ch24: CVD

Question 1

anemia

Answer 1

• reduction in RBC volume or the hemoglobin concentration
• caused by impaired RBC formation, excessive loss or destruction of RBCs
• RDA for iron: 8mg/day men, 18mg/day women
  effects
• reduces max aerobic capacity
• dec physical work capability at sub-max level
• inc lactic acidosis
• inc fatigue
• dec exercise time to exhaustion

Question 2

predisposing factors of anemia

Answer 2

• family hx
• chronic disease
• jaundice
• exessive mentrual flow
• chronic blood loss
• drug/toxins
• childbirth
• poor diet
• cancer
• blood donor

Question 3

stages of anemia

Answer 3

stage 1= iron depletion characterized by less than 12mg/mL of ferritin, other components remain normal

satge 2= several months of iron depletion, dec lvls of circulating iron but hemoglobin and hematocrit remain normal

stage 3= several weeks of iron-f=deficient erythropoiesis, hemoglobin prod diminished, indv dev clinically recognized iron-deficiency anemia

Question 4

iron-deficiency anemia

Answer 4

• childhood - inadequate diet
• adult - bld loss
• endurance athletes and indv who maintain a lower % body fat
  s/s
• fatigue
• tachycardia
• bld in feces
• pallor
• epithelial abnormalities
• cardiac heart murmurs
• loss of hair
• pearly sclera
• m. burning
• nausea
• vomiting
• scry scaling of lips
• inflammation of tongue

Question 5

exercise-induced hemolytic anemia

Answer 5

• runners anemia: occurs during exercise when rBCS are desroyed and hemoglobin is liberated into the medium in which the cells are suspended
• foot-strike hemolysis= hard foot strike destroys RBCs
• intravascular hemolysis= m. contraction, acidosis, inc body temp destry RBC
• management: rarely severe enough to cause loss of iron

Question 6

sickle cell anemia

Answer 6

• abnormalities in hemoglobin structure prod a sickle or crescent RBC that is fragile and unable to transport oxygen
• sickle cell clump together and cause block
  s/s
• asymptomatic
• swollen painful and inflated hands/feet
• irreg heart beat
• fatigue
• h/a
• pallor

no tx but avoid dehydration

Question 7

reye syndrome

Answer 7

• 2-16 y/o rare but serious
• always follows an upper respiratory tract infection
• cause unknown, using aspirin
• accumulation of ammonia and acidity in the blood while level of sugar drops, liver swells and dev fat deposits, brain edema

Question 8

stages of reye syndrome

Answer 8

1= lethargy, vomiting, hepatic dysfunction followed by a few days of recovery

2= hyperventilation, delirium and hyperactive reflex

3= coma and rigidity of organ cortices

4= deepening coma, large and fixed pupils, loss of cerebral func

5= seizures, loss of deep tendon reflex, flaccidity and respiratory arrest

Question 9

lymphangitis

Answer 9

• inflammation of the lymphatic channels that occurs as a result of infection at a site distal to the channel
• pathogenic organism invade lymphatic vessels directly or as a complication of an infection
  s/s
• red streaks
• fever
• chills

Question 10

syncope

Answer 10

• sudden, transient LOC, fainting
• presyncope: sense of impending LOC, light-headedness or weakness

Question 11

reasons of dec blood flow in syncope

Answer 11

1- heart fails to pump the blood
2- the blood vessels dont have enough tone to maintain BP to deliver blood to the brain
3- not enough blood or fluid within the blood vessels
4- combination of these reasons

Question 12

types of syncope
reflex vs orthostatic hypotension vs cardiac

Answer 12

reflex= vasovagalB(EMOTIOANL DISTRESS), situation(cough, sneeze, GI stim, micro nutrition, post-exercise)

orthostatic hypotension= primary autonomic failure, secondary autonomic failure, drug-induced, volume depletion

cardiac= arrythmia

Question 13

shock

Answer 13

• occurs if the heart is unable to exert adequate pressure to circulate enough oxygenated blood to the vital organs,
  s/s
• rapid/weak pulse
• BP drops
• breathing rapid and shallow
• cool/clammy skin
• profuse sweating
• disoriented
• dizziness
• pupils dilated

Question 14

hypovolemic shock

Answer 14

excess blood/fluid loss

Question 15

respiratory shock

Answer 15

insufficient oxygen in the blood (result from iproper breathing)

Question 16

neurogenic shock

Answer 16

peripheral bld vessels dilte, and insufficient blood vol cannot supply organ

Question 17

psychogenic

Answer 17

temporary dilation of bld vessels resulting in the draining of bld from the head

Question 18

cardiogenic shock

Answer 18

heart muscle is no longer able to sustain enough pressure to pump blood

Question 19

metabolic shock

Answer 19

severe loss of body fluids because of untreated illness that alters biochemical equilibrium
(insulin shock, diabetic coma, vomiting, diarrhea)

Question 20

septic shock

Answer 20

severe, bacterial infection where by toxins attack the wall of small bld vessels, causing them to dilate decreasing bp

Question 21

anaphylactic shock

Answer 21

severe allergic rx

Question 22

primary vs secondary hypertension

Answer 22

primary= chronic, progressive disorder w/ no identifiable cause that often attacks the heart, brain, kidneys and eyes, treated w/ meds

secondary= identified cause (renal disease, renovascular)

Question 23

classification of hypertension

Answer 23

normal: <120/<80
prehypertension: 120-139/80-89
stage1: 140-159/90-99
stage 2: >160/>100

Question 24

hypotension

Answer 24

• dec 20mmHg or more of normal SBP
• cause: shock, hemorrhage, dehydration, orthostatic hypo, postural hypo, over tx of hyper

Question 25

how to reduce effects or orthostatic hypotension

Answer 25

- avoid prolonged standing, vigorous exercise, alcohol, hot env, hot showers - execute slow, careful posiiton change - eat multiple small meals - PA in PM - inc salt and fluid intake

Question 26

hypertrophic cardiomyopathy

Answer 26

- abnormal thickening of the L ventrical wall (2-4 to 15cm) - goes undetected - abnormal thickness -electrical prob, abnormal rhythm - suspected in young athletes w/ exertional dyspnea, chest pain, unexplained syncope, heart murmur

Question 27

mitral valve prolapse

Answer 27

- redundant tissue is found on one or both leaflets of the mitral valve - chest pain, palpitations, fatigue w /exertion, dyspnea

Question 28

restriction to sport for people with mitral valve prolapse

Answer 28

cant engage if - prior syncope- arrhythmogenic in origin - tachyarrythmias - mitral regurgitation - LV systolic dysfunction - prior embolic event - family hx of sudden death

Question 29

myocarditis

Answer 29

- inflammatory cond of the muscular walls of the heart that can result from a bacterial or viral infection - infiltratoin of inflam cells into myocardium leading to an abnormally enlarged left ventricle s/s - fever - body aches - fatigue - cough - vomiting - palpitations - syncope

Question 30

cond to RTP w/ myocarditis

Answer 30

- LV function/wall motion/ cardiac dimensions return to normal, - arrhythmias absent - markers of inflammations normal - ECG normal

Question 31

acquired valvular heart disease

Answer 31

- stems from a defect or insufficiency in a heart valve that can lead to improper blood flow through the heart types - valvular stenosis: narrowing of orifice around cardiac valves - regurgitation: backward flow of blood can participate in PA if mild-to mod

Question 32

Coronary artery disease

Answer 32

- excessive build-up of cholesterol within the coronary arteries narrows the diameter of the arteries and impedes the flow of blood, reducing the amount of oxygen supplied to the heart - angine: subsequent to dimished oxygen - build up of cholesterol= risk myocardial infarction

Question 33

marfan syndrome

Answer 33

- genetic disordeer of the connective tissue that can affect the skeleton, lungs, eyes, heart and bld vessels - mutant gene linked cond - tall in stature, long extremities, hypermobility, sunken chest, scoliosis, inc incidence of hernias

Question 34

long QT syndrome

Answer 34

hereditary disorder of the hearts electrical system, arrhytmias, insufficient contraction of the heart

Question 35

right ventricle dysplasia

Answer 35

formation of adipose or fibrous tissue extending from the epicardium to the endocardium, inc risk of ventricualr fibrillation

Question 36

wolf-parkinson-white syndrome

Answer 36

abnormality of cardiac rhythm that manifests as an SVT - associated w/ accessory electrical pathway in the heart proximal to the ventricles that can spontaneously produce episodes of rapid twitching of the atrium muscle fibers

Question 37

congenital coronary artery anomalies

Answer 37

abnormal origin of left coronary artery