KMU Past Paper Practice

Question:

A nutritionist prepares identical daily menus for a healthy adult man and a woman who is breastfeeding. Although both menus contain the same food groups, the second woman requires adjustment of the quantities. Which principle best explains this difference?

Options:

Correct Answer: Nutrient requirements vary with physiological state

Explanation: Energy and nutrient needs change with growth, pregnancy, lactation and activity; a balanced diet must therefore be adapted to the individual.

Question:

A university student consumes mainly refined bread, meat and sweetened beverages and develops persistent constipation. There is no gastrointestinal disease. Which dietary modification best addresses the nutritional problem?

Options:

Correct Answer: Increase whole grains, vegetables and fruit

Explanation: Fibre-rich foods increase stool bulk and support normal gastrointestinal function; refined foods provide much less dietary fibre.

Question:

A 70-kg healthy adult has a normal activity level and no condition that increases protein requirements. Which daily protein intake most closely matches the approximate requirement taught for healthy adults?

Options:

Correct Answer: 60 g/day

Explanation: At approximately 0.8–1.0 g/kg/day, a 70-kg healthy adult requires roughly 56–70 g of protein daily.

Question:

A child has been maintained for months on an extremely low-fat diet. He develops poor growth and dry, scaly skin despite adequate carbohydrate and protein intake. Deficiency of which dietary component best explains the findings?

Options:

Correct Answer: Essential fatty acids

Explanation: Linoleic and alpha-linolenic acids are essential dietary fatty acids; severe deficiency may impair growth and cause dry, scaly skin.

Question:

A young adult whose diet consists predominantly of polished rice develops progressive weakness and peripheral neurological symptoms. The deficient vitamin normally plays an important role in carbohydrate metabolism and neural function. Which vitamin is most likely deficient?

Options:

Correct Answer: Vitamin B1

Explanation: Thiamine is required for normal carbohydrate metabolism and neural function; deficiency produces beriberi and neurological dysfunction.

Question:

A patient with a chronically poor diet develops fissuring at the angles of the mouth, sore lips and a smooth inflamed tongue. Which nutritional deficiency best fits this pattern?

Options:

Correct Answer: Riboflavin deficiency

Explanation: Riboflavin deficiency characteristically causes cheilosis, angular stomatitis and glossitis due to impaired flavin-dependent metabolic reactions.

Question:

A nutritionally deprived patient develops dermatitis, peripheral sensory symptoms and anemia. Deficiency of a vitamin involved in amino-acid metabolism, neurotransmitter synthesis and heme formation is suspected. Which vitamin is involved?

Options:

Correct Answer: Vitamin B6

Explanation: Pyridoxine participates in amino-acid metabolism, neurotransmitter formation and heme synthesis; deficiency can cause dermatitis, neuropathy and anemia.

Question:

A woman planning pregnancy receives nutritional counselling. Adequate intake of one vitamin is emphasized because deficiency during early fetal development increases the risk of neural tube defects. Which vitamin is most relevant?

Options:

Correct Answer: Folate

Explanation: Folate is essential for DNA synthesis and rapid cell division; inadequate maternal folate increases the risk of fetal neural tube defects.

Question:

A patient with severe nutritional deficiency develops peripheral neuropathy and evidence of increased red-cell membrane fragility. Deficiency of which vitamin, whose major function is antioxidant protection of cell membranes, is most likely?

Options:

Correct Answer: Vitamin E

Explanation: Vitamin E protects lipid membranes against oxidative injury; severe deficiency can produce neuropathy, myopathy and hemolytic changes.

Question:

A community nutrition worker counsels families whose main iron sources are plant foods. Which meal combination would best improve utilization of the iron already present in the diet?

Options:

Correct Answer: Pulses with a vitamin C-rich fruit

Explanation: Vitamin C improves absorption of non-heme iron from plant foods, whereas phytates can reduce mineral bioavailability.

Question:

A patient with prolonged severe dietary restriction develops anemia together with neutropenia and skeletal abnormalities. Deficiency of which trace element best explains this combination?

Options:

Correct Answer: Copper

Explanation: Copper supports iron metabolism and enzyme systems; severe deficiency may cause anemia, neutropenia and skeletal abnormalities.

Question:

A child has adequate food available at home but progressively loses weight during a prolonged systemic illness that reduces appetite and increases metabolic requirements. How should this form of undernutrition be classified?

Options:

Correct Answer: Secondary undernutrition

Explanation: Secondary undernutrition results from disease that reduces intake or utilization or increases nutrient requirements despite food availability.

Question:

During rapid community screening, health workers need a simple anthropometric measure that reflects muscle and subcutaneous tissue reserve in young children and can help identify acute malnutrition. Which measurement is most useful?

Options:

Correct Answer: Mid-upper-arm circumference

Explanation: Mid-upper-arm circumference is a practical rapid measure of muscle and subcutaneous tissue reserve used in assessment of acute childhood malnutrition.

Question:

A child’s anthropometric measurement is compared with a reference population and lies below −3 Z-scores for the relevant nutritional indicator. Which interpretation is most appropriate?

Options:

Correct Answer: Severe nutritional abnormality

Explanation: In WHO growth assessment, values below −2 Z-scores indicate abnormal undernutrition, while values below −3 indicate severe abnormality.

Question:

A national nutrition survey identifies stunted children, adults with obesity and widespread micronutrient deficiencies within the same communities. Which public-health concept best describes this pattern?

Options:

Correct Answer: Double burden of malnutrition

Explanation: The double burden describes coexistence of undernutrition or micronutrient deficiency with overweight and obesity in the same population.

Question:

An adult gains considerable weight after beginning a long-term medicine. Dietary intake and activity also contribute, and no major endocrine disorder is found. How should the medicine be interpreted in the development of obesity?

Options:

Correct Answer: It may act as one contributing determinant

Explanation: Obesity is multifactorial; some medicines promote weight gain but generally interact with dietary, behavioral, genetic and environmental determinants.

Question:

A 46-year-old patient with longstanding obesity has mildly elevated liver enzymes. Imaging shows excess fat within the liver without another obvious nutritional explanation. Which obesity-associated complication is most likely?

Options:

Correct Answer: Metabolic fatty liver disease

Explanation: Excess adiposity and insulin resistance promote hepatic triglyceride accumulation, making metabolic fatty liver an important complication of obesity.

Question:

A 52-year-old woman with longstanding obesity develops progressive knee pain that worsens on walking. Examination suggests degenerative joint disease. Which mechanism most directly links her nutritional condition with this complication?

Options:

Correct Answer: Increased mechanical loading of joints

Explanation: Excess body weight increases chronic mechanical stress on weight-bearing joints, contributing to osteoarthritis and mobility limitation.

Question:

A 30-year-old woman with obesity reports increasingly irregular menstrual cycles and difficulty conceiving. No separate structural cause is identified. Which category of obesity-related complication best explains the presentation?

Options:

Correct Answer: Reproductive complication

Explanation: Obesity can disturb reproductive function and is associated with menstrual irregularity and impaired fertility in susceptible women.

Question:

A patient has severe obesity with significant obesity-related health problems despite structured lifestyle management. The clinical team considers escalation of treatment. Which principle is most appropriate regarding metabolic or bariatric surgery?

Options:

Correct Answer: It may be considered in selected patients with severe obesity

Explanation: Metabolic or bariatric surgery is an escalation option for appropriately selected patients with severe obesity and requires specialist assessment and continued follow-up.