Lecture 3: Medical Conditions Flashcards
Type I Diabetes
aka juvenile diabetes
Problem: pancreas doesn’t produce enough endogenous insulin
- can’t get sugar out of blood and into cells
- filtered out by kidneys
Leads to dependence on exogenous insulin
Type II Diabetes
inadequate insulin produced by the pancreas and/or
significant resistance at the cellular level (more frequent)
Hypoglycemia
Minimal sugar in blood stream
- too much insulin
- not enough food
- excessive exercise
- decreased nutrients to brain
- hunger
- double vision
- insulin shock/rxn.
Hyperglycemia
EMERGENCY
- sugar present in blood stream but can’t get into tissue
- cells starving
- body starts converting fat
- acidosis : ketoacidosis present
- breath FRUITY smell
- frequent urination
- thirst
- possible coma
Signs and Symptoms of hypoglycemia and hyperglycemia
- altered level of consciousness (dizzy, drowsy, confused)
- rapid breathing
- rapid pulse
- feeling ill
Management of Diabetes
- ask if they have eaten or taken insulin
- give sugar (juice, hard candy, glucose, non-diet soft drinks)
- monitor for FIVE minutes
- if hypoglycemic, it will improve
- if hyperglycemic, there will be NO change (contact emergency medical care)
Epilepsy
Condition defined by recurrence of unprovoked seizures
Must have more than TWO (2) to be termed epilepsy
Seizure
A result of a discharge of electrical activity within the brain
could be focal (one part) or throughout the brain
Classification of Seizure Types
Focal onset
- aware, impaired awareness
- one part of brain
- motor and non-motor
Generalized onset
- throughout brain
- impaired awareness
- motor
Unknown onset
- motor and non-motor
Focal Seizures
occur in one part of brain and activate only a small number of neurons
- aware: usually BRIEF sensory, motor or memory-related symptoms
- impaired awareness: behavioural arrest, staring, blinking and automatism (ex. smacking lips), lasting minutes with postictal amnesia
- might not remember what is going on around them
- might know they had one or will have one
They may be motor to non motor (classified by first prominent sign/symptom)
Generalized seizures
bilateral discharge involving entire cortex
impaired awareness
can be motor or non-motor
Generalized motor seizures
ex. tonic/clonic (formerly Grand Mal)
- motor
- athlete falls to ground
- goes through a tonic phase of stiffness
- followed by “clonic” phase of twitches
Generalized non-motor seizures
ex. absence (formerly petite mal)
- non-motor
- sudden interruption of activity followed by a blank stare
- eye fluttering and head nodding
Unknown onset seizures
- Motor
- athlete falls to ground
- goes through a tonic phase of stiffness
- followed by “clinic” phase of twitches - Non-motor
- sudden interruption of activity followed by a blank stare
- may or may not realize it happened
Management of seizures
- protect their head
- remove objects close by
- do NOT restrain the athlete
- do not place object in their mouth
- position on side in RECOVERY position
- TIME the seizure (activate EAP if >5 minutes)
- assess for injury (contusions, dislocations; posterior shoulder dislocation is common)
- 1st time = take them to hospital
Epilepsy and exercise
- very few ppl have exercise as a precipitant
- studies show that exercise actually decreases seizure frequency
- normalize the EEG = increase seizure threshold and decreases likelihood of seizures ( decrease in EEG during exercise)
- regular exercise = decrease in seizures compared to those who did not exercise
- physical activity also enhances alertness and focus, which increases seizures threshold
Sports Participation and seizures
- avoid activities where you can’t control environment (scuba, rock climbing, motor racing, downhill skiing)
- frequency of seizures are important when considering swimming (ok with a buddy but risk for submersion accidents)
- no adverse effects with regards to contact sports
What needs to be stressed to patients with seizures?
Proper diet, rest and adherence to medication
Asthma
Chronic inflammatory disorder of airways
- excess mucus production and bronchial smooth muscle constriction = airway narrowing
- max expiratory flow rate is reduced as air is trapped behind blocked airways (problem breathing out)
- athlete must work harder to breathe b/c thorax becomes over-inflated
- leads to respiratory muscle fatigue and physical distress (intercostal muscles must compensate)
Signs and Symptoms of Asthma
Airway hyperresponsiveness, leading to
- recurrent episodes of wheezing
- breathlessness
- chest tightness
- coughing (dry)
– especially at night or in the cold morning
– after exercise (especially in cold, dry env.)
EIB
Exercise Induced Bronchospasm
A temporary narrowing of the airways INDUCED BY STRENUOUS EXERCISE
- symptoms peak 8-12 minutes after exercise
Pathiphysiology of EIB
After exercise, cells of lung rehydrate via hyperemia = bronchoconstriction + mucus production b/c the lung airways are dehydrated
- due to inhaled air being dry + cool
- lungs are dried out when they warm/humidify air
Degree is dependent on exercise intensity, temperature and humidity of inhaled air
Diagnosis of EIB
Need TWO (2) things to diagnose
- symptoms (shortness of breath, coughing, chest tightness/wheezing)
- obstructed airways (10-15% DROP in FEV1) - FEV1 = amount of air you can breathe out in 1 sec
To test
- athlete works 6-8 mins at 80% max
- better if test is sport-specific
- may need cold air
- test w/ spiromete to see if there’s a 10-15% drop
Management of EIB
- educate on signs, symptoms, triggers
- avoid exercising around irritants
- using bronchodilators prior to exercise (if prescribed)
If bronchospasm happens:
- use bronchodilator
- position for ideal breathing (hands on heads, seated leaning forward)
- begin by slowing exhalation then inhalation
