Quiz #5 Flashcards
Kidney and Liver:
Responsible for most of the _ that provide nutrition to all cells
metabolic processes
The biochemicalprocess by which body converts food into energy
metabolic processes
Kidney and Liver:
Do we pay enough attention on them?
- _ adults diagnosed with kidney disease
4.9 million
Kidney and Liver:
Do we pay enough attention on them?
- _ percent of adults with diagnosed kidney disease
2.0%
Kidney and Liver:
Do we pay enough attention on them?
- cause of death rank
9th
Kidney and Liver:
Do we pay enough attention on them?
- _ adults with diagnosed liver disease
3.9 million
Kidney and Liver:
Do we pay enough attention on them?
- _ percent of adults with diagnosed liver disease
1.6%
Bean shape, behind liver and stomach
Kidney
Kidney functions:
- _ & _ waste and extra fluid from blood to form urine
Filter & remove
Kidney functions:
- _ blood before sending it back to the heart, waste gets removed, and salt, water, and minerals are adjusted
Filter
Kidney functions:
- Release _ that help produce red blood cells, promote bone health, and regulate blood pressure
hormones
Kidney functions:
- All blood in body passes through kidneys _
several times a day
Kidney Once Damaged:
- _ & _ build up
Waste & toxins
Kidney Once Damaged:
- Affect _ cells, tissues, metabolic pathways
all
Kidney Once Damaged:
- Can’t be cured, unless _ or _
transplant or dialysis
Chronic Kidney Disease - Pathophysiology:
- Becomes _
- Lose ability to _, then _
- Chronic condition
- damaged
- filter, then wastes build up
Chronic Kidney Disease caused by _
- Hypertension
- Diabetes
- Injury
- Poisoning
Two main causes of chronic kidney disease
- Hypertension
- Diabetes
A main cause of chronic kidney disease:
- Hypertension
– Kidneys are supplied with blood vessels, and _ of blood flow
high volumes
A main cause of chronic kidney disease:
- Hypertension
– Over time, uncontrolled _ can cause arteries to narrow, weaken or harden
High BP
A main cause of chronic kidney disease:
- Hypertension
– Damaged arteries cannot deliver enough blood to the _
kidney tissue
A main cause of chronic kidney disease:
- Diabetes
– High level of _ in the blood damage the filtering units in kidney
sugar
A main cause of chronic kidney disease:
- Diabetes
– _ diabetes patients develop kidney disease
20-30%
Football size, accounts 20% of resting total O2 consumption
Liver
Liver Function:
- The liver is responsible for _, usually in combination with other systems and organs.
- Currently, no artificial organ or device is capable of reproducing all the functions of the liver
> 500 vital functions
Liver Function:
- Blood supply
(15-18% of all blood)
Liver Function:
- _ the blood coming from the digestive tract, before passing it to the rest of the body
Filter
Liver Function:
- _ food
Digesting
Liver Function:
- Breakdown and remove _
toxic substance
Liver Function:
- Produce _
Proteins
Liver Once Damaged:
- _ caused by virus infections
Hepatitis (an inflammation of the liver)
Liver Once Damaged:
- _ be healed
Cannot
Late stage of scarring on liver
Chronic Liver Disease - Cirrhosis
Chronic Liver Disease - Cirrhosis:
- Each time liver is injured (whether by disease, excessive alcohol consumption or another cause), it tries to repair itself
- In the process, _ forms
scar tissue
Chronic Liver Disease - Cirrhosis:
- As cirrhosis progresses, _ forms, making it difficult for the liver to function
more and more scar tissue
Chronic Liver Disease - Cirrhosis:
- Lead to _
liver failure
Main causes of chronic liver disease
- Infection (Hepatitis)
- Immune system abnormality
- Genetics
- Alcohol abuse
- Obesity
Main cause of chronic liver disease:
- Alcohol Abuse
– _ of consumedalcohol passes through the liver to be detoxified
85-90%
Main cause of chronic liver disease:
- Alcohol Abuse
– Chronic alcohol abuse causes destruction of _
liver cells
Main cause of chronic liver disease:
- Alcohol Abuse
– The liver can only process a certain amount of alcohol at a time
– When drink too much, the alcohol left unprocessed by the liver circulates through the _
– The alcohol in the blood starts affecting the heart and brain, which is how people become intoxicated (drunk)
bloodstream
Ex testing for CKD & CLD—low functional capacity in this population
Self-guided method, CVD risk factor, pre-screening
Ex testing for CKD & CLD—low functional capacity in this population:
- In patients receiving hemodialysis, testing should be scheduled for _
non-dialysis days
Ex testing for CKD & CLD—low functional capacity in this population:
- Tests
Senior fitness test; FITNESSGRAM; 6-min walk
Ex testing for CKD & CLD—low functional capacity in this population:
- Submaximal cycle ergometer or treadmill for _
low intensity
Ex programming for CKD (especially those on dialysis) & CLD patients use _
chronic disease guideline
Ex programming for CKD transplantation patients use _
chronic disease guideline
Ex programming for CKD & CLD:
_ at the beginning period
- Easier on FITT
Modifications
Ex Training Considerations for CKD & CLD:
- The duration of the work interval can be _, whereas the rest interval can be _
- gradually increased
- decreased
Ex Training Considerations for CKD & CLD:
- Initially, a total exercise time of 15 min can be used, and this can be increased within tolerance to achieve up to _
20-60 min of continuous activity
Ex Training Considerations for CKD & CLD:
- As little as _ of continuous activity or whatever amount the individual can tolerate
10-15 min
Ex Training Considerations for CKD & CLD:
- The duration of PA should be increased by _ increments weekly until the individual can complete _ of continuous activity before increasing the intensity
- 3-5 min
- 30 min
Ex Rx for individuals with CKD:
- Ex training leads to _ reductions and improvements in aerobic capacity, Hr variability, muscular function, and quality of life
BP
Ex Rx for individuals with CKD:
- The ideal FITT principle has _ developed
not been fully
Ex Rx for individuals with CKD:
- Aim for PA of an aerobic nature _ for at least 30 min
5 days/week
Ex Rx for individuals with CKD:
- Initially using _ intensities and gradually progressing over time based on individual tolerance
light-to-moderate
Ex Rx for individuals with CKD:
- Medically cleared recipients of kidney transplants can initiate exercise training _ the transplant operation
soon after
FITT recommendations for individuals with CKD:
Aerobic
- Frequency
3-5 days/week
FITT recommendations for individuals with CKD:
Aerobic
- Intensity
Moderate intensity ( 40-<60% VO2R, RPE 11-13)
FITT recommendations for individuals with CKD:
Aerobic
- Time
20-60 min of continuous activity; however, if this amount cannot be tolerated, 3-5 min bouts of intermittent exercise aiming to accumulate 20-60 min
FITT recommendations for individuals with CKD:
Aerobic
- Type
Walking, cycling & swimming
FITT recommendations for individuals with CKD:
Resistance
- Frequency
2-3 days/week
FITT recommendations for individuals with CKD:
Resistance
- Intensity
Moderate intensity (70-75% 1 RM)
FITT recommendations for individuals with CKD:
Resistance
- Time
A minimum of 1 set of 10-15 repetitions
- Chose 8-10 different exercises to work the major muscle groups
FITT recommendations for individuals with CKD:
Resistance
- Type
use either machine weights or free weights for resistance exercise
FITT recommendations for individuals with CKD:
Flexibility
- should be performed following the guidelines for _
healthy adults
FITT recommendations for individuals with CKD:
Aerobic
- Intensities
– Start with _
– Try _ only if well-tolerated
- light (30-40% VO2R: 10-15 mins of continuous activity)
- Moderate
Immune systemis made up of a network of cells, tissues, and organs that work together to _
protect body
_ protect body against both infectious disease and foreign invaders
White blood cells
White blood cells:
recognize & remember invaders
B cell (military intelligence system)
White blood cells:
destroy invaders
T cell (soldiers)
_ detect and recognize the antigens, then produce _, which are specialized proteins that lock onto specific antigens
- Once produced, these antibodies stay in our body, immune system encounters that antigen again, antibodies are already there to do their job
– So if someone gets sick with a certain disease, like chickenpox, that person usually won’t get sick from it again.
- B cells
- antibodies
Although antibodies can recognize an antigen and lock onto it, they are not capable of destroying it without help
- That’s the job of the _, who destroys antigens
T cells
_ happen when a part of the immune system is missing or not working properly
Immuno-deficiency disorders
Some people are born with an immunodeficiency, although symptoms of the disorder might not appear until later in life
- Immuno-deficiencies also can be _ through infection or produced by drugs, etc., such as acquired immunodeficiency syndrome (AIDS)
acquired
- immune system mistakenly attacks the body’s healthy organs and tissues
- Cause is generally unknown
Auto-immune disorders
_ attacks the immune system, specifically the T cells
HIV (human immunodeficiency virus)
_ happens when the immune system is destroyed by HIV, AIDS is the final stage of HIV infection
AIDS (acquired immunodeficiency syndrome)
Once have HIV, have it for _
life
_ cure for HIV/AIDS, but medical care can slow the progression
“No effective”
_ people worldwide are currently living with HIV/AIDS
36.7 million
_ children worldwide are living with HIV
- Most of these children were infected by their HIV-positive mothers during pregnancy, childbirth, or breastfeeding
1.8 million
1 in 8 people living with HIV are _ of their infection
unaware
More than _ people in the US are living with HIV infection
1.2 million
HIV can be transmitted by _
- Sexual contact
- Sharing needles to inject drugs
- Mother to baby during pregnancy, birth, or breastfeeding
HIV progression & stage characteristics:
- within a few (2-4) weeks of HIV infection, flu-like symptoms
Seroconversion (stage 1)
In immunology, _ is the time period during which a specific antibody develops and becomes detectable in the blood
seroconversion
HIV progression & stage characteristics:
- can be invisible and last for > 10 years
Asymptomatic (stage 2)
HIV progression & stage characteristics:
- viral load starts to go up and the T cell count begins to go down, multi-symptom disease begins
Symptomatic (stage 3)
HIV progression & stage characteristics:
- Immune system damaged badly
- T cell count drops below 200 cells/mm3
- Opportunistic illnesses appear: severe weight loss, fever, fatigue, recurrent infection of multiple organ systems, especially the respiratory, digestive, and nervous systems, and skin.
AIDS (stage 4)
Without treatment, people with AIDS typically survive about _
3 years
HIV/AIDS Effects of Ex Training:
- Ex training is _ for HIV/AIDS individuals who are medically stable
safe
HIV/AIDS Effects of Ex Training:
- _ aerobic, resistance, combination are safe and elicit favorable and beneficial changes in the HIV-infected population.
L-M-V
HIV/AIDS Effects of Ex Training:
- _ Ex increases T4 cell counts
LM aerobic
HIV/AIDS Ex Programming:
For asymptomatic follow _
healthy individual guideline
HIV/AIDS Ex Programming:
For asymptomatic: follow healthy individual guideline
- Aerobic Ex should begin with _
low volume
HIV/AIDS Ex Programming:
For symptomatic to AIDS use _
chronic disease guideline
HIV/AIDS Ex Programming:
HIV-infected individual should obtain _ before any Ex programs
medical consultation
FITT for HIV/AIDS Individuals:
Aerobic
- Frequency
3-5 days/week
FITT for HIV/AIDS Individuals:
Aerobic
- Intensity
begin at light intensity (30-39% VO2r or HRr)
- Gradually progress to moderate intensity (40-59% Vo2r or HRr)
FITT for HIV/AIDS Individuals:
Aerobic
- Time
Begin with 10 mins and progress to 30-60 min/day
FITT for HIV/AIDS Individuals:
Aerobic
- Type
– Contact and high risk (Ex: skateboarding, rock climbing) sports are _ because of risk of bleeding
not recommended
FITT for HIV/AIDS Individuals:
Aerobic
- Type
Modality will vary with the health status and interests of the individual
- presence of osteopenia will require weight-bearing physical activities
FITT for HIV/AIDS Individuals:
Resistance
- Frequency
2-3 days/week
FITT for HIV/AIDS Individuals:
Resistance
- Intensity
Begin at a light intensity with goal of gradual progression to 60% of 1 RM
FITT for HIV/AIDS Individuals:
Resistance
- Time
1-2 sets with gradual progression to 3 sets of 8-10 repetitions
FITT for HIV/AIDS Individuals:
Resistance
- Type
Machine weights are safe and effective without supervision
- Free weights can be used for experienced lifters and/or under supervision
FITT for HIV/AIDS Individuals:
Flexibility
- Frequency
> /= 2-3 days/week
FITT for HIV/AIDS Individuals:
Flexibility
- Intensity
Stretch to the point of tightness or slight discomfort
FITT for HIV/AIDS Individuals:
Flexibility
- Time
Hold static stretch for 10-30seconds;
2-4 repetitions of each exercise
FITT for HIV/AIDS Individuals:
Flexibility
- Type
Static, dynamic and/or PNF stretching
FITT for HIV/AIDS Individuals:
Progression
Aerobic and resistance exercise programs for this population should be initiated at a low volume and intensity
Ex Rx HIV/AIDS Individuals:
The varied presentation of individuals with HIV requires a _ approach
flexible
Fibromyalgia in the US:
- The prevalence is about 2-4%
- _ 18 or older
≥ 5 million Americans
Fibromyalgia in the US:
- Most patients are _ (F:M ratio 7:1)
women
Fibromyalgia Pathophysiology:
- Cause not very clear; _ rather than psychological
Biological
Fibromyalgia Pathophysiology:
- Influential factors _
- Family history
- Infection could be a trigger
- Trauma
Fibromyalgia Pathophysiology:
- Amplifies _ by affecting the way brain processes pain signals
painful sensations
Fibromyalgia Pathophysiology:
- No _, medications can help
cure
Widespread muscle pain and tenderness
Fibromyalgia
Fibromyalgia:
- 18 points (9 pairs) are _ when pressed, and may spread pain to other body parts
painful
Fibromyalgia:
- People withFMhave pain _with a certain amount of pressure
(≥ 3 mo) in at least 11 of 18tender points
Fibromyalgia diagnosis 3 criteria
- at least 3 months with pain
- 11 out of 18 tender points
- Pain when tender points are pressed
Fibromyalgia:
Very common
- More than _ US cases per year
3 million
Fibromyalgia:
- Often accompanied by _
fatigue and altered sleep, memory, and mood
Fibromyalgia:
Fatigue affects 78-94% of individuals with fibromyalgia and is often linked to _
- _ is the key symptom
- poor sleep
- Pain
Fibromyalgia:
Approx 30% of individuals with FM have a diagnosis of _
depression
Fibromyalgia:
Widespread muscle pain and tenderness are the _
most common symptoms
Fibromyalgia:
Medications, talk therapy, and stress reduction may help _
control symptoms
Fibromyalgia:
Ages affected
19-40, 41-60 & 60+
Effects of Ex Training - Fibromyalgia:
- Ex training is _ for FM individuals
safe and beneficial
Effects of Ex Training - Fibromyalgia:
- Reduces _ and number of _
- pain
- tender points
Effects of Ex Training - Fibromyalgia:
- Improves _ and less _
- sleep
- fatigue
Effects of Ex Training - Fibromyalgia:
- Builds _
positive motivation
Effects of Ex Training - Fibromyalgia:
- _ better
function
Ex Testing - Fibromyalgia
- Self-guided method & CVD risk factor classification
- Senior fitness test; FITNESSGRAM; 6-min walk
Ex Testing - Fibromyalgia:
- For individuals with depression, provide _
high level motivation, constant verbal encouragement and possibly rewards
Ex Testing - Fibromyalgia:
- Watch intensity; determine & monitor _
pain & fatigue
Ex Testing - Fibromyalgia:
- The _ is most often used to assess physical function, overall impact of fibromyalgia, and fibromyalgia related symptoms
Revised Fibromyalgia Impact Questionnaire
Fibromyalgia - Tips on pain management
- Start out slow
- Self-message, hot or cold
- Personalize your program
- Aerobic exercises
Fibromyalgia - Tips for a better night’s sleep
- Establish & maintain a regular bedtime & wake up time everyday
- Find the amount of sleep you need to feel consistently refreshed
- Create a comfortable, quiet, clean, and dark environment for sleeping. Your bed and bedroom temperature should be comfortable
- establish a regular pattern of relaxing behavior for 10-60 minutes before bedtime
- Use the bed & bedroom for sleeping and sex only
- Exercise on a regular basis (but not too close to bedtime)
Ex Programming - Fibromyalgia:
- For people with FM, follow the _, and advance as tolerated to the _
- chronic disease guideline
- healthy individual guideline
Ex Programming - Fibromyalgia:
- _ time
Recovery
Ex Programming - Fibromyalgia:
- At the beginning, PA level should be _
doable or do without undue pain (< 7 on the scale)
FITT for Fibromyalgia:
Aerobic
- Frequency
Begin 2-3 days/week and progress to 3-4 days/week
FITT for Fibromyalgia:
Aerobic
- Intensity
Begin at </= 30% VO2r or HRr and progress to <60% VO2r or HRr
FITT for Fibromyalgia:
Aerobic
- Time
Begin with 10 min increments and accumulate to a total of at least 30 min/day and progress to 60 min/day
FITT for Fibromyalgia:
Aerobic
- Type
Low impact/non-weight bearing exercise (Ex: water exercise, cycling, walking, swimming) initially to minimize pain that may be caused by exercise
FITT for Fibromyalgia:
Resistance
- Frequency
2-3 days/week
FITT for Fibromyalgia:
Resistance
- Improved performance of _
functional activities
FITT for Fibromyalgia:
Resistance
- Intensity
50-80% 1RM
- If individual cannot complete at least 3 reps easily & without pain at 50% 1RM, it is advised the starting intensity be reduced to a level where no pain is experienced
FITT for Fibromyalgia:
Resistance
- Time
- Muscular strength: perform 3-5 eps per muscle group, increasing to 2-3 sets
- Muscular endurance: perform 10-20 reps per muscle group, increasing 2-3 sets
- Typically, the strength ex are completed first followed by a 15-20 min rest period before completing endurance ex
FITT for Fibromyalgia:
Resistance
- Type
Elastic bands, cuff/ankle weights, and weight machines
FITT for Fibromyalgia:
Flexibility
- Frequency
1-3 times/week, progress to 5 times/week
FITT for Fibromyalgia:
Flexibility
- Intensity
Active & gentle ROM stretches for all muscle tendon groups in the pain-free range
- Stretch should be held to the point of tightness or slight discomfort
FITT for Fibromyalgia:
Flexibility
- Time
Initially hold the stretch for 10-30 sec, progress to holding each stretch for up to 60 sec
FITT for Fibromyalgia:
Flexibility
- Type
Elastic bands and unloaded (non-weight bearing) stretching
FITT for Fibromyalgia:
Functional Activity Recommendation
- Functional activities (Ex: walking, stair climbing, rising from a chair, dancing) are daily activities that can be performed without using specialized equipment
- For individuals with symptoms such as pain and fatigue, functional activities are recommended to _
allow for maintenance of light-to-moderate intensity, physical activity even when symptomatic
FITT for Fibromyalgia:
Progression
- Will depend entirely on _
their symptoms and recovery from or reduction in symptoms on any particular day
FITT for Fibromyalgia:
Progression
- They should be educated on how to _
reduce or avoid certain exercises when their symptoms are exacerbated
FITT for Fibromyalgia:
Progression
- Should be advised to attempt _ during flare-ups but listen to their bodies regarding their symptoms in order to minimize the chance of injury
low levels of exercise