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NMT200 midterm (wk1-6) > keys > Flashcards

keys Flashcards

1
Q

mobilization is applied within the ____but not passed the ____

A

physiologic ROM but not passed the elastic barrier

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2
Q

what do oscillations in a mobilization do

A

oscillations activate sensory mechanoreceptors to reduce pain and improve proprioception

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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

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4
Q

physiologic barrier vs elastic limit

at end of AROM or PROM

A

pb- end of AROM

el- end of PROM

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5
Q

manipulation creates a

A

paraphysiological space

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6
Q

manipulation goes to

A

end of elastic brinier, past physiological ROM (not exceeding anatomical limit)

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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
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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.

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9
Q

3 monosacchairde

A

glucose
fructose
galactose

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10
Q

3 disaccharrides

A

sucrose
lactose
maltose

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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

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12
Q

storage form of polysaccharides in plants and animals

A
  • Starch is storage carb in plants
  • Glycogen is storage carb in animals
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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

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14
Q

zinc importance

A

periods of growth
- Protein, DNA and RNA metabolism

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15
Q

manganese importance

A
  • Involved in amino acid, cholesterol, glucose and carb metabolism, ROS, bone formation, reproduction, immune response, blood clot and hemostasis
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16
Q

excess manganese

A
  • Excess accumulates in liver and CNS  psychiatric and neuromuscular problems
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17
Q

chromium helps with blood sugar?

A
  • Part of a protein complex that potentiates insulin activity and moves glucose into cells
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18
Q

glutathione peroxidase and deiodinase needs selenium and which vitami

A

vitamin e

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19
Q

excess fluoride

A

pitted and discoloured teeth

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20
Q

supplementation in hypothryoid

A
  • Iodine and selenium supplement

o Avoid excess iodine if medicated

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21
Q

3 goitrogens

A

thiocyanates, glucosinolates, flavonoids

o i.e. cassava, lima beans, sorghum, soy, Millet, cruciferous vegetables

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22
Q

what to do to offset effect of foods that cause goitrogens

A
  • reduced by cooking
  • ensure iodine intake sufficient to offset effects
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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.
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24
Q

contrast shower effects

A
  • Improve circulation, alertness/energy, reduce severity or frequency of cold and flu
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25
Q

who not to use cold water treading for

A
  • 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
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26
Q

cold water treading effects

A
  • Increase circulation and help build up resistance to infections.
  • Leg cramping or leg pain that comes from exertion
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27
Q

why does underwater brush massage have stronger effects than dry skin brushing

A

due to the hydrostatic pressure of the bath water.

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28
Q

knee affusion benefits

A
  • eliminate feelings of tiredness in feet and legs
  • varicose veins
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29
Q

what is the derivation effect in knee affusion

A

decrease head congestion, tension headaches, migraine and cold symptoms presenting in the nose and throat. It is stimulating to the circulation.

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30
Q

epson salt beenfits

A
  • releases toxins and metabolic waste through perspiration
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31
Q

who should avoid epsom salt bath

A
  • very stimulating and therefore people with high blood pressure and severe varicose veins should avoid it
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32
Q

short vs long hot and cold

A

short hot: < 5 mins
long hot: > 5 mins
short cold: < 1 min
long cold: > 1 min

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33
Q

flavour of burdock/ atrium lappa

A

sweet

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34
Q

main actions for NAFLD in botanicals

A

alterative and hepatic

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35
Q

flavour and effect of botanicals in NAFLD

A
  • Bitter and cool formula (put with warming ginger)
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36
Q

peony paeonia lactiflor has an affinity for

A

female hormones and fertility

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37
Q

botanical actions for T2DM

A
  • Endocrine modulator (insulin), bitter, alterative
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38
Q

what metformin botanical made from

A

galega officinalis (goats rue)

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39
Q

cinnamomum zeylancicum action in botanical

A

o Facilitate glucose transport into the cell

o Warming carminative

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40
Q

what 2 botanical shell breast milk productions

A

galega officinalis (goats rue) and fenugreek (trigonella foenum graceum)

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41
Q

bitter melon (momordica charantria) can cause negative effects

A

o 2-3 fruits can cause GI pain and diarrhea
o Can cause hypoglycemic events

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42
Q

what does berberine/ barbers vulgaris pair well with in hepatic infections and T2D

A

Bupleurum sinensis in hepatic infections. Galega officinalis (goats rue) in type II diabetes.

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43
Q

what constitution to avoid using buplerurum sinuses in

A

Avoided in cold conditions or constitutions

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44
Q

when to use buplerum with peony

A

stagnant menses with heat presentation

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45
Q

caution when using gentian lutea

A

dont use if ulceration

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46
Q

gentian is very

A

bitter

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47
Q

what is blood purifier and laxative

A

rumex crisupus (yellow dock)

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48
Q

what to use in deficiency or weakened vitality

A

schisandra

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49
Q

what pairs well with paeonia alba in female hormone patterns that need tonifciation and rooting

A

schisandra

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50
Q

actions seen in nafld for botanicals

A

bitter, hectic, anti inflam, alterative, hepatoprotective, adaptogen, laxative, astringent, a

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51
Q

actions seen in T2D for botnaicsl

A

, antimicrobial, bitter, hepatic, anti-inflammatory, alterative, endocrine modulator (insulin), carminative, hypoglycmeic,

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52
Q

what will goats rue/galega officinalis do if using other treatments

A

: Will augment effects of other hypoglycemic agents

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53
Q

what botanical for hypoglycemia

A

goats rue/ galega

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54
Q

herbs for NAFLD

A

barberry/ berberis vulgaris
bupleurym
burdock/ articum lappa
yellow dock/rumex crispus
peony/ paeonia lactiflora
milk thistle. silybum marianum
gentian
schisandra
sweet wormwood

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55
Q

herbs for diabetes

A

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
Q

SMILE and CLEMS

A

SMILE
Sensations
Modalities (< , >)
Intensity
Location
Etiology
CLEMS
Complaint
Location
Etiology
Modalities
Sesations

57
Q

2 homeopathic for NAFLD

A

phosphorus and kalium bicarbonate

58
Q

2 homeopaths for shoulder pain

A

arnica and natrum sulphuricum

59
Q

what makes phoshphorus condition worse

A

touch, exertion, twilight, thunder, warm food

60
Q

what makes phosphorus better

A

cold food, open air, sleep

61
Q

phosphorus physical picture

A

tall, slender, nervous, transparrent skin

62
Q

what does phsohpyorsu crave

A

thirsty
cold drinks

63
Q

picture of phosphorus

A

burning ab
weak
restless
fear
charming
magnetic
sympathetic
sensitive
easily stimulated

64
Q

diseases that phosphorus is good for

A

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
Q

what is kalium bicarbonate better with

A

heat

66
Q

heat vs cold in kalium bicarbonate and phoshporus

A

heat makes KB better and phosphorus worse

cold make P better and KB worse

67
Q

what makes kalium bicarbonate worse

A

beer (craves)
morning
cold
wet weather
undressing

68
Q

what type of pain pattern for kalium bicarbonate

A

pain in small spots or migrates quickly from place to place

69
Q

discharge in kalium bicarbonate

A

green, thick lumpy

inflamed sinuses
f
liver fatty infiltrate

70
Q

kalium bicarbonate conditions

A

gastroenteritis
hepatitis
mucosal and cutaneous lesions

71
Q

what is a mental picture of kalium bicarbonate

A

indifferent
adverse to exertion
avoids people (fear)
bad memory

72
Q

homeopath that is afraid of people and avoids them

A

kalium bicarbonate

73
Q

what 2 homeopaths are worse with exertion

A

kalium bicarbonate and phosphorus

74
Q

what homeopath has green thick lumpy discharge and sinuses and mucus

A

kalium bicarbonate

75
Q

charming , magnetic, sympathetic and sensitive and easily stimulated

A

phosphorus

76
Q

what is arnica better with

A

lying down or head low

77
Q

what is arnica worse with

A

least touch
motion
rest
wine
damp cold

78
Q

type of eruptions for arnica

A

symmetrical

79
Q

arnica usages

A

sore, back and limb pain
mental or physical (emotional trauma)
injuries
shock
trauma
surgery

80
Q

arnica and bed

A

bed is hard

81
Q

arnica doesnt like

A

touch (fears) and wants to be alone

82
Q

2 homeo worse with cold

A

kalium carbonate and arnica (damp cold)

83
Q

natrum sulphuricaum is better with

A

dry weather
pressure
changing position

84
Q

natrum sulphuricum is worse with

A

music
left side lying
damp basement and weather

85
Q

natrum sulphuric is a shoulder remedy but also good for

A

mental
liver, hepatitis
brusises
rheumatism (worse w damp)

86
Q

natrum sulphuricum and music

A

lively music saddens

87
Q

natrum sulphuricum and mental picture

A

mental tousle, melancholy and mania, suicidal

88
Q

what drug causes the most weight loss

A

semaglutide

89
Q

what has longer half life; semaglutide or liraglutide

A

semaglutide

90
Q

side effects of semaglutide and liraglutide

A

N/V, diarrhea, ab pain, fatigue

91
Q

what action are semaglutide and liraglutide

A

GLP 1 agonist

 Reward systems, delay gastric empty, increase satiety, decrease appetite

92
Q

what are GLP1 metabolized by

A

DPP4 enzyme

93
Q

buproprione mechanism to suppress appetitie

A

sympathomimetic SNS

94
Q

when not to use a sympathomimetic drug like buproprione

A

 Since SNS don’t do if hypertensive, seizure, hepatic, ESRF

95
Q

orlistat inhibits fat absorption; what type of diet to take with

A

o High fat intake is poorly tolerated
o Less effective on low fat diet
o Take multivitamin

96
Q

drugs that cause weight gain

A

antidepressants (TCAs), antipsychotics, corticosteroids, antihyperglycemic drugs (i.e. sulfonylureas), lithium

97
Q

can you take orlistat in pregngnacy

A

no because reduces DAKE absorption

98
Q

% goal of weight loss to see changes in health

A

5-10%

99
Q

what drugs can cause dysglycemia

A

beta blockers, corticosteroids, diuretics, antipsychotics etc

100
Q

adverse effects of insulin

A

hypoglycemia, localized fat hypertrophy, allergic rxn

101
Q

acarbose inhibits what

A

alpha-glucosidase;; which delays starch and disaccharide digestion (to reduce postprandial glucose levels)

102
Q

if hypoglyceic when taking acarbose take what

A

glucose not sucrose (bc inhibits disaccharides)

103
Q

best drug for T2D

A

metformin

104
Q

what does metformin do

A

o Decrease hepatic glucose production

105
Q

what can metformin cause deficiency in

A

b12

106
Q

stigagliptin is kind of similar to semaglutide and liraglutide because indirectly acts as an incretin mimetic how?

A

it inhibits DPP4 enzyme which degrade GLP1

107
Q

what 2 diabetes meds can help with CVD events

A

semaglytide and liraglutide
and canagliflozin (Na+/glucose con transport inhibitor)

108
Q

can you use semaglutide and liraglutide in pregnancy

A

contraindicated

109
Q

glyburide does what in diabetes

A

o Insulin secretagogue  stimulate basal and meal insulin release

110
Q

how to use glyburide

A

add on to metformin

111
Q

2 weight gain drugs in diaebetes

A

pioglitazone and glyburide

112
Q

2 drugs that are insulin secretagogues

A

glyburide (sulfonylureas) and repalinide (Meglitinides)

113
Q

pioglitazone works as agonist at what receptor in adipose tissue

A

PPARG

114
Q

what does pioglitazone do

A

PPARG agonist –> up regulate GLUT4 –> increase glucose reabsorption and hydrolyze TGs

115
Q

which diabetes drugs has most risks and needs consent to prescribe

A

pioglitazone

o Weight gain, edema, fractures, heart failure

116
Q

canaglifozin action in diabetes

A

inhibit Na+/glucose cotransporter so it prevents glucose reabsorption in the kidneys and excretes it more

117
Q

adverse effects of canagliflozin (think kidneys excreting more glucose and less absorbed, act on Na+/glucose cotransport)

A

hyperkalemia, genitourinary infections, hypotension, DKA

118
Q

levothyroxine replacement dose vs conservative dose

A

replace= 1.6 mcg/kg/ day PO

conservative 25-50 mcg

119
Q

how long to see if levothyroxine works

A

6 weeks

120
Q

what does levothyroxine interact with?

A

antacids and mineral supplements (i.e. calcium, iron, magnesium) reduce absorption, PPIs, estrogen

i. Take separately, 1st thing in AM

121
Q

adverse effects of levothyroxine

A

hyperthyroid is overtreat, glycemic control declines, possible angina exacerbation

122
Q

desiccated thyroid dosage in comparison to levothyoxine

A

c. 2/3 dosage (x0.65) of levothyroxine

c. Replacement dosage of levo: 1.6 mcg/kg.day PO

123
Q

pill option for desiccated thyroid dose

A

b. 30, 60 and 125 mg tablets

124
Q

what extra side effects does desiccated thyroid have

A

d. Similar adverse effects as levothyroxine plus CVD and neurological risks bc of T3
i. Palpitation, tachycardia, nervous, insomnia, sweat, weight loss

125
Q

2 antithyroid agents to treat hyperthyroid

A

methimazole and propylthiouracil

126
Q

methimazole vs propylthiouracil

which does aplasia cutis in 1st trimester?
which is overall better?
which in thyroid storm?

A

M
M
P

127
Q

methimazole vs propylthiouracil mechanism of action on thyroid

A

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
Q

radioactive iodine to do what

A

a. Ablate thyroid tissue in Graves w toxic nodules

129
Q

risks of radioactive iodine

A

hypothyroid, graves orbitopathy, radiation thyroiditis

130
Q

use beta blocker propanolol in hyperthryoid but it doesnt effect thyroid hormone production- what does it do

A

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
Q

when to avoid propanolol

A

bradycardia and asthma

it helps with adrenergic excess like elevated heart rate but if take too much can cause : bradycardia, hypotension, fatigue

132
Q

3 drugs for obesity

A

orlistat (decrease fat absorption)

semaglutide and liraglutide (GLP1 agonist)

burproprion and naltrexone (appetite suppress; sympathomimetic)

133
Q

3 drugs for hyperthyroid

A

radioactive iodine

propanolol (beta block to decrease adrenergic excess)

methimazole and propylthiouracil (decrease thyroid hormone)2

134
Q

2 drugs for hypothryoid

A

levothyroxine (t4) and desiccated thyroid (T3/T4)

135
Q

drugs for diabetes

A

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)

NMT200 midterm (wk1-6) (22 decks)

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