lecture 18: systemic conditions Flashcards
what is anemia
Reduction of RBC volume (eg. Hematocrit) or
hemoglobin concentration
or low iron
what are some reasons for Reduction of RBC volume (eg. Hematocrit) or
hemoglobin concentration
Impaired RBC formation, excessive loss, or destruction of RBC
what is the function of iron in the form of hemoglobin
- Carries oxygen
- Storage in muscles
- Transport of electrons
- Helps with enzyme reactions
true or false: insuffienct iron amoutns is acceptable
false Insufficient amounts of iron can interfere with vital function and lead to serious illness or even death
what does anemia reduce in terms of physical excerise
- Maximum aerobic capacity
- Decreases physical work capacity at submax levels
- Increases lactic acidosis
- Increases fatigue
- Decreases time to exhaustion
true or false: anemia increases lactic acidosis
true
anemia reduces or increases max aerpbic capaity
reduces
anemia decreases of incnreases physical work capacity and sub max levels
decreases
true or false: you get more easily faituged with anemia
true
what are some SS of anemia
palpitations, fatigue, muscle burning, nausea,
SOB, appetite for substances with little or no
nutritional value, spoon shaped nails, drying scaling
and fissures of lips, inflammation of tongue
why may there be msucle burning in anemia
not able to properly remove CO2 and waste because the lack of iron/hemoglobin therefore theres no 02 coming in
what is a sign of anemia in the hands
spoon shaped nails
what is a sign of anemia in the tongue
inflammationn of the tonngue
what are some predisoping factors for anemia
- Family history
- Poor diet (fad diets, disordered eating) or dietary restrictions (vegetarian)
- Excessive menstrual flow/pregnancy/childbirth
- Chronic bleeding
- Disadvantaged socioeconomic background
- Chronic use of aspirin or NSAIDs
- Cancer
- Volunteer blood donor
- Diminished hepatic, renal or thyroid dysfunction
true or false: diet does not contribute to anemia
false, a poor diet (fad diets, disordered eating) or dietary resitrictions like vegetarian can be a predisposing fator
do meds have an effect on anemia
yes chronic use of aspirin or NSAIDs can be predisposing factors
what is the most common nutritional deficency wordlwide
iron deficency
what population is not as affected by iron defience anemia
not common in men 18+ or post menopausal women
what is the treatment for iron deficeicny anemia
• Increase iron ex: Red meat or dark poultry • Vegetarianàlegumes, grains, nuts/seeds • Iron supplementation
what is the function of vitamin c for anemia
enhances iron absorption
what liquid should you avoid with iron deficency anemia and why
Avoid caffeine products- hinders iron absorption from grains
true or false: there is only 1 type of anemia>?
false there is 3
1) iron defiency anemia
2) exercuse induced hemolytic anemia
3) sickle cell anemia
what is another name for runners anemia
exercise induced hemolytic anemia
what is the main reason behind exrcise induced hemolytic anemia
RBCS are restroyed during exercise
how are rbcs destroyed during exercise
beacuse of repetive trama
explain some reasons because foot strike hemolysis
• Overweight, run on hard surfaces, poor absorption, limited cushioning in shoes
explain some reasons for intravascular hemolysis
• Intravascular hemolysis
• Swimmer, rowers
• Muscle contractions, acidosis or
increased body temperature
can exercise induced hemolytic anemia be improved?
yes AT can help limit the repetive trauma (ex: not hitting the floor so hard when running)
where is the sickle cell gene common?
Sickle cell gene is common in people whose origin is in areas where
malaria is widespread
• Example: Africa, Middle East, Caribbean, South and Central America
is sickle cell anemia more common in white or black people
black peiple
what is sickle cell anemia
Abnormalities in RBC
=Clump together and block vessels, leading to occulusion or infacts in CNS
organs such as heart, lungs, spleen
= Unable to transport oxygen
what is sickle cell anemia attributed to
Inheriting an autosomal recessive gene or to possessing two sickle genes
true or false: sickle cell aneamia is mostly asymptomatic
true
what is the problem with heat/humidity and high altitude in people with sickle cell anemia
may lead to dehydration, increased body temp, hypoxia, acidosis
what are some signs and symptoms associated to oxygen deprivation in sickle cell anemia
Re occurrent bouts of swollen/painful hands/feet, irregular heart beat, muscle
weakness, extreme fatigue, headache, muscle cramping, extreme pain
sickle cell collapse can be mistaken for what
heat collapse or cardiac collapse
what is the onset for sickle cell collapse
often occurs first 30 minutse on the field (core temp not greately elevated)
what is the treatment for sickle cell anemia collapse
Treatment: no cure, hydration is key (dec. caffeine), build up slowly with PA
levels, more rest between reps, acclimatize to altitude and heat, control
asthma etc.
what os the difference between heat cramp and sickle cell in terms of cramping
heat cramping often has a prodrome of muscle twinges (actual spasms) whereas sickle does not
where is the pain greater, in heat cramping or sickle cells
heat cramping pain is more excrutation
what is the difference in the “stopping” during exercise between heat cramp and sickle cell
What stops the athlete is different – heat crampers hobble to a halt with “locked-up” muscles, while sickling players slump to the ground with weak muscles
what is the difference in physical findings b/w heat cramp and sickle cell
heat crampers writhe and yell in pain,
with muscles visibly contracted and rock-hard; whereas,
sicklers lie fairly
still, not yelling in pain, with muscles that look and feel normal
is recovery faster for sicle cell collapse or heat cramping
sickling players caught early and treated
right recover faster than players with major heat cramping (7).
what is the name for bleeding disorder
hemophiliia
hemophilia is caused by a deffiency is what system
clotting system
what are the SS of hemophiliea
large or deep bruises, joint pain and swelling caused by internal bleeding, intramuscular bleeding, blood in urine or stool and prolonged bleeding from procedures
what is lymphangitis
inflammation of the lymphatic channels as a result of infection at a site distal to the vessels
how do pathogenic organisms invate lymphatic vessels
thourgh abraisions/wounds or other infections
what are some SS of lymphangitus
local inflammation, red streaks, headache, loss of appetite,
fevers, chills, malaise, and muscle aches
• Can progress rapidly
what is the treatment for lymphangitis
refer, antibiotics, anti-inflammatory medication, possible drainage
of an absess
red streaks on the skin are associated with what disease
lymphangistus
what is syncompe
sudden LOC “fainting)
hypertension is elevated…
bp
hypertension increases your risk of what
CV disease
what are some risk factors for hypertension
Age, obesity, alcohol abuse, race, sex, smoking, heredity, diabetes
what is the values for pre hypertensive hypertension
120-139
or 80-89
what is stage 1 hyprtension
140-159 or 90-99
hypotension is an elevated or decreased BP
lower bp
what is the problem with hypotension
inadeqate blood circulated to heart and vital organs
what is sudden cardiac death
Unexpected death resulting from sudden cardiac arrest shortly after
exertion (<1 hours) where other definitions include any SCD from
exertional or other events due to acquired coronary artery disease.
what is the leadingn cause of death in young adults
sudden cardiac death
who is at a higher risk for suden cardiac death
males, black athletes and basketball players
are women or men more likely to have an increased death rate for sudden cardica death
men
what is the most common cause of sudden cardiac death in individuals younger than 35 years
hyertrophic cardiomyotpathy
what is hyperrtophic cardiomyotpahy
abnormal thickeneinng of left ventricle wall
true or false: during routine physical examination, hypertrophic cardiomyotpathy
false, it can go undetetcted
what is the normal left venticle size vs hypertrophic cardiomyophaty
normal 1cm
HCM greater than 3 cm
when is Hypertrophic cardiomyotathy suspected in young atheletes
Suspected in young athlete with exertional dyspnea, chest pain,
unexplained syncope, palpitations or prior recognition of heart
murmur
what is the problem with a larger left ventricle
can lead to electrical problems and abnornal rhythems
what is myocarditis
Inflammatory condition of the muscular walls due to bacterial or viral infection
• Abnormally enlarged left ventricle
what is the problem with inflammation of the musclarwalls of the heart
can lead to degenration or death of muscle cells
what can myocarditis cause
electrical isntability and life threathening arryhtmias
what are tthe SS of myocarditus
maybe asymptomatic, fever, body aches, fatigue, cough or vomiting
• Exercise intolerance, SOB, and more serious cardiac symptoms
does marfan symftom lead to SCD
not necessary but it can lead to a weakened aorta q
what is marfan syndrome and what can it affect
Genetic disorder of the
connective tissue that can affect the skeleton, lungs, eyes, heart and blood vessels
• Single mutant gene, usually
inherited
what are some SS of marfan syndrome
overly long extremities
• Joint hypermobile
- Pigeon chest (sunken chest)
- Stretch marks
- Scoliosis
- Increased incidence of hernias
- Positive thumb test and wrist test
what is the positive of the chest for marfan syndrome
pigeon chest (sunken chest)
what is a headache
Irritation of one or more of the pain0sentitive structures or tissues in
the head/neck
• Including cranial arteries and veins, CN’s and spinal nerves, cranial and
cervical muscles, and the meninges.
what are some causes of headaches
- Organic disorders (toxins, systemic diseases)
- Psychoneurological problems (nervous tension, fatigue, worry, excitement)
• Environmental (head trauma, bright lights, noise, altitude change, sunstroke,
motion sickness or irritants like smoke, pollen)
how long do migraine headaches usually alst
4-72 hours
who are more likelt to get migraines and why
women because of change in estrogen levels that are linked to migraines
what are some common ttriggers for migaines
Common triggers- caffeine, missed meals, too much or little sleep, stress, bright
lights, strong odors, change in altitude, red grapes, aspartame
explain migraines without aura
Pulsating quality, aggravated by PA, nausea, photo/phonophobia, desire to lay down
in dark room
explain migraines with aura
Develops over 5 min and last 60 min
• Unilateral visual, sensory, and other sensory or CNS symptoms such as reversible
changes in speech, motor or visual chances
what is the most common type of headache
tension type headaches
where are tension type headaches most common (what part of brain)
Typically in frontal or occipital region bilaterally spreading over the
entire head
• Pressing or tightening quality
what is tthe typical duration for tension type headaches
30 min-7 days
what are some SS of tension type headaches
mild nausea, phonophobia, photophobia
when can you consider it a chronic tension type headache
Chronic TTHs are present at least 15 days per month for at least 6 months
what are cluster headaches
Severe unilateral pain, either orbitally or supraorbitally, or temporally or a
combination of these sites, that lasts from 15-180 minutes
true or false: cluster headaches always occur 5x a day
false, can occur from every othre day to 8x a day and often wake a patient up from sleep
what type of headache often wakes someone up from sleep
cluster headaches
what is the least common type of headache
cluster headaches
what gender is more likely to get cluster headaches
males
how are cluster headaches often describes
Often described as unilateral, stabbing, boring, burning, clusters or groups
can last 3 weeks to 3 months, followed by headache free periods months to years
cluster headaches are associated with at lead 2 of the following factors …
• Conjunctival infection, lacrimation, nasal congestion, forehead/facial sweating,
pupillary contraction, lid drooping, and eyelid edema
• Agitation during attacks
how are most headaches treated
with drug therapy (over the counter pain relivers like acetomineaphinen)
true or false: there is only drug therapy to help with headaches
false, stress reduction can also be helpful for some patients
when is a CT scan or MRI necessrery with headaches
• CT scan or MRI may be necessary if other techniques fail to determine if there is a structural disorder of the CNS
how is meningitus most commonly caused
by bacteria or a virus
what are some other causes of meningitus besides bacteria or virus
Can occur from blow to head*, cancers, inflammatory diseases, reaction to medications (especially ibuprofen)
explain viral meningitus
• Usually mild and clears on its own 1-2 weeks
• Viruses associated with mumps, herpes infection, or other diseases as well as
polluted water can cause this
explain bacterial meningtigus
- Streptococcus, requires antibiotics
- Caused by infection from other part of body and travels through bloodstream to brain and spinal cord
- Contagious through exposure to bacteria (coughs, sneezes, sharing things)
wht type of meningitus is a medical emergency
bacteria
is meningitis fatal
10% of cases of fatal
meningitus has similar symtpoms to what other sickness
flu
what are some SS of meningtisu
High Fever, severe headaches, cervical rigidity, vomiting, irritability,
lack of appetite, photophobia, lack of energy, mental confusion
• Neurological complications (blindness, deafness, loss of speech,
learning disabilities)
whta is encephalitis
inflammation of the functional brain tissue
is encephalitis a bacterial or viral infection
viral
how is encephalitis spread
by insects (mosquotis)
what is primary encephalitis
direct viral invasion of brain and spinal chord (fever and headache to start)
what is secondary encephalois
viral infection in other part of body and overreaction of the immunte system
what is the treatment for encephalitis
Antiviral medication NSAIDs Improve immune system (nutrition, physical activity, stress reduction)
what is Complex Regional Pain Syndromes
chronic pain disorder lasting longer than 6 mtnhs
presents of regionnal pain and sensory changes followed by a noxious events
what are some findings associated with Complex Regional Pain Syndromes
• Associated with findings such as abnormal skin colour, temperature
changes, abnormal sweating, hypersensitivity, subnormal edema, and
significant motor function
• These findings exceeds the magnitude of the known physical damage
what gender and age is more affected by complex regional pain syndrome
more women any age (peak 40)
what is the treatment for complex regional pain syndromes
Pain reduction therapy, NSAIDs (systemic or local),nerve blocks, psychological improvement, movement
upper respiratory tract infections are very damaging or no>
minor but can affect perfomance
when should you not participate in exercise with an upper respiratory tract infections
Do not participate if ever (>100.5F/38C), severe malaise, myalgia,
weakness, SOB, and/or severe cough or if they are dehydrated
what is the virus associated with the cold
most common the human rhinovirus
how is the common cold transmitted
direct contract or airborne dropplets
when does a cold usually behin
1-2 daus after exposire and can continue for 2-3 wekks
when should you resume PA after a cold
• Physical performance decreaseresume
activity a few days after
symptom cessation
what are the SS of common coldn
• Rhinorrhea • Nasal itching • Sneezing, unproductive cough • Itching and puffy eyes • Associate itching and puffiness of the eyes
sinusitus is an indlammation of what
paranal sinus
what is sinusitis caused by
bacteria, virus,
allergy or environmental factors
when is sinusitis suspected
adter a common cold lasts more than 7-10 days
what are tthe ss of sinusitus
• S/S- nasal congestion, facial pain (upper teeth), pressure (eyes), nasal discharge, coughing, palpable pain in sinuses, fever, chills, swelling of eyes, tension headaches
what is the fancy name for sore throat
pharyngitis
true or false: pharyngitis can only be caused by viral infectio
false, also bactterial and fungal
pharyngitis may results from what
May result from common cold or influenza, streptococcal infection,
HSV1or2, candidiasis, etc
what is the appearance of the tonsils in pharyngitis
Dark red tonsils, swollen, pus discharge may be present
what atre the SS of pharyngitis
Pain with swallowing, may radiate to ears, common cold symptoms may also be presents
what tissues are swollen in laryngitis
tissues inferior to epiglottis are swollen and inflammed
laryngitis is swelling after the BLANKS
vocal cprds (cannot vibrate normally)
laryngitus is common with what
with cold, trauma to throat, allergies, cigarette smoking,
general irritation of straining vocal cords
what are the SS of laryngitis
Weak, hoarse, gravelly voice, sore throat, fever, cough, tickling in throat,
difficulty swallowing
what is tonsilitis
the inflammation of tonsils
how is tonsilitis often caused by
Often causes by streptococcal infection
• Sometimes by viral infections, such as flu, cold, mononucleosis or herpes simplex
• Contagious- cough, sneeze, nasal fluids
what are the SS of tonsilitis
white specks or white excaudate on tonsils, swollen lymph nodes,
headache, bad breath
what can occur along with tonsilitis
pharyngitis
if you have white specks on tonsils, what condition do you hsve
tonsilitis
if you have dark swollen tonsils, what condition would you have
pharyngitis
what is bronchitis
Inflammation of mucosal lining of tracheobronchial tree
what is bronchitis caused by
infection or inhaled particular
true or false: bronchitis can be chronic or acute
true
what is an example of chronnic bronchitis
COPD
what arte the SS of bronchitis
- Bronchial swelling, mucus secretion, increases resistance to expiration
- Coughing, wheezing, mucus production
in bronchitis, there will be wheezing in what pahse of breathing
exhalation
in bronchitis there is increased resistance on inhalation or expiration
expiration
what is influenza caused by
Haemophilus influenza (A,B, or C)
what are the SS of influenza
• Fever (39-39.5C, 102F-103F), chills, malaise, headache, general muscle aches,
hacking cough, inflamed mucous membranes
• Rapid onset within 24-48 hours after exposure
• Sore throat, watery eyes, photophobia and non productive cough may linger
for 5 days
true or false: the flu can lead to bronchitis
true
what is the traatment of the flu
fluids, saltwater gargles, cough medication, analgesics to
control fever/aches/pain. If fever does not return to near normal
within 24 hours, seek physician care
when should you seek physician care with the flu
if fever does not return to near nromal within 24 bh
wnhat are some difference variattions of corona virus
SARs, MARs, SARS-CoV, SARS-CoV-2…
how is covid spread
air borne
what are the SS of covid
• Fever, chills, headache, general malaise, loss of appetite, respiratory
symptoms
• Cough, SOB
• Can lead to hypoxia and develop pneumonia
what can coronaravirus lead to
hypoxia and pneumonia
pneumoia is the inflammation of
the lungs
what population is at greater risk of pneumoni a
65+ and sedentary
what happens to the alveoli in pneumonai
• Alveoli fill with pus and fluid, preventing oxygen from
transferring to bloodstream
what aret some SS of pneumonnai a
Shaking, chills, high fever, sweating,
chest pain, and cough (producing
thick phlegm-green, rust or yellow
what is known as the kissing disease
infectious mononucleoisis
how is mono transmitted
saliva
what age is more at risk of mono
15-25
what is the incubation period for mono
30-50 days
what virus causes mono
epstein barr (in herpes fam)
what are the SS of infectious monoclueoisis
- General feeling of malaise and fatigue
- 3-5 days- fever, swollen lymph glands, sore throat (unable to swallow)
- Enlarged and vulnerable spleen
- Avoid contact/collision sports
what condition can cause an enlarged and vulnerable spleen
infectious mono
what is GERD stand for
gastroesophageal reflux disease
what is gerd
Gastric juice regurgitates into the esophagus
• Very acidic
what are some causes of GERD
• Eats/drinks to much, obesity, pregnancy, running
whatt are some SS of GERD
mild heartburn, upper chest pain
what is gastroenteritis
Acute inflammation of the mucous membrane of the stomach or small
intestine
what is another name for gastroenteritis
intestinal flu, traveler’s diarrhea, or food poisoning
what is gastroenteritus caused by
Bacterial, viral, allergic reaction, medication, parasites, contaminated food,
emotional stress
what arre some SS of gastro
indigestion, nausea, gas, sour stomach, cramping, diarrhea, fever,
vomiting, lead to dehydration
irritable bowel syndomr ie a disorder of what
Lower GI
Abdominal pain and altered bowel function (constipation, diarrhea) are assocaited with what condition
irritatble power syndrome
whatt are the causes of IBS
Can be psychological in origin, some physiological irritation or errors in
GI tract
IBS needs to last for at least how long
12 weeks
in iBS you have 2/3 what symtpoms
relief with defecation, change in frequency or appearance of
stool
what is the treatment for IBS
refer to physician for blood/stool samples, dietary
modifications, adequate rest, exercise and stress reduction
crohns disease is considered what type of enteritis
regional enteritis
cronhs disease is a Serious, chronic inflammation, usually of what regions
of the distal ileum and colon
true or false; the cause of cronh’s is unknowen
true
croh’s disease inflammation extends through all layers of intestinl wall which results in what
resulting in thickening or toughening of the wall and narrowing of the lumen
what are the SS of chrons disease
chronic abdominal pain in lower right quadrant, diarrhea 10-20x/day,
loss of appetite, weight loss, malnutrition, sores in anal region
what are some complications of cronhs
joint pain, eye problems, skin rash, liver disease
hyperthyroidism is the overproduction of what
thyorxine
what is hypothyroidsm
insufficient quality of thyroid tissue, loss of functional tissue, excessive
or insufficient iodine in diet, certain medicines
in hypertthyroidism is there weightt gain or loss
sudden weigh loss
true or false: goiter is on\ly associated with hypothyroidsm
false, also hyper
in hyperthyroidsm, is your skin usually sweaty or dry
in hyper: sweaty
in hypo: dry
true or faslse: both hyper and hypothyroidsm affected menstral pattersn
trur
consitpations are associatied with hypo or hyper thyroidism
hypo
what is the function of the pancreas
Produce digestive juices, secrete the hormones insulin and glucagon
into bloodstream
what is the elading cause of acute pancreastis
Gallstones leading cause (move
into pancreas)
where is there pain in pancreatitus
Abdominal pain, referred to
back or chest
true or flalse: alcohol improves the pain associated with pancreastis
false, worsens pain
true or falsel: acute pancreatiis requires immediate medical attension
true
whatt is the problem of gallstrones that move into the pancrease
block the flow of pancreatic juices
in chronic pancreatitis there is permanent damage to structures and function nwhy
to progressive inflammation
what is the leading cause of chronic pancreatitus
alcohol
in chronic panncreatitis, what happenns to the cells
cells tahtt produce insulinn are impaired causeinng diabetes
know the diabetes table???
//
what are the diabetic complications in terms of vascular and nerve
- Affect ability to feelàimportant for hot/cold, electrical modalties
- Increase risk of coronary heart disease
- Can’t feel cuts/lacerations etcàinc risk of infection
what is hypoglycemia
low blood sugar
true or false, to have hypoglycemia, you have to have diabetes
false
hypoglycemia is common in who and why
common in ahteltes because icrease exercise which is not counterbalances with enough food
what is insulinn shock
too mich insulin around exercise
what are the SS of hypoglycemia
Dizziness, feeling shaky, headache, intense hunger, pale, cold/clammy skin, confusion,
dec. in performance, staggering gait
what is the treatment for hypoglycemia
Treatment: “15-15 rule”à15g of CHO (fast acting), wait 15 minutes to see
improvement and the blood sugar
• Fruit juice, sugar packers, 1tbsp honey/maple syrup, glucose tablets
true or false: diabetic coma is not a medical emergency, just need to wake them up
fals, it is an emergency
what are the SS of diabetic coma
Increasingly restless and confused, SOB, dry mouth, intense thirst
• Can slip into a coma, dry/red/warm skin, rapid/weak pulse, and a sweet fruity acetone
breathe (like nail polish remover)