Gero Test 2 Dm & Osteo

Front 1

Women who have gestational DM has a _____ chance of developing Type 2 DM

Back 1

50%

Front 2

____ of all DMs are Type 1

Back 2

10%

Front 3

Gestational DM effects 1 in ___ pregnancies worldwide

Back 3

25

Front 4

What are 2 signs of gestational DM?

Back 4

Larger child, high blood glucose

Front 5

4 things that revolves around insulin resistance?

Back 5

Low PA, Sarcopenia, Decreased Insulin Action, Visceral Adiposity

Front 6

____ of Americans over 60 has DM

Back 6

25%

Front 7

What is the usual age of diagnosis for DM?

Back 7

45-60

Front 8

You have DM if your fasting glucose is what? normal should be?

Back 8

126 mg/dL.. less than 100 is best

Front 9

You have DM if your Hemoglobin A1C is... whats preDM.. what should it be?

Back 9

Normal: Less than 5.7%

Pre DM: 5.7-6.4%

DM: more than 6.5%

Front 10

You have DM if your Oral Glucose Tolerance Test is

Back 10

Greater than 200mg/dL

Front 11

Annual cost of DM is

Back 11

$174 Billion.... 116Billion to direct med cost, 58 billion to indirect (disablity, premature mortality etc). 25billon goes to pre DM

Front 12

What is the primary risk factor for DM? 2ndary? other risk factors?

Back 12

Age; being overweight; High cholestorol, sedentary lifestyle, fam hx, ethnicity

Front 13

Which ethnicity is most at risk for DM? least?

Back 13

Blacks WHites (the order is Asian Americans is the least, then whites, then Hispanics, then AA)

Front 14

Type 2 DM symptoms?

Back 14

Frequent peeing (w/ glucose in urine), unusual thirst, slow healing cuts, extreme fatigue, sweet smelling breath

Front 15

Factors that affect DM control?

Back 15

Altered senses, diff in eating/preparing food, decrease mobility/exercise, altered renal/hepatic function, altered circulation, co-morbidities, polypharmacy, social changes

Front 16

What is the most common co-morbities with DM

Back 16

Heart Dz

Front 17

2 key txt options for DM

Back 17

Nutrition & Exercise

Front 18

professional who possesses comprehensive knowledge of and xp w/ DM mgmt, pre DM, and DM prevention

Back 18

Certified DM Educator

Front 19

What is the goal of improving nutrition w/ DM

Back 19

Monitor energy intake, maintain healthy weight to improve insulin sensitivity and control BG levels

Front 20

What should a DM's diet look like?

Back 20

3 meals/day 4-6hrs a part, starchy foods at each meal (bread, pasta, potato, rice), have a balanced diet, no fatty or sugary foods

Front 21

What macronutrient has the greatest effect on blood glucose levels?

Back 21

Carbs

Front 22

What is a complex carb? simple?

Back 22

Complex: Starches - cereals, breads, pasta, veggies

Simple: Candy, fruits, juices, cakes, cookies

Front 23

The specific amount of carbs measured in serving sizes throughout the day to ensure stable blood sugar levels

Back 23

Carb counting/ Carb exchange system

Front 24

what should you encourage for a DM patient?

Back 24

PA even if not to optimal levels consider t safety and preferences

Front 25

How can PA help a pt with DM?

Back 25

Lower risk of MO, dec body fat, maintain lean mass, cardio conditioning, dec BP and improve lipid profile INCREASED EFFECT OF INSULIN!

Front 26

What does "Increasing effect of insulin mean?"

Back 26

Increase sensitivity and binding

Front 27

what kind of exercise increases the effectiveness of insulin?

Back 27

resistance training

Front 28

What should u check before engagng in PA w/ DM?

Back 28

Check your BG before and after exercise

Front 29

how do u prevent hypoglycemia?

Back 29

BG testing and sufficent CARB intake before activity

Front 30

How to prevent hyperglycemia?

Back 30

BG Testing, insuling or meds when required

Front 31

whats retinopathy? neuropathy? Nephropathy? all caused by what? DM is the leading cause of_ _-___

Back 31

impairment or loss of vision; nerve damage and foot probs; kidney dz; blood vessel damage;ESRD & blindness & amputations

Front 32

When is it most important to monitor BG before and after PA?

Back 32

if newly diagnosed or poorly controlled DM

Front 33

Contraindications to exercise

Back 33

low BG, poorly controlled BG, ketones in urine, extreme temp

Front 34

Results of Diabetes Prevention Program?

Back 34

DM can be prevented or delayed, incidence of DM was reduced w/ lifestyle intervention and by 31% w/ metaformin compared to placebo, similar events across the board

Front 35

What is the major finding of the Look Ahead Action fr Health in DM?

Back 35

an intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovasuclar events in obese adults w/ Type 2DM bc the diet portio didn't work for heart dz pt

Front 36

DM is associate dw what?

Back 36

Accelerated loss of both muscle mass and strength causing functional disability

Front 37

The Glucose and insulin masurements from the oral glucose tolerance teast and relationship too muscle mass study found that

Back 37

ppl who have poor insulin control already have muscle impairment; high fasting and OGT values of glucose and insulin is associated w/ lower muscle mass

Front 38

Mechanisms of age related glucose impairment?

Back 38

chronic pro inflamatory state, loss of muscle mass and strength, low levels of insulin-like growth, mitochondrial dysfunction.

Front 39

How can we help w/ med adherence among seniors?

Back 39

prescribed a 90 day supply of meds, has a copay of 10 or less, had an out of pocket maxof 2k or less, used a mail order pharmacy for more than 1/2 a year of refills

Front 40

What forms the outer layer of the bones (dense & compact)

Back 40

Cortical

Front 41

What is the spongy, honey comb like structure that forms the inside of bones?

Back 41

Trabecular

Front 42

Bone acts as a ______ for the body's ________

Back 42

Reserve; Calcium

Front 43

What is bone?

Back 43

Dynamic, living, growing tissue

Front 44

What is the distribution of bone tissue?

Back 44

80% cortical & 20% Trabeular

Front 45

Name a bone strengthening activity

Back 45

Running

Front 46

What is Wolff's Law?

Back 46

Bones grow according to the stress placed on it.

Front 47

In childhood the process enables what

Back 47

bones to grow

Front 48

In adulthood the purpose is of bone is to

Back 48

maintain bone strength

Front 49

What happens to bone during childhood, adolecences and early adulthood?

Back 49

Large amts of calcium and other substances are added to the bone, strengthening the skeleton as it develops

Front 50

Breaks down & removes old bone

Back 50

Osteoclast

Front 51

Builds new bone formation by laying down collagen

Back 51

Osteoblasts

Front 52

Osteoblasts that no longer secrete bone

Back 52

Osteocytes

Front 53

When does the bone starts to decline?

Back 53

30

Front 54

___% net bone loss begins in middle age; post menopausal is what ____

Back 54

1%, 2% to 3%

Front 55

what 3 things u need to maximize bone formation?

Back 55

Calcium, Vit D, and exercise (weight bearing)

Front 56

2 mechanisms that determine adult bone health

Back 56

Peak Bone Mess and Rate of bone loss

Front 57

What measures the absolute amount of bone in grams?

Back 57

Bone Mineral Content

Front 58

What measures bone strength in grams?

Back 58

Bone Mineral Density (z & t score)

Front 59

Shows how much your bone mass varies or deviates from the bone mass of an average healthy 30 year old adult. (Gender Matched and how it comparse to others)

Back 59

T Score

Front 60

Compares your bone density to the average bone density of people your own age and gender.

Back 60

Z-Score

Front 61

When you have osteo, what parts of the body are more susceptible to fx?

Back 61

Wrist, hip & lower spine

Front 62

Over ___ of women and ____ men over the age of ____ have osteopenia/porosis

Back 62

50%; 30-45%; 50

Front 63

Who is more apt to get osteoporisis?

Back 63

White & Asian women over 50

Front 64

___ of folks 80 or over have osteoporosis

Back 64

70%

Front 65

men over 60 has a ___ risk of osteoporotic fx

Back 65

25%

Front 66

_____ is the gold standard to measure

Back 66

DXA Scan

Front 67

What should u score on the DXA to be considered normal?

Back 67

Greater than -1

Front 68

You would be considered osteopenic if you score___ on the dxa

Back 68

bt -2.5 and -1

Front 69

You will be considered osteoporotic if you score _____ plus fragility fractures?

Back 69

less than -2.5; severe or established osteoporosis

Front 70

How can u go from osteoporosis to osteopenia?

Back 70

Medication and exercise

Front 71

Why are women more likely to get osteo?

Back 71

due to menopause

Front 72

Risk factors of Osteo .. Genetics, lifestyle nutrition

Back 72

Genetics: White and Asians get it more, and postmenopausal. Lifestyle: lack of weight bearing stuff, and smoking, nutritional: low calcium level and alcohol use

Front 73

____ of hip fx patients age 50 or older die in the following year

Back 73

24%

Front 74

Hip fx is the ___ leading cause of hospitalizations for OAs

Back 74

2nd

Front 75

_____ end up in a nursing facility after hip fx

Back 75

25%-30%

Front 76

2 causes of osteoporotic fx

Back 76

low peak bone mass, increased bone loss

Front 77

Recommended activities for children and YA? Goal, Type of Activity, ex?

Back 77

Goals: Attain peak bone mass, high impact, sprinting, jumping, track and field, volleyballs, basketball, gymnastics, soccer, weight training

Front 78

Recommended activities for premenopausal adults. Goal, Type of Activity, ex?

Back 78

Goal: Slow the rate of bone loss and prevent musculosketal injury; moderate impact loading movements; walking jogging, running, hiking, stair climbing, stepping machines, dancing weight training

Front 79

Recommended activities for adults below normal BMD Goal, Type of Activity, ex?

Back 79

Goal: to decrease risk of injury, low to moderate impact; stair climbing, hiking, cross country, sking weight training

Front 80

Recommended activities for adults w/ very low BMD Goal, Type of Activity, ex?

Back 80

Goal: avoid injury; low impact loading; walking, water aerobics, swimming, cycling

Front 81

What drug interferes w/ osteoclast activity, slowers resorption and reduces incident of fx, slows bone loss?

Back 81

Bisphosphonates (Fosamax, Actonel)

Front 82

What drug is estrogen w/ progestin/progesterone. good and bad?

Back 82

Hormone replacement therapy; Good: dec the risk of falls and colorectal cancer; Bad: if taken for more than 5 years inc risk of breast CA, stroke and blood clots

Front 83

What drug is a antireabsportion agent that interferes with osteoclast activity to reduce vertebral fx?

Back 83

Calcitonin

Front 84

What drug mimic estrogen by binding to receptor to reduce spinal fx

Back 84

Selective estrogen recepter modulators SERMs

Front 85

Sources of Vit D?

Back 85

Fatty Fish, light, supplements

Front 86

In the PA and OA: Expert Consensus for a New Research Agenda what were the findings?

Back 86

Health benefits of PA was strong except flexibility, dose response relationship

Front 87

FIndings of Dose-response effect of 40 weeks of resistance training on bone mineral density in OA

Back 87

All groups responded similarly to the intervention; Some exercise is better than none

Front 88

What do older adults fear most about aging?

Back 88

Losing cog abilities, losing their independance

Front 89

Why do OA exercise?

Back 89

Longevity, health, prevention, maintenance of being independent.

Front 90

Public health guidelines for PA

Back 90

1) OA should avoid inactivity.. some is better than none. 150/week of mod intesisty or 75/week for vig aerobic PA or a combo

2) 300 for mod or 150 for vig for more health benefits

3) Be as active as their bodies will allow

4) know how their conditions can affect their ability to PA

5) 2 days a week they should do muscle strengthening activities that involve all muscle groups, balance train 3 days a week

Front 91

What are the foundational principles of exercise?

Back 91

adaptation, overload, progression, maintenance, regression/reversibility, specificity (MARSPO)

Front 92

What part of the foundational principles of exercise occurs if physiological system is exposed to training stimulus

Back 92

Adaptation

Front 93

What part of the foundational principles of exercise that means: stimulus must be greater than system is accustommed to

Back 93

Overload

Front 94

What part of the foundational principles of exercise means: must continually increase stimulus to meet above principles

Back 94

Progression

Front 95

What part of the foundational principles of exercise means: improvement experience maintains if adequate stimulus is sustained.

Back 95

Maintenance

Front 96

What part of the foundational principles of exercise means: gains are lost if stimulus is not maintained

Back 96

Regression

Front 97

What part of the foundational principles of exercise means: stimulus will provide gains specific to the system used (What is special in regards to OAs?

Back 97

Specificity; for OAs, exercise should be related as closely as possible to the activities in which the older adult wants to participate

Front 98

What happens if a OA takes on too much stimulus?

Back 98

Greater risk of injury

Front 99

What happens if a OA takes too little stimulus?

Back 99

need to see and feel production if they are going to spend time on exercise; may turn them off to exercise

Front 100

Individual's current physical capacity and goals will guide choices for

Back 100

exercise specificity, frequency, intensity, duration

Front 101

General prescription for beginners working out

Back 101

Start slow with aerobic, strength, flexibility, and balance, low intensity, 3-4 sessions per week, 10=15mins per session

Front 102

What is FITT? ensures what?

Back 102

Frequency, intensity, time, type; well balanced prescription

Front 103

What are the ranges for aerobic exercise for beginner or low fitness?

Back 103

50%-60%

Front 104

How do u calculate HR max?

Back 104

200-age

Front 105

What are the ranges for aerobic exercise for avg fitness?

Back 105

60-70%

Front 106

What are the ranges for aerobic exercise for high fitness?

Back 106

70-85%

Front 107

WHat is the heathy heart zone?

Back 107

provides loss of body fat, improves BP and chole, 50-60% of HR max1

Front 108

What is the fitness zone?

Back 108

more total calories expended 60-70%of HR Max

Front 109

What is aerobic zone?

Back 109

Improves CV and respiratory system function, 70%-80% of HR Max

Front 110

what kind of stretching is a warm up?

Back 110

dynamic

Front 111

what kind of stretching is cool-down?

Back 111

static? hold 10-20sec, slow smooth sustained movement to focus on 1 joint at a time

Front 112

how many reps should u inc before increasing weight

Back 112

15-20

Front 113

what is balance

Back 113

control of our center of gravity

Front 114

What are ADLs? etc?

Back 114

self care activities; person hygiene, dressing feedng walking

Front 115

what are iADLs

Back 115

let an individual live independenty in a community; houseword, managing money, using tech, transportation

Front 116

5 components of exercise programming with a functional approach

Back 116

client centered, goal driven exercise, measurable outcomes, functional activities, screening and safety

Front 117

WHat does client centered approach mean

Back 117

focus on goals, expectiations, needs, and abilites of the individual

Front 118

how can u improve adherence?

Back 118

Point out health benefits that maybe come from their type of regime, seek the clients input, give feed back and get feedback, provide support

Front 119

what does goal-driven exercise means?

Back 119

address specific goals, and structure program arond them, relevent to curfew living situation, interest hobbies

Front 120

what is the smart goal approach?

Back 120

Specific, measureable, action oriented, realistic, time frame

Front 121

What does measureable outcomes mean

Back 121

have a reliable and valid baseline and use field tests

Front 122

what are some functional activities?

Back 122

Lift and carry tasks, chair rises, transfers, chair dip

Front 123

What does screening and saftey mean?

Back 123

Empower and give confidence, they need to feel safe, screens (ParQ, Easy for You, Doc appt).

Front 124

_____ should be promoted in all individuals

Back 124

Active living