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Nutrition Semester 2 > Clinical evaluation tools > Flashcards

Clinical evaluation tools Flashcards

1
Q

What is the rule of three?

A

Looking for a minimum of 3 indications that support your hypothesis.

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2
Q

What are the 3 main structures of a nail?

A
  1. The nail plate
  2. The nail bed
  3. The cuticle
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3
Q

What 3 indications may nails give us?

A
  1. overall vitality (strength & quality)
  2. Occupations and hobbies
  3. Nutritional status
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4
Q

What is paronychia and what may it indicate?

A 
Nail infection around the nail. Caused by:
Stress, trauma
poor nutrition
low immunity
poor hygiene
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5
Q

What can wicks or hangnails be due to?

A

Too little protein, lack of vit B and vit C.

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6
Q

What may nail dryness indicate?

A

Low EFAs, low vit A and D or low thyroid condition.

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7
Q

Excessive use of chemical detergent, irritants and hand washing may indicate?

A

Need for nervous system/adrenal support or may be due to occupational hazards.

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8
Q

What is clubbing (Schamroth’s sign)?

A

Involves a softening of the nail bed with the loss of normal angle between nail bed and the fold. If you can see a diamond space between them (Schamroth’s sign) then the nails are not clubbed.

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9
Q

What are 3 causes of clubbing?

A
  1. Pulmonary and Cardiovascular (80%)
  2. Gastrointestinal (5%)
  3. Hyperthyroidism (1%)
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10
Q

What is koilonychia?

A

spoon shaped concave nails

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11
Q

Which age group does koilonychia normally appear in?

A

Children, usually resolves with aging.

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12
Q

What test can we perform to see if a nail is spooned?

A

Water drop test - if water doesn’t slide off nail is spooned.

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13
Q

Name 3 conditions spooned nails can indicate?

A
  1. Iron deficiency
  2. diabetes mellitus
  3. Haematomachrosis
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14
Q

In Beau’s nails the location and depth of transverse lines indicate what?

A

The approximate date and severity of the illness.

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15
Q

Name 3 illnesses producing Beau’s lines?

A
  1. Severe infection
  2. Hypotension, shock
  3. Hypocalcaemia
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16
Q

Along with transverse lines, what other appearance is there in Beau’s lines?

A

Beau’s Growth Arrest Line

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17
Q

Name 3 things thin brittle nails may indicate?

A
  1. Metabolic bone disease
  2. Thyroid disorder
  3. Severe malnutrition and common mineral deficiency
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18
Q

Name 3 deficiencies associated with central longitudinal ridges?

A
  1. Iron deficiency
  2. Folic acid deficiency
  3. Protein deficiency
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19
Q

Which nail is central nail canal normally present?

A

Thumbs

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20
Q

What 3 conditions are associated with central nail canal?

A
  1. Malnutrition
  2. Repetitive trauma
  3. Severe arterial disease
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21
Q

What type of deformity can appear with central nail canal?

A

Fir Tree deformity

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22
Q

What is the main cause of nail pitting?

A

Nail matrix inflammation due to psoriasis and eczema.

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23
Q

Can you describe nail beading?

A

The beads seem to drip down the nail like wax.

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24
Q

What condition is nail beading associated with?

A

Endocrine (diabetes mellitus, thyroid, addison’s disease)

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25
Q

Name one condition to consider when nails look sandpapered and dull.

A

Autoimmune disease

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26
Q

Identify 3 possible causes of nail thickening.

A
  1. Slowed nail growth
  2. Onychomycosis (fungal nail infection)
  3. Chronic eczema
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27
Q

What is onycolysis?

A

Distal separation of the nail plate from the underlying nail bed.

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28
Q

Name 3 conditions associated with onycolysis?

A
  1. Eczema
  2. Psoriasis
  3. Contact dermatitis
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29
Q

What should be investigated if lunula is absent from the thumbs?

A

Anaemia or malnutrition

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30
Q

What would a pale blue lunula suggest?

A

Diabetes mellitus

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31
Q

Why should we take a urine specimen mid stream?

A

Because when urine is exposed to air, it starts to be broken down by bacteria that contaminate it from the outer part of the urinary tract and the skin.

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32
Q

What are the salts in the urine converted into?

A

Ammonia which have a powerful smell.

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33
Q

Very dark yellow, orange or brown urine may be a sign of?

A

Jaundice

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34
Q

How often should a saliva test be repeated?

A

Three times a day (an hour after brushing teeth, before lunch and before evening meal) for 4-5 days in succession.

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35
Q

What can white nails be caused by?

A

anaemia
oedema
vascular conditions

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36
Q

White spots on nails like paint are linked to what?

A

calcium deficiency

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37
Q

What is the cause of transverse white lines (Mee’s Lines) across nails?

A

Acute illness, heavy metal toxicity or chemotherapy

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38
Q

What is distinctive about Terry’s nails?

A

The tip of the nail has a darker band.

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39
Q

What is the whiter part of Terry’s nails related to?

A

oedema or anemia

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40
Q

What condition may be related to Terry’s nails?

A

Renal or liver disease

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41
Q

Name 3 conditions pink or red nails may be caused by?

A
  1. Malnutrition
  2. Carbon monoxide
  3. Polycythemia (dark) - increased concentration of haemoglobin in the blood
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42
Q

Name 3 conditions brown grey nails may suggest?

A
  1. cardiovascular disease
  2. diabetes mellitus
  3. Vit B12 deficiency
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43
Q

In TCM, why is the tongue considered to be an exterior part of the body?

A

Because it is in almost contact with air (the exterior)

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44
Q

What does the TCM tongue map represent?

A

The internal organs

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45
Q

Where would you find the heart on the tongue map?

A

Tip of tongue

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46
Q

What would a healthy tongue look like?

A

A kittens tongue, pink, free of cracks and moist with a thin clear or white coat.

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47
Q

What is Qi?

A

An energy/life/vital force

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48
Q

Thin Tongue

A

weakness or deficiency

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49
Q

Swollen tongue

A

dampness

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50
Q

Scalloped tongue (teeth marks on sides)

A

weakness in digestion, fatigue

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51
Q

Pale tongue

A

reduced qi/coldness

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52
Q

Red tongue

A

Inflammation/infection

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53
Q

Red and painful tongue

A

Deficiency of B1, B12 or folate

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54
Q

Magenta tongue

A

B2 deficiency

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55
Q

Purple tongue

A

Blood stagnation/reduced qi/poor ciculation

56
Q

Under the tongue -high red

A

inflammation/excess animal foods

57
Q

Under the tongue - blue/green

A

Disorder of blood vessels due to animal fats

58
Q

Under the tongue -yellow

A

Excessive bile secretion or excessive dairy/mucus/stagnation

59
Q

Under tongue -Deep purple

A

Drugs, medication, chemicals and sugar causing lymph/blood vessel disorder

60
Q

What are cracks on the tongue called? What sign is this showing?

A

Fissures

Long-term health problems

61
Q

A medical fissure - crack through middle of tongue, not to tip may be a sign for?

A

Deficiency of digestion, requiring B vits, esp B12 and folate. It may also indicate iron deficiency and under secretion of HCL and pepsin.

62
Q

A medical fissure -crack running to tip and pronounced deep may represent what?

A

Heart condition

63
Q

In ayurvedic tongue diagnosis, what does the mid line of the tongue represent?

A

Spine

64
Q

In ayurvedic tongue diagnosis, what does the tip of the tongue represent?

A

Top and back of bottom

65
Q

Cracks all over the tongue represent?

A

B2 deficiency often seen in psoriasis sufferers

66
Q

When might you see a hairy tongue? What can you suggest?

A

Following antibiotic treatment. Probiotics and prebiotics required

67
Q

A thick, damp coated tongue may mean?

A

mucous production, dampness, congestion due to refined carbohydrates, dairy and sugar intake

68
Q

A sticky and moist tongue may mean?

A

Extreme dampness of stomach/spleen

69
Q

White coating of tongue

A

cold, deficient

70
Q

Dark brown coating of tongue

A

some form of stagnation

71
Q

Slimy tongue

A

Phlegm, mucous, damp

72
Q

Yellow tongue

A

Heat, excess, if thick can be dampness

73
Q

Black tongue

A

Indicates severe form of heat, if over digestive area - chronic constipation.

74
Q

No coat, shiny tongue

A

Possible deficiencies, exhaustion of energy, weak digestion

75
Q

Dry tongue

A

Heat excess,not enough fluids or not holding fluids - consider mg and omega 3s.

76
Q

Impaired taste

A

zinc deficiency

77
Q

Name 3 things dampness of the tongue can be caused by?

A
  1. Diet (bananas, dairy, sugar)
  2. Environment (damp house)
  3. Tiredness (regardless of sleep)
78
Q

Quivering tongue

A

Tremor - indicates mg deficiency

79
Q

What is cheilosis? Which deficiencies can this relate to?

A

A dry scaling and cracking of the red surface of the lips

B2, B3 and folate

80
Q

What is angular stomatosis? Whcih deficiencies can this relate to?

A

Manifests as reddened cracking and scaling in the corners of the mouth
B2, B3, B6, B12, folic acid and iron

81
Q

Bleeding gums (also receding)

A

Vit C deficiency and/or zinc, CoQ10. Consult dentist to rule out peridontal disease

82
Q

Gingivitis represents what about the diet?

A

Diet too acidic

83
Q

Peridontal disease

A

High acidity, low bioflavonoids, zinc and CoQ10

84
Q

Pale mucous membranes (gum)

A

Iron deficiency

85
Q

Greyish mucous membranes

A

Biotin defciency

86
Q

Describe a yin face?

A

Large and broad at the forehead, narrow at chin. Large eyes with widely spaced arched eyebrows, narrow bridge of the nose and paler skin

87
Q

Describe a yan face?

A

Round to square face, the broader the jaw the more yang the face. Wide nose and mouth with medium to small eyes. There is often high colour in yang face.

88
Q

Which syndrome relates to an extreme round face?

A

Cushing’s syndrome

89
Q

Blue/black shadows under eyes (bags)

A

fluid retention and kidney/adrenal exhaustion

90
Q

Redness on cheeks

A

Marker for food allergies

91
Q

Receding hair line

A

decreased function of gallbladder

92
Q

‘Purse strings’ on upper lip

A

Often seen in menopausal women - weakness in reproductive organs.
May also be a sign of smoking

93
Q

Bitot’s spots

A

Vit A past or present deficiency

94
Q

Dry eyes

A

Vit A, EFAs

95
Q

Night blindness

A

Vit A, zinc

96
Q

Pale conjuctiva

A

Iron

97
Q

Blue sclera

A

Iron

98
Q

Retinal haemmorrhage

A

Iron

99
Q

Photophobia

A

Vit B2, B3, zinc

100
Q

Lack of eyelashes

A

Copper

101
Q

Premature greying

A

Vit B12, protein, biotin

102
Q

Nasolabial derrmatitis

A

Vit B2

103
Q

Butterfly rash around nose (deficiency & poss condition)?

A

Vit B3 or linked to acne rosacea or lupus

104
Q

Painful scaly, greasy red rashes on ears and eyelids

A

Vit B2

105
Q

Cyanosis in cold weather

A

Protein

106
Q

Thin dull grey skin

A

Protein

107
Q

Pallor

A

Vit B12, folate, biotin

108
Q

Hair loss

A

EFAs, iron, selenium, protein

109
Q

Thinning hair with loss of colour

A

Biotin

110
Q

Brittle, dry and lustreless hair

A

Iron, protein

111
Q

Garlic breath

A

Selenium

112
Q

Metallic taste

A

Selenium

113
Q

Oedema

A

Vit E

114
Q

Perifollicular hyperkeratosis

A

Vit A, B complex, EFAs, Vit C

115
Q

What is an exudate?

A

Any fluid that filters from the circulatory system into lesions or areas of inflammation

116
Q

What does a clear blister compose of?

A

An exudate that contains water (and solutes), together with some plasma proteins, but not many blood cells.

117
Q

What does pus compose of?

A

Exudate found in infected wounds that also includes bacteria and high concentrations of WBCs.

118
Q

What is Blood pressure?

A

The pressure of the blood inside the arteries

119
Q

What is high BP associated with?

A

Stress, obesity, inactivity, hormonal disruptions and risk factor for stroke, heart and kidney failure.

120
Q

Low BP may be associated with stress. Which group of people tend to have a lower BP?

A

Vegetarians and healthier people - associated with decreased mortality.

121
Q

A BP reading should be taken for every child over what age?

A

2 years old

122
Q

Ideally what should a patient avoid before having a BP taken?

A

Smoking and drinking caffeine 30 mins prior to BP taken.

123
Q

3 signs of hypertension

A

headaches
dizziness
flushing

124
Q

3 signs of hypotension

A

dizziness on standing
weakness
visual disturbance

125
Q

Stool very pale/clay colour

A

insufficient production of bile

126
Q

Green stools

A

release of toxic matter from the gallbladder

127
Q

white mucous in stools

A

indicates disturbance of intestinal flora, infection, an immune response

128
Q

very dark brown stools

A

slow transit time in colon; hyperactive thyroid

129
Q

orange coloured stool

A

insufficient bile or lipase insufficiency

130
Q

black tarry stool

A

Red Flag! can be indicative of cancer. May be due to blood from GI tract.

131
Q

red/maroon stools/blood in stools

A

Red Flag! Refer patient to medical doctor

132
Q

Floating stools

A

Fats in diet not emulsified properly by the bile.

133
Q

Sinking stools

A

Heavy with decaying matter or unused minerals

134
Q

Thin stools

A

Tension (colon is in contractile state)

135
Q

Dry stools

A

Poor water intake; slow transit time - poor fibre, hypothyroid, stress

136
Q

How does The TCM body clock work?

A

Qi circulates in a distinct pattern
The vital energy moves from organ system to organ system giving it fuel to function.
Every organ in our body takes an active role at a given time of the day. The opposite oran in the clock is at it’s lowest ebb at that time.

Nutrition Semester 2 (18 decks)

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