NUTRITION THERAPY 2

NAME:___________________________________________________ Date: _______________ Score:__________________

I. MULTIPLE CHOICE (75 points): Read questions carefully before responding.

Directions: Encircle the letter corresponding to the best answer. No erasures please.

1. An adverse reaction to food with no accompanying immunological response.

a. food sensitivity b. food allergy c. food intolerance d. food idiosyncrasy
2. Foods that most often cause allergies are:
a. eggs, nuts, milk c. apples, noodles, rice
b. bananas, juice, water d. pears, oatmeal, chocolate
3. Considered the gold standard for food allergy testing; done by a board-certified allergist:
a. skin testing c. double-blind, placebo-controlled food challenge
b. radioallergosorbent extract test d. enzyme-linked immunosorbent assay
4. Which of the following foods seems to benefit rheumatoid arthritis in some people?
a. Milk b. Olive oil c. Iodized salt d. Refined cereals
5. All of the following are features of arthritis except
a. the immune system is directly involved in rheumatoid arthritis.
b. weight loss improves the pain in the hands from osteoarthritis.
c. weight-bearing exercises often aggravate the pain from osteoarthritis.
d. supplements of glucosamine and chondroitin seem to reduce the pain of arthritis.
6. Which of the following types of diets has been shown to prevent or reduce arthritis inflammation?
a. High in simple sugars, low in canned fruits c. Low in polyunsaturated fat, high in oleic acid
b. High in animal protein, low in canned fruit d. Low in saturated fat, high in omega-3 fatty acids
7. All of the following are characteristics of gout except
a..it has a higher prevalence in men. c. it is considered a common form of arthritis.
b. dairy products seem to be protective. d. it promotes formation of neurofibrillary tangles.
8. Glucosamine and/or chondroitin supplements are used by some people to treat symptoms of
a. arthritis. b. sarcopenia. c. pressure ulcers. d. mild memory loss.

9. Which of the following is not a common feature of gout?

a. It affects mostly men c. It results from uric acid crystals in the joints
b. It is a form of arthritis d. It is treated by reducing intake of milk products
10. Which of the following is thought to promote the development of brain senile plaques and neurofibrillary tangles?
a. Oxidative stress c. Dietary deficiency of choline
b. Excess acetylcholine d. Low blood levels of homocysteine
11. Factors known to be related to the appearance of Alzheimer’s disease include all of the following except
a. an increase in free radicals. c. a decrease in acetylcholine synthesis.
b. an increase in beta-amyloid. d. a decrease in homocysteine synthesis.
12. A major side effect from the regular use of some antipsychotics, antidepressants, and corticosteroids is
a. anemia. c. substantial weight gain.
b. chronic constipation. d. insomnia, loose stool, and acid reflux.
13. Which of the following is a characteristic of Alzheimer’s disease?
a. It affects 60% of those over 80 years of age
b. It is responsive to dietary choline supplementation
c. It is associated with stability of brain nerve cell number
d. It is associated with clumps of beta-amyloid protein in the brain
14. How does aspirin reduce inflammation and pain?
a. It acts as a sedative and barbiturate c. It interferes with the synthesis of prostaglandins
b. It promotes wound healing and blood clotting d. It binds to nerve receptors involved in pain perception
15. All of the following are characteristics of aspirin use except
a. it acts as a pro-clotting agent. c. it works faster when taken on an empty stomach.
b. it should not be taken before surgery. d. it irritates the stomach lining, especially on an empty stomach.
16. What two nutrients are known to interfere significantly with the utilization of the antibiotic tetracycline?
a. Iron and calcium b. Zinc and chromium c. Vitamin B12 and folate d. Vitamin C and vitamin E
17. Regular use of antacids interferes significantly with absorption of all of the following except
a. iron. b. zinc. c. folate. d. vitamin B12.
18. Your father was recently prescribed an anticoagulant medicine and was surprised that the doctor advised him to
maintain consumption of consistent amounts of green leafy vegetables every day. You inform your father that
a. these vegetables significantly reduce absorption of the drug.
b. these vegetables significantly increase absorption of the drug.
c. variable intake of green leafy vegetables will affect activity of monoamine oxidase inhibitors.
d. inconsistent intakes of green leafy vegetables will interfere with the regular action of the drug.
19. Which of the following foods in particular must be restricted in the diet of a person taking a monoamine oxidase
inhibitor drug?
a. Acid-forming foods b. Aged cheeses c. Soybeans d. Cruciferous vegetables
20. What ingredient commonly used as a sweetener in liquid medicines often causes diarrhea?
a. Sorbitol b. Maltose c. Saccharin d. Aspartame
21. A person’s level of C-reactive protein appears to be a strong predictor for
a. cancer. b. diabetes. c. a heart attack. d. HIV progression.
22. Which of the following defines the association between nutrition and chronic disease?
a. Diet can influence the time of onset of some chronic diseases
b. Diet is the primary factor affecting the development of chronic diseases
c. Dietary influence in the development of chronic diseases is direct, straightforward, and well understood
d. Dietary advice for combating heart disease and cancer prevents their development if instituted early in life
23. Conventional medicine and alternative medical therapies are commonly linked together into a practice called
a. interactive therapy. c. herbal-assisted healing.
b. yin and yang medicine. d. complementary medicine.
24. Why is complementary and alternative medicine considered to be unconventional medicine?
a. It is not taught in medical schools c. Safety and effectiveness are not well established
b. Insurance companies refuse to cover it d. It is used primarily by chiropractors and herbalists
25. What is ayurveda?
a. A system that combines biofeedback with hypnosis
b. An oriental plant that suppresses colon and breast tumor growth
c. A Hindu system for enhancing the body’s ability to prevent illness and to heal itself
d. A variation of standard acupuncture technique that applies electromagnetic impulses to the needles
26. Naturally occurring salicylates in curry, paprika, and certain teas provide the same protective effects as low dose
a. statins. b. aspirin. c. insulin. d. diuretics.
27. All of the following are features of herbs sold to the public except
a. they are not regulated as drugs by the FDA.
b. they are not evaluated for safety or effectiveness by the FDA.
c. the FDA, and not the manufacturer of the herb, has the burden of proving the product is unsafe.
d. they are considered appropriate for treatment of certain major health disorders such as cancer or AIDS.
28. Your aunt Gladys has a family history of heart disease. She decides to begin eating a bowl of oatmeal every morning
to help lower her blood cholesterol. After about a month of following this routine, her cholesterol declined about 5
points. Which of the following is the most likely explanation for this effect?
a. Oatmeal is a low-fat food and inhibits the body’s synthesis of cholesterol
b. Oatmeal is high in complex fibers that inhibit cholesterol-synthesizing enzymes
c. Oatmeal consumed on a regular basis suppresses the craving for high-cholesterol foods
d. Oatmeal is high in soluble fibers that trap bile, causing the body to use more cholesterol for bile replacement
29. Which of the following is a characteristic of egg nutrition?
a. Eggs are high in both cholesterol and saturated fat
b. High omega-3 fat eggs are now available by prescription only
c. Although it is high in cholesterol, the egg is low in saturated fat
d. Even in people with a healthy lipid profile, consumption of one egg/day is detrimental
30. Which of the following is a feature of fat metabolism?
a. Cholesterol is stored primarily on the surface of veins
b. High-density lipoproteins represent the major transport vehicle for delivering fat to the adipose cells
c. Fat storage is highly efficient due to the rapid uptake of the intact triglyceride molecule by adipose cells
d. Triglycerides in the blood must first be broken down to monoglycerides, fatty acids, and glycerol prior to uptake
by the adipose cells
31. All of the following foods contain liberal amounts of eicosapentaenoic and docosahexaenoic acid except
a. tuna. b. salmon. c. human milk. d. soybean oil.
32. Which of the following is a likely explanation for the imbalance between omega-6 and omega-3 lipids in the U.S.
and the diet in most developed countries?
a. High intakes of meat and low intakes of fish
b. Low intakes of vegetable oils and high intakes of fish
c. High intakes of beef fat and low intakes of vegetable oils
d. Low intakes of beef fat and high intakes of vegetable oils
33. Alberta is a 20 year old who has been a vegetarian for 3 years. She comes to you for advice after reading some
material online by the Meat Promoters of America organization. One of their statements is: “. . . vegetarians are at
risk for protein deficiency because they cannot consume all of the essential amino acids necessary for healthy
individuals.” How should Alberta be advised?
a. She should consume dairy and egg products at every meal to protect herself against protein deficiency
b. She should avoid the “limiting” amino acids because they are limiting her ability to maintain proper protein status
c. Because the statement is basically true, she should consider eating small quantities of meat every day in order to
avoid protein deficiency
d. Although many foods don’t provide all the essential amino acids individually, she could consume complementary
proteins throughout the day, which would provide all the essential amino acids she needs
34. All of the following are characteristics of protein-energy malnutrition except
a. it is found in hospitalized adults. c. it almost always exhibits overt signs.
b. it is found in elderly living alone. d. it is common in people with anorexia nervosa.
35. Which of the following conditions is associated with edema?
a. Excessive use of certain drugs, which causes high excretion of water and amino acids
b. Above-normal concentration of blood proteins, which causes fluid to leak from the blood vessels
c. Diminished concentration of blood proteins and hormones, which causes fluid to leak from the blood vessels
d. Excessive protein in the diet leading to increased retention of fluid, especially in the extravascular spaces
36. You are reading a case study from a researcher at World University. The researcher has traveled to the largest city in
India and is reporting on an illness present in a 15-month-old boy. The researcher described the child as extremely
thin and bony, with wrinkled skin and enlarged fatty liver. For the past year, this child has subsisted almost entirely
on diluted cereal drink. Your first thought is that all of these observations are characteristic of marasmus except for
the
a. wrinkled skin. b. food intake pattern. c. enlarged fatty liver. d. extremely thin, bony appearance.
37. What is the most likely explanation for the fatty liver that develops from protein deficiency?
a. Increased uptake of circulating fats c. Inability of adipose tissue to remove circulating fats
b. Increased absorption of dietary fats d. Inability of the liver to synthesize lipoproteins for fat export
38. Jim, a college baseball player, tells you that he has started to take glutamine supplements. How would you advise
him?
a. As long as he keeps the dose under 10 g/day, the benefits outweigh the costs
b. Since he plays baseball, he should consider taking alanine supplements instead
c. Since he plays baseball, he should consider taking tryptophan supplements instead
d. Since single amino acids do not occur naturally in foods, they offer no benefit to the body and may even be
harmful
39. The study of how environmental factors influence the expression of genes without altering the DNA is known as
a. epigenetics. c. microarray technology.
b. nucleotide sequencing. d. epidemiological consequences.
40. During the first few days of a fast, what energy source provides about 90% of the glucose needed to fuel the body?
a. Protein b. Ketones c. Glycogen d. Triglycerides
41. Which of the following dietary nutrients would most rapidly reverse a state of ketosis in a starving person?
a. Fat b. Protein c. Amino acids d. Carbohydrate
42. Which of the following is used to supply some of the fuel needed by the brain only after the body has been fasting
for a while?
a. Ketones b. Glycerol c. Fatty acids d. Amino acids
43. Elizabeth has been fasting for 4 days in observance of her religious beliefs. You note that her breath smells “fruity.”
This is most likely due to
a. her intake of religious wafers. c. her body’s shift to a state of ketosis.
b. her intake of dilute fruit juices. d. her body’s switch to a lipogenic state.
44. Adverse side effects of typical low-carbohydrate diets include all of the following except
a. fatigue. b. nausea. c. constipation. d. high blood pressure.
45. Which of the following is one explanation for the generally lower tolerance for alcohol in women in comparison to
men?
a. Women fast more often
b. Women do not eat as much food with the alcohol
c. Women consume more of their alcohol in sweetened drinks
d. Women have lower amounts of stomach alcohol dehydrogenase
46. What organ is first to absorb alcohol after a person takes a drink?
a. Colon b. Stomach c. Jejunum d. Duodenum
47. What is the primary organ that oxidizes alcohol?
a. Brain b. Liver c. Pancreas d. Digestive tract
48. Which of the following is(are) best suited for slowing alcohol absorption?
a. Not eating b. Protein snacks c. Caffeine drinks d. Carbohydrate snacks
49. What is the sequence of stages that brings about advanced liver disease caused by chronic alcohol toxicity?
a. Fibrosis, gout, cirrhosis c. Cirrhosis, fat accumulation, fibrosis
b. Fibrosis, cirrhosis, fat depletion d. Fat accumulation, fibrosis, cirrhosis
50. Apparent hyperactivity produced in a child by the combination of lack of sleep and over-stimulation is called:
a. caffeine overdose b. food allergy c. ADHD d. tension-fatigue syndrome
51. A diet which avoids foods containing wheat, rye, oat and barley; may be prescribed high in protein and low in fat
a. purine restricted b. sodium restricted c. gluten restricted d. phenylalanine restricted
52. The loss of calcium in the bones leading to increased risk of fracture
a. osteoarthritis b. osteoporosis c. diabetes d. cardiovascular disease
53. A disorder of purine metabolism characterized by abnormally high uric acid levels in the blood and deposits of
sodium urate in soft and bony tissues such as joints, cartilage, and tendons.
a. lupus erythematosus b. gout c. osteoarthritis d. rheumatoid arthritis
54. Condition characterized by inflammation affecting the small and large joints resulting from immune-mediated
damage where surrounding muscles, ligaments and tendons that support and stabilize the joint become weak and
unable to work normally
a. ankylosing spondylitis b. gout c. osteoporosis d. rheumatoid arthritis
55. Foods lowest in purines so they can be given during acute gouty attacks:
a. offals, red meat, shellfish, roe, pulses c. beans, legumes and peas
b. milk, cheese and nuts d. green leafy vegetables and oatmeal
56. The type of arthritis common in the elderly population that usually affects the weight-bearing joints and those joints
subjected to excessive strain at work.
a. lupus erythematosus b. gouty arthritis c. osteoarthritis d. rheumatoid arthritis
57. A dynamic, lifelong process in which old bone is removed from the skeleton and new bone is added.
a. bone resorption b. bone formation c. bone loss d. bone remodeling
58. Occurs in women 18-20 years after menopause, with pain in the vertebrae, rounding of shoulders, height loss &
proneness to fractures
a. type I osteoporosis b. type II osteoporosis c. senile osteoporosis d. osteopenia
59. High or excess intake of the following increase urinary Ca excretion and are associated with increased risk of
osteoporosis. Identify the exception.
a. phosphorus b. caffeine c. alcohol d. zinc
60. Amount of calcium the body can best handle at one time from food and/or supplements so it is advisable to consume
calcium sources throughout day instead of all at one time:
a. 500 mg b. 1000 mg c. 300 mg d. 700 mg
61. Mineral involved in calcium metabolism, the synthesis of vitamin D, and the formation of bone. It is found in nuts,
seeds, peanuts, soybeans, peas, cooked dried beans, yogurt, milk, liver, meat, fish, poultry, and green vegetables:
a. manganese b. phosphorus c. magnesium d. zinc
62. Maternal practice advocated to prevent cancers and childhood obesity as well as reduce incidence of allergies:
a. complementary feeding b. weight management c. hydration therapy d. breastfeeding
63. An essential trace mineral which is closely associated with sulfur and purine metabolism and is a co-factor for the
oxidative-reduction process is:
a. manganese b. molybdenum c. silicon d. boron
64. Which of the following is not applicable in the management of Parkinson’s disease?
a. for patients taking levodopa, restrict protein to 0.8 g/kg/day since high level of protein interferes with this drug
b. give HBV proteins, modifying the consistency according to the chewing and swallowing abilities of the patient
c. serve the protein-rich foods mainly in the morning meal as this may reduce tremors and allow some normal
functioning during the day
d. limit the intake of pyridoxine to less than 5 mg/day to make levodopa more effective.
65. Which of the following is not considered a broad category of CAM?
a. mind-body medicine b. natural products c. herbal medicine d. manipulative &body-based practices
66. The TAMA Act of 1977 creating the PITAHC to provide better health through the provision of safe, beneficial, and
culturally-acceptable traditional and alternative health care products, services and technologies:
a. RA 9965 b. RA 8976 c. RA 8423 d. RA 8172
67. The layer of the skin with the greatest metabolic activity, producing pigments.
a. Dermis b. Epidermis c. Blood vessels d. Subcutaneous gland tissue
68. Clinical concept explaining the numerous factors (genetics, intestinal barrier integrity, resident intestinal microflora,
stress, psychological factors, environmental and physiological) affecting response to food or a component of food
and its ultimate interpretation of the body as friend or foe.
a. adverse food reactions c. biochemical uniqueness
b. oral mucosal tolerance d. food intolerance
69. The method of introducing gradually increasing amounts of a particular food that causes allergy until the person
would have established immunity towards that particular food.
a. Desensitization b. Elimination c. Avoidance d. Food challenge
70. The most dangerous allergic reaction which can occur within several minutes to several hours after ingestion of a
food; the symptoms of which include abdominal pain, nausea, cyanosis, a drop in blood pressure, angioedema,
chest pain, shock or even death.
a. Hives b. Anaphylaxis c. Eczema d. Shortness of breath
71. A neurologic condition marked by muscular rigidity and tremors, ataxia, and mental confusion where nystagmus is a
prominent feature; slurred speech, poor mastication, dysphagia, and slowed gastric motility; a progressive disabling
disease marked by a low concentration of the neurotransmitter dopamine at the basal ganglia of the brain.
a. Parkinson’s disease b. Dementia c. Multiple sclerosis d. Alzheimer’s disease
72. Autoimmune neuromuscular disorder characterized by fatigue and exhaustion of the muscular system without
sensory disturbance or atrophy; affects skeletal muscles especially those of the face (with blepharoptosis of left eye),
lips, tongue, throat, neck.
a. Multiple sclerosis b. Myasthenia gravis c. Dementia d. Huntington’s disease
73. Central nervous system disorder of unknown etiology; characterized by destruction of the myelin sheaths of the
brain and spinal cord.
a. Myasthenia gravis b. Dementia c. Multiple sclerosis d. Parkinson’s disease
74. Condition caused by Parkinson’s, Huntington’s and Alzheimer’s disease characterized by irreversible loss of mental
function and intellectual abilities.
a. Dementia b. Delirium c. Anaphylaxis d. Psychosis
75. Considered the hallmark of inflammation in the central nervous system and thought to be a key event in the
progression of Alzheimer’s disease.
a. Microglial activation b. Phrynoderma c. Synovitis d. Bedsores

Best of Luck and God bless --- Prof. Dr. AdelaJamorabo-Ruiz, RND