Nutritional Assessment Questions and Answers

Answer: D

The paper's match is a-IV, b-I, c-II, d-III.

• At 1½ years, head and chest circumference are compared: by this age chest circumference should exceed head circumference.
• At 3 years, mid upper arm circumference is a standard screening measure for malnutrition in children aged 1 to 5.
• At 8 years, weight for age is used to assess growth.
• At 42 years, an adult, body mass index is the standard measure.

Several measures can be used across these ages, so the key rests on the textbook pairing of each age with its most typical measure. Every other option assigns BMI to a child or head and chest circumference to an older person, which is clearly wrong.

Answer: B

The normal range is 18.5 - 24.5.

Quetelet's index is the body mass index, weight in kilograms divided by the square of height in metres. The WHO classes a BMI from 18.5 up to just under 25 as normal, below 18.5 as underweight, 25 to 29.9 as overweight and 30 or more as obese.

Among the options only 18.5-24.5 lies within the normal band. 15.0-22.5 starts in the underweight range, 20.0-30.0 runs into obesity, and 25.5-29.5 is the overweight range.

Answer: B

The method is the food balance sheet.

A food balance sheet works at the macro level. For a country or region over a year, it adds up food production, imports and stock changes, subtracts exports, seed, feed and wastage, and divides what is left by the population to give the food available per head.

The other three are micro-level methods used on households or individuals. The weighment method weighs the food actually cooked or eaten, the 24-hour recall asks a person what they ate the previous day, and a food frequency questionnaire asks how often foods are eaten.

Answer: C

The method is the 24 hour recall method.

In the 24-hour recall method, a trained interviewer asks the respondent to remember everything eaten and drunk in the previous 24 hours. To estimate amounts, the interviewer uses a set of standardised cups, bowls and spoons, so the respondent can show how much was taken.

The food balance sheet estimates food available at national level, not from individuals. The inventory method records food stocks at the beginning and end of a period. The weighment method weighs the food actually prepared and eaten rather than relying on memory.

Answer: C

BMI stands for Body Mass Index.

Body Mass Index is a person's weight in kilograms divided by the square of the height in metres. For adults a BMI of 18.5 to 24.9 is considered normal, below 18.5 underweight, and 25 or more overweight.

The other expansions change 'Body' to 'Basic', 'Mass' to 'Measure', or 'Index' to 'Indicator', and none is the term used.

Answer: B

The keyed range is 70 to 110 mg/dl.

Textbooks of nutrition and biochemistry give the normal fasting blood glucose as about 70 to 110 mg/dl, measured after an overnight fast of 8 to 10 hours. Current diagnostic criteria set a tighter upper limit, treating 100 to 125 mg/dl as impaired fasting glucose and 126 mg/dl or more as diabetes, but 70 to 110 is the standard range the question uses.

50 to 80 mg/dl runs into hypoglycaemia, 80 to 120 sets the upper limit too high, and 130 to 140 mg/dl would be diagnostic of diabetes.

Answer: C

The key's answer is Infants.

Head circumference reflects the growth of the brain, which is fastest in the first year of life: it is about 34 cm at birth and about 45 cm at one year, after which it changes little. Nutrition textbooks therefore list head circumference as an anthropometric measure for infants, where a small head points to chronic undernutrition in early life.

Measurement is often continued until about two years of age, which is why 'Children under 2 years' is close, but the key follows the textbook reading that the measure belongs to infancy. It has little value in children under five generally or in adolescents, whose head growth is nearly complete.

Answer: D

The right design is a cross-sectional survey.

Prevalence is the proportion of a population that has a condition at a given time. A cross-sectional survey measures exposure and outcome in a representative sample at one point in time, so it gives prevalence directly, as in national surveys of anaemia or iodine deficiency.

Longitudinal and cohort studies follow people over time to measure incidence (new cases) and risk factors, and an experiment tests the effect of an intervention. They are slower and costlier and do not answer a prevalence question better.

Answer: C

Glycosylated haemoglobin (HbA1c) is used in the screening of diabetes.

Glucose binds slowly and irreversibly to haemoglobin in red cells. Because red cells live about 120 days, the HbA1c percentage reflects average blood glucose over the previous two to three months. A value of 6.5 per cent or more is a diagnostic criterion for diabetes, and the test is used to monitor control.

Iron deficiency anaemia is screened with haemoglobin and serum ferritin, and sickle cell anaemia with a sickling test or haemoglobin electrophoresis. CVD risk is assessed with lipid profiles and blood pressure, not with HbA1c alone.

Answer: D

Chronic renal failure is indicated by increased blood urea nitrogen.

When the kidneys fail, the glomerular filtration rate falls and nitrogenous wastes such as urea and creatinine are retained in the blood. A rising blood urea nitrogen (BUN), together with rising serum creatinine, is the classic biochemical sign.

Creatinine excretion falls, not rises, as filtration fails, so the first option is backwards. Serum albumin usually falls in kidney disease because protein is lost in the urine, and serum transferrin also tends to be low, so neither increase points to renal failure.