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Nutrition 1 (Semester II) > 12. Advanced Naturopathic Case Taking > Flashcards

12. Advanced Naturopathic Case Taking Flashcards

1
Q

What are the 5 naturopathic principles?

A 
Healing power of nature
Treat the cause, not the symptoms
Treat the whole person
Prevention is preferable to a cure
Education
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2
Q

What are Hering’s laws of cure?

A 
From the inside out
From more important organs to less
The mind gets better before the body
Symptoms disappear in the reverse
From above to below
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3
Q

How is health like a tree?

A

Imbalances begin at the roots - and include traumas and lifestyle factors throughout life stages
Symptoms are the end result - leaves on the trees
(treating the individual leaves doesn’t get to the root)

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4
Q

When assessing the whole person, what should you take into account?

A 
Antecedents
Triggers
Mediators
Lifestyle factors
Timeline of events
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5
Q

What are antecedents?

A

Predisposing factors to a disease

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6
Q

Examples of antecedents

A 
Genetics
Constitution
Age
Sex
Lifestyle/environment
Historical trauma
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7
Q

What lifestyle/environmental factors can be antecedents?

A

Nutritional deficiency at birth
Dietary toxins - pesticides, alcohol use
Drugs - antibiotics
Other toxins - pollution, heavy metals

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8
Q

How do genes play a part in the health of an individual?

A

Genetics can influence the person but…
The expression of genes can be altered by the environment they’re bathed in
Switching genes on/off to create/prevent disease

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9
Q

What can congenital factors be affected by?

A

Gestational environment during pregnancy
Low/high birth weight
Infections
Environment on the epigenetics of the baby

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9
Q

What is the definition of a trigger?

A

Anything that initiates an acute illness or the emergence of symptoms

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10
Q

What are common triggers?

A 
Physical/emotional trauma
Stressful life events
Medications
Dietary allergens
Environmental toxins
Temperature changes e.g. asthma/OA in winter
Microbes
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11
Q

What kind of questions can you ask to ascertain triggers?

A

When did the symptoms start?

Did anything happen around the time that the symptoms started?

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12
Q

How can we test for trigger factors?

A 
Parasitology
Dysbiosis (stool testing)
Heavy metal toxicity
Hair mineral analysis
Kinesiology (muscle testing)
Allergy elimination technique (NAET)
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13
Q

What is the definition of mediators?

A

Factors that contribute to pathological changes and dysfunctional responses

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14
Q

Examples of mediators

A 
Chronic stress
Intestinal dysbiosis
Sedentary lifestyle
Free radicals
Electromagnetic frequencies (EMFs)
Cognitive/emotional
Social/cultural
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15
Q

How can chronic stress be a mediator?

A

Can increase cortisol levels and decrease progesterone

This can be associated with menstrual problems and lead to the effects of excess oestrogen

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16
Q

How can intestinal dysbiosis be a mediator?

A

Western diet, antibiotics etc can affect neurotransmitters

e.g. reduced melatonin and increased oxidative stress

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17
Q

How can a sedentary lifestyle be a mediator?

A

Influences neuropeptides

e.g. increase in substance P = increase in pain

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18
Q

How can free radicals be a mediator?

A 
Continued use of:
Smoking
Alcohol
Highly processed diet
Medications
Vaccines
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19
Q

How can electromagnetic frequencies be mediators?

A 
TVs
Computers
WiFi
Mobile phones
All can disrupt sleep (lowering melatonin)
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20
Q

How can cognitive/emotional factors be mediators?

A

Personal beliefs about illness

Poor self-esteem

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21
Q

How can social/cultural factors be mediators?

A

Lack of resources due to social isolation/poverty
Lack of cultural understanding
Reinforcement for staying sick (supported emotionally and financially when sick but not when well)

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22
Q

Which biochemical mediators can be tested?

A

Inflammatory - CRP, ESR, serum ferritin, calprotectin

Endocrine - TSH, T4, fT4, fT3, oestrogen, progesterone, testosterone, cortisol

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23
Q

What are the seven core clinical imbalances that need to be considered when deciding which systems are under stress?

A 
Assimilation
Structural integrity
Communication
Defence and repair
Transport and circulation
Energy - mitochondrial health
Detoxification and elimination
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24
Q

What are the areas to assess under assimilation?

A

Digestive secretions - HCl, pancreatic, bile, IF
Digestive motility - vagus nerve, SNS, PSNS, enteric NS
Digestive hormones - ghrelin, gastrin, CCK
Absorption of nutrients - villi, BB enzymes
Microbiota balance - parasites, bacteria, yeast, SCFA (fibre), lactobacilli, bifidobacteria

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25
Q

What are the areas to assess under structural integrity?

A

Cell membrane health - EPA/DHA
Mucous membrane/skin integrity - vit A, E, glutamine
Bones/teeth - minerals
Joints/cartilage - Ca, Mg, P, vit D, C

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26
Q

What are the areas to assess under communication?

A

Hormones/endocrine system

Neurotransmitters/nervous system

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27
Q

What are the areas to assess under defence and repair?

A 
Inflammation
Infections
Microbiota imbalances
Allergies
AI
Lowered immune function
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28
Q

What are the areas to assess under transport and circulation?

A

Lymphatic structures - tonsils, spleen, thymus, nodes
Vascular structures - arteries, veins, capillaries
Mobilisation of blood lipids

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29
Q

What are the areas to assess under energy (mitochondrial health)?

A

Energy co-factors
Biochemical imbalances in energy pathways - aluminium, fluoride, arsenic, lead
Mitochondrial integrity
Oxidative damage

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30
Q

What are the areas to assess under detoxification and elimination?

A

Liver/gall bladder function
Kidney function
Bowel function
Skin
Lungs
Biochemical imbalances in the biotransformation pathways
e.g. lack of methyl donors (cysteine, choline, glutathione, methionine

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31
Q

Signs and symptoms of assimilation imbalance

A 
Pallor
SOB
Dysbiosis
Gas
Bloating
Food intolerances
Heartburn
Increase/decrease in body weight
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32
Q

Signs and symptoms of structural integrity imbalance

A 
Joint pain/injury, tendons, muscles
Skin problems
Gut membrane integrity/AI conditions
Diet low in EFAs
Low exposure to sunlight
Low bone minerals - Ca, Mg, Zn, B, P
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33
Q

Signs and symptoms of communication imbalance

A 
Hormonal issues 
Reproductive
Fatigue 
Stress
Mood
Sleep
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34
Q

Signs and symptoms of defence and repair imbalance

A 
Recurring infections
Fatigue
Poor wound healing
Skin issues
AI
Intestinal permeability
Low vit D/AO
High free radicals
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35
Q

Signs, symptoms and conditions of mitochondrial health imbalance

A 
Weakness/fatigue
CFS/ME
Parkinson's
MS
Long Covid
Poor cognitive function
Poor memory
Intestinal permeability
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36
Q

Conditions suggesting a transport imbalance

A

CVD
Raynaud’s
Peripheral neuropathy
Oedema

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37
Q

Things to consider for a detoxification and elimination imbalance

A 
Medications
Poor diet/lifestyle
Poor stool quality/quantity
Light coloured stools
Smoking
Alcohol
Exposure to chemicals
Low AO in diet
Jaundice
Lethargy
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38
Q

For a client whose main concern is optimal health and prevention, would should you ask about?

A

Past/present medical history
Family history
Risk factors for potential future illness - fitness, diet, sleep, alcohol, drugs, tobacco, home/work environment, stress, relationships, goals

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39
Q

For a client with an active health problem, what should the questions focus on?

A

What was your health like before this problem began?
Ask about antecedents, triggers, mediators
Focus on where in the client’s life those triggers are occurring

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40
Q

What constitutes the art of case taking?

A

Observe
Listen
Clarify
Empower

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41
Q

During case taking, what can you observe?

A 
Skin - tone, condition, markings, hair distribution
Nails
Tongue
Posture
Mannerisms
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42
Q

During case taking, how should you listen to a client?

A

Without judgment

Pay attention to repetitive words/statements/phrases

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43
Q

During case taking, what should you clarify?

A

What the client has just said, using their words

Summarise to ensure you’ve understood correctly

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44
Q

During case taking, how can you empower the client?

A

Give them an understanding of why they feel like they do

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45
Q

What evaluation tools can be used during a consultation to support your decision making?

A 
Tongue analysis
Nail analysis
Facial analysis
Urine/stool interpretations
Anthropometric measurements
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46
Q

What is the Rule of Three?

A

Needing three factors to support a hypothesis

e.g. low intake Mg rich foods, muscle cramps, dilated pupils

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47
Q

When identifying a potential nutrient deficient, what should you avoid saying to the client?

A

You are Mg deficient

Your Mg intake is insufficient

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48
Q

When identifying a potential nutrient deficiency, what should you say to a client?

A

You could benefit from taking more Mg

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49
Q

What can strong red skin indicate?

A

Excess heat

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50
Q

What can pale red skin or flushing indicate?

A

Yin deficiency
SLE
Rosacea (linked to H. pylori)
B3 deficiency

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51
Q

What can pallor indicate?

A

Qi deficiency

Anaemia

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52
Q

What can yellow skin indicate?

A

Liver disease

Spleen Qi deficiency

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53
Q

What can puffy skin indicate?

A

Yang deficiency

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54
Q

What can dry skin indicate?

A

Yin deficiency

Dehydration

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55
Q

What can many lines across the forehead indicate?

A

Poor intestinal health

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56
Q

What can one line across the forehead indicate?

A

Small intestine issue

e.g. decreased absorption

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57
Q

What can one vertical line between the eyebrows indicate?

A

Stomach insufficiency

e.g. HCl, pepsin

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58
Q

What can two vertical lines between the eyebrows indicate?

A

Liver imbalances

e.g. alcoholic, suppressed anger

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59
Q

What can lines above the lips indicate?

A

‘Purse strings’ on upper lip

e.g. reproductive organ weakness, blood deficiency, smoker

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60
Q

What can brown shadows under the eyes indicate?

A

Liver stagnation

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61
Q

What can blue/black shadows under the eyes indicate?

A

Adrenal exhaustion

Kidneys

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62
Q

What can a strong body odour indicate?

A

Heat

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63
Q

What can bad breath indicate?

A

Stomach heat

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64
Q

What can smelly urine or stools indicate?

A

Damp heat

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65
Q

What are the observational signs of poor thyroid function?

A 
Dry skin
Thin hair
Goitre
Bradycardic pulse
Low blood pressure
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66
Q

What are the observational signs of anaemia?

A 
Pallor
Angular stomatitis
Pale tongue/gums
Tachycardic pulse
Nails - spooning
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67
Q

What are tissue salts?

A

Homeopathic remedies based on minerals

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68
Q

What can white nails indicate?

A

Anaemia
Oedema
Vascular conditions

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69
Q

What can white spots on the nails indicate?

A

Ca def
Zn def
Silica def

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70
Q

What can an absent lunula indicate?

A

Anaemia

Malabsorption

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71
Q

What can a pyramidal lunula indicate?

A

Excessive manicure

Trauma

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72
Q

What can a pale blue lunula indicate?

A

Diabetes
Anaemia
Peripheral neuropathy

73
Q

What can a red lunula indicate?

A

CV disease

Connective tissue disorder

74
Q

What are Terry’s nails?

A

White nails with a pink or brown band at the end

75
Q

What can Terry’s nails be caused by?

A 
Ageing
Liver cirrhosis
Chronic kidney disease
T2D
Congestive heart failure
76
Q

What may brown-grey nails indicate?

A 
CV disease
Diabetes
B12 def
Melanoma
Topical agents
e.g. hair dyes
77
Q

What can thin, brittle nails indicate?

A

Osteopenia
Thyroid disorders
Severe malnutrition

78
Q

What non-dietary factors can cause thin, brittle nails?

A

Hand cream
Manicures
Nail varnish
Nail varnish remover

79
Q

What is paronychia?

A

Infection of the skin around the nails

80
Q

What can cause paronychia?

A

Trauma
Poor nutrition e.g. low vit C
Low immunity
Poor hygiene

81
Q

What can cause wicks/hangnails?

A

Too little protein
Lack of B vits
Lack of vit C

82
Q

What can dryness around the nails indicate?

A

EFA status
Vit A/D def
Hypothyroidism
Chemical irritants

83
Q

How do you assess for nail clubbing?

A

Place both forefinger nails together

Should show a diamond shape

84
Q

What can cause nail clubbing?

A

Pulmonary disorders
CV disease
GI causes
Hyperthyroidism

85
Q

What is koilonychia?

A

Concavity in the nails

86
Q

What can cause koilonychia?

A 
Fe def
Haemochromatosis
SLE
Raynaud's
Diabetes
Protein def
87
Q

What are Beau’s Lines?

A

Furrow across the nail

88
Q

What can cause Beau’s Lines?

A 
Severe infection
Myocardial infarction
Severe Zn def
Surgery
Chemo
89
Q

What are Mee’s Lines?

A

White lines across the full width of nail

90
Q

What can cause Mee’s Lines?

A

Heavy metal toxicity

Chemo

91
Q

What can horizontal ridges on nails indicate?

A

Sign of ageing
B vit def
RA
Peripheral vascular disease

92
Q

What can central ridges on nails indicate?

A

Repetitive trauma
Fe def
B9 def
Protein def

93
Q

What can nail pitting (dents in nails) indicate?

A

Psoriasis
Eczema
Alopecia

94
Q

What can nail thickening indicate?

A

Fungal infection
Chronic eczema/psoriasis
Peripheral vascular disease

95
Q

What is nail beading?

A

Looks like small drops of wax along nail

96
Q

What can cause nail beading?

A

Diabetes
Thyroid disorders
B vit def

97
Q

What is onycholysis?

A

Where nail plate splits from nail bed

98
Q

What can cause onycholysis?

A 
Hyperthyroidism
Eczema
Psoriasis
Trauma
Contact dermatitis
99
Q

What can brittle, peeling or splitting nails indicate?

100
Q

What can frequent hang nails or swollen tissue indicate?

101
Q

What can brittle or peeling nails indicate?

102
Q

What can white spots, weak or brittle nails indicate?

A

Ca def

Zn def

103
Q

What can a pale nail bed, central ridge or spooning indicate?

104
Q

What can weak, brittle nails indicate?

A

Protein def

105
Q

What can dry, peeling nails indicate?

106
Q

Which tissue salt can be used for white spots on nails?

107
Q

Which tissue salt can be used for fungal infections or brittle nails?

A

Kali sulph

108
Q

Which tissue salt can be used for any nail malformation?

109
Q

Which organs does the tip and front of the tongue represent?

A

Heart

Lungs

110
Q

Which organs do the sides of the tongue represent?

A

Liver

Gall bladder

111
Q

Which organs does the centre of the tongue represent?

A

Stomach

Spleen

112
Q

Which organs does the back of the tongue represent?

A 
Lower abdomen
Kidneys
Bladder
Intestines
Reproductive organs
113
Q

What can a pale tongue indicate?

A

Excess cold
Yang deficiency
Blood deficiency
e.g. iron deficiency anaemia

114
Q

What can a red tongue indicate?

A

Excess heat
Inflammation
Infection

115
Q

What deficiencies can a painful red tongue indicate?

A 
Folate
B1
B2
B3
B6
116
Q

What can a purple tongue indicate?

A

Blood stagnation
Poor circulation
Cyanosis (low O2)

117
Q

What does prominent red spots on the tongue suggest?

A

Excess heat

118
Q

What does a dry and cracked tongue suggest?

A

Yin deficiency

e.g. not enough fluids, or dried out due to excess heat

119
Q

What does a wet tongue suggest?

A

Excess moisture

Excess fluids

120
Q

What does impaired taste suggest?

A

Zn deficiency

121
Q

What does a thin tongue represent?

A

Blood deficiency

122
Q

What does a swollen tongue suggest?

A

Fluid retention

Dampness

123
Q

What does scalloped edges around the tongue suggest?

A

Weak digestion

Pancreatic insufficiency

124
Q

What do raised edges on the tongue suggest?

A

High stress

125
Q

What does a quiver on the tongue suggest?

A

Mg deficiency

Anxiety

126
Q

What is a medial fissure on the tongue?

A

Shallow crack through middle (not to tip)

127
Q

What can a medial fissure suggest?

A

Digestion deficiency

Under secretion of digestive juices

128
Q

What does a midline fissure at the tip suggest?

A

Heart problems

Thyroid issues

129
Q

What does a mapped tongue suggest?

watermarks all over

A

B vit deficiency

130
Q

In which pathology do you often see a mapped tongue?

131
Q

What can a brown coating on the tongue suggest?

A

Chronic excess heat

132
Q

What can a greasy yellow coating on the tongue suggest?

A

Inflammation

Infection

133
Q

What can a greasy white coating on the tongue suggest?

A

Excess mucus/phlegm

134
Q

What can no coating on the tongue suggest?

A

Yin deficiency

135
Q

What can dry lips suggest?

A

Dehydration
Excess heat
B2, B3 or folate deficency

136
Q

What can cracks and scaling in the corners of the mouth suggest?

A

Deficiencies - Fe, B vits
Infections - fungi, bacteria
Bite issues

137
Q

What can bleeding/receding gums suggest?

A

Vit C deficiency
Zn deficiency
CoQ10 deficiency

138
Q

What can untreated gingivitis suggest?

A

High sugar, meat, dairy

Low Zn, CoQ10

139
Q

What can pale gums suggest?

A

Fe deficiency

140
Q

What can grey gums suggest?

A

Biotin deficiency

141
Q

What can a contracted pupil suggest?

A

PSNS dominance
Inward tension
Cautious

142
Q

What can dilated pupils suggest?

A

SNS dominance

Possible adrenal exhaustion

143
Q

What deficiencies do dry eyes suggest?

A

Vit A

EFAs

144
Q

What deficiencies does night blindness suggest?

145
Q

What deficiency does pale conjunctiva suggest?

146
Q

What deficiency does a blue sclera suggest?

147
Q

What deficiency does photophobia suggest?

A

Vit A
Zn
B2
B3

148
Q

What deficiency does lack of eyelashes and eyebrows suggest?

A

Cu

thyroid needs support

149
Q

What deficiency can dermatitis suggest?

150
Q

What deficiency can hyperpigmentation of the mouth, cheek and eye area suggest?

151
Q

What deficiencies can inelastic skin suggest?

152
Q

What deficiencies can hair loss suggest?

A

Fe
Protein
Biotin

153
Q

What deficiencies can brittle, dry hair suggest?

A

Fe
Protein
EFAs

154
Q

What deficiency can grey hair suggest?

155
Q

What is the optimal pH range for urine?

156
Q

What is the optimal pH for saliva?

157
Q

What colour should normal urine be?

A

Straw colour

158
Q

What colour/smell is dehydrated urine?

A

Dark yellow

Strong smelling

159
Q

What colour of urine suggests jaundice?

A

Very dark yellow, orange, brown

160
Q

What can unpleasant smelling, cloudy urine suggest?

161
Q

What can waist to hip ratio indicate?

A

Risk level for heart attack, stroke, diabetes, premature death

162
Q

What waist to hip ratio is considered low risk?

A

<0.80 - women

<0.95 - men

163
Q

What waist to hip ratio is considered medium risk?

A
  1. 81 - 0.85 - women

0. 96 - 1.0 - men

164
Q

What waist to hip ratio is considered high risk?

A
  1. 85+ - women

1. 0+ - men

165
Q

What is the ideal stool?

A

Neither sinks nor floats - submerged
Medium brown colour
No obvious undigested food

166
Q

What can floating stools indicate?

A

Fats in diet not being properly emulsified by bile
Excessive intake of fats
Insufficient bile

167
Q

What can sinking stools indicate?

A

Heavy with decaying matter

Heavy with non-used materials

168
Q

What can thin stools indicate?

169
Q

What can dry stools indicate?

A

Poor water intake

Slow transit time - poor fibre, hypothyroid, stress

170
Q

What is the definition of constipation?

A

Passing stools less than 3 times a week
Needing to strain
Passing hard pellet-like stools

171
Q

What is a normal number of bowel movements?

A

1-3 times per day

172
Q

What can cause constipation?

A 
Low fibre diet
Digestive insufficiency - reduced peristalsis, low bile, HCl, panc enzymes
Dehydration
Sedentary lifestyle
Stress
Change in routine
173
Q

What can the colour of a stool be influenced by?

A

Presence of bilirubin

Reflection of certain foods eaten - beetroot, dark leafys, liquorice

174
Q

What can pale, clay coloured stools indicate?

A

Insufficient bile

175
Q

What can green stools indicate (non-food)?

A

Release of toxic matter in bile

176
Q

What can white mucous in stools indicate?

A

Disturbance of intestinal flora
Microbial infection
Immune response to gluten, lactose
Inflammation from ulceration

177
Q

What can very dark brown stools indicate?

A

Slow transit time in colon

Hypothyroidism

178
Q

What can orange coloured stools indicate?

A

Insufficient bile

Insufficient pancreatic lipase enzymes

179
Q

What can black, tarry stools indicate?

A 
Oesophageal/gastric bleed
Iron supplementation (not tarry)
180
Q

What can blood in stools indicate?

A

Darker blood - serious pathology

Bright red blood - haemorrhoids

Nutrition 1 (Semester II) (16 decks)

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