Deck 19: Diet and Health

Question 1

Cytokines are which of the following?

A) scavengers of the immune system
B) specialized antibodies that retain B cell memory
C) specialized proteins that activate responses to infection
D) highly specific cells that attack only 1 type of antigen

Answer 1

C

Question 2

Which of the following leading causes of death in the Canada does NOT bear a relationship to diet?

A) cancer
B) heart disease
C) stroke
D) pneumonia and influenza

Answer 2

D

Question 3

Which of the following are modifiable risk factors for disease?

A) age
B) gender
C) heredity
D) low HDL level

Answer 3

D

Question 4

Which of the following characteristics of HIV or AIDS is true?

A) HIV but not AIDS is curable.
B) AIDS develops from HIV infection.
C) Optimal nutrition can prevent but not cure HIV.
D) Since the 1990s, the death rate from HIV and AIDS has increased markedly.

Question 5

HIV is known to be transmitted through direct contact with:

A) saliva
B) blood
C) tears
D) sweat

Question 6

Four-month old Kimmy was playing near some large dust particles under the couch, which caused her to sneeze and develop a runny nose and a cough. Two weeks later she came across more dust from the same place. Which of the following aspects of immunity allows Kimmy's body to remember how to respond to this dust again?

A) T cells
B) B cells
C) beta cells
D) spleen cells

Question 7

Immunoglobulins are produced primarily by which of the following cells?

A) T cells
B) B cells
C) red blood cells
D) phagocytes

Question 8

What percentage of cells of the body are white blood cells?

A) 0.01 percent
B) 0.1 percent
C) 1 percent
D) 10 percent

Question 9

Lymphocytes are which of the following?

A) white blood cells that ingest and destroy foreign substances
B) white blood cells that participate in immunity
C) substances that elicit the formation of antibodies
D) proteins capable of acting as antibodies

Question 10

Of the 10 leading causes of illness and death, how many are associated directly with nutrition?

A) 1
B) 4
C) 7
D) 10

Question 11

The immune system treats foreign substances such as bacteria and toxins as which of the following objects?

A) antigens
B) antibodies
C) synergists
D) immunoglobulins

Question 12

Which of the following terms describes an event, such as a GI infection, that results in decreased nutrient absorption, which in turn results in inability to synthesize sufficient immune cells and immune factors, thereby leading to increased susceptibility to another GI infection?

A) synergistic
B) antagonistic
C) enteroimmune recirculation
D) reinforced negative nutrition spiral

Question 13

What is the term given to mounds of lipid material mixed with smooth muscle cells and calcium that develop in the artery walls?

A) plaques
B) angina streaks
C) arterial thickening
D) pre-thromboemboli

Question 14

The process by which immune cells engulf and then destroy bacteria is known as which of these terms?

A) bactocydosis
B) phagocytosis
C) cytotoxicosis
D) immunoglobinemia

Question 15

Being obese is known to increase the probabilities of contracting all of the following diseases EXCEPT:

A) cancer
B) diabetes
C) kwashiorkor
D) hypertension

Question 16

Which of the following functions of the T cells is true?

A) recognize antigens
B) produce antibodies
C) produce immunoglobulins
D) are scavengers of the immune system

Question 17

Which of the following cell types make up the immune system?

A) P cells
B) red blood cells
C) platelets
D) phagocytes

Question 18

Which of the following disorders is influenced strongly by genetics?

A) AIDS
B) diabetes
C) smallpox
D) polio

Question 19

Approximately how many people in North America have HIV or AIDS?

A) 100,000
B) 550,000
C) 1.3 million
D) 3.3 million

Question 20

For which of the following chronic diseases are dietary risk factors least involved in its development?

A) cancer
B) obesity
C) diabetes
D) atherosclerosis

Question 21

The obstruction of a blood vessel by a clot that broke away from arterial plaque is termed which of the following?

A) an anginism
B) an embolism
C) circulatory hypoxia
D) a deplaquing event

Question 22

A person's level of C-reactive protein appears to be a strong predictor for which of these disorders?

A) cancer
B) diabetes
C) a heart attack
D) HIV progression

Question 23

Tiny, disc-shaped bodies in the blood that are important in clot formation are called which of the following terms?

A) T cells
B) C cells
C) plaques
D) platelets

Question 24

A significant reduction in blood flow to the brain is called which of the following terms?

A) angina
B) a stroke
C) a vascular event
D) metabolic syndrome

Question 25

Which of these properties applies to pre-hypertension?

A) predictor of stroke risk
B) slightly high blood pressure
C) precursor for Syndrome X
D) component of the metabolic syndrome

Question 26

Which of the following forms of cardiovascular disease is most common?

A) stroke
B) atheromatous disease
C) coronary heart disease
D) hypertensive aneurysm

Question 27

Markers for inflammation as a risk factor for cardiovascular disease include high levels of:

A) CRP
B) ephedra
C) resveratrol
D) HDL cholesterol

Question 28

Anyone who is medically advised to lower blood cholesterol should do which of the following?

A) eat fish oil capsules
B) take lecithin supplements
C) achieve desirable body weight
D) lower his/her intake of insoluble fibre

Question 29

Which of the following describes a known association with coronary heart disease (CHD)?

A) In men, CHD begins 10-15 years earlier than in women.
B) Women who take estrogen to reduce the risk for osteoporosis are at significantly higher risk for CHD.
C) Men with blood cholesterol levels in the borderline-high range account for up to 10 percent of all deaths from CHD.
D) Women younger than 45 years of age tend to have higher LDL cholesterol than do men of that age, but this difference disappears after menopause.

Question 30

By what age do most people first have well-developed arterial plaque?

A) 30 years
B) 40 years
C) 50 years
D) 60 years

Question 31

Which of the following blood pressure readings first signifies a diagnosis of hypertension?

A) 110 over 50
B) 120 over 70
C) 130 over 80
D) 140 over 90

Question 32

Which of the following associations between smoking and coronary heart disease is true?

A) Smoking damages platelets.
B) Smoking decreases blood pressure.
C) Smoking as a risk factor for CHD differs for women and men.
D) Cessation of smoking begins to lower the risk of CHD after 36 months.

Question 33

Beverly is a 48-year-old woman with a strong family history of atherosclerosis. She eats a diet high in fat, smokes, and doesn't exercise much because she typically works 12-hour days. Beverly visits her doctor because she has recently been having chest pains. Her doctor suspects she is at risk for a heart attack. Which of the following indicators would be the most definitive predictor of this suspicion?

A) platelet count
B) C-reactive protein concentrations
C) LDL cholesterol serum concentrations
D) HDL cholesterol serum concentrations

Question 34

Which of the following features of low-density lipoproteins and coronary heart disease is true?

A) HDL is more atherogenic than is LDL.
B) Excess LDL cholesterol is vulnerable to oxidation.
C) HDL-lowering treatments are designed to stabilize arterial plaques.
D) Excess LDL cholesterol in the blood is removed by high-density lipoproteins.

Question 35

Which of the following test results may be classified as a risk factor for coronary heart disease?

A) low lipoprotein-associated phospholipase A(2) levels
B) low LDL-cholesterol levels
C) high HDL-cholesterol levels
D) high C-reactive protein levels

Question 36

Which of the following is considered a risk factor for coronary heart disease?

A) obesity
B) moderate sugar intake
C) low LDL cholesterol
D) high HDL cholesterol

Question 37

The ballooning out of an artery wall at a point where it has been weakened by deterioration is called which of the following terms?

A) an aorta
B) a plaque
C) an aneurysm
D) a diverticula

Question 38

Which of these blood cholesterol carriers is of greatest concern in atherosclerosis?

A) HDL
B) LDL
C) HDk
D) VLDk

Question 39

Which of the following characteristics of arterial plaque is true?

A) Size of the plaque is not as important as composition.
B) Stabilization of the plaque occurs with moderate intake of alcohol.
C) The amount of C-reactive protein in the plaque is a marker for high risk.
D) The rough surface of plaques promotes neutrophil aggregation and antigen formation.

Question 40

Which of the following features of blood triglycerides and risk for coronary heart disease is true?

A) High triglyceride levels are now designated as a major risk factor.
B) Non-fasting triglyceride levels more strongly predict risk than fasting levels.
C) High triglyceride levels correlate strongly with high HDL levels, which is a predictor for low risk.
D) Triglyceride concentrations are low in very-low-density lipoproteins, which correlate with risk for metabolic syndrome.

Question 41

Approximately how many million people in Canada are believed to have hypertension?

A) 2
B) 4.5
C) 6
D) 10.5

Question 42

Peripheral resistance is affected primarily by the resistance of which of the following?

A) blood flow in the atria
B) blood flow in the arterioles
C) the carotid arterial flow in the brain
D) blood flow in the portal venous system

Question 43

Risk factors for coronary heart disease that can be minimized by behavioural change include all of the following EXCEPT:

A) stress
B) smoking
C) heredity
D) hypertension

Question 44

Direct contributors to the metabolic syndrome include which of the following?

A) waist circumference >102 cm (for men) or >89 cm (for women)
B) triglycerides $\leq$ 1.7 mmol/L
C) blood pressure $\geq$ 120/80 mmHg
D) fasting glucose $\geq$ 4.1 mmol/L

Question 45

For which of the following reasons should the measurement of a person's blood cholesterol be performed at least twice, with measurements taken at least 1 week apart?

A) The person may not be fasting.
B) The reliability of laboratory testing instruments for cholesterol is inexact.
C) Blood cholesterol concentrations are known to vary significantly day to day.
D) The person may have an infection (e.g. cold) which affects cholesterol concentration.

Question 46

Blood pressure measurement is expressed in which of the following units?

A) centimetres of silver
B) centimetres of depth
C) millimetres of plaque
D) millimetres of mercury

Question 47

Which of the following factors would lead a person with high blood pressure to develop the metabolic syndrome?

A) diuretic use
B) insulin resistance
C) high HDL levels
D) low blood triglycerides

Question 48

Which of the following characteristic factors associated with hypertension is true?

A) Most people with hypertension have BMIs <25.
B) Most people with hypertension are extremely salt sensitive.
C) Three to 4 alcohol drinks per day lowers risk for hypertension.
D) African-Americans develop high blood pressure earlier in life and their average blood pressure is higher than whites'.

Question 49

Stefan was recently diagnosed with metabolic syndrome. His primary care physician refers him to your office for some counselling on his modifiable risk factors. Which of the following topics will you most likely discuss with Stefan?

A) which medications to take
B) how to improve his atherogenic diet
C) how to slow down his aging process
D) how to map out his family tree, identifying all relatives with heart disease

Question 50

Which of the following is the most likely reason that a blood pressure reading should be repeated before confirming a diagnosis of hypertension?

A) The person reacted emotionally to the procedure.
B) Blood pressure measuring devices often give inaccurate readings.
C) The cuff of the blood pressure measuring device was wrapped too tightly on the arm.
D) The cuff of the blood pressure measuring device was wrapped too loosely on the arm.

Question 51

What should be the next course of action for a person who was unsuccessful in lowering LDL or blood pressure by lifestyle changes?

A) prescribe medications
B) consider coronary bypass surgery
C) obtain regular nutrition counselling
D) consider gastric surgery to reduce body weight

Question 52

What is the appropriate method of assessing blood lipids to ensure reliable results?

A) Take at least 2 measurements at least 1 week apart.
B) Send the patient to 2 different laboratories and average the results.
C) Take a fasting and a non-fasting blood sample and average the results.
D) Perform a fat tolerance test by having the patient drink a beverage containing 25 g of vegetable oil and obtain blood samples over the next 4 hours.

Question 53

To lower a high blood cholesterol level, which of the following is recommended?

A) Consume 2 servings/week of fish.
B) Consume at least 300 mg of cholesterol per day.
C) Lower saturated fat intake to $\leq$ 17 percent total energy.
D) Limit trans-fat intake to $\leq$ 10 percent total energy

Question 54

Among the following, which should be the first action taken to lower blood cholesterol?

A) begin drug treatment
B) consume a high-protein diet
C) consume large amounts of fish and fish oils
D) achieve and maintain appropriate body weight

Question 55

A person who produces a normal amount of insulin but whose cells show suboptimal response is said to be in which of the following states?

A) polydipsic
B) insulin resistant
C) hyperglucagonemic
D) pancreatic beta-cell deficient

Question 56

What is the magnitude of the increase in risk for CVD for a person with a blood pressure reading of 140/80 compared with the optimum blood pressure?

A) 20 percent
B) 40 percent
C) 75 percent
D) 100 percent

Question 57

Which of the following risk factors predict the development of hypertension?

A) age
B) race
C) salt intake
D) family background

Question 58

Which of these values is the best predictor for risk of a stroke?

A) blood pressure
B) LDL-cholesterol blood level
C) HDL-cholesterol blood level
D) trans-fatty acid intake

Question 59

Which of the following characteristics of the metabolic syndrome is true?

A) Being physically active plays a major role in its development.
B) Malnutrition is thought to play a greater role than other risk factors.
C) At least 3 of 5 specific diet-related risk factors must be present for diagnosis.
D) The risk factors act synergistically to predict the risk for coronary heart disease.

Question 60

Approximately what percent of people with high blood pressure are sensitive to salt?

A) 15 percent
B) 35 percent
C) 50 percent
D) 90 percent

Question 61

Which of the following recommendations is used by health professionals to treat hypertension?

A) Decrease fibre intake.
B) Eat foods high in iron.
C) If overweight, reduce weight.
D) Decrease intake of dairy products to avoid sodium.

Question 62

How do diuretics lower blood pressure?

A) by increasing fluid loss
B) by decreasing potassium loss
C) by reducing arterial plaque formation
D) by increasing retention of calcium and potassium

Question 63

Which of the following statements describes a relationship between sodium/salt and high blood pressure?

A) People with chronic kidney disease are less likely to be salt-sensitive.
B) Lowering sodium intakes reduces blood pressure only in certain ethnic groups.
C) People over 30 years of age with hypertension are most likely to be salt-sensitive.
D) Weight loss is often as effective as sodium restriction in lowering blood pressure.

Question 64

Which of the following metabolic activities is stimulated by insulin?

A) fat release
B) glucose uptake
C) protein catabolism
D) alcohol breakdown

Question 65

Which of the following explains how obesity increases the risk for developing hypertension?

A) Obesity is associated with altered kidney function and fluid retention leading to higher blood pressure.
B) The excess fat pads surrounding the kidneys impair blood flow to these organs and lead to higher output of renin.
C) Sodium intake in obese people significantly exceeds the recommended intake, thereby predisposing them to higher blood pressure.
D) Higher lipoprotein lipase activity in obese people triggers the angiotensin cascade, leading to increased peripheral resistance to blood flow.

Question 66

People who use diuretics are most at risk of developing imbalances of which of these nutrients?

A) sodium
B) calcium
C) potassium
D) phosphate

Question 67

Among the following lifestyle changes, which has the least favourable effect on reducing blood pressure?

A) adopting the DASH eating plan
B) limiting daily alcohol intake to 1-2 drinks
C) reducing body weight to less than a BMI of 25
D) performing physical exercise for 30 minutes per day, 5 days a week

Question 68

What happens to the risk for CVD for a person with a blood pressure of 120/90?

A) It is halved.
B) It is doubled.
C) It is unchanged.
D) It is reduced by 25 percent.

Question 69

The DASH diet was developed to lower the risk for which of the following disorders?

A) cancer
B) diabetes
C) hypertension
D) metabolic syndrome

Question 70

Which of these diseases does diabetes contribute to?

A) blindness
B) osteoporosis
C) inflammatory bowel disease
D) HIV

Question 71

The DASH diet is actually the acronym for which of the following?

A) Dramatic Alternatives to Solving HIV
B) Diabetes And Sodium Hyperglycemia
C) Dietary Approaches to Stop Hypertension
D) Disorders-Associated Severe Hyperlipidemias

Question 72

Which of the following characteristics of drug therapy for hypertension is true?

A) Antihypertensive drugs work by lowering blood volume.
B) The most frequently prescribed drug therapies are DASH inhibitors.
C) Most people with hypertension need only 1 medicine to reduce blood pressure.
D) Major side effects of antihypertensive drugs are depletion of body sodium and phosphorus.

Question 73

Which of the following statements describes a risk factor for high blood pressure?

A) Three alcohol drinks per day increases the risk for developing high blood pressure.
B) Most people are genetically sensitive to sodium and will develop high blood pressure from excess salt intake.
C) Ninety-five percent of people under 50 years of age with high blood pressure respond favourably to low salt intake.
D) Ninety-five percent of people with high blood pressure who restrict salt intake show a significant decrease in blood pressure.

Question 74

Which of the following features of the DASH diet is true?

A) It works synergistically with reduction of sodium intake.
B) It was originally designed as therapy for atherosclerosis.
C) It is effective due to the high intakes of iron and vitamin B₁₂.
D) It includes an exercise component and a limitation on trans-fat intake.

Question 75

The sixth leading cause of death is which of the following?

A) cancer
B) diabetes
C) hypertension
D) coronary heart disease

Question 76

Strategies to reduce the risk of coronary heart disease in people who drink include limiting daily alcohol intake to which of these amounts?

A) 1 drink for both women and men
B) 1 drink for women and 2 for men
C) 2 drinks for both women and men
D) 2 drinks for women and 4 for men

Question 77

Which of the following changes in diet would be most effective in lowering blood pressure?

A) eliminating the use of table salt altogether
B) including 3 servings of skim milk and 10 servings of fruits and vegetables a day
C) substituting all table salt use throughout the day with Mrs. Dash seasoning product
D) including 3 servings of skim milk and 10 servings of fruits and vegetables a day plus restricting sodium to 2 g/day

Question 78

Which of these is believed to be the primary cause of type 1 diabetes?

A) defect in insulin sensitivity
B) excessive body weight gain
C) defect of the immune system
D) excessive intake of simple carbohydrates

Question 79

In which of the following conditions would the pancreas be unable to synthesize insulin?

A) hyperglycemia
B) type 1 diabetes mellitus
C) type 2 diabetes mellitus
D) hypoglycemia

Question 80

A person who hasn't consumed anything except water for the past 8 hours has a blood glucose concentration of 5.6 mmol/L. This person would be classified as which of the following?

A) normal
B) diabetic
C) pre-diabetic
D) impaired glucose tolerant