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Comp Exam Nov > Nutri Theraputics > Flashcards

Nutri Theraputics Flashcards

1
Q
  1. Know how to interpret folate, B12, and iron deficiency anemias on blood chemistries and nutrient support for anemia.
    • decreased transferrin saturation – in those with?
  • Hemolytic anemia
  • iron deficiency anemia
  • macrocytic anemia
A

iron deficiency anemia

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2
Q

• megaloblastic anemia resulting from _____ deficiency is identical to the megaloblastic anemia resulting from _____ ___ deficiency, and further clinical testing is required to diagnose the true cause of megaloblastic anemia

  • B12, B6
  • B6, iron
  • folate, B12
  • folate, iron
A

folate, B12

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3
Q

Signs of what?

fatigue, poor balance memory loss, pallor (paleness), reduced sensation of touch, shortness of breath, or tingling feet

A

anemia

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4
Q

Megaloblastic or macrocytic anemia: can be classified by what kind of cells? what nutrients?

  • B12, B6
  • B6, iron
  • folate, B12
  • folate, iron
  • enlarged, immature red blood cells
  • enlarged, immature white blood cells
  • shrunken, immature red blood cells
  • sickle shaped cells
A

enlarged, immature red blood cells.

B12, or folate

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5
Q

Recommendations for:
• the DASH, Mediterranean or a full plant-based diet3 in order to help balance out his blood chemistry.
• Lower dietary sodium
• Increase water
• Increase plant based protein (pg112)
• Omega -3’s (pg114)
• Fiber, Alpha Lipoic Acid, CoQ10, garlic etc

A
  1. Know dietary and nutritional support for hypertension pg 105 - Week 2 Discussion Board A
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6
Q 
What condition do these test for?
•	Homocysteine, 
•	CoQ10, 
•	alpha-tocopherol, 
•	gamma- tocopherol, 
•	lipid peroxieds  
•	low vitamin C 
•	CRP
A

cardiovascular health

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7
Q

two heavy metals associated with poor cardiovascular health

  • aluminum, cadmium
  • cadmium, lead
  • lead, aluminum
A

cadmium, lead

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8
Q

T or F: RBC potassium is a better indicator of total body stores than serum potassium

A

True

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9
Q

Numerous research has demonstrated a significant reduction of blood pressure with increased dietary intake of ____. At ___ g per day

  • biotin, 5.7
  • folate, 5.7
  • magnesium, 4.7
  • potassium, 4.7
A

potassium, 4.7

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10
Q

A high dietary intake of 500 – 1000 mg per day of ____ reduces blood pressure in most of the clinical trials.

  • calcium
  • magnesium
  • potassium
  • sodium
A

magnesium

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11
Q

T or F: Body magnesium is more accurate in assessing total RBC magnesium

A

False , opposite

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12
Q

Adding 1000 – 2000 mg/d of _____ will enhance the anti-hypertensive effects of magnesium.

  • Glycine
  • Lysine
  • Serine
  • Taurine
A

taurine

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13
Q

T or F: High serum zinc levels have been associated with hypertension as well as cardiovascular disease

A

false, low

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14
Q

______ mcg of allicin (four cloves) is the required amount to have a significant effect on lowering blood pressure

  • 100
  • 1000
  • 10,000
  • 100,000
A

10,000

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15
Q

____ : decrease potassium, magnesium, phosphorus, sodium, chloride, folate, vitamin B6, zinc, iodine, and CoQ10.

  • Beta blockers
  • Diuretics
  • PPI
  • SSRI
A

Diuretics

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16
Q

_____ reduce CoQ10 and zinc

  • Beta blockers
  • Diuretics
  • PPI
  • SSRI
A

Beta Blockers:

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17
Q

5 statements required to be on dietary supplement labels

A
  1. Name of the dietary supplement
  2. Amount
  3. Nutrition labeling
  4. Ingredient list
  5. The name and place of business of the manufacturer, packer, or distributor
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18
Q

Vital for brain and organ function

  • 25% of total _______ in the body is in the brain
  • Required for the synthesis of steroid hormones
  • Required to synthesize vitamin D
  • Required to produce bile salts
  • Cholesterol
  • Chylomicron
  • LDL
  • Lipids
  • VLDL
A

cholesterol

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19
Q

Mechanisms in which _____ induce vascular damage

  • Inflammation
  • Oxidative stress
  • Autoimmune dysfunction
  • None
  • All
  • A and B only
A

all

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20
Q

_____ and ____ have a positive effect on serum lipids and CHD risk.

  • Monounsaturated and PUFAs
  • Monounsaturated and Saturated
  • PUFAs and n-3s
  • PUFAs and saturated
A

Monounsaturated and PUFAs

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21
Q 
\_\_\_\_\_ \_\_\_\_\_ contribute to:
–Insulin resistance
–Artherogenic LDL
–LDL particle number
–VLDL
–Triglycerides
–Total HDL and HDL subfractions
A

Refined carbohydrates

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22
Q

___ Particles Cause Plaque
•Cholesterol cannot float freely in the body
•Cholesterol is carried inside ___ particles through your blood.

  • Cholesterol
  • Chylomicron
  • LDL
  • Lipids
  • VLDL
A

LDL

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23
Q

Expanded Lipid Panels looks at what 4 things?

A

LDL particle number
LDL small
LDL medium
LDL Large

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24
Q

How to Change Small ___ to Large ___

Exercise
–4-5 days per week for at least 30 minutes
–2 days per week, do weight training
•Nutrition
–Consume fish 2-3 times per week or take a fish oil supplement
–Plant Sterols (2,000 mg/day)

A

Small LDL to Large LDL

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25
Q

How to improve ____?

–Body fat loss
–Exercise
–Consume fish 2-3 times per week or take a fish oil supplement (3 - 5 g/d)
–Niacin (500 mg to 4000 mg in divided doses)
–Quit smoking

  • Apo A
  • Apo B
  • Cholesterol
  • HDL2B
  • LDL
  • VLDL
A

HDL2b

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26
Q

____ is a true measurement direct measurement of amount of LDL particles
•A high number of ____ increase your risk of heart disease
•____ is a direct measurement whereas LDL is a calculated number, so ____ is a better marker for disease risk

  • Apo A
  • Apo B
  • Cholesterol
  • HDL2B
  • LDL
  • VLDL
A

Apo B

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27
Q

How to improve ____?

Increase foods with plant sterols
–Decrease foods high in saturated and eliminate trans fat
–Increase soluble fiber
–Exercise

  • Apo A
  • Apo B
  • Cholesterol
  • HDL2B
  • LDL
  • VLDL
A

Apo B

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28
Q

____ fiber binds fatty acids, cholesterol and bile acids and prevents their absorption or reabsorption during circulation.
•____ fiber increases bile acid synthesis, creating a pathway for cholesterol excretion.
•Since insulin stimulates cholesterol and triglyceride synthesis, lowering insulin with fiber may lower blood lipids.

A

soluble fiber

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29
Q

most of the cholesterol found in serum is derived from intestinal reuptake of cholesterol that has been deposited into the intestine from the ____ and ____

  • Gall bladder and kidney
  • Liver and gall bladder.
  • Liver and kidney
A

liver and gall bladder.

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30
Q
  • High levels can increase your risk for heart attacks and strokes
  • Diet and exercise have no significant affect on lowering abnormal values
  • A high level of ___ can be genetic – Family members may consider testing to see if they are at risk
  • Niacin
  • High dose vitamin C
  • Apo B
  • HDL
  • LDL
  • Lp(a)
A

Lp(a)

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31
Q

3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (HMG CoA reductase inhibitors)
•_____ is synthesized in the same pathway as cholesterol; therefore also involves the HMG CoA reductase enzyme.
•Research suggests that some statin drugs decrease serum _____ levels by as much as 40%

A

CoQ10

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32
Q 
\_\_\_\_ induced nutrient depletions:
–CoQ10
–Carnitine
–Vitamin E
–Vitamin D
–Omega-3 fatty acids
–Selenium
A

Statin

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33
Q

Nutrients to Improve__________ (9)

  • Fish Oil
  • Niacin
  • Tocotrienols
  • Red Yeast Rice
  • CoQ10
  • Green Tea (EGCg)
  • Garlic
  • Plant Sterols
  • Fiber
A

Dyslipdemia

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34
Q

It has a positive impact on all lipid fractions
–Lowers LDL, Lp(a), and triglycerides
–Raises HDL and increase the ratio of large/small particle LDL

  • Biotin
  • Folate
  • Niacin
  • Pantothenic acid
A

niacin

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35
Q

Research indicates that the two most potent forms of tocotrienols are ____ and ____

  • alpha and delta
  • delta and gamma
  • gamma and alpha
A

delta and gamma

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36
Q

Benefits:

  • Reduce oxidation of unsaturated lipids in cell membranes and lipoprotein particles.
  • Reduce foam cell formation by reducing oxidation of LDL particles and reducing the surface expression of cellular adhesion molecules.
  • Reduce the translation of HMG-CoA reductase mRNA as well as increasing the degradation of the enzyme post-transcriptionally

Recommended dose: 250 mg of gamma and delta ____ at night with food.
•The dosage is very important because increased dosing will induce its own metabolism and effectiveness
•Lower doses are not as effective

  • Tocotrienols
  • Garlic
  • Green Tea (EGCG)
A

Tocotrienols

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37
Q
  • Reduces intestinal cholesterol absorption
  • Inhibits enzymes involved in cholesterol synthesis
  • Deactivates HMG CoA reductase
  • Fibrinolytic and anti-platelet activity
  • Lowers blood pressure
  • Reduces LDL
  • Decreases coronary calcification
  • Tocotrienols
  • Garlic
  • Green Tea (EGCG)
A

Garlic

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38
Q

What botanical?

  • Protects LDL cholesterol from oxidation
  • EpiGallo-Catechin-3-Gallate- one of the more extensively studied green tea polyphenols
  • Can cause a small decrease in LDL levels and reduce platelet aggregation
  • Reduces fatty acid gene expression
  • Inhibits HMG CoA reductase
  • Decreases APO B lipoprotein secretion from cells
  • Dosage: 500 – 700 mg/d
  • Tocotrienols
  • Garlic
  • Green Tea (EGCG)
A

Green Tea (EGCg)

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39
Q 
Dietary Recommendations for \_\_\_\_\_
•Reduce or eliminate refined carbohydrate intake
•Anti-inflammatory diet
•Avoid hydrogenated vegetable oils
•Increase dietary fiber
•Eat garlic often
•Cook with coconut oil
•Add olive oil to cooked foods and raw vegetables
A

dislyipidemia

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40
Q

Congestive heart failure. Issue with ____ ____. Restrict intake to _ _____ a day .

A

fluid retention, 2 quarts

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41
Q

• ____ foods further increase fluid retention, may lead to increased blood pressure

  • Processed
  • Whole
  • Raw
  • Macrobiotic
A

Processed

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42
Q

CHF patients are commonly deficient in what two minerals?

  • calcium and sodium
  • chloride and magnesium
  • magnesium and potassium
A

magnesium and potassium

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43
Q

diuretic mediation often deplete what two minerals?

  • calcium and sodium
  • chloride and magnesium
  • magnesium and potassium
A

magnesium and potassium

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44
Q

three non mineral nutrients often needed in CHF.

  • d-ribose, CoQ10, L – carnitine
  • d-ribose, CoQ10, L – lysine
  • d-ribose, CoQ10, L – phenylalanine
  • d-ribose, CoQ10, L – serine
A

d-ribose, CoQ10, L - carnitine

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45
Q

• GI – 4Rs

A

o Remove food sensitivities or allergies, alcohol, aspirin, NSAIDS from the diet. Use antimicrobials for dysbiosis or GI infection
o Replace digestive enzymes and HCL if necessary.
o Reinoculate the bowel with pre- and probiotics.
o Repair the GI mucosa

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46
Q

What supplement ?
• Protects the intestinal epithelial cells and supports intestinal barrier function.
• Increases sIgA secretion
• Directly inhibits colonization of harmful bacteria
• protects gastrointestinal tract during antibiotic therapy
• Restores normal intestinal function in children and adults with diarrhea
• Prevents traveler’s diarrhea
• C. difficile
• Inflammatory Bowel Disease
• Use with GERD
• A nonpathogenic, probiotic yeast.

  • Bifidobacterium breve
  • Bifidobacterium infantis
  • Lactobacillus
  • Saccharomyces boulardii
A

• Saccharomyces boulardii

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47
Q

Know underlying causes of ___

Visceral hypersensitivity,
disordered cortical pain processing,
small bowel bacterial overgrowth,
increased intestinal permeability

A

IBS

48
Q
  • A chronic illness that is unremitting intestinal in cfhlaamramctaetriiozend w bityh tissue sdtarmesasge caused by increased oxidative metabolic
  • Iennfelarmgym, mataiocrno annudtr iinetnets, tainnadl mdaicmroanguet irniecrneta ses requirements.
  • eDsieset n(atinatli oroxlied ainn thse, aolminegg, aim-3m fautntye afucindcst)i opnla, yasn adn downregulating inflammation

What disease?

  • IBS
  • IBD
  • GERD
  • Leaky gut
A

Inflammatory Bowel Disease

49
Q

• CMP-14 • Lipid Panel • HA1c • Insulin • Homocysteine • Hs-CRP/CRP • Sed rate • Iron Panel • Vitamin D 25-OH; 1,25 dihydroxyvitaminD

labs to run for ?

  • IBS
  • IBD
  • GERD
  • Leaky gut
A

Inflammatory Bowel Disease

50
Q
  • Gluten
  • Food Sensitivity
  • Nutrient Deficiency
  • Stress and Hormone Imbalance
  • Dysbiosis
  • Infections
  • Toxins

Potential triggers for ___

  • IBS
  • IBD
  • GERD
  • Leaky gut
A

IBD

51
Q

_______ is a stool (fecal) test that is used to detect inflammation in the intestines. a marker of neutrophil activity and inflammation

  • Calprotectin
  • elastase
  • sIgA
  • Eosinophil Protein X
A

Calprotectin

52
Q
  • a marker of eosinophil activity
  • and inflammatory, allergic, and parasitic influences

which test?

  • Calprotectin
  • elastase
  • sIgA
  • Eosinophil Protein X
A

Eosinophil Protein X

• Eosinophil : are a variety of white blood cells and one of the immune system components responsible for combating multicellular parasites and certain infections in vertebrates.

53
Q
  • a marker of secretory
  • immune function, GI mucosal defense, and the
  • maintenance of gut barrier function

which test?

  • Calprotectin
  • elastase
  • sIgA
  • Eosinophil Protein X
A

sIgA

54
Q

test for microbiome (3)

A

n-butyrate
Acetate
Propionate

55
Q

benzoate, hipurate, phenylacetate, phenylpropionate, p-hydroxybenzoate, p-hydroxyphenylacetate, indican, tricarballyate, d- lactate, 3,4 dihydroxyphenylapropionate, d- arabintol

markers for?

A

Bacterial or yeast/fungal over growth

56
Q
  • CBC w/diff
  • CMP-14
  • Lipid Panel
  • HA1c
  • Insulin
  • Homocysteine
  • Cardio CRP
  • Iron Panel
  • Vitamin D 25-OH; 1,25 dihydroxyvitamin D

Test for? (2)

  • IBS
  • IBD
  • GERD
  • Leaky gut
  • Autoimmune
A

Autoimmune, IBS

57
Q

A comprehensive metabolic panel is a blood test that measures your sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function. Glucose is a type of sugar your body uses for energy. Electrolytes keep your body’s fluids in balance.

  • CBC w/diff
  • CMP-14
  • Lipid Panel
  • HA1c
A

CMP-14

58
Q

• GI – 4Rs

A

Remove gluten, egg, alcohol, aspirin, NSAIDS from the diet.
o Replace digestive enzymes and HCL if necessary.
o Reinoculate the bowel with pre- and probiotics.
o Repair the GI mucosa with L-Glutamine and GI Repair Nutrients

59
Q
  • Gluten
  • Food Sensitivity
  • Nutrient Deficiency
  • Stress and Hormone Imbalance
  • Dysbiosis
  • Infections
  • Toxins

environmental _____ triggers

  • IBS
  • IBD
  • GERD
  • Leaky gut
  • Autoimmune
A

autoimmune

60
Q
  • basophil or mast cell histimine release.
  • IgG or IgE.
  • Type I allergic reaction

Describes what?

  • food allergy
  • food intolerance
  • food sensitivity
  • IgE
A

food allergy

61
Q
  • immune system mediated response.
  • forms immune complexes that can stimulate complement cascade and local inflammation
  • delayed hours to 7 days after
  • Type III Allergic reaction

Describes what?

  • food allergy
  • food intolerance
  • food sensitivity
  • IgE
A

food sensitivity

62
Q
  • non immunological mechanisms
  • lactotose and MSG sensitivity

Describes what?

  • food allergy
  • food intolerance
  • food sensitivity
  • IgE
A

food intolerance

63
Q

Elevated levels of food specific ___ can cause allergic reactions to food involving the anaphylactic response

Describes what?

  • food allergy
  • food intolerance
  • food sensitivity
  • IgE
A

IgE

64
Q

Physical Exam for _______ patient

– Waist circumference
– Waist to hip ratio
– Body Mass Index = Weight Kg/Height (m)2
– Bioimpedence (BIA)

A

Physical Exam for diabetes patient (4)

65
Q

labs for suspicion of _______

– CBC
– CMP
– Lipid Profile
– Fatty acid profile
– HbA1c
– TSH
– Homocysteine
– CRP
– Vitamin D
A

labs for suspicion of diabetes (9)

66
Q 
MEN, metabolic syndrome:
• Waist Circumference > 
• Triglycerides > 
• HDL Cholesterol < 
• Blood Pressure > 
• Fasting Glucose >
A
  • Waist Circumference > 40 in.
  • Triglycerides > 150 mg/dL
  • HDL Cholesterol < 40 mg/dL
  • Blood Pressure > 130/85 mm Hg
  • Fasting Glucose > 100 mg/dL
67
Q 
WOMEN metabolic syndrome::
• Waist Circumference > 
• Triglycerides > 
• HDL Cholesterol < 
• Blood Pressure > 
• Fasting Glucose >
A 
Waist Circumference > 35 in.
• Triglycerides > 150 mg/dL
• HDL Cholesterol < 50 mg/dL
• Blood Pressure > 130/85 mm Hg
• Fasting Glucose > 100 mg/dL
68
Q

Excess sugar in your bloodstream can react
with proteins and lipids (fatty substances) in
your body, leading to the formation of highly
toxic product called?

A

– Advanced Glycation End products (AGEs).

69
Q

A key reason why diabetics are at a high risk of
nerve, artery and kidney damage - because the
high blood sugar levels in their bodies
significantly accelerate the formation of ____

A

AGEs

70
Q

• In your body, AGEs cause ___________ and
________ stress, and contribute to the
progression of atherosclerosis, particularly
among people with diabetes.

A

inflammation

oxidation

71
Q

How to Avoid A.G.E.s in Your Diet
• Foods that are high in AGEs are those that are? (5 methods of cooking)

• Any food that is “______,” particularly highfat,
high-protein food, is also likely to be high
in AGEs.

A

grilled, fried, broiled, roasted, pasteurized or
sterilized.

browned

72
Q

Use “___” cooking methods, such as stewing, boiling,
braising, crock pot or steaming, often because dry-heat
cooking methods create more AGEs than moist ones

A

wet

73
Q

When you do grill, use _____ marinades including
lemon juice and vinegar, which are thought to help to
fight AGEs. Also, trim the fat off the meat beforehand.

  • Acidic
  • Sugary
  • Spicy
  • Oily
A

acidic

74
Q

what test correlates with AGE’s?

– Fatty acid profile
– HbA1c
– TSH
– Homocysteine

A

HbA1C

75
Q

what does GLUT stand for?

A

Glucose transport protein

76
Q
  • Body weight in kg/m2 .
  • Take body weight in pounds and divide by 2.2 = kg.
  • Take height in inches and multiply by .0254 then square it.
A

how to calculate BMI

77
Q

BMI:

Underweight

A

Below 18.5 Underweight

78
Q

BMI:

Normal or Healthy Weight

A

18.5 – 24.9 Normal or Healthy Weight

79
Q

BMI:

Overweight

A

25.0 – 29.9 Overweight

80
Q

BMI:

Obese

A

30.0 and Above Obese

81
Q

mannitol/lactulose
zonulin
Lipopolysacchairdes (LPS)
Actomyosin IgA

tests for?
•	IBS
•	IBD
•	GERD
•	Leaky gut
A

leaky gut

82
Q

If lower esophageal sphincter fails to close
stomach acids enter esophagus & cause heartburn

  • IBS
  • IBD
  • GERD
  • Leaky gut
A

GERD

83
Q
  • Endoscopy
  • Food antibody testing
  • Test for H. Pylori
  • Stool testing
Tests for?
tests for?
•	IBS
•	IBD
•	GERD
•	Leaky gu
A

GERD

84
Q

•Reduce animal protein
•8 glasses water daily
•Juicing (especially cabbage)
–Methymethionine sulfonium can be a substitute for cabbage juice
•Deglycyrrhizinated Licorice (DGL) chewable tablets 400mg TID between meals.
•Zinc carnosine 75 mg BID
•Plant based digestive enzymes (before meals)
•Calcium glycerophosphate- acid-reducing properties in the gut

____ Lifestyle Recommendations

  • IBS
  • IBD
  • GERD
  • Leaky gut
A

GERD

85
Q

Functions of ___
•Reduce stomach pH to about 2.0
•Kills bacteria in food
•Inactivates amylase (starch digestion stops).
•Converts (activates) pepsinogen to pepsin.
•Starts protein breakdown (denature)

A

HCL

86
Q

_____ ______ Repair nutrients

  • Zinc Carnosine
  • L-Glutamine-
  • Mucin-Intestinal lining support via a glycoprotein,
  • N-Acetyl Glucosamine- GI tissue support
  • DGL, Slippery Elm, Marshmallow, Chamomile, Okra, and Cat’s Claw GI soothing
  • Reduction of inflammation- Omega-3 fatty acids and Polyphenols - curcumin, boswellia, ginger, quercetin, rutin, rosemary, resveratrol, EGCg -
A

GI

87
Q
  • Alcohol
  • Smoking
  • Carbonated beverages
  • Coffee
  • Chocolate
  • Tomatoes
  • Fatty foods
  • Onions
  • Peppermint
  • Junk food

to avoid with?

  • IBS
  • IBD
  • GERD
  • Leaky gut
A

GERD

88
Q
  • Calcium channel blockers
  • Beta blockers
  • Alpha-adrenergic agonists
  • Theophyline
  • Nitrates
  • Progesterone
  • Aspirin
  • NSAIDS

Can cause ____:

  • IBS
  • IBD
  • GERD
  • Leaky gut
A

GERD

89
Q

_____ _______ and food allergy are frequently herald conditions for other manifestations of ‘the allergic march’. They commonly co-exist, particularly in those with early onset, severe and persistent atopic eczema. Filaggrin gene defects substantially increase the risk of ______ _______.

A

Atopic dermatitis

atopic eczema

90
Q

Regarding kidney stones:

Elevated serum uric acid suggest:

  • increase Ca uptake
  • primary hyperparathyroidism associated with Ca-phosphate stones. ~5% of people with nephrolithiasis have elevated parathyroid hormone levels
  • secondary hyperparathyroidism;
  • uric acid stones, especially when combined with a history of gout and fructose ingestion
A

• uric acid stones, especially when combined with a history of gout and fructose ingestion

91
Q

Regarding kidney stones:

Elevated serum Ca can suggest:

  • increase Ca uptake
  • primary hyperparathyroidism associated with Ca-phosphate stones. ~5% of people with nephrolithiasis have elevated parathyroid hormone levels
  • secondary hyperparathyroidism;
  • uric acid stones, especially when combined with a history of gout and fructose ingestion
A

primary hyperparathyroidism associated with Ca-phosphate stones. ~5% of people with nephrolithiasis have elevated parathyroid hormone levels

92
Q

Regarding kidney stones:

Serum 25-hydroxy Vit D is valuable as both high and low levels promote stone formation.

Low is associated with:

  • increase Ca uptake
  • primary hyperparathyroidism associated with Ca-phosphate stones. ~5% of people with nephrolithiasis have elevated parathyroid hormone levels
  • secondary hyperparathyroidism;
  • uric acid stones, especially when combined with a history of gout and fructose ingestion
A

secondary hyperparathyroidism;

93
Q

Regarding kidney stones:

Serum 25-hydroxy Vit D is valuable as both high and low levels promote stone formation.

High levels:

  • increase Ca uptake
  • primary hyperparathyroidism associated with Ca-phosphate stones. ~5% of people with nephrolithiasis have elevated parathyroid hormone levels
  • secondary hyperparathyroidism;
  • uric acid stones, especially when combined with a history of gout and fructose ingestion
A

increase Ca uptake

94
Q

Regarding kidney stones:

Urine Ph is an important biochemical factor in the prod of kidney stones;

cysteine, and Ca oxalate stones tend to form in ____ urine,
while struvite and calcium phosphate stones form in ______ urine

  • acidic
  • alkaline
  • Ca, phosphorus, Mg, uric acid, oxalate
  • Calcium
  • Creatinine
  • increase Ca uptake
A

acidic, alkaline

95
Q

Regarding kidney stones:

A 24- hour collection can be analyzed for ____, and the stone-inhibiting factors citrate and phytate. In the absence of the actual stone analysis, these 24-hour urine parameters help indicate potentially abnormal or treatable conditions such as low urinary citrate.

  • acidic, alkaline
  • Ca, phosphorus, Mg, uric acid, oxalate
  • Calcium
  • Creatinine
  • increase Ca uptake
A

Ca, phosphorus, Mg, uric acid, oxalate

96
Q

Regarding kidney stones:

24-hour urine ______ should be measured to evaluate the adequacy of the collection

  • Ca, phosphorus, Mg, uric acid, oxalate
  • Calcium
  • Creatinine
  • increase Ca uptake
A

creatinine

97
Q

An elevated urine _______ excretion is another important stone-forming risk factor. Elevation can occur with increased diet acid loads, increased salt intake, and both inadequate and excessive vitamin D levels.

  • acidic, alkaline
  • Ca, phosphorus, Mg, uric acid, oxalate
  • Calcium
  • Creatinine
  • increase Ca uptake
  • primary hyperparathyroidism associated with Ca-phosphate stones. ~5% of people with nephrolithiasis have elevated parathyroid hormone levels
  • secondary hyperparathyroidism;
  • uric acid stones, especially when combined with a history of gout and fructose ingestion

Regarding kidney stones:

A

calcium

98
Q

AGEs have also been associated with a
number of chronic diseases such as _____.

(choose all that apply)

  • Diabetes
  • Heart disease
  • Kidney
  • Metabolic syndrome
  • Renal disease
A

diabetes,

heart disease, and renal disease.

99
Q
  • Hs-CRP/CRP
  • Sed rate
  • Vitamin D 25-OH; 1,25
  • dihydroxyvitamin D

IBD, to test for?

  • Anemia
  • Hydration
  • Inflammation and disease activity
A

• Inflammation and disease activity

100
Q

CBC w/diff
Iron Panel
Vtiamin B12 or MMA, Folate

IBD, to test for?

  • Anemia
  • Hydration
  • Inflammation and disease activity
A

• Anemia

101
Q
  • Vital signs,
  • CBC w/diff,
  • CMP-14

IBD, to test for?

  • Anemia
  • Hydration
  • Inflammation and disease activity
A

• Hydration

102
Q

What nutrient recommendations would you make for someone on a proton pump inhibitor (PPI)?

Betaine HCL
Goldenseal
Vitamin B12 and Magnesium
Ginger

A

Vitamin B12 and Magnesium

103
Q

o Interstitial deposits containing calcium oxalate are also known as Randall’s plaques and are visible on uroscopy as whitish deposits)
o Plaque formation increase with increased urinary calcium excretion and decreased urine pH.
o Stones may also form in the tubules at sites of luminal injury such as the opening of the ducts of Bellini

What kind of kidney stone?

  • Calcium Oxalate
  • Calcium Phosphate
  • Cystine
  • Struvite
  • Uric Acid
  • Other
A

Calcium Oxalate

104
Q

o Often seen in those with renal tubular acidifying abnormalities are found protruding from the ducts of Bellini

What kind of kidney stone?

  • Calcium Oxalate
  • Calcium Phosphate
  • Cystine
  • Struvite
  • Uric Acid
  • Other
A

Calcium Phosphate

105
Q

Regarding kidney stones, children vs adults:
• Calcium Oxalate

  • (2-4%; 9-17%)
  • (24-30%; 8-18% - up to 75% incidence in prego women)
  • (4%; 2%)
  • (45-65%; 56-61%)
  • (5-8%; 1%)
  • (7-13%; 2-4%)
A

• Calcium Oxalate (45-65%; 56-61%)

106
Q

Regarding kidney stones, children vs adults:
• Calcium Phosphate

  • (2-4%; 9-17%)
  • (24-30%; 8-18% - up to 75% incidence in prego women)
  • (4%; 2%)
  • (45-65%; 56-61%)
  • (5-8%; 1%)
  • (7-13%; 2-4%)
A

• Calcium Phosphate (24-30%; 8-18% - up to 75% incidence in prego women)

107
Q

Regarding kidney stones, children vs adults:
• Cystine

  • (2-4%; 9-17%)
  • (24-30%; 8-18% - up to 75% incidence in prego women)
  • (4%; 2%)
  • (45-65%; 56-61%)
  • (5-8%; 1%)
  • (7-13%; 2-4%)
A

• Cystine (5-8%; 1%)

108
Q

Regarding kidney stones, children vs adults:
• Struvite

  • (2-4%; 9-17%)
  • (24-30%; 8-18% - up to 75% incidence in prego women)
  • (4%; 2%)
  • (45-65%; 56-61%)
  • (5-8%; 1%)
  • (7-13%; 2-4%)
A

• Struvite (7-13%; 2-4%)

109
Q

Regarding kidney stones, children vs adults:
• Uric Acid

  • (2-4%; 9-17%)
  • (24-30%; 8-18% - up to 75% incidence in prego women)
  • (4%; 2%)
  • (45-65%; 56-61%)
  • (5-8%; 1%)
  • (7-13%; 2-4%)
A

• Uric Acid (2-4%; 9-17%)

110
Q

Regarding kidney stones, children vs adults:
• Other

  • (2-4%; 9-17%)
  • (24-30%; 8-18% - up to 75% incidence in prego women)
  • (4%; 2%)
  • (45-65%; 56-61%)
  • (5-8%; 1%)
  • (7-13%; 2-4%)
A

• Other (4%; 2%)

111
Q
  • Melatonin
  • L-tryptophan and 5-HTP
  • Chamomile
  • Kava
  • Hops
  • Lemon Balm
  • Valerian Root
  • Magnesium

nutrients for what issue?

A

sleep disturbance

112
Q
  • Alcohol
  • Most frequent food triggers: Wheat; orange; egg; tea and coffee; chocolate; milk; beef; corn and cane sugar; yeast; mushrooms; peas

triggers for what?

A

migraines

113
Q

• Pathophysiology – primary hypogonadism, y chromosome defect, altered sperm transport, secondary hypogonadism, developmental or physiological, immunological, unknown
o Other considerations: obesity, increased scrotal temperature, radiation, smoking, marijuana

potential causes of what?

A

male infertility

114
Q 
o	avoid environmental exposures 
o	detoxification
	glutathione 
o	l-arginine
o	l – carnitine 
o	antioxidants
o	zinc
o	CoQ10
o	Vitamin C, A, E, D, B12, folate
o	Alpha lipoic acid

nutritional support for?

A

male infertility

115
Q

health screen and fertility work up, hormone profile and semen analysis
o Environmental – PCBs, chlorinated pesticides, volatiles solvents, phthalates, parabens, nutrient and toxic element screening (heavy metals), other toxins

Evaluation for?

A

male infertility

Comp Exam Nov (4 decks)

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