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Nut 2 Sem 1 > Assessment and Diagnostics > Flashcards

Assessment and Diagnostics Flashcards

1
Q

What is functional testing?

A

Focuses on how body systems are functioning.

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2
Q

What are diagnostic tests?

A

Markers to diagnose illness.

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3
Q

Benefits of functional testing

A

Deeper understanding
Targeted
Quantitative

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4
Q

Disadvantages of function testing

A

Expensive
Challenging to read

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5
Q

What is the rule of 3? (e.g. SIBO)

A
  1. Clinical symptoms
  2. Stool test findings
  3. Other stool test findings indicating poor digestion.
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6
Q

How is the reference range set?

A

By measuring a sample of the population, then setting the mean and standard deviation of what is viewed as normal.

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7
Q

Why use a microbiome test?

A
  1. Help optimise diet
  2. Ascertain if there is intestinal permeability
  3. Look for inflammation, gas producing bacteria or pathogenic microbes.
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8
Q

Microbes that live in harmony with the host and provide a benefit are….

A

Commensal

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9
Q

Microbes that possess certain evolutionary advantages to invade our microbiome at a cost to our health are….

A

Pathogenic

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10
Q

Microbes that live with us normally don’t pose a problem unless there’s opportunity are….

A

Pathobiont (opportunistic)

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11
Q

Bacteria that possess an outer cell wall, rich in lipopolysaccharides (LPS) are…..

A

Gram negative bacteria

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12
Q

A major component of gram-negative bacteria and can induce inflammation/immune responses are…

A

LPS.

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13
Q

What is a microbial marker?

A

Commensal bacteria, pathogenic bacteria, parasites, mycology, worms.

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14
Q

What is a host marker?

A

Made my the human host such as immune, digestive, inflammation, intestinal permeability.

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15
Q

Describe the inflammation marker - calprotectin

A

Calprotectin: A protein made by leukocytes when they have migrated to and are active in the GI wall.

Over 50 ug/g (High)
50- 175 (Mid-range inflammation)

Relates to pathogens and NSAIDS.

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16
Q

Describe the inflammation marker - Eosinophil Protein X

A

Raised with intestinal inflammation and food allergies / parasites

Normal <1.1. mcg /g
Mod 1.1 - 4.6 mcg /g
High > 4.6 mcg / g

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17
Q

Describe the metabolic marker Beta-glucuronidase

A

An enzyme made by some intestinal bacterial
Elevated due to dysbiosis

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18
Q

Describe the digestion marker - pancreatic elastase (PE-1)

A

Enzymes secreted by the pancreas that do not breakdown with the GIT with amylase

Normal: 200-500 ug / g
< 200 need dig support

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19
Q

Describe the digestion marker - faecal fats

A

Measure of fat in stool
High levels suggest maldigestion associated with pancreatic insufficiency & SIBO.

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20
Q

Describe the immune marker - slgA

A

Secreted by mucosal tissue - first line of immune defence.

Low < 100 ug / g

21
Q

Describe the immune marker Beta-defensin 2

A

Antimicrobial peptides produced by the GI wall.
High > 62 ng /g

22
Q

Describe the intestinal permeability marker Zonulin

A

A peptide produced by epithelial cells when GI tight junctions are open.

High > 100 ug /g

23
Q

What to check for w/ commensal bacterial

A

Diversity
SCFA producers (e.g. butyrate)
High bifidobacterium

24
Q

What is an example of mucin-degrading bacteria

A

Akkermansia muciniphila
It also plays a protective role in supporting the mucosal barrier.
If absent it could lead to metabolic endotoxemia patterns of disease.

25
Q

Name a gas producing bacteria

A

Methanobrevibacter smithii (methane prod.)
Desulfovibrio (sulphur prod)

26
Q

Name a pathobiont bacteria

A

Staphylococcus

27
Q

What could low pancreatic elastase mean?

A

Chronic stress and low HCL.

28
Q

What is SIBO

A

Small Intestinal Bacterial Overgrowth ( > 105 CFU /ml)
Raised hydrogen / methane

Breath tests to use:
Lactulose (the best one)
Glucose
Fructose

29
Q

What is SIBO associated with?

A

Poor MMC functioning
Low HLC / Pancreatic juice
Poor ileocaecal valve functioning

30
Q

When should one test the Vaginal Microbiome (VMB)?

A

Bacterial Vaginosis
Recurrent thrush
Infertility
Miscarriages
Endo

31
Q

Describe a pH vaginal marker test

A

Low vag pH = high levels of lactic acid and a healthy microbiota
High vag pH (>4.5) indicates overgrowth of bacteria.

32
Q

Describe the Interleukin bata-1 vaginal marker

A

An inflammatory marker made when epithelial cells break apart.

33
Q

Which bacteria is vaginal health associated with?

A

Low community diversity and high lactobacilli dominance.

34
Q

How do you support the vaginal microbiome?

A

Avoid soap, antibiotics and the copper coil (all increase colonisation of BV-associated microbiota)

Avoid simple carbs, alcohol and smoking (by-products are secreted into vagina)

Include vaginal probiotics (food / supps).

35
Q

How do you support the oral microbiome?

A

Prebiotic fibres and polyphenols
Probiotic foods
Low trans/processed
Avoid snacking
Avoid mercury fillings, smoking and antibiotics

36
Q

What are organic acids?

A

Natural by-products (metabolites) created from the functioning of many enzymatic pathways in the body

Measured by urinalysis
Indirect way of assessing need for vits and minerals

People with CFS, nut.def, mito dys, autism and mood disorders would benefit from this test.

37
Q

What are the benefits of an OAT test?

A

Good overview of metabolic function
Help guide a nut. plan

38
Q

Disadvantages of an OAT test?

A

Hard to interpret
Diet eaten at the time impacts markers
Not measuring vits directly

39
Q

Why use a serum test?

A

Good for standard nutrients like B12 / D3 (and inflam markers)

40
Q

Why use RBC tests?

A

Can show minerals and toxic elements taken up by RBCs

41
Q

Why use urine tests?

A

Looks for organic metabolites or pure excretion

42
Q

Why use mineral tests?

A

To see what minerals have been laid down in the hair. Shows mineral status and toxic metal accumulation.

43
Q

Which serum tests can be carried out?

A
  1. Serum B12 and serum folate
    - Homocysteine is a functional biomarker for low B9/12
    - Methylmalonic Acid (MMA) is more sensitive and is tested via serum and urine. If raised - typically a B12 def.

2.Serum ferritin (iron storage)

  1. Vit D3 (levels over 75 nmol are optimal)
  2. Serum Mg
  3. Serum Ca (only for highlighting kidney/hormonal probs)
44
Q

Describe the inflammatory marker C-Reactive Protein (CRP)

A

Can highlight low grade inflammation in the body
Normal <5mg/l

45
Q

What would high cortisol readings suggest?

A

Stress

46
Q

What would low cortisol readings suggest?

A

Exhaustion

47
Q

What does DHEA do?

A

It downregulates the cellular effects of cortisol.

48
Q

What is the DUTCH?

A

Dried Urine Test for Comprehensive Hormones

Nut 2 Sem 1 (8 decks)

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