UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
DURATION: 3 HOURS
TOTAL MARKS: 170
______________________________________________________________________________
External Examiner: Ms C Biggs
Internal Examiner: Mrs K Pillay
______________________________________________________________________________
NOTE: THIS EXAM PAPER CONSISTS OF FOUR (4) PAGES PLUS A MULTIPLE
CHOICE QUESTIONNAIRE (MCQ) ANSWER BOOKLET (7 PAGES), WHICH MUST
BE HANDED IN. PLEASE MAKE SURE THAT YOU HAVE ALL PAGES.
PLEASE ANSWER SECTIONS A, B AND C.
______________________________________________________________________________
SECTION A
QUESTION 1 – MULTIPLE CHOICE QUESTIONS
See separate booklet
(30 MARKS)
SECTION B
SHORT QUESTIONS
(100 MARKS)
PLEASE ANSWER ALL OF THE QUESTIONS BELOW AND START EACH
QUESTION ON A NEW PAGE
QUESTION 2
“The Recommended Dietary Allowances (RDA) were first published in 1943 and have now been
replaced by the Dietary Reference Intakes (DRIs)”.
2.1
Explain why the DRIs have replaced the original RDAs.
[5]
2.2
Explain what the DRIs are and give a detailed explanation of each of the nutrient based
reference values that make up the DRIs.
[15]
TOTAL = 20 MARKS
QUESTION 3
3.1
Discuss the stability of vitamin E.
[5]
3.2
List three (3) common forms of calcium supplements and give the amount of calcium
found in each form.
[1X3=3]
3.3
List ten (10) factors that can affect the absorption of vitamin B12.
1
[1 X 10=10]
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
3.4
What are the consequences of inadequate maternal intake of iodine
during pregnancy?
[2]
TOTAL = 20 MARKS
QUESTION 4
4.1
Outline the process by which 1,25 dihydroxy vitamin D3 is able to regulate blood calcium
levels in the body.
[8]
4.2
Give a detailed explanation of how the visual cycle occurs.
4.3
Explain why athletes may require riboflavin in amounts higher than the Recommended
Dietary Allowance (RDA).
[2]
[10]
TOTAL = 20 MARKS
QUESTION 5
5.1
Explain the difference between a single blind study and a double blind study.
[4]
5.2
List five (5) limitations of using the diet history method of dietary assessment.
[1 X 5 = 5]
5.3
Explain what is meant by somatotyping and discuss the three body types.
5.4
List the two (2) enzymes that require molybdenum for optimal functioning. [2 X ½ =1]
[10]
TOTAL = 20 MARKS
QUESTION 6
6.1
Define the “Scientific Method of Enquiry” and outline the steps involved in the correct
sequence.
[4½]
6.2
Outline the biochemical findings of the South African National Nutrition Survey Study
(SANNSS) of 1995.
[6]
6.3
Explain how a household survey can be used to measure food intake.
6.4
Explain the difference between haemochromatosis and haemosiderosis.
[2½]
[7]
TOTAL = 20 MARKS
2
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
SECTION C
CASE STUDY
40 MARKS
QUESTION 7
PLEASE READ THE FOLLOWING CASE STUDY AND ANSWER ALL THE QUESTIONS
THAT FOLLOW
Miss S is 42 years old and works as a cleaner at a local school. She weighs 89 kg and is 1.61m
tall. She has been complaining of weakness, fatigue and shortness of breath on exertion.
Clinically she appears pale but is otherwise well.
Her biochemical results are as follows:
Haemoglobin (Hb)
Haematocrit (Hct)
Red Blood Cells (RBC)
10 g/dl
32%
2.5 X 10 12/ L
(12.3-17 g/dl)
(36-50%)
(4-5.7 X 1012/ L)
A diet history was obtained from Miss S and revealed the following:
Breakfast (6:30 am)
2 slices brown bread
2 teaspoons margarine
1 cup tea (no milk)
2 teaspoons white sugar
Snack (9:30 am)
1 cup tea (no milk)
2 teaspoons white sugar
1 small apple
Lunch (12:30 pm)
2 cups cooked white rice
2 cups boiled cabbage
1 cup tea (no milk)
2 teaspoons white sugar
2 Romany Creams
Snack (3:30 pm)
1 cup tea (no milk)
2 teaspoons white sugar
1 packet Simba chips (30g)
Supper (8:00 pm)
2 cups cooked samp
1 cup cooked sugar beans
3
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
1 cup cooked carrots
1 cup tea (no milk)
2 teaspoons white sugar
A dietary prescription was formulated for Miss S and her nutritional requirements are as follows:
Energy = 6300 kJ
Carbohydrate = 204 g
Protein = 56 g
Fat = 50 g
7.1
Using the information provided carry out a complete nutritional assessment on Miss S
and draw a conclusion regarding her overall nutritional status.
[10]
7.2
What practical dietary advice can you offer to Miss S in order to improve her current
condition?
[10]
7.3
Using the information provided complete a diet plan for Miss S using the exchange
system.
[14]
Please make use of the following exchanges only:
 Low fat milk
 Starch
 Medium fat meat
 Vegetable
 Fruit
 Fat
 Sugar
7.4
A follow up blood test found that Miss S has low calcium levels and she has been
prescribed both an iron and a calcium supplement (calcium carbonate) to take orally.
Advise her on when and how she should take these supplements.
[6]
TOTAL = 40 MARKS
END OF SECTION C
4
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
STUDENT NUMBER: ______________________
SECTION A:
MULTIPLE CHOICE QUESTIONS
(1 X 30 = 30 MARKS)
QUESTION 1
Indicate your answer to each question by placing a circle over the appropriate letter.
Mark allocation as follows:
0 marks of no answer is given
1 mark for each correct answer
- ½ mark for each incorrect answer
Vitamins (1 X 10)
1.
Which of the following statements on vitamins is false?
A.
B.
C.
D.
2.
____ is an important component of Co-enzyme A which is needed for metabolism of
carbohydrate, fat and protein.
A.
B.
C.
D.
3.
Many fat soluble vitamins require protein carriers for transport in the blood.
Fat soluble vitamins are more likely to reach toxic levels when consumed from
supplements.
Fat soluble vitamins are required in frequent doses of every 1-3 days.
Fat soluble vitamins are absorbed directly into the blood.
Vitamin B6
Niacin
Pantothenic acid
Biotin
The conversion of carotenoids to the retinoid form is dependent on the _____ enzyme.
A.
B.
C.
D.
Hydroxylase
Dioxygenase
Catalse
Carboxylase
5
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
4.
Which of the following is not a function of vitamin B6?
A.
B.
C.
D.
5.
A deficiency of ____ is unlikely to result in high levels of homocysteine.
A.
B.
C.
D.
6.
200 000 IU
150 000 IU
100 000 IU
50 000 IU
All of the following are non-essential vitamins, except:
A.
B.
D.
C.
8.
Niacin
Folate
Vitamin B6
Vitamin B12
What dose of vitamin A is given to infants (6-11 months) as part of the Preventive
Supplementation Protocol?
A.
B.
C.
D.
7.
Participates in the conversion of tryptophan to niacin.
Facilitates the conversion of linolenic acid to arachidonic acid.
Required for the production of hydrochloric acid.
Synthesis of key neurotransmitters.
Biotin
Folate
Niacin
Vitamin K
Which vitamin is also known as the anti-scorbutic vitamin?
A.
B.
C.
D.
Vitamin E
Folate
Riboflavin
Vitamin C
6
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
9.
Which of the following statements on vitamin E is false?
A.
B.
C.
D.
10.
The structure of alpha tocopherol was established by Fernholz in 1938
Vitamin E is needed for the maintenance of nervous tissue and iron metabolism
Megadoses of vitamin E can interfere with blood clotting action
Vitamin E acts as a redox agent, donating an electron to oxidising agents and thus
becomes reduced
Pteroglutamic acid is an alternative name for:
A.
B.
C.
D.
Pantothenic acid
Folic acid
Pyridoxine
Biotin
Minerals (1 X 10)
11.
The greatest amount of insensible losses of water takes place via the ___?
A.
B.
C.
D.
12.
A deficiency of phosphorus could also contribute to _____.
A.
B.
C.
D.
13.
Faeces
Urine
Lungs
Skin
Microcytic, hypochromic anaemia
Pernicious anaemia
Haemolytic anaemia
Megaloblastic anaemia
Which of the following is a function of zinc?
A.
B.
C.
D.
Important for the storage, release and function of insulin
Part of enzymes that synthesise norepinephrine and dopamine
Needed for the formation and maintenance of myelin
Important for blood clotting and bone development
7
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
14.
All of the following are known to enhance calcium absorption, except?
A.
B.
C.
D.
15.
Which of the following statements on Type 1 (postmenopausal) osteoporosis is true?
A.
B.
C.
D.
16.
Affects women aged 50 to 70 years and involve both cortical and trabecular
bone
Affects women 70 years and older and involved trabecular bone only
Affects women 70 years and older and involves trabecular bone only
Affects women 50 to 70 years old and involves trabecular bone only
Wilson’s disease is a genetic condition in which there is an accumulation of _____ in the
liver, brain, kidney and cornea.
A.
B.
C.
D.
17.
Lactose
Pregnancy
Oxalic acid
Stomach acid
Iron
Copper
Zinc
Selenium
Which of the following statements on iron is incorrect?
A.
B.
C.
D.
Absorption from food is approximately 10-20% in iron deficient individuals
Consumption of haem iron and non-haem iron together increases the absorption
of haem iron
Ferrous iron is better absorbed than ferric iron
Consumption of pica is a potential cause of iron deficiency anaemia
8
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
18.
Which is the major intracellular cation?
A.
B.
C.
D.
19.
Which of the following minerals hardens and stabilises the crystals of teeth and makes
the enamel resistant to decay?
A.
B.
C.
D.
20.
Potassium
Sodium
Phosphorus
Chloride
Calcium
Phosphorus
Fluoride
Chloride
Which of the following is not a trace mineral?
A.
B.
C.
D.
Fluoride
Iodide
Manganese
Chloride
Nutritional assessment (1 X 5)
21.
Which dietary intake assessment method would provide information on the trends of food
consumption in a country?
A.
B
C.
D.
22.
Food balance sheets
24 hour recall
Food frequency questionnaire
Diet history
Which of the following statements on weight is false?
A.
B.
C.
D.
It is best to carry out a weight measurement in the morning after voiding
Weight can be influenced by genetics and the environment
Weight indicates current nutritional status and recent nutritional intake
Weight is the sum of lean tissue, bone and fat
9
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
23.
Which of the following statements on biochemical assessment is incorrect?
A.
B.
C.
D.
24.
Which of the following increases disease risk?
A.
B.
C.
D.
25.
Biochemical assessment information is compared to standard values
Biochemical assessment tells us about the body’s chemistry
All biochemical values reflect short tern nutritional status only
Biochemical tests can be repeated for confirmation of results
BMI of 22.4kg/m2
Waist: Hip ratio < 0.8 in women
Android obesity
Waist: Hip ratio < 1 in men
A child with a low weight for height can be considered to be:
A.
B.
C.
D.
Wasted
Overweight
Stunted
Underweight
Nutrition in South Africa (1 X 5)
26.
According to the South African National Nutrition Survey Study (SANNSS) of 1995,
which statement on macronutrient intake in Black South African adults is false?
A.
B.
C.
D.
27.
Rural Blacks obtained ⅔ of their protein from plant sources
Rural Blacks had the highest intake of carbohydrates
Rural Blacks had the highest intake of sugar
Rural Blacks had a fat intake of < 30%
According to the SAVACG Study of 1994, the number of children in South Africa with
marginal vitamin A status was:
A.
B.
C.
D.
1 in 3
1 in 5
1 in 10
1 in 4
10
UNIVERSITY OF KWAZULU-NATAL
SCHOOL OF AGRICULTURAL SCIENCES & AGRIBUSINESS
DISCIPLINE OF DIETETICS & HUMAN NUTRITION
SUPPLEMENTARY EXAMINATION: JUNE 2011
SUBJECT, COURSE & CODE: NUTRITION 224,
MICRONUTRIENTS, NUTRITIONAL ASSESSMENT, P1
28.
According to the National Food Consumption Survey (NFCS) of 1999, which were the
most commonly consumed food items?
A.
B.
C.
D.
29.
According to the NFCS Fortification Baseline 2005, the number of women with a poor
vitamin A status was:
A.
B.
C.
D.
30.
Maize, white sugar, meat and beans
Maize, white sugar, tea, whole milk and brown bread
Maize, white sugar, tea, whole milk, and rice
Maize, white sugar, fish and brown bread
1 in 2
1 in 3
1 in 4
1 in 5
According to the NFCS Fortification Baseline 2005, the number of children with a
poor iron status was:
A.
B.
C.
D.
1 in 3
1 in 5
1 in 4
1 in 7
END OF MULTIPLE CHOICE QUESTIONS
11