Chapter 9. Complementary and Alternative Medicine Flashcards

1
Q
743. Acupuncture needles used in current practice
(A) are under same marketing rules as
syringes
(B) are under same standard control like
medical needles
(C) have same quality control as surgical
scalpels
(D) are used once only
(E) all of the above
A
  1. (E) In 1996, the US Food and Drug Administration
    (FDA) changed the classification of acupuncture
    needles from experimental to medical equipment.
    So acupuncture needles are under the same strict
    quality control standards demanded for medical
    needles, syringes, or surgical scalpels. It includes
    manufacture, marketing, and use.
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2
Q
  1. Which of the following statements is incorrect?
    (A) Acupuncture was widely practiced by
    thousands of physicians, dentists,
    acupuncturists, and other practitioners
    (B) Acupuncture can be used to relive pain
    and in various other health conditions
    (C) The National Institutes of Health (NIH)
    have funded many research projects
    relating to acupuncture
    (D) In a national survey, the number of visits
    to alternative medicine was nearly twice
    of the visits to primary care physician
    (E) Few medical schools in the United
    States have included subjects on integrated
    medicine
A
  1. (E) Acupuncture is being “widely” practiced by
    thousands of physicians, dentists, acupuncturists,
    and other practitioners for relief or prevention of
    pain and for various other health conditions. The
    majority of medical schools in the United States
    have already added courses on integrated medicine.
    In a 1998 survey, the number of visits to
    alternative medicine was almost twice that of
    visits to primary care physician.
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3
Q
745. Which of the following statements is correct?
(A) There are 600 to 2000 acupuncture
points on the human body
(B) Acupuncture points are mostly located
along the meridians
(C) Acupuncturist could use points on the
ears, scalp, hands, and feet to treat
diseases
(D) Each treatment may use different
acupuncture points even with the same
disease
(E) All of the above
A
  1. (E) There are between 600 and 2000 acupuncture
    points on the human body in 12 major meridians
    named after organ systems, and 8 minor meridians.
    There are also points on the ears, hands,
    feet, and scalp corresponding to organs throughout
    the body, and extra points outside the traditional
    meridians. Acupuncture points are usually
    chosen based on the practitioner’s assessment
    of the particular imbalance that needs to be
    restored. Even with the same patient and medical
    condition, acupuncture points used in each
    acupuncture treatment may be different.
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4
Q
  1. In the acupuncture theory
    (A) “qi” is the life force or energy that flows
    through the body
    (B) “qi” influences our health at physical,
    mental, emotional, and spiritual levels
    (C) any excess or deficiency of “qi” will
    contribute to our health problems
    (D) blockage of “qi” may cause pain
    (E) all of the above
A
  1. (E) According to traditional Chinese medicine,
    “qi” (pronounced “chee”) is the life force or
    energy that flows through all living things.
    “Qi” affects our body at physical, mental, emotional,
    and spiritual levels. Any imbalance
    (deficiency or excess) or blockage of “qi” may
    result in disease or pain. Acupuncture treats
    disorders by influencing the flow of “qi,” thus
    restoring the normal balance of organ systems.
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5
Q
  1. Which of the following statements is incorrect?
    (A) Electroacupuncture (EA) can be used
    through needles to enhance the stimulation
    of acupuncture points
    (B) Percutaneous electric nerve stimulation
    (PENS) is a modified form of acupuncture
    treatment
    (C) “Deqi” sensation is a side effect of
    acupuncture
    (D) Moxibustion can be used with or without
    insertion of acupuncture needles
    (E) Acupressure and cupping are also helpful
    in treating different diseases
A
  1. (C) EA uses electrical impulses conducted
    through needles for enhanced stimulation of
    acupuncture points. Different frequencies of
    electrical stimulation have showed distinctive
    effects and mechanisms of action. PENS is an
    adapted form of acupuncture that is widely
    practiced. Other techniques include moxibustion
    (burning of herbs to apply heat near
    acupuncture points), acupressure and reflexology
    (stimulation of points without penetration
    of the skin with needles), and cupping
    (heat creates a partial vacuum in small jars,
    which are used to stimulate points with suction).
    The sensations of “deqi” at the insertion site
    noted by the patient include aching, tingling,
    numbness, warmness, or heavy pressure feeling.
    It usually corresponds to the acupuncturist’s
    feeling of the needle “catching” in the muscle.
    deqi is thought to be necessary for achieving the
    acupuncture therapeutic effect
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6
Q
748. Which one of the following complications associated
with acupuncture is mostly reported?
(A) Infection
(B) Bruising or bleeding
(C) Transient vasovagal response
(D) Pneumothorax
(E) Intra-abdominal abscess
A
  1. (B) In the hands of a skilled practitioner, complications
    associated with acupuncture are
    actually quite rare, and usually very mild. The
    most commonly reported complication is bruising
    or bleeding. A second, less common side
    effect is a transient vasovagal response. Severe
    complications and fatal reactions such as pneumothorax,
    abdominal abscess, or pericardial
    effusion associated with acupuncture are rare.
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7
Q
  1. With regard to the scientific basis of acupuncture’s
    effects, which of the following statements
    is incorrect?
    (A) Electric acupuncture can activate the
    central nervous system (CNS) to release
    endogenous opioids into blood or cerebrospinal
    fluid (CSF)
    (B) The analgesic effects of acupuncture
    may occur after 20 to 30 minutes of
    treatment
    (C) Naloxone and other opioid antagonists
    can inhibit the acupuncture analgesia
    (D) Acupuncture analgesia can not be
    passed from one animal to another animal
    via CSF transfer or blood transfer
    (E) Substances that inhibit endorphin enzymatic
    degradation enhance the analgesic
    effects of acupuncture treatment
A
  1. (D) In the most widely accepted acupuncture
    model, needling of nerve fibers in the muscle
    sends impulses that activate the spinal cord,
    midbrain, and hypothalamus-pituitary system. Subsequently, it releases β-endorphin into the
    blood and CSF to cause analgesia at a distance.
    The effects of acupuncture are not immediate;
    rather analgesia occurs after a 20- to 30-minute
    induction period. Analgesia persists for 1 to
    2 hours after cessation of acupuncture. Naloxone
    and other opiate antagonists inhibit acupuncture
    analgesia. Substances that inhibit endorphin
    enzymatic degradation enhance acupuncture
    effects. Acupuncture analgesia can be passed
    from one animal to another via CSF transfer or
    via cross-circulation of blood between two
    animals.
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8
Q
750. Which of the following is not involved in the
analgesic effect of acupuncture?
(A) Nicotine
(B) Serotonin
(C) Norepinephrine
(D) Nitric oxide
(E) β-Endorphin
A
  1. (A) EAinduces upregulation of neuronal nitric
    oxide/nicotinamide adenine diphosphate
    (NADPH) diaphorase expression in the gracile
    nucleus in rats, and then mediates acupuncture
    signals through dorsal medulla-thalamic pathways.
    This may play a significant role in central
    autonomic regulation of somatosympathetic
    reflexes that contribute to acupuncture effects in
    somatic and visceral pain processing, and cardiovascular
    regulation. Other evidence also
    supports the notion that those neurotransmitters
    (eg, serotonin and norepinephrine) as well
    as β-endorphin all act as mediators.
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9
Q
751. Which of the following is the condition/disease
that acupuncture has not shown to be an effective
treatment modality?
(A) Allergies
(B) Dysmenorrhea
(C) Leukemia
(D) Biliary colic
(E) Leukopenia
A
  1. (C) In 2002, the World Health Organization
    (WHO) published a summary and review of all
    clinical trials through the year 1999, and determined
    four categories of disorders treated by
    acupuncture. Allergies, dysmenorrhea, biliary
    colic, and leukopenia are disorders among
    many others in the category of proven efficacy
    of acupuncture through controlled trials.
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10
Q
752. Complementary and alternative medicine
includes all of the following EXCEPT
(A) herbs
(B) mind-body therapy
(C) massage
(D) aspirin
(E) homeopathic therapy
A
  1. (D) Complementary and alternative medicine
    include following practices: mind-body medicine,
    biologically based practices, manipulative
    and body-based practices, energy medicine, and
    whole medical systems. Whole medical systems
    include homeopathic medicine, naturopathic
    medicine, traditional Chinese medicine (herb,
    acupuncture, massage, meditation, etc), and
    ayurveda (herb, massage, and yoga).
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11
Q
753. Mind-body interventions have been used in all
the following conditions EXCEPT
(A) headache
(B) low back pain
(C) arthritis
(D) chemotherapy-induced nausea and
vomiting
(E) none of the above
A
  1. (E) Mind-body interventions have also been
    applied to various types of pain. Clinical trials
    indicate that these interventions may be a
    particularly effective adjunct in the management
    of arthritis, with reductions in chronic pain
    for up to 4 years and reductions in the number of
    physician visits. When applied to more general
    acute and chronic pain management, headache,
    and low back pain, mind-body interventions
    show some evidence of effects, although results
    vary based on the patient population and type of
    intervention involved. Evidence from multiple
    studies with various populations of cancer
    patients suggests that mind-body interventions
    can improve mood, quality of life, and coping as
    well as ameliorate disease- and treatmentrelated
    symptoms, such as chemotherapyinduced
    nausea, vomiting, and pain.
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12
Q
  1. The following statements regarding Ginkgo
    biloba are true EXCEPT
    (A) Ginkgo biloba has been used to treat multiple
    conditions such as asthma, bronchitis,
    fatigue and tinnitus
    (B) Ginkgo biloba has also been tried to
    improve Alzheimer disease and dementia
    (C) patients with intermittent claudicating,
    multiple sclerosis have tried Ginkgo
    biloba supplement
    (D) Ginkgo biloba has side effects including
    headache, nausea, diarrhea, dizziness,
    and allergic skin reactions
    (E) Ginkgo biloba does not increase bleeding
    risk so it can be safely taken with other
    anticoagulant drugs
A
  1. (E) Recently, Ginkgo biloba has been used to treat
    a variety of health conditions, including asthma,
    bronchitis, fatigue, and tinnitus. Some encouraging
    results have been seen from the studies of
    Alzheimer disease/dementia, intermittent claudication,
    and tinnitus. But a trial of more than 200
    healthy adults older than 60 years found that
    Ginkgo biloba taken for 6 weeks did not improve
    memory. Side effects of Ginkgo biloba include
    headache, nausea, GI upset, diarrhea, dizziness,
    or allergic skin reactions. More severe allergic
    reactions have occasionally been reported. There
    are some data to suggest that Ginkgo biloba can
    increase bleeding risk, so people who take anticoagulant
    drugs, have bleeding disorders, or
    have scheduled surgery or dental procedures
    should use caution.
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13
Q
  1. The evidence from research supports the following
    effects of ginseng EXCEPT
    (A) ginseng supports overall health and
    boost immune system
    (B) ginseng does not cause allergic reactions
    (C) ginseng can increase both mental and
    physical performance
    (D) some studies have shown that ginseng
    lowers the blood glucose level
    (E) most common side effects of ginseng are
    headache, sleep disturbances, and gastrointestinal
    (GI) problems
A
  1. (B) Ginseng has numerous potential benefits
    which include: supporting overall health and
    boosting the immune system; improving recovery
    from illness; increasing a sense of well-being
    and stamina; improving both mental and physical
    performance; treating erectile dysfunction,
    hepatitis C; reducing symptoms related to
    menopause; lowering blood glucose; and controlling
    blood pressure. The most common side
    effects are headaches and sleep disturbance and
    GI problems. Ginseng can cause allergic reactions.
    There have been reports of breast tenderness,
    menstrual irregularities, and high blood
    pressure associated with ginseng products.
    Ginseng may lower the level of blood glucose;
    this effect may be seen more often in patients with diabetes. Therefore, diabetic patients
    should use extra caution with Asian ginseng,
    especially if they are taking medicines to lower
    blood sugar or taking other herbs.
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14
Q
  1. The biologically based practice is a domain of
    complementary and alternative medicine. It
    includes
    (1) vitamins
    (2) fatty acids
    (3) proteins
    (4) prebiotics
A
  1. (E) The biologically based practice is a branch of
    complementary and alternative medicine.
    It includes, but is not limited to, botanicals,
    animal-derived extracts, vitamins, minerals,
    fatty acids, amino acids, proteins, prebiotics and
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15
Q
  1. Naturopathy is a system of healing. Its principles
    include the following:
    (1) The healing power of nature
    (2) Identification and treatment of the cause
    of disease
    (3) Treatment of the whole person
    (4) The doctor as a teacher
A
  1. (E) Naturopathy is a system originating from
    Europe. It considers that a disease is a manifestation
    of alterations in the processes by which the
    body naturally heals itself. It emphasizes health
    restoration as well as disease treatment. There are
    six principles that form the basis of naturopathic
    practice in North America: (1) the healing power
    of nature; (2) identification and treatment of the
    cause of disease; (3) the concept of “first do no
    harm”; (4) the doctor as teacher; (5) treatment of
    the whole person; and (6) prevention.
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16
Q
  1. Which of the following statement(s) is (are) correct
    for homeopathy?
    (1) It stimulates the body’s ability to heal
    by itself
    (2) Remedy contains giving small doses of
    highly diluted substance that can cause
    similar symptoms
    (3) Same substance if given in a larger dose
    would produce illness or symptoms
    (4) “Principle of similar” is not the theory
    of homeopathy
A
  1. (A) Homeopathy is a complete system of medical
    theory and practice that is founded by the German
    physician Samuel Christian Hahnemann. He
    hypothesized that one can select therapies on the
    basis of how closely symptoms produced by a
    remedy match the symptoms of the patient’s
    disease. He called this the “Principle of similar.”
    Hahnemann proceeded to give repeated
    doses of many common remedies to healthy
    volunteers and carefully record the symptoms
    they produced. As a result of this experience,
    Hahnemann developed his treatments for sick
    patients by matching the symptoms produced
    by a drug to symptoms in sick patients.
17
Q
  1. Glucosamine and chondroitin are used to treat
    knee osteoarthritis, which of the following
    statements is (are) correct?
    (1) In the United States, glucosamine and
    chondroitin are considered dietary supplements
    (2) It may cause serious adverse events
    such as congestive heart failure and
    chest pain
    (3) It may have more substantial treatment
    effects in a subgroup of patients with
    moderate to severe pain
    (4) Overall, glucosamine and chondroitin
    sulfate alone or in combination reduces
    the pain effectively in patients with knee
    osteoarthritis
A
  1. (A) In the United States, glucosamine and chondroitin
    sulfate are considered dietary supplements
    and are not held to the stringent standards
    of pharmaceutical manufacture. Treatment effects
    were more substantial in the subgroup of
    patients with moderate to severe pain. Overall,
    glucosamine and chondroitin sulfate were not
    significantly better than placebo in reducing
    knee pain by only 20%. Adverse events were
    generally mild, but some serious adverse events
    were judged by the investigator to be related to the study treatment: congestive heart failure
    (ina patient receiving combined treatment) and
    chest pain (in a patient receivingglucosamine).
18
Q
  1. Which of the following is (are) true about
    mind-body interventions?
    (1) May have impact on health by the
    mechanism of the brain and CNS influencing
    immune, endocrine, and autonomic
    function
    (2) Multicomponent mind-body interventions
    may be useful adjunctive treatment
    for coronary artery disease and
    certain pain-related disorders
    (3) Cognitive behavioral therapy, combined
    with educational/informational component
    can be effectively used as adjuncts
    in the management of variety of chronic
    conditions
    (4) When applied presurgically, a group of
    mind-body therapies (imaginary, hypnosis,
    relaxation) may improve recovery
    time and reduce pain following surgical
    procedures
A
  1. (E) Recent evidence from randomized controlled
    trials, case reports, and systematic reviews of
    the literature suggest that the mechanism of
    mind-body therapy may rely on the brain and
    CNS influence immune, endocrine, and autonomic
    functioning, which is known to have an
    impact on health. Mind-body interventions can
    be effective in the treatment of coronary artery
    disease. In a study, mind-body intervention
    enhanced the effect of standard cardiac rehabilitation
    in reducing all-cause mortality and
    cardiac event recurrences for up to 2 years. This
    treatment modality has also been used to treat
    various types of pain. Clinical trials indicate
    that these interventions may be a particularly
    effective adjunct in the management of arthritis,
    with reductions in chronic pain for up to 4 years
    and reductions in the number of physician
    visits. When applied to more general acute and
    chronic pain management, headache, and low
    back pain, mind-body interventions show some
    evidence of effects, although results vary based
    on the patient population and type of intervention
    involved.In multiple studies with different
    types of cancer patients, it is suggested that
    mind-body interventions can improve mood,
    quality of life, and coping, as well as ameliorate
    disease- and treatment-related symptoms, such
    as cancer-related pain, nausea, or vomiting from
    chemotherapy. Other studies have shown that
    this behavioral therapy has effects of reducing
    discomfort and adverse effects during percutaneous
    vascular and renal procedures, reducing
    self-administration of analgesic drugs and
    improving hemodynamic stability in the perioperative
    period.
19
Q
  1. Which of the following is (are) true about
    Echinacea?
    (1) Studies indicate that Echinacea does not
    prevent colds or other infections
    (2) Studies have not proven that Echinacea
    shortens the course of colds or flu
    (3) Echinacea can cause allergic reactions
    including rash, asthma, and anaphylaxis
    (4) GI side effects are most common
A
  1. (E) Echinacea has been used to treat or prevent
    colds, flu, and other infections that are believed
    to stimulate the immune system to help fight
    infections. Less commonly, Echinacea has been
    used for wounds and skin problems, such as
    acne or boils. With recent evidence, it is indicated
    that Echinacea does not appear to prevent
    colds or other infections, shortens the course of
    colds or flu. For example, two studies did not find any benefit from Echinacea, either as
    Echinacea purpurea fresh-pressed juice for treating
    colds in children, or as an unrefined mixture of
    Echinacea angustifolia root and E purpurea root
    and herb in adults. Other studies have shown
    that Echinacea may be beneficial in treating
    upper respiratory infections. When taken by
    mouth, Echinacea usually does not cause side
    effects other than mild GI side effects. However,
    some people have experienced allergic reactions,
    including rashes, worsening asthma, and life
    threatening anaphylaxis. People are more likely
    to experience allergic reactions to Echinacea if
    they are allergic to related plants in the daisy
    family, which includes ragweed, chrysanthemums,
    marigolds, and daisies. Also, people with
    asthma or atopy may be more likely to have an
    allergic reaction when taking Echinacea.
20
Q
  1. Which of the following is (are) true about chiropractic
    practice?
    (1) It is an alternative medical system and
    takes a different approach from conventional
    medicine in diagnosing, classifying,
    and treating medical problems
    (2) The chiropractic theories consider that
    the body has a powerful self-healing
    ability and the body structure and its
    function are closely related and this
    relation affects our health
    (3) The goal of this therapy is to normalize
    the relation of structure and function
    (4) There have been serious reported
    adverse effects such as stroke, caudal
    equine syndrome associated with chiropractic
    therapy
A
  1. (E) Chiropractic focuses on the relationship
    between the body’s structure, primarily of the
    spine, and its functions. The basic concepts of
    chiropractic can be summarized as follows: the
    body has a powerful self-healing ability; the
    body’s structure, essentially the spine, and its
    function are closely related and this relationship
    affects health. Chiropractic therapy practices
    with the goals of normalizing the
    relationship between spine and its function, and
    assisting the body as it heals. Conditions commonly
    treated by chiropractors include neck
    pain, back pain, sports injuries, repetitive
    strains, and headaches. Patients with pain associated
    with other conditions, such as arthritis,
    also seek this treatment. In the United States,
    chiropractors perform more than 90% of manipulative
    treatments. With current data, the risk
    appears to be very low. The serious complication
    appears to be more associated with neck
    manipulation. Stroke has been reported with
    cervical spine manipulation and rarely, cauda
    equina syndrome with low back adjustment.
    Such risk was estimated to be one in one million
    treatments.