strain-counterstrain
Which of the following conditions are often amenable to strain-counterstrain therapy?
a. Febrile seizures
b. Irritable bowel symptoms
c. Headaches
d. Only B and C
e. All of the above
答え: d だと思う….
Which of the following statements about strain-counterstrain technique of Osteopathic manipulation is/are true?
a: Counterstrain manipulation can often resolve Travell’s myofascial “trigger points” and can provide resolution of long-lasting symptoms
b: For patients with chronic abdominal pain, treatment of trigger points in the external abdominal oblique and the rectus abdominus can often provide significant relief
c: The technique relies upon the passive shortening of muscles, ligaments, or tendons in order to “turn off” the inappropriate firing of nerves
d: Only B and C
e: All of the above
答えe
Infertility
Lisa is a 34 year old woman who is facing infertility issues. Her workup did not identify any medical causes for the infertility, and prior to pursing other methods of conception, she is coming to see you for advice. Based upon published evidence, you might recommend:
a. Daily douches with chasteberry.
b. Kagel exercises
c. Infertility support group with relaxation training
d. Only A and Ｃ
e. All of the above
答えe.
Chasteberry…. vitex, ニンジンボク、モンク胡椒。0.5-1gの実を１日三回。プロラクチンの活性を阻害し、ドパミン様作用を有すると考えられている。
（佐藤製薬でも サトウチェストツリーとして製品あり。）
b は 骨盤低筋群のエクササイズ。尿失禁の治療に用いられる。
A 58-year old post menopausal healthy and active woman has recently been diagnosed with osteopenia (T-score -1.5). The only medication she takes is levothyroxine and her TSH has remained steady between 1.5 and 2.0 for years. She takes a daily multi-vitamin (see level ). She does not eat any dairy products because of a milk protein allergy. What recommendations would you make for her?
a. Add calcium citrate 600mg BID, taken separately from her thyroid medication
b. Purchase a multivitamin that contains no more than 2500 IU preformed vitamin A and no iron.
c. Check serum 25(OH)D level and increase vitamin D dose accordingly.
d. Only A and C
e. All of the above
答: e.
ちなみに、bは正しい。
- アメリカにおける、男性および閉経期後の女性は8mg、閉経期前の女性は18mg、妊婦27mg、許容上限は45mg。問題内のサプリの内容量は15ｍｇ。女性は58歳なので閉経を迎えている。従って、このサプリの鉄分は取りすぎ
- ビタミンＡ、一日摂取量の目安 135μｇ（450ＩＵ）〜600μｇ（2000ＩＵ）。このサプリは10,000 IUなので、明らかに取りすぎ。
Which of the following statements is/are TRUE regarding carbohydrates and inflammation?
a. Chronic low grade systemic inflammation is now considered a primary culprit(原因） in the pathogenesis of many chronic conditions, such as cardiovascular disease
b. Studies have shown that a high dietary glycemic load is associated with elevations in high sensitivity CRP
c. Substituting whole grains for refined grains and eating a low glycemic diet does not reduce inflammation and or insulin resistance
d. A and B
e. All of the above
答え：d
A 21-year old college student has been diagnosed with irritable bowel syndrome and is interested in using a holistic approach. Her IBS is considered to be of the mixed type, having periods of constipation and occasional diarrhea. Which of the following has/have evidence of benefit in IBS?
a. Soluble fiber
b. Peppermint oil capsules
c. Garcinia mangostana
d. Only A and B
e All of the above
答え: d. Study guideより:
IBS – Be familiar with the role of supplements (enteric coated peppermint oil, soluble fiber) and mind-body approaches.
The Diabetes Prevention Program clinical trial compared the incidence of metabolic syndrome in a high risk population following 3 interventions: metformin therapy, intensive lifestyle modifications, or placebo. Which of the following was true of this landmark study?
a. Interventions that prevent diabetes will also reduce the development of the metabolic syndrome
b. The subjects in the lifestyle modifications group had a lower incidence of metabolic syndrome than those in the metformin group
c. Metabolic syndrome is defined by measures of waist circumference, serum triglyceride and HDL levels, blood pressure, and fasting plasma glucose levels.
d. Both A and C
e. All of the above
答え:e
DPP study : DM リスク減少 – 58％ ライフスタイル> 31％ メトフォルミン
Which of the following is/are true regarding acupuncture and cancer?
a. It is contraindicated in patients with neutropenia (<500/mm3)
b. Acupuncture may be helpful in reducing cancer related symptoms such as fatigue and hot flashes
c. The NIH recognized that acupuncture is efficacious for chemotherapy- induced nausea
d. Both A and C
e. All of the above
Which of the following statements is/are TRUE regarding glutamine?
a: Glutamine may be useful in preventing chemotherapy-induced neuropathy
b: It is given as a 10 gram dose three times daily
c: Glutamine is an amino acid abundant in muscle tissue
d: Both A and C
e: All of the above
答えe
Diabetes
Which of the following is/are true statements about diet and supplements commonly promoted for diabetes?
a: Alpha lipoic acid has been shown to improve the symptoms of diabetic neuropathy
b: Prickley pear is commonly used for diabetes by indigenous peoples of the desert Southwest
c: Chromium picolinate has only been shown to be effective in type 1 diabetes
d: Only A and B are true
e: All of the above are true
答え d
Which of the following statements about magnesium is/are TRUE?
a: Most Americans have excessive magnesium in their diet, making supplementation unnecessary.
b: Magnesium status has been shown to have an impact on the development of insulin resistance and type II diabetes
c: High dose magnesium supplements must be used cautiously in patients with renal failure
d: B and C
e: All of the above
答え e
マグネシウムがインスリン耐性の予防に効果がある
Licorice root has been used in conventional medicine and Traditional Chinese Medicine for many years. Which statements is/are true regarding its use?
a: Prolonged use of licorice can lead to hypertension and hypokalemia
b: Licorice is thought to inhibit corticosteroid degradation
c: It is contraindicated in patients with Cushings Syndrome
d: Both A and C
e: All of the above
答え e
甘草は弱いながら糖質コルチコイド作用をもっている(つまり作用がダブる)
低カリウム血症、高血圧
糖質コルチコイドが持つ鉱質コルチコイド作用によってナトリウムの再吸収が亢進し、逆にカリウム利尿が亢進して低カリウム血症が起こるため。
クッシング症候群
ACTH産性腫瘍。グルココルチコイドの過剰放出。下垂体性はクッシング病という
Which of the following is/are antioxidants?
a: N-acetylcysteine
b: Selenium
c: Vitamin E
d: Both A and C
e: All of the above
答え e
Echinacea is a popular herb for colds and flu and is also used by many people to “boost” their immune system. Which of the following statements is/are true about this indigenous North American plant?
a: Echinacea can cause allergic reactions in some individuals, especially those with atopy
b: Cold prevention and treatment trials are mixed, though, some preparations appear superior to placebo
c: Only the flowers have been shown to be of therapeutic benefit
d: Only A and B
e: All of the above
答え d : c は、免疫力アップは根っこ
Which of the following has been demonstrated to significantly lower systolic blood pressure in published studies?
a: Magnesium
b: Retinyl palmitate or retinyl acetate
c: DASH diet
d: Both A and C
e: All of the above
答え d
b – Retinyl palmitate is a synthetic alternate for retinyl acetate in vitamin A supplements, and is available in oily or dry forms.
Which of the following botanicals has bronchodilator activity?
a: Ma Huang(麻黄)
b: Echinacea
c: Gymnema
d: Both A and C
e: All of the above
答え ａ
麻黄はeffedorin 作用あり
Which of the following herbs has/have been shown in some clinical trials to be beneficial for the treatment of acute back pain?
a: Glucosamine
b: Devil’s claw
c: Willow
d: Only B and C
e: All of the above
腰痛とグルコサミンの関連性….はっきりわからない
http://apital.asahi.com/article/kiku/2013071600008.html
Devil’s claw 抗炎症作用があり。腰痛に、きくようだ
http://umm.edu/health/medical/altmed/herb/devils-claw
togomed 