Deck 39: Medical Nutrition Therapy for Rheumatic Disease

Question 1

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.

Answer 1

B
Sjögren syndrome is a chronic autoimmune inflammatory disease that affects the exocrine glands, particularly the salivary and the lacrimal glands, leading to dryness of the mouth (xerostomia) and of the eyes (xerophthalmia).Modification of dietary habits to cope with oral symptoms, particularly to improve biting (cutting fruits, vegetables, and meats in small pieces), chewing (making foods softer by preparing them as soups, broths, casseroles, or as tender cooked vegetables and meats), and swallowing (moistening foods with sauces, gravies, yogurts, or salad dressings) often helps.Foods that worsen oral symptoms should be limited, like citrus fruits, as well as irritant, hot, or spicy foods.

Question 2

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

Answer 2

C
The primary omega-3 fatty acids that have been demonstrated as having various beneficial effects in humans have been docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).Through the diet, these two omega-3 fatty acids are primarily provided by fatty fish such as salmon and tuna.Alpha linoleic acid, which also has an omega-3 bond, is found in flaxseed, walnuts, soy, and canola oils.Lard provides saturated fatty acids.

Question 3

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

Answer 3

D
Tophi are deposits of uric acid that crystallize on the bone and cartilage, leading to damage of the joint.In rheumatoid arthritis, inflammation of the synovial fluid damages the cartilage and bone, leading to bone erosion and loss.Osteoarthritis is characterized by the presence of bone spurs in the joint.

Question 4

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 5

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 6

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 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

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 9

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 10

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 11

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 12

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 13

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 14

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.

Question 15

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

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

Question 16

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 17

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

Question 18

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

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 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