msu management & Science university MID-SEMESTER EXAMINATION (NOVEMBER 2014 SESSION) NUTRITION AND IMMUNOLOGY SNT2033 LECTURER : MATRIC NO PROGRAMME : VENUE JANUARY 2015 DURATION : 2 HOURS INSTRUCTIONS: 1. Candidates must read all questions carefully. 2. The examination script consists of the followings: Part Types of Instruction ‘Answer Sheets to Questions be Used ONE 25 MCQ ‘Answer ALL ‘Answer sheets questions _| TWO Essays ‘Answer THREE(3) | Answer sheets questions ONLY _| THs EXAMINATION SCRIPT CONTAINS & PAGES INCLUDING TRE FRONT COVER DO NOT OPEN THE EXAMINATION SCRIPT UNTIL FURTHER INSTRUCTIONCONFIDENTIAL, ‘$NT2033 PART ONE (25 marks) Time: 30 minutes INSTRUCTION This part consists of TWENTY FIVE (25) questions. Answer ALL questions in the answer sheets provided. 1. What are the two divisions of the immune system? A. Cell mediated immunity and antibody mediated immunity. B. First line and second line defense. C. Natural Killer cell and T lymphocytes, D. Passive and active immunity. 2. What is another term known as antibody mediated immunity? A. Regulatory T cells. B. Natural killer cells, C. Humoral immunity. D. Passive immunity 3. Which of the following related with CD8+? ‘A. Protein which is related with helper T cells. B. Protein which is related with killer T cells. C. Protein which is related to MHCI D. Protein which is related to MHC The following information is for question 4 Danish is having symptoms of sneezing, runny nose and watery eyes after happily eat seafood for his dinner. 4, Which of the following is needed by Danish to relief from the above symptoms? A Anti histamine. B. Histamine. ¢. Apoptosis. D. Aspirin. The following information is for question 5 Iskandar has a symptoms of bad coughing with yellow sputum. Doctor has diagnosed that he is having Tuberculosis. 5. In your opinion, which of the following vaccine is needed to prevent for this disease? A Pneuomococal, B. MMR. iG HPV. D. BCG. SNT2033 NUTRITION AND IMMUNOLOGY 47CONFIDENTIAL SNT2033 6. Which of the following are the best techniques to be used to identify the mobility of elderly people? A. Dietary assessment. B. Functional assessment. C. Biochemical assessment. D. Clinical assessment. The following information is for question 7 It correlates with brain size and is usually detect microcephaly and macrocephaly in children up to 24 months of age but is generally used independently as indicator of nutritional status. 7. What do you think is the BEST matched for above inform: A Elbow breath, B. Head circumferences. c, Mid upper arm circumferences. D. Body weight The following information is for question 8 Low value also seen in liver diseases, nephrotic syndrome, and any condition expanding the vascular volume. Normal value excludes protein malnutrition, 8. Which of the following assay is suitable with laboratory interpretation above? A. Serum albumin, B. Vitamin and mineral Cc ‘Serum homocysteine. D. Serum methylmatonic acid. 9. In your opinion, which method is suitable to allow physician to determine Whether patient is in a state of net anabolism or catabolism of muscle protein? A Indirect calorimetry, B Bioelectric impedance analysis (BIA). c. Nitrogen Balance. D. Muscle function. The following information is for question. 10 ‘Weight loss, edema, decrease temporal and skeletal muscle, parotid enlargement. 10. Which of the following deficiency is related with physical findings in above? A Vitamin A, B, Vitamin B, @ Protein. D. Body fat. ‘$NT2033 NUTRITION AND IMMUNOLOGY 207CONFIDENTIAL SNT2033 14. Which of the following is the effect of zinc deficiency? A Increase glucocorticoids, B. Increase apopto: C. Increase lymphocytes. D. Increase tymic hormone production. The following information is for question 12 Thymic atrophy Lymphopenia Reduction in cell and a dy mediated response 12. Choose the deficiency related to above effect. A Vitamin D. B. Vitamin A. ic, Zine, D. Cooper. 13. Which of the following is CORRECT regarding leptin. I Will be able to prevent apoptosis I Promoting T helper | response M. Hormone secreted by adipose tissues \V. Regulates food intake and basal metabolism A Vand I 8 Vand Il C. iland it, Ds kihilland iv. The following information is for question: 14 Clinical signs of selenosis Hair and nail loss Skin lesions Abnormalities of the nervous system 14. In your opinion, what is the BEST deficiency related? A Zine. B Selenium. Cc. Copper. D. Protein. 15. Severe growth retardation normaly related with deficiency in trace elements. Choose the BEST answer. A Deficiency of zinc. B. Deficiency of selenium. Oj Deficiency of cooper. D. Deficiency of protein. 16. Which of the following diseases related with deficiency in iron? A Anemia. B. Keshan Diseases. i Inflammatory Bowel Diseases. D. Fever. SNT2033 NUTRITION AND IMMUNOLOGY aTCONFIDENTIAL, ‘$NT2033 Wh 18, 19, 20. 2 22. In human milk, what is the predominant class antibody available? A IgE. B. IgA. G. IgD. D. lg The iron binding protein in human mik play an important role in having bacteriostatic effect. Choose the BEST answer. A Lactoferrin. B. Transferrin. @ Lactose, D. Fructose. Which of the following diseases are susceptible to children? A Measles. B Tuberculosis. Cc. Atherosclerosis, D. Anemia, Why do you think immunization i important during childhood? To reduce the cases of malnutrition 8 To reduce immune responses. @ Most cost effective strategy to reduce the burden of morbidity and mortality. D. As a strategy to replace supplementation. Why ¥y do you think that children are susceptible to communicable diseases? Less of supplementation intake. Less exposure of vaccine. Enhanced direct transfer of infectious agents by hand-mouth contact and close physical interactions. Fails to achieve sufficient vaccine coverage. Jet injectors and national immunization days. Diminished postimmunization Give awareness about immunization. A B. ¢, D. How is the possible ways to increase immunization coverage previously? A B. c D. Increase supplementation intake. Following information is for question 23 It is diseases caused by virus that leads to painful swelling of parotid glands. Usually occurs in children between ages 2-12 years who have not been vaccinated. Symptoms can be fever, headache, swollen gland at area neck, face and jaw. 23. From the information above, which of the following vaccine is needed to prevent from this diseases? A. Polio, B. BCG. Cc. MMR. D. Hep B vaccine. SNT2033 NUTRITION AND IMMUNOLOGY arCONFIDENTIAL SNT2033 24, — Suggest how the molecular biology contributed to vaccine development. H M U WV, A B iS} D. The ability to create genetically altered organisms Selected and site-directed mutations Specifically designed new antigens Costeffective strategy to reduce the burden of morbidity and mortality tand II |, and It 1,11, and It 1,11, Mand IV. 25. Haikal is now turning 1 year old.Suggest the appropriate vaccine should be given to Haikal at this age. gomP Polio, BCG. MMR. Hep B vaccine. SNT2033 NUTRITION AND IMMUNOLOGY 6iTCONFIDENTIAL SNT2033 PART TWO (75 marks) Time: 1 hour and 30 minutes INSTRUCTION This part consists of FOUR (4) questions. Answer THREE (3) question only in the answer sheets provided. 1. Nutritional assessment is an important technique to determine nutritional status of an individual. Dietary assessment is the measurement of dietary intake that can be carried out for large groups of people, smaller groups or individuals. (a) (b) ©) (a) (CO) C0] State TWO (2) objectives of nutritional assessment. (4 marks) Explain Individual 24-h Recall and Food Frequency Questionnaire in dietary assessment. (4 marks) Define anthropometric technique and give ONE (1) advantage and disadvantage of anthropometry. (4 marks) ‘Suggest the most suitable method of dietary assessment in the study adequacy of daily total calories among housewives in Banting, Selangor. (4 marks) State your reasons for your answer in 1(d). (3 marks) Dietary intake can contribute to body weight status of an individual. Mr. X has the weight of 38 kg and height of 166 cm. Calculate the Ideal Body Weight of Mr. X. Discuss the implication of nutrition status based on his body weight and Ideal Body Weight. (6 marks) Eee ‘$NT2033 NUTRITION AND IMMUNOLOGY 67CONFIDENTIAL, $SNT2033 2. Nutritional status is tightly linked and the immune intergrity can be rapidly altered by changes in nutritional status. (a) State FIVE (6) Immunological parameters to measure the status of immune system and its responsiveness to antigenic challenges. (5 marks) (b) State the physical findings for deficiency of these nutrients: i Protein i, Niacin Vitamin By2 Iron Vitamin A, (5 marks) (0) State FOUR (4) effects of zinc deficiency to the immune system. (4 marks) (4) Nutrients are able to modulate apoptosis in cells of human immune system. Describe apoptosis. (5 marks) (€) _ Discuss THREE (3) effects of dietary restriction on immune response (6 marks) 3. Leptin is hormone derived from adipose tissues. Discuss in details on how leptin could help in immune response. (25 marks) 4, Vaccination in childhood has been given a great attention nowadays. It can be as a strategy to reduce morbidity and mortality for communicable diseases worldwide. ‘Suggest the immunization schedule for children in Malaysia. (25 marks) END OF QUESTION PAPER ‘SNT2033 NUTRITION AND IMMUNOLOGY 7m