with a loss of structure in the intestine and damaged microvilli --> nutrient malabsorption

explain the basic steps of and APC finding gluten and presenting it to a T-cell - Answers

    1. APC phagocytoses gluten and presents it on the MCHII receptor
  1. The MCHII and antigen is recognized by the TCR and binds it
  2. the now activated T-cell differientiates into a specefic T helper cell subset. Each T- cell subset will release signature cytokines that identify the. Th1 is used in CD
  3. T-cell is goig to proliferate (clonal expansion) and release cytokines. in CD these cytokines damage the intestinal structure what are the two Th cells important in CD and what specefic TF activates them and what cytokine do they secrete? - Answers - Th1 cells. TF=Tbet, IL12 promotes its differientiation, its cytokine is IFNy Treg cells, TF+FoxP3, TGFB and IL2 promotes its differientiation, its cytokine is IL what are prolamins? - Answers - proteins that contain gluten and trigger the immune response is patients with CD WHat two AA are prolamins high in? - Answers - Glu and Pro what is the subfamily for the prolamins? - Answers - pooideae what makes proteins resistant to digestion by BBE? - Answers - the high proline content what does the high glutamine content do to these AA? - Answers - makes them a perfect target for deamndation by TTG what is the DQ loci that is common for people with celiac disease to have? - Answers - HLADQ2/8/ What two facotrs influence the high affinity binding of HLADQ2/8 with gluten peptides? - Answers - 1) high Glu content
  4. deamidation of gluten by TTG inducing a negative charge what does TTG do in terms of lysine? - Answers - It links GLutamine residues to lysine residues and cross linked proteins are more difficult to digest! Explain the role of TTG in the genetic componetnt of CD? - Answers - - TTG deamindates glutamine which gives it a negative charge
  • HLADQ2 has a high binding affinity for - ve charged residues at 4,6, nd 7 of its ABG
  • HLADQ8 has high binding affinity at position 1 and 9 of its ABG
  • this is why the negative charge increases the affinity deamindated gluten peptides are presented by HLADq2/8 to T cells which ___________. - Answers - increases T cell activation, cloncal expansion and cytokine release

RECAP: how do large peptides leak across the epi barrier? - Answers - - APC mediated luminal capture of gluten peptides ( periscoping or through M cell transcellular pore)

  • M-cell transcytosis
  • Epithelial cell luminal uptake of antigen and presentation at the basolateral membrane (pass to APC or some evidence of direct presentation to T cell)
  • leaky or damaged membrane what are two mechanisms IFNy has? - Answers - 1) activates MMPs which promote epi cell apoptosis and other things leading to villus atrophy
  1. it activates APCs in the LP and causes them to secrete TNFa which also stimulates the production of MMP1 and MMP WHat are some things that IL21 does? - Answers - 1) produced by TH1 cells they activate IEL ( NK and CD8 T cells)
  2. amplify the effect of IL
  3. also activate B cells What is the pathway for IL 15 activation of MICA? - Answers - Il15 induces epi cells to express MIC prooteins (MIC A)
  • MICA is the ligand for receptor NKG2D on the surface of IEL
  • activated IEL mediate apoptosis by 2 mechanisms 1a) binding of FasL to Fas and activating Cas 8 leading to apoptosis 1b) by releasing granules containing perforin and granzymes produced by the IELs which trigger Cas 3 and leads to apoptosis what do B cells release antibodies against? - Answers - anti-collagen/anti-actin anti-endomysium Why dont the anti-gluten antibody + gluten complex have a protective role in neutralizing gluten? - Answers - The complex binds with CD71, a receptor on the atypical surface of the epi cell and this is upregualted in active CD what does CD71 do? - Answers - helps bring gluten in contact with TTG. and this leads to further deamidation of gluten by TTG. As a result, gluten transporters are transported across the epithelial cell barrier and this increases gluten access into the LP and perpetuates the immine repsonse to gluten why doesnt Anti-TTG have a protective effect? - Answers - TTG in the LP binds to firbonectin so it also has an important role in ECM assembly. Therfore TTG can influence/promote epi cell barrier processes and epi cell proliferation TTG plays a key rol ein rebuilding the damaged when TTG is bound to its AB it cannot preform these protective effects and it actaually pertetuates the barrier to be more leaky what else do Anti-TTG ABs cause? - Answers - dermatitis herpetitofrmis, pancreatic islet cell destruction and T1D