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Nutrition 1 semester 2 > Advanced naturopathic case taking > Flashcards

Advanced naturopathic case taking Flashcards

1
Q

Name the 5 naturopathic principles

A

The healing power of nature
treat the cause not the symptoms
treat the whole person
prevention over cure
A naturopath is an educator - empower

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2
Q

Explain Hering’s Law of Cure

A
  1. From the inside out (boil clears internal toxins)
  2. From more important organs to less (from lungs/asthma to skin/eczema)
  3. Mind gets better before body (anxiety before IBS)
  4. Symptoms disappear in reverse order
  5. From above to below (progression of disease fingers, wrist, elbow… elbow, wrist, fingers)
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3
Q

Explain ATM

A

Antecedents (predisposing factors to illness). Genetic, enviornment (xeno-oestrogens exposure), low fibre

Triggers (something that started the problem) eg stressful life event, environmental toxins, meds, allergens

Mediators (what keeps the illness going/things we can fix). eg work stress (raised cortisol), poor sleep

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4
Q

what three steps should a practitioner undertake to assess the whole person

A
  1. Take into account the ATM
  2. Uncover lifestyle factors
  3. Plot on a timeline
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5
Q

What factors should be considered in antecedents

A

Genetics, family history of disease, constitution, age, sex, lifestyle and environment (drugs, deficiencies), Historical trauma

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6
Q

What does the term epigenetics mean

A

the study of modifying gene expression rather than the genetic code itself

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7
Q

What is genomic testing

A

analysis of genetic material to detect genetic predispositions

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8
Q

Name some common TRIGGERS

A

TRAUMA - never been well since…
Microbes - H, pylori
Meds
dietary allergens
stressful life even
environmental toxins
Temperature changes - eg asthma in winter

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9
Q

What are mediators

A

factors that contribute to pathological changes and dysfunctional responses.

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10
Q

Name some physiological mediators

A

chronic stress - hormones (eg work). can increase cortisol and reduce progesterone. Associated with menstrual problems

Intestinal dysbiosis - neurotransmitters (eg caused by diet or antibiotics) reduced melatonin and increased oxidative stress

Sedentary lifestyle - neuropeptides: increase substance P which increases pain

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11
Q

Name biochemical mediators

A

free radicals - increase risk of alzheimers and CVD due to free rads

Electromagnetic frequencies (EMF) (TV, phone, WiFi) can disrupt sleep and lower melatonin

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12
Q

What biochemical mediators might lab tests be helpful in discovering

A

inflammatory mediators: C reactive Protein, erythrocyte sedimentation rate, serum ferritin, calpropectin

Endocrine mediators: TSH, fT4 fT3, oestrogen metabolism, progesterone, testosterone, cortisol, DHEA, HbA1C

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13
Q

When deciding which symptoms are under stress, there are 7 core areas of clinical imbalance which need to be considered. Each impacts overall health due to influencing multiple systems and structures. Name the 7 areas

A
  1. ASSIMILATION
    2.STRUCTURAL INTEGRITY
  2. COMMUNICATION
  3. DEFENCE AND REPAIR
  4. TRANSPORT AND CIRCULATION
  5. ENERGY: MITOCHONDRIAL HEALTH
  6. DETOX AND ELIMINATION
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14
Q

Explain the clinical imbalance ASSIMIILATION and list key signs an symptoms

A

All aspects of digestion and assimilation
- digestive secretions
- Digestive motility and innervation (vagus nerve, SNS, PSNS, enteric nervous system)
- Digestive hormones
- Absorption of nutrients (villi)
- Microbiota imbalance

SIGNS
Pallor, short of breath, dysbiosis, gas bloating, food allergies, weight loss/gain, illness that impedes absorption, heartburn

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15
Q

Explain the clinical imbalance STRUCTURAL INTEGRITY and list key signs an symptoms

A
  • cell membrane health (EPA/DHA balance)
  • Mucous membrane and skin integrity (vit A, E, glutamine)
  • none and teeth (minerals)
  • joint and cartilage (Ca, Mg, Phosphorus, Vit D and C)

SIGNS
structural pain/injury, skin problems, gut membrane integrity, autoimmune conditions, low dietary EFAs , low sun, low minerals eg Ca, Mg, Zn, B P

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16
Q

Explain the clinical imbalance COMMUNICATION and list key signs an symptoms

A

Hormones and endocrine system
Neurotransmitters and nervous system

SIGNS
hormonal issues from reproductive to fatigue, stress mood and sleep

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17
Q

Explain the clinical imbalance DEFENCE AND REPAIR and list key signs an symptoms

A
  • Acute and chronic inflammation
  • infections - WBC, ESR, lymphocytes
  • Microbiota imbalance
  • allergies/autoimmune disease indicating imbalanced immune system
  • lowered immune functions eg reduced secretory IgA which protects the mucous membrane

SIGNS
recurring infections, fatigue, poor wound healing, skin issues, autoimmune conditions, intestinal permeability, low vit D, high free rads

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18
Q

Explain the clinical imbalance TRANSPORT AND CIRCULATION and list key signs an symptoms

A
  • Lymphatic structures (tonsils, spleen, thymus, nodes)
  • Vascular structures (arteries, veins, capillaries, high waist circumference, high BP, high ferritin
  • mobilisation of blood lipids (high triglycerides, High LDL, low HDL

SIGNS
CVD, raynauds and peripheral neuropathy. Oedema

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19
Q

Explain the clinical imbalance ENERGY: MITOCHONDRIAL HEALTH and list key signs an symptoms

A
  • cofactors for energy production (Mg, Fe, B1,2,3,6, Zn)
  • biochemical imbalances in the energy production pathways due to heavy metals, etc
  • mitochondrial integrity and oxidative damage

SIGNS
anything around ATP production - weakness, fatigue, CFS, ME, Parkinsons, MS, poor cognitive function, poor memory, intestinal permeability

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20
Q

Explain the clinical imbalance DETOX AND ELIMINATION and list key signs an symptoms

A

Liver, kidney, bowel, skin and lungs, biochemical imbalances in teh biotransformation pathways (eg lack of methyl donors)

SIGNS
When clients are on meds, poor diet, lifestyle, poor stool quality, alcohol, low antiox in diet, jaundice, lethargy

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21
Q

Naturopathic case analysis - list 5 steps to gathering the case analysis

A
  1. GATHER all of the clients information
  2. HIGHLIGHT ATMs
  3. PLOT the information within a timeline
  4. IDENTIFY which systems are under stress
  5. DECIDE which are the core clinical imbalances for the naturopathic summary
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22
Q

Naturopathic evaluation tools.
What should a practitioner do when taking a case

A

 OBSERVE – skin tone/condition/markings, nails, tongue, posture
 LISTEN
 CLARIFY
 EMPOWER

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23
Q

Face evaluation
What do MANY and ONE lines across the forehead indicate

A

MANY: poor intestinal health
ONE: SI issue - decreased absorption etc

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24
Q

Face evaluation
What do lined between the eyebrows indicate
one
two

A

one: stomach insufficiency (eg HCl, pepsin)
two: Liver imbalances (alcoholic, suppressed anger)

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25
Lines above the lip (purse string)
Smoking reproductive organ weakness blood deficiency
26
Brown shadows under eyes Blue/black shadows/bags
Liver stagnation adrenal exhaustion/kidneys
27
Diagnosis by smelling: BO No smell bad breath smelly urine/stools
BO: high heat no smell: cold bad breath: stomach heat smelly urine/stools: damp heat
28
If you suspected poor thyroid function, what signs/symptoms might you look for
goitre, dry skin, hair loss, bradycardiac, low BP
29
If you suspected anaemia what signs might you look for
Skin and conjunctiva (pallor?), mouth - angular stomatitis/pale or red tongue, tachycardia, spooning nails
30
What are tissue salts and who created them
homeopathic remedies based on minerals. Organs are made of specific mineral or ratios of minerals Schuessler developed 12 minerals in homeopathic form, each acting on a specific tissue, stimulating them to heal.
31
How should tissue salts be taken by Adults/children/infants If acute/chronic For how long
Adults: 1-2 Children: 1/2 - 1 Infants: 1/ 4- 1/2 Crush/chew/dissolve Acute: every 15-30 mins until symptoms disappear Chronic: 4-6 times per day Take as long as work and stop after symptoms disappear. Stop after 2 weeks if no improvement.
32
Name the tissue salts for nails, food source and herb White spots fungal infection brittle nails nail malformations
White spots: Calc phos. the cell restorer - oats, green leafy veg, carrots - chamomile Fungal nail: Kali sulph, the skin conditioner Brittle nails - alternate with silica - oats, linseed, barley, carrots - Meilissa, mustard, parsley Nail malformations: silica, the skin cleanser - tall grains, lentils, spinach - dandelion
33
What is the presentation of these nutrient deficiencies in nails. Vitamin A def Vit C Vit D Zn/Ca Fe Protein EFA
VIt A: brittle, peeling, splitting Vit C: hang nails/swollen tissue Vit D: Brittle/peeling Zn/Ca: white spots, weak, brittle Fe: pale nail bed, spooning, central ridge Protein: weak and brittle EFA: dry, peeling, swollen skin around nails
34
Tongue examination - what physical factors are taken into consideration
condition shape colour patterns coating
35
What organs do the following areas of the tongue represent Root/back Centre Sides Tip and front
Root/back: Kidney and bladder Centre: stomach and spleen Sides: liver and gallbladder Tip and front: lungs and heart
36
Tongue colour: Pale Red Purple
Pale: Excess cold. Qi or Yang deficiency Red: Excess heat, inflammation, infection -map indicates where. Heart = anxiety Purple: poor circulation,cuanosis, blood stagnation, reduced Qi
37
Tongue condition and taste; Prominent red papillae Excess papillae/hairy tongue Dry and cracked Wet Impaired taste
Prominent red papillae: excess heat Excess papillae/hairy tongue: antibiotic treatment. Need pro and prebiotics Dry and cracked: yin deficiency - not enough fluids/excess heat Wet: excess moisture / fluids Impaired taste: zinc deficiency
38
Tongue shape: Thin Swollen Scalloped Raised edges Temor
Thin: Blood deficiency Swollen: Qi/yang def causing fluid retention - dampness Scalloped: weak digestion, pancreatic insuffiiency Raised edges: high stress Temor: nervous energy/anxiety. Mg deficiency
39
Cracks/FISSURES on the tongue What area of the body does the midline of the tongue represent in ayurvedic medicine MEDIAL FISSURE MIDLINE FISSURE AT TH ETIP GEOGRAPHIC TONGUE
Tip is the top/cervical region, midline is the spine, back is the lumbar region. Cracks correspond to painful areas. Medial fissure (not to tip): vertical crack through middle - DIGESTION DEFICIENCY, lack of digestion juice secretion MIDLINE fissure at the TIP: heart or thyroid health Geographical - yin deficiency - B vitamin. Psoriasis sufferers.
40
Tongue coating: Thin white Brown Greasy yellow Greasy white No coat
Thin white: normal Brown: chronic excess heat Greasy yellow: damp heat - inflammation / infection Greasy white: damp cold (excess mucus/phlegm) No coat: yin deficiency
41
😁Lip condition: DRY Angular stomatitis/cheilitis - what is the possible cause and what tissue salts can be used to treat it
Dry: dehydration/excess heat (can be stomach heat from spicy food/sugar/alcohol) B2, B3, folate deficiency Angular stomatitis: reddened, cracking scaling at corners of mouth. Iron, B vits deficiency Infections Tissue salts: Calc sulph, kali sulph and/or silica
42
GUMS What should healthy gums look like and what could the following symptoms indiciate deficiency of: Bleeding Periodontal disease Pale mucus membranes Greyish mucous membranes
Normal: pale red, well defined margins and shallow crevices between teeth and gums. Bleeding: vit C, Zn CoQ10 def (Pull daily with organic coconut oil for two mins and brush teeth after) Periodontal disease: high sugar, meat, dairy, LOW Zn, coQ10, bioflavonoids Pale mucus membranes: Fe def Greyish mucous membranes: biotin def
43
The iris is governed by the autonomic nervous system. What can the following indicate and what is the dominant neurotransmitter for each: CONTRACTED PUPIL DILATED PUPIL
CONTRACTED PUPIL: parasympathetic dominance. ACETYLCHOLINE is the dominant neurotransmitter DILATED PUPIL: sympathetic nervous system dominance. ADRENALINE is the dominant neurotransmitter
44
What nutrient deficiencies can the following eye conditions indicate: Dry night blindness pale conjunctiva Blue sclera Photophobia lack of eyelashes/eyebrows
Dry: Vit A. EFAs night blindness: Vit A, Zn pale conjunctiva: Iron Blue sclera: iron Photophobia: B2, B3, beta carotene, Vit A, Zn lack of eyelashes/eyebrows: Copper. Thyroid support needed
45
What nutrient deficiencies do the following symptoms indicate: Facial dematitis Hyperpigmentation of mouth/cheek/eyes Inelastic skin Hair loos Brittle, dry lacklustre hair Hyperkeratosis
Facial dematitis: B2 Hyperpigmentation of mouth/cheek/eyes: Portein Inelastic skin: C, EFAs, copper Hair loss: Fe, protein, biotin, endocrine (ie hypothyroidism) Brittle, dry lacklustre hair: Fe, protein, EFAs Hyperkeratosis: A, EFAs
46
Ph levels are important as acidic tissue environment is favourable for cancer cells. What pH should the following be: Blood Urine Saliva
Blood: 7.35-7.45 Urine: 6.5-7.25 Saliva: 6.8-7.5
47
How test pH in saliva
Spit onto pH test strip 3x day 4-5 days in succession. Not first thing due to acidic bacterial levels. Test 1: 1 hr after brushing teeth Test 2: 30 mins before lunch Test 3: 30 mins before evening meal
48
What can affect the colour of urine
beetroot asparagus blackberries B2 supplementation
49
Waist to hip ratio - what can it indicate and how to measure
risk level for heart attack, stroke, diabetes, premature death! Waist: measure between top of hip bone and bottom of last rib. Breathe in and out and relax. Hip: largest part of buttocks CALCULATE: WAIST DIVIDED BY HIP
50
What are the Waist: Hip ratio health risk numbers for men and women Low Moderate High
Men: Low: 0.95 or below Moderate: 0.96 - 1 High: 1 + Women: Low: 0.8 or below Moderate: 0.81-0.85 High: 0.85+
51
Bristol stool chart: what types/numbers should clients be aiming for. Describe the ideal stool
type 3-5 Mostly submerged,medium brown, no obvious undigested remnants (corn/seeds OK)
52
Bristol stool chart. What is type 1 and 2 associated with What is type 5 associated with
Type 1 and 2: constipation Type 5: vegetarian/vegan diets
53
What do the following types of stool indicate: Floating Sinking Thin Dry
Floating: fats are not emulsified properly by bile. Excess intake of fat. Insufficient bile Sinking: heavy with decaying matter or non-used minerals Thin: Tension - IBS Dry: poor fibre, low water intake, slow transit time, hypothyroid, stress
54
What is constipation defined as what is the idea number of bowel movements per day What might cause infrequency of bowel movements
passing stools less than three times per week. Straining or passing hard pellet like stools on more than a quarter of occasions. Ideally 1-3 bowel movements per day. Caused by low fibre, digestive insufficiency, inadequate water intake, sedentary lifestyle/stress/travel
55
What do the following colour of stools indicate Very pale Green White mucous in stool Very dark brown Orange Black tarry Blood
very pale: insufficient bile production green: toxic matter in bile white mucous in stool: disturbance of microflora, immune response to gluten, lactose, inflammation from ulceration very dark brown: low transit time in colon, hypothyroidism Orange: insufficient bile/lipase Black tarry: red flag - oesophageal / gastric bleed. Could be iron supplementation Blood: red flag - the darker the blood the further it has travelled through the GIT.
56
TCM body clock. Why is 7am to 3pm the best time to eat
when stomach, SI and spleen energy are strongest.
57
What could a loss of the lateral eyebrow indicate
hypothyroidism Copper deficiency
58
what is meant by paronychia and what causes this
Infection or inflammation of the skin next to the nails. Vitamin C def.
59
When. may be a preferable time to test for pH
Before food.
60
What may very pale stools indicate
Lack of bile flow. Gall bladder
61
Explain how a crack/fissure in the middle of the tongue might be interpreted in both TCM and ayurvedic medicine
Weakness of the digestive tract
62
Describe three characteristics of the perfect stool
Neither floats nor sinks, sits just below the water Light brown in colour Easy to pass No signs of undigested material
63
If your client regularly awakes between 1-3am, which organ might you consider supporting
Liver
64
Explain how the pupil might give you an insight into the status of an individual's autonomic nervous system
If the pupil is dilated it indicates that the sympathetic nervous system is activated. If not dilated then parasympathetic

Nutrition 1 semester 2 (11 decks)

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