MATERIA MEDICA & THERAPEUTICS (CMH2028) WRITTEN EXAMINATION 2003/2004 (model answers)

MIDDLESEX UNIVERSITY

EXAMINATION PAPER

2013/2014

WBS4762

CLINICAL HERBAL MEDICINE (WESTERN HERBAL MEDICINE)

MODULE TUTOR: COLIN NICHOLLS

Time allowed: 2 hours

Total number of questions:6

Instructions to candidates:ANSWER ALL QUESTIONS. Ensure that you write your student number in the space provided below and on the answer booklet provided.

Write in the answer booklet provided.Total possible marks for each question are indicated in bold type

Total marks for this paper = 100

Exam weighting: 50% of total marks for module

Total number of pages

Student ID number

No books, paper or electronic devices are permitted to be brought into the examination room other than those specified aboveCandidates are warned that illegible scripts will not be marked

SECTION A Multiple-choice questions

Please note:

1.a. Extracts of Andrographis paniculata have been reported to inhibit the production of the following proteins in experimental research: interleukin-1 (IL-1), tumour necrosis factor-alpha (TNF-) and nuclear factor-kappaB (NF-B). Provide a possible explanation for these findings with references to the medicinal properties of A. paniculata. In your answer, explain the role of IL-1, TNF- and NF-B in specific human pathologic conditions. [8 marks]

b. Diterpenoids isolated from Andrographis paniculata have been shown to inhibit COX-2 in vitro. Explain how these findings could relate to the traditional use of A. paniculata. [2 marks]

(10 marks)________________________________________________________________

2.a. Identify three prebiotics accepted in the scientific literature as possessing all the three distinguishing properties of a prebiotic. In addition briefly explain their structural composition. [1.5 marks]

b. Explain the main functions of prebiotics. [3 marks].

c. Some medicinal plants with antioxidant effects contain high concentrations of vitamins C and E. Explain why is significant. In your answer explain the structure of one reactive species and the function of the above mentioned antioxidants. [5.5 marks]

(10 marks)__________________________________________________________________

3.Explain what you understand by the Bowel Flora Protocol. Describe in detail the main principles of the protocol (i.e. the actions required to address the various aspects of GIT imbalance), how you would implement these principles using herbal medicines, and the kinds of pathology that might benefit from such intervention (explain why). Also, explain the role of the liver in the screening and biotransformation of antigens present as a result of gut dysbiosis/'leaky gut', and discuss herbs that are known to have an influence on these processes.

(20 marks)

4.A young woman of 27 presents with bronchitis following a bout of influenza, with fever, hacking cough, expectoration of thick green mucus, a frontal and occipital headache, tonsils slightly enlarged, and pain in the ears and throat. A course of antibiotics has not improved her condition. Her previous medical history includes: sinusitis (4 years ago), alleviated by avoiding dairy food; pleurisy (2 years ago); and bronchitis three or four times in recent winters when run down (treated by antibiotics). She is sensitive to certain foods, especially bread (which causes bloating) and cheese (headaches). Fatty foods give her nausea, and she also feels drunk after small amounts of alcohol; she has loose motions, with stools that are often yellowish. Recently she has experienced some pre-menstrual tension and bloating. Her diet is generally good (vegetarian + fish).

Describe what kind of treatment plan you would draw up for this patient, paying attention to symptomatic treatment, drainage of emunctories, correction of autonomic imbalances, and (briefly) diet. Give a detailed explanation of your choices. Your plan should include at least one separate aromatic formula in your prescription.

(20 marks)

5.Outline the considerations that would influence your treatment with phytotherapy of a patient with a thyroid disorder, whether hyper- or hypo. Consider important causative factors, including hormonal and immunological influences, state the main aims of treatment and the way you would fulfil these aims using phytotherapy, and include a discussion of the key herbs known to affect thyroid function, and their mechanism of action.

(20 marks)6.A man of 50 comes to see you following a check-up with his GP. His blood pressure is 170/100, total cholesterol 6.9 mmol/l, HDL 0.95 mmol/l (giving a ratio of 7.3), and his triglycerides are raised. He is overweight, with a large belly; his family has a history of cardiovascular disease and diabetes. He wishes to try herbal and dietary strategies in order to avoid, if possible, taking the hypolipidaemic and antihypertensive drugs proposed by his doctor. Discuss in detail the various pathophysiological factors involved in the development of cardiovascular disease (for example, haemodynamic factors...), and how you would propose to address these using phytotherapy. Finally, outline a programme for this patient to reduce his cardiovascular risk factors: focus on the herbal actions required, but also say briefly what dietary and lifestyle advice you would give. (20 marks)