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Final year semester 2 exam > Skin/respiratory health and fertility > Flashcards

Skin/respiratory health and fertility Flashcards

1
Q

Explain the narrowing of airways in asthma (3 points):

A
  • bronchial smooth muscle spasm
  • swelling of bronchial mucosa
  • excess viscous mucus secretion
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2
Q

Hallmark asthma symptoms

A
  • wheezing on out breath
  • intermittent shortness of breath
  • tight chest
  • dry cough
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3
Q

Which immunoglobulin is asthma usually mediated by?

A

IgE

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4
Q

Which inflammatory mediators are released due to IgE in ashtma?

A
  • histamine
  • leukotrines
  • prostaglandins
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5
Q

If asthma is untreated, which cells migrate to the airways?

A
  • eosinophils
  • T helper cells
  • mast cells
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6
Q

what causes airway remodelling?

A

chronic inflammation causes small muscle hytrophy, formation of new vessels and interstitial collagen deposition, which results in persistent airflow obstruction

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7
Q

What does excessive T2 cause?

A

increased inflammation and excess IgE

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8
Q

Why is obesity a risk for asthma?

A
  • lung function
  • increased systemic inflammation
  • microbiome (increased SCFA which increase allergic airway disease
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9
Q

Name some risk factors for asthma

A
  • preservatives
  • Molybdenum deficiency (sulphite sensitivity)
  • food colourings
  • low vitamin D and Mg
  • aspirin and NSAIDS
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10
Q

How can female sex hormone fluctuation cause asthma?

A
  • oestrogen dominance favours Th2
  • HRT
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11
Q

List some natural approaches to asthma

A
  • fresh whole organic foods
  • dietary exclusion (milk, eggs, chocolate, soy, apples)
  • Salicylate sensitivity
  • avoid sulphates (alcohol, dried fruits, bagged salads)
  • avoid very cold drinks
  • reduce red meat, sugar, dairy, processed foods
  • keep hydrated
  • reduce salt
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12
Q

What are the best antioxidants to reduce oxidative stress in asthma, and how do they do this?

A
  • vitamins A, C and E
  • quercitin
  • carotenes
  • cofactors such as zinc, selenium, copper and flavonoids
  • increase selenium for glutathione

inhibit leukotrine formation and histamine release, increase epithelial lining integrity and protect lungs against free radicals

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13
Q

How can a vitamin B complex supplement help with asthma? RD?

A
  • B3: decreases histamine release
  • B5: reduces cortisol during stress
  • B6: reduces severity and frequency of ashtma
  • B12: helps with detoxification and metabolism of sulphites. Helps inflammatory reactions and methylation.

RD: 100-150mg per day

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14
Q

How can a vitamin C help with asthma? RD?

A
  • antioxidant
  • antihistamine
  • stimulates neutrophils
  • increases lymphocytes
  • increases interferon production
  • lowers release of arachidonic acid which impedes PGE-2 synthesis

RD: 2/3g per day

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15
Q

How can a vitamin D help with asthma?

A

modulates genes for asthma/allergy, and inhibits eosinophils

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16
Q

How can a CoQ10 help with asthma? RD?

A
  • antioxidant (lowers oxidative stress and asthma symptoms)
  • may lower LTSE of glucocoritoid steroids

RD: 150mg /day

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17
Q

What are the symptoms for bronchitis?

A
  • unproductive cough that becomes productive with thick yellow mucus
  • fever
  • sore throat
  • SOB
  • runny nose
  • muscle aches
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18
Q

What is the natural approach to bronchitis?

A
  • stop smoking
  • look into environmental irritants
  • reduce sugar, red meat, salt, diary, processed foods
  • avoid histamine foods
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19
Q

Which foods are mucolytic?

A
  • garlic
  • onion
  • ginger
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20
Q

Which enzyme reduces airway inflammation?

A

Bromelain

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21
Q

What is emphysema?

A

dilation of the alveolar sacks by destruction of the alveolar wall, leading to collapse of the alveolar during expiration

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22
Q

Why is cigarette smoking so bad for COPD?

A

Cigarette toxins activate NF-Kb pathway leading to inflammatory cascade in the airway epithelial cells and recruitment of macrophages and neutrophils

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23
Q

How does N-acetyl cysteine help with COPD? RD?

A
  • mucolytic, making it easier for the expulsion of mucus
  • increases glutathione lowering oxidative damage

RD: 400-1200mg /day

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24
Q

How do fish oils help with COPD? RD?

A
  • decreases inflammation
  • reduces COPD morbidity, fewer symptoms

RD: 800mg of EPA, 300mg of DHA

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25
Q

How does shiitake help with COPD? RD?

A
  • increases phagocytes, T and B-lymphocytes, and NK cells.
  • enhances interferon synthesis (anti-viral proteins)
  • Increases secretory IgA

RD: 1.5-10g /day

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26
Q

How does Thyme help with COPD?

A
  • mucolytic and anti-bacterial
  • antioxidant properties
  • down-regulates activated NF-Kb
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27
Q

Which hormones are increased and cause acne?

A
  • free testosterone (DHT)
  • DHEA
  • DHEAS
  • 5-alpha-reductase
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28
Q

How does DHT and free testosterone cause acne?

A
  • stimulates hyperkeritinisation of follicles
  • increases sebum production
  • stimulates acne lesions
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29
Q

How does hyperinsulinemia cause increased free testosterone?

A

hyperinsulinemia decreases Sex Hormone Binding Globulin (SHBG) causing higher free testosterone

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30
Q

High levels of 5-alpha-reductase is linked to what conditions/deficiencies?

A

obesity, hyperinsulinaemia and low zinc

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31
Q

How does insulin resistance cause acne?

A
  • increased proliferation of keratinocytes
  • stimulates synthesis of androgens
  • increases sebum production
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32
Q

How does IGF-1 cause acne?

A

Downregulates Fox01 (a protein that influences glucose metabolism and insulin signalling). This leads to activation of mTORC1.

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33
Q

What is the role of mTORC1 in acne?

A

Mediates sebaceous gland hyper-proliferation, lipid synthesis and hyperplasia of keratinocytes

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34
Q

According to TCM, what is the cause of acne?

A

damp and heat in the body rising to the head

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35
Q

How can we change the diet to help with ance?

A
  • low GI diet
  • high fibre
  • omega-3 to increase IGF-1
  • flaxseeds can decrease free androgens, and helps with the conversion of DHT to testosterone
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36
Q

How does EPA help with acne?

A
  • reduces inflammation
  • inhibits mTORC1 activation
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37
Q

How can we naturally decrease mTORC1?

A

with polyphenols in green tea, turmeric and berries

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38
Q

How would vitamin A supplementation help with acne? RD?

A
  • plays a role in collagen synthesis and supports the skin barrier
  • reduces sebum and hyperkeratosis of follicles
  • Inhibits growth of C. Acnes

RD: 5000 iu/day

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39
Q

How would vitamin B3 (niacinamide) supplementation help with acne? RD?

A
  • works alongside chromium in insulin resistant
  • reduces histamine release
  • anti-inflammatory
  • inhibits c-acnes induces IL-8 production of keratinocytes through NF-Kb and MAPK pathways

RD: 20-50mg /day in B complex

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40
Q

How would zinc supplementation help with acne? RD?

A
  • modulates immune and inflammatory process
  • inhibits 5-a-reductase, causing lower DHT
  • ## antimicrobial against C. acnes
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41
Q

name some risks/causes for rosacea?

A
  • H. Pylori
  • SIBO
  • Vascular hyperactivity
  • food allergy/intolerances
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42
Q

List some natural approaches to rosacea:

A
  • identify and avoid dietary triggers
  • Reduce high histamine foods
  • Focus on detoxification
  • support gut health (H. Pylori)
  • increase omega-3, for skin integrity and reduce inflammation
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43
Q

Which foods can be helpful in rosacea?

A

vitamin C and proanthocyanidin containing foods such as red grapes, blueberries and cranberries.

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44
Q

Which gene mutation is linked to atopic dermatitis, and what does it cause?

A

Fillagrin gene mutation, cause aggregation of keratin filaments

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45
Q

Why might people with atopic dermatitis have low levels of EFAs?

A
  • FADS2 SNP
  • deficiency in Mg, Zn or B6
  • IR
  • alcohol
  • high stress
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46
Q

What blood results would you be looking for atopic dermatitis?

A
  • FBC (eosinophils)
  • Serum IgE
  • genetic testing (FADS2 and VDR)
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47
Q

What is the allopathic treatment for AD?

A
  • topical corticosteroids
  • antihistamines
  • immunosuppressants
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48
Q

Which dietary inclusions would you recommend for someone with AD?

A
  • ow histamine diet
  • anti-inflammatory diet
  • daily sources of omega-3 (wild fish)
  • quercetin rich foods (apple, kale, blueberries, spinach, red onion)
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49
Q

How does vitamin A help with atopic dermatitis? RD?

A
  • skin cell homeostasis
  • collagen synthesis

RD: 5000 iu/day

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50
Q

How does vitamin C help with atopic dermatitis? RD?

A
  • overall barrier function
  • collagen synthesis
  • ceramide production in keratinocytes

RD: 1-2g/day

51
Q

How does zinc help with atopic dermatitis? RD?

A
  • maintains skin homeostasis
  • reduces pro-inflammatory actions of keratinocytes

RD: 15-30mg /day

52
Q

How does vitamin E help with atopic dermatitis? RD?

A
  • helps maintain the skin water barrier
  • lowers oxidative stress
  • can help with itchiness topically

RD: 600iu /day

53
Q

How does quercitin help with atopic dermatitis? RD?

A
  • bioactive effect in inflammation, oxidative stress and wound healing.
  • inhibits cytokines via NF-Kb
  • stabilises mast cells

RD: 3g /day

54
Q

How does vitamin D help with atopic dermatitis? RD?

A
  • normalises the effect on Th1 and Th2 on cytokines
  • reduces IgE production
  • dampens IgE-mediated mast activation
  • reduces immune allergic response

RD: optimise

55
Q

How do EFAs help with atopic dermatitis?

A
  • good levels of GLA inhibits PG1, which inhibits arachadonic acid metabolites
  • good levels of EPA increases the production of anti-inflammatory prostaglandin PG3
56
Q

If someone has atopic dermatitis, what herbal baths could you recommend?

A
  • calendula
  • chickweed
  • oatseed
57
Q

How can a calendula herbal bath help someone with AD?

A
  • inhibits inflammatory cytokines / COX2 production
  • inhibits NO in several skin cells
  • anti-microbial
58
Q

Explain the autoimmune pathogenesis of psoriasis

A

deregulated T-call mediated inflammatory process, which leads to keratinocyte proliferation and dysfunctional differentiation

59
Q

Explain the pathogenesis of the initiation phase of psoriasis

A
  1. keratinocytes respond to a trigger
  2. stimulate dendritic cells
  3. stimulates cytokine production
  4. leads to Th-cell differentiation
60
Q

Explain the pathogenesis of the maintenance phase of psoriasis

A
  1. Th-cells release cytokines
  2. Keratinocyte proliferation
  3. more inflammation
61
Q

List some causes/triggers for psoriasis

A
  • genetics (PSORS1)
  • trauma
  • vaccination
  • air pollution
  • medication
  • alcohol
62
Q

How does alcohol cause/worsen psoriasis

A

ethanol increases TNF-a, which causes lymphocyte proliferation and mast cell histamine release

63
Q

How does vitamin A help with psoriasis? RD?

A
  • epithelial cell differentiation
  • collagen synthesis
  • intracellular adhesion

RD: 5000IU /day

64
Q

How does vitamin D help with psoriasis?

A
  • downregulates TNF-a and IL-1, -6 and -8.
  • anti-inflammatory
  • immunomodulatory effects
65
Q

How does vitamin E help with psoriasis? RD?

A
  • lowers pro-inflammatory cytokines
  • lowers monocyte adhesion to endothelial tissue

RD: 400-800IU /day

66
Q

How does omega-3 help with psoriasis? RD?

A

Arachadonic acid is found in high levels in psoriasis along with it’s metabolite leukotrine B4. EPA supplementation specifically targets leukotrine B4 via the COX and LOX inflammatory pathways.

RD: 6g daily

67
Q

How does alcohol increase oestrogen?

A

by promoting production of aromatase and inhibiting hepatic oestrogen metabolism.

68
Q

What is the minimum semen volume for it to work? and what is the right pH?

A

1.5ml, pH 7.2 or higher

69
Q

What is hypogonadism? and what are the causes?

A

low functioning gonads and low production of sex hormones.

  • tumor
  • illegal drugs
  • Klinefelter syndrome
70
Q

Which bacteria should be dominant in the seminal microbiome?

A

Lactobacillus

71
Q

What is the seminal microbiome negatively impacted by?

A
  • anti-fungals
  • antibiotics
  • prostatitis
  • lubricants
  • smoking
  • alcohol
  • obesity
  • STIs
72
Q

Which 2 bacteria have been linked to miscarriage, along with the presence of low lactobacillus and a higher pH?

A

ureaplasma and gardenerella

73
Q

Name some high folate foods

A
  • dark leafy greens
  • asparagus
  • avocado
  • legumes
  • poltury
74
Q

Name some high B12 foods

A
  • eggs
  • meat
  • liver
  • fish
  • chlorella
  • nutritional yeast
75
Q

Name some high B6 foods

A
  • wholegrains
  • green veggies
  • sunflower seeds
  • pistachios
  • fish
76
Q

Name some high B2 foods

A
  • mushroom
  • spinach
  • almonds
  • avocado
  • eggs
77
Q

Name some foods high in methionine

A
  • brazil nuts
  • sunflower seeds
  • wholegrains
  • fish
  • beans
    -chicken
78
Q

Where is AMH released from?

A

immature ovarian follicles

79
Q

What could overly high levels of AMH indicate?

A

PCOS

80
Q

What functional test could you do for a women struggling with infertility?

A
  • blood test for folate and homocysteine; if folate is low and homocysteine is high, this could indicate poor methylation. This can effect oestrogen detoxification
81
Q

What are some risks associated with IVF?

A
  • cancer
  • ectopic pregnancy
  • low birth weight
  • ovarian hyper stimulation syndrome
  • multiple births
82
Q

Why might caffeine be causing infertility?

A

caffeine increase cortisol, which down-regulates the production of COMT. COMT detoxifies oestrogen, so this could lead to oestrogen dominance. Associated with early miscarriage and longer conception time

83
Q

What should be avoided in step 1 of natural fertility?

A
  • processed foods
  • caffeine
  • alcohol
  • unnecessary medications
84
Q

Which foods should you be focussing on for fertility?

A
  • antioxidant rich
  • beans and legumes for fibre
  • organic eggs for cholesterol
  • fish and seafood for protein and zinc
  • organic liver
  • ## high quality fats
85
Q

Why are cruciferous veg good for female fertility?

A

They help with phase1 detoxification of oestrogen

86
Q

What is the optimal BMI for fertility?

A

20-25

87
Q

How does selenium help with fertility? RD?

A

sperm motility and structural motility

RD: 100mcg /day

88
Q

How does Zinc help with male fertility? RD?

A
  • high levels of zinc in seminal fluid
  • antioxidant effects
  • needed for spermatogenesis
  • needed for thyroid function

RD: 15-45mg /day

89
Q

How does CoQ10 help with male fertility? RD?

A
  • key antioxidant for sperm motility concentration

RD: 200mg /day

90
Q

How does fish oil help with male fertility? RD?

A
  • omega-3 is required for cell membrane fluidity
  • increase sperm count

RD: 900mg DHA /day

91
Q

How does L-carnatine help with male fertility? RD?

A
  • needed for sperm maturation and motility
  • works well with CoQ10

RD: 1000mg /day

92
Q

How does folate, B12, B2 and B6 help with male fertility?

A
  • needed for methylation and detoxification
93
Q

How does vitamin A help with female fertility? RD?

A
  • needed for progesterone
  • not recommended during pregnancy, just before

RD: Cod liver oil, 1 tbs /day

94
Q

How does CoQ10 help with female fertility? RD?

A
  • needed for oocyte development
  • improves ovarian response to IVF

RD: 200mg /day

95
Q

How does myo-inositol help with female fertility? RD?

A
  • promotes ovarian function
  • enhances oocyte quality
  • encourages regular cycle

RD: 2mg /day for 26 weeks

96
Q

How does argenine help with female fertility? RD?

A
  • precursor to NO
  • angiogenesis
  • hormone secretion
  • supports cell devision and embryo development

RD: 1000 - 2000mg /day

97
Q

How does L-carnatine help with female fertility? RD?

A
  • increases endometrial thickness
  • useful for implantation

RD: 500-1000mg /day

98
Q

If your client was going to have IVF, what 2 supplements would you suggest and why?

A
  • L-carnatine: increases endometrial thickness
  • Alpha-lipoic acid: immunomodulating to help the body accept the pregnancy
99
Q

How does folate help with female fertility? RD?

A
  • required for RNA and DNA synthesis (neural tube development)
  • needed if there is a MTHFR defect

RD: 400mcg /day or 800mcg /day if high risk, obese or twins

100
Q

Which herbs are useful for female fertility?

A
  • vitex agnus castus
  • ashwadanga
  • shatavari
101
Q

When should intercourse happen in the cycle to maximise conception chances?

A

5 days before ovulation, during and 3 days after

102
Q

Which day of the cycle do you start testing LH levels for ovulation?

A

day 9

103
Q

How can we increase cervical mucus?

A
  • stay hydrated
  • evening primrose oil (only first half of cycle, follicular phase)
  • fertility friendly lubricant
104
Q

What should our BBT be in the folicular phase?

A

36.4/5 oc

105
Q

What should our BBT be after ovulation?

A

37 oc (0.5 above average)

106
Q

What can effect the BBT?

A
  • erratic sleep
  • getting up and going to the toilet before
  • alcohol consumption can elevate temp
107
Q

What are the three foetal stages?

A
  1. Blastogenesis stage
  2. Embryonic stage
  3. Foetal stage
108
Q

name some foods that should be avoided during pregnancy and why

A
  • pate, soft and blue cheese: listeria risk (miscarriage, still birth, pre-term labour, illness, new born death)
  • raw eggs: salmonella
  • ## raw fish: parasite risk
109
Q

How much does blood volume increase by during pregnancy?

A

30%

110
Q

what are some emmenagoug herbs that can stimulate the uterus?

A
  • parsley
  • rosemary
  • basil
  • wormwood
  • yarrow
111
Q

what is toxoplasmosis

A

a protozoan parasite found in cat faeces, raw meat and soil on unwashed fruit and veg

112
Q

which medications should not be taken during pregnancy and why?

A
  • antibiotics: can cause miscarriage or birth defects
  • antidepressants can cause congenital defects
113
Q

Explain why calcium is so important during pregnancy

A

to support foetal, placental and maternal tissue growth. extra 6-10g per day

114
Q

Explain why protein is so important during pregnancy

A

ossification of the foetal skeleton, teeth and neural development. protection of maternal bones.

1000mg per day

115
Q

Explain why magnesium is so important during pregnancy

A

needed for pregnancy and breast feeding.

Deficiency has been linked to pre-eclampsia, slow foetal growth, pre-term labour, metabolic dysregulation and SIDS.

360-400mg /day

116
Q

Explain why iron is so important during pregnancy

A
  • increased blood volume
  • support increase material production of RBC
  • blood transport
  • meet growth demands
117
Q

Explain why vitamin A is so important during pregnancy

A
  • foetal growth: vision, hearing, immune and respiratory function
  • anything above 1000 IU/day of vitamin A has been shown to cause birth defects, so supplementation should be beta-carotene
  • vitamin A before conception
118
Q

Explain why vitamin D is so important during pregnancy

A
  • crosses placenta
  • fully through mother
  • later part of pregnancy usually low vitamin D
  • low VD can effect bone health, brain development, risk of CVD, risk of T1DM, insulin resistance, dental issues and low muscle mass
  • low VD can cause pre-eclampsia

RD: 2000 IU/day during pregnancy

119
Q

Which probiotic supplements would you suggest to a pregnant woman in her last trimester and why?

A
  • Lactobicillus rhamnosus GG
  • Biffidobacterium lactus

protective against allergies (especially if genetic)

120
Q

What are some potential causes for morning sickness?

A
  • high HcG levels
  • high oestrogen (oestradiol)
  • poor nutritional status
  • poor blood sugar regulation
  • heightened sense of smell
121
Q

List some risk factors for pre-eclampsia

A
  • 40+
  • first pregnancy
  • twin pregnancy
  • family history
  • ## hypertension
122
Q

list some pre-eclampsia symptoms

A
  • water retention
  • severe headaches
  • vision problems
  • pain below the ribs
123
Q

If someone has pre-eclampsia, when is it recommended they give birth?

A

35-37 weeks

Final year semester 2 exam (9 decks)

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