NMT 150 final quiz
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Questions and Answers

What is the recommended treatment duration for quadruple therapy in pylori eradication?

  • 7 days
  • 10 days
  • 21 days
  • 14 days (correct)

    • What is the primary mechanism of GERD?

  • Inappropriate lower esophageal sphincter relaxation (correct)
  • Weakened stomach muscles
  • Food allergies
  • Increased stomach acid production

    • What is the indication for gastroscopy in a patient with heartburn and red flags?

  • To diagnose GERD
  • To identify underlying bleeding, weight loss, dysphagia, or vomiting (correct)
  • To monitor the effectiveness of PPI therapy
  • To rule out other gastrointestinal conditions

    • What is the recommended dietary approach for managing GERD symptoms?

    <p>Low FODMAP diet</p> Signup and view all the answers

    What is the potential risk associated with long-term use of PPIs?

    <p>Nutrient deficiencies, such as vitamin B12 deficiency</p> Signup and view all the answers

    What is the Number Needed to Treat (NNT) to benefit 1 person with regards to Antihypertensive therapy in terms of first major cardiovascular event?

    <p>143</p> Signup and view all the answers

    What is the most common adverse effect of Statin therapy?

    <p>Myalgia</p> Signup and view all the answers

    Which of the following adverse effects is common to both Statins and Fibrates?

    <p>Rhabdomyolysis</p> Signup and view all the answers

    What is the main function of 'Regulates' in terms of qi?

    <p>Bring into balance or return to normal levels</p> Signup and view all the answers

    What is the classification of the point that influences the bone and marrow?

    <p>Influential point</p> Signup and view all the answers

    What is the action of Linden (tilia cordata) on anxiety and hypertension?

    <p>It has an anxiolytic effect</p> Signup and view all the answers

    What is the potential interaction of Hawthorn (Crataegus oxyacantha) with pregnancy?

    <p>It should be avoided during pregnancy</p> Signup and view all the answers

    What is the action of Cayenne (capsicum frutescens) on circulatory deficiencies?

    <p>It has a stimulant effect</p> Signup and view all the answers

    Which of the following symptoms can be treated by addressing the root cause of the problem?

    <p>Depression, anxiety, and stress</p> Signup and view all the answers

    What is the primary purpose of expelling wind in traditional medicine?

    <p>To open the gates and allow wind to escape</p> Signup and view all the answers

    What is the main difference between treating symptoms and addressing the root cause of a problem?

    <p>Treating symptoms only addresses the superficial issue, while addressing the root cause addresses the underlying issue</p> Signup and view all the answers

    Which of the following is a key concept in Botanical Medicine?

    <p>Differentiating between physical and mental/emotional causes</p> Signup and view all the answers

    What is the result of stagnation in the body?

    <p>Pain and lack of flow</p> Signup and view all the answers

    What is the characteristic of a pulse in an athlete?

    <p>Slower</p> Signup and view all the answers

    What is the pulse characteristic associated with a fasting individual?

    <p>Weak and deficient</p> Signup and view all the answers

    According to the seasonal changes, what is the characteristic of a pulse in Autumn?

    <p>Floating</p> Signup and view all the answers

    What is the treatment principle for a patient with Lung Qi deficiency?

    <p>Tonify lung and tonify qi</p> Signup and view all the answers

    What is the point action of a treatment that subdues and prevents ascending by holding down?

    <p>Subdues</p> Signup and view all the answers

    Which of the following non-pharmacological interventions is expected to have the greatest impact on blood pressure?

    <p>Weight loss</p> Signup and view all the answers

    Which of the following etiologies of erectile dysfunction is commonly associated with cardiovascular disease?

    <p>Vascular factors</p> Signup and view all the answers

    Which of the following drugs can cause rhabdomyolysis when used in combination?

    <p>Atorvastatin and fenofibrate</p> Signup and view all the answers

    According to Traditional Chinese Medicine, which points are connected to treat certain conditions?

    <p>Back shu points and connecting Luo points</p> Signup and view all the answers

    Which of the following is NOT a non-pharmacological intervention for preventing hypertension?

    <p>Statin therapy</p> Signup and view all the answers

    Which of the following is a common etiology of erectile dysfunction?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a non-pharmacological intervention for preventing hypertension that is expected to have a moderate impact on blood pressure?

    <p>Aerobics and resistance exercise</p> Signup and view all the answers

    What type of laser therapy is used for wound healing, fracture healing, and pain management in low back pain treatment?

    <p>Laser therapy</p> Signup and view all the answers

    Which of the following homeopathic remedies is used for low back pain with symptoms worsened by morning and relieved by lying down?

    <p>Natrum</p> Signup and view all the answers

    What is the primary function of the pericardium in Traditional Chinese Medicine?

    <p>It protects the heart and governs blood</p> Signup and view all the answers

    What is the main effect of opioids on the body when used to treat acute low back pain?

    <p>All of the above</p> Signup and view all the answers

    What is the name of the vessel that connects the pericardium channel to the uterus in Traditional Chinese Medicine?

    <p>Bao Mai</p> Signup and view all the answers

    What is the primary benefit of melatonin (3mg/day for 8 weeks) in GERD management?

    <p>Improving sleep quality</p> Signup and view all the answers

    What is the Number Needed to Harm (NNH) measuring in antihypertensive therapy?

    <p>A measure of how many people need to be treated for 1 person to have an adverse effect</p> Signup and view all the answers

    What is the primary mechanism of action of Ezetimibe in reducing cholesterol levels?

    <p>Inhibiting the absorption of cholesterol into the lumen</p> Signup and view all the answers

    What is the effect of Niacin on lipolysis in adipose tissue?

    <p>It decreases lipolysis, leading to reduced formation of VLDL</p> Signup and view all the answers

    What is the Number Needed to Treat (NNT) to benefit 1 person with regards to statin therapy in terms of cardiovascular events?

    <p>52</p> Signup and view all the answers

    What is the common adverse effect of both Statin and Fibrate therapy?

    <p>Rhabdomyolysis</p> Signup and view all the answers

    What is the function of the 'Clears' action in terms of qi?

    <p>Removes from the body, mainly for heat</p> Signup and view all the answers

    Which botanical medicine is used to treat hypertension, CHF, and cardiovascular conditions?

    <p>Lily of the valley</p> Signup and view all the answers

    What is the effect of Sulphur on the physical body?

    <p>Resulting in a more robust person, with stooped shoulders</p> Signup and view all the answers

    What is the action of Hibiscus on the body?

    <p>Hypotensive and anti-inflammatory</p> Signup and view all the answers

    What is the primary function of the small intestine in Traditional Chinese Medicine?

    <p>To separate pure from turbid and communicate with the stomach, spleen, bladder, and large intestine</p> Signup and view all the answers

    Which of the following adaptogens is used for immune stimulation, libido, and cardiotonic effects?

    <p>Panax ginseng</p> Signup and view all the answers

    What is the primary effect of opioids on the body when used to treat acute low back pain?

    <p>Analgesia and respiratory depression</p> Signup and view all the answers

    Which of the following homeopathic remedies is used for low back pain with symptoms worsened by activity and cold, and relieved by vigorous exercise?

    <p>Sepia</p> Signup and view all the answers

    What is the name of the vessel that connects the pericardium channel to the uterus in Traditional Chinese Medicine?

    <p>Bao Mai</p> Signup and view all the answers

    What is the typical pulse characteristic of an individual with a Lung Qi deficiency?

    <p>Slow and weak</p> Signup and view all the answers

    Which of the following pulse types is associated with the summer season?

    <p>Flooding</p> Signup and view all the answers

    What is the primary goal of a treatment plan based on a Zang-Fu diagnosis?

    <p>To treat the underlying dysfunction</p> Signup and view all the answers

    What is the characteristic of a pulse in an individual with a heavier body set?

    <p>Slow and deep</p> Signup and view all the answers

    What is the typical intensity of a pulse in an individual with an excess condition?

    <p>Strong</p> Signup and view all the answers

    What is the primary purpose of calms the mind in Botanical Medicine?

    <p>Slowing overactive mind or quickening slow mind</p> Signup and view all the answers

    What is the expected reduction in blood pressure with a moderate level of physical activity?

    <p>-4 mmHg</p> Signup and view all the answers

    Which of the following is a hormonal etiology of erectile dysfunction?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended dietary approach for managing hypertension?

    <p>DASH diet</p> Signup and view all the answers

    What is the expected reduction in blood pressure with a healthy weight loss?

    <p>-5 mmHg</p> Signup and view all the answers

    Which of the following is a local penile factor that can cause erectile dysfunction?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a neurologic etiology of erectile dysfunction?

    <p>All of the above</p> Signup and view all the answers

    What is the primary mechanism of action of TCM in treating erectile dysfunction?

    <p>Connecting points (Luo)</p> Signup and view all the answers

    What is the primary risk factor for Barett's esophagus?

    <p>Smoking and obesity</p> Signup and view all the answers

    What is the mechanism of action of PPIs in GERD management?

    <p>Reducing gastric acid secretion</p> Signup and view all the answers

    What is the potential risk associated with long-term use of PPIs?

    <p>Nutrient deficiencies, such as vitamin B12 deficiency</p> Signup and view all the answers

    What is the indication for gastroscopy in a patient with heartburn and red flags?

    <p>All of the above</p> Signup and view all the answers

    What is the absolute risk reduction of antihypertensive therapy for a first major cardiovascular event?

    <p>0.7%</p> Signup and view all the answers

    What is the number needed to treat to benefit one person with regards to statin therapy in terms of cardiovascular events?

    <p>52</p> Signup and view all the answers

    Which of the following lipid-lowering drugs is most effective in increasing HDL and decreasing triglycerides?

    <p>Fenofibrate</p> Signup and view all the answers

    What is the mechanism of action of Niacin in reducing LDL-C?

    <p>Inhibiting lipolysis in adipose tissue</p> Signup and view all the answers

    What is the most common adverse effect of both Statin and Fibrate therapy?

    <p>Rhabdomyolysis</p> Signup and view all the answers

    What is the primary action of Hawthorn (Crataegus oxyacantha) on the cardiovascular system?

    <p>Cardiotonic</p> Signup and view all the answers

    Which of the following herbs is indicated for anxiety and hypertension related to stress?

    <p>Linden</p> Signup and view all the answers

    What is the primary action of Garlic (Allium sativum) on the cardiovascular system?

    <p>Vascular tonic</p> Signup and view all the answers

    Which of the following homeopathic remedies is indicated for symptoms of atherosclerosis, obesity, and diabetes?

    <p>Calcarea carbonica</p> Signup and view all the answers

    What is the primary action of Hibiscus on the cardiovascular system?

    <p>Hypotensive</p> Signup and view all the answers

    What is the primary mechanism of action of Rhus tox in treating low back pain?

    <p>Reducing restlessness and stiffness</p> Signup and view all the answers

    Which of the following adaptogens is used for immune stimulation, libido, and cardiotonic effects?

    <p>Panax ginseng</p> Signup and view all the answers

    What is the primary function of the small intestine in Traditional Chinese Medicine?

    <p>To separate pure from turbid and communicate with the stomach</p> Signup and view all the answers

    Which of the following homeopathic remedies is used for low back pain with symptoms worsened by morning and relieved by lying down?

    <p>Natrum</p> Signup and view all the answers

    Study Notes

    Hypertension Management

    • Non-pharmacological interventions for prevention of hypertension:
      • Weight loss
      • Healthy diet (DASH diet)
      • Reduced intake of dietary sodium
      • Increased potassium intake
      • Aerobic and resistance exercises
      • Moderation in alcohol consumption
    • Impact on blood pressure: -5 mmHg (weight loss) -11 mmHg (DASH diet) -5 to -6 mmHg (reduced sodium intake) -4 mmHg (increased potassium intake) -4 mmHg (aerobic exercise) -~5.5 mmHg (moderation in alcohol consumption)

    Etiologies of Erectile Dysfunction

    • Vascular: CVD, hypertension, DM, smoking, major surgery, radiotherapy, hyperlipidemia
    • Neurologic: spinal and brain injuries, Parkinson disease, Alzheimer disease, multiple sclerosis, stroke, major surgery, radiography of prostate
    • Local penile (cavernous) factors: Peyronie’s disease, cavernous fibrosis, penile fracture
    • Hormonal: hypogonadism, hyperprolactinemia, hyper/hypothyroidism, hyper/hypercortisolism
    • Drug-induced: anti-hypertensives, antidepressants, antipsychotics, recreational drugs, alcohol
    • Psychogenic: performance anxiety, PTSD, relationship issues, anxiety, depression, stress

    Low Back Pain Treatment

    • IFC (Interferential Current): treatment involves electrical current, used to relieve pain and relax muscle
    • TENS (Transcutaneous Electrical Nerve Stimulation): works with pain gate control theory and endorphin release
    • Ultrasound: sound waves go 2-5cm into soft tissue, good for tissues with high collagen content (tendons, ligaments, joint capsules, fascia, connective tissue)

    Adaptogens and Anti-Inflammatory Diet

    • Adaptogens:
      • Stimulating: Panax ginseng (Korean red ginseng), Rhodiola rosea
      • Immune adaptogens: Astragalus, Panax quinquefolius (North American ginseng)
      • Hypotensive: Withania somnifera (Ashwagandha), Rehmania
    • Anti-inflammatory diet:
      • Focus on fruits, vegetables, nuts, legumes, whole grains, and unsaturated fats
      • Low glycemic index/load diet
      • Omega 3-rich foods and polyphenol-rich fruits and vegetables
      • Limited intake of animal products and pro-inflammatory foods

    Opioids in Pharmacology

    • Full opioid agonists: morphine, codeine
    • Partial opioid agonists: tramadol
    • Opioid antagonists: naloxone
    • Side effects: analgesia, respiratory depression, euphoria, sedation, hypotension, vasodilation, constipation, N/V

    Traditional Chinese Medicine

    • Heart: governs blood, controls sweat, and manifests in complexion, opens into the tongue, houses the mind (shen), and is associated with the fire element
    • Small intestine: separates pure from turbid, communicates with stomach, spleen, bladder, and large intestine
    • Pericardium: protects the heart, governs blood, and houses the shen
    • Triple warmer: mobilizes original Qi, controls transportation and penetration of Qi, and controls water passages and excretion of fluids

    IBS/GI Botanical Medicine

    • Botanicals for IBS:
      • Peppermint: carminative, anti-emetic, antispasmodic
      • Lemon balm: carminative, antispasmodic
      • Fennel: carminative, antispasmodic
      • Curcumin: anti-inflammatory
      • Psyllium: bulk laxative, demulcent
      • Flaxseed: bulk laxative, demulcent, phytoestrogen

    Homeopathy and Naturopathic Approach to IBS

    • Remove food sensitivities, add fiber, relieve flatulence, eliminate cramping, stimulate laxatives, and manage stress### Point Classifications
    • 5 transporting points: Well-Spring-Stream-River-Sea
    • Source points: 12 regular meridians
    • Influential points: Qi, blood, zang, fu, bone, marrow, sinews, vessels
    • Command points: face/mouth, posterior neck, abdomen, back
    • Back shu: 12 primary meridians, mainly for physical concerns and less emotional/spiritual
    • Outer back shu: more emotional/spiritual, next to back shu points
    • Front mu: 12 primary meridians, for both physical + emotional concerns

    Botanical Medicine for Hypertension and CVD

    • Lily of the valley (Convallaria): hypertension, CHF, any cardiovascular conditions; contains cardiac glycosides; use with caution; avoid in pregnancy
    • Hawthorn (Crataegus oxyacantha): cardiotonic, hypotensive, vascular tonic, nutritive; use in hypertension or CVD/CHF; flavonoids; safe
    • Linden (tilia cordata): cardiotonic, circulatory tonic, nervine, hypotensive; use in anxiety, CVD related to stress/anxiety, hypertension, URTIs; volatile oils, flavonoids, mucilage, tannins; safe
    • Garlic (allium sativum): vascular tonic, antimicrobial, hypotensive, stink-producer; use in digestive infections, skin infections, URTI, CVD, hypertension; safe
    • Cayenne (capsicum frutescens): stimulant, circulatory tonic, rubefacient; use in circulatory deficiencies, arthritis, pain relief; safe
    • Hibiscus: ePective hypotensive + vascular tonic; use in hypertension, inflammation, and heat patterns; flavonoids, vitamin C, tannins, anthocyanidins; mild uterine tonic

    Homeopathy Questions

    • Number needed to treat (NNT) to benefit 1 person: measure of how many people need to be treated for 1 person to have a benefit
    • Number needed to harm (NNH): measure of how many people need to be treated for 1 person to have an adverse effect
    • Antihypertensive therapy: MI ARR = 0.7%, NNT = 143, 20-40% risk reduction for first major cardiovascular event vs. placebo
    • Statin therapy: cardiovascular event ARR = 1.39%, NNT = 52, most common adverse effect is myalgia
    • Low-dose ASA: major cardiovascular event ARR = 0.4%, NNT = 241, major bleeding usually within GI tract

    Drugs that Lower Cholesterol

    • HMG CoA Reductase inhibitors (statins): lower LDL-C, prevent CVD, stabilize plaques; can cause rhabdomyolysis
    • Absorption Inhibition: Ezetimibe; cannot absorb cholesterol into the lumen (bile acid binding resins)
    • Cholestyramine: bile acid binding, allows more LDL-C to be used up
    • Fibrates: not as good for LDL-C, better for increasing HDL and decreasing cholesterol (reducing triglycerides); benefit best in diabetic populations; can cause rhabdomyolysis
    • Niacin: broadest spectrum but needs to be a huge dose, which causes intense flushing/itching; works by inhibiting lipolysis in adipose tissue; reduces formation and secretion of VLDL (precursor to LDL)

    Root Cause and Treatment

    • Expels wind: specifically for wind, opens gates to allow wind to escape (wind gate, posterior neck); exterior wind caught in Wei Qi layer
    • Calms the mind: slows overactive mind or quickens slow mind; helps with insomnia from overactive mind; treats depression, anxiety, stress
    • Removes obstruction: obstructions usually manifest as pain or lack of flow; can be used for stagnation (gi, blood, phlegm/damp, cold); symptom treatment vs. cause

    Erectile Dysfunction and Weight

    • Key treatment principles: differentiate between physical and mental/emotional causes; differentiate between difficulty with arousal vs. Follow same procedure for guan and chi pulses
    • Normal variations in pulses: athletes, women, children, heavier set, thin, fasting individuals
    • Pulse variables: speed, type, depth, intensity
    • Treatment plans: written as Zang-Fu diagnosis, multiple organs can be included, objective is to treat the underlying dysfunctionHere are the study notes for the provided text:

    Non-Specific Low Back Pain (NSLBP)

    • Definition: pain and stiffness in the lower back region
    • Physical Medicine:
      • Interferential Current (IFC) therapy: relieves pain and muscle spasms, improves circulation
      • Transcutaneous Electrical Nerve Stimulation (TENS): temporary pain relief, 20-minute sessions
      • Ultrasound: treatment for tissues with high collagen content (tendons, ligaments, fascia)
      • Laser therapy: promotes wound healing, reduces inflammation and pain
    • Homeopathy:
      • Sepia: treatment for NSLBP with depression, symptoms worsen with activity, cold, and sadness
      • Natrum: treatment for NSLBP with grief, depression, and emotional vulnerability
      • Rhus tox: treatment for NSLBP with stiffness, redness, and swelling
    • Botanical Medicine:
      • Adaptogens: help body adapt to stress and promote healing (Panax ginseng, Rhodiola rosea, Astragalus)
      • Anti-inflammatory diet: emphasizes fruits, vegetables, nuts, legumes, whole grains, and unsaturated fats

    Pharmacology

    • Opioids:
      • Indications: acute, severe low back pain
      • Contraindications: depression, anxiety, PTSD, substance abuse
      • Side effects: analgesia, respiratory depression, constipation, nausea, and vomiting
    • Opioid classes:
      • Full agonists: morphine, codeine
      • Partial agonists: tramadol
      • Antagonists: naloxone

    Traditional Chinese Medicine (TCM)

    • Heart and Small Intestine Channel:
      • Heart functions: governs blood, controls sweat and complexion, houses the mind (Shen)
      • Small intestine functions: separates pure from turbid, communicates with heart, stomach, bladder, and large intestine
    • Pericardium Channel:
      • Protects the heart, governs blood, houses the Shen
    • Triple Warmer Channel:
      • Mobilizes Original Qi, controls transportation and penetration of Qi, controls water passages and excretion of fluids

    Gastrointestinal (GI) Issues

    • IBS:
      • Symptoms: abdominal pain, bloating, gas, changes in bowel habits
      • Naturopathic approach: remove food sensitivities, increase fiber, relieve flatulence, eliminate cramping
    • Botanical Medicine for IBS:
      • Peppermint: carminative, anti-emetic, antispasmodic
      • Lemon Balm: carminative, anti-emetic, cramping
      • Fennel: indigestion, bloating, antispasmodic, anti-inflammatory
    • Homeopathy for IBS:
      • Nux vomica: anxiety, constipation, bloating, headaches
      • Podophyllum peltanum: IBS-like symptoms, gallbladder pain, bloating, gas

    Erectile Dysfunction (ED)

    • Causes: vascular, neurologic, hormonal, local penile, and psychogenic factors
    • Non-pharmacological interventions: weight loss, healthy diet, increased potassium intake, physical activity, moderation in alcohol intake

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