CP Implications of Specific Diseases

Question 1

Disease:

Energy balance

Associated wtih HTN, CV disease, OA, Cancer, DM, pulmonary HTN, sleep apnea

Cardiac and pulmonary function

Fatigue

Oxygen consumption (body vs. lean body mass - lots of tissue not producing energy)

Answer 1

Obesity

More complex than over eating and being inactive

Question 2

PT role for those with Obesity (3)

Answer 2

1. Weight loss [5-10% reduction]
2. Exercise [prehab prior to surgery]
3. Lifestyle changes

Question 3

Disease:

Plaques obstruct blood flow in large/medium sized arteries [LE]

Intermittent claudication [pain w/exercise]

Skin changes

Necrosis

Answer 3

Peripheral Arterial Disease

Question 4

PT goal for PAD

Answer 4

Activity at higher load w/o complaint, progress will be SLOW

Question 5

PT role for those with PAD (4)

Answer 5

Exercise Training to increased reduced peak exercise capacity

Short intervals and progression

Goal of 30-60 min continuous

Longer warm up times [esp. in cold weather]

Question 6

Disease:

Impaired ability to modulate extracellular fluid, electrolytes, acid-base balance

Metabolic disturbances

Sx unnoticed until late stage

Affects CV, neuro, MSK, respiratory, and endocrine systems

Answer 6

Renal Failure

Question 7

Disease: Major Complications

HTN

Pericarditis

Bleeding disorder

Renal osteodystrophy

Proximal myopathy

Peripheral neuropathy

Immunosuppression

Answer 7

Chronic Renal Failure

Question 8

Goal of Tx for Chronic Renal Failure (5)

Answer 8

1. Diet
2. Fluid balance
3. BP management
4. Reduce sx of uremia
5. Dialysis

Question 9

Dialysis Facts (2)

Answer 9

1. Most sx can be resolved w/dialysis
2. Wipes pts. out, can’t tx following dialysis

Question 10

End-stage renal disease (ESRD)

Answer 10

1. CV complications result in 50% of deaths
2. Fluid overload [periphery, heart, lungs – increased pressure]
3. MI, CVA, heart failure

Question 11

Chronic Renal Failure and Exercise (5)

Answer 11

1. Decreased exercise tolerance; sedentary [using more energy at lower levels due to poor O2 perfusion]
2. Decreased O2 consumption
3. Loss of mm strength
4. Abnormal HR response
5. Sharp increase in BP

Question 12

Disease:

Systemic

Abnormalities of vasculature

Inflammatory lesions [joints, mm, tendons]

Cardiac and pulmonary manifestations

Answer 12

Collagen Vascular Diseases

Question 13

Disease:

Chronic inflammatory disease

Affects joints

Chronic can impact other systems

CV involvement

Edema

Pulmonary changes

Answer 13

Rhematoid Arthritis

Question 14

Disease:

Multi-system auto-immune

Increased production of auto-antibodies

Immune complexes w/diffues and widespread inflammation [joint, skin, brain, kidney, heart, lungs]

Cardiac Involvement

W > M; 30-40; post-partum

Answer 14

Systemic Lupus Erythematosus

Question 15

Disease:

CV involvement [HTN]

Vascular system

Infections/wounds

Pulmonary involvement [HTN, fibrosis, weakness, pneumonia, pleural effusion]

Answer 15

Systemic Lupus Erythematosus

Question 16

PT Role in Systemic Disease (4)

Answer 16

1. Increase ACtivity [monitor physiologic signs]
2. Functional performance [prevent decline]
3. Mm strength [periphery and core]
4. RPE scale

Question 17

Those with ALS are at risk for ___1___ ____2____.

Answer 17

1. Aspiration
2. Pneumonia

Question 18

Disease:

Respiratory weakness

Loss of swallow/aspiration pneumonia

Mechanical ventilation

Answer 18

Guillain-Barre Syndrome

Question 19

Disease:

Acquired autoimmune disorder

Ach receptor deficiency [voluntary mm system]

Cardiac involvement [drugs may exacerbate disease]

Respiratory involvement [mm weakness, risk for mechanical vent]

Answer 19

Myasthenia Gravis