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NMT 150 final quiz

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81 Questions

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

14 days

What is the primary mechanism of GERD?

Inappropriate lower esophageal sphincter relaxation

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

To identify underlying bleeding, weight loss, dysphagia, or vomiting

What is the recommended dietary approach for managing GERD symptoms?

Low FODMAP diet

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

Nutrient deficiencies, such as vitamin B12 deficiency

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

143

What is the most common adverse effect of Statin therapy?

Myalgia

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

Rhabdomyolysis

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

Bring into balance or return to normal levels

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

Influential point

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

It has an anxiolytic effect

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

It should be avoided during pregnancy

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

It has a stimulant effect

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

Depression, anxiety, and stress

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

To open the gates and allow wind to escape

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

Treating symptoms only addresses the superficial issue, while addressing the root cause addresses the underlying issue

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

Differentiating between physical and mental/emotional causes

What is the result of stagnation in the body?

Pain and lack of flow

What is the characteristic of a pulse in an athlete?

Slower

What is the pulse characteristic associated with a fasting individual?

Weak and deficient

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

Floating

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

Tonify lung and tonify qi

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

Subdues

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

Weight loss

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

Vascular factors

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

Atorvastatin and fenofibrate

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

Back shu points and connecting Luo points

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

Statin therapy

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

All of the above

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

Aerobics and resistance exercise

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

Laser therapy

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

Natrum

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

It protects the heart and governs blood

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

All of the above

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

Bao Mai

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

Improving sleep quality

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

A measure of how many people need to be treated for 1 person to have an adverse effect

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

Inhibiting the absorption of cholesterol into the lumen

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

It decreases lipolysis, leading to reduced formation of VLDL

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

52

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

Rhabdomyolysis

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

Removes from the body, mainly for heat

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

Lily of the valley

What is the effect of Sulphur on the physical body?

Resulting in a more robust person, with stooped shoulders

What is the action of Hibiscus on the body?

Hypotensive and anti-inflammatory

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

To separate pure from turbid and communicate with the stomach, spleen, bladder, and large intestine

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

Panax ginseng

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

Analgesia and respiratory depression

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

Sepia

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

Bao Mai

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

Slow and weak

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

Flooding

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

To treat the underlying dysfunction

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

Slow and deep

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

Strong

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

Slowing overactive mind or quickening slow mind

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

-4 mmHg

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

All of the above

What is the recommended dietary approach for managing hypertension?

DASH diet

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

-5 mmHg

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

All of the above

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

All of the above

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

Connecting points (Luo)

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

Smoking and obesity

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

Reducing gastric acid secretion

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

Nutrient deficiencies, such as vitamin B12 deficiency

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

All of the above

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

0.7%

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

52

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

Fenofibrate

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

Inhibiting lipolysis in adipose tissue

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

Rhabdomyolysis

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

Cardiotonic

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

Linden

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

Vascular tonic

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

Calcarea carbonica

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

Hypotensive

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

Reducing restlessness and stiffness

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

Panax ginseng

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

To separate pure from turbid and communicate with the stomach

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

Natrum

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

Test your knowledge of Gastro Esophageal Reflux Disease (GERD) diagnosis, management, and treatment options. This quiz covers quadruple therapy, PPI trials, and indications for gastroscopy. Are you ready to assess your understanding of GERD?

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