Study Q's - Soska

Question 1

Know the various causes of elevated transaminases:

Answer 1

• Alcoholic steatohepatitis
• Hepatitis - toxic, viral
• Celiac dz
• NASH
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Wilson’s dz

Question 2

Know the relationship btw celiac dz and elevated transaminases:

Answer 2

x

Question 3

Understand seroconversion of acute and chronic HBV. Which antigen is persistent in carrier status?

Answer 3

x

Question 4

What are signs and symptoms of HBV and HCV?

Answer 4

x

Question 5

Conventional tx of acute HBV? Chronic?

Answer 5

x

Question 6

Conventional tx of HCV?

Answer 6

x

Question 7

What is the role of antioxidants, and mechanism of action for HBV and HCV?

Answer 7

x

Question 8

How does Silymarin and Silybin-Phosphatidylcholine Complex help in the tx of HBV/HCV?

Answer 8

x

Question 9

What is the role of Glycyrrhiza glabra in the treatment of HBV/HCV?

Answer 9

x

Question 10

What is the role of Low-Dose Naltrexone in tx of HBV and HCV? Mechanism of action?

Answer 10

x

Question 11

Be able to identify the homeopathic picture for the various remedies as it relates to the case/question format.

Answer 11

x

Question 12

What are the risk factors for NAFLD/NASH?

Answer 12

• Obesity
• Diabetes
• Insulin resistance
• Hyperlipidemia
• Metabolic syndrome
• Excess fructose consumption
• Female > Male
• Surgical procedures - resection, bypass, gastroplasty, IV glucose, etc

Question 13

Compare fructose and EtOH metabolism:

Answer 13

x

Question 14

Understand the outcome of continual fructose consumption on uric acid levels:

Answer 14

Uric acid will be increased due to ATP breakdown to peptides in an effort to maximize phosphate groups for fructose metabolism.

Question 15

Which pharmaceuticals are risk factors for NASH?

Answer 15

• Ca channel blockers
• tamoxifen
• corticosteroids
• synthetic estrogens
• aspirin
• methotrexate
• valproic acid
• cocaine
• AZT
• amiodarone

Question 16

How does MSG consumption influence NASH?

Answer 16

• causes increased serum FFAs, TGs, HDL, and insulin.

* increased expression of genes implicated in adipocyte differentiation.

Question 17

Basic treatment protocol of NASH:

Answer 17

• weight loss
• regulate insulin, glucose, lipids
• choleretics, cholegogues

Question 18

Be able to name at least 4 conditions that would be included in the differential diagnosis in acute cholecystitis.

Answer 18

x

Question 19

Know the difference between the types of stones in found in cholelithiasis and how etiology will influence treatment.

Answer 19

x

Question 20

What are the best methods of imaging for cholelithiasis, in terms of safety, cost, and reliability?

Answer 20

v

Question 21

Which hydrotherapies are best for cholelithiasis, biliary dyskinesia, and cholecystitis, know how they differ, any precautions, or potential contraindications.

Answer 21

x

Question 22

What dietary/lifestyle changes are appropriate for cholelithiasis and biliary dyskinesia?

Answer 22

x

Question 23

Know the role of food allergies, and which ones are commonly seen in cholelithiasis, biliary dyskinesia, and cholecystitis

Answer 23

x

Question 24

What are the primary etiologies for cholelithaisis?

Answer 24

x

Question 25

Why isn’t lithotripsy used more often as a therapy?

Answer 25

x

Question 26

Understand the role of exercise (or lack thereof) in gallbladder conditions.

Answer 26

x

Question 27

What are the appropriate herbal therapies for cholelithiasis, biliary dyskinesia, and cholecystitis, how do they differ?

Answer 27

x

Question 28

What imaging is best for diagnosing acute pancreatitis?

Answer 28

x

Question 29

Know the possible complications of acute pancreatitis

Answer 29

x

Question 30

Which lab values are indicative of acute pancreatitis?

Answer 30

x

Question 31

Serum amylase: How quickly and long does it stay elevated?

Answer 31

x

Question 32

What ND treatments are appropriate for acute pancreatitis?

Answer 32

* Pancreatic rest * fluid fast * topical COP (no heat) * avoid alcohol * fish oil (9-12g)

Question 33

Know the uses and limitations of chymotrypsin and elastase-1 testing

Answer 33

x

Question 34

What is the etiology of pancreatic insufficiency? a. Celiac disease role in pancreatic insufficiency b. Cow Milk Enteropathy role in pancreatic insufficiency

Answer 34

x

Question 35

Chronic pancreatitis etiology?

Answer 35

x

Question 36

Gold standard testing to diagnose chronic pancreatitis?

Answer 36

ERCP

Question 37

Dietary considerations in chronic pancreatitis?

Answer 37

Inc foods with: vit CADKB12, calcium, folic acid

Question 38

Therapies useful for chronic pancreatitis?

Answer 38

x

Question 39

Pancreatic cancer – why is this condition so often missed?

Answer 39

x

Question 40

Tumor markers that can be helpful diagnosis?

Answer 40

x

Question 41

Primary means of prevention of pancreatic cancer?

Answer 41

* quit smoking * maintain healthy weight * regular exercise * healthy diet (fruit, veg, low animal fat, 10% sat fats) * stress management

Question 42

Treatment options in pancreatic cancer?

Answer 42

x

Question 43

Common non-GI diseases that have sx of constipation?

Answer 43

* Hormonal disorders * Pelvic floor dysfunction * Spinal cord lesions - MS, meningitis, tumors, tabes dorsalis * Peripheral nerve lesion - diabetic neuropathy, Hirschsprung * Chagas * Drugs - particularly opioids, atropine * Muscular weakness

Question 44

Limitations of cathartic herbs in the tx of constipation:

Answer 44

* don't use more than 10 days * potential dependence or electrolyte imbalance * may provoke uterine contractions (cx in pregnancy and lactation)

Question 45

Why is sudden onset constipation concerning?

Answer 45

potential obstruction??

Question 46

Why does Western/SAD diet often result in constipation?

Answer 46

* lack of fiber * poor hydration * overeating

Question 47

What role does ignoring stool urge have on constipation?

Answer 47

Loss of reflex

Question 48

Know the homeopathic remedies for constipation:

Answer 48

? damn gina

Question 49

What changes to BUN levels occur 2° to colon bleeding?

Answer 49

x

Question 50

DDX for colorectal bleeding:

Answer 50

* Diverticulitis/osis * Hemorrhoids * UC/Crohns/IBS/IBD * anal fissure

Question 51

Which imaging is the best in diverticulitis?

Answer 51

Abdominal CT (barium enema may be complementary)

Question 52

Key dietary principles for diverticulosis prevention?

Answer 52

* high-fiber diet * low fat / low beef diet * hydration * short fruit/veg juice fasts * Vit A/B foods * avoid intolerances

Question 53

Acute diverticulitis therapies:

Answer 53

``` Mild - • Initial - rest, liquid diet, oral antibiotics • After a few days - soft, low-fiber diet, psyllium QD • After 1 month - high-fiber diet Severe - (perforation, peritonitis) • Should be admitted to hospital • IV fluids and antibiotics • Bed rest • Nothing by mouth until sx subside ```

Question 54

Treatment protocols for diverticulosis/diverticulitis:

Answer 54

* Abdominal castor oil pack with heat 60 mins TID * Probiotics 50-100bil QD * Water fasting * Yarnell acute div. formula * Monitor Q 12 hours (hospitalize at 48 hrs)

Question 55

What are herbal therapies for colorectal cancers?

Answer 55

``` avena baptisia conium echinacea gentian larrea mahonia phytolacca rumex tarax trifolium viola viscum alba ```

Question 56

Recommendations for colorectal screening schedule:

Answer 56

over 50 years old, or ~40 if FHx colon cancer • pos: repeat w/in 5 yrs • neg: q 10 yrs (opinion varies)

Question 57

Homeopathic remedies for colorectal CA/Polyps:

Answer 57

``` alumen cadmium iod. hydrastis nitric acid ruta scrophularia sepia alcoholus ```

Question 58

Darnell's Acute Diverticulitis Formula:

Answer 58

* Echinacea ang. * Curcuma long. * Populus trem. (aspen) * Glycyrrhiza glabra * Mahonia aq. * Larrea trid. * Foeniculum vulgare