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197 Cards in this Set
- Front
- Back
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Q. Which gender is affected more in AUTO-IMMUNE HEPATITIS?
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WOMEN
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Q. What are the best 2 test for AUTO-IMMUNE HEPATITIS?
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1. Anti-Smooth Muscle ASMA
2. Anti-LIVER-KIDNEY MICroSOMAL ANTIBODY |
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Q. What OVERLAP SYNDrOME should ALWAYS be TESTED for in AUTO-IMMUNE HEPATITIS?
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CELIACS
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Q. In FULMINANT HEPATITIS what must they stop the consumption of?
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ALCoHOL
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Q. What is a good OIL to ingest with FULMINANT HEPATITIS?
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COCONUT OIL
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Q. What 2 nutrients are important for FULMINANt HEPATITIS?
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1. SELENIUM
2. LAURICIDIN |
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Q. IMPORTANT: What is a great triple combination formula for FULMINANT HEP, Hep C & B?
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Silybum Marianum, ALA, and SELENIUM
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Q. What is the Dr. Patrick BOTANICAL FORMULA?
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TAT=Tumeric, Artichoke, Taraxacum
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Q. What are the two beneficial bacteria found in the gut?
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1. LACTOBACILLI
2. BIFIDOBACTERIA |
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Q. What are 2 Health BENEFITS of beneficial bacteria?
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1. SYNTHESIS of SCFAs
2. Prevention of candida in hyphae form penetrating through gut lining into cellsinflammatory symptoms. |
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Q. Imbalance of GUT FLORA can cause what 3 problems?
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1. PRODUCE CACINOGENS
2. Loss of IMMUNE FUNCTION 3. INCREASED LEAKY GUT |
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Q. Imbalnce in GUT FLORA is CAUSED BY WHAT 2 things?
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1. ANTI-BIOTICS
2. OTC Meds: NSAIDS |
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Q. **What are 3 INDICATIONS for PROBIOTIC USE?
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1. DURING/POST ANTI-BIOTIC THERAPY
2. CHRONIC GI DISEASE 3. LONG TERM BENEFITS in HEALTHY PEOPLE |
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Q. What is the most common GI bacteria in INFANTS?
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BIFIDOBACTERIUM
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Q. What is the daily DOSE of PROBIOTICS?
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20-25 BILLION/Day
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Q. What is the BEST TREATMENT for C.Diff 100% of the time?
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MICROBIOTA TRANSPLANTATION
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Q. What disease is commonly ASSOCIATED with C. DIFF?
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AUTISM
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Q. What 3 diseases are COMMONLY ASSOCIATED with KLEBSIELLA?
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1. Ankylosing Spondylitis
2. Ulcerative Colitis 3. Hashimotos Thyroiditis |
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Q. What disease is associated with ENTEROVIRUS?
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TYPE 1 DM
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Q. NAME THE DISEASE: If a patient presents with small and large bowel secreting electrolytes and water, instead of absorbing them?
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ENTERITIS
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Q. Which population with ENTERITIS should come to the DOCTOR?
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1. INFANTS and YOUNG CHILDREN
2. ELDERLY |
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Q. Which COMPLICATION is usually seen with ENTERITIS?
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POST-INFECTION REACTIVE ARTHRITIS
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Q. If the patient has symptoms which are GRADUAL, FEVER, SEVER ABDOMINAL PAIN, NV, FECAL LEUKOCYTES, and CHRONIC presentation which type of diarrhea do they have?
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INFLAMMATORY
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Q. When should you perform a stool culture?
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CHRONIC PROBLEMS with DIarrhea
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Q. SIGNS of SEVERE DEHYDRATION can occur how quickly in INFANTS?
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WITHIN HOURS
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Q. What are 2 Signs of GRAVE CONCERN in DIARRHEA?
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1. SIGNS of SEVERE DEHYDRATION
2. DIARRHEA PERSISTS MORE THAN FOUR DAYS |
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Q. Which VIRUS is the LEADING CAUSE OF DIARRHEA in INFANTS and CHILDREN?
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GROUP A ROTAVIRUS
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Q. What type of SHIGELLA is the most common?
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GROUP B
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Q. What are the symptoms of SHIGELLA?
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REITERS SYNDROME POST INfectious ARTHRITIS
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Q. What are 3 risk FACTORS for SALMONELLA?
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1. POULTRY
2. EGGS 3. DAIRY |
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Q. What are TRANSMISSION ROUTES of CAMPYLOBACTER JEJUNI?
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RAW PULTRY/ BIRDS
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Q. PPIs TRIPLE the RISK of what BACTERIAL INFECTION?
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C-DIFFICILE
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What are 2 other RISK FACTORS for developing C.DIFF?
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1. ANTI-BIOTICS
2. HOSPITALIZATION |
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Q. What TREATMENT do we NEVER USE with C.DIFF PATIENTS?
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ANTI-DIARRHEALS
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Q. What are 3 MD Treatments for C.DIFF?
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1. MetroNIDAZOLE
2. VANCOMYCIN 3. RIBAXIMIN |
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Q. What treatment does DR. MORSTEIN think is the BEST for C.DIFF?
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FECAL MICROBIOTA TRANSPLANT
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Q. Name the disease: Acute PROFUSE WATERY Diarrhea, UP to ONE LITER per HOUR; DEHYDRATION. TREAT: WATER & ELECTROLYTES?
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CHOLERA
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Q. What TYPE of BACILIUS CEREUS occurs 6-15 hours after consumption, and persist for 24 HOUrS?
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TYPE D
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Q. Clostridium Botulinum is a MEDICAL EMERGENCY? T or F
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TRUE
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Q. Which 4 types of CLOSTRIDIUM BOTULINUM cause HUMAN BOTULISM?
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A, B, E, & F
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Q. Which ROUTE is CLOSTRIDIUM BOTULINUM MOST COMMONLY TRANSFERRED INTO HUMANS?
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DUST & DIRT
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Q. What should patientis AVOID with INFANT CLOSTRIDIUM BotuLINUM?
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CORN SYRUP, HONEY, SWEETNERS
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Q. What are 2 TREATMENTS for CLOSTRIDIUM BOTULINUM?
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1. HUMAN BOT IMMUNE GLOBULIN (BABYBIG)
2. PREVENTION: COOK FOODS at 250 F for 3 Min |
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Q. How MANY seperate STOOLS must WE SEE in ORDER TO RULE OUT GASTROINTESTINAL PARASITES?
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3 SEPARATE STOOLS
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Q. What is the COMMON PRESENTATION of Gastro PARASITES?
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FROTHY DIARRHEA
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Q. What is the treatment for GASTRO PARASITES?
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ALINIA 500mg
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Q. What is the TREATMENT for CrYPtOSPORIDIM PARVUM?
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ALINIA
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Q. Which population is AFFECTED the MOST with CRYPTOSPORIDIUM PARVUM?
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HIV/AIDS Patients
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Q. What is the most COMMON INTESTINAL WORM INFECTION?
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ASCARIS LUMBRICOIDES (ROUNDWORM)
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Q. What is ASCARIS LUMBRICOIDES due to?
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POOR HYGIENE, POOR SANITATION
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Q. What region of the COUNTRY are TAPEWORMS FOUND?
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SOUTHERN US STATES
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Q. How do we treat TAPEWORMS?
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PRAZIQUANTEL
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Q. What is the MOST COMMON WORM IN THE US?
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PINWORM
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Q. How do we diagnose PINWORMS?
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TAPETEST: SEEING THE EGGS on THE TAPE removed from the ANUS is DIAGNOSTIC
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Q. Treatment for PINWORMS?
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MEBENDAZOLE, Wash bedding, towels, etc. CUT NAILS, DONT SCRATCH.
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Q. How long before repeating the test for PINWORMS?
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2 weeks
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Q. What is the best LIQUID treatment for VIRAL or BActeriahial DIARRHEA?
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PEDIALYTE (SODIUM, POTASSIUM, CHLORIDE)
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Q. What is the best FOOD treatment for VIRAL or BActeriahial DIARRHEA?
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BRAT Diet: BANANNA, RICE, APPLESAUCE, TOAST
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Q. Which OIL is very effective in treatment for VIRAL or BActeriahial DIARRHEA?
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OREGANO OIL
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Q. Dr. USES DRUGS FOR PARASITES? T or F
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TRUE
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Q. **NAME THE DISEASE: Patient presents with BRAIN FOG, GASSY BLOATING, Hx of ANTIBIOTIC USE, WATER WEIGHT, FATIGUE, **MUSCLE SORENESS, ENVIRONMENTAL SENS?
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SYSTEMIC CANDIADISIS
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Q. In regard to Systemic Candiadisis, out of 100 PATIENTS how MANY WILL HAVE A KILL OFF REACTION? How to treat them?
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5
ACTIVATED CHARCOAL |
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Q. What are the 3 phases to ND treatment for SYSTEMIC CANDIADISIS?
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1. ANTI-FUNGAL DIET
2. PROBIOTICS 3. ANTI-FUNGAL PRODUCTS |
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Q. What are good ANTI-FUNGAL MEDICINES?
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MYCOSTAT
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Q. What are the 4 Naturopathic test we use to diagnose gut issues?
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1. Food Allergy Test
2. Comprehensive Digestive Stool Analysis 3. Metametrix GI Panel 4. Gluten Sensitivity Antibody Tests |
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Q. What is one strong risk factor for developing food allergies?
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GMO FOods
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Q. Which ANTI-BODIES in the gut act as barriers, preventing the uptake of food antigens?
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IgA
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Q. What is the half life of a Type I food allergy?
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2-3 days
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Q. What TYPE of food allergy do NDs look for?
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Type 3
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Q. What is the half life of a TYPe 3 food allergy reaction?
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20 days
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Q. What are 2 ways we test for food allergies?
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1. Elisa: Patients Serum is Used
2. Elimination Challenge |
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Q. If the patient has more then 15-20 foods they are allergic to, what does it indicate?
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LEAKY GUT
(1-5 DOES NOT INDICATE LEAKY GUT) |
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Q. If patient has auto-immunity what 3 test must we test for?
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1. Vitamin D
2. Heavy Metals 3. Celiac Panel |
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Q. How long does it generally take to heal a leaky gut?
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2-12 Months
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Q. What are 3 treatments to heal up gut lining?
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1. GLUTAMINE (GI BENEFITS)
2. DIGESTIVE ENZYMES 3. PROBIOTICS |
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Q. Which patients should we be careful with when using GLUTAMINE?
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PEDS PATIENTS UNDER 3yo
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Q. Name the disease: Anorexia and periumbilical pain followed by nausea, RLQ pain, vomiting AFTER THE PAIN.
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Appendicitis
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Q. What is the general cause of appendicitis?
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Fecolith obstructs lumen of appendix
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Q. What percentage of people have appendix at McBurneys point?
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4%
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Q. T or F: On physical exam patients will have Rebound tenderness, pain on percussion, rigidity, and guarding?
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TRUE
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Q. What do the scores represent in the analysis of appendicitis?
Score 0-3? Score >7? Score 4-6? |
Score 0-3=Discharge Home
Score >7=Refer for surgical consult Score 4-6=CT Scan |
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Q. What is the best diagnostic tool in appendicitis?
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CT Scan
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Q. What can be a complication of appendicitis?
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DEATH due to PERITONITIS
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Q. What is the cause of intestinal malabsorption?
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CELIAC/ IBD
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Q. Name the disease: diarrhea, weight loss, signs/symptoms of nutrient deficiencies, fatigue, weakness?
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MALABSORPTION
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Q. How do we test for lactose intolerance 2 ways?
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1. Hydrogen Breath Test
2. Elimination/ CHallenge |
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Q. What is an important differential diagnosis when evaluating lactose intolerance?
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FRUCTOSE INTOLERANCE
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Q. What is the treatment for lactose intolerance?
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AVOID LACTOSE
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Q. In a patient with INHERITED AUTO-IMMUNE celiacs disease, which antigen is present?
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HLA-DQ2 and DQ8
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Q. Which part of the intestine is affected in CELIACS DISEASE?
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PROXIMAL SMALL INTESTINE, ESPECIALLY TH JEJUNUM
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Q. Which yeast breaks down gluten?
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MOTHERS
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Q. If a patient has Positive/negative serology, positive genes, no mucosal damage, what TYPE of CELIACS DISEASE do they have?
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LATENT
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Q. What is an IMPORTANT SYMPTOM in CELIACS DISEASE?
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Highly SYMMETRIC EXTREMELY itchy DERMATITIS HERPETIFORMIS
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Q. What are 2 other important auto-immune diseases associated with CELIACS DISEASE?
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1. HASHIMOTOS/ GRAVES
2. DM 1 |
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Q. T or F: Consider CELIAC for LIVER PROBLEMS?
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TRUE
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Q. How LONG should a patient be eating gluten in order to diagnose CELIACS
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3 WEEKS
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Q. What is the GOLD STANDARD for diagnosing CELIACS DISEASE?
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DUODENAL BIOPSY
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Q. What percentage of the population have GLUTEN sensitivity but NOT CELIACS?
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10%
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Q. T or F: MOST patient have GLUTEN insensitivity and NOT CELIACS?
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TRUE
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Q. Name the disease: gradual or sudden obstruction of the vascular supply in the intestines?
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Intestinal Ishemia
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Q. What is the most important diagnostic TEST for Intestinal Ischemia?
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ARTERIOGRAPHY
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Q. What is the ND Treatment for Intestinal Ischemia?
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STRICT DIET CHANGE-RAW FOOD, VEGGIE JUICE, FASTING
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Q. Benign MASSES are more FREQUENT than MALIGNANT ONES in Small Intestine Cancer? T or F
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TRUE
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Q. Which disease is associated with Adenocarcinoma Small Intestine Cancer?
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Crohns
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Q. Name the disease: FATIGUE, WEIGHT LOSS, pain, bleeding, palpable abdominal mass
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Small Intestine Cancer
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Q. NAme the disease: Appears in “skip lesions” that jump from spot to spot?
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CHRONS
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Q. What are 2 important associations you must make when dealing with Crohns?
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1. PATHOGENS in GUT
2. ENVIRONMENTAL INFLUENCES |
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Q. What are 2 risk factors which puts you at the highest risk for Crohns?
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1. Genetic Mutation: COMPOUND HETEROZYGOUS=29-44x
2. NOT BREAST FED |
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Q. IMPORTANT: What part of the GI is mostly affected by Crohns?
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Terminal Ileum and ASCENDING colon 40%
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Q. What part of Crohns disease will we see wasting and pain?
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Abdominal abscess and/or fistula—late problem
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Q. Is the diarrhea BLOODY in Crohns?
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NO
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Q. In a patient with COLOGASTRIC FISTULAS what 4 symptoms might we see?
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1. Feculent vomiting, 2. enterovesical fistula (recurrent UTI), 3. enterovaginal fistula (fecal vaginal discharge), 4. enterocutaneous fistulae (fecal soiling of skin).
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Q. What is the perianal complication of Crohns?
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ANAL Fissures
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Q. What muskuloskeletal effects will you see with Crohns? What skin effects will you see with Crohns? What oral effects will you see with Crohns?
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1. Arthritis & Arthralgia
2. Erythema Nodosum 3. Apthous Stomatitis |
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Q. IMPORTANT: What is a common nutrient deficiency in Crohns, and why?
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B Vitamins. Due to obstruction of the terminal Illium
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Q. What DDX is usually considered in the ACUTE PRESENTATION of Crohns?
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APPENDICITIS
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Q. In what disease is BLEEDING more common with Stool?
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Ulcerative Colitis
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Q. What is the diagnostic test for Crohns?
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ASCA
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Q. What pathogen do we look for in the STOOL of Crohns patients?
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C. DIFFICILE TOXIN
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Q. We REFER if patients have Crohns? T or F
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TRUE
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Q. What are 3 major complications of Crohns?
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1. FIBROSTENOSING STRICTURES & ADHESIONS
2. FISSURES/ FISTULAS 3. ABSCESSES |
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Q. When does the drug SULFASALAZINE work best for Crohns?
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When Crohns IS IN COLON(LARGE INTESTINE) and is in CHRONIC stage
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Q. When is it best to use Immunomodulators (REMICADE to DMARDS) for Crohns?
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When disease is in colon and when corticosteroids do NOT work
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Q. What is the best treatment when the patient has obstructions in Crohns?
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SURGERY
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Q. What is the leading cause of mortality in Crohns Patients?
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GI TRACT CANCER
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Q. What is the cause of Small Intestine Bacterial Overgrowth?
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Commensural and Opportunistic bacteria
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Q. What is SIBO due to?
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Due to Migrating Motor Complex deficiency
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Q. What is the BIG Symptoms that will lead you to SIBO Dx?
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BLOATING/ ABDOMINAL GAS, BURPING, FLATUS
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Q. What treatment will temporarily make GUT symptoms BETTER with SIBO?
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ANTIBIOTICS
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Q. What would make GUT symptoms WORSE?
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PROBIOTICS containing PREBIOTICS
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Q. If a patient has constipation, belching, retrograde motility, what type of GAS are you suspecting with SIBO?
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METHANE
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Q. If a patient has Diarrhea, and cramping, what type of GAS are you suspecting with SIBO?
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HYDROGEN
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Q. What test MUST be done with SIBO?
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BREATH TEST
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Q. If gas is >35, will need more than one treatment dose to eradicate gas? T or F
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TRUE
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Q. What is the BEST DIET for SIBO patients?
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Specific CHO Diet. Patients generally feel BEtTER in 1-2 DAYS
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Q. Should ANTIBIOTICS be GIVEN CONCURENTLY when treating SIBO with a ELEMENTAL DIET?
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NO
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Q. Which ANTIBIOTIC REGIMINE should be USED for SIBO
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DOUBLE ANTI-BIOTICS: RIFAXIMIN & METRONIDAZOLE
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Q. What did Dr. S LEWIS use for SIBO?
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KLAIRE LACTOPRIME BID
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Q. What is the treatment for SMALL BOWEL SYNDROME?
|
VERY HIGH SUPPLEMENT DOSING
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Q. What are complications of SMALL BOWEL SYNDROME?
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NUTRIENT DEFICIENCY PROBLEMS SYSTEMICALLY
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Q. Name the disease: Altered bowel habits
Constipation—skipped days; small, hard stools; Diarrhea, abdominal distention? |
IBS
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Q. Patient have had recurrent abdominal pain/discomfort at least 3 days per month during the past 3 months, and experienced at least two of the below: name the type of diagnosis, MUCORRHEA?
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ROME 3 diagnosis for IBS
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Q. ME must be assesed for in patients with IBS? T or F
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TRUE
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Q. What 2 drugs can lead to IBS?
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1. METFORMIN
2. NSAIDS |
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Q. What drugs are given to IBS patients?
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Bulk Forming Laxatives
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Q. IMPORTANT: ALTERNATIVE TEST for IBS?
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CANDIDA QUESTIONAIRE
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Q. IMPORTANT: What is the KEY TREATMENT in IBS?
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PROBIOTICS
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Q. What IMMUNOGLOBULIN WILL be ELEVATED in IBS PATIENTS?
|
IgG4
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Q. What diagnostic test is used in IBS patients?
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PANCREATIC ELASTASE STOOL 1 Test
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Q. What is a good supplement for ME aspect in IBS?
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MOTICALM PURE ENCAP SUPP
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Q. Name the Disease: Incidence begins at 40 y/o though 90% occurs after 50 y/o, peaking between 60-75 y/o. Passed along genetically in autosomal dominant manner, thus each child has 50% chance of having the defect?
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COLON CANCER
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Q. What part of the GI in COLON CANCER is effected more commonly in WOMEN?
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COLON
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What part of the GI in COLON CANCER is effected more commonly in MEN?
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RECTUM
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Q. What is the etiological factor for colon cancer?
|
Familial adenomatous polyposis
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Q. What type of diet leads to COLON CANCER?
|
HIGH MEAT DIET
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Q. What nutrient is shown to increase occurence of colon cancer?
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FOLIC ACID FORTIFICATION
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Q. IMPORTANT: If the Colon CANCER presents in the RIGHT COLON what will you see first?
|
ANEMIA
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Q. IMPORTANT: If the Colon CANCER presents in the LEFT COLON what will you see first?
|
CANCER TENDS TO CONSTRICT BOWEL
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Q. What is the best test for COLON CANCER?
|
INSURE FECAL IMMUNOCHEMISTRY TEST
89% Sensitivity |
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Q. Q. How often should CT Colonography be performed in Colon Cancer according to ACG GUIDELINES?
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EVERY 5 YEARS FROM age 40, or 10 YEARS before EARLIEST DIAGNOSIS
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Q. What do 70% of ascites patients have?
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CHRONIC LIVER DISEASE
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Q. What are 2 characteristics seen in the PATHOGENSIS of ASCITES?
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1. Cirrhosis
2. Protein-losing enteropathy |
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Q. What is a sign of ASCITES?
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POSITIVE FLUID WAVE TEST
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Q. What is the diagnosis of ASCITES?
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Diagnostic Paracentesis
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Q. IMPORTANT: NAME THE DISEASE: PAINLESS RECTAL BLEEDING, >50% of symptom onset occurs in children less than **2 y/o. GENETIC ABNORMALITY?
|
Meckle’s Diverticulum
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Q. DO we REFER for MECKLES DIVERTICULUM?
|
YES (CALL 911)
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Q. What form of PERITONITIS does this patient have? Powder from SURGICAL GLOVES, CHEMICAL IRRITANT, PERFORATED STOMACH
|
SECONDARY PERITONITIS
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Q. How do we treat PERITONITIS?
|
MEDICAL EMERGENCY
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Q. IMPORTANT: NAME THE DISEASE: AUTO-IMMUNE DISEASE. peak rates of occurrence are 15-30 y/o and also 50-70 y/o?
|
ULCERATIVE COLITIS
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Q. Disease limited to rectum—is most common and most benign form of the disease. NAME THE DISEASE?
|
ULCERATIVE PROCTITIS
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Q. What is a TREATMENT which has been used in UC Patients?
|
NICOTINE PATCHES
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Q. If the patient has FULMINANT DISEASE of UC what are their symptoms?
|
More than 10 BM a Day
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Q. Name 2 Significant Symptoms of UC?
|
1. GRADUAL ONSET
2. BLOODY DIAHREA |
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Q. What is the GOLD standard to Diagnose UC?
|
COLONOSCOPY
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Q. What is the Naturopathic TREATMENT for UC?
|
FECAL MICROBIOTA IMPLANTS: 10 days is a key for IMPROVEMENT
AVOID RAW FOOD |
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Q. What should be given in HIGH DOSE for UC?
|
PROBIOTICS
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Q. NAME THE DISEASE: LLQ ABDOMINAL PAIN WORST w/ EATING, BETTER DEFECATION/ FLATULENCE, NO FEVER ?
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DIVERTICULOSIS
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Q. Does the patient need to AVOID nuts/ seeds/ popcorn/ veggies?
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NO
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Q. What are 4 ND treatments for DIVERTICULOSIS?
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1. SLIPPERY ELM GRUEL
2. ROBERTS FORMULA 3. BCQ-Anti-Inflammatory 4. BioVegetarian |
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Q. What are 3 common causes of Hemorrhoids?
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1. CONSTIPATION
2. LIVER CONGESTION 3. PREGNANCY |
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Q. What are the signs and symptoms of Hemorrhoids?
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Pain, ITCHING, IRRATATION of the ANUS
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Q. What is the diagnostic test for Hemorrhoids?
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ANUSCOPE
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Q. What is a good Natural RECIPE for BOWEL movement in PATIENTS with Hemorrhoids?
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1 cup Wheat Bran, 1 Cup Apple Sauce 1/4 cup PRUNE JUICE
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Q. What is the ND TREATMENT FOR Hemorrhoids?
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RUTIN & B6
LIVER HERBS |
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Q. What is the Kesey Treatment Used FOR?
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Using negative galvanic machine to desiccate hemorrhoids, both internal and external.
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Q. IMPORTANT: NAME THE DISEASE: PAIN with DEFICATION, feels like STOOL is MADE OF GLASS?
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ANAL FISSURE
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Q. What is the MD Treatment for ANAL FISSURE?
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STOOL SOFTENER and HIGH FIBER DIET
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Q. WHat is the ND TREATMENT FOR ANAL FISSURE?
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HERBAL ED SALVE APPLIED TO ANUS
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Q. NAME THE DISEASE: GAS, bloating, COATED TONGUE, BAD BREATH (toxemia). TRANSIT TIME SHOWS DELAYED EMPTYING?
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CONSTIPATION
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Q. What are 2 COMMON causes of Constipation?
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1. ABUSE LAXATIVES
2. IGNORING THE URGE to HAVE A BOWEL MOVEMENT |
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Q. What is a LUBRICATING agent for CONSTIPATION?
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DOCUSATE SODIUM/calcium
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Q. What is the HYPEROSMOTIC AGENT for CONSTIPATION?
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1. MIRALAX is #1 Recommended
2. MILK OF MAGNESIA |
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Q. What is the STIMULANT LAXATIVE for CONSTIPATION?
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SENNA, CASCARA, BISACODYL
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Q. What is a good FOOD NDs use for CONSTIPATION?
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YAM/ SWEET POTATO
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Q. What type of herbs do we want to focus on in COnstipation?
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LIver Herbs
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Q. What are 2 common causes of PRURITIS ANI (Itchy BUTT)?
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1. Micro-Organisms: FUNGI, STREP INFECTION, BACTERIAL
2. PARASITES: PINWORMS |
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Q. What is a ND treatment for PRURITIS ANI?
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COCONUT OIL TOPICALLY
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