Deck 12: Diseases and Disorders of Energy Imbalance

Question 1

Which 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 and 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

Answer 1

C

Question 2

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) ​the duodenal switch with biliopancreatic diversion.

Answer 2

D

Question 3

Which is considered 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 may include visceral fat and subcutaneous fat.

Answer 3

E

Question 4

The 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.

Question 5

Which describes 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 6

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 7

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 8

Which factor influences the thermic effect of food (TEF) during 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 9

Which best describes night eating syndrome?​

A) ​Consuming at least 25% of total energy intake between the evening meal and the next morning.
B) ​Eating excess foods during the night while still asleep.
C) ​Eating non-food items as extra intake after the evening meal.
D) ​Consuming at least 75% of total energy intake between midnight and 6 am.
E) ​Consuming all calories in a 24-hour period between 6 pm and 6 am.

Question 10

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

A) ​An increase in sports requirements 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 11

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 12

For the average North American, resting energy expenditure accounts for how much of total 24-hour energy expenditure?

A) ​5-10%
B) ​10-25%
C) ​25-50%
D) ​60-75%
E) ​80-90%

Question 13

Which describes the most appropriate initial treatment for a patient with a BMI between 25 and 29.9 who has co-morbidities?

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 14

Alcohol contains how many kcalories per gram?​

A) ​3
B) ​4
C) ​7
D) ​9
E) ​10

Question 15

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 16

Which is identified as a high-risk waist circumference for males?​

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

Question 17

Which is considered a congenital cause of obesity?​

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

Question 18

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.

Question 19

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

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

Question 20

Which is considered a factor affecting resting energy expenditure (REE)?​

A) ​Height
B) ​BMI
C) ​Age
D) ​Heart rate
E) ​Blood pressure

Question 21

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

Question 22

Which is an example of a risk factor for weight loss and malnutrition in older adults?​

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

Question 23

Current guidelines for weight loss goals among patients are:

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

Question 24

Which is classified as a 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 25

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 26

Which information is part of the food and nutrition-related history during the nutrition assessment for overweight and obese clients? 

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

Question 27

If CP has the Roux-en-Y procedure, which type of nutrient malabsorption is she at highest risk for?​

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

Question 28

If CP should elect not to have bariatric surgery, she should work with the registered dietitian to change her intake by:​

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

Question 29

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

A) ​consuming 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 30

Calculate CP's BMI.

A) ​34.4
B) ​36.5
C) ​39.2
D) ​40.7
E) ​41.6

Question 31

Successful weight maintenance is defined as a regain of weight that is less than ____ in 2 years.

A) ​3.4 pounds
B) ​6.6 pounds
C) ​10 pounds
D) ​12.4 pounds
E) ​15.2 pounds

Question 32

The best method of achieving a desired energy deficit for many people is by:​

A) ​eliminating carbohydrate intake.
B) ​avoiding vitamins A and E.
C) ​restricting fat intake.
D) ​limiting protein intake.
E) ​avoiding alcohol.

Question 33

Which type of treatment is most appropriate for a patient with bulimia nervosa?​

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

Question 34

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 35

The type of surgery that CP is considering is most accurately described as:

A) ​banding.
B) ​restrictive.
C) ​restrictive-malabsorptive.
D) ​malabsorptive.
E) ​high volume.

Question 36

According to an observational study of successful weight losers in the National Weight Control Registry (NWCR), which is most important for weight maintenance?​

A) ​Eating a diet low in carbohydrates
B) ​Having snack foods readily available
C) ​Managing emotional eating
D) ​Eating a diet high in protein
E) ​Skipping meals when necessary

Question 37

Which activity would be considered most vigorous and require the least amount of time to derive benefits?​

A) ​washing windows
B) ​stair walking
C) ​gardening
D) ​pushing a stroller
E) ​raking leaves

Question 38

Which physical finding may be associated with anorexia nervosa?​

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

Question 39

Which is an example of the most appropriate educational topic that could be used with an overweight or obese patient?​

A) ​Purchasing more high-energy density foods
B) ​Limiting caffeine consumption
C) ​Adding high kcalorie ingredients during cooking
D) ​Decreasing water intake
E) ​Reducing portion sizes

Question 40

Which indicates a measurement that contributes to failure to thrive (FTT) among infants and children?​

A) ​Length for age < 85th percentile
B) ​BMI < 10th percentile
C) ​Weight < 75% of median weight for age
D) ​Weight < 50% of median weight for height
E) ​Head circumference less than 15th percentile

Question 41

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

Question 42

_______________, a hormone produced by adipose tissue that is involved in energy balance and fat storage, appears to signal that ample fat has been stored.

Question 43

Once a person reaches his or her healthy adult weight, the desired goal is to avoid additional weight gain with age.

Question 44

The term _______________ has been coined to refer to those environments that both promote weight gain and act as barriers to weight loss.

Question 45

The _______________is calculated by dividing the waist circumference measurement by the hip circumference measurement.

Question 46

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 47

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

Question 48

Mexican-American men with higher incomes are more likely to be obese than those with lower incomes.

Question 49

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 50

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 51

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 52

Overweight and moderate obesity are characterized by _______________ of adipocytes.

Question 53

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

Question 54

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

Question 55

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

Question 56

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

Question 57

Children and adolescents having a BMI-for-age >85th percentile, but <95th percentile are considered overweight.

Question 58

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 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

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

Question 61

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

Question 62

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

Question 63

In general, complications of bariatric surgery are more likely to result from the _______________ procedures than from the restrictive procedures.

Question 64

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

Question 65

_______________ is primarily caused by catabolism as a result of increased metabolic rate and protein breakdown and results in wasting of muscle mass.

Question 66

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

Question 67

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

Question 68

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

Question 69

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

Question 70

_______________ are medications that promote weight loss by acting on the central nervous system to decrease appetite and increase satiety, thus reducing food consumption and energy intake.

Question 71

Of the four bariatric procedures, _______________is the most complicated and the least frequently performed, but also results in the greatest amount of weight loss.

Question 72

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.

Question 73

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

Question 74

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

Question 75

Describe the basic formula for calculating BMI in adults.

Question 76

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

Question 77

_______________ are low in energy while high in weight, and include such foods as high-water vegetables and fruits, and broth-based soups.

Question 78

_______________ 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 79

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 80

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