Ch15 Exam Questions Bone Health And Body Defense Systems

Perspectives in Nutrition, A Functional Approach, 2e (Byrd)

Chapter 15 Bone Health and Body Defense Systems

1) The 250 mg of calcium found in a cup of spinach ________.

A) is the only source of calcium for a vegan

B) has low bioavailability because the calcium is bound to oxalic acid

C) is poorly absorbed unless the spinach is cooked

D) has low bioavailability because the calcium is bound to phytic acid

2) Individuals advised to consume calcium supplements should consume ________.

A) about 2,000 mg in a single dose each day

B) only calcium citrate as other calcium salts are poorly absorbed

C) an amount of no more than 500 mg

D) the calcium supplement at the same time as other mineral supplements

3) Absorption of dietary calcium in the duodenum is aided by ________.

A) consumption of lactose

B) acidic environment

C) 1, 25 (OH)2 vitamin D

D) All of these choices are accurate.

4) Which of the following population groups generally has the highest rate of calcium absorption?

A) postmenopausal women

B) pregnant women

C) premenopausal women (not pregnant or lactating)

D) athletes in training

5) Measuring blood calcium levels is not an accurate indicator of total body calcium because ________.

A) calcium in the blood reflects only the most recent dietary intake of calcium

B) there are no reliable tests for measuring blood calcium

C) blood calcium levels vary according to the intake of other positive ions (e.g., sodium, potassium, and magnesium)

D) blood calcium levels are strictly controlled by hormones and do not reflect total body stores

6) Which factor(s) limits absorption of dietary calcium?

A) phytic acid

B) chronic diarrhea

C) tannins in tea

D) vitamin D deficiency

E) All of these choices are accurate.

7) Parathyroid hormone elevates blood calcium levels by ________.

A) increasing the synthesis of 1,25 (OH)2 vitamin D

B) reducing calcium excretion by the kidneys

C) increasing bone resorption by osteoclast activity

D) All of the choices are accurate.

8) Which of the following foods provides the greatest amount of calcium per serving?

A) 1 cup of yogurt

B) 2 oz. cheddar cheese

C) 3 oz. canned salmon with bones

D) 1 cup cooked spinach

9) Assuming that milk is an adolescent's only source of dietary calcium, how much milk must he/she drink every day to meet the RDA for calcium?

A) 1-2 cups

B) 2-3 cups

C) 3-4 cups

D) 4-5 cups

10) The two life stage groups with the highest RDAs for calcium are ________ and ________.

A) children; adolescents

B) infants; children

C) adolescents; adults over age 50

D) infants; adolescents

11) The very dense outer surface of bone is called ________.

A) osteoclastic bone

B) osteoblastic bone

C) trabecular bone

D) cortical bone

12) At the end of long bones, inside the spinal vertebrae, and inside the flat bones of the pelvis, is a spongy type of bone known as ________.

A) osteoclastic bone

B) osteoblastic bone

C) trabecular bone

D) compact bone

13) ________ replacement after menopause greatly reduces bone loss in women.

A) Calcium

B) Calcitriol

C) Estrogen

D) Calcitonin

14) In addition to its role in bone development and maintenance, calcium is also required for ________.

A) blood clotting, transmitting nerve impulses, and muscle contraction

B) regulating potassium excretion, normal kidney function, and regulating intracellular water content

C) phospholipid synthesis, muscle contraction, and formation of DNA and RNA

D) blood clotting, magnesium absorption, and insulin release from the pancreas

15) The bones most likely to be affected by the disease osteoporosis include the ________.

A) ankle, shoulder, and neck

B) hip, thigh, and ankle

C) hip, wrist, and vertebrae in the spine

D) wrist, forearm, and neck

E) All of these are correct as all bones are affected equally by osteoporosis.

16) Risk factors for osteoporosis include ________.

A) overweight and obesity

B) amenorrhea

C) African-American race

D) high levels of physical activity

17) Phosphorus absorption is promoted by the hormone ________.

A) calcitonin

B) 1, 25 (OH)2 vitamin D

C) cholecalciferol

D) aldosterone

18) The RDA for adults for phosphorus is ________.

A) the same as calcium

B) twice the amount of calcium

C) 700 mg/d

D) 200 mg/d

19) Good food sources of phosphorus include ________.

A) fruits and vegetables

B) nuts and oils

C) dairy products, meats, and cereals

D) dairy products and leafy green vegetables

20) The richest dietary sources of magnesium generally are ________.

A) animal products, e.g., beef and milk

B) plant products, e.g., green vegetables, beans, whole grains

C) fats and oils

D) bottled waters

21) Magnesium deficiency is most often caused by ________.

A) excessive intakes of sodium and potassium

B) low dietary intake of magnesium

C) GI disorders that cause prolonged diarrhea or vomiting

D) osteopenia or osteoporosis

22) Over half of the body's magnesium is found in the ________.

A) heart

B) liver

C) bones

D) brain

23) High amounts of ________, especially from supplements, can cause diarrhea.

A) magnesium

B) sodium

C) calcium

D) potassium

24) Some scientists believe that vitamin D recommendation should be much higher than currently set.

25) Beta-carotene is also called ________.

A) provitamin A

B) retinal or retinol

C) calcitriol

D) rhodopsin

26) In the intestinal cells, ________.

A) vitamin A, as retinal, is converted to beta-carotene

B) carotenes are split by an intestinal enzyme to form vitamin A

C) excess vitamin A is carried to the kidney for excretion

D) All of these choices are correct.

27) Retinal, retinol, and retinoic acid are all forms of ________.

A) vitamin A

B) vitamin K

C) vitamin D

D) vitamin E

28) Rhodopsin, the visual pigment in the retina of the eye, is regenerated when opsin combines with ________.

A) retinoic acid

B) 11-cis retinal

C) 13-cis-retinol

D) beta-carotene

29) Of the following, the best source of preformed vitamin A is ________.

A) fried liver

B) sautéed spinach

C) fresh mango

D) cheddar cheese

30) Of the following, the best source of provitamin A is ________.

A) fried liver

B) baked sweet potato

C) fresh bananas

D) soybeans

31) The yellow-orange coloring of carotenoid-rich dark green vegetables is masked by the pigment ________.

A) lycopene

B) chlorophyll

C) beta-carotene

D) alpha-carotene

32) Mucus-forming cells in the body deteriorate and can no longer produce mucus when there is a deficiency of ________.

A) vitamin D

B) beta-carotene

C) vitamin K

D) vitamin A

33) When viewing items at night or in very dim light, light strikes the retina of the eyes ________.

A) and causes the retinal to change from its cis form to its trans form

B) and splits the rhodopsin into opsin and all-trans-retinal

C) to trigger an electrical signal along the optic nerve

D) All of these choices are accurate.

34) A deficiency of vitamin A can lead to development of a condition called ________.

A) xerophthalmia

B) osteomalacia

C) jaundice

D) scurvy

35) Vitamin A deficiency is characterized by the ________.

A) inability of the pancreas to produce insulin

B) failure to form blood clots

C) inability of the eyes to adapt quickly to changes in light intensity

D) production of excessive amounts of collagen by the skin

36) The maintenance of mucus-forming cells depends on adequate amounts of ________.

A) vitamin D

B) vitamin C

C) vitamin A

D) vitamin K

37) The biochemical functions of vitamin A include all of the following except: ________.

A) controlling vision in dim and bright light

B) development and maintenance of mucus-forming cells

C) cell differentiation

D) coenzyme synthesis

38) Which statement correctly describes vitamin A?

A) Vitamin A is carried from the liver by retinol-binding protein and transthyretin in the blood.

B) Nearly all cells have vitamin-A binding retinoid receptors.

C) Within a cell, vitamin A is involved in gene expression and cell differentiation.

D) All of the above statements are correct.

39) Vitamin A supplements are not necessary for most adult Americans, as they have significant reserves in ________.

A) the eye

B) the skin

C) the kidney

D) the liver

40) The current RDA for vitamin A is expressed in ________.

A) Beta Carotene International Units (BCIU)

B) Retinol Activity Equivalents (RAE)

C) Alpha-Tocopherol Equivalents (ATE)

D) None of these answers are correct.

41) In North America, population groups at increased risk of vitamin A deficiency include all of the following EXCEPT ________.

A) college-aged diabetics

B) alcoholics with liver disease

C) those with GI diseases that prevent fat absorption

D) low birth weight, premature infants

42) The most likely cause of a vitamin A toxicity would be ________.

A) consuming large amounts of dark green and yellow vegetables

B) eating sautéed liver and onions twice a week

C) consuming high levels of vitamin A supplements

D) drinking carrot juice twice a day

43) Vitamin A toxicity is known to cause all of the following EXCEPT ________.

A) birth defects

B) permanent damage to the liver

C) kidney disease

D) death

44) What vitamin would most likely lead to death in both deficient and toxic levels?

A) vitamin A

B) vitamin C

C) vitamin E

D) vitamin B-12

45) A potential danger of using oral Accutane for acne is that it ________.

A)  can cause spontaneous abortion and birth defects

B) can cause blindness if used for over a year

C) may lead to atherosclerosis

D) can lead to osteomalacia

46) Children eating large amounts of carrots can develop ________.

A) hyperactivity

B) hypercarotenemia

C) hyperglycemia

D) vitamin A toxicity

47) A derivative of vitamin A, 13-cis-retinoic acid (Accutane), is used to ________.

A) prevent xerophthalmia

B) treat serious cases of acne

C) treat hypercarotenemia

D) prevent skin cancer

48) Vitamin D deficiency can result in poorly mineralized bone. The resulting disease is called ________.

A) osteoporosis

B) osteomalacia

C) osteoarthritis

D) osteopenia

49) Healthy, light-skinned individuals can make sufficient vitamin D to meet the body's needs with a minimum of about ________ of sun exposure on their face, arms, and hands 2 or 3 times per week.

A) 15 minutes

B) 60 minutes

C) 90 minutes

D) 120 minutes

50) The nutrient that can be considered both a vitamin and a hormone is vitamin ________.

A) E

B) K

C) D

D) A

51) Vitamin D is sometimes called the sunshine vitamin because ________.

A) it is available in fresh orange juice

B) exposure to sunlight converts a precursor form to vitamin D

C) it can be destroyed by exposure to sunlight

D) it is the yellow-orange color of the sun

52) The main active form of vitamin D in the body is ________.

A) calcitriol

B) retinal

C) cholecalciferol

D) calcitonin

53) Vitamin D is involved in the regulation of body levels of ________.

A) cholesterol

B) calcium

C) prothrombin

D) potassium

54) Functions of vitamin D include ________.

A) prevention of scurvy

B) antioxidant activity

C) glucose regulation

D) absorption of calcium

55) As calcitriol, vitamin D functions in calcium and bone metabolism by ________.

A) reducing calcium excretion by the kidney

B) regulating calcium and phosphorus absorption through the intestinal wall

C) regulating the levels of calcium and phosphorus in bones

D) All of these choices are accurate.

56) Calcitriol is the ________.

A) precursor to vitamin D that is activated by sunlight

B) plant source of vitamin D

C) animal food source of vitamin D

D) biologically active form of vitamin D

57) Vitamin D deficiency in adults is called ________.

A) osteoporosis

B) osteomalacia

C) rickets

D) hypocalcemia

58) In children, bowed legs, an enlarged head, rib cage, and knee joints, and a deformed pelvis are symptoms of ________.

A) rickets

B) xerophthalmia

C) osteopenia

D) None of the above are correct.

59) A reliable food source of vitamin D is ________.

A) yellow-orange colored fruits

B) dark green leafy vegetables

C) whole grain breads

D) fortified milk

60) As calcium levels in the blood drop below normal, ________ is released to increase the synthesis of calcitriol.

A) calcitonin

B) thyroid hormone

C) parathyroid hormone

D) secretin

61) Vitamin D synthesis in the skin is affected by all of the following EXCEPT ________.

A) use of sunscreen

B) skin color

C) geographic location

D) All of these factors can affect vitamin D synthesis.

62) Individuals at increased risk of vitamin D deficiency include all of the following EXCEPT ________.

A) elderly adults living in nursing homes

B) dark-skinned children with limited outdoor activity

C) young adults who eat high amounts of fatty fish and fish oils

D) individuals with diseases of fat-malabsorption

63) Which of the following is NOT a function of vitamin D?

A) maintaining phosphorus homeostasis

B) regulating cell cycle activity

C) promoting antioxidant activity

D) increasing immunity against infections

64) Excess intake of vitamin D ________.

A) is readily excreted

B) can cause hypercalcemia

C) can cause rickets

D) can cause osteomalacia

65) Vitamin E is a family of compounds comprised of the ________.

A) 4 tocopherols

B) 4 tocotrienols

C) 4 triglycerides

D) 4 tocopherols and 4 tocotrienols

66) Vitamin E functions to ________.

A) protect cell membranes from destruction by various reducing agents

B) protect phospholipids in cell membranes from damage by free radicals

C) accept electrons, thus neutralizing the action of free radicals

D) All of these choices are accurate.

67) A primary function of vitamin E is to serve as ________.

A) a coenzyme

B) an antioxidant

C) a hormone

D) a peroxide

68) Which of the following is NOT involved in antioxidant defense?

A) glutathione peroxidase

B) superoxide dismutase

C) catalase

D) hydrogen peroxide

69) The most nutrient-dense sources of vitamin E are ________.

A) refined grains and cereal products

B) orange-colored fruits

C) vegetable oils

D) animal fats

70) Vitamin E is carried to the liver and other tissues by ________.

A) albumin

B) hemoglobin

C) lipoproteins

D) retinol-binding proteins

71) Of the following population groups, those at lowest risk for vitamin E deficiency are ________.

A) premature infants

B) the elderly

C) athletes

D) smokers

72) A high intake of vitamin E can ________.

A) interfere with vitamin K's blood-clotting activity

B) result in lead poisoning

C) inhibit copper absorption

D) cause atherosclerosis

73) Which vitamin deficiency leads to hemolytic anemia?

A) vitamin A

B) vitamin D

C) vitamin E

D) vitamin K

74) The mineral that partly "spares" the antioxidant vitamin E is ________.

A) copper

B) selenium

C) chromium

D) iodide

75) The amount of selenium in foods ________.

A) is consistently high in plant-based foods

B) will depend on the total amount of other minerals in the food

C) depends on the type of water used to irrigate crops

D) depends on the amount of selenium in the soil where crops are grown

76) Excessive fluoride exposure during tooth development can cause ________.

A) glucose intolerance

B) mottling of the teeth

C) dermatitis

D) bleeding of the gums

77) The fluoridation of public drinking water is

A) responsible for reduction in dental caries in children.

B) an effective means of providing dietary selenium.

C) potentially toxic if an individual drinks 64 oz or more of municipal water per day.

D) mandatory in all states in the U.S.

78) The fluoride level in fluoridated water typically is about ________.

A) 0.2 mg/L

B)  0.7 mg/L

C) 1.2 mg/L

D)  1.7 mg/L

79) The role of hydroxyl-fluorapatite is to ________.

A) enhance insulin sensitivity and prevent diabetes

B) prevent dental caries

C) improve the rate of growth in children

D) prevent the development of anemia

80) Fluoride is typically provided by sources such as ________.

A) toothpaste

B) fluoride treatments by the dentist

C) municipal drinking water

D) All of these choices are accurate.

81) Which of the following is associated with selenium deficiency?

A) Wilson's disease

B) Keshan disease

C) Grave's disease

D) Lou Gehrig's disease

82) Which of the following enzymes contains selenium?

A) glutathione peroxidase

B) superoxide dismutase

C) lysyl oxidase

D) pancrease

83) Formation and maintenance of collagen requires ________.

A) thiamin

B) vitamin C

C) riboflavin

D) folate

84) Ingestion of vitamin C during meals can modestly improve absorption of ________.

A) beta-carotene

B) nonheme iron

C) vitamin B-12

D) folate

85) The primary function of vitamin C in cellular metabolism is to ________.

A) synthesize collagen

B) add hydroxyl groups to the amino acid proline

C) act as nonspecific reducing agent (electron donor)

D) maintain iron in its reduced form in the formation of collagen

86) Which meal contains the highest amount of vitamin C?

A) hamburger sandwich, french fries, and cola

B) meat loaf, mashed potatoes and gravy, and diet cola

C) baked fish with lemon, broccoli, cole slaw, and strawberries

D) roast beef, carrots, noodles, and coffee

87) The first symptom of scurvy is ________.

A) iron-deficiency anemia

B) sudden hair loss

C) pinpoint hemorrhages around hair follicles

D) nerve degeneration

88) Physiological changes associated with scurvy (hemorrhages, joint pain, fractures) are caused by ________.

A) defective collagen synthesis

B) inadequate production of the hormone thyroxine

C) failure to synthesize neurotransmitters

D) impaired function of the citric acid cycle

89) Which group of foods provides substantial amounts of vitamin C?

A) citrus fruits and vegetables

B) milk and dairy products

C) beef, poultry, seafood

D) breads and cereals

90) Factors such as heat, iron, copper, and oxygen ________.

A) enhance the stability of vitamin C in foods

B) destroy vitamin C in foods

C) have no effect on vitamin C

D) convert vitamin C from its inactive to active form

91) Scurvy is due to a deficiency of ________.

A) vitamin C

B) thiamin

C) folate

D) vitamin B-12

92) The RDA for vitamin C is increased by ________ mg/day for smokers.

A) 10

B) 60

C) 35

D) 1000

93) The amino acids ________ and ________ are hydroxylated with the aid of vitamin C to form strong connective tissue.

A) proline; lysine

B) glutamic acid; alanine

C) threonine; methionine

D) methionine; homocysteine

94) At intakes of supplemental vitamin C greater than 2 g/day, adverse effects, including ________, may occur.

A) blood in the urine and muscle weakness

B) masking of a vitamin B-12 deficiency

C) gastrointestinal bloating and diarrhea

D) All of these choices are accurate.

95) The more dense a bone is, the more brittle it will be.

96) Bone health is easily determined by a measurement of blood calcium level.

97) Retinoids play a role in embryonic development and cell differentiation.

98) Carotenoid supplementation has been effective in decreasing the risk of lung cancer in smokers.

99) Vitamin A deficiency can result in development of xerophthalmia in membranes of the eye.

100) Vitamin D must be hydroxylated in the liver and kidney to become biologically active.

101) Kidney disease and liver disease increase the risk of vitamin D deficiency.

102) The RDA for vitamin E was established to prevent hemolysis of red blood cell membranes.

103) Adequate selenium intake may lower risk of prostate, lung, and other cancers.

104) The RDA for vitamin C is 60 mg/day or 4 ounces of orange juice a day.

105) Large doses of vitamin C in supplement form are known to prevent, cure, or diminish the symptoms of the common cold.

Match the term with its description.

A) A compound composed of calcium and phosphate that is deposited into the bone protein matrix to give it strength and rigidity

B) The surface bone cells that dissolve bone, releasing calcium and phosphorus to the bloodstream

C) The outer dense shell of bone that makes up most skeletal mass

D) Biochemically active bone cells that are the most numerous and that increase in number when bone becomes more dense

E) The bone-building cells that produce collagen and add minerals

106) Osteoblast

107) Hydroxyapatite

108) Cortical bone

109) Osteoclast

110) Osteocyte

111) Describe how to test a calcium supplement for digestibility.

112) List and briefly describe five risk factors leading to osteoporosis.

113) List 3 functions of vitamin A.

114) Why do some scientists suggest that the DRI and UL for vitamin D be increased?

115) List 3 symptoms of vitamin A toxicity.

116) Why should individuals on anticoagulation medication avoid excess vitamin E?

117) List three food sources rich in vitamin D.

118) What trace mineral aids in vitamin E function?

119) What trace mineral toxicity causes tooth mottling and how?

120) Describe how fluoride works to prevent dental caries.

121) Why is fluoride not always classified as an essential trace mineral?

122) Should individuals with a family history of cancer take selenium supplements? Explain your answer.