Preventative health care

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QALY stands for
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quality adjusted life year
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calculate QALY by
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years times number given – 4 years x 0.75 = 3 QALY’s
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odds ratio 1, +1, -1/0
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1= no association +1 = possible association -1 or 0 = preventative effects
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whats the best arm to take blood pressure?
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left
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artery that you listen to when taking BP
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radial
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diseases from hypertension
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all vascular- stroke, heart attack,
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normal SBP and DBP
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S – 120 D – less than 80
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prehypertension SBP and DBP
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S – 120-139 D – 80-89
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stage 1 hypertension SBP and DBP
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S – 140-159 D – 90-99
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stage 2 hypertension SBP and DBP
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S – greater than 160 D – greater than 100
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First drug of choice for hypertension?
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Thiazide-type diuretics- cannot be used by those with diabetes or kidney problems
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how do diuretics for hypertension work ?
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decreases the water volume in the body which decreases BP
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DASH diet
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fruits, vegies, lowfat changes, less than 2.4g salt per day
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How does exercise effect BP?
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increases systolic BP immediately, and diastolic stays the same, after exercise, BP goes down
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Is age a risk factor?
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no
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atherogenic diet
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high in fat and cholesterol lipoprotein greater than 30 is considered high
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ABPM is warranted for evaluation of?
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“white-coat” HTN ambulatory bld prs monitoring
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CVD risk factors
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Hypertension* Cigarette smoking Obesity* (BMI >30 kg/m2) Physical inactivity Dyslipidemia* Diabetes mellitus* Age Family history of premature CVD (men under age 55 or women under age 65)
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What is PAD?
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peripheral artery disease- PAD is equivalent in risk to ischemic heart disease
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Primary or essential hypertension
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is of unknown cause or origin.
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Isolated systolic hypertension is
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defined as a SBP >140 mmHg and DBP < 90 mmHg
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Secondary hypertension can be attributed to
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a specific disease or metabolic disorder.
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JNC 7
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decrease, improve, and control hypertension
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LDL cholesterol
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optimal – less than 100 near optimal – 100-129 borderline high – 130-159 high – 160- 189 very high – above 190
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Total cholesterol
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desirable – less than 200 borderline high – 200-239 very high – above 140
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HDL cholesterol
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low – less than 40 high – greater than 60
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triglycerides
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normal – less than 150 borderline high – 150-199 high – 200-499 very high – above 500
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risk ratio calculation
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tot cholesterol / HDL-C
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How to calculate LDL
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tot chol / – [HDL-C + (0.20 x triglycerides) ]
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LDL goals with risk factors
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1 or no risk factors – goal less than 160 2 or more risk factors and no disease + 10 yr. risk under 20% – goal less than 130 greater than 20% and disease – goal less than 100
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Triglycerides are increased due to ?
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diet, high fat, and alcohol abuse diet and exercise are the first therapy.
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What do statin drugs do?
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decrease body’s liver cholesterol production (tot, HDL, LDL) decrease heart attack chances main thing: decrease inflammation and LDL (bad chol)
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Risk factors Non-modifiable:
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Non-modifiable: family history, age, gender, race/ethnicity,
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Risk factors Modifiable:
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Modifiable: diet, sedentary lifestyle, obesity, metabolic syndrome (aka insulin resistant system)
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An arrhythmia is
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an irregular heartbeat.
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When a coronary artery becomes blocked, the result is
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a heart attack.
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A hemorrhagic stroke may occur as a result of
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an aneurysm.
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Which of the following kills more people than cancer does?
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none –
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A desirable level of total cholesterol for adults is less than _______________ mg/deciliter.
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100
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What is thought to be the closest thing we have to a magic bullet against heart disease?
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exercise
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If an artery in a limb becomes blocked, it causes
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peripheral arterial disease.
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Which of the following is a noninvasive test that evaluates CVD by using sound waves to examine the heart?
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echocardiography
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TIAs (transient ischemic attacks)
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are also known as ministrokes.
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A blood-filled pocket bulging out from a weak spot in the artery wall is called a(n)
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aneurysm
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The large blood vessel through which waste-laden, oxygen-poor blood travels is called the
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vena cava.
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A cerebrovascular accident is another name for a
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stroke
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Damage to the heart muscle because of lack of blood supply is called
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myocardial infarction.
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The number 1 risk factor for developing PAD is
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Smoking

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