Question 1

Although severe microcytic hypochromic anemia is present, which of the following is also a characteristic of sideroblastic anemia?&#10;A)Iron overload&#10;B)Low serum iron levels&#10;C)High serum iron and low tissue iron levels&#10;D)Low tissue iron levels

Accepted Answer

Sideroblastic anemia presents with iron overload as an impairment in heme formation resulting in a sequestering of iron in immature red blood cells.Iron levels in both the serum and in ferritin stores measure as either normal or high.

Question 2

Which of the following enhances the absorption of dietary iron and iron supplements?&#10;A)Calcium-containing foods&#10;B)Carbohydrates&#10;C)Vitamin C&#10;D)Magnesium

Accepted Answer

Factors in food related to improved bioavailability of iron include heme form, MFP factor, and vitamin C.Factors in food that may decrease bioavailability of iron include chelators such as phytate, oxalate, carbonate, and phosphate, which are often found in fibrous foods; tannins in tea and coffee; phosvitin in egg yolk; and possible competition with other minerals.

Question 3

Which protein is most responsible for the transport of vitamin B&#8321;&#8322; to target cells in the body?&#10;A)Haptocorrin&#10;B)Intrinsic factor&#10;C)Holotranscobalamin I&#10;D)Holotranscobalamin II

Accepted Answer

Holotranscobalamin II protein is important in the delivery of vitamin B₁₂ to all cells needing it.Although only 25% of the vitamin B₁₂ is bound to TC II, lack of TC II develops into megaloblastic anemia.Haptocorrin, or TC I, binds about 75% of the circulating vitamin B₁₂.Intrinsic factor is involved with the transport and absorption of vitamin B₁₂ in the GI tract.

Question 4

Which form of folate is the one that becomes &#34;trapped&#34; when vitamin B&#8321;&#8322; deficiency occurs?&#10;A)Folate&#10;B)THFA&#10;C)5-Methyl THFA&#10;D)5,10-Methyl THFA

Accepted Answer

Vitamin B₁₂ is necessary for the removal of the 5-methyl unit from 5-methyl tetrahydrofolate to transfer it to homocysteine to produce methionine.Folate is the typical form consumed in foods and is converted to THFA in the enterocyte.5,10-Methyl THFA is the precursor form that leads to DNA synthesis.

Question 5

Which of the following foods provide significant amounts of folate in the diet?&#10;A)Fish and seafood&#10;B)Milk products&#10;C)Fresh fruit and vegetables&#10;D)Eggs and poultry

Accepted Answer

Fresh, uncooked fruits and vegetables are good sources of folate, as are legumes, tofu, and organ meats.Poultry, fish, eggs, meat, and dairy products provide small amounts of folate but not as much as fruits and vegetables.Because of fortification, grain products are also significant sources of folate in the United States.

Question 6

Which nutrient deficiency is most likely to cause an anemia that appears microcytic and hypochromic?&#10;A)Folic acid&#10;B)Pyridoxine&#10;C)Iron&#10;D)Vitamin B12

Accepted Answer

Microcytic hypochromic anemia results from iron deficiency.This occurs because the body produces small red blood cells and has decreased circulation of hemoglobin.Folic acid, pyridoxine, and vitamin B₁₂ deficiencies result in macrocytic anemias caused by the release of immature red blood cells from the bone marrow.

Question 7

How does pernicious anemia differ from folate deficiency?&#10;A)Pernicious anemia is easily treated by dietary alterations.&#10;B)Pernicious anemia affects the central and peripheral nervous systems.&#10;C)Pernicious anemia is reversible with treatment.&#10;D)Pernicious anemia results in microcytic, hypochromic red blood cells.

Accepted Answer

Pernicious anemia differs from folate deficiency because it affects the central and peripheral nervous systems.Pernicious anemia results in macrocytic anemia caused by a vitamin B₁₂ deficiency commonly resulting from a lack of intrinsic factor.By providing supplementation, both pernicious and folate deficiency anemia are reversible.Including animal protein products in the diet will treat pernicious anemia, and including green leafy vegetables and fortified grains in the diet will treat folate deficiency.

Question 8

What causes pernicious anemia?&#10;A)Problem with vitamin B12 intake or absorption&#10;B)A loss of blood through the gastrointestinal tract&#10;C)A lack of iron from both heme and nonheme iron sources&#10;D)Interference with pyridoxine metabolism

Accepted Answer

Pernicious anemia results from vitamin B₁₂ deficiency, usually resulting from a lack of intrinsic factor to ensure adequate absorption.GI blood loss and inadequate iron intake are more likely to be associated with an iron deficiency anemia.Sideroblastic anemia results from an impairment in heme synthesis, which depends on adequate pyridoxine availability.

Question 9

Foods high in _____ should be avoided by individuals with sickle cell anemia.&#10;A)protein&#10;B)folate&#10;C)iron&#10;D)vitamin A

Accepted Answer

Sickle cell anemia is a hemolytic anemia that results in increased iron stores in the liver.When a patient has received multiple blood transfusions, this could promote iron overload.Diet should focus on inclusion of sources of iron that have poor absorbability to limit the likelihood of development of iron overload.

Question 10

Which biochemical measure is useful in evaluating the body's folate stores?&#10;A)Serum folate level&#10;B)Red blood cell folate level&#10;C)Urinary formiminoglutamic acid (FIGLU)&#10;D)Serum homocysteine level

Accepted Answer

The level of folate in red blood cells measures the actual folate stores and is the first, best indicator of folate depletion.Serum folate level may initially reflect a negative balance of folate at the time of the blood draw.Urinary FIGLU and serum homocysteine levels increase when folate deficiency occurs because folate is necessary for the conversion of histidine to glutamic acid, in the case of the former, and in homocysteine to methionine.

Question 11

Which of the following may reduce the absorption of iron when consumed in large amounts?&#10;A)Coffee or tea with meals&#10;B)Leavened bread&#10;C)Pork&#10;D)Fish

Accepted Answer

The answer of Which of the following may reduce the...

Question 12

After absorption, iron is transported by&#10;A)hemoglobin.&#10;B)serum albumin.&#10;C)plasma transferrin.&#10;D)protoporphyrin.

Accepted Answer

The answer of After absorption, iron is transported by&#10;A)hemoglobin.&#10;B)serum albumin.&#10;C)plasma...

Question 13

What does the quantity plasma ferritin value reflect when iron status is evaluated?&#10;A)Supply of iron delivered to developing red blood cells&#10;B)The most sensitive indicator of negative iron balance&#10;C)Total iron-binding capacity&#10;D)Iron supply to the tissues

Accepted Answer

The answer of What does the quantity plasma ferritin value...

Question 14

Which of the following may be useful in treating sickle cell anemia?&#10;A)Iron&#10;B)Ascorbic acid&#10;C)Zinc&#10;D)Copper

Accepted Answer

The answer of Which of the following may be useful...

Question 15

In what stage of iron deficiency does the value of soluble serum transferrin receptors measure as high as in the blood?&#10;A)Stage I early negative iron balance&#10;B)Stage II iron depletion&#10;C)Stage III iron-deficient erythropoiesis&#10;D)Stage IV iron deficiency anemia

Accepted Answer

The answer of In what stage of iron deficiency does...

Question 16

Which nutrient deficiency is associated with the development of hemolytic anemia?&#10;A)Iron&#10;B)Vitamin B6&#10;C)Vitamin E&#10;D)Folate

Accepted Answer

The answer of Which nutrient deficiency is associated with the...

Question 17

Hepcidin, a peptide synthesized in the liver, is associated with what function?&#10;A)Absorption of vitamin B12&#10;B)Iron saturation of myoglobin&#10;C)Increasing iron absorption&#10;D)Systemic iron homeostasis

Accepted Answer

The answer of Hepcidin, a peptide synthesized in the liver,...

Question 18

Restless legs syndrome is associated with deficiency of what nutrient?&#10;A)Iron&#10;B)Folic acid&#10;C)Vitamin B12&#10;D)Vitamin C

Accepted Answer

The answer of Restless legs syndrome is associated with deficiency...

Question 19

Which of the following food groupings has the greatest iron content?&#10;A)Milk, raisins, and spinach&#10;B)Broccoli, Rice Krispies, and black beans&#10;C)Kidney beans, pistachio nuts, and eggs&#10;D)Tuna fish, beef tenderloin steak, and chicken liver

Accepted Answer

The answer of Which of the following food groupings has...

Question 20

The Shilling test is useful in diagnosing which type of anemia?&#10;A)Pernicious&#10;B)Iron deficiency&#10;C)Hemolytic&#10;D)Medication induced

Accepted Answer

The answer of The Shilling test is useful in diagnosing...

Deck 32: Medical Nutrition Therapy for Anemia