Week 3: Current and Emerging NCDs Flashcards
What is the goal of public health?
- To prevent premature death (death before late adulthood)
- Promote health across the lifespan
- shift the burden of illness, disability, and death from younger people to older adults
What is the epidemiological transition?
- the shift from infectious to NCDs being the primary cause of death in a population
- often follows the demographic transition where a couple becomes more wealthy, there are less babies being born, and child survival rates are improving
In the pre-transition period with the epidemiological transition, a large burden of disease falls on the ____ whereas after the transition nearly all deaths occur in____
young; older adults
during the period of transition ____ experience the burden from infectious diseases while ___ experience the burden from NCDs
children; adults
What were the top 3 risk factors for death in 2019?
- smoking
- high blood pressure
- high blood sugar
what are diseases of affluence?
a way of contrasting NCDs with infectious diseases and under-nutrition that are considered to be diseases of poverty. This is false because NCDs are the primary cause of death globally regardless of income level
True or false: NCDs are only a burden in adult populations in high income countries?
False
What are chronic respiratory diseases?
Diseases of the airway, bronchioles, and lungs
What are examples of chronic respiratory diseases? (hint there are 7 of them)
- asthma
- COPD
- lungs diseases associated with occupational exposures
- sleep apnea
- pulmonary hypertension
- bronchial taluses
- interstitial lung diseases
Is cancer included as a chronic respiratory disease?
NO
What is asthma?
a chronic but reversible inflammation of the airways that causes wheezing, especially when exhaling, coughing, chest tightness, and shortness of breath due to thickening of the airway wall and bronchial spasms that narrow the diameter of the bronchi and bronchioles
How are asthma symptoms usually managed?
With inhaled corticosteroids
How can one reduce symptom severity with asthma?
- avoid cold air
- avoid environmental triggers such as air pollution
How many people worldwide have asthma?
More than 300 million
Which age group has the highest prevalence of asthma?
18-34
What is COPD?
a chronic, progressive disease that limits airflow and causes shortness of breath and productive coughing
What are the two most common presentations of COPD?
- emphysema
- chronic bronchitis
what is bronchitis?
a consistent productive cough caused by progressive thickening and narrowing of the airways that occurs as inflammation and excess mucus blocks breathing passages
what is emphysema?
the alveoli lose elasticity and become destroyed. irreversible process that reduces surface area available for oxygen intake and the release of CO2
is damage to airways and lungs full reversible with therapies for COPD patients?
NO
How many adults worldwide have COPD/
170 million
What is the biggest risk factor for COPD?
Tobacco smoking
What age group is most affected by COPD?
65+
what is pneumoconiosis?
a restrictive lung disease caused by exposure to various types of occupational hazards?
Obstructive diseases like asthma and COPD make it difficult for a person to do what?
exhale all the air in the lungs
what are examples of obstructive lung diseases?
- asthma
- copd
what is an example of a restrictive lung disease?
pneumoconiosis
What do restrictive lung diseases make it difficult to do?
to fully fill the lungs with air when they exhale
restrictive and obstructive lung diseases both cause what?
shortness of breath with exertion
what is the most common cause of pneumoconiosis?
silicosis caused by inhalation of silica dust by minors
What are some other forms of pneumonocosis?
black lung disease and asbestosis
is pneumoconiosis a major cause of global mortality?
no because it can be prevented with PPE use
What does smoking do?
- damages cells
- alters blood chemistry
- stresses the cardiovascular system
- destroys cilia that clear mucus
- interferes with respiration
true or false? People who smoke or are exposed to second hand smoke sustain damage to every body system?
true
Smoking increases the risk of what in adults and what in children?
in adults: CVD, stroke, lung cancer
in children: Respiratory illnesses
Has the death rate in Canada from smoking increased or decreased since the 1990s?
decreased
Has the percentage of people who smoke globally increased or decreased?
decreased
what helped reduced global tobacco smoking?
2005 FCTC which was a framework convention on tobacco control with the goal of reducing global prevalence of tobacco use
How many smokers are there worldwide?
900 million including 1 in 3 men
Which sex is smoking more common among?
Males
number of daily smokers is ____ while percentage of adults who smoke is _____
increasing; decreasing
describe the dose-response relationship between tobacco and health problems
heavier consumption of tobacco is associated with steadily worsening health outcomes
smoking is least common in what age group?
12-17
among both sexes, number of daily smokers has ___ between 2015-2019
decreased
Describe Type 1 diabetes
- occurs when the body does not produce enough insulin
- childhood onset
- people diagnosed are rarely overweight
- previously called juvenile or insulin dependent diabetes
What is insulin?
a hormone produced by the pancreas that helps the body maintain a consistent level of glucose or sugars in the blood stream so the cells have a consistent supply of energy
What is type 2 diabetes?
occurs when the body develops insulin resistance and stops responding appropriately to insulin
- adult onset
- not insulin dependent
- gradual
- preventable
- people are usually overweight
What are gestational diabetes?
elevated blood sugar first diagnosed during pregnancy.
-typically resolves after delivery
people who have elevated glucose levels who are not at the threshold for type 2 diabetes may be classified as having what?
pre diabetes such as impaired glucose tolerance or impaired fasting glucose
what are the symptoms of gestational diabetes?
excessive thirst, frequent urination, unexplained weight loss, fatigue
Between 1980 and 2015, global diabetes prevalence ___ from __ to ___
doubled; 4.7% to 8.5%
the prevalence of diabetes is only rising in high income countries? true or false
False. It is rising in all income levels because obesity and other risk factors are becoming more prevalent
___ of adults with type 2 diabetes do not know they have it which can lead to preventable complications
half
What made diabetes go up?
liquid sugar, obesity and subsequent diabetes rates
Obesity prevalence is expected to be what by 2040?
10.4%
number of adults worldwide with diabetes went from ___ in 1982 to ___ in 2015
110 million; 420 million
what is the goal of diabetes management?
stop blood sugars levels from becoming too high (hyperglycaemia) or too low (hypoglycaemia)
Failure to maintain blood sugar levels can cause complications including
-blindness, heart diseases, kidney failure, nerve damage, and foot ulcers leading to amputation
People with type 1 diabetes require insulin injections to maintain safe blood sugar levels to avoid what?
ketoacidosis that can lead to seizures, coma, and death
how is type 2 diabetes managed?
through lifestyle changes such as. weight loss, diet, and oral medications
What age group has the highest diabetes prevalence?
65+
What is the role of the kidneys?
filter toxins from the blood, maintain fluid and electrolyte levels, help control blood pressure, produce red blood cells, and support bone health
when does kidney failure happen?
when kidneys are not functioning well enough for health
what are the two tests that can indicate decreased renal function?
- glomerular filtration rate: a measure of blood filtration efficiency determined by blood creatine levels
- albuminuria: presence of protein albumin in the urine is a sign of kidney damage
What is chronic kidney disease?
a progressive loss of kidney function characterized by reduced glomerular filtration rate or increased urinary albumin levels
Early stage of CKD are usually?
asymptomatic
CKD symptoms include what?
fatigue, itching, constipation, loss of appetite, pain, difficulty sleeping, anxiety
what is dialysis?
using a machine to filter the blood
what are the two types of renal replacement therapy for people with end stage renal disease?
- dialysis
2. kidney transplants
___ is a concurrent requirement for kidney patients
cardiologic care
How many of the worlds adults are thought to have kidney disease?
10% or 300 million
Number of Canadians receiving dialysis ___ over the last 20 years
doubled
How many Canadians have CKD?
between 1.3 to 2.9 million based on the prevalence of end stage renal disease
Most patients with kidney failure are on ___ but the balance is slowly shifting to ____
dialysis; transplant
kidney transplants before dialysis have
increased
what are the two most common causes of CKD worldwide?
- diabetes
2. hypertension
are most CKD hereditable?
No
what is an example of a hereditable CKD?
polycystic kidney disease
Is there a cure for CKD?
NO
How is CKD managed?
-medications, smoking cessation, low sodium diet, management of comorbidities like hypertension
Liver and digestive diseases, excluding cancer, are responsible for what percentage of global deaths?
4.5%
what is the role of the liver?
create proteins that allow the blood to clot, filters toxins out of the blood, and stores and releases glucose and lipids into the blood
what is the most common serious liver disorder?
cirrhosis
what is cirrhosis?
irreversible scarring of the liver that over time blocks the flow of blood through the liver and prevents the liver from functioning properly
As the liver becomes more scarred, what may happen?
fluid builds up in the legs called edema and the abdomen may swell called conditional assits
-may damage kidney, spleen, lungs, and other organs and increase liver cancer risk
the only cure for liver disease is?
transplant
what are the most common causes of cirrhosis?
Hep-B, Hep-C, alcohol abuse
nearly twice as many ___ than ___ die from cirrhosis, largely because of alcohol abuse
men; women
how many people have cirrhosis worldwide and how many people die from it
2.8 million; 1.3 million
what is peptic ulcer disease?
a painful wound in the lining of the stomach
-wound may perfrate and cause fatal hemorrhage
what is gastritis and duodenitis?
painful inflammations of the stomach and small intestine
what is pancreatits?
painful inflammation of the pancreas that can cause multiple organ failure, shock, and death
what are examples of inflammatory bowel diseases?
- Crohn’s
- ulcerative colitis
how many people die each year because they lack access to emergency surgery for digestive diseases?
150,000
what is appendicitis?
an inflammation of the appendix that can perforate or rupture and cause parotitis, sepsis, and death
what do intestinal obstructions do?
prevent waste through intestine and out of the blood and cause bowel rupture, sepsis, and death
what is a bowel hernia?
part of the intestine passes through the wall of the abdomen muscles causing pain and possibly cutting off blood supply to part of the intestine
What do gallstones do?
block the bile ducts and can cause pain and jaundice
what two digestive diseases are in the top 10 for causes of death?
- chronic liver disease
- cirrhosis
what are neurological disorders?
dysfunctions of the nervous system
-responsible for 5% of years lived with disability
what are examples of diseases that affect the NS?
epilepsy, migraines, headache disorders, MS, Parkinson’s, dementia, chronic brain injuries, ALS
what are the effects of neurological disorders?
paralysis, weakness, mobility limitations, cognitive impairment, behaviour problems, difficulty with communication and ADL
What is epilepsy?
a chronic seizure disorder characterized by episodes of excessive and abnormal electrical activity in the brain
some cases of epilepsy are attributable to what?
head trauma and brain injury
prevalence of epilepsy is highest in what age group?
adults
incidence rate for epilepsy is higher in what age group?
children
people with epilepsy are 8x more likely to report what?
incontinence because of the impact of seizures on autonomic function
what conditions are reported alongside epilepsy?
migraines, brain injury, stroke
people with epilepsy are more than twice as likely to also have what?
a mood disorder
how are epilepsy and psychiatric disorder bidirectional?
at an increased risk for psychiatric disorder if you have epilepsy; at an increased risk for epilepsy if you have a psychiatric disorder
migraines are more likely among what sex?
Women
what is Parkinson’s disease?
a chronic, progressive neurodegerative disorder characterized by motor symptoms
what helps manage parkinson’s disease symptoms?
a chemical prescursor of the neurotransmitter dopamine called L-DOPA or levodopa
what are the symptoms of parkinson’s disease?
rigidity, bradykinesia, tremors when resting, problems with gait, balance, and postural stability, stiffness in arms or legs, slower movement
what is MS?
a chronic, progressive disease that cause inflammatory demylenation of the sheaths of nerve cells in the CNS
MS is characterized by periods of symptoms such as?
vision disturbances, bladder or bowel control problems, pain, fatigue, walking difficulties, hand coordination problems, memory issues, confusion, followed my periods of partially or fully recovered function
what does the immune system do in MS patients?
attacks myelin which disrupts communication between CNS and other parts of the body
First symptoms for MS usually occur at what age?
30
what is myelin?
an insulating material that helps speed up the transmission of signals between nerves
what directs every function of the body?
genes
what is a chromosomal disorder?
an extra or missing part of a chromosome
What is Turner syndrome?
missing one sex chromosome (have 45 instead of 46)
most genes have how many alleles?
2
what is a monogenic disorder?
the result of a child inheriting a single disease causing gene from one or both parents
what is an allele?
a version of a gene
what is a genotype?
a set of alleles a person inherits for a particular gene
what is the difference between homozygous and heterozygous
with homozygous an individuals has inherited 2 identical copies of a gene; with heterozygous an individual has inherited two different alleles for the gene
what is a gene
sequences of nucleic acids that are part of the chromosomes found in the nucleus
what are epigenetics?
the differential expression of the genetic code through activation or inactivation of genes
what is a phenotype?
the way a particular set of alleles is expressed in physical appearance
what is an examples of an autosomal dominant genetic disorder?
Huntington’s Disease
What is an example of a recessive genetic disorder?
cystic fibrosis
what are two examples of autosomal recessive blood disorders that cause hemolytic anemia due to the breakdown of red blood cells?
- thalassemia
- sickle cell disease
what are two other examples of genetic blood disorders?
hemophilia and G6PD
thalassemia is characterized by what?
impaired production of hemoglobin
what is the cure for thalassemia?
bone marrow transplant
where is thalassemia most present?
African, the Med, and Asia
what is sickle cell disease?
a genetic disorder that causes hemoglobin to be malformed
-blood cells look like crescents instead of donuts
musculoskeletal disorders include what
problems of the muscles, bones, tendons, ligaments, and joints
what are the two most common causes of YLD worldwide?
low back and neck pain
what is arthritis?
joint inflammation that often causes swelling and pain
what is osteoarthritis?
a degenerative disease that slowly causes loss of cartilage in the joints causing pain, stiffness, and disability
what is rheumatoid arthritis?
a chronic inflammatory disease that damages cartilage and bones in many joints
what are the most common joints affected with OA and what are the most prominent risk factors?
- knees, hips, and hands
- age, obesity, and history of traumatic joint injuries
which of the arthritis’s is an autoimmune disorder?
rheumatoid arthritis
what is osteoporosis?
a loss of bone density that significantly increases the risk of fractures of the hip, vertebrae, and other bones in older adults, especially women
what is gout?
a painful swelling on a joint, usually at the base of the big toe, due to elevated levels of uric acid in the blood
what is recommended to manage gout?
reduce sodium in the diet to relieve pain, swelling, and uric acid levels
about 40% of all vision impairment is due to what?
refractive errors
what are examples of refractive errors?
extreme nearsightedness (myopia), farsightedness (prebyopia), or astigmatism
what is low vision?
vision is 20/60 meaning a person would need to be within 20 feet of an object to see it as clearly as a person who sees the object from 60 feet away
what is blindness?
having no light perception no better than 20/400
___ is responsible for more than one in three cases of blindness worldwide
cataracts
what are cataracts?
cloudiness over the lense of the eye. surgery replaces the lens with a clear or artifical lens
what causes glaucoma?
damage to the optic nerve
- could be caused because of pressure or excess fluid buildup
- loss of peripheral side vision occurs because of pressure
what is the most common form of glaucoma in Canada?
open-angle glaucoma
when does macular degeneration occur?
when a portion of the retina deteriorates and causes loss of central vision
what is the retina?
tissue in the back of the eye that receives images and sends it to the brain via the optic nerve
which eye disease affects vision the worst?
macular degenration
are men or women more likely to have hearing loss?
men
