According to current guidelines, in order to burn fat stores obese patients should exercise:
Correct Answer B:
Because glycogen is the primary energy source for muscles during the first 20 minutes of exercise, at least 30 minutes of exercise is necessary to begin burning fat stores. Current guidelines recommend a minimum of 30 minutes of exercise 5 days per week. Twenty minutes of exercise daily or three 10-minute sessions daily does improve cardiovascular fitness, but does not cause significant weight loss. Walking, on land or in water, and stationary biking are equivalent in benefit.
A 50-year-old male who is a heavy smoker asks you about vitamin supplementation to prevent cancer and cardiovascular disease. The patient is unwilling to stop smoking. According to the recommendations of the Preventive Services Task Force, which one of the following is true regarding vitamin supplementation in adults who are middle age or older?
Correct Answer A:
The Preventive Services Task Force found that Beta-carotene was associated with a higher incidence of lung cancer and all-cause mortality. In general, little evidence was found to determine whether supplementation of any of the mentioned vitamins reduces the risk of cardiovascular disease or cancer.
Recent studies and meta-analyses have shown that supplementation with a particular vitamin may do more harm than good. This has resulted in a reversal in the recommendation for its use in patients with known coronary artery disease, and a recommendation for caution in its use in general for elderly patients.
This is true of which one of the following?
Correct Answer E:
At one time, studies indicated that the antioxidant vitamin E should be recommended to patients with heart disease for prevention of on ongoing heart changes. However, results of a meta-analysis of 19 randomized, placebo-controlled trials suggest that high doses of vitamin E increases the risk of all-cause mortality, and this dose-dependent increase begins at doses of 150 IU/day. Cardiovascular disease prevention guidelines state that supplemental vitamin E is not recommended. This reversal of thought on vitamin E in the past 10 years or so exemplifies the need for physicians to monitor closely both the recommendations of physician study groups and the advertisements of alternative medicine and related fields.
A 33-year-old white female has a 12-year-history of headache occurring 3-4 times per month, accompanied by nausea and vomiting. She takes over-the-counter analgesics, but relief is usually obtained only when she falls asleep. This is her first visit to you for this problem. You diagnose migraine without aura. Although the patient is willing to consider prescription drugs, she says that she would prefer “something that is natural and without side effects”.
Which one of the following would be the best recommendation?
Of the listed options covering the realm of complementary and alternative medicine, only biofeedback has been shown to have a therapeutic effect on migraine. Specifically, the modality that seeks to control physiologic response to skin temperature and skin conductance appears to be the most successful. It is best performed in a medical office by caring, supportive staff members under physician supervision. Oxygen is used to treat cluster headaches. The Epley maneuver is used for managing benign positional vertigo, and phototherapy is useful in seasonal affective disorder. Ma huang, a Chinese herb, has ephedrine properties but is not useful in treating migraine headaches.
A 20-year-old college student is anxious to avoid traveler’s diarrhea during a 4-week visit to Central America.
You would advise him that which one of the following is generally safe?
Baked goods such as breads can generally be considered safe from most causes of traveler’s diarrhea. Ice from local water sources is commonly contaminated, as freezing does not kill most causes of traveler’s diarrhea. Raw vegetables are often contaminated because human and animal wastes are commonly used for fertilizer. Alcohol is not an effective disinfectant for traveler’s diarrhea pathogens. Raw fish and shellfish are high-risk foods.
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