test 4 Flashcards
What is classified as COPD? What are the different subclasses?
disease characterized by the presence of airflow obstruction attributable to chronic bronchitis or emphysema
Chronic bronchitis?
presence of a productive cough most days during 3 consecutive months of 2 successive years
Emphysema?
abnormal permanent enlargement of respiratory bronchioles and alveoli
How is spirometry used to help and determine COPD?
reduction in FEV1 is a strong predictor of mortality rate
How does FEV1 and FVC relate and what is their ratio testing for?
FEV1= forced expirometry
FVC= total air forced out
What are the different stages of COPD based on the FEV1/FVC ratios?
1: FEV1 >= 50% of predicted; mild
2: FEV1 btwn 35-49% predicted; moderate
3: FEV1 <35% of predicted; severe
How does hyperinflation of the lungs relate to dyspnea?
trapping air in the lungs reduces space available for fresh air to enter the lung leading to SOB
How does COPD cause skeletal muscle dysfunction?
reduction in type 1 fibers and increase in type 2 fibers in quads; indiv. can’t walk as much bc of reduced lung function so atrophy of type 1 fibers and inactivity
What are the exercise responses in COPD patients? Table 19.2
COPD–> dyspnea, inflammation, respiratory work increase, energy intake goes up, protein breakdown increase, hypermetabolism all leads to weight loss and malnutrition
What 2 therapies have been used to help COPD?
oxygen therapy: maintain partial pressure @ 90% saturation
pharmacological therapy: bronchodilation
What are the different pharmacological therapies used for COPD and what are some examples? How do they work?
steroids and beta 2 agonists. both are bronchodilators
How is Asthma related to COPD and why are not classified together?
asthma is not chronic, COPD is chronic. asthma is vasoconstriction and caused by allergies, exercise, leading to inflammation and dyspnea
What is the physiology of asthma?
inflammation in medium sized bronchi, structural changes, hypertrophy and hyperplasia, increased mucus hypersection
What are the factors that cause asthma?
Host factors: genetic, obesity, gender
environmental: indoor allergens, outdoor allergens, infections, smoke, air pollution, diet
What are the roles of CD4 lymphocytes and eosinophils and mast cells in asthma?
believed to promote inflammation by the eosinophils and mast cells- caused by edema formation
how is spirometry used to diagnose
for asthma
- FEV1 (80% of predicted)
-FEV1/FVC (<65% of predicted)
-flow/ volume loop
Is exercise testing required with asthma individuals? When would it be recommended?
typically only reserved for ppl w/ unusual decline in exercise tolerance
What considerations need to be made for exercise training?
for asthma
people w/ asthma are sensitive to changes in air temp & humidity
What are some medications used for asthma and their functions?
corticosteroids, immunomodulators, leukotriene modifiers, long-lasting beta-agonists, methylxanthines
What is cystic fibrosis and what does it effect/what are the symptoms.
a genetic disorder that affects the respiratory, digestive, and reproductive systems. symptoms: excessive mucus leading to obstruction of passageways and increased sodium and chloride contents of sweat
What gene is CF located on and what change does it cause?
chromosome 7, produces CFTR, a protein that functions as a chloride channel. abnormal CFTR leads to abnormal sodium chloride and water movement across the cell membrane
What is CFTR and what does it do to cause the symptoms of CF
abnormal CFTR leads to abnormal sodium chloride and water movement across the cell membrane
What other diseases are related to CF?
hemoptysis, nocturnal headaches or cyanosis, pulmonary hypertension, right heart failure
What are the effects of CF on GI system, metabolic system, bone disease, sinuses, and sweat glands?
exocrine pancreatic insufficiency: malabsorption of important nutrients (fat and protein)
sinus infections, CF-related diabetes, 20% of CF cases had bone disease, sweat is high in salt/chloride
What role does the oxyhemoglobin saturation, hypoxemia, and scoliosis play in CF?
oxyhemoglobin: lower b/c gas exchange is impaired by elevated mucus levels in the lungs
hypoxemia: decline in lung function, increased inflammation, promotes bacterial growth, exacerbates mucus build-up
scoliosis: lings are squished and cannot properly inflate
What diagnostic tests can be used to screen for CF?
genetic testing, chest x-ray, sputum culture, chest CT, liver function
What exercise special considerations need to be noted?
for CF
monitor pulse ox, use ECG @ baseline maximal aerobic exercise
Are there any drugs that help with CF? What are they and what are their functions?
mucolytics, bronchodilator, anti-inflammatory, antibiotics
What are some of the anticipated responses to exercise that one needs to be prepared for in the CF population?
pneumothorax
What is the term neoplasm? How can cancer be described?
abnormal growth of tissue
What does the term metastasize mean?
ability to spread to other body parts
What are some risk factors that affect cancer? Gender? Age? Ethnicity?
cancer equally affects all people
What role does the stem cell have in causing cancer?
stem cells can differentiate into any kind of cell for self-renewal. if there is a DNA mutation that gets missed that DNA is replicated and causes cancer
What are the five broad categories for causing cancer? How do they relate and how might they increase cancer risk?
environment, heredity, oncogenes, hormones, impaired immune function
What are meant by these terms and how do they relate to cancer: Oncogenes, tumor suppressor genes, tumorigenesis
oncogenes: cancer causing genes
tumor suppressor genes: genes that prevent tumors
tumorigenesis: creation of tumors
What are the components of the immune system and how do they relate to cancer?
innate: inflammation
adaptive: antigen response
What is the adaptive vs the acquired immune systems? How do they relate to question 5?
adaptive: antigen-specific response
How does estrogen play a role in cancer?
presense of estrogen could potentially accelerate cancer cell growth
What are the four types of cancer and be able to describe them
carcinoma; epithelial tissues
sarcoma: connective tissues
leukemia: WBC
lymphoma: lymphatic system
What are the signs and symptoms of cancer?
weight loss, fatigue, nausea, malaise
How can cancer be diagnosed?
biopsy of tissue or tumor
What are the different treatment plans and how are they performed
surgery: excise tumors and surrounding tissues
chemo: drugs to minimize cancer cells
biotherapy: stimulate immune response of the body
radiation
When or what are the preferences for the different treatment plans?
based on stage, type, location of cancer
What is the difference in AIDS and HIV?
HIV- 200 CD4 cells or less
AIDS- later stages of HIV
What type of virus is HIV and how does it destroy the immune system?
takes over cells and duplicates itself before destruction of immune system
What is HAART and how does it relate to HIV
treatment that reduces RNA and DNA replication of HIV virus. stands for highly active antiviral therapy
What are the different stages of HIV and their characteristics
- AIDS not present, CD4 count >= 500 cells
- AIDS not present, CD4 count 200-499
- AIDS, CD4 count <200 cells
What are the primary routes of infection for HIV
infection from bodily fluids (blood, semen, breast milk), IV drug use. not transferred by insects, saliva or sweat
What are the signs and symptoms of HIV and when do they occur?
sore throat, fever, fatigue
What is meant by wasting in individuals with HIV
losing a ton of weight
What are these complications and their reasons for occurring: Lipodystrophy, Cardiac Dysfunction, What types of exercise precautions need to be taken bc of those complications?
changes in glucose, lipid, and insulin resistance. Lipodystrophy: loss of subcutaneous fat deposits in arms, legs & face
cardiac dysfunction: arrhythmias. high fatigue, assess for orthopedic complications, test early in the morning
What are the complications of HAART regimens?
assess for HAART-related orthopedic complications test early in the morning than later in the day
How do the drugs that treat HIV work and what are some examples?
protease inhibitors, fusion inhibitors, NRTIs; all inhibit viral replication process
