Medical Illnesses Flashcards
What are the Canadian statistics on Diabetes
One in three Canadians is living with diabetes or prediabetes, yet knowledge of the risk and complications of the disease remains low
What must the body maintain a constant level of?
blood glucose
- GI tract- food
- liver - glycogen, gluconeogenesis
What is blood glucose homeostasis regulated by?
Insulin
Glucagon
Epinephrine
Insulin?
responds to a rise in blood sugar
promotes uptake and/or storage of glucose by cells
Glucagon?
responds to a drop in blood sugar
brings glucose out of storage
Epinephrine?
helps to raise blood glucose
“fight or flight
What is normal fasting blood glucose?
4.0-6.0 mmol/L
What is diabetes?
complex metabolic disorder
- insufficient production or utilization of insulin
- inability to absorb, transport and utilize glucose
- glucose builds up in the bloodstream instead of being used for energy
What is the diagnosis of diabetes made on the basis of?
□ fasting blood sugar: ≥7.0 mmol/L
□ oral glucose tolerance test: ≥ 11.1 mmol/L
□ A1C: ≥ 6.5% (in adults)
What is a complication of diabetes associated with it?
long-term exposure to hyperglycemia (high levels of glucose in the blood)
What is Type 1 diabetes?
the pancreas produces too little or no insulin
cause unknown
What are the probable causes of Type 1 diabetes
probably autoimmune
body’s immune system attacks the beta cells of the pancreas
Is Type 1 diabetes preventable?
No
What was Type 1 diabetes previously known as?
insulin-dependent or juvenile diabetes (old term)
How many cases does diabetes account for?
accounts for 10% of cases
onset in childhood to young adulthood
What is Type 2 diabetes?
the pancreas produces too little insulin or the body is no longer sensitive to the presence of insulin
insulin resistance
What are the risk factors of Type 2 diabetes
obesity, age, (>40 y), ethnicity, genetics
When is Type 2 diabetes traditionally present?
adult-onset disease (old term)
□ now diagnosed in children & adolescents
How many cases does Type 2 diabetes account for?
90% of diabetic cases
What is Gestational Diabetes (GDM)?
temporary condition in pregnancy (5.4%, PHAC, 2016)
What causes GDM?
pancreas produces insufficient insulin to deal with excess needs in pregnancy & change in hormones
What are the risk factors of GDM?
age (≥35y), obesity, previous baby > 9lbs (macrocosmic)
Pre-diabetes, GDM in a previous pregnancy
What does GDM increase the future risk of?
increases future risk of diabetes – mom & baby
What are prevention strategies for Type 2 Diabetes?
- lifestyle factors:
- healthy eating
- limit intake of refined sugars
- increase soluble fibre intake
· regular PA (physical activity)
weight management
*all of these aid in blood glucose control
(primary risk)
What are the Signs and Symptoms of diabetes?
· excessive thirst, frequent urination
· excessive hunger
· extreme fatigue
· weight loss (type 1)
· headache, blurred vision
· elevated blood sugar - hyperglycemia
glucose in the urine - glucosuria
What are some Health complications associated with diabetes?
· associated with chronic exposure to increase blood sugar
· damage to vessels & nerves
· retinopathy - eye disease and blindness
· nephropathy - kidney disease
· peripheral vascular disease, neuropathy
· tingling or numbness in extremities
· poor circulation – infection & amputation
· erectile dysfunction
Diabetes is a key risk factor for?
a key risk factor for CVD
What are the annual statistics for people living with diabetes
Annually, people living with diabetes account for:
* 30% of strokes, 40% of heart attacks,
* 50% of kidney failure requires dialysis
70% of non-traumatic amputations
What are some management/ treatments for diabetes?
- diet planning
· regular balanced meals + snacks
□ 50-60% energy from CHO spread over the day
· limit intake of refined/added sugars (<10%)
· ↑ fibre intake - including soluble fibre sources
· small amount of protein at each meal
stabilizes blood sugar - regular exercise, weight management
- blood glucose control
▪ oral medications, insulin
* monitoring of blood sugar
▪ traditional = glucometer
· skin check - footcare
· regular medical assessment
· lower/regulate blood sugar levels: 4-7 mmol/L - Anti-diabetic medications
▪ several types
▪ multiple mechanisms of action - Insulin
▪ rapid, short, intermediate, and long-acting
▪ different strengths: e.g. U-100
▪ by injection: 1-4 /day
syringes, pens, pumps
What is the cause of hypoglycemia?
too much insulin or not enough food
too much PA - no adjustment of food or insulin
What are the early signs of hypoglycemia?
shaky, lightheaded, sweaty, weak, tachycardia, headache
How can we find out if we have hypoglycemia?
check blood sugar
- eat or drink a form of simple sugar
wait 10-15 minutes → test → treat again?
Why is severe hypoglycemia is extremely dangerous?
disorientation, seizure, loss of consciousness
What is it like living with diabetes?
· 1st goal – primary prevention
· after diagnosis:
- Blood sugar control
- minimize long-term complications
· resources:
- family physician, certified diabetes educator
- Diabetes Canada, Health Canada
- Regional public health Department
What is Cardiovascular disease (CVD)?
Collection of diseases of health and blood vessels
- Heart disease and stroke
· 2nd leading cause of death in Canada
· 23.3% of all deaths in Canada (>66,000/year, Stats Can, 2020)
Why are the incidence and mortality rates declining?
□ Understanding, and management of risk factors
□ Advances in diagnostic procedures, treatments
□ Better emergency medical assistance programs
What is the cardiovascular system?
Heart and blood vessels
- Transports, O2, nutrients, hormones, and enzymes to tissues, removal of waste products
- Role in regulation of body temp, fluid balance, pH
- Protects the body from infection, blood loss
What is the cardiorespiratory system?
Heart, lungs, blood vessels
Gas exchange - O2 and CO2
What is the anatomy of the heart?
· Weights 200-425g (7-15 oz)
· During an average lifetime
- 2.5 billion beats
· 100,000/day (7,200 litres)
Pericardium: (double-layered sac surrounding heart)
· 4 chambers
· Separated by valves - regulate the flow of blood
· Sinoatrial (SA) node - pacemaker
Electrical signal for contraction of the right atrium
The flow of blood through the heart?
What are the blood vessels?
Arteries carry blood away from the heart
□ Branch into smaller blood vessels -arterioles
Veins carry blood back to the heart
□ Branch into smaller blood vessels - venules
Capillaries: very small blood vessels
□ Connect the arterial and venous sub-circulation
□ Passage of oxygen, nutrients, and waste between blood and part of your body.
What is the coronary blood supply part of the blood vessels
□ Right and left coronary arteries
- Supply blood to the heavy muscle - myocardium
□ Cardiac veins
▪ Removal of de-oxygenated blood
- My/-(muscle), cardi/o-(heart), -um(a structure)
Cardiovascular Diseases- what is atherosclerosis?
- General term - narrowing and hardening of the arteries
· Fatty substances (plaque) in lining of artery
□ Arteries lose elasticity and narrow- Impeded blow flow - partial or full blockage
- Sten/o-(narrowness), -osis (condition)
· Atherosclerosis develops over time
· Likely begins with damage to the lining of blood vessels
□ Elevated blood pressure
□ Elevated blood cholesterol, triglycerides, and blood sugar
□ Smoking
□ … fatty deposits accumulate - Blockage, bleeding blood clots
· Atherosclerosis: minor blockage?
□ Blood may reroute through small unused blood vessels - collateral circulation - Damages tissue (heart muscle) may heal itself
Cardiovascular Diseases- What is coronary heart disease (CHD)
MOST COMMON
AKA - coronary artery disease (CAD)
· Caused by: atherosclerosis
□ Plaque build-up in one or more coronary arteries
· Restricted blood flow (75%)
□ Ischemia - insufficient blow flow relative to demands of tissue
▪ Decreases in oxygen supply
- Chest pain (angina)
· Severe restriction or complete blockage
□ Myocardial infarction (MI), AKA “heart attack”
· Often caused by thrombosis:
□ Blood cloy in coronary artery
▪ Blockage of normal blood supply to an area of heart
Cardiovascular Diseases- What is a stroke?
· AKA “cerebrovascular accident”
□ Sudden loss of brain function
· Caused by:
□ Thrombus (blood clot) or embolus
□ Disruption of blood flow to the brain
□ “ischemic stroke”
· Aneurysm: weakened blood vessel
□ Rupture of blood vessels in the brain
□ “hemorrhagic stroke”
· Transient ischemic attack (TIA)
▪ “mini-stroke”
A temporary decrease in blood flow to the brain
Cardiovascular Diseases- warning signs of stroke?
What does F.A.S.T mean?
What are the potential consequences of stroke?
Based on where the brain was injured? Degree of damage?
Impairments in movement, speech vision cognition
death
Diagnostic procedures for CVD - electrocardiogram (ECG)
- records electrical activity of heart
Holter Monitor: 24 hour heart rate, rhythm
Diagnostic procedures for CVD - Angiogram
cardiac catheterization
□ catheter threaded from groin or wrist into heart
□ contrast dye injected ® x-ray outlines structure, flow
▪ detect blockages, stenosis (narrowing of arteries), weakened valves
CVD treatment options - percutaneous coronary intervention (PCI)?
□ angioplasty with stent
- “through the skin” coronary intervention
Angioplasty with stent – stent remains and functions like a balloon for a longer period of time
CVD treatment options - pacemaker?
□ surgical implantation of the device
▪ regulates heart rate and rhythm
CVD treatment options - thrombolysis?
reperfusion therapy
□ immediate treatment for blocked artery
□ injection of medication (tPA) to dissolve blood clot
▪ restore blood flow® and prevent or reduce tissue damage
· ideally administered within 1-3 hours of event (<12 hours)
· Is an anti coagulant
· Can inject medicine using catheter right at the blood clot site
What is the survival measurement rate of cancer in Canada?
5 years
Canadian Cancer Statistic, 2021?
· prostate, breast, lung, colorectal
□ 46% of new cases
· 1 in 9 males will develop prostate CA
· 1 in 8 females will develop breast CA
· overall 5-year relative survival: 64%
· significant improvements: 1992-2021
· Some variability in this statistics
Male and Female cancer rates?
What is cancer?
- uncontrolled growth & spread of abnormal cells
- caused by: mutations in genes that regulate cell division
- mutations may be acquired (spontaneous errors, environmental exposures) or inherited
- dysregulation of cell cycle
· unchecked cell proliferation - malignant growths - tumour invades healthy tissue
□ disrupts the function of vital organs
· if cells break away from the primary site they can metastasize (travel to other parts of the body)
□ form secondary tumours
· carcinogenesis: the process of cancer development
· angiogenesis: formation of new blood vessels
What is the difference between Malignant and benign?
- tumor: abnormal mass of poorly differentiated cells:
- abnormal cells may be pre-cancerous
· benign: (not cancer) - local growth
· malignant: (cancer) - can metastasize
Different kinds of cancer?
What are cancer risk factors?
· most cancers result from a complex mix of multiple risk factors:
· Genetic predisposition is not considered a key factor for triggering factors – present itself, but only 5% overall
· Aspartame – artificial sweetener
False – cell phone use, hair dyes, and aspartame intake are known to cause cancer Iatrogenic infection
What is the most important risk factor according to Canadian cancer statistics, 2021?
Age
teady increase in incidence throughout adulthood
* > 50 y: 90% of new cases, 96% of cancer deaths
* Why is age a risk factor?
* Exposure to cancer-causing substances (carcinogens)
* Immune system becomes weaker with age
When to seek medical attention?
What are cancer diagnostic procedures?
- screening tools also used for diagnostics
- in addition:
- biopsy
○ Removal of tissue - examined by pathology - Diagnostic imaging
○ MRI, CT scans
□ tumor location, size, shape
□ Metastases
Biopsy, needle (take out a small sample of lipid, if able good sign, if not, bad sign)
- biopsy
What is cancer staging/grading?
- staging: extent of disease at diagnosis
- T: how large is the tumor?
- N: have cancer cells spread to regional lymph nodes?
- M: has cancer spread to other parts of body? (metastasis)
- grading: other important tumor characteristics
Stage 0 (in-situ): non-invasive
Stages 1-4: invasive
Cancer treatments - surgery?
- removal of the tumour
- Surrounding tissue
goal: - Clear margins
- Leave no irregular cells behind
- Surrounding tissue
