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Class 2 Flashcards

1
Q

What percent of deaths in the US are caused by chronic diseases?

A

70%

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2
Q

What defines a chronic illness?

A

An illness that lasts longer than 3 months

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3
Q

Comorbidity

A

the simultaneous presence of two chronic diseases or conditions in a patient

ex: patient with both HTN and HLD

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4
Q

What does comorbidity increase?

A

Complexity and health risk

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5
Q

What makes patients with comorbidities complex?

A

1) Treatment of one disease may contradict the treatment of the other
2) Adverse drug interactions
3) Compounding symptoms may lead to poor compliance with treatment plan
4) Patient is at increased risk of organ failure if the comorbidity affects the same organ system

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6
Q

Etiology of HTN

A

an increase in blood pressure causes excess force against the arterial walls, damaging arteries over time

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7
Q

Risk factors of HTN

A

FHx of HTN, obesity, high sodium diet, smoking, alcohol

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8
Q

Symptoms of HTN

A

often asymptomatic

headache is the most common symptom

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9
Q

Diagnosis of HTN

A

Several high BP readings

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10
Q

Systolic blood pressure

A

Top pressure reading

Measures pressure in the arteries when the heart contracts

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11
Q

Diastolic blood pressure

A

dominator

measures the pressure in the arteries when relaxed

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12
Q

Hypotensive BP

A

less than 90/60

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13
Q

Normal BP

A

90/60 to 120/80

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14
Q

Prehypertensive BP

A

121/81 to 140/90

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15
Q

Hypertensive BP

A

greater than 140/90

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16
Q

What are other chronic illnesses that HTN can lead to?

A

Hemorrhagic CVA, CAD/MI, CHF, Renal Failure, impaired vision

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17
Q

How does HTN cause other chronic diseases?

A

HTN damages blood vessels in the brain, heart, eyes and kidneys

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18
Q

Non-pharmacological management of HTN

A

low sodium diet, stop smoking and drinking alcohol, exercise, BP log at home

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19
Q

How does a low-sodium diet help manage HTN?

A

sodium increases BP because the kidneys retain more water, so eating less sodium can help the kidneys decrease fluid volume and lower pressure

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20
Q

How does stoping smoking and drinking alcohol help manage HTN?

A

Nicotine and alcohol are vasoconstrictors

Vasoconstrictors shrink blood vessels (less area = more pressure)

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21
Q

Pharmacological management of HTN

A

ACE inhibitors

Ca Channel Blockers

Diuretics

ARBs

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22
Q

ACE Inhibitors

A

relax arteries and block reabsorption of water by kidneys, which help lower BP

Lotensin, Zestril

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23
Q

Ca Channel Blockers

A

Dilate the arteries and reduce the force of the heart’s contractions, helps lower BP

Norvasc, Cardizem

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24
Q

Diuretics

A

Reduce the volume of fluid by increasing urination

HCTZ

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25
Q

ARBs

A

Dilate the arteries, which lowers BP

Cozaar, Benicar

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26
Q

Can a patient be diagnosed with HTN without showing any symptoms?

A

Yes

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27
Q

Type 1 DM

A

insulin insufficiency

pancreas is unable to produce insulin

strong FHx component of developing

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28
Q

What is the most common type of DM?

A

Type 2 (95% of patients)

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29
Q

What is the role of insulin?

A

to move glucose into the cells

so if you don’t have insulin or body resists insulin, your blood glucose levels rise

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30
Q

How is Type 1 DM treated?

A

Always treated with insulin

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31
Q

Type 2 DM

A

insulin resistance

overtime body stops responding to insulin

some FHx component, but strong SHx component

32
Q

Hw is Type 2 DM treated?

A

Can be treated with diet changes, non-insulin meds or insulin

33
Q

Type 2 DM etiology

A

The inadequency of insulin to control the blood glucose level

34
Q

Risk factors of Type 2 DM

A

FHx, obesity, high carb diet, lack of exercise

35
Q

Symptoms of Type 2 DM

A

unusual weight gain or loss

polyuria, polydipsia, blurred vision, N/V

36
Q

What are polyuria and polydipsia?

A

symptoms of Type 2 DM

polyuria = frequent urination

polydipsia = frequent thirst

37
Q

How is Type 2 DM diagnosed?

A

Fasting blood glucose / hemoglobin A1c

38
Q

What other illnesses can DM lead to?

A

CAD, CHF, PVD, Neuropathy, Renal failure, Diabetic retinopathy

39
Q

PVD

A

peripheral vascular disorder

damaged blood vessels and decreased blood flow to extremities

40
Q

Neuropathy

A

damage to the peripheral nervous system

41
Q

Diabetic retinopathy

A

DM damages blood vessels in eyes which leads to blurred vision

42
Q

Non-pharmocological treatment of DM

A

Low carb diet, weight loss, exercise, blood glucose log

43
Q

How does low carb diet help with DM?

A

carbohydrates raise blood glucose more than any other food which leads to increased release of insulin and eventually insulin resistance

44
Q

What are the three types of insulin?

A

Humalog (short-term), lantus (long-term(, sliding scale

45
Q

Oral meds for DM

A

Metformin and Glyburide

46
Q

HLD etiology

A

an elevated level of lipid in the blood causes plaque build up along arterial walls

47
Q

Risk factors for HLD

A

FHx, obesity, high lipid diets, alcohol, sedentary lifestyle

48
Q

Symptoms of HLD

A

asymptomatic

49
Q

Diagnosis of HLD

A

blood work, measuring cholesterol and lipid panels

50
Q

LDL

A

low density lipoprotein

commonly known as “bad cholesterol”

allows cholesterol to build up on arterial walls and case plaque

51
Q

HDL

A

high density lipoprotein

commonly known as “good cholesterol”

HDL is able to remove cholesterol from arterial walls

52
Q

How does HLD lead to other diseases?

A

HLD leads to narrow blood vessels

53
Q

Arterial atherosclerosis

A

caused by HLD

accumulation of cholesterol causes blood vessels to thicken and harden

54
Q

What other diseases can HLD lead to?

A

pancreatisis, TIA, ischemic CVA, CAD/MI, arterial artherosclerosis

55
Q

Non-pharmocological management of HLD

A

Low lipid diet, decrease alcohol, exercise, close follow up

56
Q

Pharmacological management of HLD

A

statins

any medication ending in statin is used to treat HLD by inhibiting the production of cholesterol

57
Q

CAD etiology

A

narrowing of the coronary arteries limits blood supply to the heart muscle causing ischemia

58
Q

Risk factors of CAD

A

HTN, HLD, DM, smoking, FHx <55y/o

59
Q

Symptoms of CAD

A

chest pain or pressure (worse with exertion)

improved rest or nitroglycerin (NTG)

60
Q

Diagnosis of CAD

A

cardiac catherization to diagnose

61
Q

What is the number one risk factor for a MI?

A

CAD

62
Q

If you have an MI which disease do you automatically have?

A

CAD

63
Q

Non-pharmacological management of CAD

A

manage other risk factor, stop smoking, manage stress, exercise

64
Q

How does stopping smoking help manage CAD?

A

nicotine is a vasoconstrictor which narrows the coronary arterties

65
Q

Pharmacological management of CAD

A

Aspirin (acetylsalicylic acid, ASA)

Nitroglycerin (NTG)

66
Q

NTG

A

Nitroglycerin

Vasodilator used to treat CAD

67
Q

Surgical management of CAD from least to most invasive

A

Angioplasty, coronary stent, CABG

68
Q

Angioplasty

A

deflated balloon is inserted to open area of blockage and then removed

treats CAD

69
Q

Coronary stent

A

similar to angioplasty however the stent is kept in

treats CAD

70
Q

CABG

A

open heart surgery to bypass area of blockage

treats CAD

71
Q

Patient problem list

A

Section of the chart that helps organize the patient’s history and allows the doctor to identify active issues quickly

72
Q

What is included in the problem list?

A

All active and resolved conditions

Chronic illnesses, surgeries/procedures, injuries, symptoms

73
Q

What is difference between patient list and past history?

A

Patient list does not include FHx or SHx

Patient list includes the status of problems

74
Q

How are chronic illnesses classified?

A

chronic illnesses are always ACTIVE even if they are currently managed

75
Q

What goes at the top of a patient list?

A

active problems

76
Q

What goes on patient list for patient with no problems?

A

“No known problems”

77
Q

What should you not put in a note on the problem list?

A

Side of body or severity

This should just be included in a more detailed description of the problem

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