Question

1. What percentage of the U.S. population is overweight by BMI?
   1. 70%
   2. 90%
   3. 50%
   4. 25%

2.   What are the potential mechanisms for increasing glucose uptake into muscle?
   1. Contraction mediated Glut1 translocation
   2. Insulin mediated Glut4 translocation
   3. Contraction mediated Glut4 translocation
   4. B+C

3. Which of the following is NOT a precaution that should be taken to reduce the risk of exercise- induced hypoglycemia (low blood sugar) in patients with type 1 diabetes?
   1. Consume carbohydrate if glucose is <100 mg/dl
   2. Avoid exercising during peak insulin action
   3. Reduce insulin dose on exercise days
   4. Increase insulin dose immediately after exercise

4. A 44 year old male who is obese but otherwise healthy and his father had type 2 Diabetes and had died at 67 from MI, would be classified as medium risk according to the ACSM risk stratification tool. Why is that?
   1. He should be classified as low risk since he has only 1 risk factor: obesity
   2. He has 2 risk factors: obesity and family history
   3. He has 2 risk factors: obesity and assumed pre-diabetic
   4. He has 3 risk factors: age, obesity and family history

5. People classified as ‘High Risk’ using the ACSM risk stratification tool may never exercise.
   1. True
   2. False

6. According to the ACSM guidelines, which of the following individuals meets the criteria for “family history” as a risk factor for developing CVD?
   1. female whose maternal uncle had a heart attack at the age of 58
   2. a male whose mother had coronary bypass surgery at the age of 70
   3. a female whose father died at the age of 63 from a heart attack
   4. a male whose father had a heart attack at the age of 48

7. Which of the following would be categorized as ‘High Risk’?
   1. Male, 25 year old smoker. Healthy and physically active.
   2. Female, 60 year old. Sedentary, BMI=31
   3. Male 65 year old. Sedentary, former smoker.
   4. Female 30 year old. Physically active, Mom died of MI at 64 years. Type 1 diabetic.
   5. B+C

8. Which of the following would be categorized as ‘Moderate Risk’?
   1. Male, 25 year old smoker. Healthy and physically active.
   2. Female, 60 year old. Sedentary, BMI=31
   3. Male 65 year old. Sedentary, former smoker.
   4. Female 30 year old. Physically active, Mom died of MI at 64 years. Type 1 diabetic.
   5. B+C

9. Which of the following would be categorized as ‘Low Risk’?
   1. Male, 25 year old smoker. Healthy and physically active.
   2. Female, 60 year old. Sedentary, BMI=31
   3. Male 65 year old. Sedentary, former smoker. On hypertension medication.
   4. Female 30 year old. Physically active, Mom died of MI at 64 years. Type 1 diabetic.
   5. B+C

10. How does exercise affect glucose metabolism in healthy individuals?
    1. Blood glucose is maintained by decreased insulin and increased counter-regulatory hormones
    2. Blood glucose decreases because of increased insulin production
    3. Blood glucose is maintained by decreased counter-regulatory hormones
    4. Blood glucose increases due to increased gut absorption

PLEASE ANSWER ALL OF THE QUESTIONS! THANKS!

Answer 1

1. What percentage of the U.S. population is overweight by BMI?

1. 70%
2. 90%
3. 50%
4. 25%

Correct Answer: Option 1 (70%)

According to the Centre for Disease Control, the percent of adults aged 20 and over with overweight, including obesity is 71.6%.

Based on the above fact, the closest fit is Option 1.

Options 2, 3 and 4 can be ruled out.

2. What are the potential mechanisms for increasing glucose uptake into muscle?

A. Contraction mediated Glut1 translocation

B. Insulin mediated Glut4 translocation

C. Contraction mediated Glut4 translocation

D. B+C

Answer: Option D

Explanation: Glucose transporter type 4 is a transport protein that is encoded, in humans, by the SLC2A4 gene. GLUT4 is the insulin-regulated glucose transporter that is found primarily in adipose tissues and striated muscle. Apart from insulin, experimental studies have shown that muscle contraction also increases the uptake of glucose into muscles through GLUT-4 through mechanisms that are independent of insulin. Thus, option A can be ruled out. Options B and C are suitable.

3. Which of the following is NOT a precaution that should be taken to reduce the risk of exercise-induced hypoglycemia (low blood sugar) in patients with type 1 diabetes?

1. Consume carbohydrate if glucose is <100 mg/dl
2. Avoid exercising during peak insulin action
3. Reduce insulin dose on exercise days
4. Increase insulin dose immediately after exercise

Answer: Option 4.

Consume carbohydrate if glucose is <100 mg/dl - This is recommended to all diabetics. Consuming carbohydrates increases blood sugar and reduces the risk of hypoglycemia.

Avoid exercising during peak insulin action - Peak action of insulin occurs a few hours of injection. This varies according to the type of insulin used. During peak action of insulin, glucose from the blood is being transported into the cells. If one exercises during this phase, they are more likely to become hypoglycemic.

Reduce insulin dose on exercise days - Type 1 Diabetics should reduce the dose of insulin on exercise days. After taking insulin, the blood glucose is reduced as glucose is transported from blood into the cells. The risk of hypoglycemia can be reduced by reducing the dose of insulin when they are planning to exercise.

Increase insulin dose immediately after exercise - This is not recommended for type 1 diabetics. After exercise, significant amount of blood glucose will have been consumed by the exercising muscles. If one takes a high dose of insulin after exercise, they will go into severe hypoglycemia.

4. A 44-year-old male who is obese but otherwise healthy and his father had type 2 Diabetes and had died at 67 from MI, would be classified as medium risk according to the ACSM risk stratification tool. Why is that?

1. He should be classified as low risk since he has only 1 risk factor: obesity
2. He has 2 risk factors: obesity and family history
3. He has 2 risk factors: obesity and assumed pre-diabetic
4. He has 3 risk factors: age, obesity and family history

Answer: Option 1

The ACSM definitions for the various risk factors are as follows:

Age> 45 for males

Obesity: BMI >30 kg/m2

Family History: Heart attack, bypass surgery or sudden death before the age of 55 years for father or brother

This person is 44 years old. So age is not a risk factor.

It is mentioned that he is obese. That is risk factor no. 1

Family history - His father died of a heart-attack (MI) at the age of 67 years. But the ACSM guidelines say the death should have occurred before the age of 55 years for it to be counted as a risk factor. Thus, family history is not a risk factor.

Diabetes - The question means that he is 'obese but otherwise healthy'. So it can't be assumed that he's pre-diabetic unless it is clearly stated even though obesity and pre-diabetes are known to co-exist together in a lot of individuals.

He has only one risk factor - Obesity. Thus the correct answer is option 1

Option 2 - Family history cannot be included. So this choice is incorrect.

Option 3: It cannot be assumed that he's pre-diabetic unless it is specifically mentioned in the question. So this choice is incorrect.

Option 4: Age is 44 years. it is not a risk factor. Even family history cannot be included as explained above.