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clinical phys > test 4 > Flashcards

test 4 Flashcards

1
Q

What is classified as COPD? What are the different subclasses?

A

disease characterized by the presence of airflow obstruction attributable to chronic bronchitis or emphysema

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2
Q

Chronic bronchitis?

A

presence of a productive cough most days during 3 consecutive months of 2 successive years

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3
Q

Emphysema?

A

abnormal permanent enlargement of respiratory bronchioles and alveoli

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4
Q

How is spirometry used to help and determine COPD?

A

reduction in FEV1 is a strong predictor of mortality rate

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5
Q

How does FEV1 and FVC relate and what is their ratio testing for?

A

FEV1= forced expirometry
FVC= total air forced out

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6
Q

What are the different stages of COPD based on the FEV1/FVC ratios?

A

1: FEV1 >= 50% of predicted; mild
2: FEV1 btwn 35-49% predicted; moderate
3: FEV1 <35% of predicted; severe

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7
Q

How does hyperinflation of the lungs relate to dyspnea?

A

trapping air in the lungs reduces space available for fresh air to enter the lung leading to SOB

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8
Q

How does COPD cause skeletal muscle dysfunction?

A

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

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9
Q

What are the exercise responses in COPD patients? Table 19.2

A

COPD–> dyspnea, inflammation, respiratory work increase, energy intake goes up, protein breakdown increase, hypermetabolism all leads to weight loss and malnutrition

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10
Q

What 2 therapies have been used to help COPD?

A

oxygen therapy: maintain partial pressure @ 90% saturation
pharmacological therapy: bronchodilation

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11
Q

What are the different pharmacological therapies used for COPD and what are some examples? How do they work?

A

steroids and beta 2 agonists. both are bronchodilators

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12
Q

How is Asthma related to COPD and why are not classified together?

A

asthma is not chronic, COPD is chronic. asthma is vasoconstriction and caused by allergies, exercise, leading to inflammation and dyspnea

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13
Q

What is the physiology of asthma?

A

inflammation in medium sized bronchi, structural changes, hypertrophy and hyperplasia, increased mucus hypersection

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14
Q

What are the factors that cause asthma?

A

Host factors: genetic, obesity, gender
environmental: indoor allergens, outdoor allergens, infections, smoke, air pollution, diet

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15
Q

What are the roles of CD4 lymphocytes and eosinophils and mast cells in asthma?

A

believed to promote inflammation by the eosinophils and mast cells- caused by edema formation

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16
Q

how is spirometry used to diagnose

for asthma

A
  • FEV1 (80% of predicted)
    -FEV1/FVC (<65% of predicted)
    -flow/ volume loop
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17
Q

Is exercise testing required with asthma individuals? When would it be recommended?

A

typically only reserved for ppl w/ unusual decline in exercise tolerance

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18
Q

What considerations need to be made for exercise training?

for asthma

A

people w/ asthma are sensitive to changes in air temp & humidity

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19
Q

What are some medications used for asthma and their functions?

A

corticosteroids, immunomodulators, leukotriene modifiers, long-lasting beta-agonists, methylxanthines

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20
Q

What is cystic fibrosis and what does it effect/what are the symptoms.

A

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

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21
Q

What gene is CF located on and what change does it cause?

A

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

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22
Q

What is CFTR and what does it do to cause the symptoms of CF

A

abnormal CFTR leads to abnormal sodium chloride and water movement across the cell membrane

23
Q

What other diseases are related to CF?

A

hemoptysis, nocturnal headaches or cyanosis, pulmonary hypertension, right heart failure

24
Q

What are the effects of CF on GI system, metabolic system, bone disease, sinuses, and sweat glands?

A

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

25
Q

What role does the oxyhemoglobin saturation, hypoxemia, and scoliosis play in CF?

A

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

26
Q

What diagnostic tests can be used to screen for CF?

A

genetic testing, chest x-ray, sputum culture, chest CT, liver function

27
Q

What exercise special considerations need to be noted?

for CF

A

monitor pulse ox, use ECG @ baseline maximal aerobic exercise

28
Q

Are there any drugs that help with CF? What are they and what are their functions?

A

mucolytics, bronchodilator, anti-inflammatory, antibiotics

29
Q

What are some of the anticipated responses to exercise that one needs to be prepared for in the CF population?

A

pneumothorax

30
Q

What is the term neoplasm? How can cancer be described?

A

abnormal growth of tissue

31
Q

What does the term metastasize mean?

A

ability to spread to other body parts

32
Q

What are some risk factors that affect cancer? Gender? Age? Ethnicity?

A

cancer equally affects all people

33
Q

What role does the stem cell have in causing cancer?

A

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

34
Q

What are the five broad categories for causing cancer? How do they relate and how might they increase cancer risk?

A

environment, heredity, oncogenes, hormones, impaired immune function

35
Q

What are meant by these terms and how do they relate to cancer: Oncogenes, tumor suppressor genes, tumorigenesis

A

oncogenes: cancer causing genes
tumor suppressor genes: genes that prevent tumors
tumorigenesis: creation of tumors

36
Q

What are the components of the immune system and how do they relate to cancer?

A

innate: inflammation
adaptive: antigen response

37
Q

What is the adaptive vs the acquired immune systems? How do they relate to question 5?

A

adaptive: antigen-specific response

38
Q

How does estrogen play a role in cancer?

A

presense of estrogen could potentially accelerate cancer cell growth

39
Q

What are the four types of cancer and be able to describe them

A

carcinoma; epithelial tissues
sarcoma: connective tissues
leukemia: WBC
lymphoma: lymphatic system

40
Q

What are the signs and symptoms of cancer?

A

weight loss, fatigue, nausea, malaise

41
Q

How can cancer be diagnosed?

A

biopsy of tissue or tumor

42
Q

What are the different treatment plans and how are they performed

A

surgery: excise tumors and surrounding tissues
chemo: drugs to minimize cancer cells
biotherapy: stimulate immune response of the body
radiation

43
Q

When or what are the preferences for the different treatment plans?

A

based on stage, type, location of cancer

44
Q

What is the difference in AIDS and HIV?

A

HIV- 200 CD4 cells or less
AIDS- later stages of HIV

45
Q

What type of virus is HIV and how does it destroy the immune system?

A

takes over cells and duplicates itself before destruction of immune system

46
Q

What is HAART and how does it relate to HIV

A

treatment that reduces RNA and DNA replication of HIV virus. stands for highly active antiviral therapy

47
Q

What are the different stages of HIV and their characteristics

A
  1. AIDS not present, CD4 count >= 500 cells
  2. AIDS not present, CD4 count 200-499
  3. AIDS, CD4 count <200 cells
48
Q

What are the primary routes of infection for HIV

A

infection from bodily fluids (blood, semen, breast milk), IV drug use. not transferred by insects, saliva or sweat

49
Q

What are the signs and symptoms of HIV and when do they occur?

A

sore throat, fever, fatigue

50
Q

What is meant by wasting in individuals with HIV

A

losing a ton of weight

51
Q

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?

A

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

52
Q

What are the complications of HAART regimens?

A

assess for HAART-related orthopedic complications test early in the morning than later in the day

53
Q

How do the drugs that treat HIV work and what are some examples?

A

protease inhibitors, fusion inhibitors, NRTIs; all inhibit viral replication process

clinical phys (6 decks)

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