Nutrition and Metabolism

Nutrition and Metabolism Indian Medical PG Question 1: What is the fasting blood glucose level that confirms a diagnosis of diabetes mellitus?

• A. >200
• B. <100
• C. ≥126 (Correct Answer)
• D. 101-125

Nutrition and Metabolism Explanation: ≥126 - A fasting plasma glucose (FPG) level of ≥126 mg/dL on two separate occasions is a diagnostic criterion for diabetes mellitus [1]. - This threshold indicates persistent hyperglycemia beyond what is considered normal. <100 - A fasting plasma glucose level <100 mg/dL is considered normal and does not indicate diabetes or prediabetes [1]. - This range reflects healthy glucose regulation in the body. 101-125 - A fasting plasma glucose level between 100-125 mg/dL indicates prediabetes or impaired fasting glucose (IFG) [1]. - While not diabetes, it signifies an increased risk for developing type 2 diabetes. >200 - A random plasma glucose (RPG) level >200 mg/dL with classic symptoms of diabetes (e.g., polyuria, polydipsia, unexplained weight loss) can confirm diabetes [1]. - However, for a fasting blood glucose alone to confirm diabetes, it needs to be ≥126 mg/dL, and a level >200 mg/dL would be an even more severe manifestation.

Nutrition and Metabolism Indian Medical PG Question 2: A destitute woman is admitted to the hospital with altered sensorium and dehydration; urine analysis shows mild proteinuria and no sugar; which test would be most appropriate to perform next to assess for possible ketosis?

• A. Rothera's test (for ketone bodies) (Correct Answer)
• B. Hays test (for bile salts)
• C. Fouchet's test (for bile pigments)
• D. Benedict's test (for reducing sugars)

Nutrition and Metabolism Explanation: ***Rothera's test (for ketone bodies)*** - The patient's presentation with **altered sensorium** and **dehydration**, along with absent glycosuria, strongly suggests conditions like starvation ketosis or alcoholic ketoacidosis, making a test for ketones essential. - **Rothera's test** specifically detects **acetoacetate and acetone**, key indicators of ketosis, which are important in diagnosing metabolic emergencies. *Fouchet's test (for bile pigments)* - This test is used to detect **bile pigments (bilirubin)** in urine, indicating **jaundice** or liver dysfunction. - The patient's symptoms do not specifically point towards a need for bile pigment detection. *Hays test (for bile salts)* - **Hays test** uses sulfur powder to detect **bile salts** in urine as a floating test. - Bile salts in urine suggest cholestasis or obstructive jaundice, which is not indicated by the current clinical presentation. *Benedict's test (for reducing sugars)* - **Benedict's test** is used to detect **reducing sugars** (like glucose) in urine. - The urine analysis already reported **no sugar**, making this test redundant for the current clinical context.

Nutrition and Metabolism Indian Medical PG Question 3: Which of the following will be target population for screening of diabetes?

• A. People over 40 years of age
• B. People with family history of diabetes
• C. Women who have had a baby weighing more than 4·5 kg
• D. All of the options (Correct Answer)

Nutrition and Metabolism Explanation: ***All of the options*** - All listed groups—**people over 40 years of age**, **individuals with a family history of diabetes**, and **women who have had a baby weighing more than 4.5 kg**—are considered high-risk populations for developing diabetes. - Screening these groups is a **cost-effective strategy** to identify diabetes early, allowing for timely intervention and prevention of complications. *People over 40 years of age* - **Age** is a significant risk factor for type 2 diabetes, with incidence progressively increasing after 40 due to decreased insulin sensitivity. - Routine screening is recommended by guidelines for adults in this age group, regardless of other risk factors. *People with family history of diabetes* - A **genetic predisposition** plays a crucial role in the development of type 2 diabetes, making a family history a strong indicator for increased risk. - Screening is essential for these individuals to detect the condition early, even if they are otherwise asymptomatic. *Women who have had a baby weighing more than 4·5 kg* - Delivering a **large-for-gestational-age infant** (macrosomia) is a strong indicator of prior **gestational diabetes (GDM)**, even if not formally diagnosed at the time. - Women with a history of GDM have a significantly increased risk of developing type 2 diabetes later in life.

Nutrition and Metabolism Indian Medical PG Question 4: Which of the following metabolic pathways in carbohydrate metabolism is required for the synthesis of nucleic acids?

• A. Gluconeogenesis
• B. Glycolysis
• C. HMP shunt (Correct Answer)
• D. Glycogenesis

Nutrition and Metabolism Explanation: ***HMP shunt*** - The **hexose monophosphate (HMP) shunt**, also known as the **pentose phosphate pathway**, is crucial for producing **ribose-5-phosphate**. - **Ribose-5-phosphate** is a direct precursor for the synthesis of **nucleotides** and subsequently **nucleic acids** (DNA and RNA). *Gluconeogenesis* - This pathway is responsible for the synthesis of **glucose from non-carbohydrate precursors**, primarily to maintain blood glucose levels during fasting. - It does not directly produce components needed for nucleic acid synthesis. *Glycolysis* - **Glycolysis** is the metabolic pathway that breaks down **glucose into pyruvate**, generating ATP. - While it produces intermediates, it is not directly involved in creating the specific pentose sugars required for nucleic acids. *Glycogenesis* - **Glycogenesis** is the process of synthesizing **glycogen from glucose** for storage in the liver and muscles. - This pathway is focused on glucose storage and has no direct role in nucleic acid synthesis.

Nutrition and Metabolism Indian Medical PG Question 5: Calcified canal is explored with all of the given instruments except:

• A. 10 K file (Correct Answer)
• B. 6 K file
• C. C+ file
• D. Profinder

Nutrition and Metabolism Explanation: ***10 K file*** - **#10 K-files** are typically used for initial negotiation of **larger, more accessible canals**, not for exploring highly calcified or severely constricted canals. - Their larger diameter (0.10 mm) makes them too stiff and prone to ledge formation or perforation in extremely calcified areas. *6 K file* - **#6 K-files** are extremely small and flexible (0.06 mm in diameter), making them ideal for initial penetration through tight, calcified canal orifices. - Their fine tip and flexibility help in navigating complex anatomy and overcoming initial resistance without causing iatrogenic damage. *C+ file* - **C+ files** are specifically designed for calcified or severely curved canals due to their **stiffer shaft, non-cutting tip**, and improved resistance to buckling. - They are offered in multiple diameters, including very small sizes like 06 and 08, which are suitable for initial exploration of challenging canal anatomy. *Profinder* - **ProFinder files** are specialized stainless steel hand files with a **triangular cross-section** and non-cutting tip, designed for initial negotiation of difficult and calcified canals. - Their enhanced tip design and shaft stiffness facilitate easy insertion into tight orifices and help maintain the canal pathway.

Nutrition and Metabolism Flashcard 1 of 5

Question: Each cycle of MMC consists of _____ phases

Answer: 3

Nutrition and Metabolism Flashcard 2 of 5

Question: Correct sequence of specific dynamic values (SDA) of proteins _____ lipids > carbohydrates.

Answer: >

Nutrition and Metabolism Flashcard 3 of 5

Question: _____ score is the best indicator of protein quality*calculated by?

Answer: Digestible indispensable amino acid

Nutrition and Metabolism Flashcard 4 of 5

Question: _____ deficiency presents with hypercholesterolemia and weight loss

Answer: Manganese

Nutrition and Metabolism Flashcard 5 of 5

Question: Starter F75 has 75 kcal and _____ g protein per 100 mL

Answer: 0.9