Lecture 3 - Medical Conditions Flashcards
1
Q
what is type 1 diabetes?
A
- aka juvenile diabetes
- pancreas fails to produce enough endogenous insulin
- can’t get sugar out of blood and into cells
- filtered out by kidneys
- leads to dependence on exogenous insulin
2
Q
what is type 2 diabetes?
A
- inadequate insulin produced by the pancreas
- defect in signaling to glut-4 (resistance at the cellular level)
3
Q
what is hypoglycemia? and what are the signs?
A
- minimal sugar in the bloodstream
- caused by too much insulin, not eating, or excessive exercise
- decreased nutrients in the brain
- hunger
- double vision
- insulin shock/reaction
4
Q
what is hyperglycemia? and what are the common signs?
A
- sugar in the blood stream, can’t get into the tissue
- cells starving
- body starts converting fat
- acidosis
- breath has a fruity smell
- frequent urination
- thirst
- possible coma
5
Q
what are the common signs of hyper and hypoglycemia?
A
- altered level of consciousness (dizzy, drowsy, confused)
- rapid breathing
- rapid pulse
- feeling ill
6
Q
how do you treat hyper/hypoglycemia?
A
- ask if they have eaten or taken insulin
- look for medical bracelet
- give sugar (glucose) –> juice, hard candy, glucose tablets, non-diet soft drinks
- monitor for 5 minutes
- improvement if hypo
- no improvement if hyper –> refer to emergency medical care
7
Q
what is epilepsy?
A
- reoccurrence of unprovoked seizures
- results from a discharge of electrical activity in the brain
- > 2 seizures to be termed epilepsy
8
Q
what are the three types of seizures?
A
- focal onset
- generalized onset
- unknown onset
9
Q
what are focal onset seizures?
A
- aware or impaired awareness
- motor or non-motor
- focal to bilateral
- tonic-clonic
10
Q
what are generalized onset seizures?
A
- impaired awareness
- motor (tonic-clonic or other-motor)
- non-motor (absence)
11
Q
what are the types of unknown onset seizures?
A
- motor (tonic-clonic or other-motor)
- non-motor (absence)
12
Q
what are the characteristics of a focal seizure?
A
- occurs in one part of the brain and activates only a small number of neurons
- are aware they have had it and potentially know before it happens
- aware = usually consisting of brief sensory, motor, or memory-related symptoms
- impaired awareness = usually associated with behavioural arrest, staring, blinking, and automatisms, lasting minutes with postictal amnesia
- can be motor or nonmotor (classified by the first prominent sign or symptoms)
13
Q
what are the characteristics of a generalized seizure?
A
- bilateral discharge involving the entire cortex. impaired awareness
- generalized motor = motor, athlete falls to the ground, goes through tonic phase of stiffness, followed by clonic phase of twitches (tonic-clonic seizure)
- generalized non-motor = sudden interruption of activity followed by a blank stare, eye fluttering and head nodding (absence)
14
Q
what are the characteristics of an unknown onset seizure?
A
- motor = athletes falls to ground, goes through a tonic phase of stiffness, followed by clonic phase of twitches
- non-motor = sudden interruption of activity followed by a blank stare, may or may not realize it occurred
15
Q
what is the management for seizures? (during and after)
A
- protect their head
- remove closeby objects
- do not restrain the athlete
- do not place object in their mouth
- position on side in recovery position ASAP
- time seizure (activate EAP if longer than 5 minutes or the first time)
- assess for injury (contusions, dislocations)
16
Q
what are common seizure triggers for epileptics?
A
- fatigue
- exertion
- stress
- intense activity
- structural lesions (mechanical damage)
17
Q
what are the benefits of exercise for epileptics?
A
- enhances alertness and focus –> increases seizure threshold (less often and less severe)
- normalizes EEG
- should avoid sports where the environment cannot be controlled (rock climbing, scuba, skiing, motor racing, horseback riding?)
- swimming should only be done with a buddy
18
Q
what is asthma?
A
- a chronic inflammatory disorder of the airways
- excess mucus production
- bronchial smooth muscle constriction
- airway narrowing
- expiratory flow rate is reduced
- muscle efficiency is eventually lost (diaphragm and intercostal muscles compensate)
- leads to respiratory muscle fatigue and physical distress (may result in death)
19
Q
what are the signs and symptoms of asthma?
A
- recurrent episodes of wheezing
- breathlessness
- chest tightness (or chest pain in children)
- coughing (dry) –> at night/early morning, and after exercise especially in cold/dry environments
20
Q
what is exercise-induced bronchospasm?
A
- temporary narrowing of the airways, induced by exercise (patient has no symptoms)
- not the same as exercise-induced asthma
21
Q
what is happening to the lungs during EIB?
A
- symptoms peak 8-12 minutes after exercise
- exercise triggers bronchoconstriction
- dehydration of the lung’s airways
- inhaled air is dry and cool
- air warmed/humidified in the lungs = drying out
- after exercise the cells rehydrate (hyperemia) –> this triggers bronchoconstriction
- degree is dependent on: exercise intensity, temperature and humidity
22
Q
what is needed to diagnose EIB?
A
- symptoms
- obstructed airways resulting in 10-15% decreased FEV (forced expiratory volume)
*both have to be associated with exercise
23
Q
how do you test for EIB?
A
- athlete works for 6-8 minutes at 80% max
- test with cold air
- check FEV
24
Q
How do you manage/cope with EIB?
A
- educate
- avoid irritants (if possible)
- use bronchodilators (as prescribed)
- position for ideal breathing (if it does occur) and breathe slowly
25
Q
what is a PPE?
A
- preparticipation physical examination
- an examination to assess the ability of an athlete to safely participate in a sport activity
- not intended to disqualify or exclude
- helps maintain health and safety in training/competition
26
Q
what is the objective of a PPE?
A
- detect conditions that would: restrict participation, be life-threatening or disabling
- injury prevention evaluation
- meet legal and insurance requirements
- provide counselling and a record-keeping system
27
Q
when does PPE occur?
A
- 4-6 weeks prior to the season
- end of the preceding season
- done 1x a year minimum
28
Q
what are the two types of methods of evaluation for PPE?
A
- office based (time-consuming and more expensive)
- station based (quicker and less expensive)
29
Q
what are the 6 components of the PPE?
A
- complete medical history (most important)
- medical evaluation form
- musculoskeletal evaluation form
- visual acuity
- concussion (SCAT5, McGill)
- player status form (MSK/medical clearance)
30
Q
how early in advance should the medical history form be provided to the athlete?
A
- 7-10 days (complete family history and past medical information)
- symptoms that require evaluation
- concussions
- meds, alcohol and drugs
- recent infections
- female athletes (RED-S)
31
Q
what are the red flags on a PPE?
A
- anything that doesn’t fit the pattern
- anything that may require further testing: bone and soft tissue tumours, rheumatological conditions, cardiovascular disorders, infections, genetic disorders
32
Q
what are the symptoms of bone and soft tissue tumours?
A
- malignant is rare
- usually found in the 2nd-3rd decade (but can be any age)
- pain aggravated by activity
- night pain/sweats
- fever
- loss of appetite
- unwarranted fatigue
- weight loss (15 lbs in weeks) –> cancer
33
Q
what are rheumatological conditions? and symptoms?
A
- rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis
- could report a single or multiple swollen joints
- no history of trauma or injury
- morning stiffness
- rashes
- fingernail pitting
- bowel disturbances
- eye irritation (conjunctivitis, iritis)
34
Q
what are the characteristics of bone infections?
A
- bone and joint infections/osteomyelitis are uncommon
- may report a single or multiple swollen joints
- no history of trauma or injury
- pain in bone (not at the joint) is very rare
35
Q
what are vascular conditions? and the symptoms?
A
- deep vein thrombosis (blood clot)
- presents with single limb pain
- aggravated by exercise
- possible precipitants (recent surgery, air travel)
- tenderness on palpation over tissue
- warmth
- swollen
- red, pale or blueish
36
Q
what are PPEs good at detecting?
A
- 75% for problems affecting initial athletic participation
- identify eating disorders, alcohol and drug abuse
37
Q
what should you look for in a medical examination?
A
- observation (health markers)
- dermatological conditions
- vital signs (HR, BP, RR, temperature)
- cardiovascular examination (heart sounds)
38
Q
what is hypertrophic cardiomyopathy (HCM)?
A
- a condition in which the heart muscle becomes thick
- the thickening makes it harder for blood to leave the heart
- this forces the heart to work harder to pump blood
- when blood leaves the heart it flows through the aortic valve into the aorta
- aortic stenosis = the aortic valve does not open fully, this decreases blood flow from the heart
39
Q
what should be tested during a medical examination?
A
- allergies
- head, eyes, ears, nose and throat
- blood tests
- ECG (if needed)
- diagnostic tests
- diabetes
40
Q
what is tested in an MSK examination?
A
- screening exam
- specific tests based on history
- functional tests
- the perfect area for clearing tests
- neurological scans
- fractures, ligaments and tendon injuries
- general strength/weakness
- laxity
- posture/scoliosis
41
Q
why might individuals be precluded from participation in contact sports or require further testing?
A
- atlantoaxial (upper c-spine) instability (neck)
- history of significant head or spine trauma
- acute/contagious illnesses
- carditis
- congenital heart disease
- pulmonary compromise
- absence of one kidney
- enlarged liver/spleen (mono)
- fever
- significant musculoskeletal disorders
- convulsive disorders (poorly controlled epilepsy)
