Cardiopulmonary Implications of Specific Diseases Flashcards
Calculation of BMI:
weight(kg)/height (m2)
[Weight (lbs)/height (in2)]x701
Resting energy expenditure
energy required for basic physiologic functions
60-75% of total daily expenditure
Diet induced themogenesis
increase in metabolic rate associated with processing of ingested food
10% of TDE
Physical activity
energy expended on volitional and nonvocational activities
10-30%
BMI underweight
less than 18.5
BMI normal weight
18.5-24.9
BMI overweight
25.0-29.9
BMI obese class I
30-34.9
BMI obese class II
35.0-39.9
BMI obese class III
greater than 40
Endurance training for obese patients
moderate intensity (40% to 60% of HRR); emphasize duration
Metabolic Syndrome
Refers to a cluster of interrelated risk factors that includes central obesity, atherogenic dyslipidemia, HTN, insulin resistance, IGT
What is visceral obesity associated with?
development of insulin resistance
How is metabolic syndrome diagnosed?
three of five criteria must be present: Central obesity Elevated triglycerides Low HDL HTN Elevated Fasting Blood Glucose
Type 1 DM
Autoimmune destruction of beta cells in pancreas
Lack of insulin secretion
Type 2 DM
Genetically heterogeneous disease characterized by insulin resistance, relative insulin deficiency, progressive decline in beta cell function
Hyperglycemia due to increased rate of hepatic glucose production
Mild to moderate hyperglycemia adrenergic:
frequent urination
dry mouth, increased thirst
Mild to moderate hyperglycemia neuroglycopenic
weakness or fatigue
More marked hyperglycemia adrenergic
increased hunger
flulike achiness
More marked hyperglycemia
neuroglycopenic:
headache
blurred vision
Serious ketoacidosis
adrenergic
facial flushing dry skin nausea or vomiting abdominal pain deep, rapid breathing fruity-smelling breath
Serious ketoacidosis
neuroglycopenic
coma
death
Kidney function
control of extracellular fluid volume, regulation of serum osmolality, electrolyte and acid-base balances, secretion of hormones
Risk factors for chronic kidney disease
DM, HTN, CVD, and obesity
Stage 1 Kidney Disease
kidney damage with normal or increased GFR
Stage 2 Kidney Disease
kidney damage with mildly decreased GFR
Stage 3 Kidney Disease
moderately decreased GFR
Stage 4 kidney disease
severely decreased GFR
Stage 5 kidney disease
kidney failure
Cardiovascular and Pulmonary Complications of Chronic Kidney Disease
Chronic kidney disease increases risk of major CV events
Patients on dialysis – 40% have evidence of CAD and 85% have abnormal LV structure and mass
HTN is both a cause and a consequence
Accelerated atherosclerosis
Heart failure is prevalent
Pulmonary edema is most serious problem
Fibrinous pleuritis
Pulmonary calcification
Treatment of ESRD (hemodialysis) is associated with pulmonary complications – decrease in arterial PaO2
Peritoneal dialysis is associated with pleural effusions and elevated diaphragm
Treatment of Chronic Renal Failure
Goals include retard the rate of progressive deterioration in renal function, minimize complications of CRF
Preventive measures using medications
Primary and secondary prevention of CVD
Renal replacement therapy using hemodialysis or peritoneal dialysis
Kidney transplantation
What lab values should be reviewed prior to each session with patients with chronic kidney disease?
Hgb, Hct, glucose, potassium, calcium, creatinine and BUN, WBC, platelets
Connective Tissue Diseases
Connective tissue cells or extracellular matrix proteins, particularly collagens, proteoglycans, and elastins are damaged Often diffuse systemic effects Autoimmune rheumatic diseases Rheumatoid arthritis Systemic lupus erythematosus Scleroderma (systemic sclerosis) Ankylosing spondylitis Mixed connective tissue disease Inflammatory myopathies Inherited connective tissue diseases
Infiltrative Diseases
Affect heart and/or lungs through infiltration or deposition of various substances within large organs
Amyloidosis
Sarcoidosis
Hemochromatosis
Neuromuscular Diseases and Neurological Disorders
Spinal cord injury Parkinson Disease Amyotrophic Lateral Sclerosis Guillain-Barré Syndrome Multiple Sclerosis Myasthenia Gravis Duchenne Muscular Dystrophy Additional types of muscular dystrophy Myotonic dystrophy Postpolio syndrome Friedreich ataxia
