A4M 2026 EXAM (300+ QUESTIONS) – A4M001
ENDOCRINOLOGY, CARDIOLOGY & NEUROLOGY
Q&A – AMERICAN ACADEMY OF ANTI-AGING
MEDICINE
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
Lewy body dementia
What is mechanism for brain injury from concussion?
- 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
ENDOCRINOLOGY, CARDIOLOGY & NEUROLOGY
Q&A – AMERICAN ACADEMY OF ANTI-AGING
MEDICINE
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
Lewy body dementia
What is mechanism for brain injury from concussion?
- 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
