Skin and Respiratory system Flashcards

1
Q

What is bronchial asthma?

A

spasm of bronchi, swelling of bronchial mucosa and excessive excretion of viscous mucus leading to breathing insufficiency

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2
Q

How is asthma diagnosed?

A

chest tightness, shortness of breath, wheezing when breathing out, rapid, shallow breathing, neck muscles tighten, coughing with thick, clear or yellow sputum.

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3
Q

What is the difference between intrinsic and extrinsic?

A

Extrinsic/atopic is generally considered an immunological mediated condition so IgE increase.
Intrinsic is a bronchial reaction due to chemicals, cold air, exercise, infection but not necessarily IgE response.

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4
Q

What is the pathophysiology of asthma?

A

Enviro trigger->increase T helper cell response-> mast cells (IgE), Eosinophils -> inflammatory mediations leads to either bronchial constriction or increased mucus production.

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5
Q

What is the most potent chemical mediator?

A

lipoxygenase products or leukotrienes stimulate bronchial constriction

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6
Q

How does Arachidonic acid link to lipoxygenase products?

A

Asthmatics have an imbalance of Arachidonic acid metabolism lead to an increase of lipoxygenase products because COX is down regulated in favour of LOX leading to an increase of leukotrienes

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7
Q

What is the conventional treatment for asthma?

A

Mild intermittent asthma needs a bronchodilator (inhaled beta-agonists).
Mild persistent asthma needs daily inhaled corticosteroid.
Moderate persistent asthma needs an inhaled corticosteroid and a long acting beta agonist.
Severe asthma needs high dose corticosteroids.

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8
Q

What is the aetiology of asthma?

A

earlier weaning, earlier introduction of solid foods to infants, replacing breastfeeding with infant formulas, inherited dysbiosis, viral infection/bacterial infection, food additive (colourings and preservatives)

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9
Q

What are some sources of sulphites?

A

prepared salads, salad dips in restaurants, wine and beer

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10
Q

Explain the link between asthma and food allergy.

A

food allergies can result in asthmatic having leaky guts so there is an increased antigen load on immune system causing an increase of bronchoconstrictive compounds into circulation.

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11
Q

Explain how C.albicans can cause asthma.

A

overgrowth of yeast in GIT tract can cause allergic conditions like asthma and C.albicans can produce acid protease.

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12
Q

Explain how asthma can be linked to salt.

A

increased salt intake increases bronchial reactivity and mortality from asthma

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13
Q

What is the link between asthma and obesity?

A

Increased leptin levels alter immune system causing pro inflammatory changes.
Obese people have different breathing patterns.
High oestrogen levels in adipose tissue linked to asthma

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14
Q

Explain the hygiene hypothesis.

A

Minimising exposure to infectious agents due to hygiene life choices leads to a dominance of Th2 immune responses which encourages atopic diseases/ asthma. Natural antigens stimulate Th1 response

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15
Q

What is the link between asthma and antibiotics?

A

Those prescribed antibiotics before their first birthday were more than twice as likely to get asthma because antibiotic contribute to excessive hygienes and disrupted normal gut and respiratory flora

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16
Q

What are some nutritional consideration for asthma?

A

Diet high in fruit and vege lead to lower risk of respiratory health.
High intake of apple and moderate red wine = less asthma severity.
Following a mediterranean diet during pregnancy is protective for asthma.
Onions and garlic = inhibit lipoxygenase and cycloxygenase enzymes
Omega 3 and fish more than 1 a week reduces risk of asthma.

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17
Q

Explain why increasing ratio of omega 3 to omega 6 helps with asthma.

A

Reduces availability of arachidonic acid which leads to significant shift in leukotriene synthesis

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18
Q

Explain the link between asthma and tryptophan.

A

Children with asthma have a defect in tryptophan metabolism and reduced serotonin. Serotonin normally constricts the bronchial so reduce tryptophan rich food is important

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19
Q

Explain how antioxidants help asthma.

A

inhibit leukotriene formation and histamine release from mast cells; increased epithelial lining integrity of respiratory tract; protects lungs from free radicals

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20
Q

How is magnesium helping with asthma?

A

Magnesium is natural bronchial dilator, stabilises mast cells and relaxes muscles opening airways

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21
Q

What is the dietary protocol for asthma?

A

increase fruit and vegetables in diet include onion and garlic; decrease sources of arachidonic acid (meat and dairy); increase cold water fish in diet; eliminate food additive, decrease salt/sugar and any know allergens.

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22
Q

Explain how to carry out allergen identification diet for asthma.

A

Food allergy needs to be identified so put the client on a hypoallergenic diet then re-introduce high allergy foods every 3 days like eggs, fish, nuts and peanuts. ONLY USE IN HEALTHY CLIENTS WITH NO MAJOR NUTRIENT DEFICIENCIES

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23
Q

What is another dietary protocol for asthma?

A

Vegan diet with only water and no caffeine, sugar and additives. This will eliminate major food allergies, alter prostaglandin metabolism, decrease arachidonic acid and increase antioxidant intake.

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24
Q

What supplements are for asthma?

A

EPA, B6, vit C, vit E, magnesium, selenium, probiotics

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25
Q

How is acne vulgaris diagnosed?

A

open comedones, close comedones, superficial pustules, nodules

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26
Q

How is acne conglobata diagnosed?

A

cysts - modules that do not discharge

Large deep pustules - break and lead to scars

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27
Q

Explain the pathophysiology of acne.

A

Sebum (oil) which normally drains to surface, gets blocked by excess skin cells (hyperkeratinisation) lining the follicle causing bacteria to grow.

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28
Q

Explain how a whitehead forms.

A

Trapped sebum and bacteria below skin surface a whitehead is formed

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29
Q

Explain how black head forms.

A

pore opens to surface and sebum oxidises turning brown/black

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30
Q

Explain what happens with inflammatory acne.

A

black or whitehead ruptures to the surface by picking or touching the skin leading to inflammatory acne.

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31
Q

What is a papule?

A

occurs when there is a break in follicular wall, WBC rush in and pore becomes inflamed

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32
Q

What is a pustule?

A

forms several days later when WBC make their way to the surface of skin (zit or pimple)

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33
Q

What is a nodule or cyst?

A

inflamed lesion collapses or explodes causing inflammation in surrounding skin

34
Q

What are some conventional treatments for acne?

A

topical: retinoids, acid preparations, benzoyl peroxide
severe acne - antibiotics and topical treatment
isotretinoin for severe cases.

35
Q

How do hormones cause acne?

A

androgen and testosterone free, DHEA as well in excess because stimulate hyperkeratinisation of follicles, increase sebum production and stimulate acne lesions.
High levels of insulin affect growth hormone
Low sex-hormone-binding globulin levels
Greater 5-alpha-reductase, an enzyme that converts testosterone to dihydrotestosteeon (potential androgen)

36
Q

Explain the mechanism 1 between nutrition and acne.

A

foods high in glucose, IGF-1 and insulin respond so chronic high levels of insulin and IGF-1 cause increase sebum production and stimulation of hyperkeratinization of follicles

37
Q

Explain mechanism 2 between nutrition and acne.

A

High glucose, increases IGF-1 and insulin so stimulates androgen production in ovarian/testicular tissue so more free androgen cause stimulation of sebum production leading to acne lesions

38
Q

Mechanism 3 for nutrition and acne.

A

Food cause pro-inflammatory changes so stimulate pro-inflammatory cytokine production leading to sebum production/acne lesions

39
Q

Fourth mechanism for food and nutrition.

A

excess fat and carbs in diet cause increase sebum and lipid secretion in human skin which stimulates acne lesions.

40
Q

What food increases postprandial insulin levels? What is the consequence of this?

A

Milk has high concentration of lactose sugar and fat which increases postprandial insulin levels so increases blood glucose levels

41
Q

What 3 things promote high IGF-1 levels?

A

high energy intake, high animal protein, dairy products

42
Q

How can you reduce insulin/IGF-1 levels?

A

plant protein, fibre, low dietary fat, less energy dense foods

43
Q

What 4 factors increase inflammation?

A

excess oil (good ones too), processed carbs, products high in sat/trans fats

44
Q

What is the nutritional protocol for acne?

A

low fat, high fibre, adequate - plant protein, adequate calories, lots of whole plant foods, minimise oils (beneficial omega -6/omega 3 ratio)

45
Q

What lifestyle protocol is important for acne?

A

exercise lowers IGF-1 and insulin levels

46
Q

What supplements are important for acne?

A

chromium, zinc, vit A, vit E, selenium, B3, yeast (brewers)

47
Q

What red flags are important with acne?

A

low fat and plant based high fibre diet will lower insulin and glucose so if taking insulin drugs then it may decrease it too much; zinc can reduce absorption of other supplements

48
Q

How is eczema diagnosed?

A

skin is dry, hyperkaratotic, lesions include papules, eczema and lichenification due to scratching

49
Q

What is the aetiology of eczema?

A

IgE levels and positive for other allergies, patients can develop allergic rhinitis or asthma

50
Q

What is the difference between extrinsic and intrinsic?

A
Extrinsic = IgE mediated
Intrinsic = non-IgE mediated
51
Q

What are some extrinsic environmental triggers?

A

foods, airborne allergens, S.aureus, topical products

52
Q

Explain the pathophysiology of eczema.

A

People have decreased cyclic adenosine monophosphate (cAMPs) which results in histamine release and decreased bactericidal activity

53
Q

What are 4 conventional treatments of eczema?

A

antihistamine, antibiotics, topical corticosteroids, systemic corticosteroids

54
Q

Explain how breast feeding can affect food allergy.

A

Breast feeding can protect against atopic dermatitis but some can develop due to breast milk because there is a transfer for allergic antigens

55
Q

Explain how leaky gut can affect eczema.

A

increased gut permeability increases antigen load on immune system which overwhelms it and they develop additional allergies

56
Q

Explain how C.albicans can affect eczema.

A

overgrowth of c.albicans in GIT can cause the allergic factors in AD so elevated levels of anti-candida antibodies

57
Q

What is the dietary protocol for AD?

A

rotation diet to eliminate major allergies, limit animal products (omega 6), include lots of antioxidants, increase fatty fish (increase omega 3), anti-candida diet if there is an overgrowth.

58
Q

What supplements are needed for AD?

A

zinc, quercetin, EPA/DHA, probiotics, bathing in dead sea salt

59
Q

How is psoriasis diagnosed?

A

sharply border reddened rash or plaques with silvery scales; mainly on scalp, back of wrists, elbows, knees and buttocks, ankles

60
Q

Explain the pathophysiology of psoriasis.

A

hyper-proliferative skin disorder due to an imbalance between cAMP and cGMP. Increase cGMP increases levels of cell proliferation but increase cAMP increases cell maturation and decreases cell replication.

61
Q

What is the naturopathic hypothesis for psoriasis?

A

factors leading to poor intestinal function cause intestinal permeability and inflammation allowing antigens to travel in the blood and initiate activated immune cascades.

62
Q

What are the 4 treatments for psoriasis?

A

tropical corticosteroids, vitamin D analogues (slow keratinocyte growth), anthralin (normalise DNA activity in skin cells), tazarotene (normalises DNA in skin cells)

63
Q

Explain how incomplete protein digestion affects psoriasis.

A

improperly digested or poorly absorbed polypeptides and amino acids are metabolised by bowel bacteria into toxic polyamines. Polyamines inhibit formation of cAMP (leading to excess cell proliferation.

64
Q

Explain what is meant by bowel toxaemia for psoriasis.

A

gut derived toxins cause increased cGMP levels which increase rate of cell proliferation. Toxins include: endotoxins, c.albicans, immune complexes

65
Q

Explain how impaired liver function can affect psoriasis.

A

liver filters and detoxifies blood so the liver can be overwhelmed by excessive levels of microbial toxins in blood.

66
Q

What can worsen psoriasis?

A

alcohol consumption can increase toxin load in liver

67
Q

Explain how EFA can affect psoriasis.

A

leukotrienes promote cGMP levels and meat/animal products are high in arachidonic acid so eating fish oils (EPA/DHA) compete for arachidonic binding sites which inhibits inflammatory compounds

68
Q

Explain how 4 different diets can improve psoriasis.

A

fasting and vegetarian = decrease gut-derived toxins, polyamines, pro inflammatory mediators
Gluten-free and elimination diet = decrease antigen load

69
Q

What diet is important for psoriasis?

A

unprocessed, organic food, plant foods, cold water fish, eliminate wheat and other sources of gluten, minimise animal products, minimise processed foods and alcohol

70
Q

What supplements are important for psoriasis?

A

omega 3 fatty acids, zinc, vita A (inhibits bacterial decarboxylase which converts amino acids into polyamines, selenium and vit E, bit D (anti-proliferative properties)

71
Q

What are the red flags with psoriasis?

A

vit A - never to pregs womens

long term zinc impairs absorption of other minerals

72
Q

What is seborrheic dermatitis?

A

commonly called dandruff or cradle cap in babies

73
Q

How is seborrheic dermatitis diagnosed?

A

superficial reddened small bumps and flaking, white scaly patches on scalp, eyebrows, forehead, cheeks; does not itch, scaly maybe yellowish

74
Q

What are the causes of seborrheic dermatitis?

A

genetic predisposition, emotional stress, diet, hormones, infection with yeast-like organisms

75
Q

What disease is seborrheic dermatitis linked to?

A

AID - manifestations of AIDs is seborrheic dermatitis.

76
Q

What is the conventional treatment for seborrheic dermatitis?

A

anti-dandruff shampoo, steroid lotions, brushing babies scalp with a soft brush

77
Q

What are some nutritional consideration of seborrheic dermatitis?

A

food allergy, biotin deficiency (absence of normal intestinal flora), B-vit deficiency, C. albicans overgrowth

78
Q

What is the dietary protocol for seborrheic dermatitis?

A

identify and eliminate all possible allergens, alleviate biotic deficiency, correct B vit deficiencies, if have candida then apply anti-candida diet.

79
Q

What supplements are for seborrheic dermatitis?

A

zinc, flaxseed oil, B complex biotin

80
Q

What are the red flags for seborrheic dermatitis?

A

vit B6 may cause adverse effects, long term zinc supplementation may impair absorption of other minerals