Vitamin A - Quiz
Vitamin A
  • 1. Which group of animals requires vitamin A?
A) Only mammals
B) All vertebrate and chordate species
C) Only carnivores
D) Only amphibians
  • 2. How do herbivores primarily obtain vitamin A?
A) From synthetic retinol supplements
B) From synthetic carotenoids
C) From consuming other animals
D) From β-carotene in green pasture
  • 3. What is a major cause of vitamin A deficiency in grazing herbivores?
A) An overabundance of green pasture
B) Exposure to sunlight
C) Drought-dried pasture grass and long-stored hay
D) The consumption of too much vitamin D
  • 4. What happens to surplus retinyl esters in some carnivores and omnivores?
A) They are destroyed by the stomach acid
B) They are converted into vitamin D
C) They are stored in the liver or excreted in urine
D) They are absorbed by the skin
  • 5. What was a common source of vitamin A before synthetic retinol existed?
A) Dried seaweed
B) Animal fat
C) Vegetable oil
D) Cod liver oil
  • 6. Can invertebrates synthesize carotenoids or retinol?
A) Yes, they synthesize them internally
B) They synthesize them from sunlight
C) Only some species can synthesize them
D) No, they must ingest them
  • 7. Where do invertebrates obtain essential vitamin A nutrients?
A) From consuming algae, plants, or animals
B) They do not need these nutrients
C) From atmospheric nitrogen
D) From soil minerals
  • 8. In 2022, what was the rank of vitamin A as a prescribed medication in the US?
A) 500th
B) 100th
C) 346th
D) 10th
  • 9. How often are large bolus-size oral doses of vitamin A administered to young children in programs?
A) Once a year
B) Every four to six months
C) Every month
D) Every week
  • 10. How many deaths did the WHO estimate were averted by vitamin A supplementation between 1998 and 2008?
A) 1.25 million
B) 5 million
C) 100,000
D) 500,000
  • 11. By what percentage was all-cause mortality reduced in children aged six months to five years due to supplementation?
A) 14%
B) 50%
C) 5%
D) 25%
  • 12. What is the reported reduction in the incidence of diarrhea in children receiving vitamin A?
A) 5%
B) 12%
C) 30%
D) 20%
  • 13. What did a Cochrane review conclude regarding vitamin A supplementation for infants aged one to six months?
A) It is harmful to all infants
B) It significantly reduced infant mortality
C) It should be mandated by law
D) There was insufficient evidence to recommend it
  • 14. Which of the following has experienced vitamin A deficiency in laboratory or pet settings?
A) Dogs, cats, and birds
B) Only amphibians
C) Only chickens
D) Only reptiles
  • 15. Where do some lymphocytes migrate to differentiate into T cells?
A) Bone marrow
B) Liver
C) Thymus
D) Spleen
  • 16. What molecule triggers receptors in bone marrow to generate new white blood cells?
A) Retinoic acid
B) Calcium
C) Vitamin D
D) Cytokines
  • 17. Which cell type in the intestinal tissue converts retinal to all-trans-retinoic acid?
A) T cells
B) Monocytes
C) Dendritic cells
D) B cells
  • 18. Where are Peyer's patches located?
A) In the large intestine microbiome
B) Inside the thymus
C) Within the bone marrow
D) On the inner wall of the small intestine
  • 19. What is the net effect of retinoic acid in the intestinal system?
A) Down-regulation of immune activity
B) Up-regulation of inflammatory response
C) Elimination of the microbiome
D) Increase in food allergen sensitivity
  • 20. What characterizes the immune state during vitamin A deficiency?
A) Predominance of pro-inflammatory Th1 cells
B) Enhanced B cell function
C) High tolerance to food allergens
D) Predominance of regulatory iTreg cells
  • 21. Which groups are most commonly affected by night blindness due to vitamin A deficiency?
A) Elderly adults
B) Athletes
C) Pregnant women
D) Young children
  • 22. What increases during the dark adaptation process?
A) Corneal thickness
B) Retinal bleeding
C) Eye moisture levels
D) Photopigment amounts
  • 23. By how much can light sensitivity increase during dark adaptation compared to daylight?
A) 100,000 times
B) 10,000 times
C) 1,000 times
D) 1,000,000 times
  • 24. Which type of light is least likely to deplete rhodopsin?
A) Yellow light
B) Green light
C) Blue light
D) Red light
  • 25. How many cases of childhood blindness due to vitamin A deficiency are estimated each year?
A) 1,000,000
B) 350,000
C) 190,000
D) 50,000
  • 26. What is a major reason why the prevalence of blind pre-school children is lower than the incidence of new cases?
A) Dietary changes in the population
B) Successful medical interventions
C) High all-cause mortality
D) High recovery rates
  • 27. What serum retinol level is the criterion for vitamin A deficiency according to the 2017 Cochrane review?
A) Greater than 2.00 μmol/L
B) Less than 0.20 μmol/L
C) Less than 1.50 μmol/L
D) Less than 0.70 μmol/L
  • 28. What is the most common synthetic vitamin A used in public health programs?
A) Retinyl palmitate
B) Retinoic acid
C) Beta-carotene
D) Retinal
  • 29. What was the reduction percentage in all-cause mortality following vitamin A supplementation?
A) 24%
B) 69%
C) 58%
D) 10%
  • 30. What do herbivores convert ionone-containing carotenoids into?
A) Rhodopsin
B) Retinoic acid
C) Retinol
D) Retinal
  • 31. Which enzyme converts retinol to retinal in human liver and peripheral tissues?
A) Cytochrome P450
B) Aldehyde dehydrogenases
C) Alcohol dehydrogenases
D) RPE65
  • 32. Which enzyme system mediates the deactivation of retinoic acid?
A) Alcohol dehydrogenase
B) Cytochrome P450
C) Opsin
D) Aldehyde dehydrogenase
  • 33. Which CYP enzyme is the predominant form in the human liver?
A) CYP26C1
B) CYP26B1
C) RPE65
D) CYP26A1
  • 34. During which stage of life is CYP26C1 mainly expressed?
A) Geriatric stage
B) Embryonic development
C) Infancy
D) Adulthood
  • 35. What is the primary early sign of vitamin A deficiency?
A) Corneal ulceration
B) Xerophthalmia
C) Night blindness
D) Color blindness
  • 36. Which enzyme converts retinol into 11-cis-retinal in the retinal pigment epithelium?
A) Aldehyde dehydrogenase
B) CYP26A1
C) Alcohol dehydrogenase
D) RPE65
  • 37. 11-cis-retinal binds to which protein to form rhodopsin in rod cells?
A) Retinoic acid
B) Glucuronide
C) Opsin
D) Cytochrome P450
  • 38. What process involves 11-cis-retinal dissociating from opsin after light exposure?
A) Esterification
B) Oxidation
C) Isomerization
D) Photo-bleaching
  • 39. What kind of vitamin is Vitamin A?
A) Mineral-based
B) Protein-based
C) Water-soluble
D) Fat-soluble
  • 40. Which of the following is a primary form of Vitamin A found in animal-sourced foods?
A) Calcium
B) Iron
C) Vitamin C
D) Retinoids
  • 41. Which molecule is a well-known provitamin A carotenoid?
A) Vitamin D
B) Cholesterol
C) Glucose
D) Beta-carotene
  • 42. How is dietary retinol absorbed from the digestive tract?
A) Facilitated diffusion
B) Active transport
C) Osmosis
D) Passive diffusion
  • 43. Which transporter protein is responsible for taking up beta-carotene?
A) GLUT4
B) SCARB1
C) Insulin receptor
D) Hemoglobin
  • 44. What happens when Vitamin A toxicity occurs?
A) Hypervitaminosis A
B) Dehydration
C) Vitamin D deficiency
D) Hypovitaminosis A
  • 45. Which biomarker is used to confirm Vitamin A deficiency?
A) Blood glucose
B) Plasma retinol
C) White blood cell count
D) Plasma calcium
  • 46. Which of the following is not a carotenoid mentioned in the text?
A) Vitamin E
B) Gamma-carotene
C) Beta-cryptoxanthin
D) Alpha-carotene
  • 47. What structural component is found in all Vitamin A vitamers?
A) Alpha-glucose ring
B) Beta-ionone ring
C) Methyl side chain
D) Carbonyl group
  • 48. Which enzyme catalyzes the conversion of retinal to retinol?
A) Retinol dehydrogenase
B) Retinaldehyde reductase
C) Retinoic acid oxidase
D) Retinal dehydrogenase
  • 49. Which process converts retinal into all-trans-retinoic acid?
A) Irreversible conversion
B) Hydrolysis
C) Reversible conversion
D) Oxidative phosphorylation
  • 50. What protein transports retinoic acid into the cell nucleus?
A) Albumin
B) Retinol binding protein
C) Hemoglobin
D) CRABp2
  • 51. Besides retinol, retinal, and retinoic acid, what else can be metabolized into retinol?
A) Amino acids
B) Retinoids
C) Carotenoids
D) Cholesterol
  • 52. Which of the following is an example of a retinoid not considered a Vitamin A vitamer?
A) Retinal
B) All-trans-retinoic acid
C) Retinol
D) Adapalene
  • 53. What protein binds retinol within the enterocyte?
A) RBP2
B) BCO1
C) RBP4
D) SCARB1
  • 54. What percentage of chylomicrons are typically taken up by the liver after a meal?
A) All of them
B) Two-thirds
C) One-quarter
D) One-half
  • 55. What protein transports retinol from the liver into blood circulation?
A) RBP2
B) RBP4
C) Retinyl ester hydrolase
D) SCARB1
  • 56. Which animal liver is notoriously toxic to humans due to high vitamin A content?
A) Lion
B) Polar bear
C) Tiger
D) Domestic cat
  • 57. Which receptors must RARs dimerize with to bind to DNA?
A) Histone receptors
B) Retinoid X receptors (RXRs)
C) Retinoic acid receptors (RARs)
D) Cyp26 receptors
  • 58. Which enzymes are responsible for deactivating retinoic acid signaling?
A) Retinaldehyde dehydrogenases
B) Cyp26 cytochromes
C) Retinol oxidases
D) Chromatin remodelers
  • 59. What is the result of altering endogenous RA signaling during early embryology?
A) Enhanced neural development
B) Improved metabolic function
C) Increased growth rate
D) Birth defects
  • 60. What substance competes with retinaldehyde for aldehyde dehydrogenase activity?
A) Acetaldehyde
B) Tretinoin
C) Retinol
D) Isotretinoin
  • 61. RARs and RXRs must perform what action before binding to DNA?
A) Dissociate
B) Dimerize
C) Oxidize
D) Metabolize
  • 62. What is the function of coactivators in the receptor complex?
A) Repress gene expression
B) Loosen chromatin structure
C) Inhibit dimerization
D) Bind to Cyp26 enzymes
  • 63. Which of the following is an example of a congenital anomaly associated with fetal alcohol spectrum disorder?
A) Increased enzyme production
B) Over-activation of RXRs
C) Enhanced receptor sensitivity
D) Craniofacial defects
  • 64. What is the primary consequence of Vitamin A deficiency mentioned in the text?
A) Adverse health consequences including death
B) Improved eyesight
C) Enhanced muscle growth
D) Increased height
  • 65. Where is Vitamin A deficiency considered a rare condition?
A) Low-income countries
B) The United States
C) Global rural areas
D) Middle-income countries
  • 66. By what percentage does vitamin A supplementation reduce the incidence of measles?
A) 75%
B) 100%
C) 25%
D) 50%
  • 67. Where was the 2025 measles outbreak mentioned in the text centered?
A) North New York
B) East California
C) West Texas
D) South Florida
  • 68. Who promoted vitamin A as a prevention and treatment for measles in the context of the 2025 outbreak?
A) The World Health Organization
B) Robert F. Kennedy Jr.
C) Covenant Children's Hospital
D) The Center for Disease Control
  • 69. Which skin cells produce and secrete antimicrobial peptides?
A) Neurons
B) Adipocytes
C) Keratinocytes
D) Melanocytes
  • 70. What enzyme cleaves β-carotene into two molecules of retinal?
A) β-carotene-15, 15'-monooxygenase
B) Carotene isomerase
C) SCARB1
D) Retinol reductase
  • 71. What is the tolerable upper intake level (UL) for vitamin A according to the US National Academy of Medicine?
A) 2600 μg/day
B) 3000 μg/day
C) 1300 μg/day
D) 900 μg/day
  • 72. What is the RDA for children ages 1-3 years?
A) 300 μg/day
B) 400 μg/day
C) 900 μg/day
D) 600 μg/day
  • 73. Which term does the EFSA use instead of RDA?
A) Retinol activity equivalent (RAE)
B) Population Reference Intake (PRI)
C) Adequate Intake (AI)
D) Average Requirement
  • 74. What is the PRI for lactating women according to the EFSA?
A) 650 μg/day
B) 1300 μg/day
C) 750 μg/day
D) 700 μg/day
  • 75. Which gene encodes the enzyme that cleaves β-carotene in mammals?
A) SCARB1
B) BCM01
C) CARA1
D) RET1
  • 76. What symptom is specifically noted in infants given an oral dose of Vitamin A?
A) Muscle weakness
B) Liver abnormalities
C) Bulging skull fontanel
D) Blurred vision
  • 77. Which of these was considered but dismissed by the US Institute of Medicine as an adverse effect for setting ULs?
A) Headache
B) Reduced bone mineral density
C) Liver abnormalities
D) Teratogenicity
  • 78. What uncertainty factor was used to determine the UL for adults based on liver abnormalities?
A) 2
B) 1.5
C) 5
D) 10
  • 79. What is the only adverse effect reported from consuming β-carotene rich foods?
A) Hypervitaminosis A
B) Cardiac failure
C) Carotenemia
D) Lung cancer
  • 80. What is the clinical term for the orange discoloration caused by excess carotenoids?
A) Carotenoderma
B) Melanoma
C) Hypervitaminosis
D) Jaundice
  • 81. When was the U.S. vitamin A labeling daily value revised to 900 μg RAE?
A) July 2021
B) 1 January 2022
C) 27 May 2016
D) May 2018
  • 82. Which regions commonly require mandatory food fortification with vitamin A?
A) North America
B) Europe
C) South America
D) Sub-Saharan Africa
  • 83. Which country was the first to officially issue a biosafety permit for Golden Rice?
A) United States
B) Australia
C) The Philippines
D) India
  • 84. Is carotenemia a reversible condition?
A) No, it is permanent
B) Only in children
C) Only if treated with medication
D) Yes
  • 85. What was the initial year for research on rice biofortification?
A) 2004
B) 2018
C) 1982
D) 2021
  • 86. How often are national Vitamin A supplementation campaigns typically conducted?
A) Weekly
B) Annually
C) Semi-annually
D) Monthly
  • 87. Which of the following is identified as a secondary cause of Vitamin A deficiency?
A) Proper caloric energy intake
B) Normal liver function
C) Systemic infections
D) High intake of animal-sourced foods
  • 88. Which specific form of retinoic acid is known as all-trans-retinoic acid?
A) Retinyl palmitate
B) Trifarotene
C) Tretinoin
D) Isotretinoin
  • 89. How is isotretinoin typically administered for acne treatment?
A) Orally
B) Intramuscular injection
C) Intravenous injection
D) Topical cream
  • 90. What is the primary function of Trifarotene?
A) Retinol inhibitor
B) RXR-alpha antagonist
C) Sebum stimulator
D) RAR-gamma agonist
  • 91. What is the Pregnancy Category for topical retinoic acid according to US designation?
A) Category A
B) Category B
C) Category C
D) Category X
  • 92. What substance is secreted by facial pores and acts as a nutrient source for bacteria?
A) Sweat
B) Collagen
C) Sebum
D) Keratin
  • 93. What is the primary medical use of oral isotretinoin mentioned in the text?
A) Treating treatment-resistant acne
B) Treating excessive dry skin
C) Preventing skin cancer
D) Treating severe hair loss
  • 94. What is the risk percentage of physical birth defects for infants exposed to isotretinoin in utero?
A) 10–15%
B) 5–10%
C) 20–35%
D) 40–50%
  • 95. How much does the recommended daily dose of isotretinoin reduce sebum excretion within a month or two?
A) 25%
B) 50%
C) 90%
D) 75%
  • 96. How long before starting isotretinoin treatment should women of child-bearing age begin contraception?
A) A week before
B) A month before
C) Six months before
D) Immediately upon starting
  • 97. What is the rate of neurocognitive impairment in infants exposed to isotretinoin without physical defects?
A) 70–80%
B) 10–20%
C) 5–15%
D) 30–60%
  • 98. What type of acne is isotretinoin approved by the FDA to treat?
A) Severe acne vulgaris
B) Psoriasis of the face
C) Bacterial skin infections
D) Mild facial acne
  • 99. How long after isotretinoin treatment should contraception continue for women of child-bearing age?
A) A month
B) A year
C) A week
D) Six months
  • 100. What does the text identify as a major developmental risk of isotretinoin?
A) Teratogenicity
B) Nephrotoxicity
C) Hepatotoxicity
D) Cardiotoxicity
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