A4M WRITTEN EXAM QUESTIONS AND
ANSWERS
Mechanism of action of curcumin Supplement whose mechanism includes decreasing
tau phosphorylation and reducing COX-2 expression. - Correct 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. - Correct
Answers -Olive leaf extract
Rate of secretion of PSA from prostate / day? - Correct Answers -0.07 ng / mL
Mineral responsible for increasing renal intra-glomerular pressure and decreasing
arterial compliance - Correct Answers -Sodium
How much does potassium decrease BP? - Correct Answers -Supplementing potassium
60-120 mEG day may decrease SBP / DBP by 4/2.5 mm HG
Actions of Magnesium on BP: are - Correct 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 - Correct Answers -False
(although may indirectly affect BP through effects on saturated fatty acids)
Recommended intake of calcium to reduce HTN - Correct Answers -> 800 mg / day may
reduce incidence of HTN
T or F: soy protein decreases blood pressure and increases arterial compliance -
Correct 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 - Correct Answers -True
Effects of garlic on HTN - Correct 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 - Correct Answers -True
Most potent B vitamin; lowers blood pressure via multiple mechanisms - Correct
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 - Correct
Answers -False
T or F: Niacin is the most effective currently known agent for increasing HDL - Correct
Answers -True
Which infectious agents have been linked to development of MS plaques in brain? -
Correct Answers -Mycoplasma pneumoniae and EBV
T or F: 20% of MS patients have been shown to have gluten sensitivity - Correct
Answers -True
What pharmaceutical / nutriceutical agents have been shown to be helpful in treatment
of MS? - Correct Answers -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)?
- Correct Answers -Hypertension; smoking; oral contraceptive usage; usage of
stimulants
What is the mechanism of action of migraine headache? - Correct Answers -Extreme
cerebral vasoconstriction followed by vaso-dilatation
Which neuro-transmitter deficiencies have been implicated in the development of
migraine headaches? - Correct Answers -GABA and serotonin
T or F: thymectomy is recommended for treatment of myasthenia gravis - Correct
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 - Correct
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 - Correct Answers -T
, Which areas of the brain are affected in a SPECT scan of a patient with Alzheimer's
disease? - Correct 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? - Correct Answers -Occipital lobe
T or F: IGG to periodontal bacteria is elevated in patients with dementia - Correct
Answers -True
What abnormalities are found in the brain on autopsy of patients with Alzheimer's
disease? - Correct 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 - Correct Answers -Lewy body dementia
What is mechanism for brain injury from concussion? - Correct 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 - Correct
Answers -Frontal Lobe Dementia
What area of the adrenal gland are the sex hormones produced? - Correct Answers -
Zona reticularis
Where is aldosterone produced in adrenal gland? - Correct Answers -Zona granulosa
(outer layer)
T or F: both Curcumin and Resveratrol cross the BBB and are helpful in treatment of
both TBI and dementia - Correct Answers -True. Resveratrol improves beta amyloid
clearance from brain.
How many genes do humans have? - Correct Answers -Humans have 23,000 genes -
only 1.5% of which code for proteins
Which estrogen metabolite is protective against breast and ovarian cancer? - Correct
Answers -2 methoxy estrone
ANSWERS
Mechanism of action of curcumin Supplement whose mechanism includes decreasing
tau phosphorylation and reducing COX-2 expression. - Correct 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. - Correct
Answers -Olive leaf extract
Rate of secretion of PSA from prostate / day? - Correct Answers -0.07 ng / mL
Mineral responsible for increasing renal intra-glomerular pressure and decreasing
arterial compliance - Correct Answers -Sodium
How much does potassium decrease BP? - Correct Answers -Supplementing potassium
60-120 mEG day may decrease SBP / DBP by 4/2.5 mm HG
Actions of Magnesium on BP: are - Correct 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 - Correct Answers -False
(although may indirectly affect BP through effects on saturated fatty acids)
Recommended intake of calcium to reduce HTN - Correct Answers -> 800 mg / day may
reduce incidence of HTN
T or F: soy protein decreases blood pressure and increases arterial compliance -
Correct 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 - Correct Answers -True
Effects of garlic on HTN - Correct 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 - Correct Answers -True
Most potent B vitamin; lowers blood pressure via multiple mechanisms - Correct
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 - Correct
Answers -False
T or F: Niacin is the most effective currently known agent for increasing HDL - Correct
Answers -True
Which infectious agents have been linked to development of MS plaques in brain? -
Correct Answers -Mycoplasma pneumoniae and EBV
T or F: 20% of MS patients have been shown to have gluten sensitivity - Correct
Answers -True
What pharmaceutical / nutriceutical agents have been shown to be helpful in treatment
of MS? - Correct Answers -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)?
- Correct Answers -Hypertension; smoking; oral contraceptive usage; usage of
stimulants
What is the mechanism of action of migraine headache? - Correct Answers -Extreme
cerebral vasoconstriction followed by vaso-dilatation
Which neuro-transmitter deficiencies have been implicated in the development of
migraine headaches? - Correct Answers -GABA and serotonin
T or F: thymectomy is recommended for treatment of myasthenia gravis - Correct
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 - Correct
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 - Correct Answers -T
, Which areas of the brain are affected in a SPECT scan of a patient with Alzheimer's
disease? - Correct 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? - Correct Answers -Occipital lobe
T or F: IGG to periodontal bacteria is elevated in patients with dementia - Correct
Answers -True
What abnormalities are found in the brain on autopsy of patients with Alzheimer's
disease? - Correct 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 - Correct Answers -Lewy body dementia
What is mechanism for brain injury from concussion? - Correct 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 - Correct
Answers -Frontal Lobe Dementia
What area of the adrenal gland are the sex hormones produced? - Correct Answers -
Zona reticularis
Where is aldosterone produced in adrenal gland? - Correct Answers -Zona granulosa
(outer layer)
T or F: both Curcumin and Resveratrol cross the BBB and are helpful in treatment of
both TBI and dementia - Correct Answers -True. Resveratrol improves beta amyloid
clearance from brain.
How many genes do humans have? - Correct Answers -Humans have 23,000 genes -
only 1.5% of which code for proteins
Which estrogen metabolite is protective against breast and ovarian cancer? - Correct
Answers -2 methoxy estrone
