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NUSCTX 10S Final Exam Questions With
100% Correct Answers
WhatiisiaiDietaryiSupplement?i-iCorrectiAnswer- Aiproductiintendediforiingestion — foriexampleiaipill,icapsule,itablet,ipowder,iliquid — thaticontainsiai"dietaryiingredient." ExamplesiofiDietaryiIngredientsi-iCorrectiAnswer--Extracts/Metabolites
- Vitamins
- Minerals
- AminoiAcids
- Herbs/Botanicals HerbaliRemediesi-iCorrectiAnswer- •Herbal iremediesiareiwidelyiusedithroughoutitheiworld
- TraditionaliChineseiMedicinei(TCM)
- ComplementaryiandiAlternativeiMedicinei(CAM)
- IntegrativeiMedicinei(asiofi 2014 iUSiMDsiareiableitoibeiaccredited) SupplementiLabelingiRegulationsi-iCorrectiAnswer-Mustiinclude: 1.Ingredientsi 2.Amountipresentiinieachipill
3.%iDailyiValuei(ifiapplicable) 4.Suggestedidailyidose 5.Commoninameiofiplantiandipartiofiplantiusedi(ifiplant-based) *Labelsicannoticlaimiititreats,iprevents,ioricuresiaidisease Wheniareisupplementsiappropriate?i-iCorrectiAnswer-- iCertainimicronutrientideficiencies
- iLimitedidietaryipatterns *Consider: 1.iEfficacy 2.iDosage 3.iLabeling 4.iContraindications 5.iMisleadingiclaims 6.iCost *DietaryiSupplementsishouldiNOTireplaceiaihealthyidietithatimeetsithei DGAs Retinoidsi-iCorrectiAnswer- Retinoidsiareiaicollectiveitermiforitheibiologicallyiactiveiformsiofivitami
•Sun iexposure •Sunscreen iuse VitaminiDi(VD):iFormsi-iCorrectiAnswer- •Body icanisynthesizeifromicholesteroliandiUVilight •VD2(ergocalciferol) iiniplantisourcesiandisupplements •VD3( cholecalciferol)iinianimalisourceifoodsiandihumanibodyi •VD2is ilessibiologicallyiactiveithaniVD •VD - binding-proteinirequirediforitransportiiniblood VitaminiDiDeficiency:iRicketsiandiOsteomalaciai-iCorrectiAnswer- VDiSynthesisi&iActivationi-iCorrectiAnswer- Whetherisynthesizediinitheiskinioriobtainedifromidietaryisources,ivitam iniDiultimatelyifunctionsiasiaihormone:i1,25(OH)2vitaminiD3(calcitriol). SomeifunctionsiofiCalciumi-iCorrectiAnswer--Boneistructure
- Releaseiofineurotransmitters
- Bloodipressure
- Muscleicontraction
- CelliMetabolism
- Regulateienzymeiactivity
- Bloodiclotting
FunctionsiofiCalciumi-iCorrectiAnswer-Boneimineralization* Intracellulariadhesion Stabilizeicomplexes(B12/IF) 2ndimessenger Neurotransmission Fertility Muscleicontraction Enzymeiactivity:iPLA2,ibloodiclotting *i~1kgiCa/70kgibodyiwt;i99%iinibone.iTheiremainingi1%iperformsiallioth erifunctions Trabecularibonei-iCorrectiAnswer-Trabecularibone(spongy)i Corticalibone(compact) Boneiremodelingi-iCorrectiAnswer- Boneimassiisimaintainedibyicontinualidegradationiofiexistingiboneiandis ynthesisiofinewibone.iThisicontinuali"remodeling"ifacilitates: 1.Adjustmentitoinewistrengthilevel 2.Adjustmentitoinewishape 3.iReplacementiofidegradingimatrixi(collageniandiproteoglycan)iduringi normaliturnover
Theirelationshipibetweenipeakiboneimassianditheiultimateiriskiofidevel opingiosteoporosisiandirelatediboneifractures. Intestinalifunctionioficalcitrioli-iCorrectiAnswer-- Calcitriol,itheihormoneiproducedifromiVitaminiD3,iisitheionlyihormoneit haticaniinduceitheiintestineitoiabsorbidietaryiCa++.
WithoutivitaminiDiandiitsiconversioniintoicalcitriol,idietaryiCa++absorpt ionibyitheiintestineiisiseverelyiimpaired. Calciumiabsorptioni-iCorrectiAnswer- 1.)iHighiconcentrationsioficalciumiallowiabsorptionibyipassiveidiffusion. 2.)iLowitoimoderateiconcentrationsioficalciumirequireiactiveitransport.i VitaminiDiturnsionitheisynthesisioficalciumitransportiproteins. 3.)iCalciumitransportiproteinsishuttleicalciumifromitheilumeniacrossithei mucosalicell. 4.)iAicalciumipumpithatirequiresienergyimovesicalciumifromitheimucosa licellsitoitheibloodstream. Hormonesiplayiimportantirolesiiniregulatingiserumicalciumi- iCorrectiAnswer- RegulationiofibloodicalciumilevelsiwithiCalcitononi-iCorrectiAnswer-- Highibloodicalciumicausesitheireleaseioficalcitononifromitheithyroidigla nd.
LowibloodicalciumicausesitheireleaseiofiPTHifromitheiparathyroidigland. CalcitoninimoderatesieffectsiofiPTH/1,25(OH)2Di-iCorrectiAnswer- Calcitoniniisisecretedibyitheithyroidiglandiwheniplasmai[1,25(OH)2D]ian di[Ca]iareihigh. Calcitoninireducesiplasmai[Ca]iby:
- Reducingiosteolyticiactivity
- Reducingiformationiofinewiosteoclasts
- Increasingiosteoblastiactivity VDiToxicityi-iCorrectiAnswer- •Megadoses ithroughisupplementation •Hypercalcemia: ielevatedibloodicalciumiconcentrationsithaticanileaditoi calcificationiofitissues
- Kidneyistones FunctionsiofiPhosphorusi-iCorrectiAnswer--Boneimineralization*
- Energyitransfer(ATP,iADP,iGTP,icreatineiphosphate,ietc)
- Acid-Baseibuffer
- ComponentiofiRNAi&iDNA
- Proteinimodification(phosphorylationiofienzymes)
- Signalingimolecules(IMP,iITP,icAMP)
- Phospholipids
•Dietary isources:igreenivegetablesiandiplantioils VKiDeficiencyi-iCorrectiAnswer- •Deficiency iisirare,icanioccuriwithifatimalabsorption,iantibiotics,iandian ticoagulantidrugs •Hemorrhaging •Low iboneidensity •Newborn iinfantsihaveisterileiGIitractiatibirthiandiareigiveniaiVKisupple ment Regulationiofibloodicalciumilevelsi-iCorrectiAnswer- Wateri&iMineralsi-iCorrectiAnswer- Wateriandimineralsiareirequirediforimanyiprocessesiinitheibody.iWaterii siiniallicells,icarriesinutrientsiarounditheibody,iandiactivelyiparticipatesii nimanyichemicalireactionsiandiphysiologicaliprocesses;ithus,iwateriisire quirediforialliofitheseifunctions. Someivitaminsiactiasiantioxidants,iwhileiotherinutrientsiareiuseditoipro duceienzymesineedediinitheibody'sidefenseisystem. FunctionsiofiSodiumi-iCorrectiAnswer-- maintainsifluidibalanceiinsideiandioutsideiofitheicell
- necessaryiforimuscleicontractioniandinerveitransmission
- regulationiofibloodipressure
TraceiMineralsi-iCorrectiAnswer- •Iron •Copper •Selenium •Zinc •Iodide •Fluoride •Essential i •Daily ineedilessithani 100 img •Biological ifunctions:
- Componentiofienzymes
- DNAisynthesis •NOT iaisourceiofienergy •Deficiency iproducesiabnormalities
- Howididiweifindithisiinformation?
- Ancienticivilizationsiknewiaboutiironiandianemia
- DwarfismiiniMiddleiEastitoiZincideficiency
- Traceimineralsimissingiinitotaliparenteralinutritioniformulas. GeneraliPrinciplesi-iCorrectiAnswer- •Bioavailability
- Whati%iofiainutrienticanibeiabsorbed
FreeiRadicaliDamagei-iCorrectiAnswer- Theiprocessiofioxidationiinitheihumanibodyidamagesicellimembranesian diotheristructuresiincludingicellulariproteins,ilipidsiandiDNA.iWhenioxyg eniisimetabolized,iiticreatesi'freeiradicals'iwhichistealielectronsifromioth erimolecules,icausingidamage. Mineralsiasicofactorsi-iCorrectiAnswer- Ironi-iCorrectiAnswer-TooilittleiIron: reducedioxygen-carryingicapacityiandienergyigeneration
- especiallyiiniwomen,ichildren TooimuchiIron: aifreeiradicalimediatedidamage b.isusceptibilityitoiinfection c.iriskiofiheartidisease,iesp.iinimen FunctionsiofiIroni-iCorrectiAnswer-1.iOxygenitransport
- Hemoglobin
- Myoglobin 2.iEnzymeiCofactor
- Moreithani 200 ienzymeireactions
3.iImmuneiFunction
- Generatesifreeiradicals MajoriIron-containingiProteinsi-iCorrectiAnswer- 1.Hemoglobin:icarriesioxygeniandicarbonidioxideiiniblood 2.Myoglobin:icarriesioxygenitoimuscles 3.Cytochromes:ienergyigeneration 4.Ferritin:istorageiforiiron,iexcessibecomesihemosiderin 5.Transferrin:itransportsiironiiniblood DietaryiIroniSourcesi-iCorrectiAnswer- NoniHemeiIroniAbsorptioni-iCorrectiAnswer- FoodiSources:imeat,ikidneyibeans,ipeas,isauerkraut,iironicookingiskillet s Enhancers:
- Need:ilowibodyistoresi
- VitaminiC
- GastriciAcid
- Meatiproteinifactor Mechanism:iReduces,iSolubilizesiFe Inhibitors:iphytates(inidietaryifiber)
- Calcium?
- Doesitheicellihaveienoughiironitoifunction?
- i--Measuredibyihemoglobin,ihematocrit IroniDeficiencyi-iCorrectiAnswer-Mild:i1.iFatiguei 2.iImpairediphysicaliworkiperformance 3.iCognitivei&ibehavioriabnormalitiesiinichildren 4.iBodyitemperatureiregulation 5.iDecreasediimmuneifunction Severe:iAnemia •Iron - deficiencyianemia
Ironideficiencyiresultsiinismalliredibloodicellsi(microcytic)ithatidoinotico ntainienoughihemoglobin
Symptomsiareifatigue,ipaleiskin,iimpairediworkiperformance,idepresse diimmuneifunction,iimpairedimemory IroniOverload:iHemochromatosisi-iCorrectiAnswer-Geneticidisease
Accumulatediironidamagesicells:iprogressiveihepatic,ipancreatic,icardia c,iandiotheriorganidamage
- Madeiworseiwithialcohol
- Prevalence:i 1 iini 13
- (1icopy-recessive)
- 1 iini 300 i(2icopies) Hemochromatosis:iifiuntreated,imayiresultiini-iCorrectiAnswer- •Arthritis •Liver idisease:icirrhosis,icancer,iliverifailure •Damage itoitheipancreas,ileadingitoidiabetes •Heart iabnormalities,iincludingiarrhythmiasiandiheartifailure •Impotence ioriearlyimenopause •Thyroid ioriadrenaliproblems FadiDieti-iCorrectiAnswer- Aiweightilossiplanithatipromisesidramaticiresults Cleansingi&iDetoxingi-iCorrectiAnswer- Aiperiodiofifastingiorisevereicalorieirestrictionifollowedibyiaistrictidietiofi fruitijuiceiorirawifruitsi&ivegetables MuscleiEnergyiSystemsi-iCorrectiAnswer-- Power:iImmediateienergyisources
- Speed:iGlycogenolyticiandiglycolyticienergyisources
- Endurance:iOxidativeienergyisources *UltimatelyiWeiNeediOxygen!!!
LipidiMobilizationiandiMetabolismi-iCorrectiAnswer- GlycolysisiandiLactateiMetabolismi(TheiTraditionaliView)i- iCorrectiAnswer--TheiResultiofiOxygeniLack
- AiMetaboliciWasteiProduct
- AiPoison Ifiso,iwhy? TraditionaliviewiofiLactateiProductioni-iCorrectiAnswer- KeyiConcept!i-iCorrectiAnswer- ActivityitoiBalanceiEnergyiinputifromiFooditoiMaintainiBodyiHealthyiRa ngeiofiBodyiWeightiBMIi=i 20 - 25! AcceptableiMacronutrientiDistributioniRangesi(AMDRs)*i- iCorrectiAnswer--iCarbohydrate:i 45 - 65%iofiEnergyi(Previous:i 5 0%+)
- iFat:i 20 - 35%i(Previous:i<i30%)
- iProtein:i 10 - 35%i(Previous:i0.8ig/kg/day)
- in- 6 iPUFAs:i 5 - 10%i(linoleniciacid)
- in- 3 iPUFAs:i0.6-1.2%(alpha-linoleniciacid)i
*ProvidediEnergyiExpenditurei=iIntake! Energyifromiglucoseiandiproteini-iCorrectiAnswer- Copperi-iCorrectiAnswer- •Copper ibindsitoiceruloplasminitheiliveriforideliveryitoitheitissuesibyioxi dizingiFe2+(ferrous)iironitoiFe3+(ferric)iironiwhichicanithenibeibounditoi transferrin. •Copper - containingiproteinsiareiinvolvediin:-Ironiandilipidimetabolism- connectiveitissueisynthesis-maintenanceiofiheartimuscle- immuneiandicentralinerveisystems •About i 30 - 40%iofitheiCuiinidietiisiabsorbed •High iZniintakeistronglyiinhibitsiCuiabsorption •Cu iabsorptioniisireducedibyihighiintakeiofiiron,iotherimetals,ilargeidose siofivitaminiCiandiantacids. •Absorbed icopperiisibounditoialbuminianditransporteditoitheiliver FoodiSourcesiofiZinci-iCorrectiAnswer- •Meat, ifish,ioysters:irichisources,iwell-absorbedi(Notiinirefinediflours) •Dairy, iwholeigrains,ilegumes:iLoweriratesiofiabsorptioni(Inhibitedibyip hytates,ihighifiber) RDAiforiZinc: assumesi70%icontributionifromimeat:
- 11mg/dimen,i 8 img/diwomeni
