Block 6 GI Vitam & Mineral MCQ's
- 1.Which of the following is true of the vitamin niacin? It:
- A.
Functions primarily in the form of thiamin pyrophosphate.
- B.
Is converted to the coenzymes FAD and FMN.
- C.
Can be synthesized from tryptophan
- D.
Is an essential component of coenzyme A
- E.
Is the prosthetic group for a number of carboxylation reactions
- 2.Which vitamin participates as a coenzyme in the carboxylation of Acetyl-CoA to malonyl-CoA?
- A.
Niacin
- B.
Riboflavin
- C.
Thiamin
- D.
Pyridoxine
- E.
Biotin
- 3.The DRI of Vitamin A for an 18a old I is: EAR 625pg/d, RDA 900pg/d and UL 2800pg/d. A patient of that group taking on average 950pg/d will suffer from symptoms of
- A.
Poisoning with a probability of about 50%.
- B.
Poisoning with a probability of about 2%.
- C.
Deficiency with a probability of about 2%.
- D.
Deficiency with a probability of about 98%.
- E.
Deficiency with a probability of about 50%.
- 4.In 1860 the explorers Burke, Gray, King and Wills star1ed on an expedition to cross Australia for the first time in South-North direction. On their return journey they ran short of food and had to supplement their diet with local fresh-water mussels (Velesunio ambiguus). After a few weeks on this diet they fell ill. They were suffering from a weakness which made it difficult and painful to get up or walk, tachycardia, confusion, convulsions, vomiting, emaciation. Gray, Burke and Wills died, the only survivor, King, never recovered from a peripheral neuropathy. The explorers were suffering from
- A.
Beri-beri
- B.
Pellagra
- C.
Scurvy
- D.
Rickets
- E.
Pernicious anemia
- 5.A 47a old male comes to the emergency room with bleeding gums, hemarthrosis (blood collection) in the right knee, and hematemesis (vomiting blood). He is homeless, admits being drunk at least 5 times a week. His diet mainly consists of leftovers from fast food restaurants. Medical history: Food poisoning treated with ampicillin 2 weeks ago. Physical exam: emaciated, with poor hygiene, ecchymosis (large patches of bleeding into skin). Lab: Hb 9.7mg/d1. Normal platelet count, fibrinogen and thrombin time. PT and PTT prolonged. The patient needs supplementation with
- A.
Vitamin A
- B.
Vitamin K
- C.
Vitamin C
- D.
Copper
- E.
Iron
- 6.Your patient is a 5a old girl, X.Y., brought by her mother into your family practice because of itchy and scaly skin. The child also complains about constant headaches and nausea, chronic fatigue and bone pain. PE reveals patches of alopecia and a moderately enlarged liver. X-ray shows bone demineralization and premature closure of epiphyses. Upon questioning the mother states that as her daughter was not putting on weight she has been giving her cod liver oil 3 times a day for the past 9mo. The most likely diagnosis is
- A.
Vitamin A poisoning
- B.
Vitamin A deficiency
- C.
Vitamin K poisoning
- D.
Vitamin K deficiency
- E.
Vitamin D deficiency
- 7.You are working in an inner-city polyclinic run by a charity. One of your patient is A. B., a 18mo old boy brought in by his mother (17-year old single parent) because of poor growth, delayed development of dentition and general weakness. Physical exam reveals bowing of legs, soft occipital and parietal bones with elastic recoil and enlargement of costochondral junctions. Serum analysis demonstrates reduced calcium and phosphate concentrations. Upon questioning the mother states that as she cannot afford much meats and dairy products, the boy is fed mainly with starchy vegetables. Because of the insecure neighborhood the boy spends most of his time indoors. The boy needs supplementation with
- A.
Vitamin A
- B.
Vitamin B complex
- C.
Vitamin C
- D.
Vitamin D
- E.
Vitamin E
- 8.Pernicious anemia in an elderly patient is most often due to:
- A.
Lack of intrinsic factor
- B.
Lack of folate in the diet
- C.
Lack of thiamin in the diet
- D.
Deficiency in methionine
- E.
Lack of B12 in the diet
- 9.Thiamin deficiency, which is common in alcoholics, slows the TCA cycle by decreasing the activity of a-ketoglutarate dehydrogenase. This deficiency also decreases the activity of another mitochondrial enzyme resulting in the build- up of pyruvate and a resulting lactic acidosis. The enzyme is:
- A.
Pyruvate carboxylase
- B.
Pyruvate kinase
- C.
Citrate synthetase
- D.
Pyruvate dehydrogenase
- E.
Pyruvate decarboxylase
- 10.The Food and Drug Administration recommends that food be fortified with folic acid to reduce the incidence of birth defects such as spina bifida. A folic acid derivative is required for which of the following eukaryotic processes?
- A.
Carboxylation of acetyl CoA to malonyl CoA
- B.
Activation of methionine to form S-adenosylmethionine
- C.
Absorption and uptake of vitamin B12
- D.
Transamination reactions of amino acids.
- E.
Thymidine synthesis
- 11.Cecelia is a 45 year - old woman, who has received long term oral antibiotic therapy for a severe infection. As a result, she presents with an elevated prothrombin time (PT). Based on this history, what vitamin deficiency is the most likely cause of the elevated PT?
- A.
Thiamin deficiency
- B.
Vitamin B12
- C.
Vitamin C
- D.
Vitamin K
- E.
Vitamin A
- 12.Lawrence is a 75 year - old man, who had a partial gastrectomy 15 years ago. He now presents with tingling and loss of sensation in his legs, and other signs of peripheral neuropathy Biochemical tests reveal a megaloblastic anemia. Based on his history, his symptoms are most likely secondary to malabsorption of which of the following vitamins?
- A.
B12
- B.
Folate
- C.
Vitamin C
- D.
Vitamin A
- E.
Vitamin K
- 13.Joseph is a 55 year old man with pellagra, characterized by dementia, diarrhea and dermatitis. Which of the following vitamin deficiencies result in pellagra?
- A.
Riboflavin
- B.
Niacin
- C.
Vitamin K
- D.
Vitamin B12
- E.
Vitamin E
- 14.Tim is s 52 year old man with a long-standing history of alcohol abuse, who comes to see his primary care physician because he has been losing balance lately. His wife related to the doctor that his memory is getting worse. Based on the patient's report what is the most likely Vitamin or mineral deficiency that would explain these symptoms?
- A.
Vitamin D
- B.
Calcium
- C.
Vitamin A
- D.
Vitamin C
- E.
Thiamine
- 15.When vitamin B12 is deficient, pernicious anemia results from the:
- A.
Lack of N5, N10-methylenetetrahydrofolate
- B.
Accumulation of S-adenosylmethionine
- C.
Lack of methionine
- D.
Lack of 5-adenosylmethionine
- E.
Accumulation of homocysteine
- 16.The synthesis of a number of neurotransmitters involves decarboxylation of amino acids. The enzymes that carry out these reactions often utilize which of the following cofactors?
- A.
Biotin
- B.
Thiamine
- C.
Tetrahydrofolate
- D.
Vitamin K
- E.
Pyridoxal phosphate
- 17.A 75 year old man who presents to the Harlsbro Medical Center with significant peripheral neuropathy. His past medical history is significant for total gastrectomy, performed when he was in his forties, after which he was never placed on vitamin supplements. He rarely drinks alcohol. Mr. Jones' neuropathy is most likely secondary to absorption of which of the following vitamins?
- A.
Folate
- B.
Vitamin A
- C.
Pyridoxine (B6)
- D.
Vitamin B12
- 18.In the absorption of vitamins and minerals, the rule is that water-soluble vitamins do not need pre-absorption chemical digestion, but do need specific apical transporters for absorption, and vice versa for fat soluble vitamins. What one vitamin is the exception to this rule?
- A.
Cobalamin
- B.
Vitamin D
- C.
Vitamin A
- D.
Folate
- E.
Vitamin K
- F.
Niacin
- 19.Tom Jones is a 52 yr old man with a long-standing history of alcohol abuse, who comes to see his Primary Care Physician because he has been losing his balance lately. He is accompanied by his wife, who adds that his memory also seems to be getting worse. Based on this patient's report, what is the most likely vitamin or mineral deficiency that would explain those symptoms.
- A.
Vitamin D
- B.
Thiamine
- C.
Calcium
- D.
Vitamin A
- E.
Iron
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