Ntr 440 Final

Front 1

Which compound is the direct source of lactate?

Back 1

pyruvate

Front 2

reduced iron

Back 2

ferrous

Front 3

adult rda niacin

Back 3

16NE

Front 4

B6 deficiency symptom?

Back 4

depression

Front 5

riboflavin source?

Back 5

egg beaters

Front 6

what agent does intravenous vitamin C produce to destroy tumor cells?

Back 6

hydrogen peroxide

Front 7

why are elderly at risk for riboflavin deficiency?

Back 7

achlorhydria (can't absorb)

Front 8

where are thiaminases found & fxn?

Back 8

raw fish and they destroy thiamin

Front 9

tryptophan load test?

Back 9

measure xanthurenic acid for B6 deficiency

Front 10

For niacin, state a major deficiency symptom and link to a function of the vitamin.

Back 10

Pellagra: black skin, person may develop dermatitis. Niacin functions to accept/donate hydrogen and electrons which allows it to protect the cells producing skin.

Front 11

Explain how niacin and riboflavin interact to (a) reduce a substrate and to (b) oxidize a substrate. Using a diagram is fine, but the text must correctly describe the process.

Back 11

Niacin and riboflavin reduce substrates by donating a hydrogen to the substrate. These vitamins oxidize a substrate by removing a hydrogen atom. (this answer got an ‘okay’)

Front 12

pyridoxine in urine

Back 12

supplemented in B6 megadose

Front 13

Oxalic acid in urine

Back 13

person consumes enough vit C to form dehydroascorbic acid
(consumes a lot of vit. C)

Front 14

NMN in urine

Back 14

Indicates niacin status person has consumed niacin in form that it is not needed so it is excreted

Front 15

Clearly explain a nutrigenomic example that was discussed in class

Back 15

About 30% of people have low functioning SVCT1 in their tissues, which leads to decreased vitamin C absorption. Those affected will benefit from vitamin C supplementation.

Front 16

Explain with clear functional detail why B6 is concentrated in RBC in blood and in muscle in tissues.

Back 16

RBCs: PLP is bound to hemoglobin- found in RBCs (protects from phosphates)
Muscle: 80% of total B6 in muscles is PLP bound to glycogen phosphorylase (release of glucose from stored glycogen)

Front 17

How does pregnancy influence the metabolism of two of the vitamins? Provide sufficient detail to demonstrate understanding of this metabolism change.

Back 17

Pregnancy increase (3 fold) the Tryptophan dioxygenase. NAD+ can be synthesized from tryptophan in the liver.
Pregnancy increases the number of riboflavin carriers. These bring riboflavin directly to the fetus.

Front 18

Discuss the role of the hexose monophosphate shunt – include two vitamins in your answer detailing the importance of the vitamins in this shunt.

Back 18

Hexose monophosphate shunt functions in thiamin for the generation of pentoses for nucleic acid synthesis and in both thiamin and niacin for NADPH generation.

Front 19

For three of the nutrients, protein transporters are required for mucosal absorption and tissue uptake. Explain membrane transport for these three nutrients (mucosal and tissue) and identify all transport proteins.

Back 19

Require ATP and are Na dependent
ascorbic acid: SVCT 1 and 2 (1 is main)
dehydroascorbic acid: GLUT 1 & 3
Thiamin ThTr 1,2
Riboflavin RFT2
With increased intake facilitated diffusion occurs.

Front 20

How many NE are in a serving of a bean burrito? 16.1 g protein and 1.92 mg niacin

Back 20

161 mg protein = 16.1 mg tryptophan = 0.27 mg tryptophan + 1.92 mg niacin = 2.19 NE
10 mg tryptophan 60 mg tryptophan

Front 21

5 day caveat

Back 21

5 a day caveat is supposed to increase vit C intake, however these foods have lower vitamin c status than recommended. Include fruits and vegetables and supplements and consume the fruits and vegetables immediately after peeling.

Front 22

Discuss the manner of vitamin C’s functionality

Back 22

Vitamin C function as a reducing agent and it function as antioxidant by oxidizing freely and promotes enzyme activity by maintaining metal ions in the reduced form

Front 23

Describe the ‘perfect storm’ for a vitamin B6 deficiency

Back 23

Diet, genetics, nutrient interactions, GI tract, environmental conditions

Front 24

Which is a correct functional test for vitamin E status?

Back 24

RBC hemolysis

Front 25

Which protein functions directly in B12 absorption into mucosal cells?

Back 25

intrinsic factor

Front 26

Xerophthalmia is best described as

Back 26

blindness

Front 27

which nutrient may reduce risk for type 2 diabetes in the elderly?

Back 27

Vitamin K

Front 28

General role of folate?

Back 28

methyl group transfer

Front 29

How is folic acid differentiated from folate?

Back 29

Folic acid is the synthetic form of the vitamin that is found in fortified foods and supplements. Folic acid had only one glutamic acid residue. Monoglutamate
Folate is the natural form of the vitamin found in food and has 5 - 9 glutamic acid residues. Polyglutamate

Front 30

What is the source of menoquinone?

Back 30

Menaquinone is the form of vitamin K found in animals and microorganisms. Microbes in the large intestine produce this form of the vitamin. Vitamin K2 is menaquinone

Front 31

What is the chylomicron remnant?

Back 31

The chylomicron remnant is what’s left of the chylomicron after it has dropped off all the nutrients it is carrying to needy tissues along the way. The chylomicron remnant is brought to the liver by systemic blood.

Front 32

What is the source, destination, and function for RBP?

Back 32

Retinol Binding Protein is made in the liver. It binds retinol (vitamin A) and carries it to the body’s tissues. RBP helps regulate tissues’ use of retinol.

Front 33

How does folate and B12 interact?

Back 33

B12 transfer methyl group from 5-methyl THF to homocysteine to be converted to methionine.

Front 34

Discuss in detail how NAD(P)H functions in metabolism of three of the vitamins.

Back 34

Niacin is important for donating hydrogen.

Folate → dihydrofolate → tetrahydrofolate (each step requires niacin.

Vitmain E requires hydrogen when it gives an H+ away it needs to be regenerated. Niacain and vitamin C reduce Vit E back to its normal state

Vitamin A interconversions require niacin
ROL→ RAL (requires Niacin) and RAL → RE (requires niacin or riboflavin)

Front 35

Your grandfather was diagnosed with anemia. Discuss THREE possible causes of anemia related to the current five nutrients [folate, B12, A, E, K]. What THREE tests would reveal if one of these vitamins were the cause?

Back 35

Anemia can be caused by a deficiency in vitamin B12, folate, or vitamin E. One test for B12 deficiency is the methylmethionine acid (MMA) urine test. Folate deficiency can be found with a blood test. Vitamin E can be found with a RBC hemolysis test.

Front 36

Discuss the biochemical function of vitamin K. Why is this function so important for vitamin K-dependent proteins? Give TWO examples.

Back 36

Vitamin K is used to carboxylate proteins. It is very important for blood clotting and for bones (osteocalcin) and cartilage to form.

Front 37

Explain in biochemical detail how folate functions to reduce the incidence of spina bifida. However, there is a concern for adverse effects of folate fortification of grains – what is this concern? Explain the biochemical detail to explain the adverse effect.

Back 37

Folate functions to reduce spina bifida by donating a methyl group from 5,10 methylene to 5-methyl THF for folate to be recycle. The concern is too much folate mask B12 deficiency. B12 is required for the conversion of folate to it reduced forms but when there is too much folate; folate is then converted to 5-methyltetrahydrofolic causing masking of B12 deficiency.
The concern is with the unmetabolized folic acid in the blood at high levels due to a majority of products being fortified. Unmetabolized folic acid could be related to an increase in cancer rates.

Front 38

Clearly explain why the Roux-en-Y gastric bypass leads to vitamin B12 malabsorption. You will need to discuss the B12 absorption pathway in detail for full credit.

Back 38

Vitamin B12 absorption follows a specific pathway. First, the B12 is freed from proteins in food by HCl and pepsin in the stomach. Next, B12 binds to R protein in saliva and gastric juices. In the small intestine, pancreatic proteases hydrolyze R protein. The free B12 then binds to intrinsic factor (IF), which is produced by the parietal cells of the stomach. The IF-B12 complex is then absorbed into mucosal cells by cubilin receptors. Gastric bypass doesn’t allow for the B12 to interact with Hcl, pepsin, or IF, and the B12 is unable to be absorbed.

Front 39

How does RRR-a-tocopherol differ from all rac-a-tocopherol? What is the RDA for vitamin E? What amount of these two vitamin E forms equal the RDA for vitamin E?

Back 39

RRR-a-tocopherol is the natural and most biologically active form of vitamin E. All rac-a-tocopherol is a 50:50 racemic mixture of 2R-a-tocopherol (which is biologically active) and 2S-a-tocopherol (which is not biologically active). The 2R and 2S forms of of vitamin E are stereoisomers. The RDA for vitamin E is 15 mg. The RDA equivalents are 15 mg of RRR-a-tocopherol or 30 mg of all rac-a-tocopherol.

Front 40

Design a lunch salad that is rich in all 5 vitamins.

Back 40

Vitamin K – kale, lettuce,
Vitamin A – carrots,
Vitamin E – almonds,
Vitamin B12 – chicken,
Folate – asparagus,
Fat source to allow for bile secretion , fat emulsion, and absorption of fat-soluble vitamins – feta cheese

Front 41

For the nutrients with ULs, state the UL and the rationale for this

Back 41

1. Folate(1000mg) due to masking of B12 deficiency
2.Vitamin E (1000mg) due to hemorrhage
3.Vitamin A(3000ugRAE) due to liver damage
no UL B12 and vit K

Front 42

Which item has the highest salt content?

Back 42

Cottage cheese

Front 43

Which nutrient functions in post receptor phosphorylation?

Back 43

Mg

Front 44

What hormone is released when Ca is high?

Back 44

Calcitonin

Front 45

What is not an excitable cell?

Back 45

Blood cell

Front 46

A normal level of vitamin D is------versus the level noted in lifeguards which is

Back 46

30 & 60

Front 47

What is differentiating feature of trabecular bone?

Back 47

Is a spongy bone, which is metabolically active and is a sign of osteoporosis due to it higher turnover of calcium.

Front 48

What is the RDA for magnesium?

Back 48

400-420mg in Adult men and 310-320 for adult women

Front 49

Which enzyme is responsible for producing the active form of vitamin D?

Back 49

1-hydroxylase

Front 50

List a function of potassium and the related deficiency symptom.

Back 50

Potassium creates an electrical gradient to excite muscle cells. Deficiency leads to muscle weakness.

Front 51

How does sodium drive osmosis?

Back 51

The sodium cation attracts the electronegative oxygen atom in water, drawing water molecules with it

Front 52

Clearly explain how aldosterone regulates (1) sodium and (2) potassium concentrations.

Back 52

Aldosterone (anti-diuretic hormone) is secreted when blood pressure is low, in response the kidney creates more sodium channels which increases sodium retention. Potassium balanced is achieved mainly through the kidneys because aldosterone increases potassium excretion when extracellular fluid is high

Front 53

Norvasc is a pharmaceutical calcium channel blocker prescribed to those with hypertension. Explain clearly how this drug lowers blood pressure. What is a natural alternative to Norvasc. Explain

Back 53

Norvasc prevents the conversion of angiotensin I to angiotensin II. This drug lowers blood pressure by relaxing blood vessel contraction. The natural alternative to norvasc is high magnesium diet

Front 54

List the transporters for vitamin D in blood. List the vitamin D forms that are transported on each of the transporters.

Back 54

Cholecalciferol from dietary sources will be transported to the liver on chylomicrons and from the dermis transported on DBP (vitamin D binding protein).
Calcitriol (from liver) -----> DBP----> KIDNEY------->1-hydroxylase------>Calcidiol (active form) ---->DBP--->Blood

Front 55

List the preferred method to determine nutrient status for sodium, calcium, and vitamin D.

Back 55

Sodium- 24 hour urine
Calcium- DEXA
Vitamin D- calcidiol in blood

Front 56

List the 6 organs that participate in sodium balance and explain their specific roles

Back 56

Kidney- upregulates by increasing/decreasing the amount of sodium channels present in the tubules
Brain- secretes aldosterone
Heart- ANP secreted when heart stretches due to excess fluid which will decrease sodium by promoting excretion
Lungs- converts Angiotension I to Angiotenion II
Hypothalamus - Forms vasopressin and transport it to the posterior pituitary for secretion.

Front 57

What is perplexing about the UL for magnesium? Explain the reasoning for establishing this value. Why is the UL for sodium controversial? How is this value to be used effectively by nutrition professionals.

Back 57

The UL for magnesium is lower than the RDA. The UL was established for non-food sources only, so supplement use would be when the upper limit should be considered. The amount of sodium needed can vary greatly depending on the client. Know your client and the factors to be considered; location (climate), physical activity, type of sweater, high BP, and other diseases can all play a role in amount of sodium needed in the diet. The body only requires about 130 mg/day.

Front 58

How does dietary potassium improve calcium status?

Back 58

Potassium neutralizes blood PH which prevents calcium crystals from dissolving and improves bone mineralization.

Front 59

What is your dietary advice to a long-term diabetic regarding Mg and K? What foods would you recommend to include/exclude in their diets to promote nutrient status and optimal health? Explain.

Back 59

Magnesium needs to be present in the diet for the role that magnesium plays role with insulin-receptors (and other enzymes) acting as a support molecule. Most foods contain Mg, especially green leafy vegetables and legumes. Potassium needs to be monitored more closely as not to have excess in the diet, as it can have adverse effects on the renal system.

Front 60

In 2010, the RDA for vitamin D was increased 3-fold. Explain why this recommendation increased markedly for Americans over a short period of time. List 3 separate strategies you can recommend to your clients to improve their vitamin D status in a healthful manner.

Back 60

The recommendation increased because researchers know more, Americans have larger amounts of adipose (where vitamin D gets sequestered), fads in low-fat diets, the increase in the elderly population and the low UVB photon exposure due to increase sunscreen use. Recommending about 30 minutes of daily sun exposure with exercise (to decrease excess adipose), 10 grams of fat with vitamin D rich foods, and a daily serving of cod liver oil.

Front 61

Picolinic acid is an isomer of

Back 61

nicotinic acid

Front 62

What is a symptom of selenosis?

Back 62

nail loss

Front 63

Iron binding protein?

Back 63

hemosiderin

Front 64

mineral deficiency linked to autism?

Back 64

iodine

Front 65

Which mineral has a specific RDA for vegetarians? State the ‘regular’ and ‘vegetarian’ RDAs.

Back 65

iron? Men/Women: 8 mg / day
Premenopausal: 18 mg
Vegetarians: Men 14 mg, Women 32 m

Front 66

identify one selenoprotein and state it's fxn

Back 66

Selenoprotein P - transport protein of selenium transports selenium in blood
Glutathione peroxidase- keeps peroxides reduced

Front 67

State a deficiency symptom for copper and link this symptom to a function of copper

Back 67

Functions of copper are ceruloplasmin which oxidize iron. Iron must be oxidized to be utilized correctly. A copper deficiency would result in an iron-deficiency. which results in anemia symptoms: fatigue, weakness, neurological issues

Front 68

What advice would you offer your mom regarding CrVI in the Phoenix water supply?

Back 68

Chromium VI in the water in the Phoenix area is low compared to other parts of the US. She does not need to be concerned because it is far below 100 ppb. To ensure safety consume higher amounts of antioxidants: vitamin a, c, e, and selenium. Water filters may also help.

Front 69

Define ‘colloid’ in the context of the lectures

Back 69

Colloid is a protein substance in the thyroid where the hormone T3 and T4 are produced by DIT and MIT

Front 70

Discuss how the body minimizes (a) iron and (b) zinc toxicities.

Back 70

Iron is regulated by down-regulating the absorption through the gut with DMT. When too much iron is present, the cells will store iron in ferritin and not allow it to be free-floating in the bloodstream.

Front 71

Discuss iodine metabolism using the following terms: thyroglobulin, deiodinase, Na-iodine symporter, monoiodotyrosine, follicle, and T3.

Back 71

The thyroid is composed of follicles, and iodine is transported into the thyrocyte by NIS (Na-iodine symporter), due to the concentration gradient. If one Iodine molecule is bound to thyroglobulin in the follicle and colloid it is called monoiodotyrosine. If 2 DIT (diiodotyrosine) combine, deiodinase will remove an iodide molecule to form T3.

Front 72

Discuss the interaction of a specific selenoprotein and vitamin C.

Back 72

Thioredoxin Reductase allows vitamin c to be recycled, it works by reducing vitamin c after it has been used as an antioxidant.

Front 73

Explain the significance of insulin-mediated transferrin binding to cells. How is this related to improve insulin receptor of action?

Back 73

Cr is able to improve glucose levels and insulin response by activating the beta subunit. Insulin promotes Cr to enter cells on transferrin and inside the cell it’s transported on chromodulin (composed of 4 Cr) which activates and stimulates the beta subunit on the plasma membrane which allows insulin and glucose to function effectively.

Front 74

Explain (with detail) the nutritional consequences of (a) Wilson’s disease and (b) Menkes’ disease.

Back 74

Wilson’s - ATP7B, increased Cu leads to toxicity
Menkes’ - ATP7A, less Cu absorbed leads to deficiency

Front 75

Pick one of the minerals and discuss why a megadose can produce a deficiency in one of the other minerals. (DO NOT use binding to the same transporter for absorption as an example).

Back 75

If Fe increases, DMT1 is down regulated to reduce its absorption. When this happens, Cu can’t get into mucosal cells and eventually will be sloughed off. This sloughing off decreased Cu levels and will produce a deficiency.

Front 76

Using the information from the lectures, discuss with detail how ‘incidental’ intakes impact tissue concentration for two of the minerals.

Back 76

Incidental intake occurs in milk, cheese, and bread and it means to incidentally add iodine to these products. This is one reason why iodine status is good in the US.

Chromium is abundant is many foods, water, soil and in the air.
Selenium is in the soil in different concentrations and animal supplementation.