Tri-9, Wk10 Catch-up, Days R,F, M,T,W,R,F, M - Days 561 to 568

Tri-9:

Week 8

Thur - 10/27, Day 561

Fri - 10/28, Day 562

Week 9

Mon - 10/31, Day 563

Tue - 11/1, Day 564

Wed - 11/2, Day 565

Thur - 11/3, Day 566

Fri - 11/4, Day 567

Week 10

Mon - 11/7, Day 568

There is a lot to say, if I were so inclined but, for now I'm looking over what needs to be done this week for my classes. Tomorrow is Clinical Nutrition and Clinical Psychology - 2 hours of each.

Clinical Nutrition - Week 10 - Covering nutritional and dietary management of functional endocrine disorders, metabolic syndrome and carbohydrate handling w/ the following reading assignments;

Female Complaints

1. Cervical Dysplasia - pgs 152-160
2. Fibrocystic Breast Disease - 249-254
3. Menopause - 476-491
4. Menorrhagia - 492-501
5. Nausea & Vomiting of pregnancy (perhaps that should say "due to" instead of "of") - 533-537
6. Pelvic Inflammatory disease - 605-617
7. Premenstrual Syndrome - 650-663
8. Hormonal Balancing with nutrition - haven't found yet

Male Complaints

1. Benign prostatic hyperplasia (BPH) - 112-118

BHP - One of the more interesting parts of the BPH reading was self learning Rx abbreviations. The abbreviations are from Latin and are as follows

• q.d. = quaque die = once a day
• b.i.d. = bis in die = twice a day
• t.i.d. = ter in die = three times a day
• q.i.d. = qaurter in die = four times a day
• p.o. = per os = by mouth - I remembered this one from pharmacology class
• gt = gutta = drop - this one I ran across last night when studying a specific type of psoriatic arthritis called Guttate Psoriasis where the skin produces small, red & scaly teardrop-shaped spots.

Cervical Dysplasia - more acronyms... the ones below refer to possible results from an abnormal Pap smear.

• ASC = atypial squamous cells
• ASC-US = ASC with "Uncertain significance" (some of your cervical cells are abnormal but, we don't really know why)
• ASC-H = ASC with possible HSIL which, begs the question, what's HSIL stand for...
• HSIL or HGSIL = high-grade squamous intraepithelial lesion. high-grade means the cells are very different
• AGC = atypical glandular cells. Glandular cells are cells that produce mucus and are located in the cervix or uterus. Again, this means that some of the glandular cells are not normal and we don't really know why.
• LSIL or LGSIL = low-grade squamous intraepithelial lesions. Here, low-grade means early changes in the size and shape of the cells.

Fibrocystic Breast Disease -

• excisional biopsy = removing all or part of abnormal tissue for examination under a miroscope
• needle aspiration biopsy = when a pt sample is removed without preserving histological architecture of the tissue cells.
• fine-needle biopsy = i'm guessing it's similar to the needle aspiration biopsy but with less histological architecture disturbance...

I suppose my focus should be more on the nutritional aspects of these reading assignments since these are for my Clinical Nutrition class. There were some interesting points I highlighted in this chapter. These points are as follows:

- Limiting dietary methylxanthines (coffee, tea, cola, chocolate, caffeinated medicines) improved 97.5% of 45 women who completely abstained and 75% of 28 women who limited consumption

- women having fewer than three bowel movements (BMs) per week have a 4.5-fold greater risk of FBD compared with women having one or more BMs every day.

Menopause - Wow - with regards to things such as hot flashes or any other symptoms ... A study of Mayan Indians showed NONE of those women experiencing any of those symptoms as well as no evidence of osteoporosis despite hormonal patterns identical to postmenopausal women in the United States. Mayan women saw menopause as a positive event, providing acceptance as a respected elder as well as relief from childbearing

As such, we could say the cultural view of menopause is directly related to symptoms of menopause. If the cultural view is negative, symptoms are common; if menopause is viewed in a positive light, symptoms are less frequent.

Menorrhagia - general def - excessive menstrual bleeding (blood loss > 80mL)

this chapter is reminding me of a few things I need to keep straight -

Graves - hyperthyroidism

Hashimoto - hypothyroidism (aka autoimmune thyroiditis)

Cushing's dz - hyperadrenocoricism, too much ACTH (adrenocorticotropic hormone) released by the pituitary

Addison's dz - hypocortisolism or chronic adrenal insufficiency or hypoadrenalism

• DUB - dysfunctional uterine bleeding
• Metrorrhagia - spotting, uterine bleeding at irregular intervals, esp btw expected periods.
• menometrorrhagia - excessive and prolonged uterine bleeding occuring at irregular, frequent intervals.
• polymenorrhea - menstrual periods that are abnormally frequent, say w/ intervals of 21 days or fewer.
• CEE - conjugated equine estrogens

Nausea and Vomiting of Pregnancy (NVP) -

• Hyperemesis gravidarum (HG) = extreme, persistent nausea & vomiting during pregnancy that may lead to dehydration.
• .

This is interesting. HG, postpartum depression and lactation failure are linked to deficiencies of zinc, magnesium, vitamin B6 and essential fatty acids.

Pelvic Inflammatory Disease -

• dyspareunia - painful intercourse (part of dx summary)
• adnexal (L. plural of adnexus) - accessory or adjoining anatomical parts as ovaries and oviducts in relation to the uterus.
• Porphyrias - a buildup of porphrins in the body. porphrins are a heme precursor in the porphyrogenic pathway and porphrins are toxic to tissue in high concentrations.

Premenstrual Syndrome (PMS) -

• PMDD - Premenstrual dysphoric disorder
• Xenoestrogens - environmental estrogens

Dietary Considerations - Guy Abraham, MD, stated that compared with symptom-free women, PMS patients consume:

• 62% more refined carbohydrates
• 275% more refined sugar
• 79% more dairy products
• 78% more sodium
• 53% less iron
• 77% less manganese

Primary Causes of Premenstrual Syndrome -

• estrogen excess
• progesterone deficiency
• elevated prolactin levels
• hypothyroidism
• stress, endogenous opioid deficiency and adrenal dysfunction
• depression
• nutritional abnormalities
• macronutrient disturbances or exesses
• micronutrient deficiency

Physiologic Effects of an Increased Estrogen to Progesterone Ratio

• impaired liver function
• reduced manufacture of serotonin
• decreased action of vitamin B6
• increased aldosterone secretion
• increased prolactin secretion.

Hormonal balancing with nutrition -

Hmmm - it's after 3 a.m. and I just finished the reading assignments for Clinical Nutrition ...almost to the point where I'd be better off just staying awake and knocking out the psych reading...