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Clinical Nutrition and Botanicals II > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Cranberry scientific name and part of the plant that was used

A 
Vaccinium macrocarpon
Ripe fruit (berry)
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2
Q

Active ingredients of cranberries

A

Flavonoids (especially anthocyanidins and proanthocyanidins)

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3
Q

Other components of cranberries (not sufficiently active)

A

Organic acids, vitamin C, natural sugars

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4
Q

Cranberry mechanisms of actions

A

Proanthocyanidins/anthocyanidins and other compounds inhibit adhesion of some urinary pathogens to the epithelial cell

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5
Q

Clinical uses of cranberry

A

Recurrent UTI prevention

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6
Q

Who should be evaluated for recurrent UTI?

A

Adult women (50x)
Elderly men and women (related to incontinence)
Catheterized patients
Neurogenic bladder patients

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7
Q

Medical treatment for recurrent UTI

A

low dose prophylactic antibiotics

Lifestyle modifications

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8
Q

Lifestyle modifications for Recurrent UTI

A

High fluid intake, frequent urination, cotton underwear, etc.

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9
Q

Efficacy of cranberry and UTI

A

Five controlled trials in adult women where all participants had significant reduction
In one cranberry was as effective as an antibiotic

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10
Q

Cranberry effective doses

A

Beverages: 10-16 oz per day of cocktail
Supplements: 400-800 mg twice daily, 500 mg at bedtime (CranMax)

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11
Q

Cranberry verified brands

A

Juice: Oceanspray
Supplements: CranMax, nature’s way, nature’s resource, Spring valley, sundown herbals celestial seasons

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12
Q

Cranberry side effects

A

GI upset
Weight gain (juice)
more insulin in diabetics (juice)

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13
Q

Contraindications for cranberry use

A

Salicylate hypersensitivity
Increase kidney stone risk in large amounts

Increased bleeding with anticoagulant therapy

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14
Q

Vitamin A uses

A

Used in treating recurrent UTI

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15
Q

Vitamin A doses for recurrent UTI

A

200,000 IU in addition to antimicrobial therapy

Helped to decreased frequency of recurring UTI

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16
Q

Chinese Herbal Medicine for recurrent UTI

A

Used for acute recurrent infection and reduced frequency of infection.
Can be used independently or with antibiotics

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17
Q

Types of CHM for recurrent UTI

A

Er Xiang Tang more effective than San Juan Pian for acute infection

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18
Q

Nasturtium herb and horseradish root containing drug “Angocin Anti-infection” can be used for what?

A

Treatment of acute pediatric UTI

By -13%

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19
Q

How common is BPH (benign prostatic hyperplasia)?

A

One third of older men develop symptoms

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20
Q

What can cause BPH?

A

Altered hormone balance with aging causing cell proliferation and gland growth.

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21
Q

Symptoms of BPH that can affect daily life

A

Incontinence and sleep disturbances

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22
Q

Subjective measures for BPH evaluation

A

Symptom scores: American urological association symptom index
Quality of life

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23
Q

Objective measures for BPH evaluation

A

Prostate size -transrectal ultrasound

Urinary function measures - maximal rivalry flow rate, post-void residual volume

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24
Q

Pharmaceuticals for BPH

A

Alpha - adrenergic blockers (tamsulosin, prazosin)

5 a-reductase inhibitors (finasteride)

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25
Q

Surgery for BPH

A

Transurethral resection of the prostate (TURP)

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26
Q

Saw palmetto scientific name and part used

A

Serenoa repens, Serenoa serrulata, or Sabal serrulate

Parts of plants: ripe fruit, lipophilic berry extract containing 80-90% fatty acids and sterols

27
Q

Saw Palmetto Mechanisms for BPH

A

Antiandrogenic - Prevents enzymatic conversion of testosterone to more active dihydrotestosterone by inhibiting 5-alpha reductase

Antiproliferative - Slows prostate cell proliferation by inhibiting growth factors, stimulating apoptosis

Anti-inflammatory - Inhibits eicosanoid pathways, lowers TNF-α, IL-1β

28
Q

Saw palmetto efficacy

A

Better than placebo only for nocturia, not peak urine flow, prostate, or total symptom scores, but comparable to Proscar and Flomax

29
Q

Saw palmetto side effects

A

Generally well-tolerated: Dizziness, GI
May prolong bleeding time
Be cautious with potent antiplatelet or anticoagulant co-medication

Contraindicated for pregnancy/lactation due to potential hormonal effects on fetus/neonate

30
Q

Saw palmetto effective dose

A

Lipophilic ripe berry extract, standardized to 80-90% fatty acids
320 mg/day in one or two doses

31
Q

Saw palmetto teas

A

Not effective

water extracts will not be high in fatty acids

32
Q

Pygeum bark scientific name and parts

A

Prunus africanus

bark (duh)

33
Q

Pygeum bark active components

A

Fat-soluble constituents: sterols and triterpenes

34
Q

Pygeum bark mechanisms

A

anti-proliferative and anti-inflammatory (like palmetto berry)

35
Q

Pygeum bark standardization and doses

A

Best products will be standardized for 14% triterpenes or 13% total sterols
75-200 mg/day in one or two doses

36
Q

Nettle roots scientific name and how it is taken

A

Urtica dioica

It is eaten as a vegetable

37
Q

Nettle roots properties

A

Anti-proliferative and anti-androgenic properties

38
Q

Nettle root products

A

Combination product with saw palmetto and nettle root was better than placebo and equivalent to Rx proscar

may not be better than Saw Palmetto alone

39
Q

What is beta-sitosterol?

A

Plant sterol found in foods and herbs

Rye pollen extract

40
Q

Properties of beta-sitosterol

A

anti-proliferative

41
Q

beta-sitosterol doses and effects

A

60-130 mg/day improves symptoms and some signs of BPH

Can also treat dyslipidemia in gram amounts

42
Q

Rye pollen extract effects

A

Anti-adrenergic effects on smooth muscle, possible antiinflammatory effects

43
Q

Rye pollen doses for BPH

A

126 mg three times daily improves symptoms and sometimes signs of BPH

44
Q

Best treatment for BPH

A

Saw palmetto and PollenAid are possibly effective

Use adequate doses for a 1-2 month trial in patients preferring natural medicine approach

45
Q

Percentage of incidence for kidney stones

A

12% and rising for unknown reasons

46
Q

Common kidney stones

A

Calcium oxalate stones - most common types
Other calcium stones
Uric acid stones

47
Q

Causes of kidney stones

A

Genetic predisposition - hypercalcuria, hyperoxaluria
Calcium losing diseases (hyperparathyroidism)
Kidney disease, UTI
Hyperuricosuria, usually associated with gout

Possible nutrition causes but unlikely

48
Q

Laboratory studies for risks of kidney stones

A

24-hour urine analysis - May identify patients with high output of either calcium, oxalate, or uric acid
Serum magnesium - identify patients with magnesium deficiency

49
Q

Preventing calcium oxalate stones

A

Maintain dilute urine
Reduce urinary calcium - similar for osteoporosis prevention
Reduce urinary oxalate
Inhibit crystal formation

50
Q

Method for maintaining dilute urine

A

14+ cups of fluid per day is recommended
water is a good choiuce
OJ and lemonade contribute citrates that counteract dietary acid residues and inhibit crystallization –

51
Q

Poor choices for diluting urine

A

Soft drinks are associated with kidney stones

Grapefruit juice dramatically raises risk

52
Q

Effect of calcium on kidney stones

A

Associated with reduced risk of kidney stones
Can prevent absorption of oxalate from diet

Patients with absorptive hypercalciuria,
diagnosed with 24-hour urine chemistry, should limit
calcium

53
Q

Diet to reduce urinary calcium

A

Plant-based
Low animal protein
High fiber diets
Similar to DASH diet, dramatically reduce risk

54
Q

Effects of plant-based, low animal protein, high fiber diets

A

Alkalinizing food to reduce urinary calcium
High potassium opposes effect of calcium on urinary calcium
Phytate from fiber may reduce calcium absorption

55
Q

Ways to reduce urinary oxalate

A

Low oxalate diet

Supplements: B6, calcium and magnesium supplements, vitamin C

56
Q

Low oxalate diet use

A

Important for those with absorptive hyperoxaluria
Avoiding all oxalate-containing foods will mean greatly reducing fruit and veggie consumption
Avoid excess protein, which may increase oxalate formation

57
Q

Foods to avoid in low oxalate diets

A

spinach, rhubarb, beet greens, nuts, chocolate, tea, bran, almonds, peanuts, and strawberries

58
Q

Supplements to reduce urinary oxalate

A

Calcium and magnesium supplements with meals
Vitamin B6, 50-150 mg/d
Vitamin C supplements of 1000 mg/day

59
Q

Two ways to inhibit crystal formation

A

Citrate-containing foods (fruits and veggies), beverages
(with orange and/or lemon juice)

Magnesium supplementation, 200- 400 mg/d

60
Q

Recommended choices for calcium use in kidney stones

A

Citrate-containing calcium, taken with meals

Oxalate-binding effect of calcium + crystal-inhibiting effect of citrate

61
Q

Useful Kidney Stone Lab Tests

A

24-hour urinary calcium before and after supplementation
24-hour urinary oxalate
24-hour urinary oxalate before and after vitamin C supplementation
Serum magnesium

Use these tests to see what plans of actions to take

62
Q

Three methods for preventing uric acid formation

A

Maintain dilute urine with fluids
Maintain alkaline urine to inhibit precipitation of uric acid
Reduce uric acid formation

63
Q

How to maintain alkaline urine

A

Same plant-based diet as recommended for

preventing calcium stones

64
Q

how to reduce uric acid formation

A

Low purine diet

Medication

Clinical Nutrition and Botanicals II (1 decks)

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