560I- Functional Medicine Comp UPDATED
Exam Questions and CORRECT Answers
Vitamin B6 deficiency causes elevated homocysteine by what mechanism? A.) Accelerating
the conversion of methionine to homocysteine B.) Blocking the transfer of methyl groups to
THF C.) Impairing the conversion of homocysteine to cysteine D.) Reducing the active form
of vitamin B12 Impairing the conversion of homocysteine to cysteine - CORRECT
ANSWER- C.) Impairing the conversion of homocysteine to cysteine
Finding elevated urinary alpha-ketoisocaproate and alpha-ketoisovalerate is an indication of
what essential nutrient deficiency?
A.) Coenzyme Q10
B.) Vitamin B1
C.) Vitamin B6
D.) Vitamin D - CORRECT ANSWER- B.) Vitamin B1
When serum lipid peroxides are elevated even though all serum antioxidant vitamins are in
their upper normal ranges, what other abnormality is likely to be present?
A.) High vitamin D
B.) High polyunsaturated fatty acids in plasma
C.) Low polyunsaturated fatty acids in plasma
D.) Low biotin - CORRECT ANSWER- B.) High polyunsaturated fatty acids in plasma
Which compound is measured as a laboratory test for vitamin K deficiency?
A.) Sepiapterin
B.) Undercarboxylated osteocalcin
C.) 7-Dehydrocholesterol
D.) Dehydroascorbic acid - CORRECT ANSWER- B.) Undercarboxylated osteocalcin
Assessment of vitamin D deficiency is done by measuring serum levels of what compound?
A.) 1,25-Dihydroxyvitamin D
B.) Calcitriol
,C.) 25-Hydroxyvitamin D
D.) Previtamin D3 - CORRECT ANSWER- C.) 25-Hydroxyvitamin D
A patient can have normal serum vitamin B12, but still show elevated urinary
methylmalonate because
A. Methylmalonate causes anemia from folic acid deficiency.
B.) The folate trap prevents proper methylation.
C.) Methylmalonate metabolism requires intra-cellular activity of vitamin B12.
D.) Vitamin B12 promotes the formation of methylmalonate. - CORRECT ANSWER- C.)
Methylmalonate metabolism requires intra-cellular activity of vitamin B12.
Which of the following is NOT a folate deficiency sign?
A.) Plasma homocysteine elevation
B.) Neutrophyl hypersegmentation
C.) Urinary xanthurenic acid elevation
D.) Urinary formiminoglutamate elevation - CORRECT ANSWER- C.) Urinary xanthurenic
acid elevation
Which vitamin insufficiencies are indicated by elevated branched chain keto acids in urine?
A.) Antioxidants
B.) Ascorbates
C.) B-complex
D.) Cholecalciferols - CORRECT ANSWER- C.) B-Complex
Why is it incorrect to speak of a "folic acid" deficiency?
A.) Folic acid is not related to tetrahydrofolate
B.) Folic acid is not an essential nutrient
C.) Human tissues can synthesize folic acid
D.) Folic acid is highly toxic - CORRECT ANSWER- B.) Folic acid is not an essential
nutrient
Vitamin B6 deficiency causes elevated homocysteine by what mechanism?
,A.) Accelerating the conversion of methionine to homocysteine
B.) Blocking the transfer of methyl groups to THF
C.) Impairing the conversion of homocysteine to cysteine
D.) Reducing the active form of vitamin B12 - CORRECT ANSWER- C.) Impairing the
conversion of homocysteine to cysteine
What does the abbreviation BH4 represent?
A.) A part of vitamin B12 structure
B.) A catabolic product of vitamin B6
C.) Tetrahydrobiopterin
D.) A test for B-complex vitamin deficiency - CORRECT ANSWER- C.) Tetrahydrobiopterin
Which of the following is NOT useful for assessing iron status?
A.) Transferrin saturation
B.) Hair iron concentration
C.) Serum ferritin
D.) Total iron binding capacity - CORRECT ANSWER- Hair iron concentration
A patient with chronic negative calcium balance is expected to have elevated calcium in
which specimen type?
A.) Erythrocytes
B.) Whole blood
C.) Unchallenged 24 hr urine
D.) Head hair - CORRECT ANSWER- D.) Head hair
What organ failure most directly causes multiple low essential trace elements to be found in
blood or urine?
A.) Stomach
B.) Kidney
C.) Liver
D.) Pancreas - CORRECT ANSWER- A.) Stomach
, A DMSA provocation test would usually be done to assess what problem?
A.) Trace element loss due to renal retention deficit
B.) Toxic element exposure
C.) Hypothyroidism due to iodine malabsorption
D.) Bone loss due to calcium deficiency - CORRECT ANSWER- B.) Toxic element exposure
When very low erythrocyte magnesium is found, the patient is likely to have what other type
of insufficiency?
A.) Selenium
B.) Iron
C.) Glutathione
D.) Vitamin C - CORRECT ANSWER- C.) Glutathione
Which of the following is not considered to be a highly toxic element?
A.) Arsenic
B.) Mercury
C.) Boron
D.) Lead - CORRECT ANSWER- C.) Boron
Which of the following is a good test for copper excess?
A.) RBC Cu
B.) Urinary copper
C.) Low serum copper to ceruloplasmin ratio
D.) Urinary HVA/VMA ratio - CORRECT ANSWER- B.) Urinary Copper
The action of what hormone is reduced in chromium deficiency?
A.) Insulin
B.) Testosterone
C.) Thyroxine
D.) Glucagon - CORRECT ANSWER- A.) Insulin
Exam Questions and CORRECT Answers
Vitamin B6 deficiency causes elevated homocysteine by what mechanism? A.) Accelerating
the conversion of methionine to homocysteine B.) Blocking the transfer of methyl groups to
THF C.) Impairing the conversion of homocysteine to cysteine D.) Reducing the active form
of vitamin B12 Impairing the conversion of homocysteine to cysteine - CORRECT
ANSWER- C.) Impairing the conversion of homocysteine to cysteine
Finding elevated urinary alpha-ketoisocaproate and alpha-ketoisovalerate is an indication of
what essential nutrient deficiency?
A.) Coenzyme Q10
B.) Vitamin B1
C.) Vitamin B6
D.) Vitamin D - CORRECT ANSWER- B.) Vitamin B1
When serum lipid peroxides are elevated even though all serum antioxidant vitamins are in
their upper normal ranges, what other abnormality is likely to be present?
A.) High vitamin D
B.) High polyunsaturated fatty acids in plasma
C.) Low polyunsaturated fatty acids in plasma
D.) Low biotin - CORRECT ANSWER- B.) High polyunsaturated fatty acids in plasma
Which compound is measured as a laboratory test for vitamin K deficiency?
A.) Sepiapterin
B.) Undercarboxylated osteocalcin
C.) 7-Dehydrocholesterol
D.) Dehydroascorbic acid - CORRECT ANSWER- B.) Undercarboxylated osteocalcin
Assessment of vitamin D deficiency is done by measuring serum levels of what compound?
A.) 1,25-Dihydroxyvitamin D
B.) Calcitriol
,C.) 25-Hydroxyvitamin D
D.) Previtamin D3 - CORRECT ANSWER- C.) 25-Hydroxyvitamin D
A patient can have normal serum vitamin B12, but still show elevated urinary
methylmalonate because
A. Methylmalonate causes anemia from folic acid deficiency.
B.) The folate trap prevents proper methylation.
C.) Methylmalonate metabolism requires intra-cellular activity of vitamin B12.
D.) Vitamin B12 promotes the formation of methylmalonate. - CORRECT ANSWER- C.)
Methylmalonate metabolism requires intra-cellular activity of vitamin B12.
Which of the following is NOT a folate deficiency sign?
A.) Plasma homocysteine elevation
B.) Neutrophyl hypersegmentation
C.) Urinary xanthurenic acid elevation
D.) Urinary formiminoglutamate elevation - CORRECT ANSWER- C.) Urinary xanthurenic
acid elevation
Which vitamin insufficiencies are indicated by elevated branched chain keto acids in urine?
A.) Antioxidants
B.) Ascorbates
C.) B-complex
D.) Cholecalciferols - CORRECT ANSWER- C.) B-Complex
Why is it incorrect to speak of a "folic acid" deficiency?
A.) Folic acid is not related to tetrahydrofolate
B.) Folic acid is not an essential nutrient
C.) Human tissues can synthesize folic acid
D.) Folic acid is highly toxic - CORRECT ANSWER- B.) Folic acid is not an essential
nutrient
Vitamin B6 deficiency causes elevated homocysteine by what mechanism?
,A.) Accelerating the conversion of methionine to homocysteine
B.) Blocking the transfer of methyl groups to THF
C.) Impairing the conversion of homocysteine to cysteine
D.) Reducing the active form of vitamin B12 - CORRECT ANSWER- C.) Impairing the
conversion of homocysteine to cysteine
What does the abbreviation BH4 represent?
A.) A part of vitamin B12 structure
B.) A catabolic product of vitamin B6
C.) Tetrahydrobiopterin
D.) A test for B-complex vitamin deficiency - CORRECT ANSWER- C.) Tetrahydrobiopterin
Which of the following is NOT useful for assessing iron status?
A.) Transferrin saturation
B.) Hair iron concentration
C.) Serum ferritin
D.) Total iron binding capacity - CORRECT ANSWER- Hair iron concentration
A patient with chronic negative calcium balance is expected to have elevated calcium in
which specimen type?
A.) Erythrocytes
B.) Whole blood
C.) Unchallenged 24 hr urine
D.) Head hair - CORRECT ANSWER- D.) Head hair
What organ failure most directly causes multiple low essential trace elements to be found in
blood or urine?
A.) Stomach
B.) Kidney
C.) Liver
D.) Pancreas - CORRECT ANSWER- A.) Stomach
, A DMSA provocation test would usually be done to assess what problem?
A.) Trace element loss due to renal retention deficit
B.) Toxic element exposure
C.) Hypothyroidism due to iodine malabsorption
D.) Bone loss due to calcium deficiency - CORRECT ANSWER- B.) Toxic element exposure
When very low erythrocyte magnesium is found, the patient is likely to have what other type
of insufficiency?
A.) Selenium
B.) Iron
C.) Glutathione
D.) Vitamin C - CORRECT ANSWER- C.) Glutathione
Which of the following is not considered to be a highly toxic element?
A.) Arsenic
B.) Mercury
C.) Boron
D.) Lead - CORRECT ANSWER- C.) Boron
Which of the following is a good test for copper excess?
A.) RBC Cu
B.) Urinary copper
C.) Low serum copper to ceruloplasmin ratio
D.) Urinary HVA/VMA ratio - CORRECT ANSWER- B.) Urinary Copper
The action of what hormone is reduced in chromium deficiency?
A.) Insulin
B.) Testosterone
C.) Thyroxine
D.) Glucagon - CORRECT ANSWER- A.) Insulin
