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Anti Aging Medicine Boards > Part 7 > Flashcards

Part 7 Flashcards

0
Q

What immune cells does vitamin A support and how?

A

It supports neutrophils and Macrophages by helping phagocytosis

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1
Q

What part of the immune system does vitamin A help protect?

A

It helps protect the integrity of mucosal barriers. Low levels lead to increased infections of the eye, respiratory tract and G.I. tract

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2
Q

How does vitamin A affect T-helper cells?

A

It plays an important role in switching Th1–> Th2. This lowers IL-2, TNF alpha and interferon gamma production

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3
Q

How does supplementing with vitamin A help with vaccines?

A

It increases delayed type hypersensitivity reactions thereby producing better and safer responses to vaccines

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4
Q

Increased levels of glutathione reduces viral loads for what conditions?

A

HIV, CMV, HBV and HCV

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5
Q

Low levels of glutathione inhibits what immune functions?

A

Antigen processing and presentation

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6
Q

Where is NAC metabolized and what does it become?

A

It is metabolized in the gut wall and liver.

NAC —> L-cysteine —> glutathione

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7
Q

Low glutathione levels have been found in what conditions?

A

1) Alzheimer’s and other dementias
2) HBV and HCV
3) hypertension and cardiovascular disease
4) metabolic syndrome

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8
Q

Name nine predisposing factors for type two diabetes

A

Toxins, no exercise, visceral adiposity, chronic stress, inflammation, genetics, high glycemic load diet, smoking and poor/lack of sleep

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9
Q

What are 13 long-term complications of type two diabetes?

A

Cardiovascular disease, inability to burn fat, glycation, brain fog (decreased blood flow), fatigue (secondary to low testosterone, low thyroid and poor adrenal function), nonalcoholic fatty liver disease, musculoskeletal problems, GERD, hypochlorhydria, dysbiosis, food allergies, fluid retention (carbs and sodium) and pulmonary complications

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10
Q

Metabolic Syndrome (Need at least 3/5 traits)

A

1) Increased waist circumference (40 inches in men and 35 inches in women)
2) Low HDL (< 40 mg/dL in men, < 50 mg/dL in women)
3) Trigs > 150
4) Fasting glu > 100
5) HTN (130/85)

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11
Q

What is the relative risk increase in cardiovascular disease mortality secondary to metabolic syndrome in middle-aged man?

A

3.55

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12
Q

How does exercise affect muscle in metabolic syndrome?

A

It alters skeletal muscle metabolism and improves glucose uptake

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13
Q

How does exercise affect lipids?

A

Decreases LDL, increases HDL

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14
Q

True or false. Exercise decreases blood pressure, decreases inflammation and decreases oxidative stress

A

True

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15
Q

Name 2 alpha glucosidase inhibitors

A

Acarbose and Miglitol (Glyset)

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16
Q

MOA of alpha glucosidase inhibitors

A

Delays glucose absorption from the G.I. tract by inhibiting enzymes that convert carbohydrates into monosaccharides

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17
Q

Name one biguanide

A

Metformin (glucophage)

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18
Q

MOA of biguanides

A

It decreases hepatic glucose production and reduces liver insulin resistance

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19
Q

Name 2 sulfonylureas

A

Glipizide (glucotrol) and glyburide (micronase)

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20
Q

MOA of sulfonylureas and glibides

A

It stimulates insulin release by inhibiting the ATP dependent potassium channel on pancreatic beta cells

21
Q

How does ALA affect vitamins?

A

It regenerates reduced vitamins C, E and glutathione from their oxidized forms

22
Q

How does ALA help in diabetes?

A

It enhances glucose transport and improves insulin sensitivity

23
Q

How does vitamin B6 (pyridoxine) help with blood pressure?

A

It is an antihypertensive via central alpha agonist, calcium channel blocker and diuretic effects

24
Q

How does vitamin B6 help with cognitive decline?

A

It slows cognitive decline (in conjunction with B12 and folic acid) in people with elevated homocystine

25
Q

What effect does low vitamin B6 have on the immune system?

A

Low levels interfere with lymphocyte maturation, growth, antibody production and T cell activity

26
Q

What effect does low B6 have on T-helper cell activity?

A

The deficiency switches from Th1 to Th2 cytokine release

27
Q

What are the active metabolites of vitamin B2 (riboflavin)?

A

FAD and FMN

28
Q

What affect does riboflavin have on glutathione

A

It helps convert oxidized glutathione to reduced glutathione

29
Q

What 4 conditions can occur from a riboflavin deficiency?

A

Anemia, cataracts, elevated homocystine and peripheral neuropathy

30
Q

What are the general features of Th1 cells?

A

They are generally cytotoxic. They are associated with several autoimmune disorders. They operate through macrophages and produced several cytokines. They stimulate production of CD8 cytotoxic T cells

31
Q

What are the general features of Th2 cells?

A

They’re generally anti-inflammatory and immune suppressing. They operate through B cells producing antibodies. They produce several cytokines that usually reduce the anti-inflammatory response. They make IL 10 which is important in decreasing autoimmune over reactivity

32
Q

What association is there between B12 and cognitive function?

A

It slows cognitive decline people with elevated homocysteine

32
Q

What effect does Methylcobalamin have on Bell’s palsy?

A

It possibly shortens recovery time

33
Q

Can Methylcobalamin improved diabetic neuropathy?

A

Yes

34
Q

How does methylcobalamin help with sleep?

A

It modulates melatonin secretion and helps with the synthesis of melatonin via donation of a methyl group which is needed for the active form

35
Q

What is Thiamine deficiency called and what are the symptoms?

A

Wernecke’s encephalopathy. The symptoms are encephalopathy, ataxia, ophthalmoplegia and nystagmus.

36
Q

What is Korsakoff psychosis?

A

Long-term Wernecke’s encephalopathy

37
Q

What percentage of women can develop a biochemical thiamine deficiency during pregnancy?

A

50% ?

38
Q

What vitamin deficiency does hyperemesis gravidarum lead to?

A

Thiamine (B1)

39
Q

What cardiac condition can occur from thiamine deficiency?

A

Wet Beri-Beri (CHF)

40
Q

Can vitamin B1 supplementation improve mood?

A

yes

41
Q

Long-term use of what four medications can result in vitamin B1 deficiency?

A

Phenytoin, tetracycline, loop diuretics and trimethoprim

42
Q

Name six vitamins and supplements that improve insulin sensitivity

A

Chromium, CoQ10, ALA, vitamin C, vitamin D and vitamin E

43
Q

The transfer of a methyl group from methionine to S adenosyl methionine results in what?

A

Increased homocystine

44
Q

How does homocystine go back to methionine?

A

By trans methylation via B 12 and folate

45
Q

How does homocystine go to regenerated glutathione?

A

Via B6 dependent trans sulfuration. It first goes to cystathionine to cysteine which then goes to regenerate glutathione

46
Q

What five diseases is an elevated homocysteine associated with?

A

Cardiac disease, stroke, seizure, autism and mental retardation

47
Q

What are optimal levels of homocysteine?

A

Seven or less

48
Q

What are lipid peroxides?

A

They are the products of damage to the lipid layer of cell membranes mediated by reactive oxygen species (ROS). They represent the bodies oxidative stress state.

49
Q

How do you measure lipid peroxides?

A

Usually in serum but they can also be seen in urine

50
Q

In what three disorders can you see elevated levels of lipid peroxides?

A

Schizophrenia, mild cognitive impairment and methamphetamine abuse

Anti Aging Medicine Boards (10 decks)

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