Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NMT200 > week 2 &3 > Flashcards

week 2 &3 Flashcards

1
Q

What’s the two treatment phases of obesity?

A

Induction of weight loss through caloric restriction and prevention of weight regain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which classes of drugs are associated with weight gain?

A
  1. Antidepressants
    - Tricyclic antidepressants
    - Amitriptyline
  2. Antipsychotics
  3. Corticosteroids (prednisone)
  4. Antihyperglycemic drugs (sulfonylureas, meglitinides, thiazolidinediones, insulin)
  5. Lithium (for mania)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Would discontinuation of anti-obesity medication result in weight regain?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s the approved appetite suppressants in Canada?

A

Bupropion/Naltrexone

Bupropion:
- a sympathomimetic drug
- given as a sustained-release formula
- used as an antidepressant and smoking cessation aid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which population is bupropion/naltrexone indicated for?

A

BMI of 30+ or BMI of 27 with weight-related comorbidity

plus weight management alongside diet and exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the adverse effect of bupropion?

A

Dry mouth
Constipation
Agitation
Insomnia
Anxiety
Seizures (if higher doses. Rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should we be careful of when prescribing bupropion?

A

Caution in patients with hepatic impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the adverse effects of a combination of bupropion/naltrexone?

A

Nausea, vomiting, constipation, headache, dizziness, insomnia, dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the contraindication of a combination of bupropion/naltrexone

A

Contraindicated with concurrent opioid therapy (due to precipitation of opioid withdrawal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Before initiating a combination of bupropion/naltrexone, what should the patient do? (opioid -wise)

A

Patients must be opioid free for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the cautions for starting bupropion plus naltrexone?

A
  1. Avoid concurrent use of drugs that lower the seizure threshold
  2. Minimize or avoid alcohol consumption
  3. Avoid consumption with a high-fat meal
  4. Avoid in patients with uncontrolled hypertension, seizure disorder, severe hepatic impairment, or end-stage renal failure.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is orlistat?

A

Pancreatic and gastric lipase inhibitor which reduce dietary fat absorption by 30%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the adverse effects of orlistat?

A
  1. Oily spotting, flatus with discharge, fecal urgency.
  2. Decreased absorption of fat-soluble vitamins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the contraindication for orlistat?

A

It is contraindicated in patients with chronic malabsorption syndrome or cholestasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the cautions for orlistat?

A
  1. Advise patients to take a multivitamin daily ≥2 h before or after orlistat or at bedtime 2. A high fat intake is poorly tolerated
  2. Less effective in patients on low-fat diets and is difficult to take for individuals with irregular eating patterns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is liraglutide, what is it indicated for and how is it administered?

A

Liraglutide is GLP-1 agonist (incretin mimetics). Originally it is for type 2 diabetes and then rebranded for obesity. It is administered by subcutaneous injection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the adverse effects of liraglutide?

A
  1. Most common: nausea, vomiting, constipation, diarrhea.
  2. Gastrointestinal side effects can be minimized by a slow titration.
  3. pancreatitis (rare)
  4. Severe hypoglycemia observed in patients with type 2 diabetes (adjustment of diabetes medications may be required)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the cautions of liraglutide?

A

Caution in patients with heart rhythm disturbances, hepatic insufficiency, and severe renal impairment. Should not be used in IBD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the contraindication of liraglutide?

A

Contraindicated in pregnancy, breastfeeding, personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Under which circumstance, should a patient discontinue liraglutide?

A

Discontinue after 12 weeks if body weight loss <5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is semaglutide and how is it administered?

A

GLP-1 agonist like liraglutide but with a longer half-life. It is administered by weekly subcutaneous injection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the adverse effects of semaglutide?

A

Similar to liraglutide.

  • Nausea, diarrhea, abdominal pain, vomiting, constipation, digestive upset, fatigue, dizziness.
    2. Increase in amylase and lipase, suggesting possible pancreatitis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is obesity during pregnancy associated with?

A
  1. Gestational diabetes
  2. Gestational hypertension
  3. Preeclampsia
  4. Birth defects
  5. Caesarean delivery
  6. Fetal macrosomia
  7. Perinatal deaths
  8. Postpartum anemia
  9. Childhood obesity in offspring
  10. Longer labor
  11. Increased risk of complications following caesarean delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Despite the increased risks, is weight loss during pregnancy recommended?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What should pregnant women with obesity do?

A

Counsel regarding weight gain targets (to gain no more than 5 – 9.1 kg (11 – 20 lb) during pregnancy).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why orlistat is specifically not recommended during pregnancy?

A

Due to reduced fat-soluble vitamin absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If a pregnant patient with obesity is already taking bupropion, should it be withheld for continuation of therapy ?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Liraglutide, Orlistat, Bupropion and Semaglutide. Which medications is expected to cause the greatest amount of weight loss?

A

Answer: Semaglutide

Liraglutide (8kg weight loss over 2 years)
Orlistat (2.9% weight loss over a year)
Bupropion (2.2% - 5.1% weight loss)
Semaglutide (16kg over 2 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Does the risk factors for insulin resistance also apply to NAFLD?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the foundational interventions for NALFD?

A

Diet and lifestyle counselling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which two factors increase the risk of NAFLD?

A

Obesity and sedentary lifestyles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the common body fuel for oxidation and is found in blood and tissue fluids and metabolized in most body tissues?

A

Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Most complex carbohydrates are digested/converted into units of what for fuel?

A

Units of glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is sucrose made of?

A

Glucose + fructose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is lactose made of ?

A

glucose + galactose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is maltose made of ?

A

Glucose + glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Is galactose found as a monosaccharide in foods?

A

No. Galactose is bound to glucose to form the disaccharide lactose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How is galactose used as fuel?

A

Converted to glucose in the liver through a reversible process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

During lactation, what is converted to galactose?

A

Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is a common constituent in glycolipids and glycoproteins?

A

Galactose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the dietary sources of galactose?

A

Dietary sources include anything with lactose (dairy foods, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Is fructose the sweetest simple sugars?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is fructose converted to in the liver and intestine?

A

Glucose

44
Q

Does transport and metabolism of fructose require insulin?

A

No

45
Q

Does the body have a lot capacity to metabolize fructose?

A

No. Only a few tissues have the capacity to metabolize fructose (liver, intestine, kidney, adipose and muscle tissue)

46
Q

What is fructose ended up doing in the liver?

A

Fructose usually ends up replacing liver glycogen or being used in the synthesis of triglycerides.

46
Q

Where is the vast majority of fructose metabolized in the body?

A

Liver

47
Q

Which transporters is the majority of ingested fructose passively absorbed by?

A

GLUT5 transporters

48
Q

How do high fructose diets amplify absorption?

A

High fructose diets can amplify absorption by upregulating additional transport mechanisms.

49
Q

Is processing of fructose in the liver controlled by hormone or allosteric mechanisms ?

A

No. There is no rate-limiting step like there is with glycolysis.

50
Q

Do metabolic changes act as feedback inhibitors to fructose metabolism as they do with glycolysis?

A

No

51
Q

Which pathway do excess metabolites (like pyruvate) enter?

A

Various other pathways such as fatty acid synthesis and cholesterol

52
Q

What is the dietary sources of fructose?

A

Naturally found in fruit and some vegetables, honey, agave nectar/syrup.

53
Q

What are some high-fructose corn syrup ?

A

Sugar-sweetened beverage
Processed foods
“Added” sugar

54
Q

What is longer chains of glucose units called?

A

Polysaccharides

55
Q

What is smaller chains of 3 – 10 glucose units called?

A

Oligosaccharides

56
Q

What is the storage form of carbohydrates in plants?

A

Starch

57
Q

What is the storage form of carbohydrates in animal?

A

Glycogen

58
Q

Can all polysaccharides to digested?

A

No. we refer the undigested one as dietary fiber.

59
Q

Do general recommendations that prevent obesity also prevent NAFLD?

A

Yes

60
Q

What are some therapeutic considerations for NAFLD?

A

Avoiding additional damage to the liver
- Avoiding/abstaining from alcohol consumption
- Mindful of other therapeutics that can harm the liver

Recognizing other risk factors or conditions
- NAFLD is often found in patients with other conditions like diabetes, obesity, hypertension, etc.

61
Q

What are some basic therapeutic considerations for NAFLD?

A

Avoiding excess sugar/carbohydrate consumption, especially fructose

Reducing saturated/trans fat intake

Opting for lean proteins and increasing vegetable consumption

EXERCISE

62
Q

wk2 nutrition lecture page 22 for medi diet guidance….

A
63
Q

What is the best diet for preventing and treating NAFLD?

A

Mediterranean diet for both prevention and treatment

A general low-concentrated carbohydrate diet (Depending on other comorbidities, poorly managed diabetes, for example)

64
Q

Which of the following dietary recommendations is consistent with the Mediterranean diet?

A. Three servings or more of red meat per week
B. Three or more servings of legumes per week
C. One daily serving of white wine
D. Less than four tablespoons of olive oil per wee

A

B. Three or more servings of legumes per week

65
Q

What does CLEMS refer to in homeopathy?

A

C: Concomitants (associated symptoms)
L: location
E: Etiology
M: Modality
S: Sensation

66
Q

This patient came in with chief complain of vertigo. He is a charming person with magnetic appeal. He has enlarged liver, elevated enzymes and had polyps in bowels (removed). He has foggy vision which would occur in stressful situations, for example, in situations where he had to talk in front of an audience and all of a sudden, he could not see properly. He liked to drink alcohol: wine, beer, in large quantities. He emptied a glass in one sip. (page 25 of wk3 HOM for CLEMS)

A

Phosphorus

67
Q

What are the toxicity of phosphor?

A
  1. Irritation: mucus membranes…
  2. Inflammation: serous membranes, spinal cord and nerves
  3. Degeneration or destroy: bones, especially lower jaw and tibia
  4. Fatty degeneration
    • blood vessels and tissues
    • organs of the body
  5. Increasing hemorrhage
  6. Sub-acute hepatitis
  7. Great susceptibility to external impressions (light, sound, odors, touch…)
68
Q

The characteristics of this remedy is sympathetic, sensitive, social, stimulated easily and fearful at the same time. What is this remedy?

A

Phosphorus

69
Q

This remedy is for acute hepatitis, pulmonary disease or severe infectious syndromes. What is this remedy?

A

Phosphorus

70
Q

The characteristics of this remedy is:

  1. restless, constant motion, nervousness
  2. frequent burning or heat sensation in stomach and liver
  3. Hemorrhage: nose bleeds with profuse flow
  4. weakness (prostration and debility)
  5. crave for cold drinks (icy cold water, refreshing juicy food, ice cream).
A

Phosphorus

71
Q

With the characteristics of this remedy, symptoms get worse with touch, physical or mental exertion, warm food or drink, twilight, change of weather and during a thunderstorm. What is this remedy ?

A

Phosphorus

72
Q

With the characteristics of this remedy, symptoms get better with cold (cold food, cold, open air, washing with cold water) and get better with sleep. What is this remedy ?

A

Phosphorus

73
Q

With the characteristics of this remedy, patient has pneumonia (left lower lobe) or laryngitis from talking, singing, with pain (dry, raw, sore throat) or liver disease or intend to prophylactic against viral hepatitis or have fatty degeneration, tumors, growths, caries or nausea/vomiting from hot drinks, as water is thrown up as soon as it gets warm in the stomach or post-operative vomiting. What is this remedy ?

A

Phosphorus

74
Q

This patient is tall and slender, with narrow chested, thin & transparent skin, weakened by loss of animal fluids, with great nervous debility, emaciation, amative tendencies. What remedy should be given to this patient?

A

Phosphorus

75
Q

What is the toxicity of potassium bichromate? (acute & chronic)

A

Acute:
1. Gastroenteritis followed by collapse
2. Acute tubular nephritis and hepatitis

Chronic:
1. Mucosal lesions (thick adhesive lesions)
2. Cutaneous lesions (allergic contact eczema)

76
Q

What are the affinities of kali bichromate?

A
  1. Mucous membranes: stomach, bowels, airways (including sinuses)
  2. Bones and fibrous tissue
  3. Kidneys
  4. Heart
  5. Liver (Cirrhosis of liver)
77
Q

This patient is indifferent, indolent and averse to mental and physical exertion. He avoids human society, anthropophobia (fear of people), has weakness of memory (i.e. dates) and has frequent vanishing of thoughts. What remedy is it?

A

Kali bichromate

78
Q

This patient has pains that occur in small spots or migrate quickly from place to place. The pains appear and disappear suddenly or the disease conditions progress slowly but deeply. What remedy should be given?

A

Kali bichromate

79
Q

Symptoms such as:

  1. greenish, thick, STICKY, stringy, lumpy discharge.
  2. Chronic inflammation of frontal sinus with stopped up sensation
  3. Coryza with obstruction of nose
  4. Rheumatic and gastric symptoms alternate
  5. Fatty infiltration of liver and increase in soft fibrous tissue.

are characteristic of this remedy. What is it?

A

Kali bichromate

80
Q

Patient feel better from heat but the symptoms get worse with beer (cravings)/morning/cold/wet weather/hot weather/undressing. What remedy should be given?

A

Kali bichromate

81
Q

What are the key actions in botanicals for NAFLD treatment?

A

Alterative. Hepatic

82
Q

What is the overall flavor of your formula for NALFD should be ?

A

Bitter and cool.

83
Q

What will be the thrust of your treatment plan for NALFD?

A

Food and exercise

84
Q

If what condition is present in NAFLD, we should treat that condition primarily?

A

Constipation

85
Q

In the case of NAFLD, what are the primary botanical action/secondary or supportive/others should we consider?

A

Primary: hepatic, bitter

Secondary/supportive: hepatoprotective

Others: carminative, laxative

86
Q

In the case of NAFLD, what are the herbs selection for ‘HEPATIC’ action?

A

Barberry (Berberis vulgaris)
Yellow dock (Rumex crispus)
Peony (Paeonia lactiflora)
Bupleurum (Bupleurum sinensis)
Burdock (Arctium lappa)
Gentian (Gentian lutea)
Sweet wormwood (Artemesia annua)
Andrographis (Andrograpis paniculata)
Schisandra (Schisandra sinensis)

87
Q

In the case of NAFLD, what are the herbs selection for ‘HEPATOPROTECTIVE’ action?

A

Milk thistle (Silybum marianum)
Schisandra (Schisandra sinensis)

88
Q

In the case of NAFLD, what are the herbs selection for ‘HEPARIC+LACATIVE’ action?

A

Burdock (Arctium lappa)
Yellow dock (Rumex crispus)

89
Q

In the case of NAFLD, what are the herbs selection for ‘CARMINATIVE + HEPATIC’ action?

A

Gentian (Gentiana lutea)
Yarrow (Achillea millefolia)
Archangelica (Angelica archangelica)
Sweet wormood (Art. annua)

90
Q

For herb-drug interaction, what does berberis vulgaris do to diabetes medications?

A

Berberis vulgaris may augment the effect of diabetes medications.

91
Q

In uncomplicated cases of NAFLD, which two interventions are needed most?

A

Diet and exercise

92
Q

In the cases of NAFLD, what are the main aggravating foods?

A

Sugar, Dairy, and alcohol, as well as fried foods.

93
Q

What are the primary actions of arctium lappa and which condition should it be indicated to use?

A

Arctium lappa (burdock) in the case of NAFLD.

Primary actions: Alterative (Hepatic, mild laxative, nutritive)

** Pairs well with Zingiber officinalis for nausea of deficient stomach.

94
Q

What are the primary actions of berberis vulgaris and which condition should it be indicated to use?

A

Berberis vulgaris (Barberry) in the case of NAFLD.

Primary actions: Antimicrobial (potent), excellent hepatic, alterative (during and post-infection and useful in stimulating digestion), cholagogue, bitter, anti-inflammatory, endocrine modulator (insulin)

**Pairs Well With:
Bupleurum sinensis in hepatic infections

Galega officinalis in type II diabetes

Chelidonium majus and Peumus boldo in addressing gallstones.

95
Q

What is the contraindication in using berberis vulgaris?

A

Avoid during pregnancy and lactation

96
Q

What are the primary actions of gentiana lutea and which condition should it be indicated to use?

A

Gentiana lutea (Gentian) in the case of NAFLD.

Primary Actions: Bitter (potent and effective to improve digestion), silagogue, hepatic.

**Pairs well with Archangelica and Zanthoxylum americanum for toning the stomach.

Indications:
1. Sluggish digestion
2. Low appetite
3. Constipation
4. Bloating

97
Q

Under which condition, should we not use Gentiana lutea?

A

Not to be used in cases of known ulceration.

98
Q

What are the primary actions of bupleurum sinensis and which condition should it be indicated to use?

A

Bupleurum sinensis (bupleurum) is used in the case of NALFD.

Its primary actions are:
Hepatic

Alterative (Excellent hepatic alterative for long-standing inflammation from physical or emotional accumulation)

Anti-inflammatory ( hepatitis )
Hepatoprotective ( hepatitis )

**Pairs Well With:

Inflammation (expecially joints):
Berberis vulgaris
Uncaria tomentosa
Harpagophytum procumbens

Stagnant menses with heat presentation:
Paeonia alba

99
Q

Under which conditions, should we avoid the use of bupleurum sinensis?

A

Avoid in cold conditions or constitutions

100
Q

What are the primary actions of Paeonia lactiflora and which condition should it be indicated to use?

A

Paeonia lactiflora (Peony) in the case of NAFLD.

Primary Actions
Female endocrine modulator
Alterative
Antispasmodic
Mild adaptogen
Mild anti-inflammatory
Emmenagogue
Nootropic

**Any condition of female hormone dysregulation, fertility challenges, acne

** TCM:
1. cool the liver and support smooth flow
2. in dysmenorrhea and other female hormone patterns of both deficiency and excess.
3. pair with glycyrrhiza glabra as a classic TCM formula for dysmenorrhea and PCOS.

101
Q

What herb-drug interaction should we pay attention when using Paeonia lactiflora?

A

Possible interaction with anticoagulants.

101
Q

What are the primary action for Rumex crispus and under which condition would you use it?

A

The primary actions for Rumex crispus (Yellow dock)are :
1. Alterative (Strong and effective, also useful in building the blood)
2.Laxative (mild)
3. Hepatic
4. Astringent
5. Mild adaptogen

Condition (case of NAFLD)
1. Chronic skin conditions
2. Constipation
3. Convalescence.

Pairs Well With:

Chronic skin conditions:
Berberis vulgaris

Convalescent adaptogen:
Inonotus obliquus
Smilax officinalis
Polygonum multiform

102
Q

What are the cautions of using Rumex crispus?

A

Not to be eaten fresh, potentiates other stimulating laxatives.

103
Q

What are the primary actions of Schisandra sinensis and under which condition would you use it?

A

Primary actions of Schisandra sinensis (Schisandra), in the case of NAFLD:

  1. Adaptogen
  2. Astringent
  3. Hepatoprotective (In ongoing toxic exposure or hepatitis )
  4. Alterative
  5. Expectorant
  6. Nervine
  7. Parturient.
    *8. Excellent tonic, particularly for the feminine aspect.

Pair with:

Paeonia alba
*In female hormone patterns in need of tonification and rooting, where there are unprocessed emotions of sadness and poorly defined boundaries.

Ephedra sinica
*In chronic deficient cough with thin, clear mucus.

Silybum marianum
Bupleurum sinensis
*Hepatoprotective formulas for ongoing toxic exposure or hepatitis.

104
Q

What are the cautions of suing schisandra sinensis?

A

Mild uterine stimulant.

105
Q

What is the recommended level of water intake?

A

Half of the body weight in ounces

NMT200 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions