Deck 39: Medical Nutrition Therapy for Rheumatic Disease

Question 1

Nonsteroidal antiinflammatory drugs (NSAIDs)

A) include the drug Tylenol.
B) work by inhibiting the COX-1 enzyme.
C) work by blocking interleukin.
D) have significant catabolic effects.

Answer 1

B
Explanation: NSAIDs include ibuprofen and naproxen and work by inhibiting COX-1 enzyme activity. Tylenol is an analgesic pain reliever. There is a group of drugs aimed at interleukin; one is anakinra. Corticosteroids, also used to decrease inflammation, have significant catabolic effects.

Question 2

Which of the following is an important component in the nutritional assessment of patients with rheumatoid arthritis?

A) ADLs
B) Degree of malabsorption
C) Blood glucose control
D) Nitrogen balance

Answer 2

A
Explanation: Because rheumatoid arthritis (RA) can affect mobility, activities of daily living (ADLs) should be assessed. An inability to perform basic self-care skills can have a negative impact on the patient's ability to feed herself. Support in the form of caregivers or adaptive equipment may be needed to ensure nutritional adequacy. Malabsorption is not a consequence of RA. Blood glucose control depends on the presence of diabetes and other lifestyle factors. Nitrogen balance may be used to monitor protein status; however, simple monitoring of the patient's weight and anthropometric measures gives an idea about protein status without need for a nitrogen balance study.

Question 3

Which of the following food lists has high purine content?

A) Enriched white bread, rice, and tomatoes
B) Cheese, chocolate, butter, and coffee
C) Fruit, ice cream, pasta, and nuts
D) Herring, kidney, sardines, and consommé

Answer 3

D
Explanation: Foods with the highest purine content include organ meats; meat extracts such as gravy, bouillon, and consommé; certain fish (herring, mackerel) and fowl (goose, partridge); and yeast taken as a supplement. These should be avoided when trying to limit purine in the diet. Moderate-purine content foods include other fish, poultry, meats, shellfish, and certain vegetables (asparagus, dried beans, lentils, mushrooms, dried peas, and spinach). These should be limited to one serving of meat and one serving of vegetable per day in the low-purine diet.

Question 4

Which of the following conditions is NOT a disease of autoimmune origin?

A) OA
B) RA
C) SLE
D) Scleroderma

Question 5

Which of the following provides abundant omega-3 fatty acids such as DHA and EPA?

A) Flaxseed and walnuts
B) Soy and canola oils
C) Salmon and tuna
D) Lard

Question 6

A group of self-reacting antibodies found in the sera of rheumatic patients

A) include CRP.
B) are known to suppress the immune system.
C) are known as rheumatoid factor.
D) are known as eicosanoids.

Question 7

Which of the following conditions is characterized by hardening of the skin and visceral organs?

A) Gout
B) Scleroderma
C) Fibromyalgia
D) Sjögren syndrome

Question 8

With what do the plasma copper levels seen in patients with rheumatoid arthritis correlate?

A) Dietary intake of copper
B) Type of medication
C) Degree of joint inflammation
D) Degree of malabsorption and diarrhea

Question 9

What should be the primary nutritional goal for patients with osteoarthritis?

A) Achieve and maintain a desirable body weight.
B) Increase fiber intake to prevent constipation.
C) Increase omega-3 oils in the diet.
D) Decrease sodium intake to reduce edema.

Question 10

Which of the following is characteristic of Sjögren syndrome?

A) Excessive sweating and salivation
B) Temporomandibular joint symptoms
C) Diminished production of tears and saliva
D) Diminished production of hydrochloric acid

Question 11

What is the role of prostacyclin or PGI₂?

A) Converts arachidonic acid into PGE₁
B) Converts arachidonic acid into PGE₂
C) Promotes platelet aggregation
D) Inhibits platelet aggregation

Question 12

Which feature associated with the joint of a person affected with gout is different from the joint of a person affected with rheumatoid arthritis?

A) Bone erosion
B) Inflamed synovium
C) Bone spurs
D) Presence of tophi

Question 13

Which of the following may have a beneficial effect in the treatment of patients with Sjögren syndrome?

A) Increase frequency of meals.
B) Moisten foods with sauces or gravies.
C) Limit fiber.
D) Increase citrus fruits.

Question 14

What drug(s) is(are) the first line of therapy for controlling the inflammatory process seen in arthritis?

A) Corticosteroids
B) Salicylates
C) Gold salts
D) Methotrexate

Question 15

How are thromboxanes involved in the inflammation process?

A) Activation of platelet aggregation
B) Activation of cytokines
C) Attraction of neutrophils and macrophages
D) Production of arachidonic acid

Question 16

Which of the following CAM therapies has been demonstrated as effective in the treatment of rheumatoid arthritis?

A) Copper bracelets
B) Echinacea
C) Borage and evening primrose oil
D) Thunder god vine

Question 17

Which spices are included in the "antiinflammatory diet"?

A) Thyme, cayenne, and cloves
B) Oregano, lemon peel, and thyme
C) Ginger, curry, turmeric, and rosemary
D) Cayenne, cumin, and parsley

Question 18

Which of the following is an autoimmune disorder that presents with severe fatigue, painful or swollen joints, and skin rashes?

A) Chronic fatigue syndrome
B) Systemic lupus erythematosus
C) Raynaud syndrome
D) Scleroderma

Question 19

Current research suggests that which of the following play a role in the inflammatory process?

A) Polyunsaturated fatty acids
B) Monounsaturated fatty acids
C) Omega-3 and omega-6 fatty acids
D) Medium-chain triglycerides

Question 20

Which of the following dietary recommendations assists in the management of patients with gout?

A) Fluid restriction and avoidance of coffee and chocolate
B) Limit intake of animal foods, seafood, and alcohol
C) High-fat, low-carbohydrate diet
D) Low-pyrimidine diet with decreased carbohydrates