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
- (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.
2
Q
- 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
- (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.
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
- (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.
4
Q
- 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
- (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.
5
Q
- 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
- (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
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
- (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.
7
Q
- 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
- (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.
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
- (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.
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
- (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.
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
- (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).
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
- (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.
12
Q
- 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
- (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.
13
Q
- 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
- (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.
14
Q
- The biologically based practice is a domain of
complementary and alternative medicine. It
includes
(1) vitamins
(2) fatty acids
(3) proteins
(4) prebiotics
A
- (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
15
Q
- 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
- (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.
16
Q
- 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
- (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
- 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
- (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
- 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
- (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
- 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
- (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
- 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
- (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.
