Nutrition Therapy

Module Learning Outcomes (NB: these are not the
assignment questions)
1. Discuss advantages and disadvantages of laboratory, and physical assessment tools used in
clinical practice.
2. Interpret laboratory, and physical assessment results in relation to reference ranges.
Assignment Questions
Please refer to the separate NTQ for Barry and Appendix 1 Case History
In the light of Barry’s weight loss, compare skin fold analysis and bioelectrical impedance as
methods of body composition analysis and evaluate which method would be most appropriate to
use in clinical practice to track Barry going forward. Please refer to appropriate research papers in
your answer. 25% 400 words
Provide an overview of Barry’s case using the information given and gained from the formative
tasks, including an overall interpretation of his blood test results. Include a discussion of his
potential ATMs and differential diagnosis of what might be causing his symptoms. 50% 800 words
Provide rationale for and evaluation of one laboratory test which you might suggest for Barry, to
enhance the clinical picture. (Expected themes in your evaluation would include test description,
validity (including sensitivity and specificity), clinical utility, cost v’s benefit, client experience, pre
or post analytical factors, ease of access etc.) 25% 400 words
Please note: You are not required to submit the work you do for the case work up tasks.
Case Work Up Tasks
To facilitate the development of your skills in evaluating and interpreting test results in relation to a
client case, you will need to work through the given case history. This can be done in groups, with a
partner or you can work on your own. You should not submit the case work-up however the quality
of your answers to the assignment questions are likely to demonstrate the effort given to completing
these tasks. There is much to be gained from working in groups (or with a partner) from the case
discussion that will arise.
Task 1 Carefully read the NTQ and case details
Note down what you think might be key pieces of information as you read through. Think about
ATMs as you are reading through.
Task 2 Red flags
Although the client has seen a general practitioner (test results given) you still need to be aware of
potential red flags. Use the BANT Red Flag Guide and the words printed in italics on the body scan of
the NTQ as your main guides to red flags.
Briefly note how potential red flags in this case might relate to the symptoms in the case.
Task 3 Functional Medicine Timeline
Plot the FxMed timeline. Compare your timeline with your partner’s or others in your group.
Task 4 Functional Medicine (FxMed) Matrix
Plot the case onto the FxMed matrix. Compare your matrix with your partner’s or others in your
group. They will all be different – this is normal but will generate discussion.
Task 5 Skin fold analysis v’s bioelectrical impedance
Research these two methods. What questions do you need to ask to compare and evaluate them?
What does the research say about accuracy and reliability? How do they compare to gold standard
methods? What are the advantages and disadvantages of each method in clinical practice? What is
the client experience of each method? What is the clinical utility of the results they give? Use this
evaluation to reach your own conclusion and to help you to answer question 1.
Task 6 Research the laboratory (blood tests) given in the case
Consider the questions you need to ask when evaluating these tests and Barry’s results? It might help
you to construct an evaluation framework/grid to collate your findings. Once you have considered
the tests individually, consider how some might link to provide a clearer overall interpretation. This
will feed into your case overview in question 2.
Task 7 Research other laboratory tests
a. Use your FxMed Timeline and Matrix to identify possible underlying causes for Barry’s symptoms.
Doing this will help you to identify potential additional tests/screens/clinical questions that may
or may not confirm your hypothesis, and inform your management of the case.
b. Collate information about proposed additional tests, including cost.
c. Determine which test has the best clinical utility (i.e. will give you the most clinically useful
information).