Test Bank for Understanding Nutrition 13th Edition by Whitney

Transcription

1 Test Bank for Understanding Nutrition 13th Edition by Whitney Link download full: Chapter 10 The Water-Soluble Vitamins: B Vitamins and Vitamin C Multiple Choice 1. Which of the following is a general feature of a vitamin? 2. It is inorganic 3. It may contain nitrogen 4. It may be required in large amounts 5. It may support growth but not maintenance 2. Which of the following is a feature of vitamins? 3. Many serve in the role of enzyme inhibitors 4. Structurally, many are found linked together 5. Several may be oxidized to yield 4 kcalories per gram 6. The quantities present in foods are measured in micrograms or milligrams 3. What is a precursor? 4. A conditionally essential vitamin 5. A sign or symptom of a vitamin deficiency disorder 6. A substance that is used to synthesize another compound 7. A substance that is recycled through the liver and intestines 4. What is meant by the bioavailability of a vitamin in food? 5. The total amount available from plant and animal food 6. The amount absorbed and subsequently used by the body 7. The amount that escapes destruction from food processing 8. The number of different chemical forms of the same vitamin

2 5. Which of the following is NOT among the general characteristics of the water-soluble vitamins? 6. They must be consumed daily 7. Toxic levels in the body are rarely found 8. They are absorbed directly into the blood 9. Excesses are eliminated by the kidneys 6. Which of the following is NOT among the general characteristics of the fatsoluble vitamins? 7. Excesses are eliminated by the kidneys 8. Absorption is via the lymphatic circulation 9. Several of them require protein carriers for transport 10. They can be stored in relatively large amounts in certain body tissues 7. Cooking a food in liberal amounts of water is least likely to affect its content of 8. folate. 9. thiamin. 10. vitamin A. 11. riboflavin. 8. Which of the following vitamins would be removed in the production of skim milk? 9. Thiamin 10. Vitamin A 11. Riboflavin 12. Vitamin B What is the primary excretory route for the water-soluble vitamins? 10. Bile 11. Kidney 12. Intestine 13. Perspiration

3 10. When thiamin is consumed in excess of needs, how does the body treat the excess? 11. Not absorbed 12. Excreted primarily in the urine 13. Excreted primarily in the feces 14. Stored in liver, bone, and adipose tissue 11. What is a chief function of the B vitamins? 12. Antioxidation 13. Anticoagulation 14. Antibody stabilization 15. Coenzyme participation 12. Which of the following explains why B vitamin deficiencies lead to lack of energy? 13. B vitamins are a source of kilocalories 14. Absorption of carbohydrates and fats is decreased 15. Oxygen for energy metabolism cannot be transported to the cells 16. Coenzymes needed for energy metabolism are produced in insufficient amounts 13. Which of the following describes the basic function of a coenzyme? 14. Attaches to RNA to assist in the synthesis of an enzyme 15. Attaches to cell membranes to assist in uptake of an enzyme 16. Attaches to an enzyme and allows a chemical reaction to take place 17. Attaches to an enzyme, which allows for transport of the enzyme through the circulation 14. Which of the following functions has a requirement for thiamin? 15. Blood coagulation 16. Formation of red blood cells

4 17. Energy release from energy-yielding nutrients 18. Formation of epithelial cell mucopolysaccharides 15. What is the primary chemical reaction in which thiamin participates as a coenzyme? 16. Transfers amine groups in the synthesis of amino acids 17. Transfers hydrogen atoms in the synthesis of erythrocytes 18. Assists in addition of methyl groups to compounds involved in energy metabolism 19. Assists in removal of one-carbon units from compounds involved in energy metabolism 16. Which of the following is the coenzyme form of thiamin? 17. Thiaminacide 18. Thiamin pyrophosphate 19. Thiamin adenine dinucleotide 20. Thiamin flavin mononucleotide 17. Beriberi results from a deficiency of 18. niacin. 19. thiamin. 20. vitamin C. 21. vitamin B Which of the following diets is most likely to lead to beriberi? 19. High intakes of white rice 20. Low intakes of whole grains 21. High intakes of unrefined rice 22. Low intakes of enriched grains 19. The Wernicke-Korsakoff syndrome may be treated with supplements of

5 20. folacin. 21. thiamin. 22. vitamin C. 23. vitamin B Which of the following is a characteristic of thiamin nutrition? 21. The coenzyme contains pyrosulfate 22. It is required for regeneration of folate 23. It is required for regeneration of niacin 24. It is an integral part of the nerve cell membrane 21. Approximately what percentage of alcoholics exhibit thiamin deficiency? All of the following are characteristic of thiamin nutrition EXCEPT 23. severe deficiency may lead to edema. 24. severe deficiency may occur without edema. 25. recommended intakes are stated in equivalents. 26. recommended intakes are based primarily on participation in enzyme activity. 23. Which of the following provides the most thiamin per serving size? 24. Ham 25. Squash 26. Whole milk 27. Whole-grain breads 24. Which of the following is a property of thiamin nutrition?

6 25. Participates in activation of prothrombin 26. Poor sources include seafood and cheeses 27. Significant amounts are found in leafy vegetables 28. Deficiency results in cheilosis and marked dermatitis 25. How does the method of cooking affect thiamin stability? 26. Microwaving the food conserves much of the thiamin 27. Prolonged heating of the food has little, if any, effect on the thiamin 28. Boiling the food tends to conserve thiamin by forming a stable, hydrated complex 29. Steaming the food can lead to substantial thiamin loss due to the high heat needed to form the steam 26. Which of the following contains the highest concentration of thiamin in muscle tissue? 27. Pig 28. Fish 29. Steer 30. Chicken 27. Of the following, which is the richest food source of thiamin? 28. Lettuce 29. Soy milk 30. Cow milk 31. Refined rice 28. Riboflavin in its coenzyme form functions in the transfer of 29. methyl groups carbon units carbon units. 32. hydrogen atoms.

7 29. Which of the following vitamins is involved substantially in energy transformation reactions? 30. Biotin 31. Cobalamin 32. Riboflavin 33. Pyridoxine 30. Which of the following is indicative of a dietary deficiency of riboflavin? 31. Beriberi 32. Diarrhea 33. Keratomalacia 34. Inflamed mouth membranes 31. Which of the following food groups ordinarily contains the highest amount of riboflavin when expressed per kcalorie? 32. Dairy 33. Meats 34. Fruits 35. Vegetables 32. What is ariboflavonosis? 33. The vitamin B 2 deficiency disease 34. Food sources devoid of vitamin B Ultraviolet destruction of vitamin B Excessive heat destruction of vitamin B The signs and symptoms of riboflavin deficiency are known collectively as 34. pellagra. 35. antiflavonosis. 36. ariboflavinosis. 37. flavin adenine dinucleosis.

8 34. Riboflavin needs are more difficult to meet when the diet is low in 35. meats. 36. grains. 37. vegetables. 38. dairy foods. 35. Riboflavin is most easily destroyed when exposed to 36. heat. 37. acid. 38. alkali. 39. ultraviolet light. 36. What type of container is best for protecting the riboflavin content of milk? 37. Airtight 38. Cardboard 39. Transparent glass 40. Translucent plastic 37. The coenzyme FAD is formed from what vitamin? 38. Niacin 39. Choline 40. Thiamin 41. Riboflavin 38. Of the following commonly eaten foods, which makes the greatest contribution to riboflavin intake? 39. Milk 40. Potatoes 41. Orange juice 42. Peanut butter

9 39. Milk and milk products provide liberal amounts of which of the following vitamins? 40. Folate 41. Biotin 42. Riboflavin 43. Pantothenic acid 40. A deficiency of what vitamin produces a characteristic cracking and redness at the corners of the mouth? 41. Biotin 42. Niacin 43. Riboflavin 44. Ascorbic acid 41. Which of the following is a property of riboflavin in nutrition? 42. Stability to heat is good 43. Deficiency leads to beriberi 44. Requirements are proportional to body weight 45. Significant amounts are found in citrus products 42. Which of the following is a property of niacin in nutrition? 43. It is susceptible to destruction in foods exposed to light 44. It participates primarily in reactions involving amino acids 45. It is soluble in both water and lipids depending upon its chemical form 46. It can be synthesized in the body from the essential amino acid tryptophan 43. Which of the following properties is shared by niacin and riboflavin coenzymes? 44. Unstable to irradiation 45. Unstable to metal cooking utensils 46. Acceptance and transfer of hydrogen atoms 47. Acceptance and transfer of carboxyl groups

10 44. When the diet contains an adequate amount of protein, what amino acid can be used by the body to synthesize niacin? 45. Lysine 46. Valine 47. Tryptophan 48. Phenylalanine 45. Which of the following nutrients functions to prevent the appearance of a bilateral, symmetrical dermatitis, primarily on areas exposed to the sun? 46. Niacin 47. Choline 48. Inositol 49. Riboflavin 46. The vitamin deficiency disease pellagra means 47. rough skin. 48. paralyzed limbs. 49. demented behavior. 50. flattened erythrocytes. 47. A low-protein diet in which corn is a principal food has been found to cause a deficiency of what vitamin? 48. Niacin 49. Thiamin 50. Vitamin C 51. Vitamin B What vitamin deficiency disease appeared in people who had subsisted on a diet high in corn and low in protein? 49. Scurvy 50. Pellagra

11 51. Wet beriberi 52. Pernicious anemia 49. Which of the following is NOT among the common signs of pellagra? 50. Diarrhea 51. Dementia 52. Dermatitis 53. Desiccation 50. A general niacin deficiency is known to be manifested in abnormalities of all of the following organs/systems EXCEPT 51. skin. 52. skeletal system. 53. nervous system. 54. gastrointestinal tract. 51. Tryptophan can be used in the body to synthesize 52. FAD. 53. biotin. 54. niacin. 55. inositol. 52. While researching your southern family history, you find that your grandmother had a sister who died fairly young. The symptoms leading up to her death included diarrhea, dermatitis, and dementia. Because the family led a poor, corn-farming existence, you suspect this relative died of 53. scurvy. 54. cancer. 55. pellagra. 56. beriberi.

12 53. Which of the following substances is found in corn and contributes to the development of pellagra? 54. Avidin 55. Leucine 56. Phytates 57. Phenylalanine 54. What term identifies the characteristic tingling sensations and reddening of the skin after ingesting a pharmacologic dose of nicotinic acid? 55. Niacin flush 56. NAD dermatitis 57. Niacin erythrema 58. Bilateral symmetrical dermatitis 55. Which of the following overt side effect(s) is likely to appear after a person ingests a high quantity of nicotinic acid? 56. Constipation 57. Mental confusion 58. Painful, tingling, itching sensation 59. Hair loss, bloating, and photophobia 56. When taken in large doses, which of the following vitamins is associated with liver injury? 57. Niacin 58. Thiamin 59. Vitamin B Vitamin B Large doses of nicotinic acid are known to result in all of the following EXCEPT 58. dilation of capillaries. 59. increased HDL cholesterol. 60. lowering of LDL cholesterol.

13 61. disappearance of learning disorders in children. 58. Which of the following is a feature of niacin nutrition? 59. Low doses may lead to kidney stones 60. High doses may lower blood cholesterol 61. Low doses may lead to heartburn and low blood pressure 62. High doses may elevate red blood cell count in mildly anemic individuals 59. Your friend Jane just returned from the doctor, who diagnosed her with a specific vitamin B toxicity. However, she doesn t recall the name of the vitamin. Which of the following is the only possible culprit associated with toxicity symptoms? 60. Niacin 61. Biotin 62. Riboflavin 63. Vitamin B What is the approximate niacin RDA for adults? mg niacin equivalents mg niacin equivalents mg tryptophan equivalents mg tryptophan equivalents 61. Among the following, which would be the best source of niacin equivalents? 62. Milk 63. Broccoli 64. Chicken 65. Strawberries 62. Which of the following is a characteristic of niacin nutrition? 63. In foods, it is more unstable than thiamin and riboflavin

14 64. The average intake is slightly lower than the RDA in the United States 65. The amount in a serving of whole-wheat bread is about twice that in a serving of peanut butter 66. About half of the daily need for most people could be met by the tryptophan found in protein foods 63. Which of the following is a feature of pantothenic acid in nutrition? 64. Absorption from foods is inhibited by aspirin 65. A deficiency or a toxicity shows similar symptoms 66. Deficiencies are seen primarily in children ages 4-10 years 67. It functions in the metabolism of amino acids, glucose, and fatty acids 64. Your brother Bob is a competitive body builder. His trainer suggested that he consume 4 egg white omelets per day. Bob remembers a warning about a possible vitamin deficiency from consuming too many egg whites and asks if he should follow the prescribed diet. Your reply to Bob is that he should NOT 65. be concerned as long as he consumes both the yolk and whites of the eggs. 66. follow the diet, since the avidin in the egg whites could bind to niacin and prevent its absorption. 67. follow the diet, since the avidin in the egg whites could bind to biotin and prevent its absorption. 68. be concerned, because, when the eggs are cooked, the avidin protein is denatured, and thus does not pose a problem for deficiency disease. 65. Which of the following is NOT among the general features of biotin in nutrition? 66. It functions in the breakdown of amino acids and fatty acids 67. It functions as a carrier of carbon dioxide in energy metabolism 68. A deficiency can be induced by ingesting large quantities of raw egg whites 69. A deficiency can be induced by ingesting large amounts of thiamin and folic acid, which interfere with its absorption

15 66. Among the following compounds that serve as coenzymes in metabolism, which is considered a vitamin for human beings? 67. Biotin 68. Inositol 69. Lipoic acid 70. Orotic acid 67. Which of the following foods contains a protein that decreases bioavailability of biotin? 68. Aged wine 69. Aged cheese 70. Raw egg whites 71. Raw cauliflower 68. Which of the following vitamins is synthesized in significant amounts by intestinal bacteria? 69. Folate 70. Biotin 71. Cyanocobalamin 72. Pantothenic acid 69. Biotin can be synthesized by 70. avidin. 71. the skin. 72. the liver. 73. intestinal bacteria. 70. What is the adult Adequate Intake for biotin? µg/day µg/day mg/day mg/day

16 71. What vitamin forms a part of coenzyme A? 72. Biotin 73. Folate 74. Riboflavin 75. Pantothenic acid 72. What is the AI for pantothenic acid for adults? mg/day mg/day mg/day mg/day 73. Which of the following vitamins is known to sustain substantial losses during processing of food? 74. Biotin 75. Niacin 76. Vitamin B Pantothenic acid 74. Which of the following is NOT a form of vitamin B 6? 75. Pyridoxal 76. Pyridoxine 77. Pyrimidine 78. Pyridoxamine 75. Which of the following vitamins is stored primarily in muscle tissue? 76. Biotin 77. Folate 78. Vitamin B Pantothenic acid

17 76. The chief symptoms of early vitamin B 6 deficiency include 77. confusion and depression. 78. muscle cramps and stiffness. 79. profound fatigue and anemia. 80. hyperactivity and shortness of breath. 77. What vitamin is involved intensively in amino acid metabolism? 78. Biotin 79. Vitamin A 80. Vitamin B Riboflavin 78. Which of the following is NOT a characteristic of vitamin B 6 in nutrition? 79. It is stored in muscle tissue 80. It is required in amounts proportional to energy expenditure 81. It can lead to irreversible nerve damage when taken in large doses 82. It functions, in part, in the synthesis of glycine and glutamic acid 79. All of the following are features of vitamin B 6 metabolism EXCEPT 80. a deficiency or toxicity leads to depression. 81. its destruction and excretion are promoted by alcohol intake. 82. it functions primarily as the coenzyme pyridoxal phosphate. 83. it enhances physical performance when supplied at a level of l mg/g of dietary protein. 80. What is the Tolerable Upper Intake Level for vitamin B 6? mg/day mg/day mg/day ,000 mg/day

18 81. A common drug for the treatment of tuberculosis is known to markedly interfere in the metabolism of vitamin 82. B B C. 85. D. 82. Irreversible nerve damage has been reported in people taking large doses of vitamin 83. B B B B Which of the following statements reflects our knowledge of watersoluble vitamin toxicity? 84. Toxicity symptoms for vitamin B 6 can be severe and irreversible 85. Toxicity symptoms for vitamin C include constipation and hyperactivity 86. Toxicities of the B vitamins occur almost as often from foods as from supplements 87. Toxicity of niacin has been reported in body builders taking large amounts of amino acid supplements 84. In what major way does alcohol intake affect vitamin B 6 metabolism? 85. It reduces acetaldehyde formation 86. It increases fecal excretion of the vitamin 87. It dislodges the PLP coenzyme from its enzyme 88. It interferes with synthesis of the PLP coenzyme 85. What is the adult RDA for vitamin B 6? mg/day

19 mg/day mg/day mg/day 86. On a per-kcalorie basis, which of the following foods is richest in vitamin B 6? 87. Meats 88. Fruits 89. Legumes 90. Grains 87. Which of the following is an essential dietary nutrient for human beings? 88. Folate 89. Inositol 90. Methoxatin 91. Lipoic acid 88. Pteroylglutamic acid is known as 89. folate. 90. choline. 91. inositol. 92. pyridoxamine. 89. Which of the following is NOT among the properties of folate in nutrition? 90. It is needed for proper functioning of vitamin B It functions primarily in the transfer of amino groups 92. The coenzyme of folate requires vitamin B 12 to function properly 93. It requires enzymes on the intestinal mucosa to enhance its absorption from most foods 90. Which of the following characteristics is shared by vitamin B 12 and folate?

20 91. Both are required for nucleic acid synthesis 92. Both require intrinsic factors for their release from food proteins 93. Both are found in significant amounts in green leafy vegetables 94. Both are considered problem nutrients for strict vegetarians 91. Which of the following vitamins undergoes significant enterohepatic circulation? 92. Folate 93. Niacin 94. Thiamin 95. Pyridoxine 92. Which of the following vitamins is usually found in a form that is bound to one or more glutamic acid molecules in food? 93. Folate 94. Thiamin 95. Vitamin B Ascorbic acid 93. A person with a disorder that limits absorption of bile is at increased risk for deficiency of 94. folate. 95. niacin. 96. riboflavin. 97. ascorbic acid. 94. Which of the following is NOT a feature of folate nutrition? 95. Most food folate is bound to a string of amino acids 96. Folate is actively secreted back into the GI tract with bile 97. Food folate must be hydrolyzed by intestinal cell enzymes prior to absorption 98. Folate must be methylated by homocysteine prior to crossing the brush border membrane

21 95. What is the most likely explanation for the impaired functioning of the GI tract resulting from folate deficiency? 96. Insufficient bile production, thereby promoting fat malabsorption and diarrhea 97. Reduced mucosal cell replacement, thereby resulting in decreased GI functioning 98. Decreased enzymatic capacity in the intestines, thereby resulting in malabsorption 99. Decreased oxygen supply to body tissues, with the intestines being particularly affected because of their high metabolic activity 96. Approximately what percentage of naturally occurring dietary folate is bioavailable? The percent bioavailability of a folate supplement taken on an empty stomach is How many dietary folate equivalents are provided by 100 µg of a folate supplement?

22 99. Research has shown that the risk for neural tube defects is lowered by taking supplements of 100. niacin folate vitamin C vitamin B Which of the following is a type of neural tube defect? 101. Scurvy 102. Beriberi 103. Pellagra 104. Spina bifida 101. Which of the following is true regarding B vitamins and homocysteine metabolism? 102. Folate catabolyzes homocysteine 103. Biotin supplements reduce blood homocysteine levels 104. Excessive homocysteine intake reduces vitamin B 12 absorption 105. High blood homocysteine levels correlate with reduced incidence of colon cancer 102. Methylcobalamin is a coenzyme form of 103. vitamin B vitamin B vitamin B niacin What vitamin contains cobalt? 104. A 105. B B Pantothenic acid

23 104. Which of the following is a feature of folate nutrition? 105. The coenzyme form is FAD 106. Dairy foods are a poor source of folate except for goat s milk 107. Insufficient folate intake results in deficiency of homocysteine 108. Synthetic folate is 70% more available than naturally occurring food folate 105. By law, what amount of folate (µg) must be added to 100 g of food products such as breads, flour, and rice? Nicole is pregnant and is trying to monitor her folate intake. She is eating foods high in folate as well as taking folate supplements, and she is having a hard time determining how many dietary folate equivalents she is consuming. Below is a list of her daily intake with respect to folate: 1 /2 cup of cooked lentils (180 μg food folate) 1 /2 cup of fresh orange juice (60 μg food folate) folate supplement (200 μg) How many DFEs is Nicole consuming? Because of adverse interactions with other vitamins, a safe daily folate intake is up to µg µg.

24 8. 1,000 µg. 9. 2,000 µg A deficiency of which of the following vitamins results in accumulation of homocysteine in the blood? 109. Folate 110. Biotin 111. Niacin 112. Vitamin K 109. The appearance of vitamin B 12 deficiency symptoms may be delayed due to high intake of supplements of 110. folate niacin vitamin C vitamin B What vitamin is involved mainly with the replacement of red blood cells and digestive tract cells? 111. Folate 112. Niacin 113. Thiamin 114. Riboflavin 111. Which of the following substances is known to adversely affect folate utilization? 112. Insulin 113. Calcium supplements 114. Regular use of antacids 115. Vitamin B 12 supplements

25 112. Which of the following is representative of folate availability in foods? 113. Good sources are dairy products and meats 114. Poor sources are fruit juices and vegetable juices 115. Much of the vitamin is lost due to heat and oxidation 116. Only about 10% of the amount in foods is bioavailable 113. Which of the following is known to significantly affect the body s folate status? 114. Sedentary lifestyle 115. Some anticancer drugs 116. Excess protein intake 117. Insufficient fiber intake 114. Physiological stresses such as blood loss, burns, measles, and cancer are known particularly to increase the risk of deficiency for 115. biotin folate riboflavin pantothenic acid Which of the following is associated with a deficiency of folate? 116. Hemolysis 117. Hypoxemia 118. Hemolytic anemia 119. Macrocytic anemia 116. Folate deficiency has been reported in infants fed 117. soy milk goat s milk chicken liver infant formula.

26 117. Among all the vitamins, which is believed to be most vulnerable to interactions with drugs? 118. Folate 119. Niacin 120. Vitamin B Vitamin B What is the RDA for folate for a woman weighing 132 pounds? μg/day μg/day μg/day μg/day 119. What is the adult RDA for folate (µg/day)? Which of the following foods is highest in folate? 121. Meats 122. Starches 123. Dairy products 124. Green, leafy vegetables 121. Which of the following is required for the absorption of dietary vitamin B 12? 122. Bile 123. Lipase 124. Intrinsic factor 125. Carboxypeptidase

27 122. Which of the following is NOT among the factors required for efficient dietary absorption of vitamin B 12? 123. Pepsin 124. Intrinsic factor 125. Hydrochloric acid 126. Mucosal cobalaminase 123. What is the function of intrinsic factor in vitamin B 12 absorption? 124. It catalyzes release of the vitamin from its protein-bound form 125. It attaches to the vitamin, thereby allowing absorption from the small intestine 126. It acts as a storage protein for the vitamin within the intestinal epithelial cells 127. It acts as a cofactor for mucosal enzymes involved in absorption of the vitamin 124. What is the most likely reason for the development of a vitamin B 12 deficiency? 125. Inadequate intake 126. Increased excretion 127. Inadequate absorption 128. Increased losses in food preparation 125. Pernicious anemia results from a deficiency of 126. folate selenium vitamin B iron and copper The nasal spray route represents a safe and efficacious means for the supply of

28 127. folate vitamin B vitamin C vitamin B The absorption of which of the following vitamins is most affected by the disorder atrophic gastritis? 128. Choline 129. Vitamin C 130. Vitamin B Pantothenic acid 128. Which of the following is a property of vitamin B 12? 129. It is efficiently recycled by the body 130. It is necessary for protection from pinpoint hemorrhages 131. It requires attachment to fatty acids for transport in the circulation 132. It is absorbed from the stomach with the aid of a special binding protein 133. A similar type of anemia is produced when there is a deficiency of either 134. riboflavin or niacin vitamin B 12 or folate thiamin or riboflavin vitamin B 6 or vitamin B Which of the following is a common treatment for pernicious anemia caused by inadequate absorption? 131. Injection of cobalamin 132. Topical administration of liver extract 133. Oral supplements of B-vitamin complex 134. A diet high in liver and green, leafy vegetables

29 131. If a person refrained from ingesting any of the water-soluble vitamins, deficiency symptoms would appear last for 132. folate vitamin C vitamin B vitamin B Normally, the body s storage and re-utilization of vitamin B 12 prevents a primary or secondary deficiency from occurring until after about days weeks months years In a person who loses the ability to absorb vitamin B 12, approximately what period of time could elapse before deficiency signs develop? 134. One month 135. Six months 136. One year 137. Three years 134. Pernicious anemia results from a combination of lack of intrinsic factor and 135. ariboflavonosis lack of hydrochloric acid lack of pancreatic vitaminases pharmacologic intakes of folate Which of the following is NOT known to be a risk factor for development of atrophic gastritis? 136. Age over 50 yrs 137. Iron deficiency 138. Helicobacter pylori infection

30 139. Avoidance of leafy vegetables 136. Among the following water-soluble vitamins, a secondary deficiency would most likely be seen for 137. biotin thiamin vitamin C vitamin B Which of the following is a feature of vitamin B 12 nutrition? 138. Deficiencies lead to wet beriberi 139. Even marginal deficiency impairs cognitive function 140. Excess intake leads to loss of appetite and constipation 141. Severe deficiency is characterized chiefly by free-radical damage 138. Why are fermented soy products, sea algae, and most nutritional yeast products poor sources of vitamin B 12? 139. The vitamin is not in a bioavailable form 140. These foods contain high amounts of antiintrinsic factor 141. The vitamin is readily destroyed by the presence of microbes 142. These foods contain high levels of folate, which inhibits B 12 absorption 139. Which of the following is a feature of vitamin B 12 bioavailability? 140. Synthetic B 12 in supplement form is highly utilizable 141. Fermented soy products are optimal sources of the vitamin 142. Yeast consumed by vegans is a good source of the vitamin 143. Sea algae such as spirulina contain vitamin B 12 that is about 50% available

31 140. Why are strict vegetarians at risk of developing a vitamin B 12 deficiency? 141. Vegetarian diets inhibit absorption of the vitamin 142. Vegetarian diets provide insufficient amounts of the vitamin 143. The fiber content of vegetarian diets causes decreased storage by the liver 144. The fiber content of vegetarian diets causes increased excretion of the vitamin 141. Of the following foods, which would be the only source of vitamin B12? 142. Pecans 143. Hot dog 144. Cauliflower 145. Whole-grain bread 142. Which of the following is a characteristic of vitamin B 12 nutrition? 143. Toxicity symptoms are serious and irreversible 144. Units in food are expressed as cobalamin equivalents 145. It is inactivated when the food is heated in a microwave 146. Bioavailable amounts are found in fermented soy products 143. The adult RDA for vitamin B 12 (µg/day) is Which of the following vitamins has an RDA? 145. Biotin 146. Choline 147. Cobalamin 148. Pantothenic acid

32 145. Which of the following is a feature of choline in nutrition? 146. It is an analog of ascorbic acid 147. It is abundant in green leafy vegetables 148. The body can synthesize it from cysteine 149. Average intakes in the United States are lower than recommended 146. Which of the following nutrients is synthesized in significant amounts in the body? 147. Choline 148. Thiamine 149. Ascorbic acid 150. Pantothenic acid 147. Which of the following is known to perform an essential function in the human body? 148. Carnitine 149. Orotic acid 150. Methoxantin 151. Pangamic acid 148. Which of the following is NOT known to be required in the diet of human beings? 149. Folic acid 150. Lipoic acid 151. Ascorbic acid 152. Pantothenic acid 149. Which of the following is NOT known to be a vitamin for human beings? 150. Cobalamin 151. Ubiquinone

33 152. Pyridoxine 153. Pantothenic acid 150. Which of the following is frequently affected by deficiencies of the B vitamins? 151. Bones 152. Tongue 153. Eyesight 154. Hair and nails 151. Which of the following is an overt sign of a possible B vitamin deficiency? 152. Anemia 153. Smooth tongue 154. Abnormal liver function 155. Abnormal heart function 152. Which of the following characteristics is shared by vitamins B 6, B 12, C and folate? 153. Required for glycolysis 154. Consumption prevents anemia 155. Required in microgram quantities 156. Found in citrus products and legumes 153. What is a free radical? 154. An inactive vitamin 155. An unphosphorylated vitamin 156. A molecule of unbound cobalamins 157. A molecule with at least one unpaired electron 154. Which of the following is a general function of vitamin C?

34 155. Antiviral agent 156. Antifungal agent 157. Anticancer agent 158. Antioxidant agent 155. In what capacity does vitamin C function? 156. Coenzyme for energy release 157. Cofactor in collagen formation 158. Cofactor with calcium in blood coagulation 159. Coenzyme in the formation of red blood cells 156. The protein that requires ascorbic acid for its formation is 157. keratin albumin collagen hydroxyproline The synthesis of collagen requires both vitamin C and 158. iron zinc cobalamin beta-carotene What organ stores the highest concentration of vitamin C? 159. Liver 160. Muscle 161. Thyroid gland 162. Adrenal glands

35 159. Which of the following represents the results of well-controlled studies of vitamin C supplementation on the resistance to, and recovery from, colds? 160. There was a reduction in the duration of colds by 50% on the average 161. There was only a minor effect on reducing the number and severity of colds 162. There was a consistent reduction in the duration of colds in people who consumed at least 200 mg a day 163. There was a significant reduction in the number of colds only in people who consumed more than three grams per day 160. Why might vitamin C supplements be beneficial in treating the common cold? 161. They deactivate histamine 162. They reduce episodes of diarrhea 163. They destroy intestinal pathogens 164. They alter hypothalamic control of body temperature 161. Which of the following vitamins is known to deactivate histamine, a substance that causes nasal congestion? 162. Niacin 163. Vitamin E 164. Vitamin C 165. Vitamin B What is the minimum daily amount of ascorbic acid that will prevent the appearance of scorbutic symptoms in human beings? mg mg mg mg

36 163. How much vitamin C is needed daily to raise blood ascorbic acid concentrations to a maximum? mg mg mg mg 164. Which of the following is an early sign of vitamin C deficiency? 165. Bleeding gums 166. Pernicious anemia 167. Appearance of a cold 168. Hysteria and depression 165. In the United States, what is the adult RDA for vitamin C? mg mg mg mg 166. People who smoke require additional vitamin C in the amount of mg mg mg mg Which of the following symptoms is indicative of a deficiency of vitamin C? 168. Hair loss 169. Muscle spasms 170. Bilateral symmetrical dermatitis 171. Subcutaneous pinpoint hemorrhages

37 168. People with the condition known as iron overload may be adversely affected from taking supplements of 169. niacin retinol cobalamin ascorbic acid Which of the following is a feature of vitamin C in the body? 170. Severe deficiency is irreversible 171. Low levels are found in people who chew tobacco 172. Extremes of physical stress impair mobilization of vitamin C 173. Severe deficiency signs become apparent when blood levels fall by about 20% 170. Which of the following is NOT among the characteristics of vitamin C? 171. Easily degraded by heat 172. Easily degraded by oxygen 173. With moderate intake it acts chiefly as a prooxidant 174. Adequate amounts are contained in breast milk but not cow s milk 171. Which of the following food groups is a rich source of vitamin C? 172. Milk group 173. Meat group 174. Fruit group 175. Grains group 172. What term is used to describe the outcome of a diagnostic test that apparently shows that you have mononucleosis when in reality you do not? 173. True positive 174. True negative 175. False positive 176. False negative

38 173. What term describes the outcome of a diagnostic test that apparently indicates that you do not have an infection when in reality you do? 174. True positive 175. True negative 176. False positive 177. False negative 174. John is looking to increase his dietary sources of vitamin C. However, he expresses a strong dislike for all citrus fruits. Which of the following shopping lists would you recommend? 175. Liver, yogurt, milk 176. Brussels sprouts, broccoli, strawberries 177. Banana, peanut butter, canned tuna fish 178. Whole grains, pork, fortified corn flakes 175. Which of the following foods provides ample amounts of vitamin C? 176. Tofu 177. Yogurt 178. Legumes 179. Broccoli 176. Which of these meals is lowest in vitamin C? 177. Roast beef, carrots, noodles, and tea 178. Hot dog, cabbage, french fries, and milk 179. Roast beef, broccoli, noodles, and coffee 180. Spaghetti with tomato sauce, meatball, garlic bread, and red wine 177. Which of the following would be a very good source of vitamin C for the lacto-ovo-vegetarian? 178. Milk 179. Eggs

39 180. Broccoli 181. Whole-grain bread 178. All of the following are consequences of ingesting excess vitamin C supplements EXCEPT 179. they frequently cause diarrhea they appear safe at levels up to 2000 mg/day they enhance the action of anticlotting medications they interfere with laboratory urine tests for the diagnosis of diabetes Moderate intakes of which of the following would provide sufficient amounts of vitamin C? 180. Potatoes 181. Brown rice 182. Low-fat milk 183. Whole-wheat bread 180. What food makes a significant contribution to vitamin C intakes in the U.S. population despite its modest vitamin C concentration? 181. Potatoes 182. Organ meats 183. Breaded fish 184. Whole-grain cereals 181. Which of the following would be the poorest dietary source of vitamin C? 182. Liver 183. Potatoes 184. Whole grains 185. Cruciferous vegetables

40 182. A vitamin supplement labeled as high potency contains an amount that is % of the Daily Value equal to the UL up to 200% of the Daily Value % or more of the Daily Value Approximately what percentage of the U.S. population takes a dietary supplement regularly? The known dangers of taking vitamin supplements include all of the following EXCEPT 185. vitamin toxicity the taker may ignore warning signs of a disease the taker may feel a false sense of security and consume a poor diet pathogenic bacterial overgrowth of the large intestines leading to increased risk of infection Which of the following statements is representative of vitamin supplementation practices? 186. Most people who take supplements consume a poor diet 187. Most people should take supplements daily because of the great difficulty in obtaining the needed amounts from food 188. People who have low energy intakes or are pregnant are at risk for developing deficiencies and may benefit from supplementation 189. People should take supplements daily because nutrition surveys in the U.S. and Canada have detected deficiencies in some population groups

41 186. A person who shuns dairy and spends most of her time indoors would likely benefit from a supplement of 187. vitamin A vitamin B vitamin C vitamin D Those groups of people who are at risk for developing marginal nutrient deficiencies and may benefit from taking vitamin supplements include all of the following EXCEPT 188. vegans food faddists athletes who are engaged in intense competitive events people with low energy intakes, such as habitual dieters and the elderly Which of the following is NOT among the common effects from ingesting a mild iron overdose? 189. Nausea 190. GI distress 191. Black tongue 192. Black diarrhea 189. Why shouldn t vitamin E supplements be taken for at least one week before surgery? 190. Vitamin E interferes with barbiturate pain medications 191. The antioxidant activity affects stability of most anesthetic agents 192. Vitamin E acts as a blood thinner and could lead to excessive bleeding 193. The antioxidant activity interferes with synthesis of replacement erythrocytes 190. Which of the following is a feature of nutrient intakes and supplement use in the United States?

42 191. Few people ingest the optimal amounts of all vitamins and minerals from foods 192. The NIH recommends that people use supplements to prevent chronic diseases 193. The NIH recommends that people NOT use supplements to prevent chronic diseases 194. The FDA recognizes that most nutrient supplements are associated with little, if any, harm 191. What nutrient is responsible for causing the most accidental ingestion deaths in children? 192. Iron 193. Calcium 194. Vitamin A 195. Vitamin D 192. Nutrient supplements known as green pills often contain 193. mostly food coloring high-potency vitamin C dehydrated alfalfa and parsley dried extracts of spoiled meats If a dietary supplement poses a significant risk of illness to consumers, what agency must prove harm before removing the product from the market? 194. FDA 195. CDC 196. USDA 197. USPHS

43 Matching 1. Name of thiamin deficiency disease 2. A food unusually rich in thiamin 3. Exposure to this leads to destruction of riboflavin 4. A food source that supplies a substantial amount of people s riboflavin intake 5. Deficiency of this vitamin leads to cracks and redness at corners of the mouth 6. Used for synthesis of niacin 7. Overconsumption of this food has resulted in pellagra 8. High doses are known to lower LDL cholesterol 9. Deficiency of this vitamin is induced by feeding raw egg whites 10. This vitamin is a component of acetyl CoA 11. Toxicity from this vitamin is known to cause nerve damage and inability to walk 12. Prevention of neural tube defects is related to increased intake of this substance by pregnant women 13. One of the first symptoms of folate deficiency 14. Required to maintain nerve fiber sheath 15. Required for absorption of vitamin B Made in the body from methionine 17. The antiscorbutic factor

44 18. Vitamin C is required for the synthesis of this substance 19. Excess intake of vitamin C may aggravate this disorder 20. A concentrated source of vitamin C A. Pork H. Anemia B. Corn I. Collagen C. Dairy J. Beriberi D. Folate K. Broccoli E. Biotin L. Riboflavin F. Niacin M. Vitamin B 6 G. Choline N. Vitamin B 12 O. Tryptophan P. Iron overload Q. Ascorbic acid R. Intrinsic factor S. Ultraviolet light T. Pantothenic acid Essay 1. Provide a brief definition of a vitamin. Do all vitamins contain an amino group? 2. What steps should be taken by consumers to minimize the loss of vitamins from foods? 3. Discuss the effects of heat and ultraviolet light on vitamin stability. 4. What is meant by the bioavailability of a vitamin? How is it determined? 5. Provide examples of how the vitamins differ from the macronutrients in terms of structure, function, and food contents. 6. Discuss the meaning and significance of the Tolerable Upper Intake Levels for the water-soluble vitamins. 7. Compare and contrast the water-soluble vitamin group with the fat-soluble vitamin group with respect to absorption, transport, storage, excretion, toxicity, and requirements.

45 8. Discuss thiamin nutrition including functions, risk factors for deficiency, symptoms of deficiency, food sources, and stability. 9. Discuss riboflavin nutrition including functions, risk factors for deficiency, symptoms of deficiency, food sources, and stability. 10. Describe the type of diet associated with pellagra in the U.S. in the early 1900s. 11. Why was pellagra once believed to be caused by a pathogen instead of a vitamin deficiency? 12. Explain the medicinal uses for niacin supplements. What conditions make people more susceptible to the side effects from niacin supplements? 13. Discuss the essentiality, deficiency symptoms, and major food sources of biotin and pantothenic acid. 14. Explain how vitamin B 6 and isoniazid interact to affect the vitamin s metabolism. 15. a. What is the effect of excess alcohol intake on vitamin B 6 metabolism? 16. Describe the toxic effects of excess vitamin B 6 supplements. 17. What factors are associated with vitamin B 12 inadequacy other than low intake? 18. Explain the absorption mechanisms for folate from foods. How does the body dispose of excess folate? 19. Why is the bioavailability of folate from food almost always lower than from the synthetic form? 20. Explain the role of folate in red blood cell synthesis and maintenance of cells lining the GI tract. 21. Discuss through the use of examples the importance of folate in development of the neural tube during the early weeks of pregnancy. 22. Discuss the expected benefits of folate fortification of grain products. What are the possible adverse effects of this practice? 23. What are the associations between folate intake and development and progression of certain cancers? 24. Explain the association between folate deficiency and homocysteine metabolism. What are observations from the folate fortification program regarding risk for cardiovascular disease and death? 25. Provide explanations for the development of a primary and a secondary deficiency of folate. 26. Discuss the interrelationships of folate and vitamin B 12 in the diagnosis and treatment of large-cell type anemia. 27. Define intrinsic factor and discuss its relationship to vitamin B 12 absorption. What other factors are associated with vitamin B 12 absorption? What is the

46 most common cause of vitamin B 12 deficiency, and how is vitamin B 12 deficiency treated in those with this condition? 28. Why might vegans develop a vitamin B 12 deficiency? Why might they have a normal vitamin B 12 status? Why are the amounts of B 12 listed on labels of certain plant and yeast food products inaccurate and misleading? 29. What is meant by the following: Folate cures the blood symptoms of a vitamin B 12 deficiency, but cannot stop the nerve symptoms from progressing. 30. Discuss the association between marginal vitamin B 12 deficiency and cognitive function. 31. Discuss the essentiality of choline, including chief functions and major food sources. 32. Discuss the roles of the B vitamins in energy metabolism. 33. Diagram the metabolic pathways that involve participation of B vitamins. 34. Discuss how B-vitamin deficiencies rarely present as singlevitamin deficiencies. 35. Discuss similarities in the deficiency symptoms of the B vitamins. 36. Under what circumstances can water-soluble vitamins be toxic? Cite several examples. 37. Explain the modes of action of vitamin C. 38. In what ways have vitamin C supplements been shown to affect nasal congestion from a cold? 39. Under what conditions and for what reasons would intakes of vitamin C above the RDA be desirable? 40. Describe the potential hazards of excessive vitamin C intake. 41. List common foods that are good sources of vitamin C and foods that are unusually poor sources of the vitamin. 42. What is meant by false positive and false negative medical test results? How might these tests be influenced by vitamin supplements? 43. Choose 4 water-soluble vitamins and list their chief functions, deficiency and toxicity symptoms, and major food sources. 44. List several arguments for and against the regular use of vitamin supplements. 45. List population groups that have a physiological need for vitamin/mineral supplements. 46. What type of testing is done by the U.S. Pharmacopeia to assure the quality and safety of certain vitamin and mineral supplements? 47. Explain the major provisions of the Dietary Supplement Health and Education Act of 1994.

47 Answer Key (ANS = correct answer, REF = page reference, DIF = difficulty, OBJ = learning objective) Multiple Choice 1. ANS: b REF: 297 DIF: Knowledge-level OBJ: ANS: d REF: 298 DIF: Knowledge-level OBJ: ANS: c REF: 298 DIF: Knowledge-level OBJ: ANS: b REF: 298 DIF: Knowledge-level OBJ: ANS: a REF: DIF: Knowledge-level OBJ: ANS: a REF: DIF: Knowledge-level OBJ: ANS: c REF: 299 DIF: Application-level OBJ: ANS: b REF: DIF: Application-level OBJ: ANS: b REF: DIF: Knowledge-level OBJ: ANS: b REF: DIF: Application-level OBJ: ANS: d REF: 300 DIF: Knowledge-level OBJ: ANS: d REF: 300 DIF: Application-level OBJ: ANS: c REF: 300 DIF: Knowledge-level OBJ: ANS: c REF: 301 DIF: Application-level OBJ: ANS: d REF: 301 DIF: Knowledge-level OBJ: ANS: b REF: 301 DIF: Knowledge-level OBJ: ANS: b REF: 301 DIF: Knowledge-level OBJ: ANS: a REF: DIF: Application-level OBJ: ANS: b REF: 301 DIF: Application-level OBJ: ANS: d REF: 301 DIF: Knowledge-level OBJ: ANS: d REF: 301 DIF: Application-level OBJ: ANS: c REF: DIF: Knowledge-level OBJ: ANS: a REF: DIF: Knowledge-level OBJ: ANS: b REF: 303 DIF: Knowledge-level OBJ: ANS: a REF: 302 DIF: Knowledge-level OBJ: ANS: a REF: 302 DIF: Application-level OBJ: ANS: b REF: 303 DIF: Application-level OBJ: ANS: d REF: DIF: Knowledge-level OBJ: ANS: c REF: DIF: Knowledge-level OBJ:

48 30. ANS: d REF: 304 DIF: Knowledge-level OBJ: ANS: d REF: 304 DIF: Knowledge-level OBJ: ANS: a REF: 304 DIF: Knowledge-level OBJ: ANS: c REF: 304 DIF: Knowledge-level OBJ: ANS: d REF: 304 DIF: Application-level OBJ: ANS: d REF: 304 DIF: Knowledge-level OBJ: ANS: b REF: 304 DIF: Application-level OBJ: ANS: d REF: DIF: Knowledge-level OBJ: ANS: a REF: 304 DIF: Application-level OBJ: ANS: c REF: 304 DIF: Application-level OBJ: ANS: c REF: 304 DIF: Knowledge-level OBJ: ANS: a REF: 304 DIF: Knowledge-level OBJ: ANS: d REF: 305 DIF: Knowledge-level OBJ: ANS: c REF: DIF: Application-level OBJ: ANS: c REF: 305 DIF: Knowledge-level OBJ: ANS: a REF: DIF: Application-level OBJ: ANS: a REF: 305 DIF: Knowledge-level OBJ: ANS: a REF: DIF: Application-level OBJ: ANS: b REF: DIF: Knowledge-level OBJ: ANS: d REF: 305 DIF: Knowledge-level OBJ: ANS: b REF: 305 DIF: Knowledge-level OBJ: ANS: c REF: 305 DIF: Application-level OBJ: ANS: c REF: DIF: Application-level OBJ: ANS: b REF: DIF: Application-level OBJ: ANS: a REF: 306 DIF: Application-level OBJ: ANS: c REF: 306 DIF: Application-level OBJ: ANS: a REF: 308 DIF: Application-level OBJ: ANS: d REF: 306 DIF: Knowledge-level OBJ: ANS: b REF: 306 DIF: Knowledge-level OBJ: ANS: a REF: 308 DIF: Application-level OBJ: ANS: a REF: 308 DIF: Knowledge-level OBJ: ANS: c REF: 307 DIF: Application-level OBJ: ANS: d REF: 307 DIF: Knowledge-level OBJ: ANS: d REF: DIF: Knowledge-level OBJ: ANS: d REF: 308 DIF: Application-level OBJ: ANS: d REF: 308 DIF: Knowledge-level OBJ: ANS: a REF: DIF: Knowledge-level OBJ: ANS: c REF: 308 DIF: Knowledge-level OBJ: