EXAM 2

Question 1

Interrupting which herb after taking it for a long time may result in difficulty sleeping, headaches, joint pain, nervousness, and stiff muscles?

1. ) Boswellin
2. ) Butterbur
3. ) Devil’s claw
4. ) Feverfew

Answer 1

4

Question 2

Indicate whether the statement fits the description of ginkgo biloba, St. John’s wort, or both:

1. ) Plant part(s) used: leaf only
2. ) Plant part(s) used: leaf and flowers
3. ) Clinically-proven preparations are 35-67:1 concentrates
4. ) Extracts contain phytochemicals from the flavonoid family

Choices:
A.) Ginkgo biloba
B.) St. John’s wort
C.) Both Ginkgo biloba and St. John’s wort

Answer 2

1. ) Ginkgo biloba
2. ) St. John’s wort
3. ) Ginkgo biloba
4. ) Both Ginkgo biloba and St. John’s wort

Question 3

Which constituent of ginkgo must be removed because it has been shown to incite allergic responses and other toxic reactions?

1. ) bilobalides
2. ) kaempferol glycosides
3. ) ginkgolic acids
4. ) ginkgolides

Answer 3

3.) ginkgolic acids

Question 4

On which two families of constituents are medicinal ginkgo extracts standardized?

1. ) vanillic acids
2. ) hydroxykynurenic acids
3. ) flavonoid glycosides
4. ) terpene lactones

Answer 4

3. ) flavonoid glycosides

4. ) terpene lactones

Question 5

Distinguish between the pharmacological effects of ginkgo biloba and St. John’s wort

1. ) Inhibits synaptic reuptake of neurotransmitters
2. ) Upregulates 5-hydroxytryptamine receptors
3. ) Increases tolerance of brain tissue to hypoxia
4. ) Inhibits platelet activation factor (PAF)
5. ) Increases skin response to the effects of UV radiation
6. ) Inhibits age-related decline of choline and alpha-adrenergic receptors

Choices:
A.) Hypericum perforatum (St. John’s Wort)
B.) Ginkgo biloba

Answer 5

1. ) Hypericum perforatum
2. ) Hypericum perforatum
3. ) Ginkgo biloba
4. ) Ginkgo biloba
5. ) Hypericum perforatum
6. ) Ginkgo biloba

Question 6

The German Commission E determined that ginkgo extracts were indicated for all of the following except _____________.

1. ) cognitive deficits due to organic brain disease
2. ) prevention of stroke
3. ) intermittent claudication
4. ) vertigo or tinnitus, if due to vascular or involutional etiology

Answer 6

2.) prevention of stroke

Question 7

T/F: Only St. John’s wort extracts with moderate to high hyperforin content have been found effective in clinical trials

Answer 7

False

Question 8

T/F: The placebo effect probaby accounts for at least 50% of the beneficial effects of St. John’s wort on depression

Answer 8

True

Question 9

T/F: Lower cost and fewer adverse effects are two distinct advantages of either ginkgo or hypericum extracts over pharmaceutical medicines typically prescribed for dementia or depression, respectively.

Answer 9

True

Question 10

T/F: Marked improvement in depressive symptoms can be expected to occur within one to two weeks of therapy with hypericum extracts.

Answer 10

False

Question 11

St. John’s wort may interact significantly with which of the following types of drugs? (Choose the most complete answer)

1. ) All of these
2. ) Anticoagulants
3. ) Protease and reverse transcriptase inhibitors
4. ) Two of these
5. ) Immunosuppressants
6. ) Selective serotonin reuptake inhibitors (SSRIs)

Answer 11

1.) All of these

Question 12

Match the common name with the Latin binomial:

1. ) Kava
2. ) Hops
3. ) Lemon balm

Choices:
A.) Humulus lupulus
B.) Piper methysticum
C.) Melissa officinalis

Answer 12

1. ) Piper methysticum
2. ) Humulus lupulus
3. ) Melissa officinalis

Question 13

Match the herb with the plant part(s) primarily used:

1. ) Kava
2. ) Valerian
3. ) Lavender
4. ) Hops
5. ) Lemon balm
6. ) Passion flower

Choices:
A.) strobiles (female flowers)
B.) rhizome
C.) aerial parts, including fruits
D.) flowers only, any gender
E.) leaf
F.) root

Answer 13

1. ) rhizome
2. ) root
3. ) flowers only, any gender
4. ) strobiles (female flowers)
5. ) leaf
6. ) aerial parts, including fruits

Question 14

Match the herb with its active constituent(s) or the biochemical families the constituent(s) belong to:

1. ) sesquiterpenes
2. ) linalyl acetate and cineol
3. ) pyrones
4. ) humulone and lupulone

Choices:
A.) Lavender
B.) Hops
C.) Kava
D.) Valerian

Answer 14

1. ) Valerian
2. ) Lavender
3. ) Kava
4. ) Hops

Question 15

Which medicinal herb has been studied primarily as aromatherapy?

1. ) Valerian
2. ) Lavender
3. ) Lemon balm
4. ) Hops
5. ) Passion flower

Answer 15

2.) Lavender

Question 16

Which potential adverse reaction to kava has led to a product recall in Europe and a public warning issued by the US FDA?

1. ) Teratogenicity
2. ) Liver damage
3. ) Carcinogenicity
4. ) Kidney damage

Answer 16

2.) Liver damage

Question 17

T/F: Aqueous and ethanol extracts of valerian root are equivalent in the quality of their actions.

Answer 17

False

Question 18

Which subspecies of Valerian is recommended for use in valerian preparations?

1. ) indica
2. ) officinalis
3. ) edulis
4. ) japonica

Answer 18

2.) officinalis

Question 19

Valerian products with a high content of which constituent should not be used due to potential toxicity?

1. ) Valerenic acid
2. ) Acetoxyvalerenic acid
3. ) Valepotriates

Answer 19

3.) Valepotriates

Question 20

Upon which neurotransmitter does Valerian appear to exert its pharmacological effects?

1. ) Gamma-aminobutyric acid (GABA)
2. ) Acetylcholine
3. ) Dopamine
4. ) Norepinephrine

Answer 20

1.) Gamma-aminobutyric acid (GABA)

Question 21

T/F: At least one human study has demonstrated that valerian extract had no adverse effects on the reaction time, alertness, or concentration.

Answer 21

True

Question 22

T/F: Patients with sleep disturbances can expect to achieve improvement after only a few days of valerian use.

Answer 22

False

Question 23

According to our text, which two additional herbal calmatives have each been tested in combination with valerian in clinical studies?

1. ) Kava and hops
2. ) Lavender and lemon balm
3. ) Passion flower and kava
4. ) Lemon balm and kava
5. ) Lavender and hops
6. ) Lemon balm and hops
7. ) Passion flower and lavender

Answer 23

6.) Lemon balm and hops

Question 24

Which of the following measures were affected in human studies of the effects of lavender? (Choose the most complete answer)

1. ) Increased “happiness” based on autonomic nervous system responses
2. ) Decline in EEG potentials that correlate with vigilance and alertness
3. ) All of these
4. ) Self-rated sedation
5. ) Two of these
6. ) More relaxed and less depressed self-rated mood

Answer 24

3.) All of these

Question 25

Match the reported side effect with the botanical agent: 1. ) Dystonia 2. ) Interaction with drugs used for Parkinson's disease 3. ) Headache, appetite changes, constipation 4. ) Breast growth in young boys Choices: A.) Lavender (oral use) B.) Lavender (topical use) C.) Kava

Answer 25

1. ) Kava C 2. ) Kava C 3. ) Lavender (oral use) A 4. ) Lavender (topical use) B

Question 26

Match the common name with the Latin binomial: 1. ) Foxglove 2. ) Hawthorne 3. ) Horse chestnut 4. ) Guarana ``` Choices: A.) Crataegus monogyna B.) Digitalis purpurea C.) Paullinia cupana D.) Aesculus hippocastanum ```

Answer 26

1. ) Digitalis purpurea B 2. ) Crataegus monogyna A 3. ) Aesculus hippocastanum D 4. ) Paullinia cupana C

Question 27

Match the herb with the plant part(s) used: 1. ) Hawthorne 2. ) Rosemary 3. ) Horse chestnut 4. ) Butcher's broom ``` Choices: A.) leaves only B.) leaves and flowers C.) seed D.) rhizome ```

Answer 27

1. ) leaves and flowers 2. ) leaves only 3. ) seed 4. ) rhizome

Question 28

Match the herb with its active constituent(s) or the biochemical families the constituent(s) belong to: 1. ) Hawthorne 2. ) Coffee and black tea 3. ) Indian snakeroot 4. ) Horse chestnut ``` Choices: A.) reserpine B.) flavonoids or oligomeric procyanidins C.) aescin D.) methylxanthines ```

Answer 28

1. ) flavonoids or oligomeric procyanidins 2. ) methylxanthines 3. ) reserpine 4. ) aescin

Question 29

A combination of hawthorn extract and what essential oil was found effective for raising blood pressure in subjects with orthostatic hypotension? 1. ) Camphor oil 2. ) Peppermint oil 3. ) Lavender oil 4. ) Rosemary oil

Answer 29

1.) Camphor oil

Question 30

T/F: A single dose of hawthorn extract has discernible effects on subjective complaints related to cardiac insufficiency

Answer 30

False

Question 31

Which of the following are pharmacological effects of hawthorn extracts demonstrated in preclinical research in vitro or in animal models? (Choose the most complete answer) 1. ) Cardioprotective effects during recovery from cardiac ischemia, indicated by reduced release of lactate dehydrogenase 2. ) Increased amplitude of myocardial contractions 3. ) All of these 4. ) Increase in cardiac stroke volume 5. ) Two of these 6. ) Increase in coronary blood flow

Answer 31

3.) All of these

Question 32

How does hawthorn extract differ pharmacologically from cardiac glycosides such as digitalis? 1. ) Hawthorne is positively inotropic yet antiarrhythmic 2. ) Hawthorne is negatively inotropic yet proarrhythmic 3. ) Hawthorne is negatively inotropic yet antiarrhythmic 4. ) Hawthorne is positively inotropic yet proarrhythmic

Answer 32

1.) Hawthorne is positively inotropic yet antiarrhythmic

Question 33

Which medicinal herb has been studied primarily as aromatherapy for circulatory disorders? 1. ) Indian snakeroot 2. ) Rosemary 3. ) Mate' 4. ) Guarana

Answer 33

2.) Rosemary

Question 34

Which two botanicals owe their circulatory effects to the presence of caffeine and related substances? 1. ) Mate' 2. ) Guarana 3. ) Rosemary 4. ) Indian snakeroot

Answer 34

1. ) Mate' | 2. ) Guarana

Question 35

According to our text, which outcomes have been demonstrated in human studies of horse chestnut extract? (Choose the most complete answer) 1. ) Significantly reduced symptomatic complaints in patients with chronic venous insufficiency 2. ) Significantly reduced foot and ankle edema after a long distance airplane flight 3. ) All of these 4. ) Two of these 5. ) Significantly reduced leg volume in patients with chronic venous insufficiency 6. ) Equivalence between horse chestnut extract and compression stocking therapy for reducing edema in patients with chronic venous insuffici

Answer 35

3.) All of these

Question 36

Esculin is a toxin that must be processed out of ___________, and is one reason why the raw or unprocessed herb should not be used. 1. ) Butcher's broom 2. ) Oleander 3. ) Horse chestnut 4. ) Hawthorne

Answer 36

3.) Horse chestnut

Question 37

Match the common name with the Latin binomial: 1. ) Bitter orange 2. ) Artichoke 3. ) Turmeric 4. ) Dandelion 5. ) Wild candytuft 6. ) Licorice ``` Choices: A.) Taraxacum officinalis B.) Citrus aurantium C.) Glycyrrhiza glabra D.) Cynarum scolymus E.) Iberis amara F.) Curcuma longa ```

Answer 37

1. ) Citrus aurantium B 2. ) Cynarum scolymus D 3. ) Curcuma longa F 4. ) Taraxacum officinalis A 5. ) Iberis amara E 6. ) Glycyrrhiza glabra C

Question 38

Match the herb with the plant part(s) used: 1. ) Artichoke 2. ) Ginger 3. ) Caraway 4. ) Chamomile ``` Choices: A.) Fruit (seed) B.) Rhizome only C.) Leaves only D.) Flowers ```

Answer 38

1. ) Leaves only 2. ) Rhizome only 3. ) Fruit (seed) 4. ) Flowers

Question 39

Match the herb with its active constituent(s) or the biochemical families the constituent(s) belong to: 1. ) Peppermint 2. ) Turmeric 3. ) Artichoke 4. ) Wormwood ``` Choices: A.) Curcumin B.) Menthol C.) Sesquiterpene lactones D.) Cynarin ```

Answer 39

1. ) Menthol 2. ) Curcumin 3. ) Cynarin 4. ) Sesquiterpene lactones

Question 40

Match the botanical term with the mechanism of action associated with it in the treatment of digestive tract dysfunction: 1. ) Bitter 2. ) Cholegogue 3. ) Carminative Choices: A.) Relieve bloating and fullness by facilitating gas expulsion B.) Stimulate gastric secretions C.) Promote bile production and emptying of the gallbladder

Answer 40

1. ) Stimulate gastric secretions 2. ) Promote bile production and emptying of the gallbladder 3. ) Relieve bloating and fullness by facilitating gas expulsion

Question 41

Match the herb with the digestive condition best proven to respond to its use: 1. ) Artichoke 2. ) Peppermint oil 3. ) Licorice Choices: A.) Peptic ulcer B.) Irritable bowel syndrome C.) Complaints in the upper abdomen aggravated by fat intake

Answer 41

1. ) Complaints in the upper abdomen aggravated by fat intake 2. ) Irritable bowel syndrome 3. ) Peptic ulcer

Question 42

Which alcoholic beverage uses wormwood as an ingredient? 1. ) Absinthe 2. ) Amaretto 3. ) Kahlua 4. ) Brandy

Answer 42

1.) Absinthe

Question 43

A combination of peppermint oil and which other essential oil has been shown effective for treating functional dyspepsia? 1. ) Anise 2. ) Wormwood 3. ) Fennel 4. ) Caraway

Answer 43

4.) Caraway

Question 44

According to our text, as treatment or prevention of nausea and vomiting, the effectiveness of ginger is least convincing when which of the following is the cause? 1. ) Chemotherapy 2. ) Sea sickness 3. ) Morning sickness 4. ) Postoperative

Answer 44

4.) Postoperative

Question 45

T/F: In the treatment of gastrointestinal disorders, peppermint oil given in delayed-release (enteric-coated) formulations has more clinical evidence than conventional formulations, and may be less likely to cause side effects of nausea, heartburn, and abdominal discomfort.

Answer 45

True

Question 46

Which component of licorice has mineralocorticoid-like action, and is removed in some formulations to prevent side effects of blood pressure elevation and potassium loss? 1. ) Paparavine 2. ) Glycyrrhizin 3. ) Liquiritin 4. ) Absinthin

Answer 46

2.) Glycyrrhizin

Question 47

Which herb is recommended NOT to be used in large amounts during pregnancy, based on research suggesting increased risk of preterm labor? 1. ) Chamomile 2. ) Licorice 3. ) Peppermint 4. ) Ginger

Answer 47

2.) Licorice

Question 48

Match the common name with the Latin binomial: 1. ) Black tea 2. ) Bilberry 3. ) Flax 4. ) Psyllium 5. ) Castor 6. ) Milk thistle ``` Choices: A.) Ricinus communis B.) Camellia sinensis C.) Silybum marianum D.) Linum usitatissimum E.) Vaccinium myrtillus F.) Plantago species ```

Answer 48

1. ) Camellia sinensis 2. ) Vaccinium myrtillus 3. ) Linum usitatissimum 4. ) Plantago species 5. ) Ricinus communis 6. ) Silybum marianum

Question 49

Match the substances with their mechanism of action: 1. ) Saccharomyces boulardii 2. ) Psyllium husk 3. ) Sorbitol 4. ) Senna pods and leaves 5. ) Buckthorn bark 6. ) Aloe latex Choices: A.) Osmotic laxative B.) Bulk-forming laxative C.) Anthranoid stimulation of intestinal mucosa D.) Antagonize pathogens and stimulate enteric immune system

Answer 49

1. ) Antagonize pathogens and stimulate enteric immune system 2. ) Bulk-forming laxative 3. ) Osmotic laxative 4. ) Anthranoid stimulation of intestinal mucosa 5. ) Anthranoid stimulation of intestinal mucosa 6. ) Anthranoid stimulation of intestinal mucosa

Question 50

Tannin-containing herbs can play an important role in the control of which health condition? 1. ) Alcoholic liver disease 2. ) Hepatitis 3. ) Constipation 4. ) Acute diarrhea

Answer 50

4.) Acute diarrhea

Question 51

The ability of apples, bananas, and carrots to help control diarrhea can be attributed to which common constituent? 1. ) Tannins 2. ) Hemicelluloses 3. ) Pectins 4. ) Muciliages

Answer 51

3.) Pectins

Question 52

According to our text, Saccharomyces boulardii has been effective for controlling or preventing diarrhea resulting from all but one of the following causes. Which one? 1. ) Infectious diarrhea 2. ) Nutritionally-related (feeding by gavage) 3. ) Travel-related diarrhea 4. ) Antibiotic-associated diarrhea

Answer 52

1.) Infectious diarrhea

Question 53

T/F: Wheat bran having coarse particles will be less effective for shortening intestinal transit time than wheat bran having smaller particles.

Answer 53

False

Question 54

Which type of botanical remedy for constipation is most likely to produce adverse effects of loose stools and colicky abdominal pain. 1. ) Bulk-forming agents 2. ) Anthranoid-containing herbs 3. ) Osmotic agents

Answer 54

2.) Anthranoid-containing herbs

Question 55

Which of the following is an FDA-approved non-prescription drug? 1. ) Rhubarb 2. ) Buckthorn 3. ) Senna 4. ) Cascara

Answer 55

3.) Senna

Question 56

Which TWO laxative herbs are no longer FDA-approved for use in over-the-counter medications due to lack of modern clinical and safety data? 1. ) Cascara 2. ) Rhubarb 3. ) Aloe latex 4. ) Senna

Answer 56

1. ) Cascara | 3. ) Aloe latex

Question 57

Which botanical laxative is contraindicated in cases of biliary obstruction and other biliary disorders? 1. ) Aloe 2. ) Buckthorn 3. ) Castor oil 4. ) Senna

Answer 57

3.) Castor oil