A4M Written Exam Solved Questions with
Correct Answers
Mechanism of action of curcumin Supplement whose mechanism includes decreasing
tau phosphorylation and reducing COX-2 expression.
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.
Olive leaf extract
Rate of secretion of PSA from prostate / day?
0.07 ng / mL
Mineral responsible for increasing renal intra-glomerular pressure and decreasing
arterial compliance
Sodium
How much does potassium decrease BP?
Supplementing potassium 60-120 mEG day may decrease SBP / DBP by 4/2.5 mm HG
Actions of Magnesium on BP: are
- 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
,False (although may indirectly affect BP through effects on saturated fatty acids)
Recommended intake of calcium to reduce HTN
> 800 mg / day may reduce incidence of HTN
T or F: soy protein decreases blood pressure and increases arterial compliance
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
True
Effects of garlic on HTN
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
True
Most potent B vitamin; lowers blood pressure via multiple mechanisms
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
False
T or F: Niacin is the most effective currently known agent for increasing HDL
True
,Which infectious agents have been linked to development of MS plaques in brain?
Mycoplasma pneumoniae and EBV
T or F: 20% of MS patients have been shown to have gluten sensitivity
True
What pharmaceutical / nutriceutical agents have been shown to be helpful in treatment
of MS?
Alpha lipoic acid; minocycline; doxycycline; memantine; NAC; Vitamin B12; phosphatidyl
serine; Coenzyme Q10; HRT with estrogen / estriol; hyperbaric oxygen therapy
What are the risk factors for sub-arachnoid hemorrhage (rupture of cerebral
aneurysm)?
Hypertension; smoking; oral contraceptive usage; usage of stimulants
What is the mechanism of action of migraine headache?
Extreme cerebral vasoconstriction followed by vaso-dilatation
Which neuro-transmitter deficiencies have been implicated in the development of
migraine headaches?
GABA and serotonin
T or F: thymectomy is recommended for treatment of myasthenia gravis
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
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
T
Which areas of the brain are affected in a SPECT scan of a patient with Alzheimer's
disease?
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?
Occipital lobe
T or F: IGG to periodontal bacteria is elevated in patients with dementia
True
What abnormalities are found in the brain on autopsy of patients with Alzheimer's
disease?
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
Correct Answers
Mechanism of action of curcumin Supplement whose mechanism includes decreasing
tau phosphorylation and reducing COX-2 expression.
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.
Olive leaf extract
Rate of secretion of PSA from prostate / day?
0.07 ng / mL
Mineral responsible for increasing renal intra-glomerular pressure and decreasing
arterial compliance
Sodium
How much does potassium decrease BP?
Supplementing potassium 60-120 mEG day may decrease SBP / DBP by 4/2.5 mm HG
Actions of Magnesium on BP: are
- 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
,False (although may indirectly affect BP through effects on saturated fatty acids)
Recommended intake of calcium to reduce HTN
> 800 mg / day may reduce incidence of HTN
T or F: soy protein decreases blood pressure and increases arterial compliance
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
True
Effects of garlic on HTN
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
True
Most potent B vitamin; lowers blood pressure via multiple mechanisms
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
False
T or F: Niacin is the most effective currently known agent for increasing HDL
True
,Which infectious agents have been linked to development of MS plaques in brain?
Mycoplasma pneumoniae and EBV
T or F: 20% of MS patients have been shown to have gluten sensitivity
True
What pharmaceutical / nutriceutical agents have been shown to be helpful in treatment
of MS?
Alpha lipoic acid; minocycline; doxycycline; memantine; NAC; Vitamin B12; phosphatidyl
serine; Coenzyme Q10; HRT with estrogen / estriol; hyperbaric oxygen therapy
What are the risk factors for sub-arachnoid hemorrhage (rupture of cerebral
aneurysm)?
Hypertension; smoking; oral contraceptive usage; usage of stimulants
What is the mechanism of action of migraine headache?
Extreme cerebral vasoconstriction followed by vaso-dilatation
Which neuro-transmitter deficiencies have been implicated in the development of
migraine headaches?
GABA and serotonin
T or F: thymectomy is recommended for treatment of myasthenia gravis
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
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
T
Which areas of the brain are affected in a SPECT scan of a patient with Alzheimer's
disease?
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?
Occipital lobe
T or F: IGG to periodontal bacteria is elevated in patients with dementia
True
What abnormalities are found in the brain on autopsy of patients with Alzheimer's
disease?
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
