CNM S1 Sample Paper 1 Flashcards
Compare and contrast the use of HOT and COLD water in hyrdrotherapy (2m)
History Slide 21
A
Cold Water decreases circulation and numbs the area
Hot Water relaxes muscles and increases circulation
Name the TWO enzymes released by the stomach wall and explain the action of each (2m)
Digestion Slide 9
Gastric Lipase - Breaks down Lipids (fats)
Pepsinogen - inactive enzyme activated by Hydrochloric Acid (HCI). pepsinogen is converted to active form pepsin - breaks down protein to smaller protein chains
Name TWO focuses of naturopathic nutrition
Foundations Slide 4
Use of whole Organic food as medicine
Finding the root cause of the disease rather than treating the symptom
Respecting the person as an Individual with their own Constitution
Detoxification and Cleansing - importance
Name TWO side affects of ingesting artificial sweeteners
Food Labelling Slide 32
Raise Insulin levels and affect Insulin Sensitivity
Cause DNA damage (mutations)
Addictive and increase sweet cravings
Sugar Receptors over stimulated - making fruit / veg not tasty
List TWO foods that should be reduced and TWO foods that should be increased for someone showing signs & symptoms of HEAT EXCESS (2m)
Energetics Slide 13
Increase salads, raw food, smoothies, bitter greens
Fresh Air, fasting , detox and balance excess heat
Reduce hot foods, chilli, ginger, red meat, oily food, deep fried, smoked, BBQ
If ACUTE - then have warm teas, spices, wraps leads to sweating, treat fever
Where is calcium absorbed in the body? What are the TWO absorption processes that facilitate this? what is the co-factor nutrient needed in this process? (3m)
Calcium is absorbed by all parts of intestine - especially duodenum
Active and passive absorption
Vit D for active absorption only
What is the pH of Hyrochloric acid and what two nutrients are required to produce it (2m)?
2-3 pH for HCL
Zinc and B6 (to a lesser extent B1 thiamine)
Name FOUR foods that contain Thiamine (B1)
Vits sl 49
Pork Potatoes Pulses Peas
Seeds Beans Soybeans
Oranges Nuts
Name THREE functions of triglycerides (3M)
Fats provide a source of energy BUT process of energy released is less efficient than carbs.
Fats provide a handy form to store excess calorific intake (extra glucose also turned into triglycerides)
INSULATION
Protection of body parts & organs (e.g., kidneys)
Explain the main reason why low energy can be a symptiom of magnesium insufficiency (3m)
ATP - energy currency of body - is always present as a magnesium ATP complex
Without Magnesium, ATP isn’t BIOLOGICALLY ACTIVE.
Magnesium binds to phosphate groups in ATP, holding the molecule in a shape that aids the loss of phosphate, facilitating energy release.
Describe TWP examples that illustrate suppression of symptoms (2m)
Suppression of emotions
“ Natural body secretions
“ Recurring infrections
“ Fever & Pain
“ NAtural immunity
Topical Application
Surgical Removal
Which acid is required to make coenzyme A (CoA) (1m)
PANTOTHENIC Acid vit B5
Briefly explain how dairy products create acidity in the body (2m)
Before consumption, dairy is not very acidic and is high in CALCIUM, an ALKALINE mineral. Dairy is more acidic due to higher protein / sulphur amino acid CONTENT.
Sulphur amino acids increase SULPHURIC acid formation which disrupts blood pH drawing calcium from bones and increasing calcium loss in URINE.
Describe how proteins become denatured
3d structure of a protein is key to its function proteins work like a lock & KEY.
If a protein’s 3d shape changes or unfolds - it’s denatured.
Denatured proteins no longer function correctly.
Proteins denatured by heat pH changes and heavy metals and lead and murcury.
What are FOUR therapeutic uses of Cruciferous Vegetables
Cancer Prevention -
(DNA protective
Hormone Deactivation
Estrogen reduces apoptosis
& inhibits angiogenisis)
Respiratory health
Liver detox support
Name TWO Metalloenzymes that zinc is a component of (2m)
Superoxide Dismutase SOD
Alcohol dehydrogenase
Caroboxipeptidase
Alkaline Phosphatase
Metallothionein
Carbonic anhydrase B
Other enzymes involved in HAEM synthesis, folate absorption and DNA/RNA synthesis
Who is described as father of medicine and describe one of his philosophies (1m)
Hippocrates
Food is primary source of medicine, health, healing
First use food, then herbs, then intervention
DNA has FOUR possible nucleotide bases (amino acids), name them (2m)
Adenine A - a purine
Cytosine C
Guanine G - a purine
Thymine T
answer all 3 of following questions:-
Signs & Synotoms of ZINC deficiency.
S&S of deficiency
Poor sense of taste and smell
Recurrent infection, delayed wound healing
Skin disorders, acne dandruff white spots on finger nails
Infertility (M&F) and low libido
Signs of weak digestion, (bloating fatigue)
Discuss how zinc can be used therapeutically for reproduction and cell proliferation and describe functions of each
Therapeutic uses of Reproduction
Infertility erectile dysfunction, low testosterone
Therapeutic uses for cell proliferation
Wound healing, Acne Cancer, Cirrhosis, Burns
Functions of zinc for reproduction
Production of sex hormones (!zinc usage during adolescence) . Needed for Spermatogenesis, inhibits 5a-Reductase which inhibits the conversion of testosterone to the more potent adrogen (DHT)
Functions of zinc for cell proliferation
needed for cell proliferation in skin, and differentiation.
Needed for DNA binding proteins involved in gene expression.
Aids tight junctions in skin and GIT
Aa
Reproduction
• Production of sex hormones
(↑ zinc usage during adolescence)
• Required for spermatogenesis
• Inhibits 5a-reductase (e.g., inhibits
the conversion of testosterone to the more potent androgen DHT).
• Infertility (male and female)
• Erectile dysfunction
• Low testosterone
Endocrine
• Needed for T4 to T3 conversion.
• Thyroid health
Cell proliferation
• Needed for cell proliferation (e.g., in the skin) and differentiation.
• Required for DNA binding proteins involved in gene expression
• Aids tight junctions (i.e. in skin / GIT)
• Wound healing
• Acne
• Cancer
• Cirrhosis
• Burns
Define EFA essential fatty acid and what types and what foods have them
EFA are polyunsaturated fatty acids that cant be constructed within the body from other components and so must be obtained from diet
2types, omega 3 and omega 6
Body can convert omega 3 to another omega 3 BUT cannot create omega 3 from scratch
Omega 3 fatty acids alpa-linolenic acid ALA - essential in the diet.
Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) (1/2 m )
Omega 3 fats include
ALA - flax seeds, walnuts, green leafy veg
EPA & DHA - oily fish
Omega 6 fatty acid LINOLENIC acid (LA) - essential in the diet.
GAMMA linolenic acid (GLA) and Arachidonic Acid (AA)
Omega 6 fats include
LA vegetable oils most nuts and seeds
GLA borage oil, evening primrose oil
AA meat dairy eggs
For healthy cells and healthy cell-to-cellcommunication, diet need a variety of 3 and 6
How would you explain why these fats could be dangerous and how to safely consume EFAs without consuming free radicals?
cconversion of ALA to EPA and DHA is only about 10% efficient, even lower for LA to GLA and AA.
This conversion for LA and ALA is dependent upon the same enzymes.
It will ultimately favour the EFA that is in abundance (often omega 6).
Conversion between them involves adding in double bonds. this involves DESATURASE enzymes.
Most western diets are rich in omega6 especially arachidonic acid. this is pro-inflammatory.
Oxidation of fatty acids
Polyunsaturated fats such as EFAs are prone to becoming free radicals.
When these fats are heated, electrons can be lost. this means a fat is formed that becomes a FREE RADICAL.
This then further reacts with oxygen in the air over the cooking pan which becomes even more damaging.
The CH2 group between double bonds are especially vulnerable as radicals formed in the molecule are very stable.
The damaged fats formed will be incorporated into cell membranes.
Radical formation is accelerated by light, oxygen and heat.
Keep polyunsaturated fats in dark glass bottles in the fridge - never use for cooking!
To cook with, use saturated fats, eg., organic coconut oil (for higher temps)
Olive oil can be used to cook at lower temps as it only has one double bond. however, Extra virgin olive oil remains stable when cooked at higher temps. this exception is thought to be due to its higher antioxidant content.
You suspect your client has dysbiosis. Discuss the microflora found in the large intestine and explain at least FIVE functions of it. Detail what influences the diversity and dominant species (15m)
Digestive slides 37 38 41
One mark for each point unless instructed otherwise
100t, 1000b FINnutEXT Mferm plus fermCARB waste M&H plus fermAA hydSulpH thr4 xcFart poordig bactACT
The large intestine hosts a vast community of around 100trillion microbes.
It often contains over 1000 bacterial species
The microflora performs the following crucial functions.
The final stages of nutrient extraction through microbial fermentation.
This includes the fermentation of remaining carbs to create the odorous waste byproducts methane and hydrogen as well as the fermentation of amino acids to create hydrogen sulphide.
Therefore, excess flatulence with a strong odour can indicate poor digesgtion as a result of the bacterial action on the remaining food.
Microflora functions
Synvit biotin k2, sprt IntB, b make scfa fib>entcytes LG. Pathprot 🚗 GALT if, appSAT, 🦠regPro moodRegSynNT, poorNT pathg
Stress T2DM
Synthesises vitamins
Synthesises vitamins such as biotin and K2
Supports intestinal barrier. bacteria produce short-chain fatty acids from fibre they ingest, that is then used by enterocytes. this supports the intestinal barier and is hence protective against leaky gut.
pathogen protection. out-competes for attachment to the intestinal epithelium and nutrients (eg., against candida)
Gut associated lymphoid tissue GALT
crucial for effective functioning of the immune system
regulates appetite / satiety
Bacteria prodcuce appetite regulating proteins.
Mood regulation
As indicated by EDWARD BACH (bach therapy). The microflora can synthesise neurotransmitters.
Dietary composition strongly influences the diversity and dominant species in the microflora.
By feeding bacteria with a typical western diet (refined sugars, damaged fats, concentrated proteins, including animal prote3ins and processed soya, low in fibre. , the strains become pathogenic.
The diversity of the mircoflora helps to support the immune system.
It helps leukocytes to learn from the microbes, making them more effective at combatting pathogenic organisms.
As well as poor nutrition, the colonies of bacteria can also be altered negatively by:-
Chronic stress and diabetes
Medications such as antibiotics and antacids
Lack of digestive secretions - stomach acid
Vitamin A
Vitamin A was the first vitamin to be discovered (hence ‘A’).
• The active forms (vitamers) which execute the functions of vitamin A are: Retinol, retinal and retinoic acid.
• Depending upon what the body requires, retinol will be oxidised to the different forms (retinolretinal retinoic acid). If the body doesn’t need it, it will remain as retinol and be stored in the liver.
The 2 forms of vitamin A:
• Pro-vitamin A converted into the active (usable) form of vitamin A (retinol) in the small intestinal epithelium and liver.
– Carotenes (or carotenoids) are examples
of pro-vitamin A. The most active pro-vitamin carotenes are: α- (alpha), β- (beta) and
γ- (gamma) carotenes and cryptoxanthin.
– Found in non-animal foods.
• Pre-formed vitamin A this is active vitamin A the body can use as it is.
– Only found in animal foods.
carotene = from the Greek karoton for ‘carrot’ — orange pigments
Pro-vitamin = a substance that can be converted into a vitamin Pre-formed vitamin =
a vitamin that is already formed
Vitamin A
Food sources:
• Pro-vitamin A is produced by plants, algae, fungi and bacteria. Rich food sources: Dark green, yellow / orange vegetables and fruit, e.g., carrots, squash, mango, spinach, sweet potatoes.
• Pre-formed vitamin A is only
found in animal foods e.g., liver, fish liver oils, egg yolk, mackerel, salmon.
Vitamin A
Pro-vitamin A absorption:
• Dietary carotenes are converted to vitamin A only as needed, so do not have toxicity concerns.
• The absorption of carotenoids in the small intestine varies between 5% and 60%.
• Ensure that there are adequate healthy fats in the diet as carotenoids are fat-soluble. Drizzle with coconut oil or olive oil to optimise absorption.
• Another way to increase the bioavailability of carotenoids is to cook (slightly steam) these foods, e.g., carrots. This cooking method is thought to most effectively liberate carotenoids from cells.
