Test 2 - 7-11 Flashcards
1
Q
RA aka
A
Inflammation Arthritis
2
Q
Risk Factors RA
A
Periodontal
Genes
Sex
Age
Live births
3
Q
Number of People living with RA
A
374,000 over 16 years old
4
Q
Ra been around since
A
1990
5
Q
Ra prevelance men or women
A
3-5 higher in women
6
Q
RA affects how many joints
A
5+ joints
7
Q
Why is diagnosing RA and PsA hard
A
no single test adn sympotms differ between people
8
Q
what is essential for diagnosis to prevent long term damage
A
early and accurate diagnosis
9
Q
PsA described as
A
persistent inflammation. adn progressive joint damage and disabilty
10
Q
How many people ahve PsA
A
0.25 % of canadians and 01-2% of world
11
Q
PsA men or women
A
equal to both but sometimes women see worse symptoms
12
Q
What is psA related with
A
Psoriasis 5-30% of the time
13
Q
Risk factors for PsA
A
Psoriasis
Psoriasis nail dents
Genetics
Obesiuty
Trauma Stress Infectionm
14
Q
Pathophysiology of PsA
A
triggereed by the inflammaotyr cascade
15
Q
Physical effects of RA
A
cartiladge adn bone with joint destruction and destabilization
flare ups
progressive
16
Q
Physical effects of PsA
A
worse in the morning and at insertion points
uvetis
IBS
swollen fingers
nail dents
fatigue
17
Q
Cpmorbidities of PsA
A
everything with being fat
high cholesterol
cvd Chf
lover disease
hypertension
18
Q
Treatment of PsA and Ra
A
intedned to releive pain
and decrease inflammation
it is incurable
you can use
driugs to slow the progression
ot/pt
joint replacemtn/repair
19
Q
management of RA and treatment of PsA
A
managemnet of RA has gotten better - imporoving quality of life
treateemtn of PsA has gotten better over past 10 years
20
Q
A
21
Q
special considerations of RA Psa
A
immobilization adn inactivity can amplify effects of RA PsA
gotta think about their
level of fitness
fucntional capacity
age
medications
joints affected
22
Q
Osteoarthritis
A
LOCAL degeneerative disease one or multiple joints
23
Q
OA most common in body where
A
hands , hip, spine, knees,
24
Q
Whats unlcear about OA
A
if its one diease or multiple conditions creating the outcome
25
Difference in symmetry between OA and RA
OA is asymetriacal
Ra is usually symettrical
26
OA is described physiologically as
continuouus abnormal remodelling of joint driven by inflammation
27
how many people in 2020 with OA
595million
28
how many will have OA by 2050
60-100% increase in 595million
29
OA difffernece men adn woamn
woman hands foot knees
men - hips
+ higher incidence in OA in women 50 years or older
30
Economic burden of OA
17.5 billion by 2031
31
OA risk factors
advancing age
sex
obesity
geneitcs
metabilic syndrome
acite trauma
32
primary and secondayr OA
primary OA is no obvious cause
Secondary is cause becuase of previous inury
33
OA end stage results in
cartidage erosion
stiff in the mornings
immobility
exercise intolerance ( low aerobic capcity)
decrease AODL
34
treating OA
incurable
drugs
heat/ice
assistive
Multidisciplinary
- ot/pt
- cognitive behaviour therpau
- risk factor management
-acupunture
35
what is essential to OA
regular exercsie to
improve atrophy
increase aerobic capacity
metal health
strenght
36
Special considerations for OA
5-10 minute warmup and cool down
if pain lasts longer than 2hours then stop and decrease worload
time your drugs with when you work out
dont workout during flareups
37
Testing Hudieliens Arthirtis
start with treadmill then work your way down to cyle etrgometer then ahnd ergometer depending on prgeression of ddiesase
start at 2-3 times a weeka dn get it to 3-5 then 150 minutes in total
do ROM adn resistance
38
what is cancer
incontrolled growth and metastasis of abormal cells resulting in damge to DNA
39
what are the 5 types of cancer
carcinoma
sarcoma
leukemia
lymphoma
meyloma
40
how manby types of cancer are there
100
41
what is carcinoma
effects epitheleial tissue and lining inside organs or passaseway skin
80-90% of cancers are Carcinoma
42
what is sarcoma
effects the connective tissue
43
what is leukemia
effects the blood
44
what is lymophoma
effects the immune system ( glands/nodes0
45
what is myeloma
effectsthe plasma of bone marrow
46
what is a neoplasm
abnormal growht of tissue
47
what is the leading cause of death in canada
cancer
most common are pancreatic, colorectal, breast and lung
over past 50 years
48
what cancers have declines
overall rates of cancers declined in past 10 years excpectop
cervical and melanoma
49
who has a hard time getting cancer health care
gays
racial groups
low income groups ( low screening and high mortality)
50
Cancer explain gene process simply
protooncogene controls cell regualtion of growht
once mutated the protooncogen becomes an oncologist gene and now works to icnrease cell growth
51
Tumour. Supressor Cells
work to supress tumour growht but when mutated they dont do their job
52
Risk Factores fo Cancer
Inactivity factors
Obesity factors
Envrionental Factors
Genetics
Mutations casue by
Behaviour, Environemtnal, Geneit
53
common treatments of cancer
radiation - better now with proton radiation ( not killing as many healthy cells)
surgery
chemotherpay
immunotherpay/hormone therpy
all curative or pallative
54
All treatements come with the risk of
cardiotoxicicties
(broad range of life threatenign colications of cvd and chf)
55
Pscholoigcal impact
fear of reccurence most commone 80%
Fear of distress ( 40% adn 58% ( palliative)
ancxieyt depression
all causing sleepi issue and therfore fatigue
56
exercsie for cancer
icnrease enrgy nad muscel mass and strenght and body comp and sleep
57
moderate to vigour intesity progressive exercsie traiing helps with what with cancer
decreases reoccurence of death in breast and colon cancer
58
59
cancer guideline
150 minutes aweeek
3-5 days
with resistance 2 times a week
60
Special Condiserations for cancer guidleines
dont do 1rm if they just had surgery
avoid pain
indivdualize the program
avoid pools with a catheter
61
healthy peple who survived cancer
can use regualr adulty healthy guidlines
62
FibroMyalgoa also know as
chronic widespreasn MSK Pain
or Complex pain syndrome
63
Fibro more common in who
80-90% women
64
What fdeos Fibro do
general attack of CNS
fatigue, intestinal disorders
overall pain sensitivity to pain
causeing lack of sleep concentration,
imnflammttion of brian spine and peripheral tissue
65
amount of peopple woht fibromyalgia
2-8% of the world ( relatively common)
2% of canada
66
Fibromyalgia timeline
19th century
19050 - Pain Syndrome
1970/80 - CNS causes
1990 - american college of rheumatology
67
Risk Factors of Fibromyalgia
middle age ( 35 years old)
REHUMATODI ARTHRITIS AND LUPUS
68
Fibromyalgia and rheumatic disease
- 25-65 % of the time Fibromyalgia and Rheumatic disease together
often confused with arthritis
69
70
Two diagnosiss of Fibromyalgia
1. bilateral pain, aboce adn below hips central pain
2. chronic pain for 3 months in 11/18 touch points
71
Impact of Fibromyalgia
2 x more hospitalizations
3x more depression
headache
72
treatments for fibromyalgia
eucation
acupuncture drugs
stress managemnt
beahvioural therpay
73
Exercise fo rFibromyalgia
all iporves quality of life
aerobic traing cna decrease intensity of pain, better sleep adn cognition
resitance traingn
- reudces pain intesity, beter sleep adn fiucntional capacity and strenh
74
exercsie guidleines for fibromyalgia
tai chi and yoga
pt and ot
use regualr testing and regular healthy adult guidlines
low intesity ot start 20 -30 minutes
75
COPD abnormal responses
decrease peak values
lower lactate threshold
increased dyspnea
76
5 types of pulmonary hypertension
PAH - idiopathic not knoe casue ( genes , HIV, lupus etc) ( rare)
PH LEft Sided heart failure (most common )
Ph Lung disease (less common )
CTEPH ( rare)
PH caused by other( rare)
77
hwo many people with Pulm Hyoper
5000 diagnosed
10,000 total
78
how ong to diagnose PH
2 years
79
Risk Factors of PH
Living at altitude
drugs otxins
osesity
family history
80
what race has most PH
white t(85.4) hen black 12.3)
81
Types of PH that effect certain genders
idiopathic and genetic PAH - 1.8-2.5 x more in women
preganncy efects ( PAH and CTEPH)
82
How long to live with PH
NO cure
treated 50% live 7 years
untreated 2-3 years
worse in elderly peppl
83
Psthophysiology of PH
high PAP and high PVR casueing strain adn load on right side of heart
84
right heart catheterization when
PAP greater than 20 mmHg
85
symptoms of PH
fatigue, dizziness, swelling in ankles
exercise intolerance
blue lips)
86
Exercise intolerance in PH becasue
dyspnea fatigue
oxygen desatuartion
no increasing pulmonary blood flow
87
when can we predict PH
a 6 minute walk test less than 332 m
88
in PH exercise intoleracne threshold and vo2
anaerobic threshold becomes a higher fraction of vo2 as disease progesses
89
reduction in vo2 max from PH
70 to 27%
90
treating PH
oxyugen
drugs
lung heart transplant
lifestyle change
91
acute exercise with PH
increased PVR
decrese exercise induced vasodialation
o2 desaturation
leads to
low Vo2 peak
reduced Q
low vent
reduced oxygen uptake peripherally
92
Chronic exercise with PH
increases quality of life, msucle function
may improve pulmonary Pressures
vo2 max
o2 consumption at anaeraobic thresh
93
PH exercsie guidlines
light to moderate aerobic accitivty with light resitance exercise of small muscle groups
94
BORG rating PH
11-13 ideal
95
Special considerations with PH
dont lift heavry
dont go to altidut e
optimixze o2 prescription
varying exercise capacity so be aware
96
Cytstic Fibrosis Exercsie testing
HR adn BP will usually be normal but decrease peak HR thoruought disease progression
reduced muscle strenght so be caerefil
increase in disease decrease in breathing rate
97
cycstic times a week up to 18
60 min a day 3 x a week for aerobic adn
resitiaance 2-3 times aweka with
98
Cytstic over 18 (19)
150 minutes a weekk
60 minutes a day 3 x a week adn 2-3 resitance trainign
10 munte bouts
99
3rd leading cause of dath globally
COPD
100
8th leading cause of disability
COPD
101
Epidemic COPD ?
1990 -2015 increased COPD by 44%
102
definiton of COPD
heterogenous lung conditon
wioth choric respiratory symotoms becaue of abnormalities in airways becuase of bronchitits and emphysema airflow obstruction
103
how many canadians in canada with copd
2 million 35 years plus 2012 stat
104
COPD economic burdern
4 billion
and worse if co morbid
105
leading cause of COPD Exacerbations
Resp infections
Scents
Cold weather
1-2x a year
106
copd higher in who
men
smokers
and people over 40
hihgest in peopel ver 60
107
Patho genesis of COPD
linits the empytying of lungs by over inflation adn trapping of gases
exposure
then lung injury
then airway abnormalities (structural changes
then airflow obstruction
108
TYpes of COPD
COPD
G - geneitc
D - fdevelpopment of lungs in birht
environmental
C - cigarettes
P - poluution
I - infections
A - asthma
U - unkown
109
MEchaism of airway disorder
1airway gets lumen blocked
2thickend wall
First two are obstructive Bronchities
3. loss of elastin ( emphysmA )
(airways collapsing)
110
Diagnosing COPD
Spirometyr ( often underused and used after they give vasodialator)
xrays
O2 saturation
FEv1.0/FVC = <70%
111
COPD Risk Factors
smoking , ashtma , age , pollution geneitcs
112
Genetics in COPD
1-2% of all COPD cases have the loss of a alpha 1 anti trypsin gene
the best documetned gneitc risk factor is of you have the deficiency of alpha 1 anti trypsin
113
complication at end of PH
CVD
PH
REspiritatoyr Failure
114
115
COPD is what type of tropic
Pleiotropic meaning it can effect so much more than just the lungs ,
skeletal muscle,
anmeia
osteoporisos
weight loss
systemic inflammation and economic burden etc
116
COPD and depression adn Anxiety
poeple with COPD increae risk of depression (40%) and anxiety by (36%)
117
Managing COPD
Exercise,
Stop Smooking
Medicaction
O2 supplement
surgery
exerfcise adn educational
118
COPD Exercise rehab recomend
12 week prgogrma to decrease hospitilzation and death
being caregfulyt of decrease values peak values adn lwoer lactate acid threshold
aand increase dyspnea
shorter seessions adn respiratory muscle traiign
119
