YEAR 2 SEM 2 (DIFFICULT ONES)

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  1. What is the part of the body that contains the largest amount of FFM?
    Skeletal muscles - 43% of fat free mass
  2. Heavy smokers may have 10% higher energy expenditure than non-smokers of similar body size
    Heavy smokers may have 10% higher energy expenditure than non-smokers of similar body size
  3. When energy intake falls there is a likelihood that micronutrient needs will no longer be met through diet
    When energy intake falls there is a likelihood that micronutrient needs will no longer be met through diet
  4. What are the main components of Low energy-dense foods?
    Low energy-dense foods contain: Lots of water, protein, fibre. Little fat, low sugar
  5. What does the rule of three say in naturopathy?
    The Rule of Three, is about looking for a minimum of 3 indications that support your naturopathic detective work (ex. diet, family history and nails)
  6. What are the richest food sources of Coq10?
    Meat, poultry, fish, soybean, canola oils, nuts
  7. Biotin might compete with another nutrient in its absorption, which one?
    ALA - there is some evidence that high concentrations of ALA can compete with biotin for transport across cell membranes, because they need to use the same carrier
  8. 4.Glucosamine might increase my absorption and I am a mineral needed for GAGs synthesis. What am I?
    Sulphur is required for articular cartilage glycosaminoglycan (GAG) synthesis
  9. The detoxification of sulfite to sulfate is dependent on which mineral?
    Molybdenum
  10. Supplemental coenzyme Q10 appears to be beneficial in cardiovascular health. Name two cardiovascular conditions in which it has been found to be of benefit, describing how it may be of help
    • Mitochondrial coenzyme essential for the production of ATP. Vital in cells with high energy requirements like the cardiac cells which are extremely sensitive to CoQ10 deficiency produced by cardiac diseases. CoQ10 has thus a potential role for prevention and treatment of heart ailments by improving cellular bioenergetics
    • Antioxidant, a free radical scavenging and a vasodilator effect which may be helpful in these conditions. It inhibits LDL oxidation and thus the progression of atherosclerosis. Atherosclerosis is at the core of the development of CVD
  11. With regards the energy metabolism, what is the first law of thermodynamics?
    Energy cannot be created or destroyed, but it can be  only transformed from one form into another
  12. The chemical energy obtained from foods is used to perform what 3 things?
    • Chemical work (synthesis of new macromolecules).
    • Mechanical work (muscular contraction).
    • Electrical work (maintenance of ionic gradients across membranes).
  13. Explain the Second Law of Thermodynamics
    • When food is utilised in the body (for chemical, mechanical or electrical work), this is always accompanied by the loss of some energy in the form of heat.
    • This heat energy that is no longer available for work is called ‘entropy’.
    • Up to 75% of the chemical energy in food is lost as heat!
  14. Which population groups have lower energy expenditure?
    • Elderly - decline in total energy expenditure
    • Women - have lower energy expenditure than women
    • Sedentary individuals / those not involved in physical work
  15. What are the theories of control around food intake?
    • Lipostatic theory - body fat is the key substance which regulates eating behaviour
    • Glucostatic theory - food consumption is triggered by decreased glucose availability to tissues.
    • Hepatostatic theory - metabolic activity of liver regulates eating behaviours
    • Aminostatic theory - fewer AA in blood stronger the hunger, serotonin signals satiety.
    • Thermostatic theory - heat generated by eating inhibits further food intake
  16. Name 2 chemicals which induce satiety or supress appetite
    • Serotonin
    • Leptin
    • Cholesystokinin
    • GLP-1
    • Bombesin
  17. Name 2 chemicals which stimulate food intake.
    • Neuropeptide Y - Potent stimulant of food intake
    • Ghrelin - related to growth hormone, may trigger a meal.
  18. Soy isoflavones in particular are believed to have the following actions which help combat the development of cancer?
    • have some estrogen activity
    • alter biological activity of endogenous oestrogens and testosterones
    • bind to oestrogen receptors, mimicking effects of oestrogen in some tissues and antagonizing (blocking) the effects of oestrogen in others.
    • Anti-oestrogenic properties reduce risk of hormone associated cancers (breast, uterine and prostate)
    • inhibit enzymes crucial for stimulating cell proliferation(anti-tumour property).
    • slow rising serum PSA concentrations associated with prostate tumour growth
  19. What is the name of the bacteria which can grow unchecked and cause colitis when there is frequent antibiotic use?
    Clostridium difficile (difficult)
  20. What is clubbing of the nails indicative of and how is it identified?
    • Identified by Schamroth's window!
    • Pulmonary disease (lungs) 
    • CVD (RF)
    • Hyperthyroidism
    • Irish (shamrock) Bobby smokes (lungs) and CVD from cocaine
  21. How are Beau's lines and Mee's lines different and what are they indicative of?
    • Beau's = furrowed horizontal line indicative of illness/trauma, severe infection, myocardial infarction, shock, low zinc, acute injury, chemo/immunosuppressive therapy
    • (Everything)
    • Mee's = horizontal white lines, acute illness, heavy metal toxicity
    • (me likes heavy metal)
  22. How many calories in 1g of the following:
    Alcohol
    Carbohydrate
    Fat
    Protein
    • Fat – 9kcal
    • Alcohol- 7kcal (has seven letters in it)
    • Carbohydrate – 4kcal (number + kcal = 4)
    • Protein –4kcal
  23. What are two of the three mechanisms of action by which chondroitin sulphate may protect cartilage?
    • Decreasing inflammatory action.
    • Increasing the synthesis of hyaluronic acid
    • when I'm a great anti I'm going to need more hyaluronic acid to reduce my inflammation
  24. Does Methyl Sulfonylmethane (MSM) appear to increase, decrease or have no effect on homocysteine levels?
    Decrease
  25. Explain how antibiotic therapy could decrease the biological activity of soy properties in human nutrition?
    Intestinal bacteria play an important role in the metabolism of soy isoflavones
  26. What are two of the three therapeutic actions of Shiitake mushrooms as evidenced by animal studies?
    • Anti-tumour/anti-cancer
    • Cholesterol-lowering
    • Virus-inhibiting effects
    • I have Apple Cider vinegar and shiitake
  27. What are two nutrients in pomegranate known to influence its health benefits?
    • Vitamin C - obvious - colour
    • Potassium - begins with same letter as fruit
  28. What are two of the historic medicinal uses of cilantro/coriander?
    • Heavy metal detoxification,
    • Anti parasitic (think oregano)
    • May lower blood glucose levels (me)
    • Me and Eduardo like coriander and oregano
  29. During adolescence the recommended intake of most micronutrients increases. On average what are two of the four nutrients most likely to be neglected Western diet?
    • Vitamin A
    • Vitamin E
    • Zinc
    • Calcium
    • Anna Elizabeth's Zumba Class
  30. List four dietary factors or other nutrients which magnesium absorption is inhibited by?
    • Fibre
    • Alcohol
    • calcium
    • Phosphorus.
    • Prosperous cocaine alcohol fibre
  31. Other than RMR, DIT and Physical activity, what are the other sources of energy expenditure:
    • The energy cost of growth: significant only in
    • the first months of life.
    • Adaptive thermogenesis: heat production during exposure to reduced temperatures (mostly in infants).
    • Drug-induced thermogenesis: – Nicotine: Heavy smokers may have 10% higher energy expenditure than nonsmokers of similar body size. – Caffeine (coffee, tea, chocolate) capsaicin (hot chillies)
    • Psychological thermogenesis: anxiety, anticipation and stress stimulate adrenaline production leading to increased heat production.
    • drug-IT Growth AT (infants) = anxiety 
  32. How do β-glucans work?
    • Act on several immune receptors, triggering a group of immune cells including macrophages, neutrophils, monocytes, natural killer cells and dendritic cells
    • Trigger - Macro, mono, neutro, NK & Den
  33. What are two of the three therapeutic actions of Cordyceps mushrooms?
    • Stimulate immune function
    • Cytotoxic to cancer cells.
    • Inhibit platelet aggregation and thrombus formation.
    • Corden except immune function, cancer, thrombus
  34. What are three therapeutic actions of Reishi mushrooms?
    • Stimulate immune function
    • Cytotoxic to cancer cells.
    • Stimulate detoxification enzymes
    • Gay (reishi) stimulate immune, go on detox, cancer
  35. Name 2 ways in which Coriolus mushrooms may be considered a complementary cancer therapy:
    • Slowing the spread of cancer cells
    • Improving survival rates 
    • Immune boosting properties for chemotherapy patients.
    • Lessening some side effects of chemotherapy and radiotherapy
    • Coriolus=complementary = Slow improve boost lessen
  36. Name 3 therapeutic properties of Grifiola mushrooms indicated by animal studies:
    • May lower blood pressure.
    • Improves the lipid profile in hyperlipidemia.
    • Has a hypoglycemic effect
    • When I got chosen into grifindor I was in shock (hypoglycemic) and my BP lowered.
  37. What are phytonutrients and why do plants produce them?
    • Chemicals the plant makes in reaction to its environment.
    • They are adaptive responses to maintain an evolutionary advantage.
    • They may be medicines for the plant itself.
    • Protection from animal predation.
    • Organic plants often have higher phytochemical levels, due to the fact they must protect themselves in their environment as they don’t get ‘molly-coddled’ with pesticides, fertilisers and perfect conditions.
    • The interaction the plant has with the environment around it
  38. How do phytochemicals work in the human body/what effect do they have?
    • They may function as antioxidants.
    • They may regulate the cell cycle.
    • They may increase detoxification of carcinogenic compounds.
    • They may reduce DNA damage.
    • They may mimic or interact with hormones.
    • A crab can detoxify carcinogenic compounds which can reduce DNA and make them hormonal.
  39. What are flavonoids?
    • Water soluble molecules containing 15 carbon atoms.
    • Are responsible for the colouring of fruits, vegetables and herbs
    • Are found in most plant material.
  40. What are the 6 major subgroups of flavonoids?
    • Flavanols
    • flavanones
    • flavonols
    • flavones
    • anthocyanins
    • isoflavonoids.
  41. Flavonoids main actions are:
    • Antioxidant
    • Anti-allergic
    • Anti-cancer
    • Anti-inflammatory
    • Anti-viral
    • 5 aunties
  42. In addition to its antioxidant and anti-cancer properties, explain one other action of Kaempferol and some foods rich in it:
    • Anti-oxidant
    • Chemopreventative
    • Prevents atherosclerosis / arteriosclerosis
    • Apples, citrus fruit, grapes
  43. In addition to its antioxidant and anti-cancer properties, explain one other action of Catechins and some foods rich in it:
    • Anti-oxidant
    • Chemopreventative
    • Decreases insulin resistance / mimics insulin
    • Anti-inflammatory
    • Cocoa, tea, grapes
  44. In addition to its antioxidant and anti-cancer properties, explain one other unique feature of Quercetin and some foods rich in it:
    • most abundant of flavonoids
    • building block for other flavonoids
    • Antioxidant
    • protective against CVD
    • chemopreventative
    • Apples, green tea, berries
  45. In addition to its antioxidant and anti-cancer properties, explain one other unique feature of Naringin and some foods rich in it:
    • Antioxidant
    • Anti-cancer
    • Cholesterol lowering
    • Reduces renal disease linked to diabetes
    • reduces diabetic neuropathy.
    • Can interfere with certain drug metabolism by increasing serum level of: sedatives, anti-depressants, cholesterol lowering drugs, warfarin, oestrogen, anti-psychotics
    • Grapefruit
  46. In addition to its antioxidant and anti-cancer properties, explain one other unique feature of isoflavones and some foods rich in it:
    • Antioxidant
    • Anti-cancer
    • Phytoestrogens (Genstein & Daidzen)
    • can mimic and block estrogen
    • reduce hormone related cancers
    • menopause
    • osteoporosis..
  47. Which vitamins and minerals are in Wheatgrass?
    • (ACE, Felix Can Manage)
    • Vits - ACE
    • Mins - Fe, Ca, Mg
  48. Wheatgrass contains which phytonutrients?
    • (AAC)
    • Agropyrene
    • Apigenin
    • Chlorophyll
  49. Name the main thing which Wheatgrass has proven efficacy on:
    Ulcerative colitis (due to anti-inflammatory effects of apigenin).
  50. Which phytonutrient is Barley grass abundant in?
    Chlorophyll (27mg in one 12g serving)
  51. Due to it's high chlorophyll content, human studies show the efficacy of Barley grass on what?
    Binding carcinogens (especially alflatoxin) to prevent their absorption from the GI and reduce the amount that reaches susceptible tissues.
  52. Which of the superfoods is high in protein with 19 AAs?
    Chlorella
  53. Other than the anti-cancer effects of Chlorella, what other benefits does it provide (thanks to the chlorophyll content)?
    • Heavy metal toxicity (chelates it), particularly mercury and lead elimination.
    • Viruses which sap energy (Epstein-Barr, candida overgrowth, AIDS)
  54. Spirulina is a good source of B vits, discuss it's role as a source of B12 for vegans:
    Do not recommend as a source of B12 for vegans as the analogues of B12 are nutritionally insignificant for humans.
  55. Adverse reaction of barley grass?
    • May interact with warfarin due to high vit K content.
    • Dad is a barley man
  56. Other than the anti-cancer effects of Chlorella, what other benefits does it provide (thanks to the chlorophyll content)?
    • Heavy metal toxicity (chelates it), particularly mercury and lead elimination.
    • Viruses which sap energy (Epstein-Barr, candida overgrowth, AIDS)
    • Eduardo is tired with a virus
  57. List the red flags related to PAIN:
    • any pain which is persistent, particularly if severe or in the head, abdomen or central chest
    • pain in the eye or temples, with local tenderness, in the elderly, rheumatic patient
    • pain on passing urine in a man
    • cystitis recurring more than three times in a woman
    • absence of pain in ulcers, fissures etc.
    • sciatic pain if associated with objective neurological deficit
  58. List the red flags related to BLEEDING:
    • blood in sputum, vomit, urine or stools
    • vomit containing “coffee grounds”
    • black, tarry stools
    • non-menstrual vaginal bleeding (inter menstrual, postmenopausal, or at any time in pregnancy)
    • vaginal bleeding with pain in pregnancy or after missing one period
  59. List the red flags related to PSYCOLOGICAL SYMPTOMS:
    • deep depression with suicidal ideas
    • hearing voices
    • delusional beliefs
    • incongruous behaviour
  60. List the red flags related to PERSISTENT SYMPTOMS:
    • vomiting and/or diarrhoea
    • vomiting and/or diarrhoea in infant
    • thirst
    • increase in passing urine
    • cough
    • unexplained loss of weight (1lb per week or
    • more)
  61. List the red flags related to SUDDEN SYMPTOMS:
    • breathlessness
    • swelling of face, lips, tongue or throat
    • blueness of the lips
    • loss of consciousness
    • loss of vision
    • convulsions
    • unexplained behavioural change
  62. Difficulty in what 2 things are a red flag?
    • Breathing
    • Swallowing
  63. Changes in what 2 things are a red flag?
    • in bowel habit
    • a skin lesion (size, shape, colour, bleeding, itching, pain)
  64. What are other red flag symptoms:
    • pallor
    • unexplained swelling or lumps
    • neck stiffness in a patient with fever
    • unexplained fever, particularly if persistent or recurrent
    • brown patches (Addison’s disease
  65. Explain the difference between deficiency and
    insufficiency?
    • Deficiency describes an extended lack of a particular vitamin, leading to end stage symptoms,
    • insufficiency is identified by under functioning of certain biochemical pathways
  66. Can the label on a supplement make a medical claim?
    • No there may be no presentation or labelling that infers that a supplement can
    • PREVENT, TREAT or CURE human disease
  67. What does MHRA stand for?
    The Medicines and Healthcare Products Regulatory Agency
  68. Which UK body controls most vitamins, minerals and
    supplements in the UK?
    The FSA (Food Standards Agency) under EU food legislation
  69. What %RDA must a product have to claim to be a ‘source’ of?
    15%
  70. What %RDA must a product have to claim to be ‘rich in’?
    30%
  71. Why have many small herbal companies been forced out of the market place?
    Because of the cost to register their products with MHRA
  72. Name 4 allergens that must be labelled on food products?
    Eggs, mustard, celery, nuts
  73. What is GMP?
    Good Marketing Practice – ensures that medical products are consistently produced and controlled to the quality standards appropriate to their intended use and as required by the marketing authority or product specification (only applies to licensed meds)
  74. Do UK supplement companies have to meet the requirements of GMP?
    No, but they are required to manufacture with ‘due diligence’ (therefore, they are often GMP compliant but not GMP approved)
  75. Give an example where processing can affect the quality of an ingredient?
    Fish and omega plant oils need to be cold pressed, to minimise oxidation
  76. What is ‘overage’?
    calculating how much an ingredient will degrade by and adding extra during manufacture, so that the amount left in the tablet, at the end of it’s shelf life, still meets the label claim
  77. Name 4 different forms of supplementation?
    Capsule, Liquid, enteric formulation, slow release
  78. What is Carrageenan?
    • A natural gum from seaweed used to
    • thicken formulations and as an emulsifier
  79. What common feature do the excipients Cellulose Acetate Phthalate and Diethyl
    Phthlate have?
    • They protect against breakdown of the
    • tablet/capsule in the stomach
  80. Where does most absorption of vitamins and
    minerals take place?
    • in the duodenum and jejunum
    • (apart from vitamins A, D, E, K -  absorbed in the Ileum)
  81. Name 3 things (out of the 7 principles) that must be taken into consideration when
    deciding the dose of a supplement for a client?
    • Digestive capability (absorption and excretion)
    • Therapeutic doses that have been shown to work in clinical trials in certain disease states
    • safe therapeutic range.
  82. Can you recommend a dose over that which is stated on the bottle?
    Yes, provided you keep within a safe range  and have an ‘end date’ on your plan – no one should take high doses without review.
  83. What form should a mineral be in, in order, to be absorbed?
    It must be ionised
  84. Given 2 examples of inorganic minerals?
    • Sulphates
    • nitrates
  85. Are inorganic minerals easy to absorb?
    No, absorption can be as little as 1-20%
  86. Name 2 organic minerals?
    Citrates and picolinates
  87. Give one benefit of using a supplement with
    amino acid chelated minerals?
    The body is very efficient at absorbing amino acids
  88. What vitamin is calcium normally given with?
    D3 (to increase absorption capacity, resulting in higher serum levels of calcium)
  89. Give one example of a drug/herb/nutrient
    interaction?
    Tetracyclines and calcium (take 2 hours apart)
  90. Name two things that slow the rate of absorption of iron?
    • Tannins (in tea)
    • zinc (competes for absorption sites)
  91. Which is the most bioavailable form of Vit C
    (according to marketing claims)?
    Ester-C
  92. Name two natural forms of Vit c that are
    normally used in supplements?
    Rose hip and Acerola
  93. What is Beta-Carotene?
    It is pre-formed Vit A and is converted to vit A within the body on an as-needed basis (prevents toxicity)
  94. Name two groups of people who should be cautious about taking Vit A supplementation?
    • Pregnant women and
    • those suffering with liver disease
  95. Should synthetic Vit E supplementation be promoted?
    No (comes from petrochemicals and may inhibit the natural form from entering the cells)

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YEAR 2 SEM 2 (DIFFICULT ONES)
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2017-07-04 05:35:42
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