Module 6-10 Flashcards
normal blood pressure
less than 120/ less than 80
elevated blood pressure
120-128/ less than 80
high blood pressure - hypertension stage 1
130-139/ 80-89
high blood pressure - hypertension stage 2
140 or higher / 90 or higher
hypertensive crisis
higher than 180/ higher than 120
hypertensive urgency
greater than 180/ higher than 120
asymptomatic
hypertensive emergency
higher than 180/ higher than 120 with signs and symptoms of organ damage
chest pain, organ - brain, heart, kidney
errors in BP
full bladder
talking
too small cuff
cuff over clothes
arm not at heart level
legs crossed
how much inaccuracy for full bladder
adds 10mmHg
how much inaccuracy for talking
adds 10mmHg
how much inaccuracy for too small cuff
2-10mmHg
how much inaccuracy for cuff over clothing
5-50mmHg
how much inaccuracy for arm not at heart
add 10mmHg
how much inaccuracy for legs crossed
add 2-8mmHg
calculating MAP (mean arterial pressure)
normal 70-110mmHg
((2x diastolic) + systolic)/ 3
MAP
average pressure in the arteries during one cardiac cycle
better indicator of perfusion to vital organs than SBP
Stroke belt according to REGARDS study
- Alabama
- Arkansas
- Georgia
- Louisiana
- Mississipi
- North Carolina
- South Carolina
- Tennessee
link between stroke and dementia
have stroke 2-8x more likely to develop dementia
at risk for stroke may develop cognitive impairments such as BLOOD VESSELS DETERIORATE increase risk of later developing age related COGNITIVE DECLINE and DEMENTIA
SDH - disparities in CV health
race/ethnic minority groups
pregnant or postpartum women with HTN
lower income
rural areas & access deserts
behavioral health issues and smoking
Life’s simple 7
Get Active
Eat better
Lose weight
Control Cholesterol
Manage Blood Pressure
Reduce Blood Sugar
Stop Smoking
Common sites of cerebral aneurysm
Anterior communication artery - 30%
Bifurcation of Internal Carotid Artery and posterior communicating artery - 25%
Bifurcation of middle cerebral artery - 20%
breast cancer risk factors
age
race
biological susceptibility
personal and family history
search menarche, late menopause
not breastfeeding
poor diet
physical inactivity
alcohol use
contraceptive use
hormone therapy
reproductive history
use of DES
2009 USPSTF Recommendations
women, age 50-74 recommend biennial screening
high risk populations of breast cancer
more white women diagnosed
more black women die
65 = median age at diagnosis
68 = median age at death
what are dense breasts
amount of fibrous & glandular tissue vs amount of fatty tissue in the breast - based on mammogram finding not size or appearance
what to do if you have dense breasts
breast ultrasound
magnetic resonance imaging (MRI)
who is more likely to have dense breast?
can change over time
younger
pregnant/breast-feeding
taking hormone replacement therapy
lower body weight
why is breast density important?
higher chance of getting breast cancer
more dense, higher risk
NOT more likely to die from breast cancer
breast cancer hormone receptors
estrogen
progesterone
HER-2
6 R’s of behavioral management
* how to address in dementia
reassess
reconsider
re-channel/re-direct
reassure
review
restrict
Depression S/S (SIGECAPS)
S- sleep changes - increase day, decrease night
I- interest loss (apathy)
G- guilt (worthlessness)
E- energy loss - fatigue
C- cognition/concentration reduced
A- Appetite - usually decrease but sometimes increase
P- Psychomotor agitation (anxiety) retardation
S- suicide preoccupation
TIA S/S
temporary reduction in blood supply
sudden onset of neurologic deficit
usually 2-30 min
rarely more than 1-2 hours
resolve completely in 24 hours
TIA causes
clot is fragmented and dissolved
1/3 patients eventually have major stroke
TIA treatment
carotid endarterectomy
drugs that decrease thrombi formation
long term memory
explicit memory
implicit memory
explicit memory
semantic memory
episodic memory
implicit memory
procedural memory
emotional memory
Lewy Body Dementia
5-10 %
alpha-synuclein protein, chief component of Lewy bodies
slowness
gait imbalance + parkinson movement features
Parkinson’s disease
substantia nigra = decreased dopamine; with Lewy bodies that pull alpha-synuclein protein out of the nucleus of neurons
Frontotemporal Dementia (Pick’s Dse)
loss of function in frontal and temporal lobes -
behavior
personality
difficulty with producing/comprehending language
Mixed Dementia
MC mix: AD + Vascular Dementia + Lewy body
Korsakoff Dementia
Severe Vit B1 deficiency (thiamine) - alcohol use, AIDS, cancer
TNM staging
T- tumor size
N - node involvement
M - metastasis
what does TNM describe
size, location, spread from original site
Dementia Risk Factors
advancing age
family history
CVD risk (hypertension, metabolic syndrome, diabetes, homocysteine)
stroke
atherosclerosis
apolipoprotein E Gene
mild cognitive impairment
traumatic brain injury
female
lack of social and cognitive engagement
low educational level
T/F dementia is a normal part of aging
False
top 3 types of dementia
Alzheimers disease - MC
vascular dementia
Lewy body dementia
Neurocognitive and behavioral changes in dementia (MAAAE)
memory impairment - short term first then long term
aphasia - speech/language
apraxia - movement
agnosia - recognition of faces, objects
execution function issues
why is dementia more common in females
longer life expectancy
2019 ACC/AHA guideline on the primary prevention of cardiovascular disease
healthy lifestyle throughout life
exercise > 150 min - moderate
OR 75 min of vigorous
Mediterranean Diet or DASH
sleep
diet in cardiovascular disease
minimize trans fan, red meat and processed meat, refined carbohydrates, sweetened beverages
atrophy
decrease cell size
hypertrophy
increase cell size
hyperplasia
increase cell number
metaplasia
conversion of one cell type to another
dysplasia
disorderly growth
neoplasia
new growth (benign/malignant)
neoplasia warning signs
CAUTION
c: change in bowel/bladder
a: a sore does not heal
u: unusual bleeding/discharge
t: thickening lump in breast
I: indigestion/ difficulty swallowing
o: obvious change in wart/mole
n: nagging cough or hoarseness
benign tumors
growth rate: slow
growth character: expansion
tumor spread: localized
cell differentiation: well differentiated cells
“oma” to name of cells of origin
adenoma
stage 0 breast cancer
noninvasive
carcinoma in situ
stage 1 breast cancer
1-2 cm, no lymph nodes involved
stage 2 breast cancer
invasive
2-5 cm, or + axillary LN on same side as breast cancer
stage 3 breast cancer
locally advanced
> 2 inches in diameter, extensive axillary LN, spread to other LN or tissues
stage 4 breast cancer
metastatic breast cancer
recurrent breast cancer
comes back after initial treatment
malignant tumors
growth rate: rapid
growth character: infiltration
tumor spread: metastasis by blood stream or lymphatic channel
cel differentiation: poorly-differentiated cells
ex: carcinoma, sarcoma, leukemia
metabolic syndrom components
elevated waist circumference
- >40 men >35 women
high triglyceride
> 150
low HDL
<40 men < 50 women
elevated BP
>130/85
elevated fasting glucose
>100
pro inflammatory state - C reactive protein, due to obesity
pro thrombotic state - elevated plasma plasminogen activator inhibitor
atherogenesis and formation of a coronary clot
- endothelia damage & immune response
- fatty streak forms and beginning of plaque formation
- plaque grows, fibrous cap forms, calcium deposits
- plaque ruptures, thrombus forms > AMI or stroke
LADA (left anterior descending artery)
most commonly blocked
LMCA (left main coronary artery)
blockage can lead to sudden cardiac death
Bifurcation between LMCA and LADA
blockage referred to as the widow maker
unhealthy life practices
smoking
inactivity
diet
primordial prevention
traditional: age, family history..
nontraditional: stress, pollution
primary prevention
subclinical disease
clinical disease
secondary prevention
second event
