Question 1

Most digestive enzymes in the small intestine are located in:

Accepted Answer

Most digestive enzymes in the small intestine are located in the brush border, which is a level of microvilli lining the surface of the intestinal wall. The ileocecal valves allows food to pass from the jejunum to the ileum. The duodenojejunal flexure is the junction between the duodenum and the jejunum, and the pyloric sphincter is the passage between the stomach and the duodenum

Question 2

In what ways does Lantus insulin differs from other types of insulin:

Accepted Answer

Lantus is a long-acting insulin that is injected just once a day, usually in the evening. It is prescribed for individuals who have moderate-to-good blood sugar control, and prefer the convenience of a once-daily injection. Like other types of insulin, it can cause hypoglycemia. Lantus is typically not used with other types of insulin.

Question 3

Hyperemesis gravidarum may be treated with:

Accepted Answer

Hyperemesis gravidarum (uncontrollable vomiting during pregnancy) is treated with small, frequent meals of bland carbohydrate foods, such as crackers and bread. Avoidance of caffeine and highly spiced foods is recommended. Use of enteral nutrition is considered when the condition cannot be managed with regular diet, and when dehydration and weight loss are present.

Question 4

Which of the following does not occur in diabetic ketoacidosis?

Accepted Answer

Levels of the counter-regulatory hormones glucagon and epinephrine are elevated in diabetic ketoacidosis and contribute to hyperglycemia. Loss of bicarbonate buffer leads to disruptions in the body's acid-base balance. Incomplete oxidation of fatty acids leads to the formation of ketone bodies. The elevated osmotic load cause by hyperglycemia leads to increased diuresis and eventual dehydration.

Question 5

A goitrogenic food has which of the following effects?

Accepted Answer

A goitrogenic food suppresses thyroid activity by blocking iodine uptake, thereby inhibiting the synthesis of thyroxine. Goitrogenic foods include soy foods, (containing isoflavones), and vegetables in the Brassica family (broccoli, bok choy, Brussels sprouts), which contain isothiocyanates. Both isoflavones and isothiocyanates are believed to be goitrogens.

Question 6

A pregnant woman had a pre-pregnancy BMI of 27. She is now in the second trimester and has gained 22 pounds. What recommendation should the registered dietitian provide to her concerning additional weight gain?

Accepted Answer

The RD should recommend a weight gain of 5-8 additional pounds, to keep her total weight gain to 30 pounds. A pre-pregnancy BMI of 27.0 indicates that the woman was about 20% overweight before becoming pregnant. Excessive weight gain during pregnancy is associated with increased risk to both mother and fetus.

Question 7

A typical parenteral formula used to treat a low birth weight infant weighing around 1500 grams contains:

Accepted Answer

A typical parenteral formula used to treat a low birth weight infant weighing around 1500 grams contains 60-65 kcal/kg and 8 g glucose per kg per day. An energy intake of 65-70 kcal is the minimum needed to promote growth. The low birth weight infant has poor glucose tolerance, as a result of insufficient insulin production, and may develop hyperglycemia if glucose intake is not kept to a minimum. A glucose load of 8 g/kg per day is maximum for an infant weighing 1500 grams.

Question 8

Insulin resistance is defined as:

Accepted Answer

Insulin resistance is defined as the need for large amounts of insulin to control blood sugar, and is a common feature of obesity, due to increased levels of triglycerides and fatty acids. Insulin resistance may be improved by exercise, by decreasing the cell's need for insulin.

Question 9

Which of the following is not advised for preventing dental caries in children less than 12 months of age:

Accepted Answer

Brushing teeth with fluoridated toothpaste is not recommended for children less than 12 months of age because of risk of swallowing the toothpaste. Use of prescription fluoride, avoidance of bedtime bottles, and restricting intake of sticky sugared foods are all good methods for avoiding the development of dental caries in very young children.

Question 10

Damage to the central nervous system in stroke patients may lead to which of the following disabilities affecting food intake?

Accepted Answer

Damage to the central nervous system in stroke patients may lead to apraxia (inability to move facial muscles), hemiparesis (slumping of the body), and hemianopia (partial blindness) All of these conditions can affect an individual's ability to feed himself.

Question 11

The lipoprotein that carries endogenous triglycerides from the liver to the cells is:

Accepted Answer

The lipoprotein that carries endogenous triglycerides from the liver to the cells is VLDL (very-low density lipoprotein). HDL transports cholesterol from the cells to the liver, and LDL carries dietary and endogenous cholesterol from the liver to the cells. IDL is an intermediary lipoprotein that forms LDL.

Question 12

When assessing the nutritional status of elderly individuals it is important to use age-specific height and weight tables because:

Accepted Answer

When assessing the nutritional status of the elderly it is important to use age-specific height and weight tables because the elderly have more body weight relative to height, due to losses in stature (1.2 cm per 20 years of life). Percentages of body water are lower among the elderly.

Question 13

The goal(s) of nutritional therapy in short bowel syndrome is/are:

Accepted Answer

The goals of nutritional therapy for short bowel syndrome are to reduce gastrointestinal motility and relieve steatorrhea, decrease HCl production by the stomach and to prevent bacterial overgrowth in the intestine. Short bowel syndrome is caused by surgical removal of the jejunum, and leads to many problems with digestion and malabsorption. The overall goal of nutrition therapy is to rest and heal the gut and improve nutritional status.

Question 14

Pancreatitis may be caused by which of the following:

Accepted Answer

Pancreatitis, inflammation of the pancreas, may be caused by the destruction of pancreatic tissue by digestive enzymes, chronic alcoholism, and hypertriglyceridemia. Destruction of pancreatic tissue by digestive enzymes produced by the pancreas may result from trauma, drug use, or the presence of tumors. Chronic alcoholism can lead to pancreatitis by damaging the pancreatic duct. Hypertriglyceridemia may cause pancreatitis by stimulating excessive production of lipases needed for fat digestion; high levels of these enzymes can lead to severe inflammation of the pancreas.

Question 15

Megaloblastic anemia may be caused by:

Accepted Answer

Megaloblastic anemia may be caused by a deficiency of folic acid, which regulates the formation of red blood cells through its effect on DNA synthesis. Lack of intrinsic factor, a protein found in the small intestine and needed for vitamin B12 absorption; may lead to impaired B12 status, a risk factor for megaloblastic anemia. Gluten-induced enteropathy causes damage to the intestinal mucosa, thereby interfering with absorption of both folic acid and vitamin B12.

Question 16

Which of the following enzymes is missing in infants with phenylketonuria (PKU)?

Accepted Answer

The missing enzyme in phenylketonuria (PKU) is phenylalanine hydroxylase. PKU is an inborn error of metabolism in which phenylalanine cannot be broken down by the body due to a lack of this enzyme.

Question 17

Which lab test(s) are most useful for evaluating long term blood sugar control in diabetics:

Accepted Answer

The lab test which is most useful for evaluating long-term blood sugar control in diabetics is the HbA1c test, which measures the percentage of hemoglobin in the blood that has glucose bound to it. Long periods of elevated blood glucose are associated with increasing levels of HbA1c. Two-hour post-prandial blood glucose and random non-fasting blood glucose levels do not provide information about long-term blood sugar control.

Question 18

Metabolic acidosis is caused by which of the following? (Choose all that apply.)

Accepted Answer

Metabolic acidosis is caused by excretion of large amounts of base (sodium bicarbonate) or retention of excessive amounts of hydrogen ions, leading to increased carbonic acid production. In both situations the kidneys are responding to an abnormal physiologic condition, such as uremia or diabetes. Loss of carbonic acid via respiration leads to metabolic alaklosis.

Question 19

One bread/starch exchange from the diabetic exchange lists contains:

Accepted Answer

One bread/starch exchange from the diabetic exchange lists contains 15 grams of carbohydrate, 3 grams of protein, and 80 calories.

Question 20

Insulin resistance is defined as which of the following? (Choose all that apply.)

Accepted Answer