IFMCP Test (General questions from all the modules in preparation the IFM 2024 IFMCP exam) Questions With 100% Correct Answers!!
What are the coenzymes needed for desaturase metabolism of omega 3 PUFAs Answer - zinc, magnesium, ascorbate, niacin, and
pyridoxine
List the steps in the Omega-3 pathway Answer - ALA to Stearidonic acid to Eicosatetranoic acid to Eicosapentaenoic acid (EPA) to Docosapentaenoic acid to Docosahexaenoic acid (DHA)
List the steps in the Omega-6 pathway Answer - Linoleic acid (LA) to GLA to Dihomogamma-linolenic acid to AA to Adrenic acid to Docosopentaenoic acid
What vitamin deficiency leads to food intolerance because it is essential for maintaining integrity and function of all mucosal surfaces. Answer - Vitamin A. It can be corrected with dietary supplements, 10,000+ international units a day
What vitamin enhances host defenses against cancer, enhances host defense against infection, up regulates antimicrobial peptides, and dampens inflammatory cytokines production? Answer - Vitamin D
list natural treatments that are insulin sensitizers Answer - Vanadium, Chromium, Alpha Lipoic Acid, Cinnamon, Magnesium (not citrate)
Homocysteine needs a methyl group to eventually become what? Answer - SAMe The body's methyl donor
Tyrosine is methylated and becomes what? Answer - Dopamine and norepinephrine
Tryptophan is methylated and eventually becomes what Answer - Serotonin and melatonin Why does histamine need a methyl group? Answer - To get broken down
Which vitamins are involved in folate metabolism to 5MTHF Answer - Pyridoxine (B6) and riboflavin (B2)
Which cofactor which uses 5MTHF to synthesize, is involved in the tryptophan to serotonin pathway and the tyrosine to dopamine pathway and the arginine to nitric oxide
pathway? Answer - BH4 (Tetrahydrobiopterin)
What does methionine synthase recycle? Answer - Methionine synthase is needed to recycle homocysteine to Same
What is methionine synthase blocked by and what is a clue to dysfunction Answer - Blocked by alcohol and a clue to dysfunction is elevated MCV
What are the clinically elevated SNPs involved in methionine synthase Answer - MTRR A66G and MTRRC524T
What mineral is a carrier of homocysteine Answer - Zinc
What vitamins need to be supported in a person with methionine synthase SNP defects Answer - Zinc, B12, 5-MTHF
If a patient has a methionine synthase SNP and their high homocysteine is not budging what supplement should be considered Answer - Betaine in the form of TMG
What are the two functions of COMT Answer - Breakdown catecholamines, takes part in
estrogen metabolism
What is the clinically relevant SNP for COMT Answer - COMT V158M
How does the Val/Val allele affect COMT function Answer - Up regulated so it will break down catecholamines faster
How does the Val/Met allele affect COMT function Answer - This is normal
How does the met/met allele affect COMT function? Answer - It is down regulated so it will not break down catecholamines as well
should you give a woman with the Val/Val snp aspirin for CVD protection Answer - No, there is an 85% increase risk of CVD with aspirin
Should you give a woman with the Val/Val COMT allele vitamin E for CVD protection? Answer - No, there is an increase risk of CVD with vitamin E in a woman with the Val/Val SNP Should you give a woman with the met/met allele aspirin for CVD protection? Answer - Possibly, there is a 40% decrease risk of CVD with ASA
Should you give a woman with the met/met allele for COMT vitamin E for CVD protection? Answer - Possibly, there is a decreased risk of CVD with vitamin E and women with the met/met allele
Which polyphenols can block the COMT enzymewhen it is up regulated in somebody with the Val Val allele Answer - Quercetin and EGCG
Review the considerations for a patient who has the met/met COMT allele which means
it is down regulated. Answer - Stress management, avoid caffeine and other stimulants, caution with EGCG and quercetin, consider Sam E supplementation which is a cofactor,
consider magnesium optimization, support the MS enzyme, consider creatine as the body uses a lot of creatine to make SAMe, optimize estrogen levels with DIM and sulpforaphane, in women, use ASA and vitamin E when appropriate
Review the management of a patient with MTHFR dysfunction with a COMT met/met allele Answer - Hold methylated supplements. Consider magnesium. Consider SAMe supplementation which is a cofactor. Consider creatine. Slowly introduce methyl folate at lower doses. Consider hydroxy cobalamin. Consider glutathione and/or NAC.
How does the addition of exogenous estrogen affect TSH? Answer - Estrogen increases
TSH secretion
How do high doses of glucocorticoids affect the thyroid? Answer - High doses of glucocorticoids inhibit thyroid hormone section
Steroid hormones are synthesized from what dietary intake? Answer - Cholesterol (LDL)
from the diet is required for steroid hormone synthesis.
The steroid pneumonic PTSD stands for what? Answer - Production, Transport, Sensitivity, Detoxification
How does stress affect 17,20 lyase? Answer - Decreases anabolism by slowing down 17,20 lyase
How does inflammation affect 17,20 lyase? Answer - Inflammation inhibits 17,20 Lyase
How does inflammation affect estrogen? Answer - Stimulates aromatase to increase E (estrogen) formation
How does inflammation affect the testosterone to DHT pathway? Answer - Increases 5α
reductase to increase formation of DHT. This can cause hair loss. How does weight gain affect SHBG? Answer - SHBG is decreased by body weight
How does visceral adiposity affect SHBG? Answer - SHBG decreased by VAT , independent of weight
How does insulin resistance affect SHBG? Answer - SHBG decreased by insulin resistance and hyperinsulinemia. SHBG is a marker for insulin resistance and Low SHBG is a predictor for development of Type II DM
What is the cortisol and DHEA pattern in Selye's stage 1 arousal? What is the clinical presentation? Answer - Both cortisol and DHEA increase with episodic stress, but recovery occurs to baseline. Elevated Cortisol
Elevated or normal DHEA
Asymptomatic, stimulated
What is the cortisol and DHEA pattern in Selye's stage 2 adaptation? What is the clinical
presentation? Answer - Cortisol chronically elevated, (cortisol can also be normal) but DHEA declines. Elevated cortisol/DHEA ratio "Stressed," anxiety attacks, mood swings, depression
What is the cortisol and DHEA pattern in Selye's stage 3 exhaustion? What is the clinical presentation? Answer - Adrenal insufficiency / low cortisol and DHEA
Depression and fatigued. Generally, the cortisol/DHEA ratio is no longer useful
What are the basic supplements needed to support adrenal hormone production? Answer - B-Complex (especially B5, B6, Biotin, Folate), Vitamin C, Magnesium, Omega-
3s, Zinc
What are the foundational "alarm" stage 1 interventions for transiently elevated catecholamines and cortisol? Answer - Ashwagandha, Holy Basil. L-theanine, 5-HTP, Passion Flower, Valerian Root, Kava Kava, Rehmannia, Schisandra, Polygala
What are the foundational stage 2 (resistance/early decompensation) interventions for hypercortisolism Answer - Ashwagandha, Rhodiola, Cordyceps, Siberian ginseng, St. Johns Wort, Phosphatidylserine, Dark chocolate
What are some conditions associated with insufficient HPA activity - Low Cortisol? Answer - Atypical depression, Seasonal affective disorder, Postpartum depression, Panic attacks, Generalized anxiety disorder, Bipolar II disorder, Chronic Fatigue Syndrome
What are some foundational interventions for Stage 3 - exhaustion phase/late decompensation - hypocortisolism? Answer - Ashwagandha, Licorice, Rehmannia, Cordyceps, Asian ginseng
