3.2 Chronic Disease Flashcards
Which diseases is known as the Silent Killer?
Why is it called this?
Hypertension
Because it usually has no symptoms. The only way to know if you have it is to have your blood pressure measured.
Rare symptoms are headaches or vomiting
What is blood pressure?
The force of blood pushing against the walls of arteries.
What measurement is used to report blood pressure?
Systolic (top number) = pressure in arteries during heart beat
Diastolic (bottom number) = pressure in arteries when heart is at rest between beats
Measured in millimeters of mercury (mmHg)
What blood pressure is normal?
<120/<80
What blood pressure is considered pre-hypertension?
120 - 139 / 80 - 89
What blood pressure is considered hypertension?
> =140 / >=90
Hypertension increases risks for…
Arteriosclerosis (hardening of the arteries) Angina (chest pain) Heart Failure Heart Attack Stroke (brain damage) Kidney disease
What conditions increase risk for hypertension?
Pre-hypertension
Diabetes
What lifestyle behaviors increase risk for hypertension?
unhealthy diet physical inactivity obesity excess alcohol smoking / tobacco use
Which disease is the number 1 killer in the US?
Heart disease.
CAD (coronary artery disease) increases risk of …
Angina (chest pain)
Heart Failure
What are the 5 major symptoms of a heart attack?
- Pain or discomfort in the jaw, neck, or back
- Feeling weak, light-headed, or faint
- Chest pain or discomfort
- Pain or discomfort in arms or shoulder
- Shortness of breath
What conditions increase risk for heart disease?
Hypertension
High cholesterol
Diabetes
What lifestyle behaviors increase risk of heart disease?
unhealthy diet physical inactivity obesity excess alcohol smoking / tobacco use
What characteristics increase risk of heart disease?
Age
Race: African American
What are the two types of strokes?
Ischemic stroke: blocked artery
Hemorrhagic stroke: burst artery
both deprive the brain of oxygen
What are the signs and symptoms of a stroke?
Numbness or weakness in the face, arm, or leg especially on one side of the body
Confusion, trouble speaking, or difficulty understanding speech
Trouble seeing in one or both eyes
Trouble walking, dizziness, loss of balance, or lack of coordination
Severe headache with no know cause
When you suspect someone may be having a stroke, what does it mean to act FAST?
F - Face: Ask the person to smile. Does one side of the face droop?
A - Arms: Ask the person to raise both arms. Does one arm drift downward?
S - Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
T - Time: Call 911 right away if you see any of these signs.
What is a transient ischemic attack (TIA)
A temporary blockage of a cerebral artery. The person may show symptoms of a stroke that go away after a few minutes.
How is metabolic syndrome diagnosed?
Patient has 3 of these 5
- Large waist (abdominal obesity)
Women waist >= 35”
Men waist >= 40”
- High triglycerides
>= 150 mb/dl
or being on medicine to treat - Low HDL
<50 mg/dl women
<40 mg/dl men
or on medicine to treat - Elevated blood pressure
>= 130/>=85
or being on medication to treat - High fasting blood glucose
>100 mg/dl
or being on medicine to treat
What is metabolic syndrome?
A group of metabolic changes (risk factors) that increase risk of diabetes, heart disease, and stroke.
What conditions increase risk of metabolic syndrome?
Obesity and overweight
Insulin resistance
What lifestyle behaviors increase risk of metabolic syndrome?
Excess weight
Inactive lifestyle
What characteristics increase risk of metabolic syndrome?
Age
Genetics (increased risk of insulin resistance)
What is arthritis?
An inflammatory condition affecting the joints.
It includes more than 100 conditions.
Most common forms include:
Osteoarthritis
Rheumatoid Arthritis
Fibromyalgia
What are the most common symptoms of arthritis?
Pain Stiffness Swelling Redness Decreased range of motion
What are the 5 strategies for self-management of arthritis recommended by the CDC?
- Learn arthritis management techniques.
- Be Active
- Watch weight
- See Doctor.
- Protect joints
What are the benefits of physical activity for managing arthritis?
Decreased pain
Improved joint function
Delayed disability
Why is it important to watch weight for managing arthritis?
Every pound lost (or gained) represents 4 pounds of load on knees.
What are the general recommendations about physical activity for managing arthritis?
Moderate movement 30 minutes at least 5 days a week for a total of 150 minutes per week. The 30 minutes can be broken into 3 sessions of 10 minutes.
What is osteoarthritis?
The most common form of arthritis.
It is a degenerative joint disease where the cartilage begins to break down.
It usually develops slowly and gets worse over time.
What are the modifiable risk factors for OA?
Joint injury or overuse
Overweight
What are the non-modifiable risk factors for OA?
Age
Gender (more common in women)
Genetics
Race (Some Asian races have lower risk)
What is rheumatoid arthritis?
An autoimmune inflammatory disease where the immune system attacks the cells lining the joint causing inflammation.
RA usually attacks multiple joints, most commonly the hands, wrists, and knees.
RA patients will may experience Flares (worsening of symptoms) and remissions (reduction of symptoms)
RA can cause damage to joint tissue resulting in long lasting or chronic pain, instability, or deformity.
RA may also effect the lungs, heart and eyes.
In addition to medication (DMARDS and biologicals), what is recommended as part of RA treatment?
Self-management including physical activity.
moderate activity 30 min x 5 days = 150 min per week
can be 3 x 10 min per day
What are the modifiable risk factors for RA?
Smoking
Obesity
What are the non-modifiable risk factors for RA?
Age
Sex (2 to 3 times higher in women)
Genetics
What is fibromyalgia?
A condition that causes widespread pain and sensitivity to pain.
The nervous system may become hypersensitive to pain.
What are the symptoms of Fibromyalgia?
Widespread muscle pain and stiffness Fatigue Depression and anxiety Sleep problems Foggy thinking, poor concentration Headaches
What are the non-modifiable risk factors for fibromyalgia?
Age (most people diagnosed in middle age)
Lupus
RA
In addition to medication, what is recommended to manage fibromyalgia?
Physical activity (moderate activity 30 min x 5 days, 150 minutes per week)
Muscle strengthening exercise
Stress management
Good sleep habits
Cognitive behavioral therapy for depression.
What role does chronic inflammation play in disease?
Inflammation is a common factor in most chronic diseases.
It is associated with…
- Obesity
- Type 2 Diabetes
- Cardiovascular disease
- Alzheimer Disease
- Arthritis
- Cancer
- Inflammatory bowl diseases (Ulcerative colitis and Crohn’s)
- Kidney disease
However, much remains unknown about how chronic inflammation is involved in the initiation and progression of these chronic diseases.
What is the difference between chronic inflammation and acute inflammation?
Chronic inflammation is an ongoing reaction by the immune system that is associated with chronic conditions like coronary artery disease, diabetes, obesity, arthritis, cancer, and Alzheimer disease.
Chronic inflammation is a prolonged condition in which inflammation, tissue injury, and attempts at repair coexist. In most likely starts as a low-grade response.
Acute inflammation is the immune systems natural response to heal an injury or fight infection. It is usually limited in duration. Acute inflammation is a protective response of the immune system.
What are cytokines?
A general term for any protein secreted by cells that functions as an intercellular messenger and influences cells of the immune system. Cytokines are secreted by macrophages, monocytes, lymphocytes, and other cells.
They play a role in the immune system response, triggering inflammation and can be elevated in chronic inflammation.
non-antibody protein messengers released from a macrophage or lymphocyte that is part of an intracellular immune response.
What is one way to measure chronic inflammation in the body?
CRP (C-reactive protein) test
What are the 2 sources of cholesterol in the body?
Cholesterol made by the body (in the liver)
Dietary cholesterol
What are 2 of the main roles of cholesterol in the body?
A component of hormones
Aids in digestion of fat (assists bile production in the liver)
A component of cell walls (building block for tissues)
What foods contain cholesterol?
Egg yolks
Fatty meats
Cheese
(all animal foods)
How does cholesterol cause problems?
Excess builds up in the arteries as plaques that can become inflamed and rupture causing a blood clot which blocks an artery causing a heart attack.
What is angina?
Chest pain caused plaque narrowing a coronary artery reducing blood flow and causing pain.
What is total cholesterol and its optimal measurement?
Total Cholesterol = LDL + HDL + Triglycerides
< 200 mg/dl
What is LDL cholesterol and its optimal measurement?
LDL low density lipoprotein
< 100 mg/dl or
< 70 mg/dl if diagnosed with heart disease.
Why is LDL called bad cholesterol?
high levels can lead to plaque build up in the arteries.
What is HDL and its optimal measurement?
HDL high density lipoprotein
> 60 mg/dl to reduce risk
Why is HDL called good cholesterol?
It absorbs and carries cholesterol back to the liver.
High levels are associated with reduced risk of heart disease and stroke.
What are triglycerides and their optimal measurement?
Triglycerides are a type of fat (lipid) found the in the blood (in lipoproteins).
Optimal < 150 mg/dl
Why are high triglycerides bad?
High triglycerides along with high LDL and low HDL are associated with increased risk of heart attach and stroke.
What do high triglycerides signal?
High levels are associated with insulin resistance and metabolic syndrome.
A common cause of high triglycerides is excess carbohydrates in the diet.
What is the optimal measure of non-HDL cholesterol?
Non-HDL cholesterol = total cholesterol - HDL
< 130 mg/dl
What test is used to measure cholesterol levels?
A lipid profile
What are the CDC’s recommendations for testing cholesterol?
Adults over 20 and no heart disease test every 5 years.
What conditions increase risk of high cholesterol?
Diabetes
What behaviors increase risk of high cholesterol?
Unhealthy diet (high in trans or saturated fat or cholesterol)
Physical inactivity
Obesity
What characteristics increase risk of high cholesterol?
Genetics - family history of high cholesterol
Age - tends to rise as we age
Gender - women LDL tends to rise more quickly, men ten to have lower HDL
What is diabetes?
Diseases in which blood glucose levels become elevated?
What is the difference between type 1 diabetes and type 2 diabetes?
Type 1 diabetes is an autoimmune disease that destroys the insulin producing cells of the pancreas so the body no longer produces insulin
Type 2 diabetes is due to insulin resistance and relative lack of insulin production.
What are major risk factors for type 2 diabetes?
Obesity
Lack of physical activity
What are typical treatments for type 1 diabetes
Insulin injections
Healthy eating
Physical activity
What are typical treatments for type 2 diabetes
Healthy eating
Physical activity
Oral or injected medications
What does research show is beneficial for prevention of type 2 diabetes in people with pre diabetes?
Losing 5% to 7% of body weight or
10 to 14 pounds for a 200 pound person.
Get at least 150 minutes weekly of physical activity such as brisk walking.
What does fasting blood glucose measure and how is it used to diagnose diabetes?
FBG is a measure of blood glucose after an overnight fast.
Normal < 100 mg/dl
Prediabetes 100 to 125 mg/dl
Diabetes 126 mg/dl or higher
What is HbA1c and how is it used to diagnose diabetes?
HbA1C is a measure of average blood sugar levels for the prior 2 to 3 months.
Normal < 5.7%
Prediabetes 5.7% to 6.4%
Diabetes 6.5% or higher
What is OGTT and how is it used to diagnose diabetes?
Oral glucose tolerance test. Measures blood glucose levels 2 hours after consuming a glucose drink
at 2 hours
normal < 140 mg/dl
Prediabetes 140 mg/dl to 199
Diabetes 200 mg/dl or higher
What is body mass index?
A measure of body composition based on height and weight.
BMI = weight in Kg / height in meters squared
What is considered a normal BMI?
18.5 to <25
What is considered an underweight BMI?
<18.5
What is considered an overweight BMI?
25 to <30
What is considered an obese BMI?
30 or greater
Why are both BMI and waist circumference sometimes used?
Excess abdominal fat is associated with greater risk of chronic disease.
What are the waist circumference risk levels for women?
Low risk 31.5 and below
Intermediate risk 31.6 to 34.9
High Risk 35 or greater
What are the waist circumference risk levels for men?
Low risk 37 and below
Intermediate risk 37.1 to 39.9
High risk 40 and above
Obesity increases risk of what conditions?
All causes of death Hypertension High LDL, low HDL, High triglycerides Type 2 diabetes Heart disease Stroke Gallbladder disease Osteoarthritis Sleep apnea Some cancers Mental illness Body pain
