Chronic Disease Intervention (Exam 2)

Front 1

Myocardial Infarction

Back 1

-tissue necrosis
-end stage of CAD

Front 2

Consequences of MI

Back 2

-pump failure
-decreased CO
-irritable myocardial cells that produce arrhythmias
-sudden death

Front 3

Symptoms of MI

Back 3

-angina pectoris
-nausea
-faintness
-feeling of impending doom

Front 4

Diagnosis of MI

Back 4

-EKG shows changes in ST interval
-coronary angiogram
-high cardiac enzymes

Front 5

Treatment for MI

Back 5

-thrombolytic therapy
-coronary artery stent
-revascularization
-nitrates
-morphine

Front 6

Complications from MI

Back 6

-arrhythmias
-ventricular aneurysm
-emboli development
-heart failure

Front 7

Ventricular Aneurysm

Back 7

-MI of ventricular myocardium that causes a weakness and bulge of the ventricular wall

Front 8

Valvular Heart Disease

Back 8

-decreases CO
-treated by replacing valves

Front 9

Congestive Heart Failure

Back 9

-end stage of heart disease
-usually left ventricular failure 1st
-caused by increased work load, hypertension, or myocardial dysfunction

Front 10

Left Ventricular Failure

Back 10

-increase in pulmonary venous pressure
-leads to alveolar edema

Front 11

Right Ventricular Failure

Back 11

-increase in central venous pressure
-leads to edema in dependent areas (feet, ankles, legs)

Front 12

Risks for CHF

Back 12

-CAD
-hypertension
-arrhythmias
-alcohol or drug abuse

Front 13

Symptoms of RVF

Back 13

-jugular vein distension
-attention/memory comprised
-nocturia
-cold and sweaty skin

Front 14

Symptoms of LVF

Back 14

-SOB
-dyspnea
-weight gain from water
-fatigue

Front 15

Diagnosis of CHF

Back 15

-auscultation to hear for a rapid HR or crackling breathing
-x-ray for pulmonary edema or cardiomegaly

Front 16

Precipitating Causes of CHF

Back 16

-acute MI
-high sodium diet
-anxiety
-non-compliance with diet or meds

Front 17

Management of CHF

Back 17

-sitting upright
-ventilatory support
-low sodium diet
-weighing everyday
-lower blood pressure

Front 18

Treatment of CHF

Back 18

-diuretics
-nitrates
-antihypertensives
-treat underlying cause

Front 19

Hypertension

Back 19

-140/90
Essential - no known cause, possibly genetics
Secondary - caused by a specific defect like renal disease
-asymptomatic

Front 20

Treatment for Hypertension

Back 20

1st - diuretics, antihypertensives
2nd- nitrates
3rd - lose weight, exercise and diet adjustment

Front 21

Factors influencing airway resistance

Back 21

-high lung volume
-intraluminal material
-muscle tone

Front 22

Oxyhemoglobin Dissociation Curve

Back 22

-sigmoidal curve
-partial pressure of oxygen just needs to be 60, for hemoglobin to be at normal saturation

Front 23

Left Shift of the Curve

Back 23

-high pH, low temp, low pCO2
-more oxygen can bind than normal

Front 24

Right Shift of the Curve

Back 24

-low pH, high temp, high pCO2
-less oxygen can bind than normal

Front 25

Sources of Shunt

Back 25

-congenital heart defects
-pulmonary arteriovenous anastomosis
-perfusion with no ventilation

Front 26

Vital Capacity

Back 26

-maximum inspiration plus maximum expiration

Front 27

Expiration Reserve Volume

Back 27

-from end of tidal volume to residual volume

Front 28

Inspiratory Reserve Volume

Back 28

-maximal inspiration

Front 29

Forced Expiratory Volume

Back 29

-maximal expiration plus residual

Front 30

Pathophysiology of COPD

Back 30

-increase in mucus production
-impaired clearance of mucus
-lower TLC
-persistent cough

Front 31

2 Types of COPD

Back 31

Chronic Bronchitis - airway disease, most common
Emphysema - breakdown of alveolar structure

Front 32

Risk Factors for COPD

Back 32

-smoking
-environmental exposures (pollutants, dusts, etc.)

Front 33

Main Contributors to COPD

Back 33

-Bronchospasm
-increase in mucus production
-mucosal edema

Front 34

Diagnosis of COPD

Back 34

-Chronic Bronchitis is diagnosed based on history (smoking, previous medical history)
-Emphysema diagnosed on anatomy (wheezing, barrel chest, edema)

Front 35

Pulse Oximetry

Back 35

-non invasive
-shows oxygen saturation (90% is considered normal)
-used during exercise

Front 36

Chest X-Ray with COPD

Back 36

-shows black lungs from air trapping
-shows pulmonary artery enlargement

Front 37

Change in Pulmonary function with COPD

Back 37

-higher TLC, FRC, RV
-lower diffusing capacity

Front 38

Treatment for COPD

Back 38

-stop smoking
-anti-inflammatory steroids
-mucolytic agents
-supplemental oxygen

Front 39

Restrictive Lung Disease

Back 39

-decrease in lung compliance
-inability of the lung to expand as well
-decrease in TLC, VC, FRC

Front 40

Intrinsic RLD

Back 40

-alteration of alveoli
-decrease in lung volume because of high elastic recoil
-higher expiratory flow rate
-arterial hypoxemia

Front 41

Extrinsic RLD

Back 41

-some abnormality outside of the lungs that causes restriction (spine deformity, obesity etc.)

Front 42

Intrinsic RLD Symptoms

Back 42

-dry cough
-progressive dyspnea
-hemoptysis (bloody sputum)
-pleuritic pain (painful bleeding)

Front 43

Extrinsic RLD Symptoms

Back 43

Non-muscular - dyspnea
- decrease in exercise tolerance
Muscular - respiratory weakness
- dyspnea at exertion

Front 44

Physical Diagnosis of RLD

Back 44

Intrinsic -Velcro crackles while breathing
- cyanosis (blueness of nail beds)
-pulmonary hypertension and cor pulmonale
Extrinsic - massive obesity
- abnormal configuration of rib cage

Front 45

Chest X-Ray for Intrinsic RLD

Back 45

-lightness of chest tissue because of density
-decreased rate of diffusion

Front 46

Treatment for RLD

Back 46

Intrinsic - corticosteroids
- anti-inflammatory
- supplemental oxygen
Extrinsic - reverse problem

Front 47

Asthma

Back 47

-high immunoglobulin E
-effects of this are reversible, unlike COPD

Front 48

Inflammatory Response with Asthma

Back 48

-mucosal edema
-epithelial disruption
-white cell infiltration
-bronchospasm

Front 49

Risk Factors for Asthma

Back 49

-indoor allergies
-tobacco smoke
-low birth weight
-occupational exposure

Front 50

Treatment for Asthma

Back 50

-focuses on reduction of bronchospasm
-Beta 2 agonist cause bronchodilation
-mucolytic agents

Front 51

Prevention of Asthma

Back 51

Primary- eliminate smoking, and occupational exposure
Tertiary- return lung to normal function
-exercise tolerance

Front 52

Type I Diabetes

Back 52

-autoimmune disruption of Beta Cells
-can cause diabetic ketoacidosis in children
-genetic predisposition

Front 53

Type II Diabetes

Back 53

-most cases
-overproduce insulin (hyperinsulinemia)
-obesity is characteristic
-women can get this during gestation

Front 54

Patterns with Diabetes

Back 54

-high LDL, low HDL
-low lipase activity
-high platelet adhesion and aggregation

Front 55

Signs of Diabetes

Back 55

I - acute ketoacidosis
II - asymptomatic
Both - fatigue, hyperglycemia, polyuria (urine), polydipsia ( thirst), increased hunger, sores that don't heal, dehydration

Front 56

Fasting Plasma Glucose

Back 56

-fast for 8 hrs., then test
Normal = less than 99
Pre-D = 100-125
Diabetes = more than 125

Front 57

Oral Glucose Tolerance

Back 57

-drink pure glucose after fasting
Normal = less than 139
Pre-D = 140-199
Diabetes = more than 200

Front 58

Random Glucose Test

Back 58

-test without regard to recent meals
Diabetic = more than 200

Front 59

Non-Modifiable Risk Factors

Back 59

-older than 45
- high birth weight

Front 60

Modifiable Risk Factors

Back 60

-high visceral fat
-inactivity
-smoking
-poor glycemic control

Front 61

Microvascular Injury from Diabetes

Back 61

-Retinopathy
-Nephropathy
-Neuropathy

Front 62

Macrovascular Injury from Diabetes

Back 62

-ischemic heart disease
-peripheral vascular disease
-stroke

Front 63

Primary Prevention

Back 63

-decrease
-weight loss
-eat low glycemic index food
-physical activity

Front 64

What is the best way to see long term glucose control?

Back 64

-test hemoglobin A1C

Front 65

Drugs for Diabetes

Back 65

1) stimulate pancreas to increase insulin production
2) improve insulin receptor site sensitivity