[MCQ] The Metabolic Syndrome

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The Metabolic Syndrome

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Question 1

The metabolic syndrome is also called ?

A	Syndrome M
B	Syndrome X
C	Syndrome Y
D	Syndrome Z

Question 1 Explanation:

The metabolic syndrome is also called syndrome X or insulin resistance syndrome.

Question 2

Metabolic syndrome increases the risk of ?

A	Hypertension
B	Diabetes mellitus
C	Stroke
D	All of the above

Question 2 Explanation:

Metabolic syndrome consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM).

Question 3

Major features of metabolic syndrome include all except ?

A	Central obesity
B	Hypertriglyceridemia
C	High low-density lipoprotein (LDL) cholesterol
D	Low high-density lipoprotein (HDL) cholesterol

Question 3 Explanation:

Five major features of the metabolic syndrome include central obesity, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, hyperglycemia, and hypertension.

Question 4

Which of the following about metabolic syndrome is false ?

A	Prevalence increases with age
B	Increases in waist circumference predominate in women
C	Fasting triglycerides >150 mg/dL more likely in women
D	Hypertension more likely in men

Question 5

Lipodystrophic disorder associated with the metabolic syndrome is ?

A	Berardinelli-Seip congenital lipodystrophy
B	Dunnigan familial partial lipodystrophy
C	HIV-related lipodystrophy in patients on HAART
D	All of the above

Question 6

Which of the following is central to the development of insulin resistance ?

A	Postprandial hyperinsulinemia
B	Fasting hyperinsulinemia
C	Hyperglycemia
D	Overabundance of circulating fatty acids

Question 6 Explanation:

Overabundance of circulating fatty acids

Question 7

Which of the statements is false ?

A	Insulin inhibits lipolysis in adipose tissue
B	Insulin inhibits lipolysis in adipose tissue
C	Lipolysis produces fatty acids
D	None of the above

Question 8

In the liver, free fatty acids (FFAs) result in ?

A	Increased production of glucose
B	Increased production of triglycerides
C	Increased secretion of very low density lipoprotein (VLDL)
D	All of the above

Question 8 Explanation:

In metabolic syndrome, free fatty acids (FFAs) are released in abundance from an expanded adipose tissue mass. In liver, FFAs result in an increased production of glucose and triglycerides and secretion of very low density lipoproteins (VLDLs).

Question 9

C-reactive protein (CRP) is produced in ?

A	Liver
B	Kidney
C	Pancreas
D	Lung

Question 9 Explanation:

C-reactive protein (CRP) is produced in liver

Question 10

Which of the following is an anti-inflammatory and insulin sensitizing cytokine ?

A	Interleukin 6 (IL-6)
B	Resistin
C	Adiponectin
D	Adiponectin

Question 10 Explanation:

Adiponectin is an anti-inflammatory cytokine produced exclusively by adipocytes. Reduced production of this insulin-sensitizing cytokine adiponectin is associated with the metabolic syndrome

Question 11

There is almost always a predominance of small dense LDLs when fasting serum triglyceride is ?

A	~ 100 mg/dL
B	~ 130 mg/dL
C	~ 150 mg/dL
D	~ 180 mg/dL

Question 11 Explanation:

There is almost always a predominance of more atherogenic small dense LDLs when fasting serum triglyceride is ~180 mg/dL. Small dense LDLs are toxic to endothelium and are able to pass through endothelial basement membrane & adhere to glycosaminoglycans.

Question 12

In the setting of insulin resistance, which of the following effect of insulin is lost ?

A	Increased activity of sympathetic nervous system
B	Sodium reabsorption in kidney
C	Vasodilatory
D	All of the above

Question 12 Explanation:

Under normal physiologic conditions, insulin is a vasodilator with secondary effects on sodium reabsorption in the kidney. In insulin resistance, vasodilatory effect of insulin is lost but the renal effect on sodium reabsorption is preserved. Insulin induced increases the activity of sympathetic nervous system is preserved in insulin resistance.

Question 13

Which of the following is a proinflammatory cytokine ?

A	IL-18
B	Resistin
C	C-reactive protein (CRP)
D	All of the above

Question 13 Explanation:

Proinflammatory cytokines include interleukin (IL)-1, IL-6, IL-18, resistin, tumor necrosis factor-  (TNF-) , and C-reactive protein (CRP)

Question 14

Levels of which of the following is reduced in the metabolic syndrome ?

A	Adiponectin
B	Resistin
C	C-reactive protein (CRP)
D	Interleukin-18

Question 14 Explanation:

Adiponectin is an anti-inflammatory cytokine that enhances insulin sensitivity. It is produced exclusively by adipocytes. In liver, it inhibits expression of gluconeogenic enzymes and rate of glucose production. In muscle, it increases glucose transport and enhances fatty acid oxidation, due to activation of adenosine monophosphate (AMP) kinase. Adiponectin is reduced in the metabolic syndrome.

Question 15

Which of the following is a physical finding in metabolic syndrome ?

A	Lentigo
B	Acanthosis nigricans
C	Café au lait macule
D	Ephelide (freckle)

Question 15 Explanation:

Lipoatrophy or acanthosis nigricans is a physical finding in metabolic syndrome

Question 16

Which of the following is associated with metabolic syndrome ?

A	Nonalcoholic steatohepatitis (NASH)
B	Polycystic ovarian disease (PCOS)
C	Polycystic ovarian disease (PCOS)
D	All of the above

Question 16 Explanation:

Apart from insulin resistance, other metabolic alterations specifically associated with metabolic syndrome include increases in apoB and apoC-III, uric acid, prothrombotic factors (fibrinogen, plasminogen activator inhibitor 1), serum viscosity, asymmetric dimethylarginine, homocysteine, white blood cell count, proinflammatory cytokines, CRP, microalbuminuria, nonalcoholic fatty liver disease (NAFLD) and/or nonalcoholic steatohepatitis (NASH), polycystic ovarian disease (PCOS), and obstructive sleep apnea (OSA).

Question 17

Which of the following is an endogenous inhibitor of nitric oxide synthase (eNOS) ?

A	Asymmetric dimethylarginine (ADMA)
B	Dimethyl sulfoxide
C	Phenylbenzimidazole sulfonic acid
D	Homosalate

Question 17 Explanation:

Endothelial NOS converts amino acid L-arginine into L-citrulline and NO. NO has vasodilator activity. Also, NO inhibits key processes involved in vascular disease, including leukocyte adhesion, platelet aggregation, and vascular smooth muscle cell proliferation. Asymmetric dimethylarginine (ADMA) is an early marker of atherosclerotic vascular disease. ADMA acts as a competitive inhibitor of NO synthase. ADMA is metabolised by dimethylarginine dimethylaminohydrolase (DDAH) to L-citrulline and dimethylamine

Question 18

How many kilocalories equal one pound of fat ?

A	500
B	1500
C	2500
D	3500

Question 18 Explanation:

~3500 kcal = 1 lb of fat

Question 19

For each doubling of statin dose, there is an additional lowering of LDL cholesterol by ?

A	~ 2 %
B	~ 4 %
C	~ 6 %
D	~ 8 %

Question 19 Explanation:

In metabolic synfrome and diabetes, LDL cholesterol should be reduced to <100 mg/dL. Diets restricted in saturated fats (<7% of calories), trans-fats (as few as possible), and cholesterol (<200 mg daily) should be applied aggressively. If LDL cholesterol remains above goal, statins (HMG-CoA reductase inhibitors) may produce a 20–60% lowering of LDL cholesterol. For each doubling of the statin dose, there is only ~6% additional lowering of LDL cholesterol

Question 20

In metabolic syndrome treatment, administration of which of the following can increase triglycerides ?

A	HMG-CoA reductase inhibitors
B	Ezetimibe
C	Cholestyramine
D	Fibrates

Question 20 Explanation:

Bile acid sequestrants cholestyramine & colestipol must be used with caution in metabolic syndrome because they can increase triglycerides. They should not be administered when fasting triglycerides are >200 mg/dL

Question 21

Drug that lowers triglycerides is ?

A	Fibrate
B	Nicotinic acid
C	Omega-3 fatty acids
D	All of the above

Question 21 Explanation:

Fibrates (gemfibrozil or fenofibrate) is the drug of choice to lower fasting triglycerides (35 - 50% reduction). Other drugs that lower triglycerides include statins, nicotinic acid, and high doses of omega-3 fatty acids. Concomitant administration with drugs metabolized by the 3A4 cytochrome P450 system (including some statins) greatly increases the risk of myopathy.

Question 22

Which of the following has no effect on HDL cholesterol ?

A	Fibrates
B	Bile acid sequestrants
C	Ezetimibe
D	Nicotinic acid

Question 22 Explanation:

To increase HDL cholesterol, statins, fibrates, and bile acid sequestrants have modest effects (5 - 10%). There is no effect on HDL cholesterol with ezetimibe or omega-3 fatty acids. Nicotinic acid is the only currently available drug with predictable HDL cholesterol-raising properties.

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See all quizzes of The Metabolic Syndrome at here:

1. The metabolic syndrome is also called ?
A. Syndrome M
B. Syndrome X
C. Syndrome Y
D. Syndrome Z

2.Metabolic syndrome increases the risk of ?
A. Hypertension
B. Diabetes mellitus
C. Stroke
D. All of the above

3. Major features of metabolic syndrome include all except ?
A. Central obesity
B. Hypertriglyceridemia
C. High low-density lipoprotein (LDL) cholesterol
D. Low high-density lipoprotein (HDL) cholesterol

4. Which of the following about metabolic syndrome is false ?
A. Prevalence increases with age
B. Increases in waist circumference predominate in women
C. Fasting triglycerides >150 mg/dL more likely in women
D. Hypertension more likely in men

5. Lipodystrophic disorder associated with the metabolic syndrome is ?
A. Berardinelli-Seip congenital lipodystrophy
B. Dunnigan familial partial lipodystrophy
C. HIV-related lipodystrophy in patients on HAART
D. All of the above
6. Which of the following is central to the development of insulin resistance ?
A. Postprandial hyperinsulinemia
B. Fasting hyperinsulinemia
C. Hyperglycemia
D. Overabundance of circulating fatty acids

7. Which of the statements is false ?
A. Insulin inhibits lipolysis in adipose tissue
B. Insulin stimulates lipoprotein lipase (LPL) in adipose tissue
C. Lipolysis produces fatty acids
D. None of the above
8. In the liver, free fatty acids (FFAs) result in ?
A. Increased production of glucose
B. Increased production of triglycerides
C. Increased secretion of very low density lipoprotein (VLDL)
D. All of the above

9. C-reactive protein (CRP) is produced in ?
A. Liver
B. Kidney
C. Pancreas
D. Lung

10. Which of the following is an anti-inflammatory and insulin sensitizing cytokine ?
A. Interleukin 6 (IL-6)
B. Resistin
C. Adiponectin
D. C-reactive protein (CRP)

11. There is almost always a predominance of small dense LDLs when fasting serum triglyceride is ?
A. ~ 100 mg/dL
B. ~ 130 mg/dL
C. ~ 150 mg/dL
D. ~ 180 mg/dL

12. In the setting of insulin resistance, which of the following effect of insulin is lost ?
A. Increased activity of sympathetic nervous system
B. Sodium reabsorption in kidney
C. Vasodilatory
D. All of the above

13. Which of the following is a proinflammatory cytokine ?
A. IL-18
B. Resistin
C. C-reactive protein (CRP)
D. All of the above

14.Levels of which of the following is reduced in the metabolic syndrome ?
A. Adiponectin
B. Resistin
C. C-reactive protein (CRP)
D. Interleukin-18

15. Which of the following is a physical finding in metabolic syndrome ?
A. Lentigo
B. Acanthosis nigricans
C. Café au lait macule
D. Ephelide (freckle)

16. Which of the following is associated with metabolic syndrome ?
A. Nonalcoholic steatohepatitis (NASH)
B. Polycystic ovarian disease (PCOS)

C. Obstructive sleep apnea (OSA)
D. All of the above

17. Which of the following is an endogenous inhibitor of nitric oxide synthase (eNOS) ?
A. Asymmetric dimethylarginine (ADMA)
B. Dimethyl sulfoxide
C. Phenylbenzimidazole sulfonic acid
D. Homosalate

18. How many kilocalories equal one pound of fat ?
A. 500
B. 1500
C. 2500
D. 3500

19. For each doubling of statin dose, there is an additional lowering of LDL cholesterol by ?
A. ~ 2 %
B. ~ 4 %
C. ~ 6 %
D. ~ 8 %

20. In metabolic syndrome treatment, administration of which of the following can increase triglycerides ?
A. HMG-CoA reductase inhibitors
B. Ezetimibe
C. Cholestyramine
D. Fibrates

21. Drug that lowers triglycerides is ?
A. Fibrate
B. Nicotinic acid
C. Omega-3 fatty acids

D. All of the above

22. Which of the following has no effect on HDL cholesterol ?
A. Fibrates
B. Bile acid sequestrants
C. Ezetimibe
D. Nicotinic acid

The Metabolic Syndrome

[MCQ] The Metabolic Syndrome

I. Start the exam by click the “Start” button

The Metabolic Syndrome

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