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45 Cards in this Set
- Front
- Back
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Coronary Heart Disease (CHD)
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Conditions with blockage to the heart; a chronic disease in which the arteries supply the heart become narrowed or clogged, results from either atherosclerosis or arteriosclerosis.
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Cardiovascular Disease (CVD)
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disorders of the heart and blood vessel sys, including stroke and coronary heart disease. Ex. stroke. (Broader)
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Atherosclerosis
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A chronic disease in which cholesterol and other fats are deposited on the inner walls of the coronary arteries, reducing circ. in heart tissue.
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Ichemia
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Not enough oxy/blood to heart.
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Arteriosclerosis
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Also called "hardening of the arteries," a disease in which blood vessels lose their elasticity.
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Angina
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Pain in chest often precursor to heart disease.
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Medical Treatment
1) Thinning the blood (ex. aspirin) 2) Angioplasty: ____ |
2) Balloons/nets to unclog artery; sometimes preventatively; very expensive; 2001 $31000 (7-10%yr inc. in general); 1/2mill/yr in U.S. have angioplasty.
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Medical Treatment
2) stents: ___ |
2) Meshlike wire to keep artery open; hve slow released drugs to keep plaque from forming.
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Medical Treatment
3) Bypass |
3) Part of an artery usu. from leg grafted around blocked coronary artery/to bypass heart. 2001 $46,000, 2004. Ab. incision 8-10"; robotics for smaller incision; long distance surgery.
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Behavioral
Dean Ornish Programs A. |
Reversal and preventative. Rev: very low fat (10vs.30% of cal from fat); prev: 30% from fat. Specific diet (not longterm?); research support; lowering plaque levels.
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Behavioral
Dean Ornish Programs B. |
Specific diet (not longterm?); research support; lowering plaque levels; $2mill research grant; stress reduc; comparable to medical txt; began in 1999; covered by Medicare? $7000/person.
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Behavioral
Dean Ornish Programs C. |
Problems: long term vs. short term surgery; hospitals and pharmaceutical companies lose business; currently insurance does not cover. LDL down 40% without drugs ($12000/yr for drugs); 91% red. in chest pain, less future surgeries, radical idea.
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Film
Framingham Heart Study |
5000 subjects and 5000 second generation; term "risk factors;" Tests to determine elasticity/stiffness of arteries (block blood flow); Test with images of heart, image of aorta.
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Beh. Risk Factors (Changeable)
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Cig. smoking, diet, lack of exercise.
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Nonchangeable Risk Factors
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Race (Af Am more common; arteries' elast.; 27% higher death rate; twice as likely to die from stroke than whites, access to medical care); Less common in Asian and Hispanics (ses: high fat diets, smoking, exercise, stress) Heart Dis. most common in low ses Af Am than middle class ses Af Am.
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Nonchangeable Risk Factors
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Sex: Men more likely for CHD 46%, women (35-74 are 40% die of CHD) (500000 CHD vs. 40000 Breast cancer)
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Nonchangeable Risk Factors for CHD
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Prognosis: 39% of women (vs. 30%) will die of first heart attack; do not recog symptoms, do not seek care as quickly (stents not studied in women, until 1990: hormones, pregnancy); physicians usu do not recog; txt for women less aggressive when plaque discovered.
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Type A Beh. Pattern
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Dr. Freidman and Rosenman (cardiologists), chairs worn on edges of seats; three components: 1) exagg. sense of time urgency 2) excessive compet. and achiev. striving. 3) Hostility and agg. (excentuating key words, end sent. faster, move/eat rapidly impatience; polyphasic thought)
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Type B Beh. Pattern
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No impatience, excessively humble,not superiority in games.
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Measurements for Type A
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1) Jenkin's Activity Survey (speed, impatience, competit, hard-driving, 52 questions) 2) struc. interview (how ans, posture, gestures, rapidity of speech)
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Measurements for Type A
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Popular from 1970s, 80s, some in 90s. Studies: under stress, type A have higher reactivity of sym nerv act; only if a threat to ego - psy vs. phy stressors, feel challenged.
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Measurements for Type A
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Hostility key component; study: shock experimenters (puzzle); Type B not higher shock given with instigation. Anger, Hostility, Aggression(AHA):20% of CHD/heartattacks follow outbursts; sym nerv activity, lower threshold, unhealthy beh to relax; less soc support; stressful wk environ.
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Cancer
Goals for healthy people by 2010; Nat Cancer Instit: |
Death rates (colorectal, lung, prostate, breast) all combined are declining. Rate fo cancer incidents/devel the same since 1990 (slight fall in smoking).
Prevention improving (fruit/veg up slightly, alcohol, youth smoking dec. since 1997 vs. rising; screening tests high (stable 2000-2003) Colorectal cancer screening very low (inc.); slightly more sun protec. |
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Cancer
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Incidents of breast, prostate inc; skin cancer, leukemia, non-hodgkins lymph, thyroid, kidney, esoph.inc.; lung cancer death rate still rising (not as rapidly).
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Cancer
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Prevention: Obesity inc, exer. dec; subgroup descrep (Blacks/low ses incidents/death rates higher)
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Cancer
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Cells multiply in an uncontrolled fashion, tumor of cells growing; benign: not cancerous tumor; malignant: cancerous cells/tumor, can spread; Metastisized: spread to other parts of body. Carcinogen: cancer causing (ex. asbestos). Trends: 1970s fear of communicable spreading
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Types of Cancer
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Carcinomas (epith cells, common, breast, skin); Sarcomas (muscle, bone, cartilage); Lymphoma (lymph sys); Leukemia:
(blood, bone marrow, often childhood) |
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Causes for Cancer
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1) Genetic mutations: genes allowing for division and suppression unreg) 2) Diminished Immunity: Stress, ex. AIDS, patients devel cancer; not suppressing growth, ex. opportunistic cancers.
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Causes for Cancer
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3) Risk factors: smoking, diet (sat fat/animal and colon, prostate, cancer link) Lycopene (processed tomatoes), small effect, broccoli, carrots, onions, garlic. Alcohol (neg, esp if more than 2/day) Exercise (inc immunity, better recovery)
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Causes for Cancer
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4) Genetic risk factors: genes passed on (esp breast cancer gene) small percentage (about 5% of breast cancers linked to specific genes).
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Causes for Cancer: 5) Environmental 6) Occupational
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5) Radiation from sun; cell phones, powerlines?
6) Occupational: second hand smoking, asbestos (fiber into lung; ex. tiles) |
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Causes for Cancer: 7) Personality
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7) Not likely Type C (1950; sensitive/passive) Do not express neg emotions, happy. Common life events: tense relationship with parents, lonely childhood; emotional invest in young adulthood, lost emotional invest/passion, not nec depression. 1980/90s, little research support not retrospective
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Causes for Cancer: 7) Personality
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study in Japan (30000 people, longit, no link); problems with link: hopelessness, insurance companies' personality tests? Ex. Arthritis personality
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Breast Cancer
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Rising: after 85 women have 1/8 chance now 1/7; number 2 cause of death after 50; number 1 for 40-55. Prognosis for early detection favorable but only 1/3 have regular mammograms (every year/two after 40)
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Breast Cancer
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Self examination, preventing long stage cancers: uncomfortable, quick, scared, cost (7% of surveyed cited as reason), not recommended by doctor (30% surveyed), no symptoms or history, not needed (41% surveyed; lack of awareness.)
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Breast Cancer
1) Anatomy 2) Carcinoma in situ |
1) location of ducts, lobules, muscle, breast bone.
2) confined to lobules/ducts and not to fatty tissue or other parts; lobular (in lobules); ductal (starting in ducts, more common for car. in situ) |
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Breast Cancer
3) Infiltrating (invasive) |
Lobular (can also spread); Ductal: duct but cancer cells break through and invade fatty tissue, lymph...; 80% of breast cancers.
(In general 1-2% of breast cancers are in males.) |
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After Discovery of Breast Cancer
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1/3 of women wait a few months for evaluation (esp low ses women of af am; lower survival rate) Biopsy (tissue sample; fine needle biopsy, core needle biopsy: small cylinder, 1/8" with larger needle; 3or5 removed) surgical biopsys.
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After Discovery of Breast Cancer
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Uncertainty; if malignant (blood tests to det. spreading; hormone receptor testing, estrogen, progesterone may stimulate growth; hormonal therapy for receptor positive hormones.
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Diagnosis stage of cancer (very important)
Stage 1 |
Stage 1: Tumor less than or equal than 2 cm, has not spread to lymph nodes, central node test: one node, less invasive) Can be removed; 80% survival rate.
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Diagnosis stage of cancer Stage 2
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2) 2<tumor<5 and/or spread to lymph nodes on same side; 70s% survival rate.
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Diagnosis stage of cancer Stage 3
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3) A) Tumor > 5cm and/or spread to lymph nodes; large cancer that spread; 56% survival rate.
B) Any size but spread anywhere (chest, etc) 49% survival rate |
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Diagnosis stage of cancer Stage 4
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4) Spread to distant sites regardless of size (ex. from chest to bone); 16% survival rate.
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Cancer decisions
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Continued monitoring, counseling? Before treatment: lumpectomy (only tissue affected and some surrounding) or masectomy (often chosen; longterm prognosis same).
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Cancer decisions
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Masectomy simple: keep lymph nodes under arm; radical (lymph nodes, part of chest wall, muscles under breast)
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