Medical Illnesses Flashcards

Question

What are the Signs and Symptoms of diabetes?

Answer 1

· excessive thirst, frequent urination · excessive hunger · extreme fatigue · weight loss (type 1) · headache, blurred vision · elevated blood sugar - hyperglycemia glucose in the urine - glucosuria

Answer 2

· associated with chronic exposure to increase blood sugar · damage to vessels & nerves · retinopathy - eye disease and blindness · nephropathy - kidney disease · peripheral vascular disease, neuropathy · tingling or numbness in extremities · poor circulation – infection & amputation · erectile dysfunction

Answer 3

a key risk factor for CVD

Answer 4

Annually, people living with diabetes account for: * 30% of strokes, 40% of heart attacks, * 50% of kidney failure requires dialysis 70% of non-traumatic amputations

Answer 5

1. diet planning · regular balanced meals + snacks □ 50-60% energy from CHO spread over the day · limit intake of refined/added sugars (<10%) · ↑ fibre intake - including soluble fibre sources · small amount of protein at each meal stabilizes blood sugar 2. regular exercise, weight management 3. blood glucose control ▪ oral medications, insulin * monitoring of blood sugar ▪ traditional = glucometer · skin check - footcare · regular medical assessment · lower/regulate blood sugar levels: 4-7 mmol/L 4. Anti-diabetic medications ▪ several types ▪ multiple mechanisms of action 5. Insulin ▪ rapid, short, intermediate, and long-acting ▪ different strengths: e.g. U-100 ▪ by injection: 1-4 /day syringes, pens, pumps

Answer 6

too much insulin or not enough food too much PA - no adjustment of food or insulin

Answer 7

shaky, lightheaded, sweaty, weak, tachycardia, headache

Answer 8

check blood sugar - eat or drink a form of simple sugar wait 10-15 minutes → test → treat again?

Answer 9

disorientation, seizure, loss of consciousness

Answer 10

· 1st goal – primary prevention · after diagnosis: - Blood sugar control - minimize long-term complications · resources: - family physician, certified diabetes educator - Diabetes Canada, Health Canada - Regional public health Department

Answer 11

Collection of diseases of health and blood vessels - Heart disease and stroke · 2nd leading cause of death in Canada · 23.3% of all deaths in Canada (>66,000/year, Stats Can, 2020)

Answer 12

□ Understanding, and management of risk factors □ Advances in diagnostic procedures, treatments □ Better emergency medical assistance programs

Answer 13

Heart and blood vessels 1. Transports, O2, nutrients, hormones, and enzymes to tissues, removal of waste products 2. Role in regulation of body temp, fluid balance, pH 3. Protects the body from infection, blood loss

Answer 14

Heart, lungs, blood vessels Gas exchange - O2 and CO2

Answer 15

· Weights 200-425g (7-15 oz) · During an average lifetime - 2.5 billion beats · 100,000/day (7,200 litres) Pericardium: (double-layered sac surrounding heart) · 4 chambers · Separated by valves - regulate the flow of blood · Sinoatrial (SA) node - pacemaker Electrical signal for contraction of the right atrium

Answer 16

Arteries carry blood away from the heart □ Branch into smaller blood vessels -arterioles Veins carry blood back to the heart □ Branch into smaller blood vessels - venules Capillaries: very small blood vessels □ Connect the arterial and venous sub-circulation □ Passage of oxygen, nutrients, and waste between blood and part of your body.

Answer 17

□ Right and left coronary arteries - Supply blood to the heavy muscle - myocardium □ Cardiac veins ▪ Removal of de-oxygenated blood - My/-(muscle), cardi/o-(heart), -um(a structure)

Answer 18

- General term - narrowing and hardening of the arteries · Fatty substances (plaque) in lining of artery □ Arteries lose elasticity and narrow - Impeded blow flow - partial or full blockage - Sten/o-(narrowness), -osis (condition) · Atherosclerosis develops over time · Likely begins with damage to the lining of blood vessels □ Elevated blood pressure □ Elevated blood cholesterol, triglycerides, and blood sugar □ Smoking □ … fatty deposits accumulate - Blockage, bleeding blood clots · Atherosclerosis: minor blockage? □ Blood may reroute through small unused blood vessels - collateral circulation - Damages tissue (heart muscle) may heal itself

Answer 19

□ Coronary heart disease □ Carotid artery disease - Reduced flow to the brain □ Peripheral artery disease - Pelvis, legs, arms

Answer 20

MOST COMMON AKA - coronary artery disease (CAD) · Caused by: atherosclerosis □ Plaque build-up in one or more coronary arteries · Restricted blood flow (75%) □ Ischemia - insufficient blow flow relative to demands of tissue ▪ Decreases in oxygen supply - Chest pain (angina) · Severe restriction or complete blockage □ Myocardial infarction (MI), AKA "heart attack" · Often caused by thrombosis: □ Blood cloy in coronary artery ▪ Blockage of normal blood supply to an area of heart

Answer 21

□ Chest discomfort - pain/pressure □ Radiating pain - neck, shoulders arm, chin □ Shortness of breath □ Sweating, nausea □ Light headedness · Men vs women? · Potential consequences Heart damage, cardiac arrest, death

Answer 22

· AKA "cerebrovascular accident" □ Sudden loss of brain function · Caused by: □ Thrombus (blood clot) or embolus □ Disruption of blood flow to the brain □ "ischemic stroke" · Aneurysm: weakened blood vessel □ Rupture of blood vessels in the brain □ "hemorrhagic stroke" · Transient ischemic attack (TIA) ▪ "mini-stroke" A temporary decrease in blood flow to the brain

Answer 23

Based on where the brain was injured? Degree of damage? Impairments in movement, speech vision cognition death

Answer 24

Atrial fibrillation □ Condition involving irregular heart rhythm (arrhythmia) □ Tachycardia vs bradycardia Cardiomyopathy □ disease of the heart muscle - decreased ability to pump blood Congenital heart disease □ defect in heart or blood vessels near the heart at birth Congestive heart failure □ heart disease means the heart is damaged or weakened Decreased pumping action – back up of fluid in lungs, extremities

Answer 25

MODIFIABLE: · High blood pressure (plaque build up in arterial walls · High blood cholesterol · Smoking · Physical inactivity (decrease in our blood pressure modify blood cholesterol) · Overweight, obesity · Stress · Diabetes (metabolic) · Excessive alcohol intake NON-MODIFIABLE: · Age, gender, family history (genetic predisposition), ethnicity, previous CVD event (angina, heart attack)

Answer 26

· hypertension: chronic elevated BP □ > 140/90 mmHg ▪ > 130-139/85-89 = high normal · systolic BP (upper value) ▪ pressure exerted against walls of arteries – the heart is contracting · diastolic BP (lower value) ▪ pressure exerted against walls of arteries – the heart is relaxed · primary (essential) vs. secondary “silent killer”

Answer 27

* Hypertension à not white coat syndrome, * High normal 140/90 upper number higher than 130, lower number higher than 85 means you are at risk and intervention must occur * Secondary hypertension – is caused by some other underlying condition, i.e. could be related to kidney function etc. * Primary – chronically develops over time from one of the factors * elevation in blood pressure is known as silent killer – because people with this are typically asymptomatic Blood pressure is one of the most important risk factors for stroke

Answer 28

lifestyle behaviours: · healthy eating - Increased fibre (beans, okra, strawberries) - less saturated & trans fats - More unsaturated fats - Less added sugars - less sodium (hyper-responders to sodium intake) · regular exercise · no smoking limit alcohol consumption stress management manage: * blood pressure * blood cholesterol * body weight Diabetes risk

Answer 29

* records electrical activity of heart Holter Monitor: 24 hour heart rate, rhythm

Answer 30

□ high-frequency sound waves ▪ creates image of heart and blood vessels ▪ Non invasive test First line of diagnostic

Answer 31

□ positron emission tomography (PET) □ computed tomography (CT) magnetic resonance imaging (MRI)

Answer 32

□ Lipid profile, C-reactive protein □ Homocysteine Cardiac enzymes * Lipid profile – a combination of lipid measures * C-reactive protein (CRP) – a measure of inflammation, inflammation is rising to the top of the list of risk factors. This test does not tell you where the inflammation is. * Homocysteine (is an amino acid): elevation in this associates with significant risk Cardiac enzymes – provide info after a cardiac event (like angina, heart attack) à tells you how much heart damage was sustained after this event

Answer 33

cardiac catheterization □ catheter threaded from groin or wrist into heart □ contrast dye injected ® x-ray outlines structure, flow ▪ detect blockages, stenosis (narrowing of arteries), weakened valves

Answer 34

· low to intermediate risk: the first line of defence □ lifestyle changes drug therapy: □ reduce BP/blood lipids (i.e. beta blockers/statins) □ decrease & regulate heartbeat (digoxin) □ relieve angina (nitrates class of drugs) - used sublingual - placed under the tongues, dissolve rapidly prevent or dissolve blood clots (anticoagulants)

Answer 35

balloon on tip of the cardiac catheter □ inflated to compress fatty deposits opens artery – increases blood flow

Answer 36

□ angioplasty with stent - “through the skin” coronary intervention Angioplasty with stent – stent remains and functions like a balloon for a longer period of time

Answer 37

□ surgical implantation of the device ▪ regulates heart rate and rhythm

Answer 38

reperfusion therapy □ immediate treatment for blocked artery □ injection of medication (tPA) to dissolve blood clot ▪ restore blood flow® and prevent or reduce tissue damage · ideally administered within 1-3 hours of event (<12 hours) · Is an anti coagulant · Can inject medicine using catheter right at the blood clot site

Answer 39

coronary bypass □ section of blocked artery replaced with healthy blood vessel from patient’s leg, arm or chest - increased blood flow to heart muscle valve replacement (open heart surgery) □ damaged or poorly functioning valves replaced ▪ repair or minimally invasive procedures heart transplant □ heart replaced with a donor heart ▪ extended recovery, immunosuppressive therapy - Taking own tissue does not require rejection medicine Immunosuppressive therapy decreases chances of rejecting the new heart

Answer 40

· treatment trade-offs: surgery vs. other treatments · prevention, detection and early intervention are key □ reducing morbidity and mortality · cardiac rehabilitation heart-healthy lifestyle changes address risk factors

Answer 41

· prostate, breast, lung, colorectal □ 46% of new cases · 1 in 9 males will develop prostate CA · 1 in 8 females will develop breast CA · overall 5-year relative survival: 64% · significant improvements: 1992-2021 · Some variability in this statistics

Answer 42

* uncontrolled growth & spread of abnormal cells * caused by: mutations in genes that regulate cell division * mutations may be acquired (spontaneous errors, environmental exposures) or inherited * dysregulation of cell cycle · unchecked cell proliferation - malignant growths - tumour invades healthy tissue □ disrupts the function of vital organs · if cells break away from the primary site they can metastasize (travel to other parts of the body) □ form secondary tumours · carcinogenesis: the process of cancer development · angiogenesis: formation of new blood vessels

Answer 43

* tumor: abnormal mass of poorly differentiated cells: * abnormal cells may be pre-cancerous · benign: (not cancer) - local growth · malignant: (cancer) - can metastasize

Answer 44

- metastatic disease, form solid tumours - arise from cells that cover external, and internal body surfaces - lung, breast, colon, bladder, prostate

Answer 45

- metastatic bloodstream, solid tumour - arise from cells found in supporting tissues of the body bone, cartilage, fat, connective tissue, muscle

Answer 46

- solid tumour, palpate - arise in the lymph nodes and tissues of the immune system

Answer 47

- abnormal white blood cells, non solid tumors cancers of the immature blood cells that grow in - the bone marrow - tend to accumulate in large #’s in bloodstream

Answer 48

· most cancers result from a complex mix of multiple risk factors: · Genetic predisposition is not considered a key factor for triggering factors – present itself, but only 5% overall · Aspartame – artificial sweetener False – cell phone use, hair dyes, and aspartame intake are known to cause cancer Iatrogenic infection

Answer 49

Age teady increase in incidence throughout adulthood * > 50 y: 90% of new cases, 96% of cancer deaths * Why is age a risk factor? * Exposure to cancer-causing substances (carcinogens) * Immune system becomes weaker with age

Answer 50

· Healthy lifestyle is associates with significant risk reduction · Body weight control – 33% preventable weight, diet, physical activity, smoking and alcohol

Answer 51

· Red/processed meat, salt, and alcohol increased risk □ e.g. sodium nitrates → nitrosamines * added sugars/dietary fat → weight gain veggies/fruits, fibre = protective effect

Answer 52

* regular PA risk increased □ promotes GI, increased immune function, healthy bodyweight

Answer 53

overweight/obesity increased risk □ effect on hormones, inflammation increased risk of mortality

Answer 54

· associates with many forms of CA □ leading cause of lung CA(80-90%)(NCI, 2019) □ most common form of CA in Canada AND leading cause of cancer deaths (26%) (CCS, 2019) · contain ~70 carcinogenic chemicals increased risk (20-30%) associated with second-hand smoke

Answer 55

* alcohol is a known carcinogen □ associates with many forms of CA Multiple mechanisms

Answer 56

* genetic inheritance □ accounts for ~ 5-10% of cancers * inheritance of gene mutation □ increases susceptibility □ e.g. breast cancer, colorectal cancer those who develop cancer based on genetic predisposition tend to develop it at an earlier age

Answer 57

* Environmental contaminants: □ toxic substances in air, water, soil □ natural or manufactured □ examples: asbestos, arsenic, formaldehyde □ risk associates with level of exposure & duration * Ionizing radiation □ e.g. x-rays, ultraviolet rays □ associates with DNA damage e.g. UV-B and skin cancer

Answer 58

· accounts for 17% of cancers worldwide □ 7% in developed countries · mechanisms: □ Chronic inflammation, immune suppression, DNA damage · examples: □ human papilloma virus (HPV) ® cervical cancer □ Hepatitis B, C ® liver cancer Helicobacter pylori ® stomach cancer

Answer 59

· Diethylstilbesterol (DES) - ~1940-1971 □ used to control bleeding during pregnancy and reduce risk of miscarriage, premature labor □ Increased risk of reproductive cancers, problems with fertility and pregnancy in daughters (NCI, 2011) * Hormone replacement therapy □ estrogen & progesterone □ Increased risk of breast, ovarian, endometrial cancer * Some chemotherapy treatments Increased risk for other cancers e.g. leukemia, lipomas

Answer 60

lifestyle behaviours: · healthy eating □ limit red meat, sodium □ avoid processed meat □ plant-based diet □ limit alcohol intake · regular PA · healthy body weight · no smoking · sun protection · ↓ infectious disease risk immunization, safe sex significant risk reduction (primary risk)

Answer 61

* Self-exams and cancer screening * early detection → early intervention □ Secondary/tertiary prevention · significant impact on disease progression · ↓ morbidity and mortality □ e.g. skin, colon, prostate, testicular, cervical and breast Caught cancer and early treatment

Answer 62

skin check - A - asymmetry - B – border irregularity - C – color is not uniform - D – diameter > 6mm - E – evolving, is it changing over time? breast self exam · become familiar with look and feel - monthly □ lumps, dimpling, swelling, redness, changes in nipple testicular self exam - monthly unusual lumps, markings · Recommends done in a lay down position · Hot shower before testicular self exam, common age 17-34. See if something unusual happening. Painless, enlargement, thickening of the tissue. Multiple section just like slices of oranges

Answer 63

* breast: * Mammography, genetic testing * colorectal: * NEW: fecal immunochemical test (FIT) * colonoscopy * prostate: * Rectal exam * Prostate-specific antigen (PSA) * cervical: · Pap test - Genetic CA 1 or CA 2- common test for young women or women who do have a breast cancer family history - FIT – looking for blood cells in the stool that should not be there - Prostate (only for men) Cervical – delayed until women patient is sexually active

Answer 64

* screening tools also used for diagnostics * in addition: * biopsy ○ Removal of tissue - examined by pathology * Diagnostic imaging ○ MRI, CT scans □ tumor location, size, shape □ Metastases Biopsy, needle (take out a small sample of lipid, if able good sign, if not, bad sign)

Answer 65

* staging: extent of disease at diagnosis * T: how large is the tumor? * N: have cancer cells spread to regional lymph nodes? * M: has cancer spread to other parts of body? (metastasis) * grading: other important tumor characteristics Stage 0 (in-situ): non-invasive Stages 1-4: invasive

Answer 66

* removal of the tumour * Surrounding tissue goal: * Clear margins * Leave no irregular cells behind

Answer 67

* destroy cancer cells, prevent growth, * prevent angiogenesis * target cells dividing rapidly * collateral damage → side-effects * usually 4-8 treatments over 3-6 months * adjuvant vs. neoadjuvant what’s ahead? * Targeted therapies ○ less toxic to healthy cells ○ fewer side effects Shrink cancer cells

Answer 68

* Radiation * Most effective in treating localized tumours * Destroys malignant cells - Local damage of healthy cells (side effect) · Often requires daily treatments over 4-6 weeks · May radiate larger areas - E.g. whole brain radiation · New "surgical" techniques Stereotactic radiosurgery increase precision - new surgical technique (not actually surgery, very targeted and emerging)

Answer 69

· Cancer diagnosis less threatening/isolating today - Increased public awareness and improved prognosis · During active treatment - Improved medical car, education, support groups · Growing population of cancer survivors · Need for ongoing rehabilitative and support services - Effects of treatment- increased morbidity - Managing risks for recurrence of disease Emotional support -outside "circle of care"

Medical Illnesses Flashcards

(100 cards)