Chapter 18 – Diet and Health
MULTIPLE CHOICE
1. What are cytokines?
a.
Scavengers of the immune system
b.
Specialized antibodies that retain B-cell memory
c.
Specialized proteins that activate responses to infection
d.
Highly specific cells that attack only one type of antigen
e.
Lymphocytes that produce antibodies
2. Immunoglobulins are produced primarily by
a.
T-cells.
b.
B-cells.
c.
antigens.
d.
phagocytes.
e.
NK-cells.
3. The process by which immune cells engulf and then destroy bacteria is known as
a.
bactocytosis.
b.
phagocytosis.
c.
cytotoxicosis.
d.
immunoglobinemia.
e.
immunocytosis.
4. The immune system treats foreign substances such as bacteria and toxins as
a.
antigens.
b.
antibodies.
c.
antitoxins.
d.
immunoglobulins.
e.
symbionts.
5. Which of the following is a feature of AIDS?
a.
It has no cure.
b.
Its prevention depends on good nutrition.
c.
It cannot pass from mother to infant during breastfeeding.
d.
It is among the 10 leading causes of death in the United States.
e.
There has been very limited progress made in finding effective treatments.
6. What is the role of omega-3 fatty acids in immune functioning?
a.
Maintain healthy skin and other epithelial tissues as barriers to infection.
b.
Regulate T-cell responses.
c.
Help to resolve inflammation when it is no longer needed for the immune response.
d.
Participate in antibody production.
e.
Helps maintain an effective immune response.
7. Of the ten leading causes of illness and death, how many are associated directly with nutrition?
a.
one
b.
two
c.
four
d.
five
e.
eight
8. Which of the following risk factors for disease may be modified by diet?
a.
Age
b.
Gender
c.
Heredity
d.
Low HDL level
e.
Race
9. What is the term given to the accumulation of lipid material mixed with smooth muscle cells and
calcium that develops in the artery walls?
a.
Plaques
b.
Angina streaks
c.
Arterial thickening
d.
Pre-thromboemboli
e.
Lipid tangles
10. The most common form of cardiovascular disease is
a.
stroke.
b.
atheromatous disease.
c.
coronary heart disease.
d.
hypertensive aneurysm.
e.
congestive heart failure.
11. By what age do most people first have well-developed arterial plaque?
a.
20
b.
30
c.
40
d.
50
e.
60
12. Which of the following is a feature of atherosclerosis?
a.
It is characterized by inflammation in all stages.
b.
It is improved by high blood homocysteine levels.
c.
It is characterized by infiltration of platelets in the arterial wall.
d.
It is worsened by elevated blood high-density lipoproteins.
e.
It is the second most common cause of coronary heart disease.
13. The ballooning out of an artery wall at a point where it has been weakened by deterioration is called
a(n)
a.
aorta.
b.
plaque.
c.
aneurysm.
d.
diverticula.
e.
pouch.
14. A person’s level of C-reactive protein appears to be a strong predictor for
a.
cancer.
b.
diabetes.
c.
a heart attack.
d.
HIV progression.
e.
rheumatoid arthritis progression.
15. Which of the following may be classified as a risk factor for coronary heart disease?
a.
BMI of 26
b.
Low LDL-cholesterol levels
c.
High HDL-cholesterol levels
d.
High C-reactive protein levels
e.
Low blood triglyceride (VLDL) levels
16. In the development of plaque, what is thought to be responsible for oxidation of LDL cholesterol
during the inflammatory phase?
a.
Free radicals
b.
Beta-blockers
c.
P-reactive protein (PRP)
d.
Lipoprotein-associated phospholipase A
e.
Cytokines
17. The obstruction of a blood vessel by a clot that broke away from arterial plaque is termed
a.
an anginism.
b.
an embolism.
c.
circulatory hypoxia.
d.
a de-plaquing event.
e.
plaque rupture.
18. A significant reduction in blood flow to the brain is termed
a.
angina.
b.
a stroke.
c.
a vascular event.
d.
metabolic syndrome.
e.
Chiari event.
19. Which of the following blood pressure readings first signifies a diagnosis of hypertension?
a.
110 over 50
b.
120 over 70
c.
130 over 80
d.
140 over 90
e.
150 over 100
20. What disease accounts for the majority of deaths in U.S. women?
a.
Diabetes
b.
Lung cancer
c.
Breast cancer
d.
Coronary heart disease
e.
Stroke
21. Which of the following is true of coronary heart disease (CHD)?
a.
By age 20, half of the adults in the United States have at least one major risk factor for
CHD.
b.
Women who take estrogen to reduce the risk for osteoporosis are at significantly higher
risk for CHD.
c.
Aging becomes a significant risk factor for women who are 75 and older.
d.
Women younger than 45 years of age tend to have higher LDL cholesterol than do men of
that age, but this difference disappears after menopause.
e.
Levels of the amino acid homocysteine, which protects artery walls, are typically higher
in women than in men.
22. What proportion of adults in the U.S. have high blood triglycerides?
a.
1/10
b.
1/4
c.
1/3
d.
1/2
e.
2/3
23. What is prehypertension?
a.
A predictor of stroke risk
b.
Slightly high blood pressure
c.
A precursor for Syndrome X
d.
A component of the metabolic syndrome
e.
A cluster of risk factors that predict the likelihood of hypertension
24. What blood cholesterol carrier is of greatest concern in atherosclerosis?
a.
HDL
b.
LDL
c.
HDK
d.
VLDK
e.
NK
25. Which of the following is considered a desirable blood level for triglycerides?
a.
< 150
b.
150-200
c.
200-250
d.
250-300
e.
300-350
26. A person who produces a normal amount of insulin but whose cells show suboptimal response is said
to be
a.
polydipsic.
b.
insulin resistant.
c.
hyperglucagonemic.
d.
pancreatic beta-cell deficient.
e.
glucophillic.
27. A desirable HDL cholesterol is
a.
20-30 mg/dl.
b.
30-40 mg/dl.
c.
40-50 mg/dl.
d.
50-60 mg/dl.
e.
>60 mg/dl.
28. Which of the following is true of progress in the treatment and prevention of CHD in the United
States?
a.
Mortality rates have increased among men.
b.
CHD is no longer the number 1 cause of death in women.
c.
Blood cholesterol levels have been declining since 1960.
d.
By age 45, about 1/3 of adults have at least one major risk factor for CHD, down from 1/2
20 years ago.
e.
Efforts to reduce CHD incidence by reducing cigarette smoking have largely failed.
29. What should be the next course of action for a person who was unsuccessful in lowering LDL or blood
pressure by lifestyle changes?
a.
Obtain prescription medications.
b.
Consider coronary bypass surgery.
c.
Obtain regular nutrition counseling.
d.
Consider gastric surgery to reduce body weight.
e.
Try again with a more stringent diet and exercise program.
30. Among the following, which should be the first action taken to lower blood cholesterol?
a.
Begin drug treatment.
b.
Consume a high-protein diet.
c.
Consume large amounts of fish and fish oils.
d.
Achieve and maintain appropriate body weight.
e.
Increase alcohol intake and/or use an antianxiety medication.
31. Approximately what proportion of people in the United States are believed to have hypertension?
a.
1/10
b.
1/5
c.
1/4
d.
1/3
e.
1/2
32. What is the best predictor for risk of a stroke?
a.
Blood pressure
b.
LDL-cholesterol
c.
HDL-cholesterol
d.
Trans-fatty acid intake
e.
Family history
33. Which of the following is a characteristic of factors associated with hypertension?
a.
Most people with hypertension have BMIs <25.
b.
Most people with hypertension are extremely salt sensitive.
c.
Three to four alcohol drinks per day lowers risk for hypertension.
d.
African Americans develop high blood pressure earlier in life and their average blood
pressure is higher than others.
e.
About 1/3 of people 65 and older have hypertension.
34. Hypertension contributes to an estimated ____ strokes in the U.S. each year.
a.
400,000
b.
600,000
c.
800,000
d.
1,000,000
e.
1,200,000
35. Which of the following is the most likely reason that a blood pressure reading should be repeated
before confirming a diagnosis of hypertension?
a.
The person reacted emotionally to the procedure.
b.
Blood pressure measuring devices often give inaccurate readings.
c.
The cuff of the blood pressure measuring device was wrapped too tightly on the arm.
d.
The cuff of the blood pressure measuring device was wrapped too loosely on the arm.
e.
The person failed to fast before the test was performed.
36. How does obesity increase the risk for developing hypertension?
a.
Obesity is associated with altered kidney function and fluid retention leading to higher
blood pressure.
b.
The excess fat pads surrounding the kidneys impair blood flow to these organs and lead to
a higher output of renin.
c.
Sodium intake in obese people significantly exceeds the recommended intake, thereby
predisposing them to higher blood pressure.
d.
Higher lipoprotein lipase activity in obese people triggers the angiotensin cascade, leading
to increased peripheral resistance to blood flow.
e.
Obesity alters inflammatory responses, which in turn alters the elasticity of arterial walls.
37. The lifetime percent risk of developing hypertension later in life when the blood pressure is normal at
age 55 is
a.
10.
b.
25.
c.
50.
d.
75.
e.
90.
38. Peripheral resistance is the resistance blood encounters in the
a.
veins.
b.
arteries.
c.
venules.
d.
arterioles.
e.
heart.
39. Which of the following statements describes lifestyle modifications suggested to treat high blood
pressure?
a.
Three alcohol drinks per day decreases the risk for developing high blood pressure.
b.
Optimal body mass in from 25.0 to 29.9.
c.
Sodium intake should be reduced to 1500 mg among persons who are 51 and older.
d.
Perform aerobic physical activity for at least 90 minutes per day, most days of the week.
e.
Recommended sodium intakes are higher for African Americans than for other groups.
40. Among the following lifestyle changes, which is least effective at reducing blood pressure?
a.
Adopting the DASH eating plan
b.
Limiting daily alcohol intake to 1-2 drinks
c.
Reducing body weight to achieve a BMI of less than 25
d.
Performing physical exercise for 30 minutes per day, 5 days a week
e.
Restricting sodium to less than 2500 mg per day
41. Which of the following describes a relationship between sodium/salt and high blood pressure?
a.
People with chronic kidney disease are less likely to be salt-sensitive.
b.
Lowering sodium intakes reduces blood pressure only in certain ethnic groups.
c.
People less 30 years of age are most likely to be salt-sensitive.
d.
Weight loss is often as effective as sodium restriction in lowering blood pressure.
e.
Of all racial groups, whites tend to be most salt sensitive.
42. People who use diuretics are most at risk of developing imbalances of
a.
sodium.
b.
calcium.
c.
potassium.
d.
phosphate.
e.
manganese.
43. Diuretics act to lower blood pressure by
a.
increasing fluid loss.
b.
decreasing potassium loss.
c.
reducing arterial plaque formation.
d.
increasing retention of calcium and potassium.
e.
increasing stroke volume.
44. Which of the following is a characteristic of drug therapy for hypertension?
a.
Antihypertensive drugs called diuretics work by lowering blood volume.
b.
The most frequently prescribed drug therapies are DASH inhibitors.
c.
Most people with hypertension need only one medicine to reduce blood pressure..
d.
Major side effects of antihypertensive drugs are depletion of body sodium and phosphorus.
e.
Unless weight is also reduced, antihypertensive drugs are unlikely to reduce blood
pressure.
45. Which of the following is a difference between DASH and USDA recommendations?
a.
USDA has a higher intake recommendation for grains.
b.
DASH has a higher recommendation for milk.
c.
DASH has a separate recommendation for seeds, nuts and legumes.
d.
USDA has a higher intake recommendation for lean meats, poultry, and fish
e.
USDA has a higher intake recommendation for fruits.
46. A person who hasn’t consumed anything except water for the past 8 hours has a blood glucose
concentration of 101 mg/dL. This person would be classified as
a.
normal.
b.
diabetic.
c.
prediabetic.
d.
impaired glucose tolerant.
e.
hypoglycemic.
47. Among the leading causes of death in the United States diabetes ranks number
a.
1.
b.
3.
c.
5.
d.
7.
e.
9.
48. What is believed to be the primary cause of type 1 diabetes?
a.
Defect in insulin sensitivity
b.
Excessive body weight gain
c.
Defect of the immune system
d.
Excessive intake of simple carbohydrates
e.
Environmental toxins
49. In which of the following conditions would the pancreas be unable to synthesize insulin?
a.
Hyperglycemia
b.
Type 1 diabetes mellitus
c.
Type 2 diabetes mellitus
d.
Adult-onset diabetes mellitus
e.
Hypoglycemia
50. Type 2 diabetes usually develops after people reach the age of
a.
21.
b.
30.
c.
40.
d.
55.
e.
65.
51. What percentage of people with diabetes have type 1?
a.
5-10
b.
10–15
c.
15–20
d.
20–25
e.
25–30
52. Which of the following is a characteristic of type 1 diabetes?
a.
It is an autoimmune disorder.
b.
It occurs exclusively in people under 40 years of age.
c.
It must be treated by daily oral intake of insulin pills.
d.
It accounts for approximately 50% of all cases of diabetes.
e.
It is typically preceded by metabolic syndrome.
53. Most people with type 2 diabetes have
a.
sarcopenia.
b.
osteoporosis.
c.
excess body fat.
d.
insulin dependency.
e.
relative insulin excess.
54. Which of the following conditions is characterized by insulin resistance of fat cells?
a.
Hypoglycemia
b.
Atherosclerosis
c.
Type 1 diabetes
d.
Type 2 diabetes
e.
Juvenile diabetes
55. Insulin resistance is defined as
a.
reduced sensitivity of cells to blood insulin.
b.
impaired secretion of insulin by the pancreas.
c.
increased destruction of insulin-producing cells.
d.
increased persistence of insulin molecules in the blood.
e.
relative excess of insulin-binding proteins in muscle tissue.
56. A complication of diabetes is blurry vision, which results from swelling of the lenses of the eye caused
by conversion of excess glucose to
a.
sugar alcohols.
b.
glycated fructose.
c.
long-chain ketones.
d.
glycated corneal membranes.
e.
glycoproteins.
57. The frequent urination common in diabetes is known as
a.
polyuria.
b.
polyphagia.
c.
polyuresis.
d.
pseudodiuresis.
e.
enuresis.
58. The excessive thirst common in diabetes is known as
a.
hydration.
b.
polyuresis.
c.
polydipsia.
d.
hyperhydration.
e.
paradoxical thirst.
59. Microangiopathies are disorders of the
a.
kidneys.
b.
pancreas.
c.
capillaries.
d.
coronary vessels.
e.
eyes.
60. Which of the following is a leading cause of both blindness and kidney failure?
a.
Cancer
b.
Diabetes
c.
HIV/AIDS
d.
Atherosclerosis
e.
Stroke
61. In the otherwise stable person with type 1 diabetes, a potential problem associated with physical
activity is
a.
hypoglycemia.
b.
hyperglycemia.
c.
nausea and vomiting.
d.
temporary kidney shutdown.
e.
sudden-onset blindness.
62. Which of the following describes the actions of a carcinogen?
a.
Initiates cancer
b.
Inhibits cancer
c.
Treats cancer
d.
Acts as an antipromoter
e.
Stimulates tumor necrosis
63. A tumor that releases cells, leading to the spread of cancer to other regions of the body, is said to
a.
promote.
b.
augment.
c.
metastasize.
d.
infiltrate downstream.
e.
become necrotic.
64. A substance that causes cancer is best termed a(n)
a.
carcinogen.
b.
antipromoter.
c.
DNA-modifier.
d.
RNA-modifier.
e.
mutagen
65. The higher risk for breast cancer in obese women after menopause is thought to result mainly from
chronic exposure to
a.
estrogen.
b.
aflatoxin.
c.
high-fat diets.
d.
sedentary lifestyles.
e.
progesterone.
66. Which of the following cooking techniques for meats results in formation of the highest amounts of
carcinogens?
a.
Broiling
b.
Roasting
c.
Marinating before cooking
d.
Wrapping the food in foil when cooking
e.
Steaming
67. Which of the following dietary components is thought to be protective against certain types of cancer?
a.
Fiber
b.
Inositol and biotin
c.
Certain saturated fats
d.
Protein from animal sources
e.
Certain sugars
68. Which of the following foods is known to be a protective factor for esophageal cancer?
a.
Alcoholic beverages
b.
Nonstarchy vegetables
c.
Mate tea
d.
Broiled meats
e.
Salted fish