Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUT2 Semester 1 > Assessment and Diagnostics > Flashcards

Assessment and Diagnostics Flashcards

1
Q

What is Homocysteine a functional biomarker for?

A

Low B9 and B12 levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does low vaginal pH indicate?

A

High levels of lactic acid and an abundance of Lactobacillus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What would you consider using to help push oestrogen down the 2-OH pathway, upregulating CYP1A1?

A

I3C and broccoli sprouts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of test method is used for an Organic Acid Test (OAT)?

A

Urine test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does an Organic Acid Test test for?

A

Some neurotransmitter metabolites

Nutritional function markers

Ketone and fatty acid oxidation metabolites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Low levels of T3, accompanied by high levels of TSH and thyroid antibodies suggests what?

A

Hashimoto’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the optimal range for vitamin D levels?

A

75-125 nmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Calprotectin is a protein made by what cell?

What is it an indicator of?

What would be a high result?

A
  • Leukocytes (when they have migrated to and are active in the gut wall
  • inflammation
  • Over 50mcg/g (50-175 mcg/g = ‘mid range infammation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who said “All disease starts in the gut”?

A

Hippocrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List the substrates used when testing for Small Intestinal Bacterial Overgrowth (SIBO)

A

Lactulose

Fructose

Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. Definition of functional testing
  2. Definition of diagnostic testing
A
  1. Focuses on how the body systems are functioning
  2. Looks for markers to diagnose disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the difference between a ‘reference range’ and an ‘optimal range’ on a test?

A

Reference ranges are diagnostic

Optimal ranges indicate a need for support to maintain homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. How are reference ranges produced?
  2. What variabilities are included in references ranges?
A
  1. Reference ranges are obtained by measuring a sample of the population and then setting the mean and standard deviation parameters of what is viewed as ‘normal’
  2. Age, gender, ethnicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. Give three functional testing companies
  2. Two ‘direct-to-patient’ tests
A
  1. invivo, Genova Diagnostics, Regenerus
  2. Thriva, Medichecks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. What are the different areas where microbiomes exisit in the body called?
  2. Give 5 examples
A
  1. Niches
  2. GI, vaginal, oral, skin, urinary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give 3 types of microbes with definitions

A
  1. Commensal: live in harmony with host/provide benefit
  2. Pathogenic: invade our microbiome and cause harm to health
  3. Pathobiont: opportunistic - generally don’t post a threat unless there is a clear opportunity (candida)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a gram negative bacteria?

A

Bacteria that have an outer cell wall - high in LPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are LPS? Why are they harmful to health?

A

Lipopolysaccharides - fragments of gram-negative bacteria

Can induce inflammation and immune responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define ‘metabolic endotoxaemia’

A

Caused by dysbiosis and intestinal permeability.

High levels of mucin degrading bacteria and gram negative bacteria - that produce LPS which translocate into the bloodstream via intestinal permeability and cause inflammation and immune reactivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
  1. What is a CDSA?
  2. What markers do CDSAs evaluate
A
  1. Comprehensive Digestive Stool Analysis (stool test)
  2. Microbial markers and host markers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When interpreting a CDSA, what should you look for?

A

Correlations between
- symptoms
- Microbes
- host markers

  • take a full case history first*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do different diets afftect the microbiome?

  1. Vegetarian/vegan
  2. Gluten free
  3. Keto
  4. Low FODMAP
  5. Western
  6. Mediterranean

Best diet for diversity?

A
  1. Vegetarian/vegan:
    low bifidobacteria
  2. Gluten free
    High bifidobacteria
    High e.coli
  3. Keto
    Low bifido bacteria
    high e.coli
    high desulphovibrio
  4. Low FODMAP
    Low bifidobacteria
  5. Western diet
    Low bifidobacteria
    High E.coli
  6. Mediterranean
    High bifidobacteria
    Low E.coli

Mediterranean diet offers best diversity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What might calprotection of over 175mcg/g indicate?

A

IBD, ulcers, cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

2 markers of inflammation on a CDSA

A
  1. Calprotectin
  2. Eosinophil Protein X
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Enzyme that de-conjugates molecules such as hormones in the gut

A

beta-glucuronidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Nutrients for intestinal barrier support

A

Vit A
Vit D
Zinc
Omega oils
Glutamine
Slippery elm / marshmallow (soothe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Eosinophil Protein X
- Normal range
- High range
- Causes of raised marker

A

NORMAL: 1.1.mcg/g

HIGH: > 4.6mcg/g

Raised with intestinal inflammation, food allergies, parasites, colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q
  1. What is the main metabolic marker on a CDSA.
  2. How is it made?
  3. Causes of elevated levels?
  4. What can be a complication of this?
A
  1. Beta glucuronidase
  2. enzyme is made by some intestinal bacteria
  3. Dysbiosis / Western diet high in red meat and animal protein.
  4. Oestrogen metabolites can be absorbed/recirculated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

2 immune markers found on a CDSA

Explain what each is

A
  1. Secretory IgA
    • secretion from mucosal tissue (1st line of defence in the GI mucosa)
  2. Beta-defensin 2
    • antimicrobial peptides produced in the GI wall when breached
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

SIgA

  1. what is considered LOW
  2. What is considered HIGH
A

LOW: <100mcg/g (suscepibility to GI infections (chronic stress?)

HIGH >750 mcg/g (acute infection?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

2 host markers relating to digestion found on a CDSA and what they measure

A
  1. Pancreatic elastase (pancreatic digestive enzyme sufficiency/insufficieny
  2. Faecal fats (fat digestion capacity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What would be a high result for beta-defensin 2?

Why might this be?

A

High is >62 mcg/g

Sign of the immune system responding to a breach by microbes or possibly GI inflammation caused by U.C.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pancreatic elastase

  1. normal range
  2. pancreatic insufficiency range
  3. severe insufficiency range
A
  1. normal: 200-500 mcg/g
  2. insufficiency <200 mcg/g
  3. Severe insufficiency <100 mcg/g
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why might a client have increased levels of faecal fats in a CDSA?

A
  • pancreatic insufficiency
  • SIBO
  • hypochlorhydria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Why might a client show low levels of faecal fats on a CDSA?

A

Because they are on a low fat diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the marker for intestinal permeability on a CDSA?

What would constitute a high result?

A

Zonulin

  • produced when tight junctions are open

> 100 mcg/g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

4 causes of Intestinal Permeability

A
  • Poor nutrition
  • heavy metals
  • alcohol
  • dysbiosis
  • Coeliac disease
38
Q

What should you check for when looking a commensal markers of the microbiota?

A
  1. Diversity
  2. SCFA-producers
  3. Good Bifidobacterium levels
  4. Bifido taking up more space that E-coli
    5.Lactobacilli
39
Q

What can cause dysbiosis?

A
  • lack of varied diet
  • Antibiotic use
  • FODMAP diet
  • Over-eating
40
Q

3 most common SCFAs

3 causes of low SCFAs

A
  1. butyrate
  2. proprionate
  3. acetate
  • Antibiotic use
  • Low fibre diet
  • Diarrhoea
41
Q

What can be signs of low mucosal integrity on a CDSA

A
  1. High mucin-degrading bacteria
  2. Low diversity of commensal bacteria
  3. High gram-negative bacteria
42
Q

3 symptoms of poor mucosal integrity

A
  1. Ulcers
  2. IBD
  3. Gastritis
43
Q

Bacteria strain associated with mucosal degredation

A

Akkermansia muciniphila

44
Q

2 bacteria strains associated with autoimmunity

A
  1. Ruminococcus gnavis
  2. Ruminococcus torques
45
Q

A species of bacteria that can become mucin degrading when there is an absence of diversity in the species

A

Bacteriodes

46
Q

2 types of gas-producing bacteria (what gas do they produce)?

A
  1. Methanobrevibacteria smithii (methane)
  2. Desulfovibrio spp. (hydrogen sulphide)
  3. Bilophila wadsworthia (hydrogen sulphide)
47
Q

2 bacteria species where raised levels are associated with SIBO

A
  1. methanobrevibacteria smithii
  2. Desulfovibrio
48
Q
  1. Definition of a pathobiont
  2. E.g.
A
  1. bacteria that only become pathogenic where there is opportunity (changes in terrain)
  2. Staphylococcus aureus
49
Q

2 testing options for H.pylori and what they look for

A
  1. Faecal antigen testing (positive or negative)
  2. Faecal PCR tests (looking for higher than expected amount or specific virulent factors)
50
Q

3 e.g.s of pathogens

A
  1. Giardia spp
  2. Clostridium difficile
  3. Shigella
51
Q

E.g. of a shamed parasite

A

blastocystis hominis

52
Q

Key points to analysing a stool test

A

Pattern and context
- are there signs/symptoms that match the microbe?

  • are host markers abnormal?
  • is there gut inflammation?
  • Is there high /low immune function?
  • Lack of diversity?
  • pathogenic strains?
53
Q

2 potential causes of low pancreatic elastase

A
  1. chronic stress
  2. low Hcl
54
Q

SIBO: definition

How is testing carried out?

A

Bacterial count in the small intestine of over 105 CFU/ml

Causing fermentation of carboyhydrates.

Subsrates are used for the breath test (lactulose, glucose, fructose)

After the substrate is taken, breath samples are collected every 20 or 30 minutes.

55
Q

4 causes of SIBO

A
  1. Poor MMC
  2. Low stomach acid
  3. Low pancreatic juice
  4. poor ileocaecal valve functioning
56
Q

Discuss the breath test preparation diet.

A

24 hours before the test (for an accurate baseline) clients should

  • Avoid microbiota-feeding foods
  • Foods allowed:

meat, fish, poultry (not cured or brined)
Plain steamed white rice
Eggs
Clear meat broth
Fats/oils
Salt/pepper

57
Q

What would be a positive result when analysing hydrogen on a SIBO test?

A

A rise of 20ppm before 90 minutes

58
Q

What would be a positive result when analysing methane on a SIBO test?

A

A rise of 12 ppm before 90 minutes

NB constipation - a rise of as little as 3ppm

59
Q

What would be a positive result when analysing hydrogen and methane combined on a SIBO test?

A

Combined rise of 15ppm before 90 minutes

60
Q

What causes bacterial vaginosis?

A

An imbalance of lactobacilli dominant vaginal composition

61
Q

Why might you test the vaginal microbiome?

A
  • Bacterial vaginosis
  • Recurrent thrush
  • infertility
  • miscarriages
  • endometriosis
62
Q
  1. Healthy vaginal pH of a woman of reproductive age
  2. What does a pH of >4.5 indicate?
A
  1. 3.8-4.5
  2. overgrowth of BV-associated bacteria / dysbiosis
63
Q
  1. Aside from pH, what is another vaginal testing marker?
  2. What causes this marker to be high?
  3. What is an elevated range?
A
  1. Interleukin beta-1 (IL-b1)
  2. it’s an inflammatory marker made when epithelial cells break apart = infection
  3. Healthy <220 pg/ml
    Elevated >220 pg/ml - BV/candida
64
Q

Define vaginal health in terms of microbiome

A

Low diversity and high lactobacilli that create lactic acid. Lactobacilli need to be taking up the most space.

65
Q

7 ways to support the vaginal microbiome

A
  1. Avoid soap
  2. Avoid antibiotics/copper coil
  3. avoid lubricants - opt for natural
  4. Reduce simple carbs, alcohol and stop smoking
  5. Indlude vaginal probiotics
  6. Menopause oestrogen support
  7. Diet full of pre and probiotics
66
Q
  1. 2 conditions that oral microbiome dysbiosis is associated with
  2. 2 serious health conditions associated with oral pathogenic bacteria and the reason for this
A
  1. Tooth decay, peridontitis
  2. CVD, autoimmune disease, Alzheimer’s - due to endotoxin release
67
Q

7 ways to support the oral microbiome

A
  1. Pre and probiotics in the diet
  2. Minimise carbohydrates
  3. Avoid snacking so oral pH can recover between meals
  4. Avoid mercury fillings/removal
    5.Oil pull
  5. Probiotic mouthwash
  6. Use biofilm disruptors (NAC)
68
Q

Specific health concerns where OAT analysis may be beneficial

A

CFS
Nutritional deficiencies
Mitochondrial dysfunction
Mood disorders

69
Q

Labs where OAT can be carried out

A

Biolab
Genova
Regenerus

70
Q

What can be given to boost sIgA secretion by mucosal tissue?

A

Sacharomyces boulardii
Medicinal mushrooms

71
Q

What is the normal range of pancreatic elastase (PE-1)?

A

200-500 µg/g

72
Q

3 benefits and 3 cons of OAT testing

A

Benefits
1. Good overview of metabolic function
2. Shows need for extra nutrients
3. Helps guide naturopathic care plan into areas for further investigation

Cons
1. hard to interpret
2. Diet imacts markers/changes results
3. not measuring the vitamin directly

73
Q

5 OAT metabolite groups

A
  1. Krebs cycle metabolites
  2. NT metabolites
  3. Glycolysis metabolites
  4. Ketone and fatty acid oxidation metabolites
  5. Amino acid metabolites
  6. Bacterial metabolites
  7. Mould metabolites
74
Q

OAT interpretation - key points

A
  1. outcome if displayed by shpwing how far a client’s result is from the mean
    2.Look for anything that’s ‘out of range’
  2. Use the interpretive guide
  3. Only a snapshot in time - requires context, case history
75
Q

Best method for testing B12 and D3

A

Serum testing

76
Q

Best testing method to give an indication of ‘tissue levels’

A

RBC testing - can show minerals and toxic elements taken up into RBCs

77
Q

Why is serum testing not always reliable for testing for deficiencies?

A

Because in the blood, many minerals are kepts under homeostatic control, sometimes at the expense of bone/other tissues, therefore blood lvels can be quite stable

78
Q
  1. What is a more sensitive index of B12 status compared to serum B12?
  2. How can it best tested?
A

Methylmalonic acid

Via serum and urine

79
Q
  1. Give a more accurate option for iron tests than serum iron.
  2. What would be an optimal range?
A
  1. Serum ferritin (iron storage capacity)
  2. 30-100 mcg/l
80
Q

How might you accurately test for magnesium?

A

Test cellular levels - test for RBC mg

81
Q

Best test options for Calcium

A

OAT testing or possibly serum RBC but not serum calcium as Ca is under strict homeostatic control

82
Q

What is a key marker of inflammation that is tested by he NHS?

What is the normal range?

A

CRP

NORMAL: <5mg/L

83
Q
  1. What is a better measurment of inflammation than CRP testing?
  2. What would be the normal range?
  3. Above what level might be considered low grade inflammation?
A
  1. hsCRP - high senstivity
  2. Normal range 0.2-3mg
  3. Anything over 2mg/L
84
Q

Nutrient testing is not easy, what might be the best approach?

A

Choose a lab that carried out mixed methodology testing

85
Q

Thyroid testing

  1. What does standard testing measure?
  2. What might an expanded panel/functional test measure?
A
  1. THS and T4
  2. TSH, Free T3 or T4 or both, reverse T3 and thryroid antibodies
86
Q

2 thyroid antibodies tested?

A
  1. anti-TPO
  2. anti-thyroglobulin
87
Q

What could suggest sub-clinical hypothyroidism on a test?

A

High TSH and normal T4

88
Q

What would low THS and high FT4 indicate?

A

Hyperthyroidism

89
Q

What is the marker for Grave’s disease?

A

TPO

90
Q

Adrenal testing

  1. What is the best testing option?
  2. Main approach with this option?
  3. Main metabolites tested?
A
  1. Saliva or urine testing
  2. 4 point testing - 4 samples throughout the day
  3. Cortisol and DHEA
91
Q

DUTCH test

  1. When might you choose this test?
  2. When testing female clients, what additional info will you require?
A
  1. For reproductive hormone imbalances (low libido, PMS, irregular periods etc.
  2. Menstrual history and stage
92
Q
  1. What are the 3 main oesstrogens?
  2. What are the three main phase I detoxification pathways for oestrogen?
A
  1. E1 (estrone); E2 (Estradiol); E3 Estriol
  2. 2-OH (safest); 4-OH (most toxic); 16-OH (most oestrogenic)

NUT2 Semester 1 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions