CHNI NUTRITION REVIEW 2000

Mock 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 bodys 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. Metabolism
b. 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 children
b. Sugar promotes cancer
c. Sugar causes heart diseases
d. Sugar causes obesity

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

9. Glycogenesis is:
a. Utilization of glucose
b. Breakdown of glycogen to glucose
c. Synthesis of glucose from non-glucose sources
d. 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 normal
b. How high blood glucose rises after a meal
c. How quickly glucose is absorbed after eating
d. How long glucose is elevated after a meal

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

12. Major site of absorption of food and absorption of nutrients
a. Large intestines c. Liver
b. Small intestines d. Stomach

13. The major classes of lipids are:
a. Phospholipids, glycerol, polyunsaturated fatty acids
b. Sterols, phospholipids, lecithin
c. Omega 3 fatty acids, omega 6 fatty acids, glycerol
d. Triglycerides, phospholipids, sterols

14. Sources of glucose except for:
a. Monosaccharides, disaccharides
b. Glycogen
c. Fat
d. Amino acids

15. The second aerobic stage of carbohydrate metabolism which take place in the mitochondria
a. Oxidative decarboxylation c. Glycolysis
b. 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 fructose
b. Glucose d. Maltose

18. The degree to which an ingested nutrient gets absorbed and is available to the body
a. Bioassay c. Biologic value
b. Bioavailability d. None of the above

19. An algal polysaccharide used as a thickening agent to many processed foods
a. Pectin c. Cellulose
b. Carageenan d. Hemicellulose

20. A noncellulose polysaccharide found in fruits and composed of units of a galactose derivative
a. Cellulose c. Carageenan
b. Pectin d. Hemicellulose

21. Intermediate product of starch hydrolysis
a. 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 acid
a. 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 ATP
b. 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 level
a. Epinephrine b. Insulin c. Thyroxine d. Glucagon

27. The most variable component of energy expenditure:
a. Thermic effect of food c. Basal/resting energy expenditure
b. 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 acids
b. Saturated fatty acids d. None of the above

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

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

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

34. The end product of anaerobic phase of glucose metabolism
a. Acetyl CoA c. Carbon dioxide and water
b. 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 body
a. HDL b. LDL c. VLDL d. Chylomicron

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

38. Coenzyme required in oxidative decarboxylation
a. 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-oxidation
a. Carnitine b. Lecithin c. Cholesterol d. Cephalin

40. It does not contain cholesterol
a. 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/replacer
b. Medium chain triglyceride d. None of the above

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

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

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

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

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

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

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

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

51. A product of carbohydrate metabolism used for muscular contraction
a. 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 activity
a. 15% b. 25% c. 30% d. 35%

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

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

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

57. Pathway followed by NH
2
after oxidative deamination
a. Purine and uric acid synthesis c. Ketogenesis
b. Urea detoxification d. Fat synthesis

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

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

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

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

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

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

64. A protein source that does not contain cholesterol
a. 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 protein
a. Rice b. egg c. monggo d. vegetables

67. Amino acids derived from the digestion of food proteins
a. Exogenous amino acids c. neutral amino acids
b. Endogenous amino aicds d. essential amino acids

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

69. A reduced blood albumin level leads to
a. 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/an
a. Vegetarian c. ovolactopollovegetarian
b. ovolactovegetarian d. pescovegetarian

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

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

74. NPU is a measure to test
a. Protein digestibility c. the amount of protein eaten
b. 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 is
a. Excreted directly in the urine
b. Broken down for energy or used to synthesize glucose and fat
c. Stored in the body
d. None of the above

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

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

79. Ketosis may occur
a. When there is inadequate carbohydrate in the diet
b. During infections
c. When there is too much fat in the diet
d. When there in inadequate protein in the diet

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

81. Human need for water varies with
1. Level of physical activity
2. Age
3. Environmental temperature
4. Body weight
a. 1 & 3 b. 1, 3 & 4 c. 2, 3 & 4 d. 1, 2 & 3

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

83. Adult requirement for water
a. 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 body
a. 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 B12
1. Participates in the conversion of homocysteine to methionine
2. Contains cobalt
3. When injected into patient with pernicious anemia, overcomes the lack of intrinsic factor
4. Can be obtained from peas and carrots
A B C D E

87. Vitamin K
1. Plays an essential role in preventing thrombosis
2. Decreases the coagulation time in newborn infants with hemorrhagic disease
3. Is present in high concentration in cows milk or breast milk
4. Is synthesized by intestinal bacteria
A B C D E

88. Vitamin A
1. Can be enzymically formed from dietary beta-carotene
2. Is transported from the intestine to the liver by chylomicrons
3. Is the light absorbing portion of rhodopsin
4. Is phosphorylated an dephosphorylated during the visual cycle
A B C D E

89. Alpha-tocopherol
1. Functions mainly as an antioxidant
2. Deficiency is commonly found in adults
3. Requirements increase with the amount of PUFA in the diet
4. 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 NADP
2. Derived from the degradation of tryptophan
3. Involved as a ofactor in oxidation-reduction reactions
4. Constituent of FAD
A B C D E

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

92. Vitamin D
1. Increases absorption of calcium from the intestine
2. Is not required in the diet of individuals exposed to sunlight
3. Is not really a vitamin since its active form can be synthesized by humans
4. Opposes the effect of PTH
A B C D E

93. Symptoms of ariboflavinosis
a. Cheilosis, glossitis, photophobia
b. Diarrhea, dermatitis, depression
c. Cheilosis, dermatitis around nose, glossitis
d. Cheilosis, glossitis, petechiae

94. First signs of VAD
a. Keratinization b. Bitots spot c. keratomalacia d. nightblindness

95. Preformed, biologicall active Vitamin D
a. 1,25 dihydroxycholecalciferol c. 7-derhydrocholesterol
b. 25 hydroxycholecalciferol d. cholecalciferol

96. Vitamins that can be synthesized by the bodys intestinal bacteria except
a. Riboflavin b. biotin c. folate d. pyridoxine

97. Another term for nightblindness
a. Xerophthalmia b. keratomalacia c. nyctalopia d. conjunctival xerosis

98. The need for B1 increases in the following conditions except
a. With increased alcohol consumption
b. With increased energy/caloric intake
c. With increased fat consumption
d. During pregnancy and lactation

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

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

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

102. Other names of Vit. B12 except
a. Anti-pernicious factor c. citrovorum factor
b. Erythrocyte maturation factor d. animal protein factor

103. Food constituents which enhance Ca absorption
a. Oxalates & phytates c. both A & B
b. Vits C & D d. none of the above

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

105. B vitamins that help cells to divide
a. 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 balance
b. 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 groups
a. B2 b. B12 c. B6 d. B1

108. The effect of an adequate intake of lactose
a. Enhanced calcium absorption
b. Increased Vit. D activity
c. Decrease pH in the ileum
d. A & C only
e. All of the above

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

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

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

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

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

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

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

116. Factors favouring non-heme iron absorption except
a. 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 are
a. High in K but low in Na c. High in Na but low in K
b. High in K and Na d. Low in K and Na

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

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

121. B vitamins whose requirements are dependent on a persons energy intake
a. Thiamine and niacin c. riboflavin and folate
b. Thiamine and riboflavin d. thiamine and biotin

122. Part of coenzyme A, important in energy metabolism
a. 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 are
a. Intestines, stomach, kidneys c. intestines and kidneys
b. Intestines, kidneys, and bones d. stomach and bones

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

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

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

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

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

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

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

II. Clinical Dietetics

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

132. The common method of tube feeding administration are
a. Bolus, continuous drip c. bolus, gravity drip
b. 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, TG
b. LDL-C, total cholesterol d. all of the above

134. The recommended intake for MUFA in the diet is approximately
a. 30% of total kcal c. up to 10% total kcal
b. 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 of
a. 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 of
a. 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 ascites
a. 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 supplements
b. Aromatic amino acids supplements
c. Branched chain amino acid supplements
d. 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 ventilation
b. Respiratory insufficiency d. all of the above

141. A patient with gout and urecemia will benefit from which diet prescription
a. Low purine, adequate protein, 3 liters water
b. Low purine, 15g/protein/kBW, low alcohol
c. Low purine, high CHO, adequate protein, low fat
d. Low purine, 1 g protein/kBW, calorie restricted

142. Choose the best re-feeding schedule for anorexia nervosa
a. Start with 800-1200kcal and increase by 5-10kcal/kg/day every 3-5 days
b. Start with 800-1200kcal then rapidly increase to 70-100 kcal/kg/day
c. Start with 800-1200 kcal once the patient is taking 30 kcal/kg/day
d. Start with 800-1200kcal and gradually increase by 10-29 kcal/day