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Functional Med University > Module 1 > Flashcards

Module 1 Flashcards

To understand the basics of functional medicine and an overview of how it works including the diagnostic assessment, testing, and treatment

1
Q

What are Leukocytes

A

White blood cells

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2
Q

How are Leukocytes divided

A

Into 2 groups: Granulocytes and Non-Granulocytes

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3
Q

What are the 3 types of Granulocytes

A

Polymorthphonuclear neutrophils, Eosinophils, Basophils

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4
Q

What are 2 types of Non-Granulocytes

A

Lymphocytes, Monocytes

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5
Q

What is the function of a WBC

A

To fight infection, react against foreign bodies, defend body by phagocytosis

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6
Q

Clinical significance of Increased WBC

A

Childhood disease, acute viral or bacterial infection, Intestinal parasites, some cancers, infectious mononucleosis, adrenal dsyfuncntion

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7
Q

Clinical Significant of Decreased WBC

A

chronic viral or bacterial infection, autoimmune disorder, systemic lupus erythematosus, hepatitis, vitamin B12, B6, folic acid anemia, intestinal parasites, RA

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8
Q

Red Blood Count means?

A

RBC is carrier of O2 by reason of hemoglobin it contains from lungs to body tissue and transfer of CO2 from tissue to lung

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9
Q

Clinical Significance of Increased red blood count

A

Polycythemia, respiratory distress( asthma/emphysema)

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10
Q

Clinical Significance of decreased red blood count

A

Iron anemia, vitamin B12, B6 or folic acid anemia, liver and renal dysfunction, some cancers

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11
Q

What is hemoglobin

A

HGB is major component of RBC: functions in transport of CO2

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12
Q

Clinical significance of Increased levels of hemoglobin

A

Dehydration, Emphysema, Asthma, Polycythemia

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13
Q

Clinical significance of decreased levels of hemoglobin

A

Iron deficiency
Microscopic internal bleeding
Digestive inflammation

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14
Q

What is Hematocrit

A

packed cell volume % of total volume occupied by RBC

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15
Q

Clinical significance of increased Hematocrit

A

Dehydration
EMphysema
Asthma
Polycythemia

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16
Q

Clinical Significance of decreased Hematocrit

A

Iron deficiency anemia
Microscopic Internal Bleeding
Digestive inflammation

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17
Q

What is MCV

A

MCV indicates volume in cubic microns of average single RBC
Increases along with decrease in MCH. Should always be viewed together. If problem suspected confirm with serum or urinary methylmalonic acid and homocysteine

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18
Q

Clinical significance of increased MCV

A

Vitamin B12/folic acid anemia

Dehydration

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19
Q

Clinical significance of decreased MCV

A

iron anemia

microscopic internal bleeding

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20
Q

What is MCH

A

indicates weight of hemoglobin in single RBC. Increases or decreases in response to increase/decrease of MCV

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21
Q

Clinical significance of increased MCH

A

vitamin B12/ folic acid anemia

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22
Q

Clinical significance of decreased MCH

A

iron anemia
internal bleeding
toxic effects of lead, aluminum, cadmium- other metals
Vitamin B6 anemia

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23
Q

What is MCHC

A

indicates average hemologic concentration per unit of RBC

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24
Q

Clinical significance of increased MCHC

A

Vitamin B12/ folic acid anemia

Dehydration

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25
Q

Clinical significance of decreased MCHC

A

Internal bleeding
Toxic effects of lead, aluminum and other metals
Vitamin B6 anemia

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26
Q

What is RDW

A

electronic mesasurement of anisocytosis( red cell availability)

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27
Q

Increased RDW means

A

iron deficiency anemia or B12 folate anemia

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28
Q

What are platelets

A

involved with clotting of blood coagulation and with retraction of clots

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29
Q

Increased platelets mean

A 
RA
Arteriosclerosis
Some cancer
Inflammatory Arthritis
Several Anemia
Polycythemia
slight increase in pregnancy
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30
Q

Decreased platelets mean

A

Idiopathic Thrombocytopenia
Blood loss
Thrombocytopenia

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31
Q

What are neutrophils

A

job is phagocytosis

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32
Q

Increased neutrophils mean

A

chronic viral and bacterial infection

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33
Q

Decreased neutrophils mean

A

active viral and chronic infection

Leukemia

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34
Q

What are Monocytes and function.

A

Cells that Phagocytize bacteria and matter and protozoa. They remain after neutrophils phagocytize and are responsible for clean up

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35
Q

Increased Monocytes mean

A

viral infections

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36
Q

4 important considerations with monocytes

A
  1. always rule out liver dysfunction with increased monocytes
  2. Increased monocytes indicate excessive tissue breakdown
  3. increased in monocytes, basophil and eosinophils mean respect intestinal parasites
  4. percentage will increase with decrease of lymphocytes percentage in hodgekins disease and other forms of cancer
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37
Q

Eosinophils- what are they and function

A

WBC that have role in detox and breakdown and removal of protein

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38
Q

Increase eosinophils mean

A

intestinal parasites
Food and environmental allergy/sensitivities
Asthma
Emphysema

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39
Q

Decreased eosinophils mean

A

count at or below 1% is uncommon and present adrenal cortical hyper function and should be ruled out

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40
Q

Basophils- what are they and function

A

WBC that during inflammation deliver heparin to inflamed tissue to prevent clotting; therefore basophils will almost be increased with tissue inflammation. Basophils contain histamine and serotonin.

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41
Q

Basophil increase mean

A

Tissue inflammation
Intestinal parasites
Polycythemia

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42
Q

Decreased Basophil mean

A

acute allergic reactions

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43
Q

What is included in Comprehensive Metabolic Panel

A

AST, ALT, ALP, Total Bilirubin, Total Protein, Albumin, Total Globulin, AG/Ratio, Glucose, BUN, Creatine, Bun/Creatine ratio, Calcium, Sodium, Potassium, Chloride, CO/2,

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44
Q

What is AST

A

Aspartate Amino Transferase: enzyme found in high concentration in kidney, pancreas, heart, liver, skeleton, and muscles. Does not increase as much as ALT in liver dysfunction.

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45
Q

AST increase mean

A

heart disease
liver disease
CHF
Acute pancreatitis

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46
Q

AST decrease mean

A

Vitamin B6 anemia

Renal Disease

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47
Q

ALT what is it

A

Alanine Amino transferase: used to detect hepatocellular disease

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48
Q

ALT increase mean

A

Cirrhosis of liver
Acute and chronic liver necrosis
Hepatitis/Monoucleosis
Epstein Barr Virus and city megalovirus

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49
Q

Decreased ALT mean

A

Vitamin B6 anemia

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50
Q

What is ALP

A

Alkaline Phosphatase- member of zinc metalloprotein enzyme that functions to split off a terminal phosphate- located in liver, bone, kidney and placenta

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51
Q

ALP increase mean

A

Healing Fracture
Liver Cancer
Cirrhosis
Pagets disease of the bone

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52
Q

ALP decrease mean

A

Biliary Dysfunction
Zinc Deficiency
Vitamin C insufficiency

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53
Q

What is total Bilirubin

A

breakdown of hemoglobin by spleen, liver, kupffer cells, and bone marrow

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54
Q

How is bilirubin classified

A

3 ways:

  1. ) total- combination of indirect and direct
  2. ) Direct- post hepatic, water soluble, conjugated
  3. ) Indirect- pre-hepatic, non-water soluble and unconjugated
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55
Q

Bilirubin increase mean conjugated

A

gallstones- biliary obstruction

Extrahepatic duct obstruction

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56
Q

Bilirubin increased unconjugated mean

A

Gilver syndrome- congenital enzyme deficiency interrupting conjegation of bilirubin
Hepatitis
Cirrhosis

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57
Q

Bilirubin decree mean

A

non-signficant

58
Q

What is the Total Protein

A

Combination of albumin and total globulin

59
Q

Increased total protein mean

A

Digestive Dysfunction

Dehydration

60
Q

Decreased total protein mean

A

Protein malabsorption/Amino acid need

Gastritis, Leaky Gut, Colitis, ileitis, Chron’s, IBS

61
Q

What is albumin

A

produced almost entirely in the liver- responsible for 80% colloid-osmotic pressure between blood and tissue fluids and serves as transport protein for many substances

62
Q

Albumin increased means?

A

Dehydration

63
Q

Albumin decreased means

A

Liver biliary dysfunction
Neoplasm
Protein malnutrition/ amino acid need

64
Q

What is Total Globulin

A

Combination of alpha, 1, 2 and gamma beta fractions. Most labs calculate a combination of the serum total globulin by subtracting serum albumin from total serum protein.

65
Q

Increased Total Globulin means

A

Hypochlorhydria
Liver dysfunction
neoplasm

66
Q

Decreased Total Globulin means

A

Digestive dysfunction( primary inflammation or secondary inflammation to HCL deficiency

67
Q

What is the AG/Ratio?

A

Value of A/G ratio is limited because of countless amount of variables in the components of alpha, 1, 2, beta and gamma. An abnormal A/G is called a suppressed, low or reversed ration- reflection of hepatic dysfunction

68
Q

Clinical significance of increased A/G ratio

A

not signficiant

69
Q

Clinical significance of decreased A/G ratio

A 
Liver Biliary dysfunction
Chronic Renal Disease
Some types of Cancer
Sarcoidosis
Collagen Disease
Severe Inflammation
Burns
Digestive Inflammation
70
Q

What is Glucose test

A

a sugar that is measure via blood test- levels influenced by carb intake, stress, granular and liver function

71
Q

clinical sig of increased glucose( fasting)

A

Acute stress response
Diabetes
Thiamine deficiency
Dysinsulinsim

72
Q

Decreased glucose fasting

A

Fasting hypoglycemia
Severe Liver Disease
Hypothyroidism

73
Q

What is BUN

A

reflects the difference and clearance of Urea

74
Q

Increased BUN means

A 
Chronic Renal Dysfunction
Renal Hypertension
Prescribed diuretics
Dehydration
Cirrhosis of the liver
Benign prostrate hypertrophy
Urinary Obstruction
75
Q

Decreased BUN means

A

Liver failure
Protein malnutrition
Celiac

76
Q

What is Creatine Testing

A

used to diagnose renal function. It is a waster product formed from spontaneous decomposition of creatine- which is required in muscle- those with higher muscle mass may have higher creatine

77
Q

Increased levels of creatine mean

A

Chronic Renal dysfunction

Benign prostate hypertrophy

78
Q

Decreased levels of creatine mean

A

Serum creatine is normal decreased in children, patients with less muscle mass and geriatric patients with muscle wasting
muscle wasting

79
Q

What is the BUN/Creatine Ratio

A

Useful when assessing patients with chronic renal dysfunction- has the potential to be skewed

80
Q

Clinical Significance of Increased BUN/Creatinine Ratio

A 
CHF
Intestinal Bleeding
Shock
Hypotension
Dehydration
Renal Disease
81
Q

Clinical Significance of Decreased BUN/Creatine Ratio

A

Low protein diets

Malnutrition

82
Q

what is Calcium

A

absorbed from upper part of small intestine- dependent on acidity of intestine and amount of phosphate- relates to bone metabolism

83
Q

Increased Calcium

A

Parathyroid Hyperfunction
Cancer
Hypervitaminosis D

84
Q

Decreased Calcium means

A 
Parathyroid Hypofunction
Digestive Dysfunction( Hypochlordria)
Low normal total protein
Vitamin D Deficiency
Protein Malnutrition
Osteoporosis
Pancreatitis
85
Q

Sodium- what is it

A

most abundant cation in the extra-cellular fluid- most important in osmotic regulation of fluid balance, acid-base balance, renal, cardiac, and adrenal function

86
Q

Increased Sodium means

A

Chronic Renal Dysfunction
Dehydration
Adrenal Cortical Hypofunction

87
Q

Decreased Sodium means

A

Adrenal Cortical hypofunction

Diarrhea

88
Q

What is Potassium

A

major cation found in the intracellular fluid- essential for maintenance of pH and osmotic pressure

89
Q

Increased Potassium means

A

Adrenal Cortical hypofunction

Renal Dysfunction

90
Q

Decreased Potassium means

A

Diarrhea
Adrenal Cortical hyperfunction
Drug Diuretics

91
Q

Chloride what is it?

A

Principle anion found in the serum. Chloride almond with Sodium, potassium and CO2 are important in acid-base relationships and show state of hydration, renal and adrenal function. usually varies inversely to CO2 function.

92
Q

Increased Chloride mean

A

renal dysfunction

Dehydration

93
Q

Decreased Chloride mean

A

Hypochlorhydria

94
Q

CO2- what is it

A

amount of base bound as bicarbonate in blood that is available for neurtralization of fixed acids such as lactic acid HCL. CO2 refers to base bound and not total base of blood.

95
Q

Clinical significance of increased CO2

A

Metabolic Alkalosis

Vomiting

96
Q

Decreased CO2 means

A

Thiamine Deficiency- anion gap is generally increased
Diabetes
Metabolic Acidosis

97
Q

Lipids: Cholesterol what is it?

A

a steroid normally found in all body cells and plasm. Information relative to increased/decreased cholesterol can be extrapolated to triglycerides.
Generally increased in endocrine or organ hypo function and decreased in endocrine and organ hyperfunction

98
Q

Cholesterol increased means

A

Coronary artery disease
diabetes
Primary thyroid hypofunction or hyperfunction secondary to anterior pituitary hypofunction

99
Q

Cholesterol decreased means

A 
Thyroid hyperfunction/or anterior pituitary hyperfunction
Cancer
Chrons
Cirrhosis of liver
Celiac
Malnutrition
100
Q

Triglycerides what are they

A

serum TG family of complex lipids-saturated and unsaturated. Soluble in blood and composed of 95% fat in adipose tissue. Travel in blood with cholesterol and need to be drawn together and viewed together.

101
Q

Increased Triglycerides mean

A

Dysinulinism( metabolic syndrom)

Hypothryoidism

102
Q

Decreased Tryiglycerides mean

A 
Hyperthoridism
Vegetairan diets
Autoimmune phenomenon 
Genetic Predisposition
Cirrhosis of liver
Celiac Disease
103
Q

What is HDL

A

High Density lipoprotein Cholesterol- class of heterogeneous particles of varying density and size containing lipid and protein. Includes triglycerides, phospholipids, cholesterol and apoprotein- predominatly phospholipids. Functions to transfer cholesterol to the liver for metabolism of bile acids. Must be viewed in relation to cholesterol and LDL/HDL

104
Q

Increased HDL mean

A

possibly consider autoimmune pathology

105
Q

Decreased HDL means

A

thyroid hyperfunction
Diabetes
Dysinsulinsim( metabolic syndrom)

106
Q

LDL what is it?

A

Low Density Lipoprotein Cholesterol- association between LDL and HDL. Generally, as LDL increases HDL decreases. Most cases LDL is major part of decision relative to beginning dietary therapy and supplemental support.

107
Q

Hs-CRP what is it?

A

C-reactive protein- acute phase reactant protein found in liver. Rises rapidly and nonspecifically in response to tissue inflammation and injury CRP is more sensitive than ESR in detecting inflammation. CRP is excellent test in monitoring efficacy of prescriptions/supplemental therapies.

108
Q

Increased CRP means

A

Viral and bacterial infections
Non-specific tissue inflammation
coronary artery inflammation
RA

109
Q

Iron panel- Iron what is it

A

measures iron in blood- need to order serum iron and serum ferritin- without both serum amount converted to hemoglobin is unknown

110
Q

Increased iron mean

A

Hemochromatosis

Hepatic dysfunction

111
Q

Decreased iron means

A 
Chronic blood loss
Iron deficiency anemia
Menses
Cancer
Hepatic dysfunction
Chron's disease
112
Q

TIBC what is it

A

Total Iron Binding Capacity- Transferrin is responsible for 50-70% of the iron binding capacity of the serum

113
Q

Increased TIBC means

A

iron anemia

114
Q

Decreased TIBC means

A

Inflammatory disease

115
Q

Ferritin- what is it?

A

second most abundant iron-bearing protein in the body. Functions as iron storage in the liver, spleen and bone marrow.

116
Q

What 3 factors determine levels of ferritin

A

iron content of body tissue
rate of ferritin dispersal from the tissues
rate of ferritin extraction from blood

117
Q

Increased ferritin means

A 
Iron overload- hemochromatosis 
Inflammatory disease
Hepatitis
HIV infection
Cancer
118
Q

Decreased ferritin means

A

Iron deficiency anemia

119
Q

TSH- what is it

A

Thyroid Stimulating Hormone- originally used to confirm or rule primarily hypofunction and now recognizes hyperfunction

120
Q

Increased TSH means

A

Primary thyroid hypofunction
liver dysfunction
HIV

121
Q

Decreased TSH means

A

Thyroid Hyperfunction secondary to anterior pituitary hypofunction

122
Q

What is T4

A

T4 is major hormone secreted by thyroid. transported bound to Thyroxine Binding Globulin( TBG), prealbumin and albumin. Free T4 is small part of TSH but metabolically active

123
Q

What is T3

A

thyroid hormone produced mainly from conversion of T4 to T3. Approx 1/3 of T4 is converted to T3. Higher biological activity than T4 and will bind to TBG less effectively than T4. Both T4 and T3 exist in free and bound form

124
Q

Increased T3 means

A

Primary Hyperthyroidism( graves)

125
Q

Decreased T3 means

A

Hypothyroidism

126
Q

Uric acid what is it

A

principle end product of purine, nucleic acid and nucleoprotein metabolism

127
Q

Increased Uric acid means

A

Gout

RA

128
Q

Decreased Uric Acid means

A

Molybdenum insufficiency

129
Q

GGT what is it

A

Gamma-Glutamyl Transpeptidase- more sensitive and specific indicator of liver dysfunction than serum ALP and in some cases ALT. It is generally increased in all forms of liver/biliary dysfunction and is generally increased above ALT and AST with biliary problems( gall bladder, common bile duct and pancreas) obstructive disease and alcoholism

130
Q

Increased GGT means

A

Biliary obstruction
Alcoholism
Bile duct and gall bladder inflammation/ Biliary Stasis
Acute and chronic pancreatitis and Pancreatic Insufficiency
Increased GGTP with increase of serum ALP indicates liver/biliary problem. Normal GGTP with increased ALP indicates a probably bone issue.

131
Q

Decreased GGT means

A

GGT<10 is commonly associated with vitamin B6 anemia

132
Q

Hemoglobin A1c- what is it

A

Glycated hemoglobin are an irreversible glucose protein bond that extends through life or red blood cell. Glycated hemoglobin used to assess long term glucose control in diabetes- especially insulin dependent

133
Q

Increased Hemoglobin A1c means

A

Diabetes

134
Q

What is Vitamin D 25-Hydroxy

A

Level of Vitamin D in blood

135
Q

Increased Vitamin D mean

A

Vitamin D toxicity- hypercalcemia

136
Q

Decreased Vitamin D mean

A 
Rickets( children) osteomalacia( adult
Osteopororisis
Osteoarthritis
Hypertension
Cardiovascular disease
137
Q

What is phosphorus

A

Parathryoid hormone and functional state of kidneys important in evaluating phosphorus serum levels. Parathryoid hormones responsible for increased serum calcium and phosphorus. Important in physiology of bone and formation of active compounds such as phospholipids, nucleic acids, ATP, creatine phosphate and complexes required for utilitzation of glucose. General indicator of digestive dysfunction.

138
Q

Clinical increase of Phosphorus

A

Parathyroid hypofunction
Acute and chronic renal dysfunction
Sarcoidosis

139
Q

Decreased clinical increase of phosphorus mean

A 
Parathryoid hyperfunction
Digestive dysfunction( Hypochlorhydria)
Vitamin D Deficiency
140
Q

Anion Gap is?

A

calculation from sodium, potassium, chloride and CO2 to determine the unmeasured anions and cations.

141
Q

Increased anion gap means

A 
thiamine deficiency
Diabetes
Lactic acidosis
Dehydration
Toxin ingestion
Metabolic Acidosis
Renal Dysfunction
142
Q

Decreased Anion gap means

A

Renal dysfunction

Lithium toxicity

Functional Med University (7 decks)

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