Module 3 Flashcards
(169 cards)
0
Q
How many of those diagnosed with heart failure are diagnosed for the first time?
A
Over 500,000
1
Q
Majority of those with heart failure are over the age of —- and hold —– percent of total
A
65, 80%
2
Q
What is currently the highest cost to Medicare?
A
Heart failure
3
Q
What are the total direct and indirect costs of heart failure
A
28 billion
4
Q
—- % of men and —% of women die within — years after being diagnosed with heart failure
A
80%, 70% and 8
5
Q
Which gender shows the least amount of improvement after the diagnosis of heart failure?
A
Women
6
Q
Heart failure occurs when
A
The heart is unable to meet the vascular demands of the body
7
Q
The most common cause of heart failure is
A
Ischemic LV dysfunction
8
Q
Three important characteristics of those with heart failure
A
Decreased tolerance to exercise, fluid retention in extremities and abdomen and no signs and symptoms of a different cardiac disorder
9
Q
Dysrhythmia that is a huge (500%) risk factor for stroke
A
A fib
10
Q
The moist sudden cardiac deaths are due to
A
V-fib
11
Q
What is the leading cause of morbidity and mortality in the elderly?
A
Coronary artery disease/ischemic heart disease
12
Q
Nearly _____(frac) over 65 have CAD/IHD
A
2/3
13
Q
Define CAD
A
Insufficient blood flow to cardiac muscle
14
Q
What are the symptoms/effects of CAD?
A
Fatigue, dyspnea, limited ability to withstand increased work load on heart, increased response time to activity
15
Q
2 different names for acute coronary syndrome
A
Acute MI and unstable angina
16
Q
Major risk factor for acute coronary syndrome?
A
Atherosclerotic buildup in coronary arteries obstructing oxygenated blood flow to cardiac muscle
17
Q
What is angina?
A
Chest pain due to insufficient oxygen delivery to cardiac muscle
18
Q
What is stable angina?
A
Occurs only during exercise or stress
19
Q
What is unstable angina?
A
Unexpected and occurs at rest
20
Q
How much money was spent on HTN in 2011?
A
94 billion
21
Q
What is the most prevalent condition in those over 65?
A
HTN
22
Q
Values for pre hypertension:
A
Systolic: 129-139 diastolic:80-89
23
Q
Values for stage 1 hypertension mild
A
Systolic: 140-159 and diastolic 90-99
24
Values for stage 2 hypertension moderate
Systolic: 160-179 and diastolic: 100-109
25
Values for stage 3 hypertension severe
Systolic greater than 180 and diastolic greater than 110
26
The two types of valvular disease
Stenosis and insufficiency
27
What is valvular stenosis?
Narrowing of the valve that restricts blood flow
28
What is valvular insufficiency
When the valve does not close completely resulting in backward flow
29
What are the two other names for valvular insufficiency
Regurgitation or leaky valve
30
What is myocardial degeneration
The decline of cardiac performance resulting in slow HR recovery and absence of an increased SBP with exercise
31
What is peripheral vascular disease
Partial or complete obstruction of blood flow in periphery
32
What is buerger's disease
Thromboangitis obliterans: a highly cellular, segmental and inflammatory occlusive thrombosis
33
Buerger's disease presently commonly in...
Smokers with distal ischemia
34
What is arteriosclerosis
Hardening of the arteries
35
What three things happen in arteriosclerosis
1 thickening and hardening of the arterial wall 2- accumulation of fat in the intimal lining of the blood vessels 3- increase of connective tissue in the subintima
36
What is atherosclerosis
Type of arteriosclerosis where there is a buildup of plaque in the blood vessels walls which obstructs blood flow in any area of the body
37
What is the second most common reasons for hospitalization in those over age 65?
Pneumonia
38
What is pneumonia
Acute inflammation of the lungs caused by bacterial viral or fungal pathogen
39
What are the symptoms of pneumonia
Rapid shallow breathing, fever, cough and chills
40
How will NHAP differ from pneumonia
More subtle symptoms like confusion or sleep alterations
41
What is fibrosis
The thickening of the alveolar walls as fibroblasts lay down thick collagen bundles
42
What is COPD
Both emphysema and chronic bronchitis
43
Typical vital signs in those with pneumonia
Tachycardia, hypotension, tachypnea, dyspnea, desaturation
44
Auscultation results on someone with pneumonia
Diminished normal breath sounds, rales, low pitched wheezes, bronchial breath sounds
45
Palpation results on someone with pneumonia
Increased tactile fremitus, dull percussion over consolidation, possible decrease in chest wall excursion
46
Blood has results in someone with pneumonia
Decreased PaO2 and possibly altered PaCO2
47
What would be the observable signs in someone with pneumonia
Fever, increased work to breath, facial distress, cyanosis
48
What is the most common cancer death
Lung
49
Men who smoke are ____ times more likely to get cancer
23
50
Women who smoke are ____ times more likely to get cancer
13
51
What is cor pulmonale
Right sided heart failure brought on by long term HTN in pulmonary arteries And RV
52
Cor pulmonale is present in...
End stage lung disease
53
What is osteoporosis
A systemic skeletal disease causing decreased bone mass and deterioration of bone
54
What three areas are at the greatest risk for fracture in those with osteoporosis
Wrist, hip and spine
55
There are ___ fractures every year in those over 50
2 million
56
Normal t score results
-1 to 1
57
Osteopenic t score results
-1 to -2.5
58
Osteoporotic t score results
-2.5 or lower
59
What is pagers disease
When osteoclasts are more active than osteoblasts but then osteoblasts over react and make chaotic excess bone
60
What are the characteristics of bones in those with pagets disease
Irregular mosaic pattern, large, deformed, brittle and weak
61
Over ____ people have Pagets and it is more common in ______
One million, men
62
What is osteoarthritis
Degeneration of articular cartilage and inflammation of synovium with a progressive loss of hyaline cartilage
63
What feature is common in OA
Osteophytes
64
What are the symptoms of OA
Impaired mobility with ADLs, deep ache and joint stiffness with inactivity, loss of flexibility and joint surface congruity
65
In those with knee OA what is the strongest predictor of pain and deterioration in function ability
Quad weakness
66
What in RA
Chronic inflammatory systemic disease effecting the synovium of joints leading to joint damage chronic pain and decreased function
67
What is stage 1 RA
Synovium swelling, warmth, pain, stiffness, erythema and joint effusion
68
What is stage 2 RA
Rapid division and growth of cells and thickening of synovium
69
What is stage 3 RA
Release of enzymes from inflammatory cells, development of granulation tissue (pannus) causing bone and cartilage destruction and joint malalignment
70
What is delirium
A fluctuating attentional state causing temporary confusion and loss of mental function
71
Delirium is present in ___% of adults in acute/ nursing home/SNF
70-80
72
Possible causes of delirium
Drug toxicity, systemic illness, oxygen deprivation, environmental changes and sensory deprivation
73
What is a screening test for delerium
Confusion Assessment Method
74
In dementia patients, they tend to retain ____ memory but have no_____ memory
Implicit, explicit
75
By age ___ 1/3 have some form of cognitive impairment
85
76
Stages of dementia cover a span of ___ to ____ years and has a _____ pattern
8-10 and fluctuating
77
_____ people have AD and this will increase to _____ by 2050
5.5 million, 15 million
78
How much in care does AD cost per year
60 billion
79
AD will lead to death in ____ years after diagnosis
3-9 years
80
2 markers in AD
Amyloid clumps and tau protein neurofibrillary tangles
81
2 cerebellar characteristics in AD
Atrophy and loss of nerve cells in hippocampus
82
Which chromosomes are of interest in those with AD
1,14,19,21
83
Chromosome 1 is the
Pre senile gene
84
Chromosome 14 is the
Pre senile 2 gene
85
Chromosome 19 is associated with
Later onset AD and responsible for cholesterol metabolism
86
Chromosome 21 is responsible for
Breakdown of amyloid precursor proteins
87
What is the age risk factor for AD
Doubles every 5 years after age 65
88
What is multi infarct dementia
Vascular infarct in both gray and white matter of brain
89
Which past medial history component increases changes of multiinfarct dementia
Stroke, CVD, HTN
90
What is the distribution of deficits in those with multi infarct dementia
Spotty and patchy, areas of impairment with areas of preservation
91
Word that is characteristic of the neuro signs and symptoms associated with multi infarct dementia
Focal
92
What emotional aspect is associated with multi infarct dementia
Emotional lability ( laugh or cry unexpectedly where it isn't appropriate)
93
10% of dementia cases are of this type
Lewy bodies
94
At what pace does Lewy Bodies dementia progress
Gradually
95
Physical symptoms of Lewy bodies
Stiffness, rigidity, slow movement patterns, poor balance, fine motor problems, sleep problems
96
Lewy bodies can mimic
Parkinson's
97
Sleep issues in Lewy Bodies
Insomnia and nightmares which can lead to depression
98
Does physical abilities in those with Lewy bodies evolve linearly or fluctuate
Fluctuate
99
What is the most common cause of disability in the US
Stroke
100
What is the distribution of outcomes after stroke
1/3 die, 1/3 severe disability and 1/3 mild disability
101
Majority of strokes occur over age
74
102
What are the risk factors for stroke
A fib, diabetes, genetics, high cholesterol, age, race
103
When do symptoms usually appear in Parkinson's
5-6 years before diagnosis
104
What are the early motor symptoms of Parkinson's
Bradykinesia, tremor, rigidity, asymmetrical distribution and postural instability
105
What is hypokinesia
Slow movements associated with PD
106
What is hypophonia
Loss of loud speech ( Parkinson's )
107
2 nutritional deficits that can cause peripheral NS issues
Folic acid and vitamin B12
108
Folic acid is important for
When tissues and cells are growing rapidly
109
Vitamin B 12 deficit can cause and what other function is it important for
Pernicious anemia due to malabsorption and brain cell function
110
Heavy metals can cause
Toxic neuropathy
111
What is chemotherapy induced peripheral neuropathy
Adverse effects damages nerves: pain, parasthesia and dyesthesia
112
What causes Herpes Zoster shingles
A decline in cell mediated immunity
113
What does Herpes Zoster shingles look like
Painful, blistering skin rash
114
How long before herpes zoster shingles crusts over and isn't contagious anymore
2 weeks
115
What is postherpetic neuralgia associated with herpes zoster
Pain and allodynia
116
What is seborrheic keratosis
A benign epidermal neoplasm
117
What sections of the body does seborrheic keratosis effect
Head, neck and trunk
118
What does seborrheic keratosis look like
Verrocous surface "stuck on" appearance, tan to brown in color
119
What is the leading cause of blindness in those over 55
Macular degeneration
120
What is the most common kind of macular degeneration
Dry - causes loss of blood vessels to the eye
121
What is macular degeneration
Breakdown of layer of retinal pigment epithelial cells in macula
122
Symptoms of macular degeneration
Color perception, loss or blurry central vision
123
What is cataracts
Lumping of proteins that clouds the lens
124
What is the prevalence of cataracts
70% in those over 75
125
What are the symptoms of cataracts
Blurry vision, night vision, faded colors, double vision
126
What is glaucoma
Increased intraocular pressure / blocked outflow in drainage canal
127
What is the most common type of glaucoma (90%)
Open angle that damages the optic nerve
128
What is presbycusis
Inability to hear high frequency sounds
129
What is tinnitus
Constant crackling, buzzing, ringing or whistling
| Distortion of accurate reception of voices/environment
130
What is otalgia
Ear pain from an otologic process that may refer along the neural pathway
131
The neural pathway effected by otalgia
Trigeminal, glossopharyngeal, vagus and cervical nerves
132
What may cause ear pain from another structure by referred pain
TMJ pain
133
Accumulation of cerum results in feelings of
Fullness or dizziness
134
A possible reason for accumulation of cerum
Dehydration
135
Dysphagia can be a symptom of what what issues
Neuro condition , tumor or mechanical issue
136
A lower UTI is called
Urethritis
137
An upper UTI is called
Bladder infection or cystitis
138
Risk factors for UTI
Female, cathederization, weak pelvic floor, diabetes, MS, SCI, urinary obstruction, kidney stones, large prostate, AD, PD, history of neurogenic bladder and history of stroke
139
What is acute renal failure
The kidneys are unable to filter properly causing a rapid buildup of toxic waste products and drugs, fluid overload, and elevation of serum potassium
140
What is chronic renal failure
Slow deterioration of renal function causing a permanent loss of nephrons
141
What is the leading cause of renal failure
DM and HTN
142
What are the signs and symptoms of renal failure
Anemia, fatigue, wasting, reduced work capacity, low exercise capacity.
143
Stage one renal failure
Diminished renal reserve, glomerular filtration rate about 50% of normal
144
2nd stage renal failure
Renal insufficiency, GFR about 20-35% of Normal
145
What two key characteristics appear in 2nd stage renal failure
Anemia and HTN
146
3rd stage renal failure
Renal failure , GFR <20% of normal, kidneys unable to regulate volume and solute composition
147
4th stage renal failure
Aka end stage renal disease, 90% of kidney function has been lost
148
What is diabetes mellitus
Progressive disease caused by a combination of metabolic disorders that result from coexisting defects of multiple organ sites
149
In DM ___ cells lose the inability to _________
Beta cells , produce insulin
150
Many people have DM ___ years before diagnosis
10
151
Most common type (cell) of cancer
Carcinomas
152
Carcinoma cells ______
Cover external and internal body surfaces
153
Sarcoma cells _____
Found in supporting tissues
154
Lymphomas are found in
Lymph nodes and tissues of the immune system
155
Leukemias are
Immature blood cells that grow in bone marrow
156
Cancer affect ___ in ___ women and __ in ____ men
1 in 3 and 1 in 2
157
What is the most common kind of cancer
Skin
158
About ___% over 65 have skin cancer
50
159
What is the ABCDE method for evaluating a mole
Asymmetry, border irregular, ragged or notched edges, Color, diameter greater than 6 mm, evolution, enlargement or elevation
160
Hypothermia is core temp of ___ or lower
95 F
161
Signs of hypothermia
Slow or slurred speech, sleepiness or confusion, shivering or loss of mobility in extremities, poor control of movements, slow reactions, weak pulse
162
What is heat stroke
A life threatening form of hyperthermia where body temp is greater than 104 F
163
Symptoms of hyperthermia
Mental status changes, strong rapid pulse, lack of sweat, dry flushed skin, faintness, staggering, coma
164
What is panic disorder
A sudden unexplained attack of terror or fear
165
Symptoms of panic disorder
Heart palpitations, sweating, chill, weak, faint, dizzy, extremity tingling, numb, nausea, chest pain or dyspnea
166
Four common causes of chronic disease
Inactivity, poor nutrition, tobacco use, excessive alcohol consumption
167
How many adults do not meet physical activity recommendations
1/3
168
Only ___% of adults reported eating 5 or more servings of fruits and veggies per day
24%
