A4M ACTUAL EXAMS ANSWERS AND QUESTIONS
SET A+
✔✔BMI definition of obesity - ✔✔BMI > or equal to 30
✔✔T or F: Administering pregnenolone to a person in sympathetic overdrive may
increase cortisol production - ✔✔T
✔✔What can be done to mitigate oxidation of fatty acids when administering omega-3
FA to a person with an APOE4/4 genotype? - ✔✔Add 50% GLA to omega-3 FA dose +
1/10 dosage mixed tocopherols + 200 mg mixed tocotrienols
✔✔What agents help to decrease homocysteine? - ✔✔Fish oil; coenzyme Q10; B
vitamins; methylfolate; TMG
✔✔What agents help to decrease Lp (a)? - ✔✔niacin, vitamin C, proline, lysine. also
focus on diet - reduce CHO, increase good fats
✔✔How can hs-CRP be reduced? - ✔✔Fish oil; omega-3 FA; statin, B-blocker,
Coenzyme Q10; green tea; daily ASA
✔✔What are the contraindications to replacement with growth hormone? -
✔✔Malignancy, proliferative retinopathy
✔✔Examples of ways to reduce elevated DHT in men - ✔✔Saw palmetto, progesterone
1% cream
✔✔What is the ideal level of 2:16 OHE? - ✔✔> 4.0
✔✔What percentage of circulating lymphocytes are comprised of B cells? - ✔✔5-15%
✔✔Role of IL-1 in tumorigenesis - ✔✔Promotes angiogenesis, tumor growth and
metastases
,✔✔T or F: short term exposure to particulate matter in air is associated with increased
risk of stroke - ✔✔T
✔✔What is the mechanism of action of carnosine? - ✔✔Carnosine is an amino acid
found in red meat that helps reduce glycation. It has antioxidant properties and helps
lower BP via effects on sympathetic nervous system. Carnosine also protects against
ischemia / reperfusion injury after a stroke by reducing toxicity of the excitatory
neurotransmitter glutamate
✔✔How do SERMS affect lipid profile? - ✔✔SERMS such as Tamoxifen and Raloxifene
decrease total cholesterol by 5% and LDL by 10%. They are not effective in lowering
triglycerides and do not increase HDL s well as standard HRT.
✔✔What are the effects of estrogen on neurotransmitter balance? - ✔✔Estrogen
increases serotonin availability and enhances dopamine and NE transmission
✔✔Adverse effects of Tamoxifen therapy - ✔✔May double or triple the risk of uterine
cancer and also increases risk of blood clots.
✔✔What is Raloxifene and what are its adverse side effects? - ✔✔Raloxifene is a
SERM used to treat osteoporosis. It may increase bone density up to 20% but also
increases risk of breast CA.
✔✔T or F: low levels of DHEA are often associated with hypothyroidism - ✔✔T
✔✔What role does Vitamin A play in immune system regulation? - ✔✔Vitamin A
supports phagocytosis by macrophages and neutrophils. It is involved in both innate
and cell-mediated immunity. Also helps with TH1 - TH2 response.
✔✔What is mechanism of action for cell death initiated by neutrophils? - ✔✔Neutrophils
induce cell death via NADPH oxidase which releases superoxide. Superoxide reacts
with NO to produce peroxynitrite, a potent ROS.
✔✔What is TNF-alpha? - ✔✔TNF-alpha is the cell death pathway. It initiates apoptosis
via activation of NF-kappa B. It has both pro and anti-tumorigenic effects in animal
models.
✔✔What is IL-6? - ✔✔IL-6 is a messenger cytokine that activates B cells and promotes
their maturation. Increases acute phase reactants such as CRP, ferritin and fibrinogen.
Plays important role in heart disease and also has signaling implicated in tumorigenesis.
, ✔✔What is the function of T helper cells? - ✔✔T helper cells respond to APC
expressing MHC class II Ag to augment a cytokine response. Induces IFN-gamma and
IL-2, a T cell growth factor. IL-2 also activates cytotoxic T cells (CD8).
✔✔How is estradiol produced in body? - ✔✔Estradiol is produced by aromatization of T
in ovary and other tissues or by 17 hydroxylation of estrone in periphery.
✔✔What is the function of the parietal lobe in the brain? - ✔✔Proprioception, visual
guidance, differentiate right from left, reading maps
✔✔What are the functions of the frontal lobe of the brain? - ✔✔Judgement; impulse
control, attention span; critical thinking; empathy (things that make us HUMAN)
✔✔What is the function of the temporal lobe of the brain? - ✔✔Hearing, listening, short
& long term memory, mood stability, naming things
✔✔What is the function of the occipital lobe of the brain? - ✔✔The occipital lobe is the
visual processing center of the mammalian brain containing most of the anatomical
region of the visual cortex.
✔✔What enzyme of the body does Metformin act on? - ✔✔Metformin acts on AMP
kinase, which increases ATP production and deploys GLUT4, leading to increased
glucose uptake
✔✔Symptoms observed with temporal lobe dysfunction - ✔✔memory issues; reading
issues; word finding issues, poor visual recognition
✔✔Symptoms observed with parietal lobe dysfunction - ✔✔left / right confusion; denial
of illness; neglect or unawareness; impaired position sense
✔✔T or F: Metformin may help to lower incidence of cancer in diabetic patients - ✔✔T.
Metformin increases activity of AMPK which exerts effects on tumor suppression p53
and also inhibits aromatase expression in breast tissue. Metformin has been shown to
lower pancreatic CA risk by 62% and studies have also shown decreased incidence of
breast CA in diabetics treated with Metformin vs. other agents.
✔✔What are the 4 mechanisms of action of Metformin? - ✔✔1) decreases glucose
absorption from the gut
2) inhibits hepatic gluconeogenesis
3) Increases sensitivity and # of insulin receptors
4) increases fatty acid oxidation
✔✔T or F: statins aid in DNA repair. - ✔✔T
SET A+
✔✔BMI definition of obesity - ✔✔BMI > or equal to 30
✔✔T or F: Administering pregnenolone to a person in sympathetic overdrive may
increase cortisol production - ✔✔T
✔✔What can be done to mitigate oxidation of fatty acids when administering omega-3
FA to a person with an APOE4/4 genotype? - ✔✔Add 50% GLA to omega-3 FA dose +
1/10 dosage mixed tocopherols + 200 mg mixed tocotrienols
✔✔What agents help to decrease homocysteine? - ✔✔Fish oil; coenzyme Q10; B
vitamins; methylfolate; TMG
✔✔What agents help to decrease Lp (a)? - ✔✔niacin, vitamin C, proline, lysine. also
focus on diet - reduce CHO, increase good fats
✔✔How can hs-CRP be reduced? - ✔✔Fish oil; omega-3 FA; statin, B-blocker,
Coenzyme Q10; green tea; daily ASA
✔✔What are the contraindications to replacement with growth hormone? -
✔✔Malignancy, proliferative retinopathy
✔✔Examples of ways to reduce elevated DHT in men - ✔✔Saw palmetto, progesterone
1% cream
✔✔What is the ideal level of 2:16 OHE? - ✔✔> 4.0
✔✔What percentage of circulating lymphocytes are comprised of B cells? - ✔✔5-15%
✔✔Role of IL-1 in tumorigenesis - ✔✔Promotes angiogenesis, tumor growth and
metastases
,✔✔T or F: short term exposure to particulate matter in air is associated with increased
risk of stroke - ✔✔T
✔✔What is the mechanism of action of carnosine? - ✔✔Carnosine is an amino acid
found in red meat that helps reduce glycation. It has antioxidant properties and helps
lower BP via effects on sympathetic nervous system. Carnosine also protects against
ischemia / reperfusion injury after a stroke by reducing toxicity of the excitatory
neurotransmitter glutamate
✔✔How do SERMS affect lipid profile? - ✔✔SERMS such as Tamoxifen and Raloxifene
decrease total cholesterol by 5% and LDL by 10%. They are not effective in lowering
triglycerides and do not increase HDL s well as standard HRT.
✔✔What are the effects of estrogen on neurotransmitter balance? - ✔✔Estrogen
increases serotonin availability and enhances dopamine and NE transmission
✔✔Adverse effects of Tamoxifen therapy - ✔✔May double or triple the risk of uterine
cancer and also increases risk of blood clots.
✔✔What is Raloxifene and what are its adverse side effects? - ✔✔Raloxifene is a
SERM used to treat osteoporosis. It may increase bone density up to 20% but also
increases risk of breast CA.
✔✔T or F: low levels of DHEA are often associated with hypothyroidism - ✔✔T
✔✔What role does Vitamin A play in immune system regulation? - ✔✔Vitamin A
supports phagocytosis by macrophages and neutrophils. It is involved in both innate
and cell-mediated immunity. Also helps with TH1 - TH2 response.
✔✔What is mechanism of action for cell death initiated by neutrophils? - ✔✔Neutrophils
induce cell death via NADPH oxidase which releases superoxide. Superoxide reacts
with NO to produce peroxynitrite, a potent ROS.
✔✔What is TNF-alpha? - ✔✔TNF-alpha is the cell death pathway. It initiates apoptosis
via activation of NF-kappa B. It has both pro and anti-tumorigenic effects in animal
models.
✔✔What is IL-6? - ✔✔IL-6 is a messenger cytokine that activates B cells and promotes
their maturation. Increases acute phase reactants such as CRP, ferritin and fibrinogen.
Plays important role in heart disease and also has signaling implicated in tumorigenesis.
, ✔✔What is the function of T helper cells? - ✔✔T helper cells respond to APC
expressing MHC class II Ag to augment a cytokine response. Induces IFN-gamma and
IL-2, a T cell growth factor. IL-2 also activates cytotoxic T cells (CD8).
✔✔How is estradiol produced in body? - ✔✔Estradiol is produced by aromatization of T
in ovary and other tissues or by 17 hydroxylation of estrone in periphery.
✔✔What is the function of the parietal lobe in the brain? - ✔✔Proprioception, visual
guidance, differentiate right from left, reading maps
✔✔What are the functions of the frontal lobe of the brain? - ✔✔Judgement; impulse
control, attention span; critical thinking; empathy (things that make us HUMAN)
✔✔What is the function of the temporal lobe of the brain? - ✔✔Hearing, listening, short
& long term memory, mood stability, naming things
✔✔What is the function of the occipital lobe of the brain? - ✔✔The occipital lobe is the
visual processing center of the mammalian brain containing most of the anatomical
region of the visual cortex.
✔✔What enzyme of the body does Metformin act on? - ✔✔Metformin acts on AMP
kinase, which increases ATP production and deploys GLUT4, leading to increased
glucose uptake
✔✔Symptoms observed with temporal lobe dysfunction - ✔✔memory issues; reading
issues; word finding issues, poor visual recognition
✔✔Symptoms observed with parietal lobe dysfunction - ✔✔left / right confusion; denial
of illness; neglect or unawareness; impaired position sense
✔✔T or F: Metformin may help to lower incidence of cancer in diabetic patients - ✔✔T.
Metformin increases activity of AMPK which exerts effects on tumor suppression p53
and also inhibits aromatase expression in breast tissue. Metformin has been shown to
lower pancreatic CA risk by 62% and studies have also shown decreased incidence of
breast CA in diabetics treated with Metformin vs. other agents.
✔✔What are the 4 mechanisms of action of Metformin? - ✔✔1) decreases glucose
absorption from the gut
2) inhibits hepatic gluconeogenesis
3) Increases sensitivity and # of insulin receptors
4) increases fatty acid oxidation
✔✔T or F: statins aid in DNA repair. - ✔✔T
