Chapter 29 - Additional General Medical Conditions Flashcards
antigen
invading agent
active immunity
result of natural infection or invasion of antigents
passive immunity
inoculation
cell-mediated response
lymphocytes (T cells) are produced by the thymus in response to antigen exposure
humoral immune response
plasma lymphocytes (B Cells) are produced with subsequent formation of antibodies
non-specific immune response/inflammation
reaction of the tissues to injury from trauma, chemicals, or ischemia
auto-immune response
directed against an individual’s own tissues (diabetes mellitus, rheumatoid arthritis)
Viral Infections
rhinovirus, influenza, mono, rubella, rubeola, mumps, varicella
rhinovirus
common cold
rhinovirus etiology
transmitted by direct or indirect contact; spread by droplets expelled by sneezing, coughing, or speaking
rhinovirus s/sx
starts with a scratchy or sore throat, watery discharge/stopped-up nose, and sneezing
secondary infection is possible
rhinovirus management
symptomatic treatment (most last 5-10 days regardless of type of treatment)
avoidance
pleconaril - shortens duration of cold
influenza etiology
caused by myxoviruses (types *A, B, C, D); virus enters cell through genetic material, multiplies and is spread throughout the body (athletes in winter sports, basketball, wrestling, and swimming should get vaccinated)
Influenza s/sx
fever, cough, headache, malaise, and inflamed respiratory mucous membranes with coryza (profuse nasal discharge)
incubation period of 48 hours, chills, fever (102-103), aches, photophobia, acute phase lasts 5 days
influenza management
bed rest and supportive care (avoid aspirin for under 18 years - Reyes syndrome)
steam, cough meds, salt water gargles
amantadine & Relenza
may be used for influenza A for individuals at risk
infectious mononucleosis etiology
caused by the Epstein-Barr virus (EBV); incubation is 4-6 weeks; EBV is carried in the throat and transmitted to another person through saliva (bad for athletes - severe fatigue and possible splenic rupture)
Mono s/sx
3-5 day prodrome of headache, fatigue, loss of appetite, and myalgia
day 5-15: fever, swollen glands, sore throat
second week: enlarged spleen, jaundice (10-15%), skin rash (5-15%), flushed cheeks, puffy eyelids
blood test: elevated WBC count
complications: ruptured spleen, meningitis, encephalitis, hepatitis, anemia
mono management
acetaminophen for headache, fever, malaise
can return to life 3 weeks after onset if spleen is not enlarged, no fever, liver is working normal, and pharyngitis has resolved
Rubella
German measles
Rubella etiology
highly contagious childhood viral disease; infection 13-24 days following exposure
Rubella s/sx
slight fever, sore throat, drowsiness, swollen lymph glands, appearance of red spots on the palate (occur 1-5 days prior to appearance of rash that occurs 50% of the time - rash begins on face/forehead and spreads down trunk and extremities, lasting for about 3 days)
Rubeola
measles
Rubeola etiology
highly contagious childhood viral disease (after having disease, individual has acquired immunity)
Rubeola s/sx
onset causes sneezing, nasal congestion, coughing, malaise, photophobia, spots in the mouth, conjunctivitis, fever that may elevate to 104 at about 4 days
onset of high fever, rash appears, lasts about 5 days, may cause itching
Rubeola management
every child should receive the MMR vaccine; bed rest, isolation in dark room, and antipyretic and anti-itching medication to provide relief while disease runs its course
Mumps (Parotitis) etiology
contagious viral disease that results in inflammation of the parotid and other salivary glands
appears 12-25 days following exposure
Mumps (Parotitis) s/sx
malaise, headache, chills, and a moderate fever. Pain in the neck below and in front of the ear
that progresses to marked swelling on one or both sides (may last for as long as 7 days); painful to move jaw and
swallowing may be difficult. Saliva production may be increased or decreased.
mumps (Parotitis) management
immunization with MMR. Patient should be isolated while contagious, confined to bed rest and
given a soft diet; analgesics may be used with cold applications to control swelling (later heat can be used)
Varicella (Chicken Pox)
chicken pox
varicella etiology
highly contagious viral disease caused by varicella-zoster virus. Also causes herpes zoster. Most likely to occur in children under 15 years of age; average incubation is 13-17 days following exposure. Individual is contagious for approximately 11 days (beginning 5 days before the first signs of rash appear)
varicella s/sx
begins with slight elevation of temperature for 24 hours, followed by eruption of rash
rash appears crop of red spots, begins on back/chest, disease lasts 2-3 weeks
varicella management
administration of varicella-zoster immune globulin (VZIg) within 96 hours of exposure will prevent clinical symptoms in normal healthy children. Acyclovir should be administered to adolescents and adults within 24-hours following appearance of symptoms.
Sinusitis etiology
can stem from a URI caused by a variety of bacteria, nasal mucous membrane walls and block the osmium of the paranasal sinus
sinusitis s/sx
sinus area may swollen and painful to touch; headache, malaise, purulent nasal discharge
sinusitis management
antibiotics, steam inhalation & other nasal topical sprays can produce vasoconstriction & drainage
pharyngitis
sore throat
pharyngitis etiology
acute inflammation of the pharyngitis (may be related to common cold, influenza, or mono)
Pharyngitis s/sx
pain on swallowing, fever, inflamed and swollen lymph glands, swollen tonsils, weakness, and anorexia
mucous membranes of throat may be inflamed with a covering of purulent matter
throat culture to rule out strep throat is necessary
pharyngitis management
topical gargles and rest, antibiotic therapy,
tonsillitis etiology
Tonsils are pieces of lymphatic tissue covered by epithelium; within each tonsil are deep clefts/pits
lined by lymphatic nodules (pathogens collect in pits and penetrate epithelium, where they contact lymphocytes and cause an acute inflammation and bacterial infection)
tonsillitis s/sx
tonsils appear inflamed, red, and swollen with a yellowish exudate in the pits; difficulty swallowing and possibly high fever with chills. Headache, pain in neck and back may also be present
tonsillitis management
throat culture, gargling with warm saline water, liquid diet, antipyretic medication
seasonal atopic (allergic) rhinitis
hay fever
seasonal atopic (allergic) rhinitis etiology
an acute seasonal allergic condition that results from airborne pollens
seasonal atopic (allergic) rhinitis s/sx
early stages: itchy eyes, throat, mouth and nose; followed by watery eyes, sneezing, and clear, watery nasal discharge. Sinus-type headache, emotional irritability, difficulty sleeping, red and swollen eyes and nasal mucous membranes, and a wheezing cough
seasonal atopic (allergic) rhinitis management
oral antihistamines (be aware of sedating side effect); decongestants (stimulating effect)
acute bronchitis etiology
usually occurs as an infectious winter disease that follows a common cold or other viral infection of the
respiratory tract. A secondary bacterial infection may follow this inflammation (from overexposure to air
pollution); fatigue, malnutrition, or becoming chilled could be predisposing factors
acute bronchitis s/sx
usually start with URI, nasal inflammation and profuse discharge, slight fever, sore throat and
back and muscle pains. A cough signals the beginning of bronchitis. At first the cough is dry, but within a few hours or days, a clear mucus secretion begins which becomes yellowish, indicating an infection.
acute bronchitis management
rest until fever subsides, drink 3-4 liters of water per day, and ingest an antipyretic analgesic, cough suppressant, and an antibiotic (when sever lung infection is present) on a daily basis
pneumonia etiology
infection of the alveoli and bronchioles that may be caused by viral, bacterial, or fungal
microorganisms; may also be caused by irritation from chemicals, aspiration of vomit, or other agents. Alveolar
spaces become filled with exudate, inflammatory cells, and fibrin
pneumonia s/sx
bacterial pneumonia = rapid onset, high fever with chills, pain on inspiration, decreased breath
sounds and rhonchi on auscultation, coughing up of purulent, yellowish colored sputum
pneumonia management
antibiotics (for bacterial pneumonia). Deep breathing exercises and removal of sputum through a
productive cough are helpful. Analgesics and antipyretics may be useful for controlling pain and fever.
bronchial asthma etiology
can be produced from a viral respiratory tract infection, emotional upset, changes in barometric pressure or temp, exercise, inhalation of a noxious odor, exposure to a specific allergen
bronchial asthma s/sx
spasm of the bronchial smooth muscles, edema, and inflammation of the mucous membrane
narrowing of airway and copious amounts of mucus produced
difficulty breathing could result in hyperventilation, resulting in dizziness
attack may begin with coughing, wheezing, SOB, fatigue
bronchial asthma management
reassure the athlete, give athlete medication, encourage athlete to drink water, have athlete perform controlled breathing, and relaxation exercises, remove environmental factor that may be causing attack
Exercise-Induced Bronchial Obstruction (Asthma) etiology
can be stimulated by exercise, or may be provoked only on rare occasions during moderate exercise. The exact cause in not clear. Loss of heat and water causes the greatest loss of airway reactivity. Sinusitis can also trigger an attack in an individual with chronic asthma
Exercise-Induced Bronchial Obstruction (Asthma) s/sx
airway narrowing caused by bronchial-wall spasm and excess production of mucus
chest tightness, breathlessness, coughing, wheezing, signs of nausea, hypertension, fatigue, respiratory stridor, headaches, redness of skin
occur within 3-8 minutes of strenuous activity
Exercise-Induced Bronchial Obstruction (Asthma) management
a regular exercise program, conditioning and running longer distances, exercise intensity and length should be graduated slowly, exercise in warm, humid conditions, albuterol (B2 agonist, acts for 2 hours)
Cystic Fibrosis etiology
genetic disorder that may manifest as: 1) a type of chronic obstructive pulmonary disease; 2) pancreatic
deficiency; 3) urogenital dysfunction; 4) increased electrolytes in sweat. Usually begins in infancy and is a major
cause of severe chronic lung disease in children (maximum life expectancy is 30 years)
Cystic Fibrosis s/sx
bronchitis, pneumonia, respiratory failure, gallbladder diseases, pancreatitis diabetes, and
nutritional deficiencies. Abnormally high production of mucus secretions in the lungs.
cystic fibrosis management
drug therapy (ibu) can help slow progression of disease; antibiotics used to control pulmonary disease. Constant postural drainage to mobilize secretions. High fluid intake, breathing of humidified air
Duchenne Muscular Dystrophy etiology
hereditary disease in which there is a degeneration of skeletal muscle with associated loss of strength. Muscle tissue is gradually replaced by adipose and fibrous connective tissue (connective tissue impedes circulation, which accelerates the degenerative process). Onset is usually between 2-10 years
Duchenne Muscular Dystrophy s/sx
problem manifests when child begins to walk; frequent falls and difficulty standing up; progressive degeneration hips legs abdominal and spinal musculature (muscles shorten as they atrophy, causing postural abnormalities)
Duchenne Muscular Dystrophy management
no cure; exercise to delay atrophy; death before age 20
Myasthenia Gravis etiology
autoimmine disease in which antibodies attack the synaptic junctions between nerves and muscles. Acetylcholine deficiency creates an abnormality that produces early fatigue in skeletal muscle (females 20-40 y)
Myasthenia Gravis s/sx
drooping of upper eyelid and double vision due to weakness in extraocular muscles. Difficulty
chewing and swallowing, weakness of the extremities, and general decrease in muscular endurance
Myasthenia Gravis management
drugs that inhibit breakdown of acetylcholine; corticosteroids to suppress immune system
Meningitis etiology
inflammation of the meninges that surround the spinal cord and brain (usually due to meningococcus bacteria = enter through the nose of throat). Causes swelling of the brain, enlargement of ventricles, and hemorrhage of the brain stem
Meningitis s/sx
high fever, stiff neck, intense headache, sensitivity to light and sound; progress to vomiting, convulsions, and coma
Meningitis management
cerebrospinal fluid must be analyzed (spinal tap); intravenous antibiotics
Multiple Sclerosis etiology
autoimmune inflammatory disease of the CNS that causes deterioration and permanent damage to the myelin sheath that surrounds a nerve cell axon (nerve conduction disrupted); exact cause is uncertain
Multiple Sclerosis s/sx
depend on the part of the nervous system affected; blurred vision with blind spots, speech defects, tremors, and muscle weakness and numbness in the extremities are common; disease may progress steadily or there may be acute attacks followed by partial or complete temporary remission of symptoms
Multiple Sclerosis management
dealing with symptoms as they appear and disappear; avoid overexertion and fatigue, exposure to extreme temperature, and stressful situations
Amyotrophic lateral sclerosis etiology
also known as Lou GehrigUs disease; sclerosis of the lateral region of the spinal cord along with degeneration of motor neurons and significant atrophy of muscles
Amyotrophic lateral sclerosis s/sx
difficulty in speaking, swallowing, and use of the hands; sensory and intellectual function remain intact; rapid progression of muscle atrophy
Amyotrophic lateral sclerosis management
no cure; individual still has normal intellectual function but is unable to communicate feelings and ideas
Reflex Sympathetic Dystrophy
abnormal and excessive response of the sympathetic portion of the autonomic nervous system that
occurs following injury. Most often, it is seen in the hand or foot resulting from the immobilization of an injured
part due to pain (associated with injuries to bone, soft tissue, nerves, or blood vessels)
Reflex Sympathetic Dystrophy S/Sx
extreme hypersensitivity to touch, redness, sweating, burning/aching type pain, swelling with
palpable tightness and shining of the skin, and atrophy. Symptoms may persist for months up to one year
Reflex Sympathetic Dystrophy Management
treatment should be directed at disrupting the abnormal sympathetic response; sympathetic
ganglion nerve block administered by a physician is critical; pain-free AROM exercises and therapeutic modalities for decreasing pain and reducing swelling
Iron-Deficiency Anemia Etiology
iron mainly stored in hemoglobin (64%) and bone marrow (27%).
Erythrocytes are too small
hemoglobin is decreased
ferritin concentration is low
ways of losing iron include bowel ischemia, aspirin or NSAIDs,
inadequate dietary intake
Iron-Deficiency Anemia S/sx
decline in athletic performance, burning thighs/nausea from becoming anaerobic, ice craving. Most accurate test of iron status is serum ferritin test
Iron-Deficiency Anemia management
eat a proper diet (more red meat or dark poultry), avoid coffee and tea (hamper iron absorption from grains), ingest vitamin C (enhance iron absorption), take an iron supplement
Runners’ Anemia (Hemolysis) etiology
cause is the impact of the foot as it strikes the surface; impact forces destroy normal erythrocytes
Runner’s Anemia (Hemolysis) S/Sx
mildly enlarged red cells, increased circulatory reticulocytes, decrease in concentration of haptoglobin.
Runner’s Anemia (Hemolysis) Management
running on soft surfaces, wearing well-cushioned shoes and insoles, and running light
Sickle-Cell Anemia Etiology
chronic hereditary hemolytic disease; most common in African-Americans, Native Americans, and
Mediterranean populations; red cells are sickle-shaped, in which an abnormal type of hemoglobin exists; sickle cell has less potential for transporting oxygen and is fragile when compared with normal cells (15-20 day life span, vs. 120 days of normal cell) = short life of red cell often results in anemia; sickle-shape can cause clustering of cells and clogging of blood vessels; death may occur from stroke, heart disease, or an embolus in the lungs
Sickle-Cell Anemia S/sx
a sickle-cell crisis may be brought on by high altitudes or overheating of the skin; crisis symptoms include fever, severe fatigue, skin pallor, muscle weakness, and severe pain in the limbs and abdomen.
Sickle-Cell Anemia Management
symptomatic treatment; anticoagulants and analgesics for pain
Hemophilia Etiology
hereditary disease characterized by a deficiency in a clotting factor in the blood, prolonged coagulation time, failure of the blood to clot, and abnormal bleeding (predominantly a male disease)
Hemophilia S/Sx
physical exertion can cause bleeding into muscles and joints, which can be extremely painful.
Hemophilia Management
concentrated clotting factors can control bleeding for several days; hemophilacs should avoid
trauma and wear a medical alert bracelet
Lymphangitis Etiology
inflammation of the lymphatic channels that is most often caused by strep; bacterial infection may occur in the blood (bacteremia)
Lymphangitis S/Sx
usually occurs in extremities; deep reddening of skin, warmth, lymphandentitis, and a raised border over the affected area; chills, high fever, moderate pain and swelling
Lymphangitis Management
patient should be hospitalized and vital signs should be closely monitored. Affected extremity should be elevated and warm, moist compresses applied. Antibiotics should be administered, fluid intake.
Diabetes Mellitus Etiology
Diabetics should eat before exercise and should have hourly glucose supplementation. Type I (insulin- dependent) and Type II (non-insulin dependent) = Type I commonly to those under 35 years of age. Syndrome
that results from an interaction of physical and environmental factors. Complete or partial decrease of insulin by
the pancreas.
Diabetes Mellitus S/Sx
Type I usually occurs in childhood: frequent urination, constant thirst, weight loss, constant
hunger tiredness and weakness, itchy dry skin, and blurred vision. Type II occurs later in life: associated with
being overweight, pancreas does not produce enough insulin, or body resists the insulin that is produced.
Diabetes Mellitus Management
blood glucose levels must be controlled (balanced diet, doses of insulin if needed); exercise can
enhance glucose tolerance (Type I = increases sensitivity; Type II = decreases insulin resistance).
Diabetic Coma
ketoacidosis
Diabetic Coma Etiology
if an athlete is not treated adequately through proper diet or too little insulin is produced, the diabetic athlete can develop acidosis
Diabetic Coma S/Sx
labored breathing/gasping for air, fruity-smelling breath caused by acetone, nausea and vomiting, thirst, dry mucous membrane of the mouth, flushed skin, and mental confusion or unconsciousness followed by coma
Diabetic Coma Management
early detection of ketoacidosis is essential = injection of insulin into the athlete may prevent coma
Insulin Shock
Hypoglycemia
Insulin shock etiology
occurs when the body has too much insulin and too little blood sugar (hypoglycemia results)
Insulin Shock s/sx
tingling in the mouth, hands, or other body parts; physical weakness; headaches; abdominal
pain. Normal or shallow respirations; rapid heartbeat; tremors along with irritability and drowsiness
Insulin Shock management
athlete must adhere to a carefully planned diet that includes just a snack before exercise (complex
carbs and protein)
Epilepsy Etiology
causes include genetics, altered brain metabolism or a history of injury.
Epilepsy S/Sx
if an individual has daily or weekly seizures, collision sports should be prohibited (blow during
participation that causes unconsciousness could result in a serious injury). If seizures are properly controlled, little
sports restriction is necessary (except scuba diving, swimming alone, or activities at high altitudes)
Epilepsy Management
anti-convulsant medication (side effects may occur). When an epileptic becomes aware of an
impending seizure, he/she should immediately sit or lie down. AT should cushion athleteUs fall, loosen restrictive clothing, place a soft cloth between the teeth, allow athlete to awaken normally after seizure (do not restrain athlete during seizure)
Hypertension
high blood pressure
Hypertension etiology
primary/essential: no associated disease
secondary: related to specific underlying cause
prolonged hypertension increases chances of coronary artery disease, congestive heart failure and stroke
Hypertension S/Sx
primary is usually asymptomatic until complications occur; HBP may cause dizziness, flushed appearance, headache, fatigue, epistaxis, nervousness
Hypertension Management
risk of death from heart disease doubles with every 20/10 mm/Hg increase in BP
normal BP
120/80 mm Hg
pre-hypertension
120-39/80-89 mm Hg
need to make lifestyle changes
Stage 1 hypertension
140-159/90-99 mm Hg
need meds
Stage 2 hypertension
at or greater 160/100 mm Hg
need meds
Cancer etiology
cellular behavior becomes abnormal and cells no longer perform normal functions
cell’s genetic makeup is altered and changes the functions
abnormal cell reporoduces
tumors types
benign and malignant
Benign tumor
pose a small threat to tissue and tend to remain confined in a limited space
Malignant tumors
grow out of control and spread within a specific tissue; may spread via blood and lymph systems (metastasize) to the entire body
how are malignant tumors classified
according to type of tissue in which they occur and how fast they grow
Causes of cancer
genetic origin, environment, viruses, UV light, radiation, chemicals, tobacco, alcohol, fatty diet
Cancer S/sx
change in bowel and bladder habit, sore throat that does not heal, unusual bleeding or discharge, thickening or lump somewhere in the body, ingestion or difficulty swallowing, change in wart/mole, nagging cough, hoarseness
Cancer management
early detection and treatment improves chances of survival; most effective forms of treatment include surgery, radiation, and chemotherapy
Chlamydia Trachomatis
most common STI
Chlamydia Trachomatis etiology
in females, may result in pelvic inflammatory disease (cause of infertility and ectopic pregnancy)
Chlamydia Trachomatis s/sx
males (inflammation and purulent discharge 7-28 days after intercourse; possibly painful
urination and traces of blood in urine); females (asymptomatic, may experience vaginal discharge, painful
urination, pelvic pain, and pain and inflammation in other sites)
Chlamydia Trachomatis management
organism identification and treatment; must be treated immediately in pregnant women;
uncomplicated cases treated with antibiotics
Genital Herpes
venereal infection that is currently widespread
Genital Herpes etiology
Type 2 herpes simplex virus; signs of disease appear 4-7 days after sexual contact; primary genital herpes crusts in 14-17 days, secondary cases crust in 10 days
Genital Herpes s/sx
first signs = males have itching and soreness, females may be asymptomatic; 50-60% of all sufferers will never experience a second episode; lesions become ulcerated and then crust and heal in 10 days, leaving a scar; can be fatal to a newborn child
Genital Herpes management
no cure (system antiviral medications may lessen early symptoms of disease)
Trichomoniasis etiology
caused by the flagellate protozoan Trichomonas vaginalis; affects 20% of all females during their reproductive years and 5-10% of all males
Trichomoniasis s/sx
Females experience greenish yellow and frothy discharge; causes irritation of vulva, perineum, and thighs, and may experience painful urination. Males are often asymptomatic, some experience a frothy, purulent urethral discharge
Trichomoniasis management
two grams of metronidazole in one dose for females; 500mg 2x/day for 5-7 days for males
Genital Candidiasis etiology
Candida occurs naturally in the vagina; several causes exist, may be transmitted sexually
Genital Candidiasis s/sx
vulval irritation that begins with redness, severe pain, and vaginal discharge. Males are usually
asymptomatic but could develop some irritation and soreness of the glans penis
Genital Candidiasis management
antifungal cream should be applied for 3 days
Condyloma Acuminata
Venereal Warts
Condyloma Acuminata etiology
venereal warts transmitted through sexual activity; appear on the glans penis, vulva, or anus
Condyloma Acuminata s/sx
wart produces nodules that have a cauliflower-like lesion or can be singular; early the nodules
are soft, moist, pink or red swellings that develop a stem with a flowerlike head
Condyloma Acuminata management
treated by a physician with a solution of 20-25% podophyllin; dry warts may be treated with liquid
nitrogen
Gonorrhea etiology
acute venereal disease that can infect the urethra, cervix, and rectum; caused by gonococcal bacteria Neisseria gonorrhoea which is usually spread through sexual intercourse
Gonorrhea s/sx
males = incubation period of 2-10 days, tingling sensation in urethra, greenish-yellow discharge of pus and painful urination. Females = 60% are aysymptomatic, onset is 7-21 days, vaginal discharge
Gonorrhea management
untreated gonorrhea will become latent and manifest itself in later years, usually causes sterility or arthritis; treatment is antibiotics and immediate physician referral
Syphilis etiology
caused by a spirochete bacteria Treponema pallidum; enters body by mucous membranes or lesions
Syphilis s/sx
has 4 stages (primary, secondary, latent, late/tertiary). Incubation period is 3-4 weeks
o Primary: a pain less chancre (ulceration) develops and heals within4-8 weeks; highly contagious, ulcerations can occur on the penis, urethra, vagina, cervix, mouth, hand, foot
o Secondary: 6-12 weeks after infection; skin rash, lymph swelling, body aches, mild flu like symptoms
oLatent: no or few symptoms; if untreated, approximately 33% of persons with latent syphilis will develop late/tertiary syphilis
o Late/tertiary: develops within 3-10 years of infection. Deep penetration of spirochetes that damage skin,
bond, and cardiovascular and nervous systems. Neurosyphilis can progress into severe muscle weakness,
paralysis, and various types of psychoses.
Syphilis management
antibiotics (penicillin). Air drying and cleaning with soap and water will destroy it.
Menarche
the onset of menses
delayed menarche/primary amenorrhea
menstruation not occurring by age 16 or a failure to develop secondary sexual characteristics by age 14
late maturing girls: long legs, narrow hips, less adiposity, and body weight
Menstruation
28 day cycles consists of follicular and luteal phases (each 14 days long)
menses varies from 3-7 days
FSH
stimulates maturation of an ovarian follicle
inhibited when follicle reaches maturity due to estrogenic steroids produced by ovaries
LH
stimulates the development of the corpus luteum and the endocrine structure that secretes progesterone and estrogen
eventually inhibited by progesterone
Ovulation
release of the egg from the mature follicle at mid cycle
Amenorrhea etiology
cause is often a hypothalamic dysfunction (GnRH gonadotropin-releasing hormone is often deficient). Pregnancy, abnormalities of reproductive/genital tract and cancer should be ruled out.
Amenorrhea S/Sx
i. Competition such as long-distance running, gymnastics, professional ballet, cycling, or swimming
ii. Low body weight with weight loss after beginning of training
iii. Total calorie intake inadequate for energy needs
iv. Eating disorder
v. High incidence of menstrual abnormalities before vigorous training
vi. Higher levels of stress when compared with those experiencing normal menses
vii. Likely to have begun training at an early age
viii. A rapid increase in high-intensity exercise
Amenorrhea management
reestablish normal hormone levels to return normal menstrual cycle. Nutritional counseling, reduction of exercise intensity. Estrogen replacement may be considered.
Dysmenorrhea
painful menstruation
Dysmenorrhea etiology
inconclusive whether sports participation can alleviate or produce dysmenorrheal; pathological
conditions should be ruled out
Dysmenorrhea s/sx
cramps, nausea, lower abdominal pain, headache, and sometimes emotional lability
Dysmenorrhea management
mild to vigorous exercise; most often occurs in swimmers or those athletes who perform for a long period of time
Female Athlete Triad
disorder eating, amenorrhea, osteoporosis
Female Athlete Triad etiology
the young woman athlete is pressured to fit an image, which results in disordered eating, which
may lead to menstrual dysfunction and subsequent premature osteoporosis
Female Athlete Triad s/sx
premature bone loss and inadequate bone development that results in low bone mass,
micro-architectural destruction, increased skeletal fragility, and increased risk of fracture. Special concern
should be used for those athletes whose sport focuses on an ideal body type and weight
Female Athlete Triad management
*prevention, education, identify those at risk
Bone health issues
decrease of reproductive hormones
low bone mass = stress fractures
loss of periods
need to replace calcium, decrease training, increase total calories
Contraceptive and Reproduction
Athletes should not take extra oral contraceptives to delay menstruation during competition (may cause nausea,
vomiting, fluid retention, amenorrhea, hypertension, double vision, and thrombophlebitis)
Pregnancy
Can participate in physical activity well into the 3rd month; may continue into 7th month if no problems arise
It is during the first 3 months of pregnancy that dangers of harming the fetus are greatest
Exercise and Pregnancy (Contra-indications)
pregnancy-induced hypertension, preterm rupture of membranes, preterm labor
during the prior or current pregnancy, incompetent cervix or cerclage, persistent second or third trimester
bleeding, intrauterine growth retardation
Ectopic Pregnancy
o Fertilized egg is implanted outside the uterine cavity due to inflammation of the fallopian tubes or some mechanical blockage to the normal downward movement of the ovum
o Symptoms: amenorrhea, tenderness, soreness and pain on affected side, referred pain in the shoulders, pallor, and potentially signs of shock and hemorrhage
Reyes syndrome
children recovering from infection are at risk, especially those who have been taking aspirin. causes swelling of the brain and liver damage, no cure - medical emergency
Wolff Parkinson White Disease
the heart has an extra electrical pathway between the atria and ventricles causing tachycardia.
functional scoliosis
curve in the spine but no rotation. is reversible as it is caused by muscular disturbances or leg length discrepancies
