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Flashcards in Unit 3 Deck (56):
1

Type 1 Diabetes vs Type 2 Diabetes

1: unable to produce insulin 2: insensitive to insulin

2

Diabetes Mellitus causes

kidney failure, lower limb amputations, blindness, cognitive impairment, incontinence, fracture risk, cancer

3

More ___ has Diabetes Mellitus

American Indians/ Alaska Natives > blacks
Low SES--> high fat diets, low exercise, low healthcare

4

Type 1 Diabetes

Autoimmune disease attacks islet cells of pancreas; young onset; lack of glucose use causes keto-acidosis

5

Type 2 Diabetes

Insulin resistance; older onset;

6

Hypoglycemia vs hyperglycemia

Hypo: low blood sugar
Hper: high blood sugar

7

nerve damage at legs and feet caused by high blood sugar

Diabetic peripheral neuropathy

8

Causes of diabetes

bacteria/viral infections (damage islet cells), overactive immune system, genetic, "Westernization"

9

Diathesis-Stress Model of Diabetes

Direct: Stress--> abnormal blood sugar responses
Indirect: Stress--> reduce commpliance with treatments

10

What does a health psychologist do to help patient?

Increase knowledge, treat related depression, anxiety, improve adherence to treatment, improve communication and social support

11

Illness instrusiveness

How chronic illness disrupts an individual's life

12

blood glucose awareness training

improve glucose control to prevent health complications and accidents from hypoglycemia

13

metastasis

proliferation and spreading

14

immunocompetence

ability of immune system to defend body against the harmful effects of foreign agents

15

immune surveillance theory

cells of the immune system play a monitoring function in searching and destroying abnormal cells

16

chemotherapy

medicines to treat cancer

17

radiation therapy

X-rays/ y rays

18

Alternative treatments

generally unproven, relieve symptoms only

19

Immunotherapy

checkpoint inhibitors: block mech that cancer shut down immune system; cell therapy: CAR T cells are modified from virus to have antigen receptor CD19, which can bind to B-cells.

20

Limitations to CAR cell therapy

small number of cancers attack B cells; only works for some patients; increased immune response; expensive and time consuming

21

Lartigue et al

epigenetic dysregulation leads to tumor promoting gene activation. Drugs that target enzymes that lead to these epigenetic changes could prevent cancer

22

Childhood adversity

causes greater emotional and physiological sensitivity to stress--> dysregulation of the immune system,

23

Nocioceptive pain vs Neuropathic pain

Nocio: damage to tissue or organs Neuro: neurological damage or perception of damage

24

Pain pathway

Free nerve endings travels to 2 fibers: C-fibers and A fibers.
C-fibers go to the spinal cord then the cerebrum (anterior cingulate gyrus and somatosensory cortex)
A-fibers go to the dorsal horn of the spinal chord then thalamus then cerebrum.

25

A fibers vs C-fibers

A: fast, myelinated, big (prickling)
C: slow, unmeylinated, small (burning)

26

anterior cingulate gyrus vs somatosensory cortex

emotional experience of pain; sensation of pain

27

Substance P

neurotransmitter secreted by pain fibers in spinal cord

28

Substance P is modulated by

endogenous opiate peptides Ex. enkephalins

29

Pain inhibiting system

inhibitory interneuron from the midbrain blocks fibers from signalling to brain

30

Gate control theory of pain

spinal cord and brain stem has "gates"
If open: signals stimulate transmission cells to brain
If closed: no signal to brain and no pain
Fast fibers tend to close gate and slow tend to open gate.

31

How to determine pain

McGill Pain Questionnaire

32

How to manage acute pain

patient education, CBT, self-control of situation (self-administer pain meds), steady use of pain meds

33

complex regional pain syndrome

affecting limbs after injury where pain is out of proportion to injury

34

fibromyalgia

musculoskeletal pain that is widespread and often due to fatigue, sleep, memory and mood issues

35

CBT cognitive behavior therapy

explore thoughts, feelings and behaviors (cognitive, physical and emotioanl interventiosn), self-efficacy, change patterns in thinking, education of pain, setting goals,

36

HIV basics

virus that enters CD4 cells and destroys them

37

Life cycle of HIV

1. binds to CD4 2. fuse to CD4 3. HIV RNA is changed to DNA via reverse transcriptase and enters nucleus and combines with DNA 4. Replicate HIV proteins 5. assemble and moved to surface 6. noninfections HIV pushes out. protease cuts up proteins to make it infectious HIV

38

Treatment Action campaign

capmaign for changes in AID treatment

39

Project Accept

tested community based voluntary counseling and testing model by interviewing HIV discussions with partners

40

Results

Women accepted men having multiple partners; women had to initiate discussion; Men expected to initiate sex; women inable to persuade partner to test; married women unable to insist on condom use (lack of trust in men???)

41

Approach to HIV risk negotiating

1. HIV status ask to family or friends 2. media 3. joking to "test" for reactions 4. pregnancy or desire for children

42

Bennet et al

adherene to treatment for high blood pressure was 50-70% while 1 in 5 who started warfarin discontinued after 1 year.

43

Barriers to adherance

1. health systems 2. socio eco factors 3. therapy- related factors 4. patient- related factors 5. condition related

44

Why people hate vaccines

afraid about multiple vaccines; unnecessary; no trust in western medicine; cost; forget to vaccinate; social influences; natural is better; focus on dangers; forget deadly effects of disease

45

Barriers to health care

low SES less likely to seek healthcare, cultural beliefs might hinder seeking

46

Stages of delay in seeking medical attention

1. notice symptoms-->appraisal delay
2. Am i sick?--> illness delay
3. Do I need medical attention--> behavioral delay
4. Schedule a physician--> scheduling delay
5. receive medication--> treatment delay

47

What people want from health care provider

treat with respect, listened carefully to, spend time with them, care about health, up-to-date with research, be available

48

Affordable Care act

1. help insurances companies by forcing everyone to get insurance.
2. help ppl by giving them access to insurance (medicaid, medicare) and (pre-established diseases) and preventative healthcare

49

Accoutable care organization (ACO)

organization of health care providers that agrees to be acountable for the quality, cost and overal care of members

50

Green et al

For White: as implicit bias increased, treatment increased
For black: as implicit bias increased, treatment decreased
Those who became aware of bais were more liekly to recommend treatment--> can change

51

Tamayo-Sarver et al (2003)

race didnt' affect rates of prescription of opioids

52

How to increase awareness of implicit ias

Increase awareness, use objective criteria, health literarcy, representation in the med field

53

Theorell et al

Hiv positive patients with social isolation led to decrease in T cells

54

Galvan

social support was a critical factor in prgression of HIV and AIDs

55

Mo and Coulson, 2008

social support can come from the internet too

56

self efficacy on HIV

self efficacy led to increased condom use and improve outlook on life and personal control