Question 1

Impaired glucose tolerance is defined as:

Accepted Answer

Impaired glucose tolerance is defined as a 2-hour postprandial blood glucose between 140-199 mg/dl. Impaired glucose tolerance is also characterized by a fasting plasma glucose of 100-125 mg/dl. A casual plasma glucose level of 200 mg/dl or greater is diagnostic of diabetes.

Question 2

Maple-syrup urine disease (MSUD) is an autosomal recessive disorder in infants caused by:

Accepted Answer

Maple-syrup urine disease (MSUD) in an autosomal recessive disorder in infants caused by the inability of the body to metabolize the branched-chain amino acids leucine, isoleucine, and valine. The inability to break down branched-chain amino acids is due to a mutation in the gene that controls the activity of the enzyme alpha-keto acid dehyrogenase. Plasma levels of leucine exceeding 10 mg/dl are associated with the symptoms of MSUD, including lethargy, vomiting, and neurologic changes.

Question 3

Which of the following is not true about a low serum albumin level?

Accepted Answer

A low serum albumin level is not seen in esophageal reflux. Low serum albumin levels often accompany ascites in liver disease, may be an indicator of the protein-calorie malnutrition of kwashiorkor, and are commonly seen in nephritic syndrome, in which large amounts of protein are lost in the urine.

Question 4

Which of the following nutrition assessment methods is used to collect dietary information from a community?

Accepted Answer

A food frequency questionnaire is the nutrition assessment method used to collect dietary information from a community, since validation studies have shown that it provides the best estimate of the nutrient intake of a group.

Question 5

The digestive hormone gastrin exerts all of the following effects except:

Accepted Answer

The digestive hormone gastrin increases pepsinogen production by the stomach, in response to the presence of protein foods. Gastrin also increases esophageal sphincter pressure, increases gallbladder contraction, an dincreases HCL production by the parietal cells of the stomach.

Question 6

A 16-year old teenage girl with Type I diabetes seeks counseling for erratic blood glucose levels. She is on the school track team and works out in the afternoons for 1 ½ hours. Her meal plan consists of 3 meals, a pre-exercise snack of one fruit, and a bedtime snack of ½ cup cereal and 1 cup of milk. Her insulin regimen is 3 units of regular insulin before breakfast and 2 units of regular insulin before dinner, and equal amounts of NPH mid-morning and at bedtime. Lately her pre-dinner blood glucose levels have been low. What would be the most effective nutrition intervention for her?

Accepted Answer

The most effective intervention would be to reduce the mid-morning NPH insulin by one unit and add protein exchange to the afternoon snack. NPH is an intermediate-acting insulin which has its peak effect in the afternoon. Reducing the amount of NPH by one unit and adding protein to the pre-exercise snack will help eliminate low blood glucose levels before the evening meal.

Question 7

Clinical signs of cirrhosis of the liver are:

Accepted Answer

Clinical signs of cirrhosis of the liver are ascites (abdominal edema) and hypoalbuminemia, resulting from the replacement of healthy liver cells with fibrous connective tissue. This buildup of abnormal tissue disrupts normal blood flow, eventually leading to portal hypertension, expansion of esophageal veins, hypernatremia, and increased hepatic plasma volume. The end result of these changes is decreased serum albumin and fat malabsorption, with eventual nutrient deficiencies.

Question 8

Which of the following is true for athletic amenorrhea, the loss of menstrual periods caused by excessive exercise?

Accepted Answer

Athletic amenorrhea, the loss of menstrual periods caused by excessive exercise, results in irreversible bone loss, and is treated by decreasing the intensity and amount of exercise. It is not helped by increasing intake of carbohydrates.

Question 9

Which of the following vitamins functions as a hormone?

Accepted Answer

Vitamin D functions in the form calcitriol as a hormone in the regulation of body calcium and phosphorus. It is also responsible for the formation of bone.

Question 10

An effective nutrition screening program:

Accepted Answer

An effective nutrition screening program is based on the principles of sensitivity and specificity. Sensitivity helps ensure that a nutrition screening program picks up individuals at nutritional risk, while specificity helps to exclude individuals not at nutritional risk. Nutrition screening programs may use different types of tools to collect dietary information, and are used in populations of all ages, not just children.

Question 11

Treatment goals for cystic fibrosis include:

Accepted Answer

Treatment goals for cystic fibrosis include pancreatic enzyme replacement and increased intakes of energy, protein, and fat. Cystic fibrosis is a wasting disease characterized by increased need for all nutrients, including sodium, which is lost through excessive sweating. Because the pancreatic duct may be blocked by mucous, supplementation with pancreatic enzymes is usually part of treatment.

Question 12

The Guthrie test is used to diagnose:

Accepted Answer

The Guthrie test is a blood assay used to diagnose phenylketonuria in newborn infants. It detects bacterial growth in an agar culture that is due to the presence of excess phenylalanine.

Question 13

Which of the following nutrients produces an RQ (Respiratory Quotient) of 1.0, as measured by indirect calorimetry?

Accepted Answer

Carbohydrate produces an RQ of 1.0 using indirect calorimetry. This is because the number of molecules of carbon dioxide produced during carbohydrate metabolism is equal to the number of molecules of oxygen consumed.

Question 14

The Thermic Effect of Food (TEF):

Accepted Answer

The Thermic Effect of Food (TEF) is the amount of energy needed to metabolize food. It is affected by the nutritional composition of the diet. The TEF for carbohydrate and fat is around 5%, while the TEF for pure protein may be as high as 25%. In a normal mixed diet the TEF comprises a small percentage of total energy expenditure.

Question 15

Steatorrhea may be caused by:

Accepted Answer

Steatorrhea may be caused by disruption in the activity of pancreatic enzymes that help to digest fat. It may also be caused by inadequate production of bile salts, which are needed for fat absorption.

Question 16

A 25-year old female patient recovering from surgery to correct an intestinal obstruction needs complete bowel rest which necessitates the use of Total Parenteral Nutrition (TPN). The patient was 10 pounds underweight prior to surgery and is occasionally febrile. Which of the following formulations would be most appropriate for this patient?

Accepted Answer

The formula which would be most appropriate for this patient would contain 45 calories, 2 grams of protein, and 35 ml water per kg of body weight per day, as well as 200 mg of vitamin C and 6 mg of zinc. Starting with an intermediate level of caloric and protein intake, along with moderate vitamin C and zinc to promote healing, allows staff to monitor the patient's progress and determine if adjustment in the formula is needed.

Question 17

Examples of foods avoided on a low-purine diet are:

Accepted Answer

Examples of foods avoided on a low-purine diet are sardines, broth, and organ meats. These foods are high in purine and are eliminated in the treatment of gout, caused by high levels of uric acid in the blood.

Question 18

Addison's disease is caused by the deterioration of the adrenal cortex, and results in hypoglycemia, weight loss, and muscle wasting. Dietary intervention includes:

Accepted Answer

The dietary intervention for Addison's disease includes a high protein diet with liberal sodium intake, as well as frequent meals with 50-60 grams of complex carbohydrates. Muscle wasting and weight loss require high protein intakes, and decreased activity of the adrenal hormone aldosterone causes large losses of sodium. Increasing complex carbohydrates helps stabilize blood glucose.

Question 19

Cow's milk is unsuitable for infants less than a year of age due to:

Accepted Answer

Cow's milk is unsuitable for infants less than a year of age due to its high renal solute load, which stresses the infant's kidneys. Cow's milk contains casein protein, which is less digestible than whey, and its percentages of fat and cholesterol are not significantly different from that of breast milk.

Question 20

Nutritional therapy for AIDS/HIV infection includes which of the following?

Accepted Answer

Nutritional care for AIDS/HIV infection includes avoidance of raw fruits and vegetables, since they may be contaminated with pathogens. Increasing protein intake to 1.5-2 g/kg per day is recommended to prevent muscle wasting. Use of ginseng and other herbal supplements is not recommended, since they may interfere with the activity of drugs used to treat AIDS. Use of milk-based shakes may cause diarrhea due to lactose intolerance.

Quiz 1: American Clinical Board of Nutrition