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The Dental Hygienists Guide to Nutritional Care 5th Edition by Cynthia A. Stegeman

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The Dental Hygienists Guide to Nutritional Care 5th Edition by Cynthia A. Stegeman

Chapter 07: Use of the Energy Nutrients: Metabolism and Balance

Stegeman: The Dental Hygienist’s Guide to Nutritional Care, 5th Edition

MULTIPLE CHOICE

  1. The macronutrients supplying physiologic energy are carbohydrate, protein, fat, and alcohol. After conversion to glycogen and glycerol, these basic nutrient units are delivered to the cells.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: C

The first statement is true; the second is false. The macronutrients responsible for physiologic energy are carbohydrate, protein, fat, and alcohol. These substances are converted to glucose, fatty acids, and amino acids and delivered to the cells for utilization. Glycogen is a carbohydrate derived from glucose that is stored in the muscles and liver. Glycerol is a portion of the chemical structure of triglycerides.

DIF: Recall REF: p. 122 OBJ: 1 | 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Catabolism is also called the Krebs cycle. During the Krebs cycle, glucose, fatty acids, and amino acids are converted to a usable form of energy.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: D

The first statement is false; the second is true. Catabolism, one of the two major chemical reactions, splits complex substances into simpler substances. Its counterpart, anabolism, builds or synthesizes more complex compounds. The Krebs cycle, also called the citrus acid cycle, utilizes enzymes to convert glucose, fatty acids, and amino acids into usable forms of energy.

DIF: Recall REF: pp. 122–123 OBJ: 1

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Hormones stimulate, but do not retard, the functions of other cells. Hormones act as messengers that principally control metabolic functions that affect the skeletal muscular and nervous systems.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: B

Both statements are false. Hormones are “messengers” produced by a group of cells that stimulate or retard the functions of other cells. Hormones principally control different metabolic functions that affect growth and secretions.

DIF: Recall REF: p. 123 OBJ: 1

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Each is a function of the liver, except one. Which is the exception?

a.

Regulatory control of nutrients in the bloodstream

b.

Conversion of monosaccharides to triglycerides

c.

Breakdown of polysaccharide glycogen into glucose

d.

Oxidation of digestive end products to provide energy

ANS: B

The liver converts monosaccharides to glucose to provide energy for utilization by the cells. Its major role is regulatory; it controls the kinds of quantities of nutrients within the bloodstream. The polysaccharide glycogen is stored in the liver (and muscle) and converted to glucose. In this form, glucose can be supplied to the bloodstream and delivered to the cells as needed. Other end products of digestion can be oxidized to be converted to glucose, protein, fat, or other substances as needed by the cells and tissues of the body.

DIF: Recall REF: p. 123 OBJ: 1

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. During times of low caloric intake, high-protein diets successfully build muscle mass because this type of diet utilizes the amino acid metabolic pool to stimulate anabolism of muscle.

a.

Both the statement and the reason are correct and related.

b.

Both the statement and the reason are correct but are not related.

c.

The statement is correct, but the reason is not correct.

d.

The statement is not correct, but the reason is correct.

e.

Neither the statement nor the reason is correct.

ANS: E

Neither the statement nor the reason is correct. High-protein diets are neither safe nor effective as a means to increase (anabolize) muscle mass. The amino acid metabolic pool, a small reservoir containing approximately 70 g of amino acids, is not intended for this purpose. This pool contains less amino acid than most Americans consume in a day and is not intended to supplement proper nutrition, nor is it capable of building muscle mass in the absence of caloric intake and exercise.

DIF: Comprehension REF: p. 125 OBJ: 2 | 7

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. The major waste product of protein catabolism is ammonia. The liver converts ammonia to urea to be excreted by the kidneys.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: D

The first statement is false; the second is true. Urea, not ammonia, is the major waste product of protein catabolism. Ammonia is a toxic substance the liver converts to urea to be excreted by the kidneys. The levels of urea and ammonia vary directly with dietary protein levels.

DIF: Recall REF: p. 125 OBJ: 2

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Each accurately describes aspects of lipid metabolism, except one. Which is the exception?

a.

Insulin increases fat synthesis.

b.

The liver regulates fat metabolism and lipoprotein.

c.

Modification of fatty acids deactivates their properties.

d.

Liver metabolism results in triglycerides being transported to tissues for energy and other uses.

ANS: C

An important concept is that the liver is the principal regulator of fat metabolism and lipoprotein synthesis (building of new substances). Fatty acids are an important component of this function, and they can be modified in many ways before they are released from the liver into the circulations. Modification, also known as hydrolysis, of fatty acids can be by shortening, lengthening, or adding double bonds.

DIF: Comprehension REF: p. 125 OBJ: 3

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. The liver performs each action upon cholesterol, except one. Which is the exception?

a.

Produces cholesterol.

b.

Converts cholesterol to urea.

c.

Removes cholesterol from the blood.

d.

Uses cholesterol to make bile acid.

ANS: B

The liver does not convert cholesterol to urea. Instead, the liver converts ammonia to urea, which is then excreted by the kidneys. Urea is the major waste product of the breakdown (catabolism) of protein.

DIF: Recall REF: p. 125 OBJ: 1

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. During oxidation of triglycerides, 1 lb of fat results in 1000 kcal of energy. Ketones are formed when excessive amounts of fat are oxidized for energy.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: D

The first statement is false; the second is true. During oxidation of triglycerides, 1 lb of fat results in 3500 kcal of energy. Ketones are formed when the liver becomes overwhelmed because of excessive amounts of fat being oxidized for energy. Ketones are acidic metabolic products that are not oxidized in the liver, but they are carried to the skeletal and cardiac muscle, where under normal circumstances, they are rapidly metabolized. Note that production of 3500 kcal is more energy than most individuals use in a 24-hour period.

DIF: Recall REF: p. 125 OBJ: 3

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. In addition to producing excessive water within cells, ketoacidosis is a dangerous condition because the brain and nerve cells use ketones for some of their fuel requirements when glucose levels remain low for several days.

a.

Both the statement and the reason are correct and related.

b.

Both the statement and the reason are correct but are not related.

c.

The statement is correct, but the reason is not correct.

d.

The statement is not correct, but the reason is correct.

e.

Neither the statement nor the reason is correct.

ANS: E

Neither the statement nor the reason is correct. Ketoacidosis is an extension of a condition known as ketosis. Dangerous dehydration can occur because an accumulation of ketone bodies upsets the acid-base balance. This condition, called acidosis, results in loss of large amounts of water and sodium ions and a disruption in the glucose balance. When blood glucose levels remain low for several days, brain and nerve cells adapt to use ketones for some of their fuel requirements. Ketoacidosis frequently occurs in patients with uncontrolled diabetes mellitus or individuals who are not eating because they are burning fat rather than carbohydrate because of illness or weight reduction.

DIF: Comprehension REF: p. 125 OBJ: 3

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. The best source for assuring optimal glycogen stores is:

a.

carbohydrates.

b.

proteins.

c.

fats.

d.

glycerol.

e.

amino acids.

ANS: A

Adequate carbohydrates must be consumed to assure optimal glycogen stores. In fact, glycogen stores are depleted with a carbohydrate-poor diet even when high levels of fat and protein are eaten. A patient who ingests a carbohydrate-poor diet has decreased energy reserves and is prone to having prolonged healing periods and fatigue.

DIF: Recall REF: p. 124 OBJ: 1

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. For adults of all ages, one to two alcoholic drinks daily results in the lowest mortality rate because moderate alcohol consumption provides protective effects on the cardiovascular system.

a.

Both the statement and the reason are correct and related.

b.

Both the statement and the reason are correct but are not related.

c.

The statement is correct, but the reason is not correct.

d.

The statement is not correct, but the reason is correct.

e.

Neither the statement nor the reason is correct.

ANS: E

Neither the statement nor the reason is correct. The Dietary Guidelines for Americans advise moderation in alcohol consumption. Specifically, its recommendation of one to two drinks daily applies to middle-aged and older adults only. Alcohol consumption seems to provide little, if any, health benefit for younger individuals. Alcoholic beverages should be avoided by women who may become pregnant or are pregnant or breastfeeding.

DIF: Comprehension REF: p. 126 OBJ: 3

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Regardless of whether excessive food intake is in the form of protein, carbohydrate, alcohol, or fat, most excess energy intake is stored in the liver. Fat is a good source of energy, but protein is the preferred fuel.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: B

Both statements are false. Regardless of the source of excessive food intake, most excess energy intake is stored in adipose tissue. Fat is a good source of energy, but the preferred fuel is carbohydrate. Note that in the absence of adequate carbohydrates, the body cannot metabolize excessive amounts of fat without some side effects—ketoacidosis, hyperlipidemia, and accumulation of fat in the liver. Glycogen is another storage form of energy; however, the amount of glycogen stored in the body is limited.

DIF: Recall REF: p. 126 OBJ: 3

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Each is true of metabolic interrelationships, except one. Which is the exception?

a.

Carbohydrates can be used in forming nonessential amino acids.

b.

Glucose can be converted to fatty acids and some amino acids.

c.

Proteins contribute to synthesis of some lipids.

d.

The glycerol from triglycerides can be used for synthesis of carbohydrates.

ANS: B

There are many interrelationships between macronutrients and micronutrients responsible for metabolism. In some situations, one nutrient can be substituted for another because of their interrelationship. Proteins, carbohydrates, and fats contribute to anabolism and catabolism (buildup and breakdown) of products, but glucose is not converted to fatty acids or amino acids. Rather, fatty acids and some amino acids can be converted to glucose.

DIF: Recall REF: p. 126 OBJ: 3

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Symptoms of hypoglycemia do NOT include:

a.

weakness.

b.

light-headedness.

c.

flushed color.

d.

rapid, shallow breathing.

e.

confusion.

ANS: C

During hypoglycemia, the patient’s coloring fades and is pale. It is also possible for the patient to have no symptoms but have low blood glucose levels.

DIF: Recall REF: p. 127 OBJ: 3

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Metabolic rate is lowest:

a.

after a few hours of sleep.

b.

immediately upon waking.

c.

after 5 to 6 hours of deep sleep.

d.

during the first few moments after falling asleep.

ANS: A

Metabolic rate is lowest after a few hours of sleep because muscles are more relaxed. Approximately 10% less energy is needed for the basal metabolic rate during this relaxed state.

DIF: Recall REF: p. 128 OBJ: 4

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. During which period of life is the basal metabolic rate (BMR) the highest?

a.

The neonatal period

b.

Birth through 2 years of age

c.

During the first 2 to 3 months of puberty

d.

During the early geriatric years

ANS: B

From birth through age 2 years, growth results in the highest BMR. This rate then decreases until the puberty growth spurt and is followed by a gradual decline for the rest of the life cycle.

DIF: Recall REF: p. 128 OBJ: 4

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. During the last trimester of pregnancy, the BMR increases approximately 15% to 30%. The amount of energy necessary to produce milk for lactation can increase the BMR 40%.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: A

Both statements are true. Basal metabolic rate indicates the energy required for involuntary physiologic functions to maintain life. Lactation requires extra energy, which is reflected in a higher BMR. A naturally higher BMR is why pregnant women do not feel as cold as adults under the same weather conditions.

DIF: Recall REF: p. 128 OBJ: 4

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Thyroxine, produced by the thyroid gland, has a greater influence on the basal metabolic rate (BMR) than secretions from any other gland. The pituitary gland accounts for a 15% to 20% increase in the BMR during growth of children and adolescents.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: A

Both statements are true. The iodine-containing hormone thyroxine has a greater influence on the rate of metabolic processes than secretions from any other gland. Adrenal glands affect metabolism to a lesser degree. The pituitary gland accounts for about a 15% to 20% increase in the BMR during growth of children and adults.

DIF: Recall REF: p. 128 OBJ: 4

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Many patients gain weight after age 25 because the BMR decreases and previous eating habits are maintained without increasing activity.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: A

Both statements are true. BMR is highest from birth through age 2 years. It decreases until the puberty growth spurt then is followed by a gradual decline for the rest of the life cycle. At age 25 not only is the BMR becoming lower, but also many young adults no longer have the time for physical exercise.

DIF: Recall REF: p. 129 OBJ: 4 | 5

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Which individual would be expected to have the highest basal metabolic rate (BMR)?

a.

One who is sleeping

b.

One who is breastfeeding

c.

One who is undernourished

d.

One who is chronically fasting

e.

One who is sedentary

ANS: B

A breastfeeding individual would likely have the highest basal metabolic rate. The amount of energy necessary to produce milk for lactation can increase the BMR by 40%.

DIF: Comprehension REF: p. 128 OBJ: 4

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Hunger, also known as appetite, is the physiologic drive to eat. Energy balance is maintained when the kilocalorie intake is within 10% of energy needed for body processes and physical activities.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: B

Both statements are false. Although hunger and appetite are frequently used interchangeably, the terms have different meanings. Hunger is the physiologic drive to eat, whereas appetite is the desire to eat. Appetite usually implies desire for specific types of food and is related to the pleasurable sensation of eating. Energy balance is maintained only when the kilocalorie intake equals the amount of energy needed for body processes.

DIF: Recall REF: p. 129 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. The thalamus gland, located in the center of the brain, is important in controlling huger because it contains both a satiety and hunger center.

a.

Both the statement and the reason are correct and related.

b.

Both the statement and the reason are correct but are not related.

c.

The statement is correct, but the reason is not correct.

d.

The statement is not correct, but the reason is correct.

e.

Neither the statement nor the reason is correct.

ANS: E

Neither the statement nor the reason is correct. It is the hypothalamus gland, located in the center of the brain, that is important in controlling hunger because it contains both a satiety and hunger center. The hunger center is also called the feeding center.

DIF: Comprehension REF: p. 131 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Stimulation of the satiety center results in a craving for food. If the satiety center of the hypothalamus becomes destroyed, the appetite becomes voracious, resulting in obesity.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: D

The first statement is false; the second is true. Stimulation of the satiety center results in complete satiety. This is different from damage or destruction to the satiety center, which increases the appetite. Destruction of the satiety center can occur with a head injury or stroke and results in a voracious appetite with ensuing appetite.

DIF: Recall REF: p. 131 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Many have hypothesized that the use of noncaloric sweeteners can result in increased caloric intake. More research is needed to determine the effect of noncaloric sweeteners on appetite.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: A

Both statements are true. There is concern that the use of noncaloric sweeteners interferes with the body’s ability to gauge intake by discerning food characteristics. More research is needed to ascertain the relationship between appetite and noncaloric sweeteners.

DIF: Recall REF: p. 136 OBJ: 7

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Each mechanism affects the amount eaten at a particular meal, except one. Which is the exception?

a.

Distention of the stomach

b.

Release of cholecystokinin

c.

Fat within the esophagus

d.

Secretion of glucagon

e.

Secretion of insulin

ANS: C

Several mechanisms affect the amount eaten at a particular meal. Fat within the duodenum, not esophagus, has a strong direct effect on the feeding center. The release of cholecystokinin occurs due to the presence of fat within the duodenum and causes the person to stop eating. Distention of the stomach results in inhibitory signals that suppress the feeding center, reducing the desire to eat. Food in the stomach and duodenum causes secretion of glucagon and insulin, both of which suppress the feeding center.

DIF: Recall REF: p. 131 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. The relationship between exercise and food intake is unclear. Generally, acute exercise increases food intake after the activity, whereas regular exercise decreases food intake.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: C

The first statement is true; the second is false. Although the relationship between exercise and food intake is unclear, acute exercise generally decreases food intake, whereas regular exercise promotes increased energy intake. These findings may be related to timing or duration of the exercise or individual metabolic differences.

DIF: Recall REF: p. 131 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Which is NOT true of energy expenditure as it relates to control of weight?

a.

Obese women have a similar or higher metabolic rate than thinner women do.

b.

Activity level seems to be a principal determinant in the development of obesity.

c.

Weight loss from a specific energy deficit is usually predictable.

d.

Adjustments in energy expenditure seem to be adaptive.

ANS: C

Weight loss from a specific energy deficit, such as surgery or an illness, is invariably smaller than expected. Conversely, overconsumption fails to produce the anticipated weight gains. These statements validate the theory that maintaining energy balance at an appropriate body weight is very complex. The consensus is that adjustments in energy expenditure seem to adaptive.

DIF: Comprehension REF: p. 132 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Dental hygienists should counsel patients on weight control when they recommend that a patient quit smoking because this is within the scope-of-practice.

a.

Both the statement and the reason are correct and related.

b.

Both the statement and the reason are correct but are not related.

c.

The statement is correct, but the reason is not correct.

d.

The statement is not correct, but the reason is correct.

e.

Neither the statement nor the reason is correct.

ANS: E

Neither the statement nor the reason is correct. Counseling patients about weight control is outside the scope-of-practice for dental hygienists. Quitting smoking is linked to weight gain, and it is appropriate for hygienists to encourage patients who smoke to enroll in smoking cessation along with a weight loss program. Patients should be referred to a registered dietitian for weight loss counseling.

DIF: Recall REF: p. 132 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Psychologic disorders such as anorexia nervosa can become life threatening because a lack of perception of one’s undernourishment causes a vicious downward spiral of metabolic imbalances.

a.

Both the statement and the reason are correct and related.

b.

Both the statement and the reason are correct but are not related.

c.

The statement is correct, but the reason is not correct.

d.

The statement is not correct, but the reason is correct.

e.

Neither the statement nor the reason is correct.

ANS: A

Both the statement and the reason are correct and related. This statement and reason may sound dramatic, but both are absolutely true. Inadequate energy intake can result in malnutrition and can become a serious problem during a physiologically stressful situation. Note that the extreme metabolic imbalance decreases hunger, which further exacerbates an already life-threatening situation.

DIF: Comprehension REF: p. 132 OBJ: 7

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Which is NOT a consideration for patients with altered energy intake?

a.

Depression and stress often result in overeating and decreased activity.

b.

A positive energy balance is desirable during periods of growth.

c.

It is a myth that a larger amount of energy is needed by pregnant or lactating women.

d.

When nutrient stores decrease, the feeding center of the hypothalamus becomes active.

ANS: C

Pregnancy and lactation are situations requiring a positive energy balance; that is, a proportionately larger amount of energy is needed during pregnancy and lactation.

DIF: Recall REF: p. 132 OBJ: 6

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Each recommendation is appropriate for counseling patients with diabetes mellitus, except one. Which is the exception?

a.

In obese patients, modest weight loss can improve insulin resistance.

b.

High-protein diets help adherence to weight loss programs.

c.

The use of glycemic index and load is more beneficial than carbohydrate considerations only.

d.

Moderate alcohol consumption has no acute effect on glucose and insulin concentrations.

e.

Carbohydrate ingested with alcohol can increase blood glucose.

ANS: B

High-protein diets are not recommended as a method for weight loss. The long-term effect of protein intake greater than 20% of calories is unknown. Such diets can produce short-term weight loss and improved glycemia, but effects on kidney function are unknown.

DIF: Comprehension REF: p. 136, Table 7.5

OBJ: 7 TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Each is a symptom of type 1 diabetes mellitus, except one. Which is the exception?

a.

Polydipsia

b.

Polyphagia

c.

Polyuria

d.

Ketoacidosis

e.

Weight gain

ANS: E

Weight gain is a classic symptom of type 2 diabetes, whereas weight in type 1 tends to be more normal. However, in type 1 frequently weight loss occurs, but it is also possible for obesity to occur. Note that polydipsia means increased thirst; polyphagia means increased appetite; and polyuria means the need to urinate frequently.

DIF: Comprehension REF: p. 135, Table 7.3

OBJ: 7 TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Type 1 diabetes is also referred to as juvenile diabetes because adults do not develop this disease.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: C

The first statement is true; the second is false. Although many people still refer to type 1 diabetes as juvenile diabetes, this terminology is incorrect because adults can develop type 1 diabetes.

DIF: Recall REF: p. 133 OBJ: 7

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Approximately 90% to 95% of Americans with diabetes have type 1 diabetes mellitus. This form of the disease results from insulin resistance.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: B

Both statements are false. Type 2 diabetes is far more common that type 1. Almost 90% to 95% of Americans with diabetes have type 2 diabetes. Type 2 diabetes results from insulin resistance, usually with a relative insulin deficiency. Unlike type 1 diabetes, onset of type 2 is gradual and can take years. Onset of type 1 is sudden; however, it may develop slowly in adults.

DIF: Recall REF: p. 133 OBJ: 7

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. Each is true of type 2 diabetes, except one. Which is the exception?

a.

Body mass index greater than 27 kg/m2 is a risk factor.

b.

Obesity and sedentary lifestyle are risk factors.

c.

Increased fat stores cause some degree of insulin resistance.

d.

Inadequate insulin is a major cause.

ANS: D

In type 2 diabetes, insulin production is often adequate or higher than normal. Regardless of adequate amounts of available insulin, the mechanism of glucose uptake by the cells (except the brain) is decreased. This results in insufficient insulin for use by the cells. With type 1 diabetes, insulin production is decreased or absent altogether.

DIF: Recall REF: p. 133 OBJ: 7

TOP: NBDHE, 3.0 Biochemistry and Nutrition

  1. The main manifestation of type 2 diabetes is:

a.

hyperglycemia.

b.

hypoglycemia.

c.

ketoacidosis.

d.

insulin resistance.

ANS: A

Hyperglycemia, or high blood glucose, is the main manifestation of type 2 diabetes. Its symptoms include thirst, frequent urination, hunger, blurry vision, fatigue, frequent infections, and dry itchy skin. The patient can also be asymptomatic. Hypoglycemia literally means “low blood sugar.” Ketoacidosis is a serious and potentially fatal condition associated with type 1 diabetes. Insulin resistance is a major cause of type 2 diabetes.

DIF: Recall REF: p. 133 OBJ: 7

TOP: NBDHE, 3.0 Biochemistry and Nutrition

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