Week 12: Diseases with Complex Biological Etiology Flashcards
Define etiology.
Etiology: the study of the causes or origins of diseases
Define simple and complex etiology.
Simple Etiology: diseases caused by a single factor (e.g., infectious diseases caused by a specific pathogen)
Complex Etiology: diseases resulting from the interplay of multiple genetic, environmental, and lifestyle factors
Why is etiology important in public health?
Understanding etiology aids in disease prevention, management, and policy formulation
Define diabetes mellitus.
A metabolic disorder of multiple etiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both
What is diabetes mellitus characterized by?
High levels of blood glucose resulting from defects in insulin production, insulin action, or both
What are the long-term effects of diabetes mellitus?
Long–term damage, dysfunction, and failure of various organs
What are 4 facts about the history of diabetes mellitus?
Diabetes mellitus has an ancient recorded history dating to 5th century BC Indian texts
Early historical writings show that tasting urine was the first diagnostic diabetes test
In the 19th and early 20th centuries, the first quantitative clinical and diagnostic tools were developed to test for elevated sugar in the urine (glycosuria) and blood (hyperglycemia)
The later discovery of insulin forever transformed type 1 diabetes from a rare and fatal disease to one where prolonged survival was possible
What are potential characteristic symptoms of diabetes mellitus?
May present with characteristic symptoms such as thirst, polyuria, and/or blurring of vision
What can occur in diabetes mellitus’ most severe forms?
Ketoacidosis or a non–ketotic hyperosmolar state may develop and lead to stupor, coma and, in absence of effective treatment, death
What are 2 details about diabetes mellitus symptoms?
Often symptoms are not severe, or may be absent
Consequently hyperglycaemia is sufficient to cause pathological and functional changes may be present for a long time before the diagnosis is made
What are 4 facts about the burden of diabetes?
The development of diabetes is projected to reach pandemic proportions over the next 10-20 years
By 2045, IDF projections show that 1 in 8 adults, approximately 783 million, will be living with diabetes, an increase of 46%
In most Western societies, the overall prevalence has reached 4-6%, and is as high as 10-12% among 60-70-year-old people
The annual health costs caused by diabetes and its complications account for around 6-12% of all health-care expenditure
What are the 3 types of diabetes?
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Gestational Diabetes
What are 3 details about the diagnosis of diabetes?
Several blood glucose tests are available for the diagnosis of diabetes
The fasting plasma glucose test is currently considered the diagnostic test of choice for diabetes
A random blood glucose test may be used as a screening test if diabetic symptoms are present
What are 4 details about random blood glucose tests?
A random blood glucose test may be used as a screening test if diabetic symptoms are present
This test assumes a non-fasted state and therefore allows for higher glucose values
A test result of 200 mg/dL or higher warrants further testing using one of the clinically recommended diagnostic blood glucose tests
Hemoglobin A1c test
What are the AIC levels for normal, pre diabetes, and diabetes?
Normal: less than 5.7%
Prediabetes: 5.7% to 6.4%
Diabetes: 6.5% or higher
What are the 3 major components of diabetes treatment?
Diet and exercise
Oral hypoglycemic therapy
Insulin therapy
What are 6 details about cardiovascular diseases?
“Cardiovascular disease has the same meaning for health care today as the epidemics of centuries had for medicine in earlier times: 50% of the population in developed countries die of cardiovascular disease”
Someone has a heart attack every two minutes (British Heart Foundation)
Leading cause of mortality in developed countries and a rising tendency in developing countries (disease of civilization)
Significantly contributes to morbidity and death rates in the middle aged population: potential life years lost, common cause of premature death, labor force (economic costs), family life
Morbidity: nearly 30% of all disability cases
Contributes to deterioration of the quality of life
What are the 7 types of cardiovascular disease?
Coronary heart disease
Atherosclerosis
Cerebrovascular disease (stroke)
Hypertensive heart disease
Rheumatic heart disease (streptococcal infection)
Congenital heart disease
Cardiomyopathies
What are the 8 major risk factors for CVD?
Tobacco Addiction
Elevated LDL Cholesterol
Low HDL Cholesterol
High blood pressure
Elevated Blood Glucose
Obesity
Physical Inactivity
Dietary Factors
What are 3 details about atherosclerosis?
Characterized by deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of the artery
Hyperlipidemia: abnormally high blood lipid level
Plaque: buildup of deposits in the arteries
What are 3 details about myocardial infarction?
Myocardial infarction is the interruption of blood supply to part of the heart causing a portion of the myocardium to die
Myocardial infarcts are most commonly due to occlusion of a coronary artery caused by atherosclerosis or following the rupture of a vulnerable atherosclerotic plaque
The resulting ischemia and oxygen shortage if left untreated for a sufficient period of time can cause infarction of the myocardium and often results in death of the patient
What are 4 details about the diagnosis on myocardial infarction?
Myocardial infarction presents with sudden chest pain typically radiating to the left arm or left side of the neck in combination with shortness of breath, nausea, vomiting, heart palpitations, sweating and anxiety
Approximately 25% of myocardial infarctions occur without warning in the absence of prior chest pain or other symptoms
Often, the onset of myocardial infarction is gradual over several minutes providing time for emergency treatment.
The diagnosis of myocardial infarction is inferred by electrocardiogram abnormalities and confirmed by elevated blood biomarkers of myocardial necrosis such as creatine kinase and troponin
What are 3 details about primary preventions of myocardial infarction?
Since the major risk factors are modifiable, myocardial infarction is preventable
Primary prevention is the reciprocal of exposure to proven risk factors
Avoid tobacco, eat a heart healthy diet, maintain blood pressure, blood glucose and blood lipids (cholesterol) within normal limits, exercise daily, and maintain optimal weight for height
What are 3 details about strokes?
Occurs when blood flow is interrupted, the brain cannot get the glucose or oxygen it needs
The mitochondria that rely on O2 can not produce the ATP needed to maintain the electrical state of the neuron
This change in the electrical state cause communication between cells to cease, as well as trigger apoptosis
What are the 2 major types of strokes?
Ischemic stroke: blood flow to the brain region is interrupted due to a blockage in the artery; accounts for the majority, approximately 80-85%
Hemorrhagic stroke: is due to a rupture of the blood vessel; is a result of such things as hypertension, bleeding disorders, tumors, and amyloid vascular disease
What are 6 details about hypertension/renal failure?
In a healthy adult, blood pressure is about 120/80 mmHg
Systolic pressure refers to the level of blood pressure while the heart is contracting and is represented by the top number (120 mmHg)
Diastolic pressure, the level of blood pressure in between heart contractions, is represented by the bottom number
Hypertension is sustained high blood pressure
Called the “silent killer” because it has no symptoms
Greater risk for CVD symptoms
What are the 2 types of hypertension?
Essential Hypertension constitutes 90-95% of cases; no specific cause is identifiable in essential hypertension
Secondary Hypertension constitutes 5-10% of cases; a definitive specific cause (usually a hormonal disorder) is readily identifiable in secondary hypertension
What are examples of prevention strategies for diseases with complex biological etiology?
Primary prevention: prevent the onset of disease by eliminating risk factors or increasing resistance
Smoking cessation programs
Healthy diet initiatives
Vaccination programs
Physical activity promotion
Pollution control measures
Occupational health and safety
Secondary prevention: detect and address existing diseases in early stages to halt or slow progression
Cancer screenings
Blood pressure and cholesterol control
Using risk assessment tools
Health education
Tertiary prevention: manage established disease to prevent complications and improve quality of life
Chronic disease management programs
Rehabilitation services
What are 3 ways to address complex diseases?
Health Promotion and Education: Effective health promotion requires empowering individuals and communities to take control of their health by addressing underlying determinants and promoting healthy behaviors
Policy Development: Policy interventions at the local, national, and global levels are crucial in creating environments that support health and reduce disease burden
Addressing Health Disparities: Reducing health disparities is essential for achieving health equity and requires targeted interventions to address the needs of vulnerable populations
What are the effects of insulin on glucose uptake and metabolism?
Pancreatic cells release insulin, which acts on the receptors of the cells
Once insulin binds with the receptor, it triggers a cascade of signaling pathways downstream within the cell that can lead to transportation of GLUT4 molecules to the cell surface that results in the intake of glucose
Glucose is then taken up from the blood and into the cells where it is either stored as glycogen or used for energy production
How do Type 1 and Type 2 diabetes differ regarding insulin?
Type 1:
Insulin production is decreased and is not taken up into the cells, resulting in elevated blood sugar levels
Type 2:
Insulin production is decreased and is not taken up into the cells, resulting in elevated blood sugar levels
Insulin resistance also occurs, which means that it may not bind to receptors properly and inactivate/not active signaling pathways
