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Class 2 Flashcards

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1
Q

What percent of deaths in the US are caused by chronic diseases?

A

70%

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2
Q

What defines a chronic illness?

A

An illness that lasts longer than 3 months

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3
Q

Comorbidity

A

the simultaneous presence of two chronic diseases or conditions in a patient

ex: patient with both HTN and HLD

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4
Q

What does comorbidity increase?

A

Complexity and health risk

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5
Q

What makes patients with comorbidities complex?

A

1) Treatment of one disease may contradict the treatment of the other
2) Adverse drug interactions
3) Compounding symptoms may lead to poor compliance with treatment plan
4) Patient is at increased risk of organ failure if the comorbidity affects the same organ system

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6
Q

Etiology of HTN

A

an increase in blood pressure causes excess force against the arterial walls, damaging arteries over time

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7
Q

Risk factors of HTN

A

FHx of HTN, obesity, high sodium diet, smoking, alcohol

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8
Q

Symptoms of HTN

A

often asymptomatic

headache is the most common symptom

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9
Q

Diagnosis of HTN

A

Several high BP readings

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10
Q

Systolic blood pressure

A

Top pressure reading

Measures pressure in the arteries when the heart contracts

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11
Q

Diastolic blood pressure

A

dominator

measures the pressure in the arteries when relaxed

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12
Q

Hypotensive BP

A

less than 90/60

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13
Q

Normal BP

A

90/60 to 120/80

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14
Q

Prehypertensive BP

A

121/81 to 140/90

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15
Q

Hypertensive BP

A

greater than 140/90

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16
Q

What are other chronic illnesses that HTN can lead to?

A

Hemorrhagic CVA, CAD/MI, CHF, Renal Failure, impaired vision

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17
Q

How does HTN cause other chronic diseases?

A

HTN damages blood vessels in the brain, heart, eyes and kidneys

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18
Q

Non-pharmacological management of HTN

A

low sodium diet, stop smoking and drinking alcohol, exercise, BP log at home

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19
Q

How does a low-sodium diet help manage HTN?

A

sodium increases BP because the kidneys retain more water, so eating less sodium can help the kidneys decrease fluid volume and lower pressure

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20
Q

How does stoping smoking and drinking alcohol help manage HTN?

A

Nicotine and alcohol are vasoconstrictors

Vasoconstrictors shrink blood vessels (less area = more pressure)

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21
Q

Pharmacological management of HTN

A

ACE inhibitors

Ca Channel Blockers

Diuretics

ARBs

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22
Q

ACE Inhibitors

A

relax arteries and block reabsorption of water by kidneys, which help lower BP

Lotensin, Zestril

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23
Q

Ca Channel Blockers

A

Dilate the arteries and reduce the force of the heart’s contractions, helps lower BP

Norvasc, Cardizem

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24
Q

Diuretics

A

Reduce the volume of fluid by increasing urination

HCTZ

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25
ARBs
Dilate the arteries, which lowers BP Cozaar, Benicar
26
Can a patient be diagnosed with HTN without showing any symptoms?
Yes
27
Type 1 DM
insulin insufficiency pancreas is unable to produce insulin strong FHx component of developing
28
What is the most common type of DM?
Type 2 (95% of patients)
29
What is the role of insulin?
to move glucose into the cells so if you don't have insulin or body resists insulin, your blood glucose levels rise
30
How is Type 1 DM treated?
Always treated with insulin
31
Type 2 DM
insulin resistance overtime body stops responding to insulin some FHx component, but strong SHx component
32
Hw is Type 2 DM treated?
Can be treated with diet changes, non-insulin meds or insulin
33
Type 2 DM etiology
The inadequency of insulin to control the blood glucose level
34
Risk factors of Type 2 DM
FHx, obesity, high carb diet, lack of exercise
35
Symptoms of Type 2 DM
unusual weight gain or loss polyuria, polydipsia, blurred vision, N/V
36
What are polyuria and polydipsia?
symptoms of Type 2 DM polyuria = frequent urination polydipsia = frequent thirst
37
How is Type 2 DM diagnosed?
Fasting blood glucose / hemoglobin A1c
38
What other illnesses can DM lead to?
CAD, CHF, PVD, Neuropathy, Renal failure, Diabetic retinopathy
39
PVD
peripheral vascular disorder damaged blood vessels and decreased blood flow to extremities
40
Neuropathy
damage to the peripheral nervous system
41
Diabetic retinopathy
DM damages blood vessels in eyes which leads to blurred vision
42
Non-pharmocological treatment of DM
Low carb diet, weight loss, exercise, blood glucose log
43
How does low carb diet help with DM?
carbohydrates raise blood glucose more than any other food which leads to increased release of insulin and eventually insulin resistance
44
What are the three types of insulin?
Humalog (short-term), lantus (long-term(, sliding scale
45
Oral meds for DM
Metformin and Glyburide
46
HLD etiology
an elevated level of lipid in the blood causes plaque build up along arterial walls
47
Risk factors for HLD
FHx, obesity, high lipid diets, alcohol, sedentary lifestyle
48
Symptoms of HLD
asymptomatic
49
Diagnosis of HLD
blood work, measuring cholesterol and lipid panels
50
LDL
low density lipoprotein commonly known as "bad cholesterol" allows cholesterol to build up on arterial walls and case plaque
51
HDL
high density lipoprotein commonly known as "good cholesterol" HDL is able to remove cholesterol from arterial walls
52
How does HLD lead to other diseases?
HLD leads to narrow blood vessels
53
Arterial atherosclerosis
caused by HLD accumulation of cholesterol causes blood vessels to thicken and harden
54
What other diseases can HLD lead to?
pancreatisis, TIA, ischemic CVA, CAD/MI, arterial artherosclerosis
55
Non-pharmocological management of HLD
Low lipid diet, decrease alcohol, exercise, close follow up
56
Pharmacological management of HLD
statins any medication ending in statin is used to treat HLD by inhibiting the production of cholesterol
57
CAD etiology
narrowing of the coronary arteries limits blood supply to the heart muscle causing ischemia
58
Risk factors of CAD
HTN, HLD, DM, smoking, FHx <55y/o
59
Symptoms of CAD
chest pain or pressure (worse with exertion) improved rest or nitroglycerin (NTG)
60
Diagnosis of CAD
cardiac catherization to diagnose
61
What is the number one risk factor for a MI?
CAD
62
If you have an MI which disease do you automatically have?
CAD
63
Non-pharmacological management of CAD
manage other risk factor, stop smoking, manage stress, exercise
64
How does stopping smoking help manage CAD?
nicotine is a vasoconstrictor which narrows the coronary arterties
65
Pharmacological management of CAD
Aspirin (acetylsalicylic acid, ASA) Nitroglycerin (NTG)
66
NTG
Nitroglycerin Vasodilator used to treat CAD
67
Surgical management of CAD from least to most invasive
Angioplasty, coronary stent, CABG
68
Angioplasty
deflated balloon is inserted to open area of blockage and then removed treats CAD
69
Coronary stent
similar to angioplasty however the stent is kept in treats CAD
70
CABG
open heart surgery to bypass area of blockage treats CAD
71
Patient problem list
Section of the chart that helps organize the patient's history and allows the doctor to identify active issues quickly
72
What is included in the problem list?
All active and resolved conditions Chronic illnesses, surgeries/procedures, injuries, symptoms
73
What is difference between patient list and past history?
Patient list does not include FHx or SHx Patient list includes the status of problems
74
How are chronic illnesses classified?
chronic illnesses are always ACTIVE even if they are currently managed
75
What goes at the top of a patient list?
active problems
76
What goes on patient list for patient with no problems?
"No known problems"
77
What should you not put in a note on the problem list?
Side of body or severity This should just be included in a more detailed description of the problem

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