Deck 12: Diseases and Disorders of Energy Imbalance

Question 1

Resting energy expenditure (REE), the thermic effect of food (TEF), and physical activity-related energy expenditure all make up the:

A) basal energy expenditure (BEE)
B) 24-hour energy expenditure
C) estimated energy requirements (EER)
D) non-exercise activity thermogenesis (NEAT)
E) iatrogenic body density measurement

Answer 1

B

Question 2

Two hormones produced by adipose tissue that are involved in energy balance and fat storage are:

A) interleukin-6 and c-reactive protein
B) adiponectin and leptin
C) insulin and ghrelin
D) glycogen and amylin
E) calcitonin and endothelin

Answer 2

B

Question 3

What is the energy expenditure above and beyond the thermic effect of food in response to conditions such as overfeeding or in response to a traumatic experience called?

A) 24-hour energy expenditure
B) resting energy expenditure
C) physical activity-related energy expenditure
D) resting thermogenesis
E) adaptive thermogenesis

Answer 3

E

Question 4

Which type of bariatric surgery is considered the simplest and least invasive?

A) laparoscopic adjustable gastric banding
B) open adjustable gastric banding
C) laparoscopic vertical sleeve gastrectomy
D) Roux-en-Y gastric bypass
E) duodenal switch with biliopancreatic diversion

Question 5

Which statement best describes the difference between white adipose tissue (WAT) and brown adipose tissue (BAT)?

A) The cells of BAT store triglycerides from food, while the cells of WAT store LDL cholesterol.
B) As humans age, the amount of WAT diminishes, while the amount of BAT increases.
C) In WAT, triglyceride is stored as one single molecule, while in BAT, there are multiple smaller droplets.
D) WAT is the primary fat found in infants and children, while BAT is primarily found in adults.
E) WAT derives its color from a large number of mitochondria, while BAT derives its color from carotenoids.

Question 6

Obesity is men is most likely associated with which condition?

A) cancer of the esophagus
B) bradycardia
C) hepatitis C
D) cancer of the gallbladder
E) diabetes insipidus

Question 7

The most accurate approach for measuring energy requirements in critically ill patients is:

A) doubly labeled water
B) direct calorimetry
C) the Mifflin-St. Jeor formula
D) the Harris-Benedict equations
E) indirect calorimetry

Question 8

Which is an example of an obesogenic environmental influence on physical activity habits?

A) an increase in sports activities in school
B) a lack of safe sidewalks in neighborhoods
C) a workplace that is historically less automated
D) household chores that are completed by hand
E) an increase in urban sprawl that has created more walking and bicycle trails

Question 9

Which is considered a congenital cause of obesity?

A) Cushing's syndrome
B) adrenal hyperplasia
C) Prader-Willi syndrome
D) Goldenhar syndrome
E) polycystic ovary syndrome

Question 10

The most common type of bariatric surgery performed in the United States is:

A) laparoscopic adjustable gastric banding
B) open adjustable gastric banding
C) laparoscopic vertical sleeve gastrectomy
D) Roux-en-Y gastric bypass
E) duodenal switch with biliopancreatic diversion

Question 11

Which factor affects resting energy expenditure (REE)?

A) height
B) BMI
C) age
D) heart rate
E) blood pressure

Question 12

Which is an example of a lipase inhibitor used in the treatment of obesity?

A) phentermine
B) topiramate
C) sibutramine
D) phendimetrazine
E) orlistat

Question 13

Which of the following drugs acts as a serotonin agonist?

A) orlistat
B) lorcaserin
C) phentermine-topiramate ER
D) naltrexone SR-bupropion SR
E) liraglutide

Question 14

Which of the following is a behavior that is associated with eating disorders?

A) sensitivity to cold
B) weakness
C) callus on back of hands
D) use of diuretics
E) image disturbance

Question 15

Which is a peptide hormone that is produced in the stomach and stimulates appetite?

A) ghrelin
B) lignin
C) cholecystokinin
D) amylin
E) peptide YY

Question 16

Which factor influences the thermic effect of food (TEF) of a meal?

A) the macronutrient composition of the meal
B) the setting in which the meal is consumed
C) the position of the person eating the meal
D) the total energy expenditure of the individual
E) the thermoregulation of the room where the meal is served

Question 17

Which is considered as high-risk waist circumference for males?

A) >33 inches
B) >35 inches
C) >38 inches
D) >40 inches
E) >44 inches

Question 18

Which is the most appropriate initial treatment for a patient with comorbidities and BMI between 25 and 29.9?

A) Avoid additional weight gain and increase activity.
B) Reduce calories, increase activity, and add behavioral therapy.
C) Consider pharmacological therapy combined with diet and weight loss.
D) Institute a very low-calorie diet (VLCD) combined with increased activity.
E) Consider bariatric surgery combined with pharmacological therapy.

Question 19

Which is an obesogenic environmental influence on eating habits?

A) an increase in the proportion of disposable income spent on food
B) increased availability of foods with low energy density
C) increased access to supermarkets and food stores
D) increased amounts of snack and convenience foods
E) the increased cost of energy-dense foods compared to low-energy foods

Question 20

Which is a true statement regarding central body fat distribution?

A) It is more commonly seen in females.
B) It is also referred to as a gynoid body shape
C) It gives the body a shape resembling a pear.
D) It refers to excess fat located on the hips and thighs.
E) It includes both visceral fat and subcutaneous fat.

Question 21

gastric bypass surgery CP is a 30-year-old female who met her physician to discuss Roux-en-Y gastric bypass surgery for herself.
Height: 5'3" Weight: 234 pounds Usual Body Weight: 201 pounds (2 years ago) The type of surgery that CP is considering is most accurately classified as:

A) banding
B) restrictive
C) restrictive and malabsorptive
D) malabsorptive
E) high volume malabsorptive

Question 22

gastric bypass surgery CP is a 30-year-old female who met her physician to discuss Roux-en-Y gastric bypass surgery for herself.
Height: 5'3" Weight: 234 pounds Usual Body Weight: 201 pounds (2 years ago) Calculate CP's BMI.

A) 34.4
B) 36.5
C) 39.2
D) 40.7
E) 41.5

Question 23

Which of the following common activities is more vigorous and requires less time to derive benefits?

A) washing windows for 45 minutes
B) stair-walking for 15 minutes
C) gardening for 30 minutes
D) pushing a stroller 1.5 miles in 30 minutes
E) raking leaves for 45 minutes

Question 24

A minimum initial physical activity goal for adults is ____ per week of moderate-intensity physical activity.

A) 60 minutes
B) 100 minutes
C) 150 minutes
D) 200 minutes
E) 300 minutes

Question 25

Which of the following is a medical factor that causes malnutrition and weight loss in older adults?

A) grieving
B) confusion
C) anxiety
D) dementia
E) stroke

Question 26

gastric bypass surgery CP is a 30-year-old female who met her physician to discuss Roux-en-Y gastric bypass surgery for herself.
Height: 5'3" Weight: 234 pounds Usual Body Weight: 201 pounds (2 years ago) If CP has the Roux-en-Y procedure, which type of nutrient malabsorption is she at the highest risk for?

A) vitamin B6
B) potassium
C) iron
D) niacin
E) riboflavin

Question 27

What type of treatment is most appropriate for a patient with BED?

A) inpatient hospitalization
B) enteral feedings
C) physical rehabilitation training
D) cognitive behavioral therapy
E) lipase inhibitor medications

Question 28

An example of a binge eating behavior associated with eating disorders would be:

A) little variety in foods
B) avoiding social eating occasions
C) purchasing and preparing foods ritualistically
D) eating more rapidly than usual
E) eating small amounts when not hungry

Question 29

Which is an example of a hospitalization risk factor that causes weight loss and malnutrition in older adults?

A) decreased nutrient needs
B) vision changes
C) increased access to food from supermarkets and convenience stores
D) missed meals due to medical tests
E) cardiovascular disease

Question 30

gastric bypass surgery CP is a 30-year-old female who met her physician to discuss Roux-en-Y gastric bypass surgery for herself.
Height: 5'3" Weight: 234 pounds Usual Body Weight: 201 pounds (2 years ago) If CP's BMI were above 50, she would most likely be a candidate for which type of bariatric surgery?

A) adjustable gastric banding
B) nonadjustable gastric banding
C) Roux-en-Y gastric bypass
D) vertical sleeve gastrectomy
E) duodenal switch with biliopancreatic diversion

Question 31

The best method of achieving the desired energy deficit for many people is to:

A) reduce water intake
B) avoid vitamin A and vitamin E
C) restrict fat intake
D) limit protein intake
E) avoid alcohol

Question 32

Which is a part of food- or nutrition-related history that is obtained during the nutrition assessment of overweight and obese clients?

A) usual body weight
B) blood pressure
C) visceral protein assessment
D) current weight
E) food allergies and intolerances

Question 33

Which of the following measurements indicates the risk factor for failure to thrive (FTT) among infants and children?

A) length for age
B) BMI-for-age
C) weight
D) weight
E) head circumference less than 15th percentile

Question 34

Identify a health complication that is associated with patients who have anorexia nervosa.

A) lanugo
B) hirsutism
C) diarrhea
D) tachycardia
E) elevated plasma glucose

Question 35

Identify a cardiovascular risk factor that would place a patient at high priority for treatment of overweight and obesity.

A) increased high-density lipoprotein cholesterol
B) family history of polycystic kidney disease
C) alcohol consumption of more than 2 drinks per day
D) impaired fasting glucose
E) decreased low-density lipoprotein cholesterol

Question 36

Identify the observation that is typically obtained from the physical examination of a patient.

A) serum cholesterol level
B) white blood cells count in the blood
C) blood pressure
D) concentration of protein in the body
E) amount of albumin in urine

Question 37

Which of the following is used to obtain the biochemical data of overweight and obese patients during their nutrition assessment?

A) current weight
B) data on risk of metabolic syndrome
C) data on previous food restrictions
D) blood pressure
E) evidence of muscle wasting

Question 38

gastric bypass surgery CP is a 30-year-old female who met her physician to discuss Roux-en-Y gastric bypass surgery for herself.
Height: 5'3" Weight: 234 pounds Usual Body Weight: 201 pounds (2 years ago) If CP elects not to have a bariatric surgery, she should work with a registered dietitian to change her diet by:

A) eliminating 250-500 kcal per day
B) reducing the consumption by 500-1000 kcal per day
C) eliminating 1000-1500 kcal per day
D) losing 3-5 pounds per week
E) losing 20 pounds per year

Question 39

Current guideline for an initial weight-loss goal among patients is:

A) 5-10% of baseline weight loss within 3 months
B) 5-10% of baseline weight loss within 6 months
C) 5-10% of baseline weight loss within 12 months
D) 25% of baseline weight loss in 6 months
E) 25% of baseline weight loss in 12 months

Question 40

A risk factor that is particularly relevant in developing bulimia nervosa would be:

A) perfectionism
B) obsessive-compulsive disorder
C) parental alcoholism
D) late menarche
E) childhood failure to thrive

Question 41

The "two compartment model" of body composition analysis views the body as two different compartments: liquids and solids.

Question 42

There is scientific evidence that physical activity helps people maintain a stable weight over time, but the optimal amount of activity for weight maintenance is not always clear.

Question 43

The adipocyte is a metabolically active endocrine cell that releases numerous hormones involved in regulating appetite, energy balance, body fat content, and reproduction.

Question 44

When found in large aggregations in conjunction with fibrous connective tissue, adipocytes form adipose tissue, which serves as the storage site for approximately 10% of the body's energy reserves.

Question 45

A(n) _______________ is a nation that is generally regarded as one with a high standard of living, a high per capita income, and a well-developed infrastructure.

Question 46

The use of MRI or CT scan is ineffective in the quantification of adipose tissue within the regions of the abdomen.

Question 47

Basal energy expenditure is the energy necessary to sustain life and to keep such vital organs as the heart, lungs, brain, liver, and kidneys functioning.

Question 48

Most patients with anorexia nervosa lose their desire for food and do not experience hunger.

Question 49

Lower body fat distribution is more often seen in females and is sometimes referred to as _______________.

Question 50

As plasma glucose level rises following a meal, the beta cells of the pancreas release insulin and _______________.

Question 51

Children and adolescents having a BMI-for-age ≥85th percentile but

Question 52

The term _______________ refers to the environment that promotes both weight gain and the development of obesity by encouraging consumption of energy and discouraging physical activity.

Question 53

Internationally, the most commonly used unit of measurement of food energy is the _______________.

Question 54

The _______________ is defined as the average dietary energy intake that is predicted to maintain energy balance in a healthy person of a defined age, gender, weight, height, and level of physical activity, consistent with good health.

Question 55

Overweight and moderate obesity are characterized by _______________ of adipocytes.

Question 56

Central or abdominal obesity is a major risk factor for _______________, considered the most common chronic liver condition in the Western world.

Question 57

Underwater weighing to determine the composition of body is an example of the _______________ model of assessment method.

Question 58

People who are trying to avoid additional weight gain with age need to sustain a high level of physical activity.

Question 59

Excessive adipose tissue located in the hips and thighs is associated with increased risk of type 2 diabetes, hypertension, and coronary heart disease, even when BMI is within the healthy weight range.

Question 60

_______________ is a hormone produced by the adipose tissue that is involved in energy balance and fat storage.

Question 61

Explain the purpose of waist circumference measurement, and define high-risk results for both males and females.

Question 62

List two different types of body fat distribution, their characteristics, and the complications associated with each.

Question 63

_______________ is primarily caused by catabolism as a result of increased metabolic rate and protein breakdown.

Question 64

_______________ is a third major cause of involuntary loss of muscle mass, which may be associated with dietary quality.

Question 65

List three examples of possible nutrition diagnoses appropriate for patients who are overweight or obese.

Question 66

Discuss the role of adipocytes in the body in relation to their storage capacities and metabolic activity.

Question 67

Compare the behavioral manifestations associated with each of the following: anorexia nervosa, bulimia nervosa, and binge eating disorder.

Question 68

A compensatory survival mechanism intended to conserve energy in the face of starvation is known as _______________.

Question 69

Describe the process of each of the four types of bariatric surgery, and list an advantage and a disadvantage of each.

Question 70

List the components of 24-hour energy expenditure and the approximate percentage of total energy used by each.

Question 71

Discuss the physiological consequences of obesity in the following areas: type 2 diabetes, hepatobiliary disorders, cancer, and reproductive disorders.

Question 72

Of the four bariatric surgical procedures, _______________is the most complicated and the least frequently performed; however, it yields the greatest rate of weight loss.

Question 73

Name five examples of health consequences that can develop from overweight and obesity.

Question 74

_______________ is defined as recurring episodes of eating significantly more food in a short period of time than most people would eat, with episodes marked by feelings of lack of control.

Question 75

Of all the bariatric surgical procedures, _______________ is the most common procedure in the United States.

Question 76

BMI and _______________ are used to initially assess the degree of obesity and for monitoring the patient's response to obesity treatment.

Question 77

Describe the basic formula for calculating BMI in adults.

Question 78

Patients with _______________ exhibit a severe and selective restriction of food intake, particularly of those foods that are perceived as fattening, resulting in a marked weight loss.

Question 79

_______________ are often promoted as beneficial for weight loss.

Question 80

Although greater energy deficits may be useful to provide needed motivation during the period of weight loss, a(n) _______________ providing less than 800 kcal per day should not be used for routine weight loss.