NMT 200 Midterm PDF

NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 1. given how much obesity & diet & lifestyle sedentary lifestyles increase the risk of NAFLD, ____ & _____ counselling are founda- tional interventions 2. galactose is a common con-...

NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 1. given how much obesity & diet & lifestyle sedentary lifestyles increase the risk of NAFLD, ____ & _____ counselling are founda- tional interventions 2. galactose is a common con- glycolipids & glycoproteins stituent in ___________ 3. in what ways is metabolism of its transport & metabolism do not require fructose "unregulated" insulin 4. which tissues have the capac- liver, intestines, kidney, adipose, muscle tis- ity to metabolize fructose? sue 5. because so few tissues can transported to and metabolized by the liver metabolize fructose, what into glycogen or TAGs happens to the majority of it? 6. how is fructose absorbed? passively, by GLUT 5 transporters 7. how does a high fructose diet amplifies absorption by up-regulating addi- impact aborption? tional transport mechanisms 8. why can fructose overburden processing of fructose in the liver is not the liver controlled by hormone or allosteric mecha- nisms (i.e., there is no rate-limiting step) 9. what happens to excess they do not act as negative feedback - in- metabolites of fructose me- stead they enter various other pathways tabolism? (fatty acid synthesis, cholesterol synthesis, etc.) 10. indigestible polysaccharides diety fiber are known as: 11. what is the best diet for pre- mediterranean diet venting and treating NAFLD? 12. 5 to 10 1 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv reducing weight by __ to __% can result in important health benefits 13. 5 drugs associated with - antidepressants (esp TCAs) weight gain - antipsychotics - corticosteroids - antihyperglyecmic drugs - lithium 14. which drugs are associated antipsychotics with 9-12 kg of gain & with the greatest amount of changes to insulin resistance weight gain? lithium (treats mania) with 10 kg of gain or more 15. appetite suppressants bupropion along or in combination with nal- trexone 16. bupropion sympathomimetic (stimulant ish) drug used as an antidepressant, smoking cessation aid, and appetite suppressant 17. adverse effects of bupropion dry mouth, constipation, agitation, insom- nia, anxiety; rarely, seizures (CI in those with seizure hx) 18. adverse effects of bupropion + N&V, constipation, headache, dizziness, in- naltrexone somnia, dry mouth 19. bupropion + naltrexone is opioid therapy (precipitation of opioid with- contraindicated with concur- drawal - naltrexone is opioid antagonist) rent... 20. bupropion + naltrexone sup- hormones involved in appetite & reward press appetite by mediating... 21. orlistat drug class lipase inhibitor 22. orlistat MOA 2 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv pancreatic and gastric lipase inhibitor that reduces intestinal dietary fat absorption by 30% 23. adverse effects of orlistat oily spotting, flatus with discharge, fecal ur- gency, decreased absorption of fat-soluble vitamins 24. orlistat is contraindicated in chronic malabsorption syndrome or patients with... cholestasis 25. 2 main incretin hormones GLP-1 and GIP responsible for glucose-in- duced insulin secretion 26. role of GLP-1 increases satiety, decreasing gastric emp- tying, affects reward-related systems in the brain 27. role of GIP delays gastric emptying, seems to play a role in fat deposition 28. liraglutide & semaglutide drug GLP-1 agonists (incretin mimetics) class 29. adverse effects of liraglutide N&V, constipation, diarrhea; rarely, pancre- atitis 30. adverse effects of semaglu- N&V, diarrhea, abdominal pain, constipa- tide tion, fatigue, dizziness; possibly pancreati- tis *most people will experience some form of digestive upset 31. weight loss pharmacotherapy patient is already taking bupropion as an is not recommended during antidepressant pregnancy unless... 32. reduced fat-soluble vitamin absorption 3 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv orlistat is specifically not rec- ommended during pregnancy due to... 33. in meta-analysis of incretin appetite suppression, delayed gastric emp- mimetic drugs, there is evi- tying, and *changes in taste and food pref- dence of... erences* 34. definition of lifestyle medicine branch of medicine that uses therapeutic lifestyle interventions as a primary modality to maintain optimal health and to prevent, treat and reverse chronic illness across all life stages 35. AROM tests what kind of tis- contractile and non-contractile sue? 36. PROM tests what kind of tis- non-contractile sue? 37. RROM tests what kind of tis- contractile sue 38. spinal manipulation is a con- RHPA 1991 trolled act under the 39. joint mobilization is per- the physiological range of joint motion; not formed within ________, not beyond the elastic barrier beyond the _______ 40. mobilizations are always ___ low velocoty 41. elastic barrier / limit space between the end point of AROM and end point of PROM; felt as an elastic resis- tance 42. paraphysiological space area where there is increased movement beyond the joints elastic barrier after cav- 4 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv itation (manipulation); beyond PROM end point but does not pass anatomical limit 43. anatomical limit where anatomy limits motion of the joint; movement beyond this point results in injury 44. cavitation noise that occurs as the volume of the in- tra-articular space increases and synovial fluid changes from a liquid to gaseous form 45. widely accepted, evi- pain reduction dence-based therapeutic ef- fect of joint manipulation & mobilization 46. what should not be con- short duration, mild increase in local sore- sidered an inappropriate re- ness following manipulation sponse to joint manipulation? 47. adjustments (manipulations) preloading a joint in the direction of intend- should not be forced when... ed manipulation produces pain or protec- tive patient guarding 48. indications for thoracic spine reduced thoracic ROM resulting in... manipulation - pain or upper or lower spine - decreased sport performance - postural issues - compromised chest (and therefore lung) expansion 49. fixation an articulation has become temporarily im- mobilized in a position that it may normally occupy during any phase of physiological movement 50. subluxation alteration in the physical relationship of ar- ticular structures, but contact between the joint surfaces remains intact 51. 5 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv key botanical actions for alterative, hepatic / hepatoprotective, laxa- NAFLD tive 52. arctium lappa burdock 53. burdock hepatic + laxative indicated for hepatic con- gestion & sluggish bowels 54. berberis vulgaris barberry 55. barberry antimicrobial, very strong bitter, one of the best hepatics, endocrine modulator (in- sulin) indicated for infections, hepatic con- ditions, and T2DM 56. barberry cautions avoid during pregnancy & lactation 57. bupleurum hepatic & hepatoprotective indicated for he- patic congestion & long-standing inflamma- tion 58. bupleurum safety avoid in cold conditions/constitutions; safe- ty in pregnancy & lactation not established 59. gentian strong bitter and hepatic indicated for slug- gish digestion 60. gentian safety not to be used in cases of known ulceration 61. paeonia lactiflora peony 62. peony hepatic harmonizer and female endocrine modulator indicated for any condition of fe- male hormone dysregulation 63. peony safety possible interaction with anticoagulants; safety rating during pregnancy & lactation not established 64. rumex crispus yellow dock 6 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 65. yellow dock hepatic & laxative, indicated for chronic skin conditions & constipation; thought to be one of the best "blood purifiers" 66. schisandra adaptogen & hepatoprotective indicated for cases of weakened vitality and hepatitis 67. schisandra safety mild uterine stimulant but broadly consid- ered safe 68. other than schisandra, what milk thistle herb is hepatoprotective? 69. key botanical actions for the endocrine modulator, bitter, alterative treatment of diabetes (specifically hepatics & diuretics) 70. which herb is the basis of met- goat's rue formin? 71. cinnamon carminative, endocrine modulator indicated for T2DM; may facilitate glucose transport into cells 72. cinnamon is generally con- pregnancy & lactation traindicated during... 73. galega officinalis Goat's rue 74. goat's rue galactogogue and hypoglycemic agent indi- cated for insufficient breast milk production and blood sugar dysregulation 75. goat's rue safety will augment actions of other hypoglycemic agents 76. momordica charantia bitter melon 77. bitter melon endocrine modulator & bitter indicated for T2DM 7 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 78. bitter melon safety safe, excessive intake (more than 2-3 fruits) may cause stomach upset and diarrhea; potential to cause hypoglycemia event 79. other than barberry, whats an- golden thread (coptis senisis) other common berberine con- taining herb? 80. other than bitter melon and gymnema - also an endocrine modulator goat's rue, what is another with specificity to insulin herb used almost exclusively in diabetic cases? 81. phosphorus has affinity for... hepatitis, pulmonary disease, severe infec- tions 82. phosphorus general symp- restless, burning sensation, hemorrhage, toms weakness 83. phosphorus aggravations worse with touch, exertion, twilight, warm food or drink, thunderstorm 84. phosphorus alleviations better with cold, sleep 85. phosphorus physical symp- pneumonia, laryngitis, liver disease, fat- toms ty degeneration, tumours/growths/caries, N&V from cold drinks or as soon as water is warmed up by stomach, post-operative vomiting 86. kalium bichromicum affinities GI & respiratory mucous membranes, bones/fibrous tissue, kidney, heart, liver (cirrhosis) 87. kali bic mental picture avoids human interaction, weak memory 88. kali bic general symptoms pain occurs in small spots and migrates quickly; appears & disappears quickly; dis- ease conditions progress slowly but deeply 8 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 89. kali bic physical symptoms green, sticky, lumpy discharge; fatty infiltra- tion of liver, increase in fibrous tissue 90. kali bic aggravations worse with beer (but craves beer), morning, cold, wet weather 91. kali bic alleviations better with heat 92. arnica mental picture fears touch, wants to be alone, feels bed is hard 93. arnica physical symptoms pain as if bruised or beaten; sprained or dislocated feeling 94. arnica affinities shock or trauma (including mental strain or shock), surgical shock, muscular injuries 95. arnica aggravations worse with touch, motion, rest, damp cold 96. arnica alleviations better with lying down or with head low 97. nat sulph affinities liver, hydrogenous constitution (feels change from dry to wet), head symptoms (injuries, mental troubles) 98. nat sulph mental characteris- saddened by lively music, suicidal tenden- tics cy, melancholy with periodic mania 99. nat sulph physical symptoms hepatitis (icterus, vomiting of bile, liver sore to touch/stitching pains); bruised pain, stool urgency, loose morning stools, rheumatism 100. nat sulph aggravations worse with music, lying on L side, damp- ness 101. nat sulph alleviations dryness, pressure, changing positions 102. 6 drugs that can cause dysg- - beta blockers lycemia - corticosteroids - HMG CoA reductase inhibitors 9 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv - thiazide or loop diuretics - protease antivirals - second-gen antipsychotics 103. adverse effects of insulin - hypoglycemia - localized fat hypertrophy - allergic reactions 104. biguanides example metformin 105. metformin MOA decreases hepatic glucose production 106. metformin lowers HbA1c by... 1-1.5% 107. metformin adverse effects nausea, diarrhea, abdominal discomfort are common; also anorexia, metallic taste 108. why is metformin contraindi- may cause lactic acidosis cated in pts with hepatic or re- nal disease 109. what should be supplemented B12 with metformin 110. acarbose drug class alpha-glucosidase inhibitor 111. acarbose MOA inhibits intestinal alpha-glucosidase, delay- ing digestion & absorption of carbs, reduc- ing postprandial glucose levels 112. acarbose does not inhibit in- lactase testinal ______ 113. acarbose lowers HbA1c by: 1% or less 114. hypoglycemia patients taking glucose not sucrose (sucrose will not be acarbose should be treated digested) with... 115. acarbose adverse effects gas, diarrhea, abdominal pain, nausea 10 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 116. acarbose may reduce metformin bioavailability of: 117. acarbose is CI in... IBS & IBD 118. sitagliptin drug class dipeptidyl peptidase (DPP) -4 inhibitor 119. sitagliptin MOA inhibits enzyme responsible for the degra- dation of GLP-1 (indirectly acts as an in- cretin mimetic) 120. sitagliptin & CVD risk does not seem to reduce CV risk 121. sitagliptin reduces HbA1c by: 1% or less 122. adverse effects of sitagliptin nasopharyngitis, hypersensitivity reactions; rarely, pancreatitis & severe joint pain 123. semaglutide & liraglutide MOA acts on GLP-1 receptors to increase insulin secretion, suppress postpradnial glucagon secretion, slow gastric emptying, and in- crease satiety 124. semaglutide & liraglutide low- 1 - 1.5 % er HbA1c by: 125. evidence suggests prevention cardiovascular; GLP-1 agonists of ______ events in both praimry and secondary pre- vention patients with use of _____ 126. semaglutide & liraglutide are pregnancy, personal or family Hx of CI in... medullary thyroid carcinoma or multiple en- docrine neoplasia syndrome type 2 127. glyburide drug class sulfonylurea 128. glyburide MOA insulin secretagogue that stimulates basal and meal-stimulated insulin release 11 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 129. glyburide reduced HbA1c by: 1 - 1.5 % 130. adverse effects of glyburide weight gain, hypoglycemia 131. repaglinide drug class meglitinide 132. repaglinide MOA short-acting insulin secretagogue 133. glyburide vs repaglinide similar effect and adverse effects repaglinide has lower risk of hypoglycemia but more extensive metabolic drug interac- tions 134. canagliflozin drug class SGLT-2 inhibitor (sodium-glucose cotrans- porter 2) 135. canagliflozin MOA prevents glucose reabsorption in the kid- neys, which leads to enhanced glucose ex- cretion 136. canagliflozin lowers HbA1c 1% or less by: 137. SGLT-2 inhibitors are shown risk of CV mortality, major adverse CV to reduce... events, and hospitalization due to heart fail- ure significantly *more so than statins* 138. canagliflozin adverse effects increased risk of genitourinary infections, hypotension, hyperkalemia, DKA 139. pioglitazone drug class thiazolidinedione 140. pioglitazone MOA acts as agonist at peroxisome prolifera- tor-activated receptor gamma (PPARG) re- ceptors on cell nucleus to upregulate ex- pression of GLUT4 and LPL enhancing glu- cose uptake and hydrolysis of TAGs 12 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 141. pioglitazone lowers HbA1c 1 - 1.5 % by: 142. adverse effects of pioglita- weight gain, increased fluid retention/ede- zone ma (heart failure), increased risk of fracture, worsens macular edema 143. how is dietary fiber beneficial fibers slow gastric emptying and delay ab- in the context of diabetes sorption of glucose in the SI 144. it is important to consider surgery (thyroidectomy) _______ in the treatment of hyperthyroidism as medica- tions are limited and there is potential for formation of goi- ter 145. what is a common and like- hypothyroidism ly adverse effect of thyroid surgery? 146. radioactive iodine is used to... ablate thyroid tissue in patients with Graves disease and toxic nodules 147. adverse effects of radioactive high risk of hypothyroidism, risk of radiation iodine thyroiditis, possible worsening of Graves or- bitopathy 148. methimazole MOA interferes with iodination & coupling of tyro- sine to decrease thryoid hormone produc- tion 149. adverse effects of methima- skin rash, allergic reaction, agranulocyto- zole sis; hepatotoxicity in rare instances 150. why is methimazole con- can cause aplasia cutis (congenital ab- traindicated during the first sence of skin) trimester of pregnancy? 151. propylthiouracil (PTU) MOA 13 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv interferes with iodination & coupling of tyro- sine and conversion of T4 to T3 in the pe- riphery to decrease production and function of thyroid hormone 152. PTU is more so indicated in severe thyrotoxicosis and/or thyroid storm cases of... 153. adverse effects of PTU skin rash, allergic reaction, agranulocyto- sis; can cause severe hepatotoxicity 154. beta blockers & hyperthy- beta blockers can be used to ameliorate the roidism symptoms of adrenergic excess caused by excess thyroid hormone 155. propranolol can decrease... conversion of T4 to T3 in periphery by inter- fering with deiodinase enzymes 156. adverse effects of propranolol bradycardia, dizziness, fatigue, headache, hypotension 157. propranolol should be avoid- asthma or conditions associated with ed in patients with... bradycardia 158. how long does it take to at- 6 weeks tain a new steady state after levothyroixine therapy is ad- ministered? 159. absorption of levothyroxine antacids, mineral supplements, PPIs, and may be reduced by... estrogens 160. adverse effects of levothyroix- hyperthyroidism, exacerbation of angina, ine decline of glycemic control 161. adverse effects of desiccated palpitations, tachycardia, cardiac ar- thyroid rhythmias, angina pectoris, nervousness, tremors, headache, insomnia, sweating, heat intolerance, fever, weight loss 14 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv 162. iodine not used by the thyroid urine; bile is excreted in the _____; io- dine cleaved from T4 to form T3 is excreted in the _____ 163. rate of zinc absorption is de- body status (low zine = higher absorption) pendent on..... 164. absorption of zinc is inhibited alcohol by consumption of ___ 165. zinc supplementation can re- copper sult in deficiency of: 166. zinc interferes with absorp- iron tion of: 167. deficiency of manganese is pancreatic insufficiency uncommon but may occur with: 168. manganese toxicity excess accumulates in the liver & CNS leading to psychiatric disturbances and neuromuscular symptoms usually due to environmental exposure 169. chromium is part of a protein potentiate insulin activity and assist in mov- complex that functions to... ing glucose into cells 170. selenium is deposited in all adipose tissue body tissues except... 171. selenium is integral to seleno- glutathione peroxidase and deiodinase proteins like... 172. fluoride is important during growth of calcified tissue as it results in peiods of... resistance to resorption/breakdown 173. goitrogens 15 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv compounds that interfere with thyroid hor- mone production 174. examples of goitrogens thiocyanates, glucosinolates, some flavonoids 175. thiocyanate examples cassava, lima beans, linseed, sorghum, and sweet potato contain cyanogenic glyco- sides that are metabolized to thiocyanates 176. thiocyanates act as goitro- competing with iodine for uptake in the thy- gens by... roid 177. soy and millet contain fla- impairing thyroid peroxidase activity vanoids that act as goitrogens by... 178. _____________ contain glu- cruciferous vegetables; competing with io- cosinolates, which act as dine for thyroidal uptake goitrogens by... 179. most goitrogens are reduced cooking; can be offset by ensuring iodine by ________ and can be offset intake is sufficient by ________ 180. appropriate thyroid function vit A - consider supplementation or food is needed for ___________ sources of carotenoids in the context of hy- metabolism pothyroidism 181. vibratory oscillations of joint activate sensory mechanoreceptors that re- mobilization are thought to... duce pain & improve proprioceptive func- tion 182. local application of heat can - vasodilation induce... - tissue relaxation - increased metabolism - pain reduction 183. local application of cold can - vasoconstriction induce... - tissue tightening 16 / 17  NMT 200 - Midterm Study online at https://quizlet.com/_fu7ycv - reduced inflammation - pain reduction 184. whole body cold vs hot appli- heat: vasodilation cations in terms of vasocon- struction & vasodilation cold: vasodilation & vasoconstriction 185. purpose of neutral applica- physiologic "zero" = minimal sensory input tions = relaxation 186. __ mins is the boundary be- 5; 1 tween short and long hot; __ mins is the boundary between short and long cold 187. risks of hot applications fainting, burns, circulatory issues, uncon- trolled DM 188. risks of cold applications cold intolerance, asthma 189. caution in _______ & elderly & children _________ for both hot and cold applications 190. contrast amplifies the effects hot of ____ treatment 191. hydrotherapy derivation vs derivation = increased blood flow to an area depletion depletion = decreased blood flow to an area 192. which symptoms will appear poor appetite, abdominal distension, loose in nearly all spleen dishar- stools monies? 17 / 17