Sample Paper 3 Flashcards
(15 cards)
- Define what is meant by commensal and pathobiont (2 marks)
- Commensal — microbes that live in harmony with the host (us) and provide a benefit to us. (1 mark)
Pathobiont — microbes that live with us and normally don’t pose a problem unless there is clear
opportunity. (1 mark)
- Name and explain TWO supply routes of how drugs are distributed (2 marks)
- (0.5 marks each for 2 routes and 0.5 each for explanation, max 2 marks)
Prescription only (POM) — supplied only under direction of qualified healthcare professional e.g.,
doctor’s prescription.
Controlled medicines — special group of medicines that require extra controls e.g., codeine, morphine.
Pharmacy only (PO) — sold by a registered pharmacy.
General sales list (GSL) — can be sold via a number of outlets including supermarkets.
- List FOUR anti microbials that can be used to help alleviate SIBO (2 marks)
- (0.5 marks per antimicrobial, max 2 marks) Berberine (or barberry bark and goldenseal, e.g., as a
tincture) — inhibits protein synthesis of bacteria; blocks TLR4 pathway.
Oregano oil (affects bacterial cell membrane permeability).
Allicin (extract of garlic) — mostly just for methane-producing bacteria.
Neem. Also, uva ursi and cinnamon.
- Describe TWO mechanistic reasons for prescribing B5 to a client who is
experiencing high levels of stress. What dose would be suitable? (3 marks)
- (1 mark each for any two of the following: 1 mark for dosage)
* As a precursor to coenzyme A plays an essential role in adrenal cortex function. * Increases
production of glucocorticoids and other adrenal hormones. * Thought to reduce secretion of cortisol in
times of stress.
Dosage: 100- 300 mg / day
- Name TWO clinical signs/symptoms of low pregnenolone (2marks)
- (1 mark each for any 2 of the following) Poor memory; declining concentration and attention; fatigue; dry
skin; joint and muscle pain; decreased libido.
- Kamala is presenting with typical signs of Anorexia Nervosa. What would your
priorities be when working with this client? (2 marks)
- (1 mark each for any 2 of the following) * Feeding the brain is a priority. * Building a rapport and gaining
trust. * Communicate appropriate nutrition messages. * Help to redefine the relationship with food. *
Place emphasis on nutrients and health, and not kcal and weight. * Correct nutritional deficiencies.
- List the FOUR bases contained within a nucleotide (2 marks)
- (0.5 marks each, 2 marks) A (adenine), C (cytosine), T (thymine), G (guanine)
- List TWO internal applications and TWO external applications of how herbal
medicines can be used (2 marks)
- (0.5 per point, max 2 marks)
Internal applications: ‒ Infusions, decoctions, syrups, tinctures, glycerites, powders, capsules,
lozenges, standardised extracts.
External applications: – Oils, creams, lotions, ointments, poultices, compresses.
(Any TWO – 0.5 each)
- What inflammatory blood markers would you expect to see raised in a client
presenting with Thyroiditis? (1 mark)
- Raised ESR and CRP (0.5 marks each)
10.Name THREE key contributing factors to both sleep onset and maintenance
insomnia (3 marks)
- (1 mark each for any 3 of the following, max 3 marks) Serotonin levels, blood sugar regulation and
cortisol. Sleep onset: anxiety, stimulants (e.g., caffeine), climate, fears, pain. * Sleep maintenance:
hypoglycaemia, sleep apnoea, medications, alcoholism, depression, restless leg syndrome. * High
stress (cortisol) can impact both.
11.Jane has been extremely gassy, list TWO bacteria that are associated with the
production of gas (2 marks)
- Methanobrevibacter smithii — associated with methane gas production. (1 mark)
Desulfovibrio spp. and Bilophila wadsworthia — associated with hydrogen sulphide gas. (1 mark)
12.In order to reduce the impact of first pass hepatic metabolism, suggest an alternative
administration route for a medicine to be administered. Provide ONE drug example
(2 marks)
- Spray - nitro glycerine (GTN) - spray for angina (2 marks)
- Discuss in detail FIVE supplements you might recommend for a client to support
mitochondrial function. Include in your answer your rationale and dosage for each
nutrient (15 marks)
Q1. (1 mark per point, max 3 marks per nutrient)
Coenzyme Q10 Dosage: 100–300 mg / day (solubilised) * Transports high energy electrons in the ETC
supporting mitochondrial function and energy production. * Deficiency reduces ATP production and
increases electron loss causing increased oxidative damage and fatigue. * Production of ROS, which can
damage cellular lipids, proteins and DNA, is a direct consequence of the ET process. * CoQ10 is an
efficient intra-mitochondrial antioxidant, playing a vital role in neutralising ROS. * Ability to produce CoQ10
strongly correlates with longevity.
Alpha lipoic acid (ALA) Dosage: 300–600 mg / day. * Is a co-factor for several mitochondrial enzymes
involved in glucose oxidation and ATP generation. * As an antioxidant, protects mitochondrial structures.
Acetyl L carnitine. Dosage: 500–2000 mg / day. * Essential for the transport of long chain fatty acids
across the mitochondrial membrane for subsequent β-oxidation and generation of ATP. * Increases
mitochondrial oxidative phosphorylation, thereby increasing ATP production and reducing mtROS.
Magnesium (as citrate or malate). Dosage:200 ‒400 mg / day. * Plays a fundamental role in energy
production where it transfers phosphate groups between ADP and ATP. * Magnesium insufficiency or
deficiency can result in a symptom picture reflective of chronic fatigue syndrome. * Malic acid is a Krebs
cycle cofactor, so magnesium malate may be better, and is researched to improve fibromyalgia.
B complex vitamins High dose combination. * B1 is needed in the Krebs cycle. B2 (energy carriers FAD,
FMN) and B3 (coenzymes NAD and NADP). Required for Krebs cycle and for conversion of fatty acids to
ATP. * Possibly consider even higher even dose B2/B3 — 100mg+
- Lukas has been struggling with his respiratory system since having a chest infection
last month and would like to take some supporting herbs. Discuss the key
constituents, actions and uses, cautions, and any other salient information relating to
the therapeutic application of thyme, cinnamon and sage (15 marks)
Q2. (1 mark per point, max 5 marks per herb)
Thyme (Thymus vulgaris): * Part used: Leaves, flowers. * Energetics: Warm. * Key constituents: Volatile
oils (thymol, carvacrol). * Actions and uses: Expectorant, antispasmodic, diaphoretic, anti-microbial
(bacterial, fungal, viral — shown to ↑ bacterial cell membrane permeability), anti-inflammatory (inhibits NFκB, Il-1 and Il-6); colds, sore throat, acute and chronic bronchitis / coughs, asthma; sore throat; oral and GI
dysbiosis, dyspepsia. * Intake: 3–12 g / day dried herb (infusion); a gargle or mouthwash. * Safety: As an
infusion is recognised as safe.
Cinnamon (Cinnamomum zeylanicum): * Part used: Inner bark. * Energetics: Warm / hot, dry. * Key
constituents: Volatile oil (4%), tannins. Actions and uses: Warming diaphoretic, antiseptic, carminative,
blood sugar regulating; weak digestion, nausea, poor circulation, Raynaud’s, diabetes mellitus (increases
insulin receptor sensitivity), H. pylori (inhibits urease — combine with liquorice), parasites, high cholesterol
(reduces TGs and LDL), low mood. * Intake: 1–2 tsps. daily (added to food or decoct cinnamon quills). *
Safety: Caution with anti-diabetic drugs (additive effect).
Sage (Salvia officinalis): * Part used: Leaves. * Energetics: Warm. * Key constituents: Volatile oil (inc.
thujone). * Actions and uses: Anti-spasmodic, antimicrobial, anti-cancer (antiproliferative, angiogenic), antihyperhydrotic, antioxidant; gingivitis; respiratory infections e.g., tonsillitis; ↑ cognition (↓ breakdown of
acetylcholine) — Alzheimer’s; menopausal sweats/flushes (cold tea). * Intake: 3–12 g / day dried leaf
(infusion); in mouthwash. * Safety: Therapeutic amounts contraindicated in pregnancy and lactation except
to ↓ milk flow. Long-term use is cautioned (thujone).
- Your client presents with gut dysbiosis and has recently been diagnosed with Type 2
diabetes. What are some of the signs and symptoms, and complications could arise
if their diabetes isn’t managed properly? Discuss the role of the gut microbiome in
Type 2 Diabetes, and what you expect to see on their stool test in terms of
microbiome patterns (15 marks)
Q3. Signs and symptoms – 5 marks (1 marks per correct point)
* Polyuria (increased urination).
* Polydipsia (excess thirst).
* Polyphagia (excess hunger).
* Extreme fatigue. Blurry vision.
* Poor wound healing.
* Recurrent infections.
* Acanthosis nigricans.
Complications – 4 marks (1 mark per correct point)
* Acute: Hyperosmolar hyperglycaemia.
* Macrovascular: Cardiovascular disease, hypertension, stroke. Elevated homocysteine.
* Microvascular: Retinopathy, neuropathy (peripheral, autonomic), nephropathy.
* Depression, periodontal disease. Alzheimer’s disease
Microbiome and T2DM – 3 marks (1 mark per correct point correctly explained)
