keys Flashcards
1
Q
mobilization is applied within the ____but not passed the ____
A
physiologic ROM but not passed the elastic barrier
2
Q
what do oscillations in a mobilization do
A
oscillations activate sensory mechanoreceptors to reduce pain and improve proprioception
3
Q
grade 1-4 mobilization
A
Grade 1: slow, small amplitude, near beginning of range
Grade 2: mid range (no stiffness or resistance), slow large amplitude
Grade 3: mid range to elastic barrier, slow large amplitude moving into stiffness or muscle spasm
Grade 4: within deep range to elastic barrier, slow small amplitude rhythmic oscillations, stretch into stiffness or muscle spasm
4
Q
physiologic barrier vs elastic limit
at end of AROM or PROM
A
pb- end of AROM
el- end of PROM
5
Q
manipulation creates a
A
paraphysiological space
6
Q
manipulation goes to
A
end of elastic brinier, past physiological ROM (not exceeding anatomical limit)
7
Q
adequate vs exceeding rxn in manipulation
A
- Adequate reaction (6-12 hours after): local soreness, bruising, headaches, tired, less than 2 days
- Exceeding reaction: worse signs and symptoms, interferes with work, excessive bruising, more than 2 days
8
Q
fixation vs sublimation
A
Fixation= articulation immobilized in a position that it may normally occupy during any phase of physiological movement
Sublaxation= alteration of the normal dynamic, anatomic, or physiologic relationships of contiguous (touching) articular structures.
9
Q
3 monosacchairde
A
glucose
fructose
galactose
10
Q
3 disaccharrides
A
sucrose
lactose
maltose
11
Q
how is fructose turned into glucose? what transporter for absorption? problem w excess fructose
A
converted into glucose in liver and intestine, GLUT5 transporter for absorption, excess not regulated; TG synthesis
12
Q
storage form of polysaccharides in plants and animals
A
- Starch is storage carb in plants
- Glycogen is storage carb in animals
13
Q
what affects zinc absorption
A
o Rates of absorption depend on body status
o Inhibited by alcohol
interferes with iron and copper absorption
14
Q
zinc importance
A
periods of growth
- Protein, DNA and RNA metabolism
15
Q
manganese importance
A
- Involved in amino acid, cholesterol, glucose and carb metabolism, ROS, bone formation, reproduction, immune response, blood clot and hemostasis
16
Q
excess manganese
A
- Excess accumulates in liver and CNS psychiatric and neuromuscular problems
17
Q
chromium helps with blood sugar?
A
- Part of a protein complex that potentiates insulin activity and moves glucose into cells
18
Q
glutathione peroxidase and deiodinase needs selenium and which vitami
A
vitamin e
19
Q
excess fluoride
A
pitted and discoloured teeth
20
Q
supplementation in hypothryoid
A
- Iodine and selenium supplement
o Avoid excess iodine if medicated
21
Q
3 goitrogens
A
thiocyanates, glucosinolates, flavonoids
o i.e. cassava, lima beans, sorghum, soy, Millet, cruciferous vegetables
22
Q
what to do to offset effect of foods that cause goitrogens
A
- reduced by cooking
- ensure iodine intake sufficient to offset effects
23
Q
dew walking effects (cold)
A
- Relieves mild arterial circulatory disorders, venous disturbances in the legs (varicose veins) and morning grumpiness by promoting blood circulation and strengthening the veins, muscles and immune system.
24
Q
contrast shower effects
A
- Improve circulation, alertness/energy, reduce severity or frequency of cold and flu
25
who not to use cold water treading for
- Do not use cold water treading or dew walking if there is rheumatism of toes and/or ankles, sciatica, cystitis, pelvic inflammation, or irritable bowel
26
cold water treading effects
- Increase circulation and help build up resistance to infections.
- Leg cramping or leg pain that comes from exertion
27
why does underwater brush massage have stronger effects than dry skin brushing
due to the hydrostatic pressure of the bath water.
28
knee affusion benefits
- eliminate feelings of tiredness in feet and legs
- varicose veins
29
what is the derivation effect in knee affusion
decrease head congestion, tension headaches, migraine and cold symptoms presenting in the nose and throat. It is stimulating to the circulation.
30
epson salt beenfits
- releases toxins and metabolic waste through perspiration
31
who should avoid epsom salt bath
- very stimulating and therefore people with high blood pressure and severe varicose veins should avoid it
32
short vs long hot and cold
short hot: < 5 mins
long hot: > 5 mins
short cold: < 1 min
long cold: > 1 min
33
flavour of burdock/ atrium lappa
sweet
34
main actions for NAFLD in botanicals
alterative and hepatic
35
flavour and effect of botanicals in NAFLD
- Bitter and cool formula (put with warming ginger)
36
peony paeonia lactiflor has an affinity for
female hormones and fertility
37
botanical actions for T2DM
- Endocrine modulator (insulin), bitter, alterative
38
what metformin botanical made from
galega officinalis (goats rue)
39
cinnamomum zeylancicum action in botanical
o Facilitate glucose transport into the cell
o Warming carminative
40
what 2 botanical shell breast milk productions
galega officinalis (goats rue) and fenugreek (trigonella foenum graceum)
41
bitter melon (momordica charantria) can cause negative effects
o 2-3 fruits can cause GI pain and diarrhea
o Can cause hypoglycemic events
42
what does berberine/ barbers vulgaris pair well with in hepatic infections and T2D
Bupleurum sinensis in hepatic infections. Galega officinalis (goats rue) in type II diabetes.
43
what constitution to avoid using buplerurum sinuses in
Avoided in cold conditions or constitutions
44
when to use buplerum with peony
stagnant menses with heat presentation
45
caution when using gentian lutea
dont use if ulceration
46
gentian is very
bitter
47
what is blood purifier and laxative
rumex crisupus (yellow dock)
48
what to use in deficiency or weakened vitality
schisandra
49
what pairs well with paeonia alba in female hormone patterns that need tonifciation and rooting
schisandra
50
actions seen in nafld for botanicals
bitter, hectic, anti inflam, alterative, hepatoprotective, adaptogen, laxative, astringent, a
51
actions seen in T2D for botnaicsl
, antimicrobial, bitter, hepatic, anti-inflammatory, alterative, endocrine modulator (insulin), carminative, hypoglycmeic,
52
what will goats rue/galega officinalis do if using other treatments
: Will augment effects of other hypoglycemic agents
53
what botanical for hypoglycemia
goats rue/ galega
54
herbs for NAFLD
barberry/ berberis vulgaris
bupleurym
burdock/ articum lappa
yellow dock/rumex crispus
peony/ paeonia lactiflora
milk thistle. silybum marianum
gentian
schisandra
sweet wormwood
55
herbs for diabetes
cinnamomum zeylanicum
galega officinalis/ goats rue
gymnema slyvestre
momordica/ bitter melon
citrus reticualte/ tangerine
curcuma longa/ tumeric,
trigonella foenum graecum/ fenugreek
budock/ articum lappa
barberry/berberis
dandelion
nettle
hibiscus
56
SMILE and CLEMS
SMILE
Sensations
Modalities (< , >)
Intensity
Location
Etiology
CLEMS
Complaint
Location
Etiology
Modalities
Sesations
57
2 homeopathic for NAFLD
phosphorus and kalium bicarbonate
58
2 homeopaths for shoulder pain
arnica and natrum sulphuricum
59
what makes phoshphorus condition worse
touch, exertion, twilight, thunder, warm food
60
what makes phosphorus better
cold food, open air, sleep
61
phosphorus physical picture
tall, slender, nervous, transparrent skin
62
what does phsohpyorsu crave
thirsty
cold drinks
63
picture of phosphorus
burning ab
weak
restless
fear
charming
magnetic
sympathetic
sensitive
easily stimulated
64
diseases that phosphorus is good for
NAFLD
post op vomit
fatty degeneration
pulmonary disease
severe infections
polyps in bowerls
increased liver enzymes
hepatitis
foggy vision w stress
hemorrhage
external impressions (light and sound)
65
what is kalium bicarbonate better with
heat
66
heat vs cold in kalium bicarbonate and phoshporus
heat makes KB better and phosphorus worse
cold make P better and KB worse
67
what makes kalium bicarbonate worse
beer (craves)
morning
cold
wet weather
undressing
68
what type of pain pattern for kalium bicarbonate
pain in small spots or migrates quickly from place to place
69
discharge in kalium bicarbonate
green, thick lumpy
inflamed sinuses
f
liver fatty infiltrate
70
kalium bicarbonate conditions
gastroenteritis
hepatitis
mucosal and cutaneous lesions
71
what is a mental picture of kalium bicarbonate
indifferent
adverse to exertion
avoids people (fear)
bad memory
72
homeopath that is afraid of people and avoids them
kalium bicarbonate
73
what 2 homeopaths are worse with exertion
kalium bicarbonate and phosphorus
74
what homeopath has green thick lumpy discharge and sinuses and mucus
kalium bicarbonate
75
charming , magnetic, sympathetic and sensitive and easily stimulated
phosphorus
76
what is arnica better with
lying down or head low
77
what is arnica worse with
least touch
motion
rest
wine
damp cold
78
type of eruptions for arnica
symmetrical
79
arnica usages
sore, back and limb pain
mental or physical (emotional trauma)
injuries
shock
trauma
surgery
80
arnica and bed
bed is hard
81
arnica doesnt like
touch (fears) and wants to be alone
82
2 homeo worse with cold
kalium carbonate and arnica (damp cold)
83
natrum sulphuricaum is better with
dry weather
pressure
changing position
84
natrum sulphuricum is worse with
music
left side lying
damp basement and weather
85
natrum sulphuric is a shoulder remedy but also good for
mental
liver, hepatitis
brusises
rheumatism (worse w damp)
86
natrum sulphuricum and music
lively music saddens
87
natrum sulphuricum and mental picture
mental tousle, melancholy and mania, suicidal
88
what drug causes the most weight loss
semaglutide
89
what has longer half life; semaglutide or liraglutide
semaglutide
90
side effects of semaglutide and liraglutide
N/V, diarrhea, ab pain, fatigue
91
what action are semaglutide and liraglutide
GLP 1 agonist
Reward systems, delay gastric empty, increase satiety, decrease appetite
92
what are GLP1 metabolized by
DPP4 enzyme
93
buproprione mechanism to suppress appetitie
sympathomimetic SNS
94
when not to use a sympathomimetic drug like buproprione
Since SNS don’t do if hypertensive, seizure, hepatic, ESRF
95
orlistat inhibits fat absorption; what type of diet to take with
o High fat intake is poorly tolerated
o Less effective on low fat diet
o Take multivitamin
96
drugs that cause weight gain
antidepressants (TCAs), antipsychotics, corticosteroids, antihyperglycemic drugs (i.e. sulfonylureas), lithium
97
can you take orlistat in pregngnacy
no because reduces DAKE absorption
98
% goal of weight loss to see changes in health
5-10%
99
what drugs can cause dysglycemia
beta blockers, corticosteroids, diuretics, antipsychotics etc
100
adverse effects of insulin
hypoglycemia, localized fat hypertrophy, allergic rxn
101
acarbose inhibits what
alpha-glucosidase;; which delays starch and disaccharide digestion (to reduce postprandial glucose levels)
102
if hypoglyceic when taking acarbose take what
glucose not sucrose (bc inhibits disaccharides)
103
best drug for T2D
metformin
104
what does metformin do
o Decrease hepatic glucose production
105
what can metformin cause deficiency in
b12
106
stigagliptin is kind of similar to semaglutide and liraglutide because indirectly acts as an incretin mimetic how?
it inhibits DPP4 enzyme which degrade GLP1
107
what 2 diabetes meds can help with CVD events
semaglytide and liraglutide
and canagliflozin (Na+/glucose con transport inhibitor)
108
can you use semaglutide and liraglutide in pregnancy
contraindicated
109
glyburide does what in diabetes
o Insulin secretagogue stimulate basal and meal insulin release
110
how to use glyburide
add on to metformin
111
2 weight gain drugs in diaebetes
pioglitazone and glyburide
112
2 drugs that are insulin secretagogues
glyburide (sulfonylureas) and repalinide (Meglitinides)
113
pioglitazone works as agonist at what receptor in adipose tissue
PPARG
114
what does pioglitazone do
PPARG agonist --> up regulate GLUT4 --> increase glucose reabsorption and hydrolyze TGs
115
which diabetes drugs has most risks and needs consent to prescribe
pioglitazone
o Weight gain, edema, fractures, heart failure
116
canaglifozin action in diabetes
inhibit Na+/glucose cotransporter so it prevents glucose reabsorption in the kidneys and excretes it more
117
adverse effects of canagliflozin (think kidneys excreting more glucose and less absorbed, act on Na+/glucose cotransport)
hyperkalemia, genitourinary infections, hypotension, DKA
118
levothyroxine replacement dose vs conservative dose
replace= 1.6 mcg/kg/ day PO
conservative 25-50 mcg
119
how long to see if levothyroxine works
6 weeks
120
what does levothyroxine interact with?
antacids and mineral supplements (i.e. calcium, iron, magnesium) reduce absorption, PPIs, estrogen
i. Take separately, 1st thing in AM
121
adverse effects of levothyroxine
hyperthyroid is overtreat, glycemic control declines, possible angina exacerbation
122
desiccated thyroid dosage in comparison to levothyoxine
c. 2/3 dosage (x0.65) of levothyroxine
c. Replacement dosage of levo: 1.6 mcg/kg.day PO
123
pill option for desiccated thyroid dose
b. 30, 60 and 125 mg tablets
124
what extra side effects does desiccated thyroid have
d. Similar adverse effects as levothyroxine plus CVD and neurological risks bc of T3
i. Palpitation, tachycardia, nervous, insomnia, sweat, weight loss
125
2 antithyroid agents to treat hyperthyroid
methimazole and propylthiouracil
126
methimazole vs propylthiouracil
which does aplasia cutis in 1st trimester?
which is overall better?
which in thyroid storm?
M
M
P
127
methimazole vs propylthiouracil mechanism of action on thyroid
methimazole: decreases thyroid hormone production
i. Interferes with iodination of tyrosine and coupling
ii. Doesn’t affect stored thyroid hormone or thyroid hormone in circulation
b. Propylthiouracil
i. Same as methimazole PLUS inhibit conversion of T4 to T3 in periphery
ii. Affects production of thyroid hormone and existing thyroid hormone
128
radioactive iodine to do what
a. Ablate thyroid tissue in Graves w toxic nodules
129
risks of radioactive iodine
hypothyroid, graves orbitopathy, radiation thyroiditis
130
use beta blocker propanolol in hyperthryoid but it doesnt effect thyroid hormone production- what does it do
b. Ameliorate symptoms of adrenergic excess caused by excess thyroid hormones (i.e. hypertension, elevated heart rate)
c. Propranolol can decrease conversion of T4 to T3 in periphery
131
when to avoid propanolol
bradycardia and asthma
it helps with adrenergic excess like elevated heart rate but if take too much can cause : bradycardia, hypotension, fatigue
132
3 drugs for obesity
orlistat (decrease fat absorption)
semaglutide and liraglutide (GLP1 agonist)
burproprion and naltrexone (appetite suppress; sympathomimetic)
133
3 drugs for hyperthyroid
radioactive iodine
propanolol (beta block to decrease adrenergic excess)
methimazole and propylthiouracil (decrease thyroid hormone)2
134
2 drugs for hypothryoid
levothyroxine (t4) and desiccated thyroid (T3/T4)
135
drugs for diabetes
insulin
acarbose (disaccharide absorb)
metformin (BEST, decrease hepatic glucose production)
sitagliptin (indirect incretin mimetic- DPP4)
semaglutide, liraglutide (GLP1 incerti mimetic)
glyburide (insulin secretagogue)
repaglinide (insulin secretagogue)
pioglizatone (PPARG, GLUT4, most dangerous)
canaflifozlin (Na+/glucose cotransport)
