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130 Cards in this Set
- Front
- Back
The most commonly appreciated essential function of iron in nutrition is to support the synthesis of ___ in red blood cells fro the transport of oxygen from the lungs to tissues.
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hemoglobin
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Iron is also a component of ___ and a number of dehydrogenase enzymes in skeletal muscle, dehydrogenases in braind and enzymes that scavenge or neutralize toxic radicals and chemical.s
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myoglobin
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The presence of ascorbic acid and other ___ (reducing or oxidizing) agents retards the ____ (oxidation or reduction) of ferrous iron. The reduced from is also more stable in acidic solutions.
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reducing, oxidation
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Short-term courses of TPN generally ___ (omit or include) exogenous iron administration
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omit
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Menstrating women have average iron losses that are ___ or ___ times greater than those of the non-menstrating subject.
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two or three
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___, ____, ____ and ____ are prerequisites for the efficient incorporation of parenteral iron into new erythrocytes.
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Vitamin B12, folic acid, copper and pyridoxine
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IV administration of iron dextran in patients with rheumatoid arthritis may ___ (exacerbate or benefit) joint inflammation.
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exacerbate
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Iron infused as iron dextran has a large propensoty to be taken up by the ___ system.
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reticuloendothelial system
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Only ___% of the iron from iron dextran is incorporated into new RBS of anemic subjects three weeks after administration.
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39
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___'s disease (inflammatory bowel disease) presents unique problesm regarding the bioavailability of parenteral iron since the inflammation produces an internal block inthe participation of iron in erythropoiesis.
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Crohn's
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The fully replete adult male contains about ___ g of total body iron, ___g of which is in the storage pool.
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4, 1
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The body's iron reserves are equally distributed in three parts among ____ _____, _____, and ____ _____.
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reticulo-endothelial cells and hepatocytes and skeletal muscle.
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______ is the primary transport protein for iron inthe blood.
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Transferrin
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During infection, iron is redistributed from the circulating compartment into the ____ under the influence of leukocytic endogenous mediator.
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liver
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The ____ mucosa regulates the entrance of dietary iron into the body in response to body iron reserves and the activity of erythropoiesis.
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intestinal
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In pre-menopausal women, __ to __ mg of iron or more can be lost in the monthly discharge.
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30 to 150
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It is essential that a test dose of __ mL (___mg) iron be administered before each dose to screen for an anaphylactic reaction.
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0.5 (25)
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Intramuscular iron should always be given by ___-track technique designed for deep IM administration.
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Z
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Iron deficiency, not unlike copper deficiency is reflected by ___ cytic, ____chronic morphology of the erythrocyte.
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micro, hypo
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Soluble transferrin receptor (sTfR), unlike ferritin, is not influenced by ___ or ____.
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infection, inflammation
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Zinc and ___ (trace element) compete for intestinal uptake.
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copper
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Under usual circumstances the fully zinc-replete adult contains ___ to ____ g of zinc
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2 to 3
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About ___% of body zinc is in the skeleton, a pool which is not readily mobilized for use during periods of deficient zinc intake, except when bone is being actively reabsorbed.
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20
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The liver has a zinc concentration of __g.
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1.5
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Tissue concentrations generally range from 20 to 400 microg/g with ____ (organ), retinal and gonadal tissue having higher concentration (600-800 microg/g).
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pancreatic
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Between ___ and __ mg of zinc are present in the cell-free portion of the systemic circulation.
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3;4
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___% is tighting bound to an ___2-____ (a zinc metalloprotein) fraction of serum proteins and is not available for nutritional or metabolic uses.
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40; a2-macroglobulin
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About __% of zinc is loosely bound to albumin; this appears to be the nutritional transport fraction.
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55
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About ___% of zinc is associated with free amino acids and other low-molecular-weight species in the plasma. The fraction represents the zinc filterable by the kidneys (0.5 mg to 1 mg/day excreted).
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5
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The albumin of patients with alcoholic cirrhosis has a ___ (decreased or increased) affinity for zinc.
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decreased
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Short-term fasting and tissue necrosis increase serum zinc, while corticosteroid therapy, exogenous estrogens and pregnancy ___ (decrease or increase) serum zinc concentrations.
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decrease
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Infectious or inflammatory stress will mediate a major, acute sequestration of circulating zinc by the liver, producing up to a __% decline in plasma zinc concentrations.
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50
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In the determination of zinc concentrations, external contamination of glassware or plastic ware, hemolysis and prolonged venous occlusion during venipuncture can all falsely ___ (elevate or decrease) zinc concentrations.
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elevate
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The storage sites for the metabolically active zinc in the body are the ___ (organ) and, most probably, skeletal muscle.
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liver
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The normal route of excretion of zinc from the body is via the ___ ___, largely in meal-stimulated pancreatic secretions.
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intestinal tract
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Increased sweat losses can increase the surface loss of zinc up to __-__times normal losses.
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2-3
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Approximately 3-10% of the RDA or __-__ mg/day is lost from the skin surface.
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0.5-1.5
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Low ___ ____ (liver enzyme) are associated with low plasma zinc concentrations in bone marrow transplant children
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alkaline phosphatase.
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The most common feature of reactions catalyzed by cuproenzymes is the involvement of molecular ___ or a derivative; thus, unlike the metalloenzymes of zinc, cuproenzymes almost universally govern the rate-liniting steps in the respective biochemical pathways.,
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oxygen
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The ___ (oxidized or reduced) cupric form is the more stable and by far more stable and by far the more soluble in water.
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oxidized
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Copper can form complexes with organic cations (such as amino acids) to various extents depending on ___ and competing cations in the soluton.
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pH
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___ and ___ are known to exercise competitive mineral-mineral interactions with copper at the level of intestinal absorption; however, they probably have no effect in an IV delivery situation.
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iron and zinc
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____ acid has an antagonistic effect on copper nutriture in biological systems, but this is thought to derive from an interaction in the gut.
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ascorbic
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The free ___ acids of TPN solution may produce copper diuresis.
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amino
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Chelating agents such as D-____ produce excessive renal excretion of copper.
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penicillamine
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Diseases, such as ___'s, external biliary obstruction and diseases producing intrahepatic cholestasis (such as primary biliary cirrhosis) would be conditions in which exogenous copper mught be contraindicated.
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Wilson's
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In the severe protein-depleted patient, a delay in the onset of nutritional participation of infused copper could conceivably occur if ____ synthesis were limited.
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ceruloplasmin
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The healthy adult body contains ___ micorg of copper.
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120
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The ____ is the central terminal for copper storage and metabolism.
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liver
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__% of circulating copper is bound to ceruloplasmin; the remaining __% is bound loosely to albumin and amino acids.
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94, 6
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Women have ____ (higher or lower) mean copper concentrations than men, due to the stimulation of ceruloplasmin release by estrogens.
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higher
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____ (condition) and ____ (medications) exaggerate estrogen release, driving serum copper concentrations of women in these categories to or exceedign 300 microg/dL.
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pregnancy and oral contraceptives
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Ceruloplasmin concentrations and, consequently, copper concentrations, tend to be significantly higher in ___ (smokers or nonsmokers).
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smokers
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It is likely that copper is stored on n___ (protein) in the liver cell.
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metallothionein
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The major route of copper excretion from the body is via ___.
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bile
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Malignancies generally ___ (raise or lower) circulating concentrations of copper and ceruloplasmin.
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raise
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Parenteral amino acid infusion causes ___ (greater or lesser) copper in urine in both adults and children.
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greater
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Massive introduction of copper into the circulation results in ___ ___ and ___ ___, often with a fatal outcome.
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hemolytic anemia and hepatic necrosis
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The hematological parameters are not well-defined for copper deficiency although the combination of ___ and a microcytic, hypochromic anemia with a low reticulosyte count in the presenc of adequate iron nutriture is very suggestive of copper depletion.
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neutropenia
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___ (disease) patients may be at risk for copper deficiency.
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Crohn's
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Chromium participates in metabolism as a component of a small, organic entity known as __ ___ ___ or _ _ _.
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glucose tolerance factor or GTF
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GTF is believed to potentiate the action of ___ at the cellular level, participating in the transmission of the hormonal message to the receptor cell.
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insulin
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The ___ form of chromium is of major biological importance as a nutrient.
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chromic
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____ _____ analysis is probably the analytical method of choice for chromium analysis, but it requires a nuclear reactor facility.
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neutron activation
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Free, ionic ___ is a potential chromium antagonist sinceit might saturate the binding sites on ____, which is also the transport protein for chromium.
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iron, transferrin
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For chromium to function in metabolism, ___ must be available; in the ttally ___ state, chromium supplementation will not improve glucose tolerance.
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insulin, insulinopenic
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Supplementation of chromium to a deficient pateint might substantially decrease his or her insulin requirement and careful monitoring of blood sugar required during the early period of chromium addition to avoid ____.
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hypoglycemia
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The total body content of chromium is estimated to be __ to ___ mg.
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6 to 10
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Approximately ___ mg of chromium is found in a transport form in the circulation bound to transferrin.
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1
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Chromium also enters the circulation, presumably as glucose tolerance factor, in response to _____ (Macronutrient) meals..
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carbohydrate.
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The ____ _____ _____ chromium (active) is more filterable than the ____- bound (transport) chromium.
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glucose tolerance factor, transferrin
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Carbohydrates that provoke greater insulin responses induce _____ (higher or lower ) post-prandial excretion of chromium in urine.
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higher
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Manganese is found in at least two metalloenzymes of manganese-____ ____ and _____ ____.
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superoxide dismutase and pyruvate carboxylase
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___ ____ analysis probably provides a more precise and accurate determination of manganese concetration inadditives and TPN fluids that atomic absorption spectrophotometry.
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neutron activation
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Since manganese is excreted in the bile, the administration of parenteral manganese to patients with ____ conditions mighe be contraindicated.
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cholestatic
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The total body content of manganese in an adult is estimated to be ___mg.
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20
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Manganese is concentrated in the ___ (organ) and in other mitochondrion-rich tissues.
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liver
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In the blood, manganese is found both in the ___ ___ ___ (whole blood constituent), associated with hemoglobin, and in teh serum, associated wth a beta-1-globulin.
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red blood cells
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Manganese is largely excreted fromt he body into the fecal stream in ____ and to a lesser extent in intestinal secretions.
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bile
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One gram of sodium fluoride provide ___ grams of fluoride.
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0.452
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The only recognized role of fluoride in man is to be incorporated into ___ and ___ ____.
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bone and tooth enamel
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Fluoride is commonly used as an ____ agent for the collection of blood samples.
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anticoagulant
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Fluoride prevent normal coagulation by precipitating ___ as a ____: fluoride complex.
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calcium, calcium
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About ___% of the fluoride present in most diets (0.5-5.0 mg) is available for absorption fromt he stomach and intestines via [assive diffusion.
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80
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Only about ___% of the fluoride that enters the systemic circulation is stored in the body.
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20
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About ___% of retained fluoride is avidly taken up by and deposited as fluoroapatite by the skelton.
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95
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About ___% of fluoride is elminated from the body via pH-dependent renal excretion into the urine.
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50
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An excessive consumption of fluoride during the period of tooth formation willl result in dental ____.
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fluorosis
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Blood and urine levels ___ (may or may not) necessarily reflect fluoride content in tissues, biological activity or balance status,
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may not
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The lethal dose of ingested sodium fluoride is __-___ g.
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5-10
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The lethal dose of ingested sodium fluoride is __--___g.
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5-10
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Once the compound reaches the stomach, the acidity of the gastric contents converts the salt to free ___ ___, which produces a dark red corrosion of the mucous memebrane.
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hydrofluoric acid.
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Appreciable amounts of fluoride ___ (cannot, can) be leached from the glass.
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can
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____ is the major dietary source of fluoride.
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water
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The current practice is to provide fluoride in public water supplies at a concentration os about ____ .
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1 ppm
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An adequate supply of fluoride should be present during ____ and ____ to be maximally effective.
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infancy and childhood
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A role for fluoride in the treatment of osteoporosis ____ (has, has not) been established.
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has not
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IV requirements for fluoride supplementation ____ (have or have not) been defined.
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have not
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The principal function of iodine in man concerns the formation of the thyroid hormones, ____(T_) and _______ (T_).
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triiodothyronine (T3) and thyroxine (T4)
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The most common manifestation of iodine deficiency is ______.
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goiter
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Thyroid dysfunction is estimated to be present in __ to ___ % of hospitalized patients.
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2-5
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Iodine in any form is essentially ____% bioavailable.
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100
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Iodine is distributed throughout the body in the extracellular fluid but is concentrated primarily in the ____ ______.
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thyroid gland
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Other tissues that can also concentrate iodine are the ____ _____, _____ and _____ _______.
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salivary glands, stomach and mammary glands
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Excess iodine can be temporarily stored in the ____, ____ and _____.
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liver, skin and lungs
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Adults have a total body pool of ___ to ____ mg of iodine of which 70-80% is present in the thyroid at a concentration of 10-40 mg/100 g wet weight tissue.
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10-30
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____ and _____ are molybdenum antagonists
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Copper and tungsten
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Molybdenum is required as a cofactor for the oxidase enzymes- _____ _____, _____ ______ and ______ _____.
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xanthine oxidase, sulfite oxidase, and aldehyde oxidase
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The metabolism of methionine and cysteine are dependent on sulfite oxidase to transform _____ to _______.
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sulfite to sulfate
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____ (Low or High) protein intake and high dietary consumption of copper, tungsten, and inorganic sulfate are antagonists to molybdenum bioavailability.
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Low
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Molybdenum is present in the body in low concentrations with the largest amount being in the _____ (2.5-5 microg/g dry weight tissue), followed by the kidneys, spleen, lung, brain and muscles.
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liver
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In man, the consumption of diets high in molybdenum (10-15 mg/day) has been associated with an unusually high incidence of _____ _____, accompanied by increased blood concentrations of molybdenum, uric acid and xanthine oxidase.
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hyperuricemic gout
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If deficiency or toxicity is suspected, purine and sulfur metabolic profiles and _____ statues should be obtained.
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copper
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Even though selenomethionine results in a faster repletion of deficient patients, ____ ____ is currently being used for most patient care.
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selenious acid
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______ ______ protects cells against peroxide-induced damage.
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Glutathione peroxidase
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Glutathione peroxidase is a major intracellular antioxidant that utilizes _____ as a proton donor to catalyze the reduction of hydrogen peroxide and organic hydroperoxides to nontoxic products.
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glutathione
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Selenium is primarily ingested as selenomethionine from ____ and as selenocysteine from _______.
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plants; animals
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Total body content of selenium varies according to the relative amount present in the _____.
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soil
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The highest concentrations of selenium are found in the _____, followed by the liver, muscle, skin.
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kidney
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Muscle contains almost ___% of the total body selenium content.
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50
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____ selenium reflects short term selenium status better than whole blood selenium.
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Plasma
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Selenium is incorporated as ____, the biologically active form of selenium, into glutathione peroxidase and selenoprotein P.
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selenocysteine
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Selenium is primarily eliminated in the _____, but significant losses through ____ also occur.
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urine, feces
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Less than ____% is eliminated by the lungs and skin.
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5
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Biologically active selenium can be estimated by measuring ____ _____.
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glutathione peroxidase
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Plasma glutathione peroxidase increases within __-___ days after initiating selenium supplememntation, whereas red blood cell activity does not increase for 2-4 weeks.
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1-2
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Similar to Keshan's disaease, potentially fatal ____ can occur in long-term TPN patients unsupplemented with selenium.
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cardiomyopathy
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Selenium toxicity is characterized by chronic dermatitis, loss of hair and nails, excessive fatigue, dizziness, headaches, nausea, vomiting, pulmonary edema, circulatory collapse and _____ odor on the breath.
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garlic
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The breath odor in selenium toxicity is due to the presence of ______.
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dimethylselenide
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Burn patients may require as much as ____ microg/g selenium /day for as long as two weeks.
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200
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