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What are the 4 top causes of death?
1-heart attack/cardiovascular disease; 2-cancer; 3-cerebral vascular accident; 4-COPD;
What are the two types of influeza?
Influenza A & B
Which type of influenza should you worry more about?
type A
Which type of influenza is mainly in the animal population?
type B
What are the two antigens(anything that initiates the immune system) in type A influenza?
hemaglutinin and neuraminidase
Which type of influenza has different strands, H1N1 & H3N2?
Type A
What is antigenic drift?
mutations that occur during viral replication
What is a shift?
when an entirely new strain appears to defy immunity
Which is worse shift or drift?
shift
What age group does the influenza virus cause disease?
all age groups
What age ranges is infection of influenza highest?
greater than 65 years and less than 2 years
What did the US call the influenza pandemic we had?
The Spanish Flu Pandemic
How many people died in the Spanish Flu Pandemic?
25 million to 50 million worldwide
What years were the Spanish Flu Pandemic?
1918 & 1919
Where was the first case of influenza found?
in Fort Riley, Kansas
What are symptoms for influenza?
fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, muscle aches, stomach symptoms
What are 3 complications of the flu?
1-bacterial pneumonia; 2-dehydration; 3-worsening of chronic medical conditions
What are the two types of flu vaccinations?
flu shot & nasal-spray
Which type of flu vaccine is not alive, shot or nasal-spray?
shot
What is the age you have to be to receive the flu-shot?
older than 6 months
What is the "Flu Shot"?
an inactivated vaccine that is given by injection
What is the Nasal-spray Flu Vaccine?
"Live Attenuated Influenza Vaccine" (LAIV); alive but weakened
What is the age limit for the nasal spray?
5 years to 49 years of age who are not pregnant
What months is the best time to get vaccinated?
October or November
Through what months does the flu season occur?
October through May
What people should be vaccinated for the flu?
50 yrs or older; 6-23mos; nursing home residents; ppl w/ chronic heart or lung conditions, including asthma, metabolic diseases, and weakened immune systems; children on long-term aspirin therapy; women who will be pregnant during the influenza season; ppl who can transmit flu to others at high risk for complications;
What cohorts should NOT be vaccinated?
ppl w/ sever allergy to chicken eggs; severe rxn to an influenza vaccine in the past; ppl who develop Guillain-Barre Syndrome (GBS) (PNS inflammation disorder); children less than 6mos;
What was the name of the boy in the influenza video and how old was he?
Jake, 3 yrs, had flu
What kind of virus is the human immunodeficiency virus?
a retrovirus
What does HIV use to store info, RNA or DNA?
RNA
What two parts of the immune system does HIV have a strong affinity towards?
lymphocytes and phagocytes
What are macrophages a specific type of?
phagocytes
T cells are one of 2 types of what?
lymphocytes
What are the four kinds of T cells?
helper, killer, suppressor, and memory
What protects first macrophages or T cells?
macrophages
What do the helper T Cells do?
directly after the macrophages initiate, attack against foreign entity
What do the killer T Cells do?
respond to helpers and comes in to eradicate foreign entity
What do the suppressor T Cells do?
new lyphocyte production to a halt
What do the memory T Cells do?
establishes immunity to the foreign entity
What two things does HIV go directly for?
macrophages and helper T Cells
What don't the helper T Cells activate post-infection?
the killer T Cells
Are memory T Cells ever activated in HIV?
no
What year and where was HIV first reported in the U.S.?
NY & CA in 1981
Who in the late 1980's were susceptible to HIV?
invaneous drug users and ppl who participated in blood transfusions
What are the 3 transmission modalities of HIV?
Sexual, Blood-borne(rare), and Mother-child
Where is the largest population of HIV in all the world?
Africa; then India(E. Europe) & China(Asia)
What is the 1st stage of HIV?
flu-like symptoms; 2-6mos post-infection, up to 2.5yrs;
What is the 2nd stage of HIV?
asymptomatic HIV infection; referred by CDC as Category A HIV infection;
What is the 3rd stage of HIV?
Category B; 3 specific symptoms: peripheral neuropathy, pelvic inflammatory disease, herpes zoster;
What are the 3 symptoms from Category B/stage 3 of HIV?
1-peripheral neuropathy (numbness in limbs); 2-pelvic inflammatory disease (gastro probs.); 3-herpes zoster;
What is the 4th stage of HIV?
category C; synonymous with Acquired Immunodeficiency Syndrome (AIDS); symptoms include secondary infection and cancer-like conditions; when multi-symptoms are present AIDS is diagnosed;
Is HIV the cause of death?
NO
What are some category C/stage 4 symptoms?
candidiasis, cervical cancer, cryptococosis, cytomegalovirus, encephalopathy, herpes simplex, histoplamosis, Karposi's sarcoma, lymphoma, pneumonia, septicemia, wasting syndrome;
What does ADC stand for as far as AIDS/HIV is concerned?
AIDS Dementia Complex
How many AIDS patients will get ADC?
2/3
T/F ADC has been found in acute HIV infection period.
True
T/F there is a cure for HIV.
False
What is the treatment for HIV/AIDS?
education & public awareness; symptom maintenance;
What is the life expectancy of somone with HIV? AIDS?
21 years; 1-6 years;
What are the medications for HIV/AIDS patients?
reverse transciptase inhibitors (AZT, ddI, ddC); meds for specific symptoms;
How many pills does an HIV patient take approx, and what is the problem with taking so many?
10+ 4-5x daily; compounding effects can be lethal;
What are the 4 major popular myths about AIDS?
Casual contact can cause AIDS; HIV does Not cause AIDS; The US gov't created AIDS to eliminate ______ population; man and chimpanzee;
What number killer is Cancer?
2
___ in 4 individuals have some association with cancer
1
What is cancer?
abnormal, disorderly, and uncontrolled cell growth
Are cancer cells themselves dangerous?
NO
What is dangerous about cancer if its not the cancer cells?
there rxn with other tissues and cells nearby
What are the 3 main causes of cancer?
oncogenes, "trigger effect" and diasthesis-stress model, and carcinogens;
What is an oncogene?
specific genes, if activated turn on switch & allow cancer to grow;
What are carcinogens?
any foreign thing that allows oncogenes
What are the 4 classes of cancer?
sarcomas, carcinomas, leukemias, lymphomas
What type of cancer is sarcoma?
bones, muscles, and connective tissue & heart;
What type of cancer is carcinoma?
epithelial cells
What type of cancer is leukemia?
blood-forming agents
What type of cancer is lymphoma?
infection-fighting agents
What is the top cancer killer for men?
prostate
What is the top cancer killer for women?
breast
What are the 3 top environmental factors of cancer?
tobacco-30%, diet-30%, and virus/bacterial infection-10%;
T/F We know what causes cancer.
FALSE
What cancers are associated with tobacco users?
lung, larynx, pharynx, esophagus, bladder, pancreas, and cervix
What type of cancer is associated with diet?
breast, colon, pancreas, prostate, and ovaries
What type of cancer is associated with genetics?
breast, ovary, colon, lung, and melanoma
What is the acronym for cancer developed by the American Cancer Society?
CAUTION
What do the letters in CAUTION from the ACS mean?
C-hange in bowel/bladder habits; A-sore that does not heal; U-nusual bleeding or discharge; T-hickening or lump found; I-ndigestion or difficulty swallowing; O-bvious change in skin; N-agging cough or hoarseness;
What are the 4 symptoms of cancer?
1-pressing on nearby tissue, resulting in pain; 2-becomes large enough to be seen/felt; 3-interferes w/ blood vessels, resulting in bleeding; 4-causes change in nearby organ function, resulting in symptoms;
What are 3 ways to diagnose cancer?
physical exam; lab tests; serum chemistries taken for analysis; also imaging & scopes;
T/F More women get cancer than men.
FALSE, no gender preference
What is the name of the system used to decide on appropriate treatment for cancer patients?
TNM system; T-tumor size, N-regional lymph node involvement, M-degree of metastasis;
T/F If you are assigned the number 4 by the TNM system the cancer is absent.
FALSE, 0-absent & 4-bad;
What are 4 major treatment modalities for cancer?
surgery, chemotherapy, radiation, and biologic therapy
What is the oldest form of cancer treatment?
surgery
What is chemotherapy?
drugs are used to interrupt cancer cell growth;
What 3 ways can chemotherapy be delivered?
intravenous, ambulatory infusion pump, and intra-arterial infusion(liver cancer)
How many cancer patients use radiation?
50%, alone or with another trtmt.
What is radiation?
high energy x-rays and radioactive isotopes
What is biologic therapy?
biologic substances to manipulate immune system to combat cancer
What is glycoproteins(IL-2)?
showing no side effects and that it works to combat cancer in biologic therapy
What are 3 types of transplantation?
allogenic, autologous, and syngenic
What is an allogenic transplant?
from another individual
What is an autologous transplant?
remove cells & treat externally
What is a syngenic transplant?
only identical twins
Is transplant commonly used to cure cancer?
NO
What number killer is cardiovascular disease?
1
What is the leading cause of death in the US?
heart disease
What two classes did the New York Heart Association use?
functional and therapeutic
What is the functional class of NYHA?
estimate of symptoms
What is the therapeutic class of NYHA?
recommended physical activity restrictions
What are the 4 NYHA functional classes?
Class I, II, III, IV
What are the 3 symptoms of cardiovascular disase?
high blood pressure, pain, and fatigue
What is class I of NYHA functional classes?
heart disease but no active symptoms
What is class II of NYHA functional classes?
comfortable at rest but has symptoms during ordinary physical activity
What is class III of NYHA functional classes?
comfortable at rest but has symptoms with less than ordinary activity
What is class IV of NYHA functional classes?
symptomatic while resting
What are the NYHA therapeutic classes?
Class A, B, C, D, E
What is class A of NYHA therapeutic classes?
No restrictions needed
What is class B of NYHA therapeutic classes?
No "severe" physical activity
What is class C of NYHA therapeutic classes?
Regular physical activity should be restricted
What is class D of NYHA therapeutic classes?
no physical activity
What is class E of NYHA therapeutic classes?
complete bed rest/in chair
What is an example of how NYHA would give a complete classification using both functional and therapeutic classes?
II-B or IV-E
What are 6 specific heart diseases?
valvular heart disease, mitral valve prolapse, cardiomyopathy, coronary heart disease, congestive heart failure, hypertension
What is valvular heart disease also known as?
rheumatic heart disease
What does valvular heart disease damage?
valve tissue(mitral, aortic, tricuspid) resulting in stenosis
What age group does valvular heart disease effect?
typically around teens, very rare 30+
What is mitral valve prolapse?
clicking sound "systolic click murmur syndrome"; progressive degeneration of valve due to congenital defect or viral infection
What are symptoms of mitral valve prolapse?
chest pain, fatigue, palpitations, and a sense of anxiety
What is cardiomyopathy?
inflammation of the heart muscle (enlargement of the heart muscle-hypertrophic cardiomyopathy); nerve conduction in myocardium, resulting in cardiac irregularities; increased pressure;
What are the 4 causes of cardiomyopathy?
viral/bacterial infection, chemical exposure, diabetes mellitus, and alcohol abuse
Which of the 4 causes of cardiomyopathy occurs in younger populations? viral/bacterial infection, chemical exposure, diabetes mellitus, alcohol abuse
viral/bacterial cardiomyopathy
T/F Coronary artery disease is a leading cause of death in US.
True
What is coronary artery disease?
restriction of blood flow results in insufficient oxygen delivered to heart; myocardium necrosis & arterial narrowing due to plaque deposits; anoxia results in angina pectoris, poor nerve conduction, and fibrillation; can be insidious in nature; pain & fatigue noted before heart interruption; many ppl have CAD w/out myocardial infarctions
What are some causes of coronary artery disease?
cholesterol, hypertension, diabetes, stress, obesity, lack of exercise, and cigarette smoking
T/F Congestive heart failure is a diagnosis.
False, a symptom
What is congestive heart failure?
weakness of the heart muscle due to inflammation and blockages; cardiac hypertrophy in attempt to remain sufficient; thickening of myocardium, increasing risk of myocardial infarction;
What is hypertension?
insufficient pressure for blood flow to the body
What are 9/10 hypertension cases caused by?
Stress
What is systole?
pressure during muscle contraction propelling blood out of heart
What is diastole?
immediate pressure reading post-propulsion (at rest); if this is too great there is a problem;
What are the measurements of hypertension?
normal(lowest #), high normal, mild hypertension, moderate hypertension, severe hypertension, critical hypertension
What is the cause for 95% of those with hypertension, "essential hyperstension"?
no known cause
What is the cause for 5% of hypertension "secondary hypertension"?
kidney disease
What are symptoms for hypertension?
cardio symptoms, headaches, visual problems, nosebleeds
Are the symptoms for essential hypertension & secondary hypertension different?
No
T/F Individuals with cardio problems are seen in acute setting.
True
What medications are for cardiovascular diseases?
blood thinner (activase, coumadin), prescribed aspirin, ACE inhibitors (capoten), beta-blockers (lopressor)
What are diagnostics for cardiovascular disease?
physical, exercise testing, echocardiogram, electrocardiogram/Holter Monitor, cardiac radionuclide imaging, cardiac catherterization
What is cardiac radionuclide imaging?
used in diagnosing cardiovas. disease; injected into vein leading to hart which is viewed using a Gamma camera
What is cardiac catheterization?
used in diagnosing cardiovas. disease; dye is injected into heart via catheter and observed using X-rays
What are treatments for cardiovascular disease?
behavioral intervention(diet, exercise); stress management; medications; surgical intervention(agioplasty, bypass, prosthetic valve replacement, pacemaker, heart transplant)
What is the name of the longest heart study going on?
Framingham heart study
Can women have heart attacks too?
yes
What number killer is cerebrovascular accidents?
3
What is cerebrovascular accident also known as?
stroke
What is cerebrovascular accident?
any loss of blood flow to the brain
Is reoccurence common in cerebrovascular accidents?
Yes
How many arteries transport from heart to brain?
4, CVAs most commonly occur when these are interrupted which results in anoxia
What is the age range for cerebrovascular accidents?
age 60-has occured as young as 17
What are 5 typical CVAs?
cerebral embolus, cerebral thrombus, cerebral aneurysm, cerebral vascular malformation, cerebral hypertensive hemorrhage
What two CVAs are ischemic?
cerebral embolus & cerebral thrombus
What 3 CVAs are intercrannial hemorrhages?
cerebral aneurysm, cerebral vascular malformation, cerebral hypertensive hemorrhage
What is cerebral embolus?
ischemic vascular disease; foreign substance in bloodstream delayed or stopped blood flow; brain damage & problems after 6-10 minutes; results in permanent neuro deficits
What is cerebral thrombus?
ischemic vascular disease; clot obstructs carotid/vetebral artery resulting in brain damage; can result in Transient Ischemic Attacks (TIA)-mini-stroke w/ no residual neuro damage; obstruction over several minutes leads to rapid deficiencies;
What is cerebral aneurysm?
intracranial hemorrhage; rupture of cerebral blood vessel, resulting in open bleeding; occurs in 5th decade of life=50yrs;
What is cerebral vascular malformation?
intracranial hemorrhages; congenital disorder involving abnormal amts of cerebral vessels; vessels rupture due to entanglement; 50% CVMs before age 60;
What is cerebral hypertensive hemorrhage?
intracranial hemorrhage; resulting from hypertension; pressure in cerebral vessels, leads to rupture; occur in cerebrum and brain stem: breathing, autonomic system, and hear beat; MOST DANGEROUS TYPE~fatal by 1mos post-CHH
What are 4 neurological deficits from CVA?
hemiplagia, hemiparesis, asomatagnosia, visual/hearing impairment;
What is hemiplagia?
half body paralyzed; CVA symptom
What is hemiparesis?
sensation but motor weakness; CVA symptom
What is asomatagnosis?
phantom pain; CVA symptom
When involving below the cerebrum, neurological defects are what?
contralateral (most common)
When involving above cerebrum neurological defects are?
ipsilateral
What are 3 emotional deficits due to CVA?
lability-fluctuate from happy to sad; inappropriate behavior; depression;
What is the number one treatment for CVA?
craniectomy-get blood out
What are treatments for CVAs?
craniectomy; blood thinners-for thrombus; treatment for neuro probs PT/OT/ST, behavioral modification, counseling; medication for hypertension (avapro);
What are some considerations for CVAs?
not much warning & risk factors also anyone falls in them
What is diabetes?
class of diseases that are characterized by the human body's inability to metabolize glucose, resulting in defective insulin secretion and/or uptake; resulting in chronic hyperglycemia
What number of death is diabetes?
6
What is the dilemma for diabetes?
compliance-preventable factor
What are the 3 main types of diabetes?
type I, type II, and gestational & others
What is type I diabetes?
AUTOIMMUNE disorder, does not produce insulin
What is type II diabetes?
METABOLIC disorder, cannot produce enough OR properly use insulin
What is gestational diabetes?
Rare; pregnant women develop type II diabetes during pregnancy but remits after birth
Which type of diabetes is more common?
Type II
What are some risk factors for type I diabetes?
caucasians get it more; no gender or age risks; seasonal trends-born in winter mos.; wheat, soy, cow's milk;
What are some risk factors for type II diabetes?
no gender risk; before age 30 is rare; African Americans at greatest risk; strong family history risk;
What are 3 classic symptoms of type I diabetes?
polyuria, polydipsia, and polyphagia, & weight loss
T/F Is type II diabetes very insidious in nature.
True
What some symptoms of Type I diabetes?
Diabetic Ketoacidosis (DKA), hyperglycemic rxn; rarely Lactic Acidosis;
What are some symptoms of type II diabetes?
same acute symptoms for type I; add'l problematic long-term stage, such as: peripheral vascular disorders, peripheral neuropathy, LE amputations, retinopathy, leading cause of blindness 24-70, nephropathy, atherosclerosis, hypertension, abnormal blood lipid levels; erectile dysfunction;
What are 3 findings to diagnose diabetes?
1-fasting blood glucose over 126mg/dl-most common; 2-2hr blood glucose level over 200mg/dl during oral glucose test; 3-random blood glucose test over 200 mg/dl
Is there a cure for diabetes?
No
T/F Type I diabetes uses injectable insulin.
True
T/F Type II diabetes uses oral medication or injectable insulin.
True
What are 4 treatments for diabetes?
medication, nutrition, exercise, self-monitoring blood glucose
T/F Type II diabetes is in most cases preventable.
True
T/F Only 1 in 4 follow all 4 treatment modalities
true
What is most susceptible in respiratory dysfunction?
smooth muscle airways
T/F Spinal cord is most important "muscle" in body.
True
T/F COPD is a disease state.
False, COPD is a respiratory disorder or syndrome
Individuals w/ COPD have 1 or both of what?
emphysema & chronic bronchitis
What killer number is COPD?
4
What are the 5 specific diseases of respiratory dysfunction?
emphysema, chronic bronchitis, asthma, cystic fibrosis, interstitial lung disease(ILD);
What is COPD-chronic obstructive pulmonary disease?
accumulation of symptoms produced by respiratory diseases that result in a diagnosis if COPD
What are the 2 COPD symptoms?
1-decreased expiratory air flow pressure; 2-increased resistance to expiratory air flow-breathing thru straw
What is emphysema?
difficulty releasing air; lung tissue destruction due to enzymes released by WBCs; lungs remain in expanded position; alpha-1-antitrypsin: genetic condition that leads to emphysema;
What is emphysema's number one cause?
smoking
What are some symptoms of emphysema?
numerous upper respiratory infections; history of allergies; TYPE A COPD or "Pink Puffers"
What is chronic bronchitis?
airway inflammation & then excessive mucus secretion; typically caused by irritants or can be viral infection;
What is the number 1 irritant to chronic bronchitis?
smoking
What are the 2 reasons for obstruction with chronic bronchitis?
1-inflammation of tract lining narrowing air flow; 2-presence of mucus which will not allow air flow to pass;
What is chronic bronchitis also known as?
Type B COPD or "Blue Bloaters"
What is asthma?
episodic inflammatory disease characterized by airway hyperreactivity;
Does asthma cause damage to lung tissue?
no, just small airways leading to lungs
What are 2 types of asthma?
extrinsic-triggered by external factors, allergens; intrinsic-attacks are caused by infections or physiological rxn
Can you have both types of asthma?
Yes, extrinsic & intrinsic
How can you diagnose respiratory dysfunctions?
PE & patient complaint, spirometer measurement, CBC, electrocardiogram, exercise testing
What is the treatments for respiratory dysfunctions?
bronchodilators, oxygen therapy, lung volume reduction surgery-emphysema NOT asthma, lung transplantation-greatest rejection rate of organ transplants;
What is cystic fibrosis?
GENETIC deficiency disease characterized by recurrent respiratory tract infections; 1 in 20 carry trait for CF; diagnosed by 6mos, life limited to 29yrs.; improper cellular retention of sodium chloride; dry mucus; individs can go asymptomatic until adolescence-later trigger more rapid decline in health;
How can you diagnose cystic fibrosis?
PE & history of respiratory infections during infancy/childhood; sweat test; DNA analysis;
What is the treatment for cystic fibrosis?
antibiotic therapy(flucloxacillin); pulmonary physical therapy-percussion on chest; nutritional support;
What is interstitial lung disease?
inflammation of alveolar walls inside of lungs; almost only from industrial irritants & ag byproducts;
What are some examples of ILD?
Black lung, Farmer's lung, Bird breeder's lung, silicosis, asbestosis;
What is the diagnosis of ILD?
PE, evaluation of job site, X-ray of lungs, spirometry, CBC;
What is the treatment for ILD?
job/hobby change; corticosteroid therapy; pulmonary physical therapy; lung transplantation;
What do kidneys do?
they filter the human body; sole purpose is to maintain chemical balance; only need 1 to survive
What are nephrons?
individual filtering units in kidneys; consist of 2 parts: glomerulus and tubules
What is the glomerulus?
fomation of capillary vessels
What are the tubules?
tube formation that extends from a membrane capsule over the glomerulus;
What are Bowman's capsule?
the membrane capsule that covers glomerulus;
What is the glomerulus' job?
retains blood cells and proteins while allowing waste products to pass thru; absorption & excretion process;
What is an example of the downward spiral if you have renal failure?
lose excretion function, kidneys retain excess sodium, body retains water, edema increase lead to fluid volume pressure increase in body, weakens arteries, end result CVA
What is acute renal failure?
rapid decline of kidney function due to trauma, internal bleeding, or shock; very treatable;
What is chronic renal failure?
progressive decline, resulting in waste build up
Symptoms of renal failure is similar to type II diabetes, and are?
waxy appearance, fatigue, itchiness, loss of cognitive functioning, headaches, nausea/vomiting, malnutrition & weight loss;
How can you diagnose for renal failure?
physical exam w/ chief complaints (LBP & urination probs); lab testing to measure increase levels of trace minerals
What are treatment option for renal failure?
no cure; meds-calcium channel blockers (covera); 2 modalities: dialysis & transplantation;
What are the 2 forms of dialysis?
hemodialysis & peritoneal dialysis
What is hemodialysis?
circulated outside the body thru dialysis machine for waste product removal; performed 3x week; 3-5hrs session; major fatigue and loss of appetite;
What is peritoneal dialysis?
incision thru abdomen allowing surgical placement of catheter; allows waste products to pour out as sol'n (sterile dialysate) is put in; peritoneum is membrane; not as effective;
T/F Tranplantation is the ideal treatment for renal failure?
True
How long is someone w/ renal failure expected to live?
7.9 yrs
What are rheumatic diseases?
inflammatory conditions of joints or connective tissue;
What 3 common tendencies do all rheumatic diseases share?
1-insidious; 2-maintain fluctuating periods of exacerbations(bad) and remissions(not so bad); 3-resistant to medical therapy; NO CURES
What are the 4 fundamental features of rheumatic disease?
pain, inflammation, abnormality, fatigue
What are 5 specific rheumatic diseases?
rhematoid arthritis, osteoarthritis, systemic lupus erythematosis, scleroderma, anklosing spondylitis;
How many other than that 5 known rheumatic diseases are there?
32
What is rheumatoid arthritis?
systemic disorder of the connective tissue-primary target includes joints
What is synovium?
joint endings
T/F if rheumatoid arthritis involves the hands and wrists deformity is common.
True
T/F We know the cause of rheumatoid arthritis.
False

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