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A4M WRITTEN EXAM QUESTIONS AND ANSWERS
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A4M WRITTEN EXAM QUESTIONS AND ANSWERS
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A4M WRITTEN EXAM QUESTIONS AND ANSWERSMechanism of action of curcumin Supplement whose mechanism includes decreasing
tau phosphorylation and reducing COX-2 expression. - Answers-Curcumin is an inhibitor
of phosphorylase kinase. It decreases tau phosphorylation; reduces COX-2 expression;
inhibits NF-kB.
Stimulates neutrophils and macrophages to kill microorganism. Nontoxic and does not
cause microbial resistance. Useful for treatment of intracellular organisms. - Answers-
Olive leaf extract
Rate of secretion of PSA from prostate / day? - Answers-0.07 ng / mL
Mineral responsible for increasing renal intra-glomerular pressure and decreasing
arterial compliance - Answers-Sodium
How much does potassium decrease BP? - Answers-Supplementing potassium 60-120
mEG day may decrease SBP / DBP by 4/2.5 mm HG
Actions of Magnesium on BP: are - Answers-- Acts as a calcium channel blocker
- Regulates insulin sensitivity
- Regulates pH
- Increases arterial compliance via endothelial vasodilatation
T or F: omega-6 fatty acids decrease blood pressure - Answers-False (although may
indirectly affect BP through effects on saturated fatty acids)
Recommended intake of calcium to reduce HTN - Answers-> 800 mg / day may reduce
incidence of HTN
T or F: soy protein decreases blood pressure and increases arterial compliance -
Answers-True; recommended in fermented form; 30-40 gm / day for hypertensive
individuals
T or F: omega-9 fatty acids found in olive oil have beneficial effects on both blood
pressure and cholesterol - Answers-True
Effects of garlic on HTN - Answers-garlic acts as a natural ACE-I, CCB and increases
arterial compliance via increase of NO production
T or F: The gamma isomer of Vitamin E is more potent than the alpha isomer in lipid
lowering effects - Answers-True
,Most potent B vitamin; lowers blood pressure via multiple mechanisms - Answers-
Vitamin B6. Increases bioavailability of coA and decreases cholesterol synthesis. Also
reduces oxLDL. Increases HDL, reduces LDL and triglycerides.
T or F: There is strong evidence for Guggul in treatment of cholesterol - Answers-False
T or F: Niacin is the most effective currently known agent for increasing HDL - Answers-
True
Which infectious agents have been linked to development of MS plaques in brain? -
Answers-Mycoplasma pneumoniae and EBV
T or F: 20% of MS patients have been shown to have gluten sensitivity - Answers-True
pharmaceutical / nutriceutical agents have been shown to be helpful in treatment of
MS? - Answers-Alpha lipoic acid; minocycline; doxycycline; memantine; NAC; Vitamin
What B12; phosphatidyl serine; Coenzyme Q10; HRT with estrogen / estriol; hyperbaric
oxygen therapy
Which areas of the brain are affected in a SPECT scan of a patient with Alzheimer's
disease? - Answers-Posterior cingulate gyrus; parietal and temporal lobes
What area of the brain is affected in a SPECT scan of a patient with Lewy Body
dementia? - Answers-Occipital lobe
T or F: IGG to periodontal bacteria is elevated in patients with dementia - Answers-True
What abnormalities are found in the brain on autopsy of patients with Alzheimer's
disease? - Answers-Beta-amyloid plaque and neuro-fibrillary tangles. Neurofibrillary
tangles are formed from mutations on tau protein. Beta-amyloid plaques are formed
from breakdown of APP (amyloid precursor protein). Beta amyloid causes destruction in
brain parenchyma by combining with salt and water in the brain. It also causes influx of
calcium into neurons, leading to apoptosis.
Type of dementia associated with protein deposits known as alpha-synuclein; visual
hallucinations; low dopamine levels - Answers-Lewy body dementia
What is mechanism for brain injury from concussion? - Answers-- Excitotoxic reaction
mediated by increased extracellular glutamate / aspartate and increased intracellular
calcium
- Microglia (normally dormant) become activated and release ROS; inflammatory
prostaglandins; cytokines and chemokines
- High levels of extracellular glutamate reduce astrocytic glutathione
, Type of dementia most commonly caused by abnormalities on tau protein.
Characterized by uninhibited behavior, primary aphasia, lack of insight - Answers-
Frontal Lobe Dementia
What area of the adrenal gland are the sex hormones produced? - Answers-Zona
reticularis
Where is aldosterone produced in adrenal gland? - Answers-Zona granulosa (outer
layer)
What are the risk factors for sub-arachnoid hemorrhage (rupture of cerebral aneurysm)?
- Answers-Hypertension; smoking; oral contraceptive usage; usage of stimulants
What is the mechanism of action of migraine headache? - Answers-Extreme cerebral
vasoconstriction followed by vaso-dilatation
Which neuro-transmitter deficiencies have been implicated in the development of
migraine headaches? - Answers-GABA and serotonin
T or F: thymectomy is recommended for treatment of myasthenia gravis - Answers-
False; current evidence does not support thymus removal due to risks of surgery and
lack of evidence; however, 70% of patients with myasthenia gravis have thymus
hypertrophy and 10-15% have thymomas. IVIG may be helpful for management of
myasthenia gravis.
T or F: many of the pharmacologic treatment options for demential increase
homocysteine levels, which may directly contribute to cognitive decline - Answers-T
T or F: consumption of milk > 16 oz / day over a 30 year time period leads to a 230%
increased risk of Alzheimer's disease - Answers-T
T or F: both Curcumin and Resveratrol cross the BBB and are helpful in treatment of
both TBI and dementia - Answers-True. Resveratrol improves beta amyloid clearance
from brain.
How many genes do humans have? - Answers-Humans have 23,000 genes - only 1.5%
of which code for proteins
Which estrogen metabolite is protective against breast and ovarian cancer? - Answers-2
methoxy estrone
T or F: High blood insulin levels inhibit the conversion of saturated fatty acids to
MUFA's, leading to elevated blood triglycerides - Answers-True
What is the first sign of pancreatic insufficiency? - Answers-Deficiency in pancreatic
lipase or elastase.
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