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Metabolic Disorders Flashcards

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1
Q 
• Metabolic syndrome
• Cardiovascular disease
– Coronary artery disease
– Stroke
– Hypertension
• Diabetes mellitus
A

metabolic disorders

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2
Q

• Heart, blood vessels, and blood
• Transport system of the body
• Arteries carry blood from the heart to other
organs and tissues
• Veins return the blood to the heart after the
oxygen has been used up

A

cardiovascular system

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3
Q

• Functions as a pump
• Left side takes in blood with oxygen from the
lungs
• Blood is pumped into the aorta and then
passes into smaller vessels to reach cells
• Oxygen and nutrients are exchanged for
waste material
• Blood returns to the right side of the heart
• Valves keep blood flowing in one direction

A

The Heart

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4
Q 
• Adult body – about 5 liters of blood
• Plasma (fluid portion) is 55%
• Blood cells make up 45%
– Manufactured in bone marrow
• Blood flow regulates body temperature
• Transports nutrients from digestive tract
• Carries waste to kidneys
A

Blood

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5
Q

– Absorb/remove/destroy foreign substances
(immune cells)
– Made up of granulocutes & agranulocytes
(including lymphocytes)

A

White blood cells (WBCs) or Leukocytes

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6
Q

– Contain hemoglobin

A

red blood cells (RBCs)

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7
Q

– Clump together to block holes in vessels

– Important role in clotting

A

platelets

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8
Q
  • Leukemia
  • Leukopenia
  • Leukocytosis
A

Disorders Related to White Cell

Production

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9
Q

– Cancer of the bone marrow

– Excessive WBCs → ↓RBCs in plasma → anemia

A

leukemia

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10
Q

– Deficiency of WBCs
– Result of diseases such as tuberculosis, measles, & viral
pneumonia

A

leukopenia

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11
Q

– Excessive number of WBs
– Response to infections like leukemia, appendicitis,
mononucleosis

A

leukocytosis

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12
Q

anemia, erythrocytosis, sickle-cell anemia

A

Disorders Related to Red Cell

Production

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13
Q

– Low RBCs or hemoglobin
– ↓blood transport capabilities (↓O & ↑CO2)
– Can causes permanent damage to NS & chronic weakness
– Causes:
• Iron lost (menstruation)
• Aplastic amenia (not enough RBCs produced by bone marrow)

A

anemia

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14
Q

– Excess RBCs → ↑blood viscosity & ↓blood flow rate
– Causes
• Lack of O to tissues
• 2° to other diseases

A

erythrocytosis

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15
Q

– RBCs are sickle-shaped & have abnormal hemoglobin proteins
– RBCs can easily rupture & can cause anemia
– Promotes resistance to malaria
– Genetic & more common in Blacks

A

sickle-cell anemia

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16
Q

hemophilia, clots (thromboses) in blood vessels, embolus

A

Clotting Disorders

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17
Q

– Blood can’t clot normally

– Unable to produce thromboplastin & fibrin

A

hemophilia

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18
Q

blocks flow of blood to organs, coronary thromboses, cerebral thromboses

A

clots (thromboses) in blood vessels

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19
Q

– A clot that becomes detached

– Can become lodged in a blood vessel and obstruct blood flow

A

Embolus

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20
Q 
• Congenital Defects (present at birth)
• Disorders Due to Infections (e.g., rheumatic fever)
• Cumulative Wear and Tear (Lifestyle)
– Diet
– Exercise
– Smoking
– Stress Exposure
A

Disorders

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21
Q
  • Deposits of cholesterol and other lipids, connective tissue, & muscle tissue
  • Calcify into hard, bony substance
  • Can occlude arteries
  • ATHEROSCLEORSIS
A

Formation of atheromatous plaques

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22
Q

– Major cause of heart disease in U.S.
– Caused by deposits on the arterial walls
– Blood flow is reduced, damaging tissue
– Inflammation involved

A

Atherosclerosis

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23
Q

– Loss of elasticity of the arteries

– Harder to tolerate increases in cardiac blood volume

A

Arteriosclerosis

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24
Q

interleukin-6 (IL-6) and c-reative protein (CRP)

A

indicators of coronary heart disease

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25
Q

– Damage to the coronary arteries

– Atherosclerosis and arteriosclerosis in coronary arteries

A

coronary artery disease (CAD)

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26
Q

– Damage to the myocardium due to insufficient blood supply

A

coronary heart disease (CHD)

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27
Q

– Angina pectoris (chest pain)

– Myocardial infarction (heart attack)

A

• Two primary clinical manifestations

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28
Q

• #1 Killer in the U.S. (more than 1 in 5 deaths)
-disease of modernization
• a major chronic disease
– Millions of Americans live with its symptoms

A

coronary Heart disease

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29
Q

• Condition that results from a disturbance in blood flow to the brain
– Death of brain tissue occurs within 3-5 minutes
– Often marked by resulting physical or cognitive impairments and,
in the extreme, death.
– Third major cause of death in the U.S.

A

stroke

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30
Q

– Bleeding in the brain due to a rupture of a weakened artery
• Aneurysm
• Arteriosclerosis can lead to development of aneurysms

A

hemorrhagic stroke

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31
Q

– Caused by a clot in the arteries that serve the head and neck
• Atherosclerosis and arteriosclerosis
• Clots from internal injuries
• Bubble of air (air embolism) or infection

A

common stroke

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32
Q

• Stroke affects all aspects of life
– Personal, Social,Vocational, Physical
• Motor, Cognitive, Emotional, and Relationship problems
– Symptoms and problems differ depending on which side of the brain was damaged
• A chief risk of stroke
– That more strokes will follow in its wake
– Aspirin reduces the risk of recurrent strokes

A

stroke consequences

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33
Q
  • rythmic phases of contraction and relaxtion
  • Heart sounds are from the valves closing
  • ↑heart rate →↓diastole cycle
  • ↑amount of blood in veins → ↑heart rate
A

cardiac cycle

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34
Q

blood is pumped out of the heart so blood pressure inside the vessels increases

A

systole cycle

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35
Q

blood pressure drops as the heart muscle relaxesand blood is taken into the heart

A

diastole cycle

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36
Q

• Measurement of blood pressure
– Ratio of systole to diastole force of blood on the
vessels.
• Blood pressure is influenced by :
– Cardiac output
– Peripheral resistance to blood flow in the small
arteries of the body.
• Hypertension is chronically high blood
pressure.
– Normal: 120/80
– High: >140/90

A

blood pressure

37
Q 
– Excessively high blood pressure 
– Occurs when the supply of blood through the blood vessels is excessive, putting pressure on the vessel walls
– Risk factor for other medical problems
• including kidney failure
– 1 in 4U.S. adults has it
• No symptoms
• 1/3 of these don’t know they have it
A

hypertension

38
Q

• Sphygmomanometer
• Systolic blood pressure
– Sensitive to volume of blood leaving the heart
– Sensitive to the artery’s ability to stretch to
accommodate the blood
– Incremental increases are proportionate to increased risk
– Has greater value in diagnosing hypertension
especially in older adults
• Diastolic blood pressure
– Strongly related to cardiovascular risk in younger individuals

A

how hypertension is measured

39
Q
  • 90-95% of cases are essential hypertension

* 5% of cases are secondary hypertension

A

what causes hypertension

40
Q

– Cause is largely unknown
– Related to genetic and environmental factors
– Risk factors
• Prior to age 50, men at greater risk
• After age 55, women and men have 90%chance of developing it
• Higher among minorities (related to lower SES)
• Genetic factors play a role
• Emotional factors, negative affect

A

essential hypertension

41
Q

– Caused by failure of kidneys to regulate blood pressure or

– Disorders of the endocrine system

A

secondary hypertension

42
Q

– Measurement of electrical impulses produced by the heart
– Can reveal abnormalities in resting heartbeat indicating cardiovascular disease
– However, CAD may not show up as an abnormal ECG

A

electrocardiogram (ECG)

43
Q

– Measures heart’s electrical activity during stress (usually exercise)
• Exercise increases oxygen demand by heart making blockage more detectable
• More sensitive than ECG
• Used to measure
– Ischemia
– Heart functioning after MI or coronary bypass
– Sedentary before starting an exercise program

A

stress test

44
Q

ECG, stress test, angiography, nuclear perfusion imaging, echocardiography, electron beam computed tomography, multislice spiral computed tomography

A

measures of cardiovascular function

45
Q

– Most definitive method for diagnosing CAD
– Used to determine extent of CAD after angina
pectoris, positive stress test, or MI
– Inject heart with dye so that the coronary arteries are visible during X ray
• Cardiac catheterization to deliver dye

A

angiography

46
Q 
– Advancing age
– Problems in glucose metabolism
• Type 1 or Type 2 Diabetes Mellitus
• Metabolic Syndrome
– Risk factor for coronary heart disease, stroke, peripheral vascular disease, Type 2 diabetes
– Genetic predisposition/family history
– Ethnic background
– Gender
• Men > women during middle-age years
A

risk factorsCHD

47
Q

– Leading killer of women in the U.S.
– Women have 50% chance of dying from 1
st heart attack (30% for men)
• Women seem to be protected at younger ages
relative to men
– Higher levels of HDL premenopausal
– Estrogen diminishes sympathetic nervous system
arousal
• Women have higher risk of CHD after
menopause (obesity, BP, cholesterol, &
triglycerides)

A

women and chd

48
Q

_____ less likely to :
– Receive counseling about CHD
– Learn about benefits of exercise, nutrition, & weight reduction
– Get risk factor interventions for CHD
– Receive and use drugs for the treatment of CHD
• However, women have lower quality of life after treatment than do men
• Women report more anxiety after MI
• Gender differences in personality may
differentially predict CHD

A

WOMEN and chd [relatively little research on chd in women]

49
Q

___ ___ have higher levels of risk factors for heart disease than other ethnic groups and highest risk of hypertension

  • tied to stress of racial discrimination
  • stressful locales > hypertension
  • darkskinned have higher rates of hypertension
  • racial diff decreases in nocturnal blood prssure [non dippin nightly blood pressure:risk factor]
A

african americans

50
Q
  • Physiological conditions
  • Cholesterol
  • Lipoproteins
A

CHD risk factors

51
Q

– Hypertension
– High serum cholesterol level
• Amount of cholesterol circulating in blood stream

A

physiological conditions

52
Q

– Essential for life as a component of cell membranes but too
much is bad
– Related to dietary cholesterol
• Comes from animal fats and oils

A

cholesterol

53
Q 
– Low-density lipoprotein (LDL) -- BAD
– High-density lipoprotein (HDL) -- GOOD
– Very low-density lipoproteins or triglycerides
– Add together to get Total Cholesterol
– Look at ratio of Total to HDL
A

lipoproteins

54
Q 
– Cigarette smoking
– Diet
• High saturated fat
• High sodium intake
• Can diet decrease risk?
– Diets high in fruits and vegetables decrease heart disease by 31% 
and stroke by 19%
– Omega-3 fatty acids found in fish
– Foods high in antioxidants protect LDL from oxidation» Vitamin E, beta carotene or lycopene, selenium, riboflavin
– Obesity
• Hard to isolate as independent risk factor because it is also related to hypertension, Type 2 diabetes, and total cholesterol
• Abdominal fat
– Low levels of physical activity
A

behavioral risk factors of CHD

55
Q

– Low educational level and income
– Social support and marriage
– Stress, anxiety, and depression
– Cynical hostility and anger

A

CHD Psychosocial risk factors

56
Q
  • development associated with hostility, depression, cardiovascular reactivity to stress, acute stress can precipitate sudden clinical events
  • balance of control and demand in daily life is associated
  • ppl who are under chronic stress more vulnerable to effects of stress on CVD
A

CHD role of stress

57
Q

____ is an independent risk factor in its
own right
– Environmentally rather than genetically based

A

depression

58
Q

strong associations btwn:
-depression and heart attack
-depression and heart failure among elderly
-hopelessness and heart attack
• Symptoms of depression before coronary
artery bypass graft surgery
– Predictor of long-term mortality

A

depression and CHD

59
Q

• Inflammation
– C-reactive protein
• Metabolic syndrome
• Treatment with SSRI’s
– prevent serotonin from attaching to receptors which may reduce formation of clots bypreventing aggregation of platelets in the arteries acting like blood thinners
– No evidence yet linking antidepressants to decreases in CHD incidence or survival

A

depression and CHD

60
Q 
– Behavioral and emotional style marked by an aggressive, unceasing struggle to achieve 
more and more in less time
– Often in hostile competition with 
other individuals or forces
– Risk factor for coronary artery 
disease
A

type A behavior pattern

61
Q

– Particularly lethal type of hostility
– Characterized by suspiciousness, resentment, frequent anger, antagonism, distrust of others
– Have difficulty extracting social support from others
– Fail to make effective use of available social support
– Particularly problematic if combined with defensiveness

A

Cynical Hostility

62
Q

____ predicts metabolic syndrome
and CHD in adulthood
– Both genetic and environmental factors are important
• More interpersonal conflict and less social
support
• Higher reactivity to and longer recovery from
stressful situations

A

hostility

63
Q

– Unpleasant emotion accompanied by physiological arousal
– Express as yelling, arguing, temper tantrum
– Suppress by holding in feelings
– Both are bad
• Provoked anger increases cardiovascular reactivity in
ways that predict hypertension
– Especially for men
– Forceful expression of anger may trigger cardiac event
• Suppressed anger
– Stewing about anger (rumination) increases risk

A

anger

64
Q

– Vigilant coping
– Attempting to dominate social interactions
– Vital exhaustion
• Extreme fatigue, a feeling of being dejected or defeated, and an enhanced irritability
– Social isolation and chronic interpersonal conflict increase risk of CHD
• Optimism is protective

A

Other CHD Psychological Risk Factors

65
Q 
• People who smoke
– Programs to stop smoking
• People with hypertension
– Behavioral modification important
• People with high cholesterol
– Targeted for preventive dietary intervention
• Exercise recommendations
– Aerobic exercise in particular
• Modifying hostility
– Relaxation training; speech style interventions
A

Modification of CHD Risk-Related Behavior can live 6-10 yrs longer

66
Q

• Drug Treatments– Diuretics reduce blood volume promoting the excretion of sodium
– Beta-adrenergic blockers
• Resist the effects of SNS activation
• Decrease cardiac output
• Unpleasant side effects like fatigue and impotence
• Adherence is a problem

A

Reduce Hypertension:

drug Treatments

67
Q

low sodium diet, reduction of alcohol, weight reduction, exercise, caffeine restriction, stress management and relaxation training

A

common treatments that reduce hypertension

68
Q

• Diet
– Low in saturated fats
– High in fruits and vegetables
• Increased physical activity
• Medication for people with high cholesterol
– Statins target LDL cholesterol
• Reduce risk for repeated coronary events
– Statin drugs have surpassed all other drug treatments
– Statins appear to be protective against
• Multiple sclerosis
• Alzheimer’s disease
• Some types of cancer

A

lower cholesterol treatment

69
Q

– Inducing a state of low arousal
• Biofeedback, progressive muscle relaxation, hypnosis, meditation, deep breathing, imagery
– Stress management programs
• Identify particular stressors and develop plans to deal with them: self-calming talk
– Anger management
• Identify cues, remove self from situation, self-talk, humor, relaxation, discuss feeling constructively
– Combination of diet, exercise, and behavioral
strategies for weight loss

A

cognitive behavioral treatements to modify psychosocial risk factors

70
Q

older patients, african american, patients who have consulted physician about symptoms or self treated symptoms, those with history of angina or diabetes

A

whos more likely to delay treatment

71
Q 
An intervention program designed to help heart 
patients achieve their optimal 
– Physical, 
– Medical, 
– Psychological, 
– Social, 
– Emotional, 
– Vocational, and 
– Economic status
A

cardiac rehab

72
Q 
– Exercise therapy
– Psychological counseling
– Nutritional counseling
– Education about CHD
– Medication
A

• Interventions of cardiac rehab

73
Q

– Angioplasty
• Insert balloon-tipped catheter into blocked arteries & inflate to reduce blockage
• Can involve placement of a stent (metal device) to keep it open
– Coronary artery bypass graft surgery
• Graft healthy sections of coronary arteries to bypass blocked arteries
– account for drop in deaths for CHD

A

cardiac rehab procedures

74
Q

– Aspirin is commonly prescribed
• Inhibits platelets thereby reducing clots
• Men who take ½ aspirin per day significantly reduce risk of fatal
heart attacks
• Women’s risk reduced, too
• Adherence is a problem
– Other clot-dissolving drugs
• Can be delivered with cardiac catheterization during a heart attack
– Beta-adrenergic blockers
– Statins

A

treatment by medication for cardiac rehab

75
Q

• Who’s at risk for stress after CAD?

A 
– Younger patients
– Female patients
– Those with social support gaps
– High social conflict
– Negative coping styles
76
Q

– Social support is very important for long-term
prognosis
– Patients without spouse or confidant are twice as
likely to die in the 6 months after first MI
– Spousal conflict happens after MI because patients
lose independence and have difficulty adhering to
lifestyle changes; spouses experience their own
stress

A

problems of social support with cardiac rehab

77
Q

– Psychological state that can result after a myocardial
infarction or diagnosis of coronary heart disease
– Perception that abilities and capacities are lower than they actually are
– Patients and spouses are vulnerable to these
misperceptions
– Inform spouses and have them participate

A

Cardiac invalidism

78
Q

– A method of reviving the functioning of heart and
lungs after a loss of consciousness in which the
patient’s pulse has ceased or lungs have failed to
function appropriately
• About 70% of potential sudden deaths from
heart attacks occur in the home

A

CPR cardiopulmonary resuscitation

79
Q

– Psychotherapy
• Includes treatment for depression
– Cognitive-remedial training
• To restore intellectual functioning
– Training in specific skills development
– Use of structured, stimulating environments to challenge capabilities

A

Stroke: Types of

Rehabilitative Interventions

80
Q

• A chronic condition of impaired carbohydrate,
protein, and fat metabolism
– Insufficient secretion of insulin or insulin resistance
• Cells of the body need energy to function
– Glucose is the primary source of energy
– Insulin is a hormone produced by pancreas
– Insulin acts as a “key” to permit glucose to enter cells
– Without insulin, cells don’t get the glucose they need
– Glucose stays in the blood: Hyperglycemia

A

diabetes

81
Q 
(10% of all diabetes)
– Abrupt onset of symptoms
– Immune system falsely identifies cells in the pancreas as invaders and destroys them
– Pancreas doesn’t produce insulin
– Develops relatively early in life
A

type 1 diabetes

82
Q

– Cells lose ability to respond fully to insulin (known as
insulin resistance)
– Pancreas temporarily increases insulin production
– Insulin-producing cells may give out

A

type 2 diabetes

83
Q

if overweight, get little exercise, high blood pressure, have family with diabetes, had a baby weighing over 9lbs at birth, are member of high risk ethnic group like Africans, latinos, native americans asians, and pacific islanders

A

risk factors for type 2 diabetes

84
Q 
\_\_\_\_ is associated with
– Thickening of the arteries due to buildup of wastes in 
the blood
– High rates of CHD
– Kidney failure
– Cancer of the pancreas
– Nervous system damage
• Pain and loss of sensation
• Leading cause of blindness among adults
A

diabetes health implications

85
Q

• Ideal treatment
– Patient-centered
– Patient-directed, not physician directed
• Type I patients need to
– Monitor glucose levels throughout the day
– Take immediate action when needed
• In addition to injections, pumps and inhalers can be used
• Adherence to self-management programs is low

A

diabetes self management

86
Q

• Type II patients
– Often unaware of health risks they face
– Must reduce sugar and carbohydrate intake
– Encouraged to achieve normal weight
– Encouraged to exercise
• Helps use up glucose in the blood
• Adherence is problematic

A

Diabetes:

Problems in Self-Management

87
Q

• Stress may cause diabetes
– Implicated in both the Type 1 autoimmune response
– And in the Type 2 glucose control and health
behaviors
• Stress alters regulation of glucose in diabetics
– Alters metabolism and control
• Stress management interventions decrease
stress and depression and improve control of
glucose

A

diabetes and stress

88
Q

• Programs to improve adherence include
– Education concerning glucose utilization and
metabolic control of insulin
– Improving a sense of self-efficacy and ability to
regulate behavior
• Interventions
– Type II begin taking statins to lower cholesterol
– Diabetics engage in cognitive-behavioral
interventions: Self-injection, monitoring blood sugar levels, stress management programs

A

diabetes adherence and interventions

89
Q

• Adolescents usually have Type I
– More severe
• Restrictions of diabetes interfere with issues of
independence and self-concept
• Peer culture may stigmatize those who are
different
• When parents are actively involved in diabetes
management tasks, there is better control of the
disease

A

special problems of adolescent diabetics

Health Psychology (16 decks)

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