When atherosclerosis occurs in a limb, it is called A) coronary artery disease. B) carotid artery disease. C) peripheral artery disease. D) pulmonary artery disease

peripheral artery disease More test answers on https://studyhippo.com/kin-1600-chapter-11-cvd-cancer-diabetes/

When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment? 1. Total LDL 2. Fasting HDL 3. Coronary artery disease risk level 4. Fasting total cholesterol

3. Coronary artery disease risk level More test answers on https://studyhippo.com/pharm-exam-3-ch-39-hyperlipidemia/

A health care provider at an outpatient clinic is considering prescribing sildenafil (Viagra) for 61-year-old client. The nurse would make it a priority to discuss which item in the client’s health history with the prescriber? a. Coronary artery disease (CAD) with nitroglycerine use b. Renal impairment with elevated creatinine level c. Blurred vision of unknown etiology d. Gout managed with allopurinol (Zyloprim)

A. Coronary artery disease (CAD) with nitroglycerine use More test answers on https://studyhippo.com/mens-health/

Coronary artery disease is a disease of the heart where the arteries and blood vessels become clogged with fat deposits called _____.

plaque More test answers on https://studyhippo.com/health-1/

For which problem is percutaneous coronary intervention (PCI) most clearly indicated? A. Chronic stable angina B. Left-sided heart failure C. Coronary artery disease D. Acute myocardial infarction

D. Acute myocardial infarction PCI is indicated to restore coronary perfusion in cases of myocardial infarction. Chronic stable angina and CAD are normally treated with more conservative measures initially. PCI is not relevant to the pathophysiology of heart failure, such as left-sided heart failure. More test answers on https://studyhippo.com/cad-and-acs-nclex-review-questions/

Because emphasis on prevention is important in Coronary Artery disease, the main nursing care plan is:

Imbalanced Nutrition: More than body requirements More test answers on https://studyhippo.com/coronary-artery-disease-nursing-diagnosis/

The nurse is assessing clients at a clinic. Which activity takes priority? a. Teaching smoking cessation to a middle-aged woman who smokes b. Planning an exercise regimen with a woman with a sedentary lifestyle c. Teaching an older man who is moderately obese to keep a food diary d. Assessing a man with familial coronary artery disease for specific risk factors

A All of these risk factors contribute to the development of cardiovascular disease, but cigarette smoking is a major risk factor for both coronary artery disease and peripheral vascular disease. More test answers on https://studyhippo.com/ch35/

What is Coronary Artery Disease (CAD)?

A type of blood vessel disorder included in the general category of athersclorsis. More test answers on https://studyhippo.com/cp-34-coronary-artery-disease-and-acute-coronary-syndrome/

What is coronary artery disease?

The coronary arteries become narrow and rigid and blood flow is restricted to the heart. More test answers on https://studyhippo.com/coronary-artery-disease/

What is the suggested common pathway linking chronic periodontitis and conditions such as diabetes, coronary artery disease and adverse pregnancy outcomes?

Inflammation More test answers on https://studyhippo.com/smiles-for-life/

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Chapter 24: Antiparkinsonism Agents – Flashcards 87 terms

Andrew Hubbs

87 terms

Preview

Chapter 24: Antiparkinsonism Agents – Flashcards

question

Anticholinergic

answer

drug that opposes the effects of acetylcholine at acetylcholine receptor sites

question

Bradykinesia

answer

difficulty in performing intentional movements and extreme slowness and sluggishness; characteristic of Parkinson's disease

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Corpus Striatum

answer

part of the brain that reacts with the substantia nigra to maintain a balance of suppression and stimulation

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Dopaminergic

answer

drug that increases the effects of dopamine at receptor sites

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Parkinson's Disease

answer

debilitating disease, characterized by progressive loss of coordination and function, which results from the degeneration of dopamine-producing cells in the substantia nigra

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Parkinsonism

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Parkinson's disease-like extrapyramidal symptoms that are adverse effects associated with particular drugs or brain injuries.

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Substantia Nigra

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a part of the brain rich in dopamine and dopamine receptors; site of degenerating neurons in Parkinson's disease

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Parkinson's disease signs and symptoms of the disease

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damaged neurons in the basal ganglia of the brain

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The corpus striatum is connected to the substantia nigra by a series of neurons that use

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gamma-aminobutyric acid, an inhibitory neurotransmitter

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If a child needs an antiparkinsonian drug

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diphenhydramine is the drug of choice

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The mainstay of treatment for Parkinson's disease

answer

Levodopa

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Levodopa is almost always given in combination form with

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Carbidopa as a fixed-combination drug (Sinemet)a

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A newer drug that directly stimulates dopamine receptors

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Ropinirole- also used to treat restless leg syndrome

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Initial monotherapy or as an adjunct therapy with levodopa.

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Rasagiline

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Apomorphine must be given

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Subcutaneously

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The dopaminergics are usually given

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Orally

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If dopaminergics are combined with monoamine oxidase inhibitors (MAOIs),

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therapeutic effects increase and a risk of hypertensive crisis exists

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Levodopa is contraindicated in patients with a history or presence of suspicious

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Skin lesions

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The MAOI should be stopped

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14 days before beginning therapy with a dopaminergic

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The combination of levodopa with

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vitamin B6 or with phenytoin may lead to decreased efficacy of the levodopa

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Patients who take dopaminergics should be cautioned to avoid

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over-the-counter vitamins

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Patients using rasagiline should avoid

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- tyramine-containing foods - St. John's wort - meperidine - other analgesics

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Benztropine and diphenhydramine are available in

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oral and intramuscular/intravenous forms

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Trihexyphenidyl is only available in

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oral form

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Anticholinergics should be administer these agents cautiously in the following conditions

answer

- tachycardia - dysrhythmias - hypertension - hypotension

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Anticholinergic prototype

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Benztropine

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Dopaminergic Prototype

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Levodopa

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Stalevo is a fixed-combination tablet containing

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levodopa, carbidopa, and entacapone

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Parkinson's disease is a progressive, chronic neurological disorder that is usually

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known to affect people of all ages with no known cause.

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Parkinson's disease reflects an imbalance between inhibitory and stimulating activity of nerves in the

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basal ganglia

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The main underlying problem with Parkinson's disease seems to be a decrease in the neurotransmitter

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dopamine

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Anticholinergic drugs are effective in early Parkinson's disease. They act

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to block stimulating effects of acetylcholine in the brain to bring activity back into balance.

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A patient receiving an anticholinergic drug for Parkinson's disease is planning a winter trip to Tahiti. The temperature in Tahiti is 70 degrees warmer than at home. What precautions should the patient be urged to take?

answer

Reduce dose and take precautions to reduce the risk for heat stroke

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Replacing dopamine in the brain would seem to be the best treatment for Parkinson's disease. This is difficult because dopamine

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cannot cross the blood-brain barrier

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A patient taking levodopa and over-the-counter megavitamins might experience

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return of Parkinson's symptoms

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A patient who has been diagnosed with Parkinson's disease for many years and whose symptoms were controlled using Sinemet has started to exhibit increasing signs of the disease. Possible treatment might include

answer

combination therapy with an anticholinergic drug

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A client asks the nurse to explain parkinsonism to him. Which of the following possible causes of parkinsonism might be included in the explanation?

answer

- Adverse effect of drug therapy - Brain injury - Viral infection

question

No therapy is available that will stop the loss of neurons and the eventual decline of function in clients with Parkinson's disease. As a result, nursing care should involve which of the following interventions?

answer

- Supportive education as drugs fail and new therapy is needed - Community and family support networking - Explanations of the adjunctive drug therapy that may be used

question

A nurse is caring for a patient who has received carbidopa/levodopa. After administration of the first dose of the drug, the patient has developed gastrointestinal disturbances. Which of the following nursing interventions should the nurse perform when caring for this patient?

answer

Administer the next drug dose with meals

question

When describing the action of levodopa, which of the following would the nurse include?

answer

Acts like replacement therapy

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A patient with Parkinson's disease is undergoing treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment?

answer

Observe the patient for various neuromuscular signs.

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The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for

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Falls

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Common side effects of anticholinergics include

answer

Dry mouth, urinary retention, constipation, and increased pulse rate

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Indications for use of anticholinergic drugs in the treatment for Parkinsonism include

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To decrease salivation, spasticity, and tremors

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A female client is prescribed centrally acting anticholinergics for her Parkinson's disease. Six weeks later, her daughter asks the physician to hospitalize the client for a psychiatric evaluation. The nurse anticipates that the physician will respond in what way to the daughter's request?

answer

Evaluate the client for adverse reactions from the centrally acting anticholinergics

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Which of the following drugs is classified as a catechol-O-methyltransferase (COMT) inhibitor?

answer

Entacapone (Comtan)

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A male client is diagnosed with chronic renal failure. He routinely takes amantadine for his Parkinson's disease with success. Why would his physician consider discontinuing the amantadine?

answer

With amantadine, excretion is primarily via the kidneys.

question

A patient receiving a dopaminergic agent complains of nausea, vomiting, and dysphagia. Which nursing diagnosis would be most appropriate for this patient?

answer

Imbalanced nutrition: less than body requirements

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A nurse should counsel patients receiving levodopa to avoid foods high in which of the following vitamin as it reduces the effect of levodopa?

answer

Pyridoxine (vitamin B6)

question

The symptoms of parkinsonism are caused by the depletion of dopamine in which of the following?

answer

Central nervous system

question

A 60-year-old male patient has developed a tremor of the right hand with a pill rolling motion. Upon interviewing the patient, he states he sustained several head injuries playing football. Based on this information, what do you suspect the patient is suffering from?

answer

Parkinson's disease

question

A client is to receive trihexyphenidyl as adjunctive treatment for Parkinson's disease. The nurse would expect to administer this drug by which route?

answer

Oral

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Levodopa is used as treatment for Parkinson's disease primarily acting as a replacement neurotransmitter

answer

True

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A patient has been prescribed rasagiline, which is the newest irreversible MAO inhibitor used as an adjunct with levodopa (L-dopa). When educating this patient on this medication, which herbal supplement has the potential to produce hyperpyrexia and death with rasagiline?

answer

St. John's Wort

question

A nurse is caring for a patient who has just been diagnosed with Parkinson disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help her condition. Which of the following is the correct response by the nurse?

answer

"Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms."

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A female client begins tolcapone therapy, and her physician arranges for laboratory testing to be completed on a routine basis. The nurse expects which laboratory study to be ordered by the physician?

answer

Liver transaminase enzymes

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A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?

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"Drugs do not cure these disorders; they instead enhance quality of life."

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Dopaminergic agents can exacerbate cardiovascular disease due to dopamine receptor stimulation.

answer

True

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When reviewing the medical record of a patient receiving levodopa, which of the following would alert the nurse to the need for close monitoring?

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Peptic ulcer disease

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Which of the following drugs is classified as a dopaminergic agent that treats Parkinsonism by supplementing the amount of dopamine in the brain?

answer

Carbidopa (Lodosyn)

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A nurse is caring for 70-year-old patient who is undergoing anticholinergic drug therapy. The nurse should assess for which of the following conditions when caring for this elderly patient?

answer

Confusion and disorientation

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Mr. Marks, age 52, is being treated for Parkinson disease. You are aware that Parkinson disease results in muscle rigidity, tremor at rest, and postural instability. What occurs in the neurons that causes these symptoms?

answer

There is an imbalance between dopamine and acetylcholine.

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A nurse is educating a patient who has Parkinson disease and her husband about the possible adverse effects of carbidopa-levodopa. The nurse should emphasize the need for the patient and her husband to monitor for any sudden increase in

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Involuntary movements.

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A patient who suffers from Parkinson's disease is being treated with levodopa (L-dopa). Which of the following disorders will result in the discontinuation of levodopa (L-dopa) based on a disease-related contraindication?

answer

Narrow-angle glaucoma

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The nurse should be cautious and closely monitor clients receiving carbidopa/levodopa (Sinemet) with which of the following medical conditions?

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• Renal disease • Asthma • Peptic ulcer disease

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A nurse is educating a patient newly diagnosed with Parkinson's disease. Which of the following descriptions would she offer to describe the disease?

answer

"It is characterized abnormalities in posture."

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When administering entacapone, the nurse understands that this drug affects which enzyme?

answer

Catecholamine-O-methyl transferase

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A client taking benztropine (Cogentin) will have increased anticholinergic effects if which of the following medications are initiated?

answer

• Amantadine (Symmetrel) • Perphenazine (Trilafon)

question

An instructor is preparing a teaching plan for a group of students about drugs used to treat Parkinson's disease. The nurse is planning to talk about amantadine. Which of the following would the instructor include as an action?

answer

Increases the release of dopamine

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A nurse is performing a neuromuscular assessment on a client whose Parkinson's disease is being treated with medication. The nurse expects to see which of the following symptoms while performing the assessment? Select all that apply.

answer

• Tremors • Drooling • Mask-like facial expression • Monotone speech pattern

question

A nurse is caring for a patient who has been prescribed entacapone for the treatment of Parkinson's disease. The patient informs the nurse that he is taking MAOI antidepressants for the management of depression. What effect of the interaction of the two drugs should the nurse anticipate in the patient?

answer

Increased risk of toxicity of both drugs

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Which of the following would be considered a peripheral anticholinergic effect of anticholinergic drug therapy?

answer

Blurred vision

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A nurse is making a care plan for a client with Parkinson's disease and has started on an antiparkinson medication. Which of the following nursing diagnoses would be appropriate for this client's care plan?

answer

• Altered Bowel Movements: Constipation • Risk for Injury • Imbalanced Nutrition: Less than Body Requirements

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Which action would be a priority for a client receiving apomorphine?

answer

Monitoring cardiac status

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A client is experiencing parkinsonism as a result of drug therapy with a phenothiazine. The nurse would anticipate which agent as being prescribed?

answer

Biperiden

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Which of the following would a nurse identify as least likely to contribute to a decrease in the effectiveness of levodopa?

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St. John's wort

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An 80-year-old patient has been prescribed an anticholinergic agent for treatment of Parkinson-related symptoms. What patient education should be provided?

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Avoid high environmental temperatures.

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Which of the following would a nurse expect to assess as a potential adverse effect of dopaminergic therapy?

answer

Nervousness

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A patient has been prescribed an anticholinergic agent for treatment of Parkinson-related symptoms. What patient education should be provided?

answer

Void before taking the medication.

question

Which of the following would the nurse identify as a contraindication to the use of biperiden?

answer

Prostatic hypertrophy

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Which of the following would a nurse identify as an adjunctive agent for treating Parkinson's disease?

answer

Entacapone

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Which of the following would lead the nurse to suspect that a client is experiencing an adverse effect to an anticholinergic agent?

answer

Agitation

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A male client is prescribed levodopa for his Parkinson's disease. The dosage has been modified on multiple occasions. The client asks the nurse how the doctor decides what will be the optimal dose. What is the nurse's best response?

answer

"The optimal dose is the lowest one that allows the client to function adequately."

question

Which of the following would be considered a peripheral anticholinergic effect of anticholinergic drug therapy?

answer

Blurred vision

question

A nurse is caring for a patient who requires antiparkinsonism drugs. Which of the following should the nurse confirm to ensure that the use of COMT inhibitors is not contraindicated in this patient?

answer

The patient is not lactating.

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A nurse is caring for a 59-year-old patient with Parkinson disease. Which of the following would indicate to the nurse that the patient is experiencing an adverse reaction related to the drug carbidopa-levodopa?

answer

Blurred vision

question

A nurse administering carbidopa/levodopa (Sinemet) to a client should monitor the client for decreased effects of carbidopa/levodopa when which of the following medications are initiated?

answer

• Phenytoin (Dilantin) • Zonisamide (Zonegran)

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Coronary Artery Disease Elimination Half Life Pharmaceutical Sciences Pharmacology

Pharm 2, Exam 3 – Flashcards 230 terms

Marta Browning

230 terms

Preview

Pharm 2, Exam 3 – Flashcards

question

Levothyroxine/Synthroid class

answer

Thyroid hormone replacement (synthetic T4) dosed in mcg

question

Levothyroxine/Synthroid indication

answer

Hypothyroidism. Also TSH suppression in select cases of thyroid nodules and thyroid cancer

question

Levothyroxine/Synthroid MOA

answer

Replaces normal levels of T4 and T3 (T4 is converted into T3 in the periphery.)

question

Levothyroxine/Synthroid char.

answer

PO/ IV. Oral absorption ~70%. Once a day dosing. Slow onset of action. Half life of ~1 week. Takes 6-8 weeks to achieve steady state. Treatment is usually life long. Follow patient's clinical response and serum TSH. Hold or reduce dose if any complaints of angina. Begin at low dose and advance dosage slowly in patients over age 65 or in any patients with history of coronary artery disease.

question

Levothyroxine/Synthroid side effects

answer

Toxicity directly related to thyroxine level and manifests as palpitations, tachycardia, intolerance to heat, and anxiety. Long term elevation of serum T4 may accelerate cardiac disease and osteoporosis. In patients that have Addison's disease and hypothyroidism, thyroid replacement without first replacing cortisol can be fatal.

question

Thyroid USP/Armour class

answer

Thyroid hormone (T4 and T3 as well as T2 and T1) obtained from desiccated animal thyroid gland

question

Thyroid USP/Armour indication

answer

hypothyroidism

question

Thyroid USP/Armour MOA

answer

Replaces both T4 and T3

question

Thyroid USP/Armour char.

answer

PO. Generally standardized to iodine content. Initiate medication at low dose and increase dosage according to patient response. More cautious dosing in patients over age 65 or if history of cardiac disease

question

Thyroid USP/Armour side effects

answer

Similar to those of Thyroxine/ Synthroid. Follow patient's clinical response and serum TSH. Hold or reduce dose if any complaints of angina. Begin at low dose and advance dosage slowly in patients over age 65 or in any patients with history of coronary artery disease. In patients that have Addison's disease and hypothyroidism, thyroid replacement without first replacing cortisol can be fatal.

question

Liothyronine/Cytomel class

answer

Thyroid hormone replacement (synthetic T3) dosed in mcg

question

Liothyronine/Cytomel indication

answer

Patients with hypothyroidism that have demonstrated intolerance to T4 replacement therapy or no improvement on T4 replacement therapy. Myxedema coma. Also used for "Wilson's syndrome"

question

Liothyronine/Cytomel MOA

answer

Replaces T3

question

Liothyronine/Cytomel char.

answer

PO/IV. 100% oral absorption. Rapid onset of action. Half life of several hours

question

Liothyronine/Cytomel side effects

answer

Similar to T4. Higher peaks and troughs of T3 may increase risk of coronary artery disease and osteoporosis

question

Approximate equivalent doses of thyroid hormone preparations are as follows

answer

60 mg (1 grain) Thyroid USP (Armour) ~ = 100 mcg of T4 (Synthroid) ~ = 25 mcg of T3 (Cytomel)

question

Methimazole/Tapazole class

answer

Thionamide

question

Methimazole/Tapazole indication

answer

Hyperthyroidism (Grave's dis.) Can control hyperthyroidism until more definitive therapy (surgery or 131I therapy) is used. Patients may achieve a euthyroid state after treatment is discontinued. Treatment failure or recurrence of hyperthyroid state suggests that definitive treatment is necessary.

question

Methimazole/Tapazole MOA

answer

Inhibits transformation of inorganic iodine to organic iodine, therefore blocking the production of thyroxine. Also inhibits the coupling of iodotyrosine to form T3 and T4. Minimal effect of blocking the peripheral conversion of T4 to T3

question

Methimazole/Tapazole char.

answer

P.O. Once daily dosing. May take weeks to achieve therapeutic state, thus not used for thyroid storm. Concentrated in the thyroid. Does not affect thyroglobulin already stored in the thyroid gland

question

Methimazole/Tapazole side effects

answer

May cause hypothyroidism. Rash, edema, arthralgias may occur. Agranulocytosis is the most feared side effect. Drug is usually not given beyond a 6-12 month period. Not given during pregnancy as it can cross the placenta.

question

Propylthiouracil (PTU) class

answer

Thionamide

question

Propylthiouracil (PTU) indication

answer

Hyperthyroidism (Grave's disease) Can control hyperthyroidism until more definitive therapy (surgery or 131I therapy) is used. Patients may occasionally achieve a euthyroid state after treatment is discontinued

question

Propylthiouracil (PTU) MOA

answer

Inhibits transformation of inorganic iodine to organic iodine, blocking the production of thyroxine and inhibits the coupling of iodotyrosine to form T3 and T4. Notable effect of blocking the peripheral conversion of T4 to T3

question

Propylthiouracil (PTU) char.

answer

P.O. Once daily dosing. May take weeks to achieve therapeutic state, thus not used for thyroid storm. However, once a patient with thyroid storm who has been treated and stabilized, PTU is commonly used before definitive treatment by surgery or radioactive iodine ablation. Upon initiation of treatment, PTU affects the production of thyroid hormone but does not affect the T4 and thyroglobulin already stored in the thyroid gland.

question

Propylthiouracil (PTU) side effects

answer

May cause hypothyroidism. Rash, edema, arthralgias may occur. Agranulocytosis is the most feared side effect. Drug usually not given beyond a 6-12 month period. Category D but PTU is considered safer then Methimazole and is used in pregnancy when benefit outweighs potential risks.

question

Propanolol/Inderal class

answer

Non selective beta blocker

question

Propanolol/Inderal indication

answer

Blockade of adrenergic symptoms of hyperthyroidism (i.e. tachycardia, anxiety). Emergent treatment of thyroid storm.

question

Propanolol/Inderal MOA

answer

Beta-1 and Beta-2 receptor blockade

question

Propanolol/Inderal char.

answer

PO/IV

question

Propanolol/Inderal side effects

answer

Fatigue, sedation, impotency or depression may be noted

question

Iodine/S.S.K.I. class

answer

Elemental iodine

question

Iodine/S.S.K.I. indication

answer

Hyperthyroidism, thyroid storm

question

Iodine/S.S.K.I. MOA

answer

Large doses of iodine inhibit the release of thyroxine from the thyroid gland

question

Iodine/S.S.K.I. char.

answer

PO/IV. Usually given in the form of supersaturated potassium iodide (SSKI)

question

Iodine/S.S.K.I. side effects

answer

Rash, fever. Beneficial effects generally last no more then 2-3 weeks as thyroid gland appears to adapt and resumes secretion of thyroxine.

question

Radioactive iodine (131I) class

answer

Radioactive isotope

question

Radioactive iodine (131I) indication

answer

Thyroid gland ablation in cases of Grave's disease, thyroid nodules and in some cases of thyroid cancer

question

Radioactive iodine (131I) MOA

answer

Radioactive emission of beta particles results in destruction of thyroid tissue.

question

Radioactive iodine (131I) char.

answer

Oral route. Generally takes weeks for destruction of thyroid gland tissue to be complete.

question

Radioactive iodine (131I) side effects

answer

May cause tenderness and swelling during initial week of therapy. Nausea, vomiting may occur. No evidence of increased risk for malignancy of the thyroid gland or other head and neck structures has been noted. Prior to treatment, patients generally need to be rendered euthyroid by anti-thyroid drugs and/or doses of supersaturated potassium iodide (SSKI). Strictly contraindicated in pregnancy -Category X. I-131 given during pregnancy can irreversibly damage the fetal thyroid tissue. When given to a nursing mother, radioactive iodine can reach a baby through the breast milk. Pregnancy should be delayed until at least six to 12 months after I-131 treatment, since the treatment exposes the ovaries to radiation. Extremely high doses may result in bone marrow depression which is usually transient. Acute leukemia has been reported. Most patients who have undergone radioactive iodine treatment for Grave's disease will result in hypothyroid state requiring life long administration of thyroid hormone replacement. Men who receive RAI treatment for thyroid cancer may have decreased sperm counts and temporary infertility for periods of roughly two years. A physician may discuss sperm banking with a male patient who is expected to need several doses of RAI for thyroid cancer.

question

The present criteria for the diagnosis of diabetes mellitus include

answer

A confirmed fasting blood glucose level of >126 mg/dL. Non-fasting blood glucose of >200 mg/dL in a patient presenting with symptoms or exam findings consistent with diabetes. A positive oral glucose tolerance test resulting in a blood glucose of >200mg/ dL at 2 to 3 hours after a bolus of glucose

question

Metformin/Glucophage class

answer

the single member of the biguanide class that is currently approved for use in the U.S.

question

Metformin/Glucophage indication

answer

Type 2 diabetes

question

Metformin/Glucophage MOA

answer

Metformin decreases hepatic glucose production and to a lesser extent, enhances insulin sensitivity in skeletal muscle. Metformin used alone generally does not cause hypoglycemia.

question

Metformin/Glucophage char.

answer

Metformin has a similar efficacy to the sulfonylureas (for ex. Glipizide/Glucotrol and Glyburide/Micronase) in terms of reducing a patient's fasting serum glucose, non-fasting serum glucose and A1c levels Generic Metformin comes in 500, 850 and 1000 mg tabs and is generally dosed twice a day. A usual daily dose is 1500 to 2000 mg at a cost of ~$55.00/ month. The generic form of extended release Metformin comes in 500 and 750 mg doses and is generally dosed once a day at 1500 to 2000 mg at a cost of ~$60.00 per month. Brand name substitutions such as Glucophage or Fortamet generally raises the monthly cost to $100 or more.

question

Metformin/Glucophage side effects

answer

Unlike the sulfonylureas, Metformin can cause a patient to experience a modest reduction of weight (between 4 to 7 lbs.) rather than weight gain. The most commonly noted complaint by patients taking Metformin is abdominal cramping and nausea. These effects may be notably reduced by using the slow or extended release forms of the drug. Metallic taste is another common side effect. Patients taking Metformin have an increased risk for the development of B 12 deficiency and supplementation with a B complex should be standard practice. The most serious side effect of Metformin is the development of lactic acidosis which is rare but can prove fatal. The risk for lactic acidosis is markedly diminished by not using the drug in patients with impaired renal function. Metformin should not be started or if started, should be stopped in patients with renal insufficiency (As a guideline: a serum creatinine >1.5 mg/dL in males and a serum creatinine >1.4 dL in females.)

question

Sulfonylureas MOA

answer

Sulfonylureas stimulate intact beta cells of the pancreas to release more insulin. Increased insulin release occurs as a result of the interaction of a sulfonylurea with the ATP-sensitive potassium channels in the beta cell membrane. By partially blocking potassium channels, the time the beta cell spends in the calcium release stage of cell signaling is increased which initiates more insulin release from the affected beta cell.

question

Chlorpropamide (Diabinese) and Tolbutamide (Orinase) class

answer

the only 1st generation sulfonylureas still available in the US today but they are seldom used

question

Glipizide (Glucotrol), Glyburide (Micronase, Diabeta) and Glimepiride* (Amaryl) class

answer

2nd generation sulfonylurea drugs (Glimepiride is sometimes listed as a 3rd generation)

question

Sulfonylurea side effects

answer

The adverse effect of most concern with the use of a sulfonylurea is hypoglycemia, particularly in patients with impaired renal or hepatic function. Weight gain may be the most commonly noted side effect of the sulfonylureas. As a general rule, all of the agents in the sulfonylurea class generally become ineffective in achieving glucose control after 5 to 10 years of use All drugs from this class are to be avoided in patients with a known sulfa allergy.

question

Choosing a sulfonylurea

answer

The literature suggests that Gyburide (Micronase) appears to have a greater incidence of hypoglycemic events than either Glimepiride (Amaryl) or Glipizide (Glucotrol). All of the sulfonylureas are available as generic drugs and range in cost from $4 (generic Glucotrol) to ~$20.00 (generic Glyburide) per month. The brand name versions of these drugs range in monthly cost from $30.00 (Diabeta) to ~$50.00 (Micronase).

question

Sulfonylureas char.

answer

The dosing schedule for all of these agents is usually one dose in the morning.

question

Meglitinides MOA

answer

The Meglitinides are a drug class that stimulate the beta cells to release insulin Nateglinide (Starlix) and Repaglinide (Prandin), although structurally different from the sulfonylureas, also bind to ATP-sensitive potassium channels on beta cells and thereby increase insulin release.

question

Nateglinide (Starlix) and Repaglinide (Prandin) class

answer

meglitinides These drugs are chemically unrelated to the sulfonylureas and thus they are also referred to as the non-sulfonylurea secretagogues

question

Meglitinides char.

answer

Nateglinide appears to be less effective than Repaglinide, which has proven to be equally effective to the Sulfonylureas in improving blood glucose control and lowering A1c levels. Both Repaglinide and Nateglinide are rapidly absorbed from the GI tract causing the plasma levels of insulin to peak within 30 to 60 mins. and thereafter are rapidly cleared These drugs are to be taken 3 to 4 times a day, before each meal and if a meal is missed, the drug should not be taken. There are no generic options available and the cost of using one of these drugs normally runs from $150.00 to $300.00 per month.

question

Meglitinides side effects

answer

Repaglinide and Nateglinide each cause hypoglycemia and weight gain similar to that seen with the Sulfonylureas. Both of these drugs are approved by the FDA for combined use with Metformin or with a drug from the Glitazone class but avoidance of combined use with a drug from the Sulfonylurea class is suggested due to the increased risk for hypoglycemia.

question

Thiazolidinediones/Glitazones MOA

answer

The TZDs or Glitazones improve insulin sensitivity in skeletal muscle cells, fat cells and liver cells and also decreases hepatic glucose production.

question

Rosiglitazone (Avandia) and Pioglitazone (ACTOS) class

answer

Thiazolidinediones/Glitazones

question

Thiazolidinediones/Glitazones char.

answer

Avandia and Actos are usually dosed once per day. The Glitazones may take 6 to 14 weeks to achieve their maximum effects. Avandia and ACTOS are FDA approved for use as monotherapy or in combination with Metformin or a Sulfonylurea. Only ACTOS is currently approved for concurrent use with insulin

question

Thiazolidinediones/Glitazones side effects

answer

The cardiovascular safety of the TZDs particularly Avandia, is controversial. Both Avandia and Actos increase the risk of congestive heart failure. A meta-analysis found an increased risk of myocardial infarction with Avandia but a more recent randomized prospective study specifically found no evidence of increased risk for myocardial infarction in patients taking Avandia. Liver functions tests should be performed being initiating treatment with a Glitazone, rechecked at 1 month and repeated again in 3 months to assess for any rise in ALT. Both Avandia and Actos have been associated with reduced bone density and an increased incidence of bone fractures. Weight gain from 5 to 10 pounds and much greater has been reported for each of these agents.

question

Alpha-glucosidase inhibitors MOA

answer

These agents inhibit the alpha-glucosidase enzymes that line the brush border of the small intestine, interfering with hydrolysis of carbohydrates and delaying absorption of glucose and other monosaccharides

question

Acarbose (Precose) and Miglitol (Glyset) class

answer

Alpha-glucosidase inhibitors

question

Alpha-glucosidase inhibitors char.

answer

In order to lower postprandial glucose levels, Acarbose or Miglitol must be taken with each meal

question

Alpha-glucosidase inhibitors side effects

answer

Given alone, either Acarbose or Miglitol will not cause hypoglycemia, but when given with either a Sulfonylurea or with insulin, these drugs can increase the risk for hypoglycemia. Unabsorbed carbohydrates can cause abdominal pain, diarrhea and flatulence due to both osmotic effects and bacterial fermentation. Acarbose in high doses has been associated rarely with moderate transaminase elevations and although considered to be a rare event fatal hepatic failure has been reported with Acarbose. In the event of hypoglycemia, oral treatment of patients taking these drugs must be with glucose rather than sucrose because alpha-glucosidase inhibitors interfere with the breakdown of sucrose. Acarbose and Miglitol are contraindicated in patients with chronic intestinal diseases, inflammatory bowel disease, colonic ulceration or any degree of intestinal obstruction.

question

Sitagliptin/Januvia MOA

answer

Sitagliptin works to competitively inhibit the enzyme dipeptidyl peptidase 4 (DPP-4). This enzyme breaks down the incretins GLP-1 and GIP, gastrointestinal hormones that are released in response to a meal. By preventing GLP-1 and GIP inactivation, GLP-1 and GIP are able to potentiate the secretion of insulin and suppress the release of glucagon by the pancreas. GLP-1 and GIP preservation drives blood glucose levels towards normal. As the blood glucose level approaches normal, the amounts of insulin released and the amounts glucagon suppressed diminish thus tending to prevent an overshoot of normal serum glucose levels and the subsequent hypoglycemia which can occur with other oral hypoglycemic agents.

question

Sitagliptin/Januvia char.

answer

Sitagliptin has been approved for use in the treatment of type 2 diabetes as monotherapy or in combination with Metformin, a Sulfonylurea or a TZD, but not with insulin. Efficacy trials of Sitagliptin, alone or in combination with Metformin, a Sulfonylurea or a Glitazone, have shown consistent reductions in A1c concentrations Januvia comes in 25, 50 and 100 mg tabs and the typical adult dose is generally 100 mg taken once per day. No generic versions of Januvia exist and a typical monthly cost to the patient ranges between $200.00 and $400.00.

question

Pramlintide/Symlin class

answer

Pramlintide is a synthetic form of the hormone amylin, which is produced along with insulin by the beta cells.

question

Pramlintide/Symlin indication

answer

Symlin is a drug that may be used by both type 1 diabetics and type 2 diabetics who use insulin and are still unable to reach their goal levels of HgbA1c

question

Pramlintide/Symlin MOA

answer

Symlin allows patients to use less insulin while lowering average blood sugar levels and also acts to substantially reduce the rise in blood sugar that usually occurs in diabetics immediately after meals

question

Pramlintide/Symlin char.

answer

Because of differences in the chemistry of Pramlintide and insulin, the two cannot be combined in the same vial or syringe and must be injected separately Pramlintide injections administered at meal times have been shown to improve A1c levels without causing increased hypoglycemia or causing weight gain. Pramlintide appears to actually promote modest weight loss.

question

Pramlintide/Symlin side effects

answer

The primary side effect of Pramlintide is nausea, which tends to improve over time and as the patient determines his or her optimal dose.

question

Exenatide/Byetta class

answer

Exenatide is the first in a new class of drugs referred to as incretin mimetics that have been developed for type 2 diabetes. It is a synthetic version of exendin-4, a naturally occurring hormone that was first isolated from the saliva of the Gila monster

question

Exenatide/Byetta indication

answer

type 2 diabetes

question

Exenatide/Byetta MOA

answer

Exenatide acts to lower blood glucose levels primarily by increasing insulin secretion.

question

Exenatide/Byetta char.

answer

injectable

question

Exenatide/Byetta side effects

answer

Because Exenatide only has this effect in the presence of elevated blood glucose levels, it does not increase the risk of hypoglycemia on its own, although hypoglycemia can occur if taken in conjunction with another hypoglycemic agent such as a sulfonylurea

question

Insulin indication

answer

Insulin replacement is required for the survival of all type 1 diabetics. Insulin is also used in the treatment of type 2 diabetes when diet, exercise and the use of oral hypoglycemic agents have failed to restore adequate glucose control

question

Insulin MOA

answer

Insulin stimulates glucose movement into cells, especially skeletal muscle and fat tissue which are not capable of allowing passive diffusion of glucose into myocytes and lipocytes and also activates the liver enzyme, hexokinase, which phosphorylates glucose, trapping it within the cell. Insulin activates transcription of at least 100 genes with the resultant action of increased "fuel" storage, increased cell growth and increased cell differentiation. Insulin is an anabolic hormone that promotes energy storage. Insulin promotes glycogen production and inhibits glycogenolysis. Insulin promotes fatty acid synthesis. Insulin promotes triglyceride storage. Insulin inhibits hepatic ketogenesis and hepatic gluconeogenesis.

question

Insulin char.

answer

Insulin can be given SQ, IM, and IV but cannot be utilized as an oral agent. (That is, until technology is capable of creating a delivery system that would allow oral insulin to survive proteolytic breakdown.) Insulin preparations are divided into four major categories depending upon onset of action and duration of action following SQ injection: Rapid acting Short acting Intermediate acting Long acting Combinations of above

question

Insulin side effects

answer

Insulin absorption from an injection site can vary dramatically depending upon blood flow and degree of fibrosis in sites that may be frequently used. Weight gain is a common side effect after beginning insulin treatment. Hypoglycemia as a result of insulin administration is perhaps the most feared potential complication as seizures, coma and death can result. Hypokalemia can also occur after insulin administration because potassium entry into the cell from the serum is stimulated. Injection sites may become fibrotic. Injection sites may also exhibit muscle or fat atrophy.

question

Lispro/Aspart and Humulog/Novalog class

answer

rapid acting insulin

question

Lispro/Aspart and Humulog/Novalog onset in hours

answer

≤0.25

question

Lispro/Aspart and Humulog/Novalog peak in hours

answer

0.5 - 1.5

question

Lispro/Aspart and Humulog/Novalog duration in hours

answer

3-5

question

Regular (Humulin R) class

answer

short acting insulin

question

Regular (Humulin R) onset in hours

answer

0.5-1

question

Regular (Humulin R) peak in hours

answer

2-4

question

Regular (Humulin R) duration in hours

answer

4-12

question

NPH (Humulin N) class

answer

intermediate acting insulin

question

NPH (Humulin N) onset in hours

answer

1-3

question

NPH (Humulin N) peak in hours

answer

6 - 10

question

NPH (Humulin N) duration in hours

answer

10-18

question

Glargine (Lantus) class

answer

long acting insulin

question

Glargine (Lantus) onset in hours

answer

4-6

question

Glargine (Lantus) peak in hours

answer

"flat"

question

Glargine (Lantus) duration in hours

answer

question

Insulin dosing

answer

One common insulin regimen is a combination of NPH and Regular insulin before breakfast and before dinner. Another commonly utilized insulin regimen is Regular insulin before meals with NPH or Ultralente in the afternoon. Lispro is utilized for its rapid onset of effects and is dosed ~15 minutes before each meal. Lantus insulin is utilized for its prolonged period of action which allows for improved coverage during sleeping hours.

question

Glucagon indication

answer

Glucagon is a potent hyperglycemic agent that is indicated for the treatment of severe hypoglycemia.

question

Glucagon MOA

answer

The mechanism of action of exogenous glucagon is stimulation of glucagon receptor sites with increased glucose levels obtained by breakdown of hepatic glycogen stores.

question

Glucagon char.

answer

Glucagon preparations are formulated from recombinant human DNA and can be administered IM, IV or SQ in 1 mg doses

question

Calcium supplementation recommended dosage

answer

The standard recommended amount of daily calcium intake for individuals less then 50 years of age is 1000 mg per day and the recommended dose for individuals over the age of 50 is 1,200 - 1,500 mg of calcium/ day. Breast-feeding women should have 2,000 mg of calcium supplementation per day

question

Calcium obtained from ___________ has been shown to have detectable levels of lead present as a contaminant.

answer

oyster shell source or dolomite (animal bone sources)

question

Current adult guidelines for vitamin D supplementation recommend the following:

answer

600 IU (15 mcg) for individuals from age 1 - 70 and 800 IU (20 mcg) for those individuals over 70 years of age. Data does exist to suggest that these recommendations should be at least double the above figures and that perhaps 2000 IU is a more appropriate daily dose.

question

Calcitriol (Rocaltrol)

answer

a prescription-form of vitamin D that can increase bone mass and decrease the rate of spinal fractures

question

Calcitriol (Rocaltrol) side effects

answer

calcitriol increases the risk for elevated serum calcium levels and patients on this medication require frequent monitoring

question

Magnesium dose

answer

An average dose of magnesium is 300 mg to 1000 mg a day

question

Strontium/Strontium ranelate dose

answer

Based on current evidence strontium ranelate can be taken at a dose of 500 mg to 1 gram daily to prevent osteoporosis and at a higher dose of 2 grams daily to treat existing osteoporosis

question

Strontium/Strontium ranelate side effects

answer

When taken in recommended doses, strontium supplements appear to be safe and usually free of side effects other than mild gastrointestinal upset and possible diarrhea. Attention to dosing of strontium is important as excessive intake (>2 gms per day) may actually weaken bone by replacing too much of the bone's calcium with strontium.

question

Alendronate/Fosamax class

answer

Bisphosphonates

question

Alendronate/Fosamax indication

answer

Prevention and treatment of osteoporosis, Paget's disease

question

Alendronate/Fosamax MOA

answer

Inhibition of osteoclast activity

question

Alendronate/Fosamax char.

answer

PO. Once daily. Instructions for taking Alendronate are noted under side effects.

question

Alendronate/Fosamax side effects

answer

GI - especially stomach ache, heartburn, nausea and possible erosive esophagitis. It is generally recommended that bisphosphonates be taken on an empty stomach in the morning with 6 to 8 ounces of water (not juice or carbonated or mineral water). The patient should remain upright and not eat for 30 minutes after each dose. Osteonecrosis of the jaw (rare) has been reported. Atypical femur fractures (sub-trochanteric and shaft). Myalgias.

question

Raloxifene/Evista class

answer

SERM

question

Raloxifene/Evista indication

answer

Increases bone mass and reduces the risk of vertebral fracture. Raloxifene has been shown to significantly reduce the incidence of breast cancer.

question

Raloxifene/Evista MOA

answer

Binding to select estrogen receptor sites. This drug developed to maintain beneficial estrogenic activity on bone and lipids and "anti-estrogenic" activity on endometrial and breast tissue

question

Raloxifene/Evista char.

answer

PO. Once per day.

question

Raloxifene/Evista side effects

answer

Hot flashes, arthralgias, myalgias, edema, pruritis, small but definite increased risk for development of deep venous thrombosis (DVT). Evista is contraindicated in pregnant and lactating women and women with active or past history of venous thromboembolic events, including DVT, PE and retinal vein thrombosis

question

Calcitonin/Miacalcin class

answer

Synthetic hormone to ↑serum Ca2

question

Calcitonin/Miacalcin indication

answer

Treatment of osteoporosis

question

Calcitonin/Miacalcin MOA

answer

Inhibits osteoclastic activity

question

Calcitonin/Miacalcin char.

answer

Nasal spray, IV. Not approved for the prevention of osteoporosis.

question

Calcitonin/Miacalcin side effects

answer

Nose bleeds and sinusitis noted with nasal spray. Both nasal spray and IV routes may cause headache, dizziness, edema, anorexia, diarrhea and skin rashes

question

Teriparatide/Forteo class

answer

Synthetic PTH analogue

question

Teriparatide/Forteo indication

answer

Approved for postmenopausal women and men with osteoporosis who are at high risk for having a fracture. Shown to reduce the risk of vertebral and non-vertebral fractures in postmenopausal women. In men, Teriparatide reduces the risk of vertebral fractures but the effect on nonvertebral fractures is still being investigated.

question

Teriparatide/Forteo MOA

answer

Activates bone turnover with osteoblasts being activated to a much greater extant than osteoclasts. Stimulates new bone formation in both spine and hip

question

Teriparatide/Forteo char.

answer

SQ. Once per day. Teriparatide is approved for use for up to 24 months.

question

Teriparatide/Forteo side effects

answer

The most commonly reported side effects are nausea, leg cramps and dizziness.

question

Estrogen/HRT indication

answer

Estrogen/hormone replacement therapy (ET/HRT) has been shown to reduce bone loss, increase bone density in both the spine and hip, and reduce the risk of hip and spine fractures in postmenopausal women When used solely for the prevention of postmenopausal osteoporosis, any ET/HRT regimen should only be considered for women at significant risk of osteoporosis and non-estrogen medications should be carefully considered as treatment options

question

Estrogen/HRT MOA

answer

In menopause estrogen deficiency induces cancellous as well as cortical bone loss. Highly increased bone resorption in cancellous bone leads to general bone loss and destruction of local architecture because of penetrative resorption and microfractures. In cortical bone the first response of estrogen withdrawal is enhanced endocortical resorption. Later, also intracortical porosity increases. These lead to decreased bone mass, disturbed architecture and reduced bone strength. At cellular level in bone, estrogen inhibits differentiation of osteoclasts thus decreasing their number and reducing the amount of active remodeling units.

question

Estrogen/HRT char.

answer

ET/HRT is approved for the prevention of postmenopausal osteoporosis and is most commonly administered in the form of a pill or skin patch. When estrogen is taken alone (i.e. Premarin), it can increase a woman's risk of developing endometrial cancer Before the specific dangers of conjugated equine estrogens were well understood and perhaps more importantly, accepted by the conventional medical community, the standard dose of conjugated equine estrogens (i.e. Premarin) was 0.625 mg/d. In a study by the NIH, esterified estrogens were not proven to pose the same risks to health as conjugated equine estrogens.

question

Estrogen/HRT side effects

answer

To potentially eliminate the increased risk for development of endometrial cancer for those women taking estrogen who have not had a hysterectomy, the hormone progestin is usually given in combination with estrogen (i.e. Prempro). Well documented side effects of ET/HRT include vaginal bleeding, breast tenderness, venous blood clots and increased risk for gallbladder disease. The Women's Health Initiative (WHI), a large government-funded research study, demonstrated that hormone replacement therapy with Prempro was associated with a modest but definite increase in the risk of breast cancer, stroke and MI. The WHI also demonstrated that Premarin use is associated with an increase in the risk of stroke.

question

Denosumab/Prolia class

answer

Denosumab is a human monoclonal antibody

question

Denosumab/Prolia indication

answer

Denosumab is a human monoclonal antibody that was approved by the FDA at the end of 2010 for the treatment of osteoporosis, bone metastases, rheumatoid arthritis, multiple myeloma and giant cell tumor of bone. At present, Prolia is approved for use in the treatment of osteoporosis but is not yet approved for use in the prevention of osteoporosis.

question

Denosumab/Prolia MOA

answer

Denosumab targets RANKL (the RANK ligand), a protein that acts as the primary signal to promote bone removal.

question

Denosumab/Prolia char.

answer

The drug is administered as a SQ injection, once every 6 months

question

Denosumab/Prolia side effects

answer

Similar to the adverse affect profile of other alpha-TNF agents, Prolia is known to increase susceptibility to infection

question

Statin class drugs

answer

Some studies have reported a lower risk of hip and other fractures in people who take statins drugs, such as Lovastatin (Mevacor) and Simvastatin (Zocor). To date, few clinical trials have been published, and more work is needed to confirm the possible beneficial effects that statins may have on bone density seen in these early studies.

question

Phytoestrogens

answer

Also called "dietary estrogens ", phyto-estrogens are a diverse group of naturally occurring nonsteroidal plant compounds that, because of their structural similarity with estradiol (17-β-estradiol), have the ability to bind at estrogen receptor sites. Once bound at estrogen sites, phyto-estrogenic compounds may cause estrogenic or/and anti-estrogenic effects. Phytoestrogens have the potential benefit of activating estrogen receptor sites on bone so as to enhancing bone remodeling while providing less risk of stimulating estrogen receptor sites on tissues such as breast, cervix and prostate.

question

Ipriflavone

answer

Ipriflavone, a synthetic isoflavone, has shown some promise in its ability to conserve bone in postmenopausal women. However, a three-year study of more than 400 postmenopausal women recently concluded that ipriflavone did not prevent bone loss. Further studies of phytoestrogens and isoflavones are ongoing.

question

The WHI-CEE trial arm

answer

Major results of this study were that, compared with placebo, women receiving estrogen alone experienced: No difference in risk MI An increased risk of stroke An increased risk of blood clots An uncertain effect on breast cancer risk No difference in risk for colorectal cancer A reduced risk of fracture

question

WHI-E+P trial arm

answer

This trial found that, compared with placebo, women receiving estrogen plus progestin had: Increased risk of myocardial infarction Increased risk of stroke Increased risk of DVT and PE Increased risk of breast cancer Decreased risk of colorectal cancer Fewer fractures The trial arm was ended early in 2002 when the researchers found that the subjects with estrogen plus progestin had a greater incidence of coronary heart disease, breast cancer, stroke, and pulmonary embolism than the subjects receiving placebo.

question

BiEst

answer

BiEst is a combination of two estrogens: estriol and estradiol. It is most commonly formulated in an 80: 20 ratio of estriol to estradiol.

question

TriEst

answer

TriEst is a combination of three estrogens: estriol, estradiol and estrone. It is most commonly found in a ratio of 80: 10: 10, estriol, estradiol and estrone.

question

Conjugated estrogens/Premarin class

answer

Premarin, so named because it is obtained from the urine of pregnant mares is a preparation of conjugated estrogens - estrone and equillin.

question

Conjugated estrogens/Premarin indication

answer

Indications: Prevention and treatment of osteoporosis and of post-menopausal symptoms such as hot flashes, vaginal dryness and itching.

question

Conjugated estrogens/Premarin MOA

answer

Conjugated estrogens undergo less first pass hepatic metabolism Alters gene transcription.

question

Conjugated estrogens/Premarin char.

answer

Oral and topical creams. Progesterone should be added to estrogen HRT in any women who has not undergone a hysterectomy.

question

Conjugated estrogens/Premarin side effects

answer

Vaginal bleeding, breast tenderness, increased risk of DVT, increased risk of atherosclerosis and coronary artery disease, increased risk for uterine and breast cancer. Side effects that may occur with Premarin include breast pain, increased breast size, palpitations, fever, hives, hoarseness, joint pain, stiffness or swelling, rash, redness of skin, shortness of breath, wheezing, edema and weight gain. Premarin is contraindicated if prior history of DVT or a history of breast, ovarian or uterine cancer is noted. Risks vs. benefits of use must be considered in every patient in whom hormone replacement therapy is being considered. Conjugated estrogens are in the FDA pregnancy category X.

question

Medroxyprogesterone/Provera class

answer

Medroxyprogesterone acetate is a synthetic variant of progesterone.

question

Medroxyprogesterone/Provera indication

answer

Contraceptive, hormone replacement therapy, dysfunctional uterine bleeding and treatment of endometriosis

question

Medroxyprogesterone/Provera MOA

answer

Alters gene transcription

question

Medroxyprogesterone/Provera char.

answer

PO. Depo-form is I.M. The progestin component of HRT is added to prevent the development of endometrial hyperplasia and endometrial cancer

question

Medroxyprogesterone/Provera side effects

answer

Acne, weight gain, edema, breast tenderness, increased facial hair, insomnia, anxiety, weight loss or gain. Increases the ratio of LDL to HDL cholesterol and increases risk for DVT, Contraindicated if prior history of DVT or history of breast, ovarian or uterine cancer. Can cause birth defects if taken by pregnant women.

question

Combination Oral Contraceptive Pill (COCP) class

answer

a birth control method that includes a combination of an estrogen and a progestin.

question

Combination Oral Contraceptive Pill (COCP) indication

answer

When taken every day as directed, female fertility is inhibited. Taking oral contraceptives also appears to reduce the risk of colorectal cancer, and improves conditions such as pelvic inflammatory disease, dysmenorrhea, premenstrual syndrome and acne*. Additionally, birth control pills may reduce symptoms of endometriosis and polycystic ovary syndrome, and decrease anemia The use of oral contraceptives for five years or more appears to decreases the risk of ovarian cancer in later life by 50%. Combined oral contraceptive use also appears to reduce the risk of ovarian cancer by 40% and the risk of endometrial cancer by 50% compared to non-users. The risk reduction increases with duration of use, with an 80% reduction in risk for both ovarian and endometrial cancer with use for more than 10 years

question

Combination Oral Contraceptive Pill (COCP) MOA

answer

The estrogen component suppresses ovulation while the progestin prevents implantation in the endometrium and helps to make the cervical mucus impenetrable to sperm.

question

Combination Oral Contraceptive Pill (COCP) char.

answer

Combined oral contraceptive pills should be taken at approximately the same time each day. Most brands of combined pills are packaged in one of two different packet sizes, with days marked off for a 28 day cycle. For the 28-pill packet, 21 pills are taken, followed by week of placebo or sugar pills

question

Combination Oral Contraceptive Pill (COCP) side effects

answer

A woman on the pill will usually have a withdrawal bleed sometime during the placebo week, and is still protected from pregnancy during this week. There are also birth control pills (Yaz 28 and Loestrin 24) that have 24 days of active hormone pills, followed by 4 days of placebo. If one or more tablets are forgotten for more than 12 hours, contraceptive protection will be reduced. Multiple potential side effects including increased risk for cardiovascular disease, DVT, hypertension and stroke (especially in women who smoke or who are over 35 years of age. Other side effects include acne, depression, headache, edema, nausea and breast fullness.

question

Mini pill class

answer

A progestin only pill (the so called "mini-pill") is also available wherein a consistent dose of progestin with no estrogenic agent is delivered for 21 days

question

Mini pill indication

answer

This form of contraception is indicated if patient cannot tolerate an estrogenic agent or estrogen is contraindicated.

question

Mini pill side effects

answer

The mini-pill is not as effective as the combination pill and generally causes irregular menses more frequently than does the combination pill

question

Drospirenone class

answer

Drospirenone is a synthetic progestin that has been marketed under the names Yaz and Yasmin.

question

Drospirenone MOA

answer

Drospirenone differs from other synthetic progestins in that its pharmacological profile in preclinical studies shows it to be closer to the natural progesterone. It has anti-mineralocorticoid properties, counteracts the estrogen-stimulated activity of the renin-angiotensin-aldosterone system, and is not androgenic

question

Drospirenone side effects

answer

Several studies have shown that women who take contraceptive pills containing Drospirenone have a 6- to 7-risk of developing thromboembolism compared to women who do not take any contraceptive pill, and twice the risk of women who take a contraceptive pill containing Levonorgestrel.

question

Medroxyprogesterone acetate/ Depo-Provera I.M. class

answer

Depo-Provera contraceptive injection is the brand name for a 150 mg aqueous suspension of medroxyprogesterone acetate for intramuscular injection, either in the upper arm or upper outer gluteal area

question

Medroxyprogesterone acetate/ Depo-Provera I.M. indication

answer

A woman is protected from pregnancy immediately after receiving each injection Depo-Provera has been shown to reduce the risk of endometrial cancer by up to 80%. This reduced risk is thought to be due to both the direct anti-proliferative effect of a progestogen on the endometrium as well as the protective effects of reduction of estrogen levels by suppression of ovarian follicular development

question

Medroxyprogesterone acetate/ Depo-Provera I.M. MOA

answer

Depo-Provera and other high dose forms of progestin only contraceptives inhibit follicular development and prevent ovulation as their primary mechanism of action. High dose progestogens decrease the gonadotropin-releasing hormone (GnRH) release by the hypothalamus, which decreases the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by the anterior pituitary

question

Medroxyprogesterone acetate/ Depo-Provera I.M. char.

answer

The shot is required 4 times a year to maintain the drug's high effectiveness

question

Medroxyprogesterone acetate/ Depo-Provera I.M. side effects

answer

Side effects include possible menstrual irregularities (bleeding or amenorrhea or alterations between the two), abdominal discomfort, weight changes, headache, hair loss, fatigue, depression and nervousness. Delayed return of fertility. The average return to fertility is 9 to 10 months after the last injection. Bone loss and increased risk for the development of osteoporosis is a major concern. In 2004, a black box warning was added to the package insert including the FDA recommendation that Depo-Provera not be used for longer than 2 years, unless there is no viable alternative method of contraception, due to concerns over bone loss.

question

Ortho Evra class

answer

transdermal contraceptive

question

Ortho Evra MOA

answer

The middle layer contains Norelgestromin and ethinyl estradiol. The inner layer is an adhesive and the outer is a protective cover.

question

Ortho Evra char.

answer

The first patch should be applied within the first 5 days of the menstrual cycle and a new patch should be applied every week for 3 weeks, followed by 1 patch-free week

question

Implanon class

answer

Implantable contraceptive

question

Implanon MOA

answer

Progestin implant

question

Implanon char.

answer

Implanon is placed sub-dermally, generally in the inner arm. The implant can be removed at any time, but it must be removed at the end of 3 years.

question

NuvaRing class

answer

NuvaRing is the trade name for a combined hormonal contraceptive ring made of flexible plastic that releases a low dose of a progestin and estrogen over three weeks

question

NuvaRing MOA

answer

combined hormonal contraceptive ring made of flexible plastic that releases a low dose of a progestin and estrogen over three weeks

question

NuvaRing char.

answer

The currently approved regimen specifies insertion of the ring into the vagina for a three-week period, then removal of the ring for one week, during which the user will experience a menstrual period.

question

NuvaRing side effects

answer

Contraceptive efficacy is reduced if the ring is removed, accidentally expelled, or left outside of the vagina for more than three hours. If left outside of the vagina for more than three hours, the device is to be rinsed and reinserted immediately. If this occurs, the manufacturer recommends that a backup method of contraception be used until the ring has been used continuously for a subsequent seven days The most commonly reported adverse events vaginitis, headache, leucorrhea nausea and weight gain Beyond the risks associated with combined oral contraceptives, NuvaRing is contraindicated for a risk of blood clots that is specific to 3rd generation class of contraceptives. NuvaRing contains the hormone etonogestrel, the active metabolite of the pro-drug desogestrel.

question

Paragard class

answer

copper intrauterine contraceptive

question

Paragard MOA

answer

Copper IUDs work by impairing the mobility of sperm. Additionally, the presence of a foreign body within the uterus irritates the endometrial lining and the subsequent inflammation makes it difficult for an embryo to implant.

question

Paragard char.

answer

Once in place, the Paragard IUD is approved for birth control for up to 10 years.

question

Mirena class

answer

IUD with Levonorgestrel

question

Mirena MOA

answer

The Mirena IUD utilizes a long-acting synthetic progestogen which is released into the uterine cavity to diminish the frequency of ovulation and changes the consistency of cervical mucus in addition to making implantation less likely by virtue of the inflammatory response to an indwelling foreign body.

question

Mirena char.

answer

Once in place, the Mirena IUD is approved for birth control for up to 5 year

question

The "morning after" pill class

answer

Emergency contraceptive pill

question

The "morning after" pill MOA

answer

The progestin-only method uses the progestin, Levonorgestrel, in a dose of 1.5 mg, either as two 750 μg doses 12 hours apart, or more recently as a single dose. Act both to prevent ovulation or fertilization and possibly post-fertilization implantation of a blastocyst

question

The "morning after" pill char.

answer

Progestin-only emergency contraceptive is available as a contraceptive product under many names worldwide, including: Plan B and Next Choice. The phrase "morning-after pill" is a bit of a misnomer; as emergency contraceptive pills are effective when used shortly before intercourse, and are licensed for use up to 72 hours after sexual intercourse. The WHO says they can be used for up to 5 days after unprotected intercourse

question

The "morning after" pill additional information

answer

The combined method uses large doses of both estrogen and progestin, taken as two doses at a 12-hour interval. This method is now believed to be less effective and less well-tolerated than the progestin-only method. It is possible to obtain the same dosage of hormones, and therefore the same effect, by taking several regular combined oral contraceptive pills. For example, 4 Ovral pills, 2 taken q 12 hrs x 2 doses.

question

Ulipristal acetate/Ella class

answer

Ulipristal acetate (trade name Ella) is a selective progesterone receptor modulator (SPRM) used for emergency contraception.

question

Ulipristal acetate/Ella indication

answer

It has shown to prevent about 60% of expected pregnancies, which is comparable to the emergency contraception with plan B/ Levonorgestrel.

question

Ulipristal acetate/Ella MOA

answer

It prevents pregnancy by delaying or inhibiting ovulation and inhibiting follicle rupture.

question

Ulipristal acetate/Ella char.

answer

It is to be given within 120 hours (5 days) after unprotected intercourse or contraceptive failure.

question

Mifepristone/Mifeprex class

answer

synthetic steroid compound

question

Mifepristone/Mifeprex indication

answer

Mifepristone is a synthetic steroid compound used as an abortifacient in the first two months of pregnancy, and in smaller doses as an emergency contraceptive.

question

Mifepristone/Mifeprex MOA

answer

Mifepristone acts a progestin antagonist with partial agonist activity. MOA is blockade of progesterone receptors (which when stimulated, normally sustain the endometrium) as well as causing a decline in human chorionic gonadotropin levels which in turn causes decreased production of progesterone by the corpus luteum.

question

Mifepristone/Mifeprex char.

answer

Administration of Mifepristone during the 1st trimester of pregnancy results in abortion in ~85% of cases. Mifepristone is often used in conjunction with Misoprostol (Cytotec), a prostaglandin E1 analog.

question

Mifepristone/Mifeprex side effects

answer

In clinical trials, nearly all women using Mifepristone experienced abdominal pain, uterine cramping, and vaginal bleeding or spotting for an average of 9-16 days. Up to 8% of women experienced some type of bleeding for 30 days or more. Other less common side effects included nausea, vomiting, diarrhea, dizziness, fatigue, and fever. Excessive uterine bleeding or incomplete termination of a pregnancy require emergent medical intervention. Mifepristone use is contraindicated in the presence of an intrauterine device (IUD), in cases of ectopic pregnancy, in patients with known hemorrhagic disorders or on anticoagulant therapy and patients on long term prednisone therapy

question

Clomiphene/Clomid class

answer

Estrogen receptor agonist

question

Clomiphene/Clomid indication

answer

Infertility, amenorrhea

question

Clomiphene/Clomid MOA

answer

Binding to estrogen receptor sites in the brain interferes with the normal negative feedback of estrogen on gonadotropin releasing hormone (GnRH), which results in the increased secretion of GnRH. This causes an increased release of LH and FSH and stimulation of ovulation.

question

Clomiphene/Clomid char.

answer

PO. Careful administration with assessment for potential side effects.

question

Clomiphene/Clomid side effects

answer

vaginal dryness, vaginal bleeding, breast tenderness, anxiety, hot flashes. Potentially contraindicated if prior history of liver disease, breast cancer or uterine cancer. Multiple births is a known potential risk when using this drug.

question

Testosterone class

answer

Androgenic hormone

question

Testosterone indication

answer

Testosterone replacement for both androgenic and/or anabolic effects Exogenous administration of testosterone is used in males with inadequate testosterone production (hypogonadism). Testosterone is also used in conjunction with other hormones to promote skeletal growth in prepubertal boys with pituitary dwarfism. Post-pubertal hypogonadism is manifested primarily by infertility, abnormalities of sexual function (erectile dysfunction and decreased libido), alterations in behavior (irritability, depression), loss of muscle mass and tone, increased rate of osteoporosis and possible loss of secondary sexual characteristics (decrease in axillary and pubic hair). Bone marrow stimulation and anemia Severe osteoporosis Hormone therapy for transsexual men Unapproved use - androgenic steroids are used to increase lean body mass, muscle strength and aggressiveness in athletes and body builders. "Anti-aging"

question

Testosterone MOA

answer

Alters gene transcription

question

Testosterone char.

answer

IM (as testosterone cypionate), patch, gel, SL lozenges. Not used in oral form because of inactivation by first-pass metabolism. Dosed daily for patches or gel or one dose every 1-2 weeks for injection

question

Testosterone side effects

answer

In males, excess androgens can cause acne, baldness, gynecomastia, priapism, increased risk of prostatic hyperplasia and prostatic cancer*, exacerbation of sleep apnea and result in reduced sperm count and infertility (due to negative feedback). In females, excess androgens can result in virilization such as excess body and facial hair, acne, deepening of voice, clitoral enlargement and menstrual irregularities In children, excess androgens can cause abnormal rate of sexual maturation and can result in diminished height due to premature closing of growth plates. The unauthorized use high dose anabolic steroids by athletes has been documented to result in different liver abnormalities, gynecomastia and breast cysts, cystic acne, premature epiphyseal plate closure and increased aggression ("roid rage") Additional adverse effects include abnormal lipid levels. Androgens increase serum LDL and lower serum HDL, therefore increasing the risk of atherosclerosis and coronary artery disease. Androgens can also cause fluid retention and edema. Increased red blood cell mass may cause increased blood viscosity and sludging of blood and increase the risk for ischemia.

question

Leuprolide/Lupron class

answer

Anti-androgenic hormone and anti-estrogenic hormone.

question

Leuprolide/Lupron indication

answer

Prostatic cancer, precocious puberty, endometriosis and uterine fibroids, as well as being part of some protocols of I.V.F.

question

Leuprolide/Lupron MOA

answer

Synthetic analog of gonadotropin releasing hormone (GnRH). Leuprolide interrupts production of both testosterone and estrogen.

question

Leuprolide/Lupron char.

answer

SQ, IM. Different preparations have different half lives.

question

Leuprolide/Lupron side effects

answer

Decreased libido, impotence nausea, vomiting, hot flashes, night sweats, arthralgias, myalgias, osteoporosis.

question

Finasteride/Proscar class

answer

Anti-androgen

question

Finasteride/Proscar indication

answer

Benign prostatic hyperplasia. In lower doses it is used to treat male-pattern baldness. In higher doses it is used to treat prostate cancer.

question

Finasteride/Proscar MOA

answer

Limits conversion of testosterone to dihydrotestosterone (DHT) by inhibiting type II 5-alpha reductase

question

Finasteride/Proscar char.

answer

P.O. Once daily dosing. Intended for use by men only. No blood donation is allowed while a patient is taking Proscar. Side effects: Women who are or may potentially be pregnant must not use Proscar and should be instructed not to handle crushed or broken tablets because of the risk of birth defects.

question

Finasteride/Proscar side effects

answer

Decreased libido, erectile dysfunction, impotency, depression, breast swelling and breast tenderness

question

Alpha blockers used for BPH include...

answer

Doxazosin (Cardura), Terazosin (Hytrin), Tamsulosin (Flomax and Urimax), and Silodosin (Urief) All five are equally effective but have slightly different side effect profiles

question

Alpha blocker side effects

answer

Common side effects of alpha blockers include weakness, orthostatic hypotension and nasal congestion.

question

Phosphodiesterase type 5 inhibitors MOA

answer

Phosphodiesterase type 5 inhibitors block the degradative action of the enzyme, phosphodiesterase type 5 on cyclic GMP in the smooth muscle cells lining the blood vessels supplying the corpus cavernosum of the penis. This causes blood to remain in the corpus cavernosum and thereby an erection is maintained.

question

Phosphodiesterase type 5 inhibitors indication

answer

Because PDE5 is also present in the arterial wall smooth muscle within the lungs, PDE5 inhibitors such as Sildenafil have also been utilized for the treatment of pulmonary hypertension, a disease in which blood vessels in the lungs become abnormally narrow.

question

Sildenafil citrate/Viagra class

answer

PDE5 inhibitor

question

Sildenafil citrate/Viagra indication

answer

E.D., pulmonary hypertension

question

Sildenafil citrate/Viagra MOA

answer

Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5), which is responsible for the degradation of cGMP stores in the corpus cavernosum. When this occurs in the smooth muscle cells lining the blood vessels supplying the corpus cavernosum of the penis, blood remains in the cavernosum and thereby an erection is maintained. Sildenafil does not generally cause an erection without sexual stimulation because there is lack of activation of the nitric oxide/cGMP system.

question

Sildenafil citrate/Viagra char.

answer

Sildenafil is available in 25 mg, 50 mg and 100 mg tablets. The dose of Sildenafil for erectile dysfunction is 25 mg to 100 mg, to be taken between 30 minutes and 4 hours prior to sexual intercourse. Patients are instructed to take no more than one tablet per day.

question

Sildenafil citrate/Viagra side effects

answer

The most common adverse effects of Sildenafil include headache, flushing, dyspepsia and nasal congestion. Impaired vision, including photophobia and blurred vision, is also commonly reported. Some Sildenafil users have complained of seeing everything in the visual field as being tinted blue (cyanopsia). Rare but serious adverse effects include increased intraocular pressure and acute angle closure glaucoma, ventricular arrhythmias, severe hypotension, myocardial infarction and stroke, as well as priapism.

question

Sildenafil citrate/Viagra contraindications

answer

Not to be used by patients on nitric oxide donors, organic nitrites and nitrates, such as nitroglycerin and Isosorbide dinitrate. In men for whom sexual intercourse is inadvisable due to cardiovascular risk factors such as recent stroke or heart attack Severe impairment of liver or renal function Hypotension Hereditary degenerative retinal disorders

STUDY

Coronary Artery Disease

Plant & Animal Genetics – Flashcards 109 terms

Jill Lopez

109 terms

Preview

Plant & Animal Genetics – Flashcards

question

Additive genetic component (?_A)

answer

A component of genotype. A measure of the sum of effects of allels working together. The only component that is inherited.

question

Allele

answer

Different versions of a loci. A dominant allele is represented by a capital letter and the recessive by a lower case letter.

question

Anonymous marker panel approach

answer

An approach to QTL detection. A panel of markers is developed. Then multiple markers are used to scan a region, chromosome, or genome. Uses high density marker panels.

question

ANOVA

answer

ANalysis Of the phenotypic VAriance
A regression based method of testing for significance. If Pr>F is less than 0.05, there is significance.

question

Artifical selection

answer

Selection controlled by humans. Goal oriented towards an animals' appearance, use, productivity, or even just whimsy.

question

Avian sex determination

answer

Male birds have two Z chromosomes: ZZ
Female birds have one Z chromosome: Z_ (sometimes written as Zw

question

Biddability

answer

A CARAT trait for guide dogs. How well a dog does the bidding of a human.

question

Binary trait

answer

A threshold trait with two classes. A yes/no situation. Example: diabetes.

question

Bottleneck

answer

Moderate pressure natural selection. Cheetahs had a large bottleneck 10 - 15 thousand years ago. Cheetahs are all closely related.

question

Calving ease

answer

A quantitative trait. Categorized into unassisted, easy pull, hard pull, and surgical.

question

Candidate gene approach

answer

An approach to QTL detection. A gene is selected for physiological or biochemical reasons, and the polymorphism is detected within the gene. One at a time, selective, and targeted searching. Carefuly organized and tedious.

question

CARAT traits

answer

Traits that are looked for in service dogs. Determined using a series of 36 tests. Dogs are scored by their performance.

question

Confidence with other dogs

answer

A CARAT trait for service dogs.
h² = 0.26

question

Confidence with people

answer

A CARAT trait for service dogs
h² = 0.17

question

Conformation final score

answer

A phenotype looked for in cattle. Includes rump, feet, and legs.
h² = 0.21

question

Counting method

answer

A method of calculating allele frequency. The genotypes of individuals are counted up, and the alleles counted. Population must be small enough to ount and the genotype of all individuals must be known.

question

Cross country

answer

A racing event for horses with fixed obstacles. Success in this competition is a hertiable trait.
h² = 0.41

question

Cross-dressing roosters

answer

An example of sex-limited inheritance. All hens show characteristic hen feathering. Cocks with a dominant H allele (HH or Hh) show hen feathering. Homozygous recessive cocks (hh) show characteristic cock feathering.

question

Cull

answer

The genetic equivalent of death in artificial selection. It may be slaughter, neutering, or preventing that animal from breeding.

question

Cut-off point (t)

answer

aka Truncation point
In quantitative trait selection, the point in the phenotypic sliding range where individuals survive or are culled.

question

Detection of carriers

answer

Calculating the probability that a dominant phenotype individual is heterozygous without a test cross, where the individual mates randomly.
P = [f(AA) + 0.75f(Aa) + 0.5f(aa)]ⁿ

question

Dominance genetic component (?_D)

answer

A component of genotype. A measure of combined dominance effects of individual loci.

question

Draft horse

answer

The genetic differences between large horses and small horses is one section of the genome.

question

Drip loss

answer

The loss of water from meat while in storage. If it is really bad, the meat can become concave. It is a heritable trait in pigs.

question

Easy pull

answer

A class of calving ease. Cow needs a small amount of assistance in birth.

question

Environment (?_E)

answer

A component of phenotype. The conditions in which the genotype is expressed. Changes to this factor (altering diet, habitat, et cetera) are reversible.

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Epistasis

answer

When alleles at one locus effect the expression of alleles at a different locus. Example: a white cat has a genotype of W_, and a genotype of ww allows other colour patterns to express.

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Evolution

answer

Subtle pressure of natural selection.

question

Extinction

answer

Massive pressure natural selection.

question

Fat percentage

answer

A phenotype in cows.
h² = 0.5

question

Fat yield

answer

A phenotype in cows.
h² = 0.34

question

Feet and legs conformation

answer

A phenotype in cattle
h² = 0.12

question

Fertility

answer

A phenotype in cattle
h² = 0.07

question

Fitness (w)

answer

The suitability of an animal's phenotype to its environment, be that a natural or artificial environment. Expressed as a fraction representing how many of the individuals with that phenotype will reproduce.

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Gaited horse

answer

A horse with a particular way of running where the horse's back does not move up and down as much. There is genetic basis for this phenotype.

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Genotype (?_G)

answer

A component of phenotype. Many loci contribute to it. Changes to this factor (breeding), are permanent.
?_G = ?_A + ?_D + ?_I

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Genotyping

answer

Determining the genotypes of individuals. The challenge is to decrease the cost per genome, and increase the number of loci. Can be expensive.

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Gold/silver chicken sexing

answer

A method of maxing determining the sex of chicks easier. A silver hen (S_) is crossed with a gold cock (gg). All the female chicks will be gold (g_) and all the male chicks will be silver (Sg).

question

Hard pull

answer

A class of calving ease. Cow needs a large amount of assistance in birth.

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Hardy-Weinberg equilibrium

answer

Population must be large with random mating, and lack migration, mutation, and selection. All allele and genotypic frequencies remain constant
1 = p² + 2pq + q²

question

Herd life

answer

A phenotype in cattle
h² = 0.1

question

Heritability (h²)

answer

The portion of total variance that is additive genetic. Half is transmitted to offspring
h² = ?_A² / ?_P²

question

High density marker panel

answer

A device used in anonymous marker panel approach of QTL detection. Photo etches 50,000 - 1,000,000 markers onto a glass slide, building "velcro" tags that "grab" matching DNA. The grabbed areas light up, thus genotyping the individual. A thousand times cheaper, and faster than PCR method.

question

Highland cattle

answer

A cattle breed bred to survive harsh environments. Smaller size, thicker coat. Can survive rough conditions on marginal feed.

question

Holstein

answer

A cattle breed bred for high milk production. Require high quality feed to produce milk at the rate they do. Prevalent in the dairy industry.

question

Horned/polled sheep

answer

An example of sex-limited inheritance. Homozygous deominant (PP) sheep are horned. Homozygous recessive (rr) sheep are polled. Heterozygous ewes (Pp) are polled, and heterozygous rams (Pp) are horned.

question

answer

i = S / ?_P
Depends on the proportion of the population selected in quantitative trait selection. Use the standard distribution curve table to find values based on the S value (portion of the population that is selected).

question

Inheritance

answer

A factor affecting QTL detection. Crosses of divergent lines (looking for multi-modal distribution), offspring-parent resemblance (deviation from the parent average), and segregation analysis (expected inheritance using pedigree).

question

Imprinting

answer

Genes expressed only if they are inherited from a particular parent (from the mother or father). One of the parent's genes is destined to be inactive because of their sex.

question

Interaction genetic component (?_I)

answer

aka Epistasis
A componenet of genotype. A measure of the combined interactions between loci.

question

Johanna Rag Apple Pabst

answer

A bull who is the ancestor of 99.5% of all Canadian Holsteins. Came from Quebec, but lived in Guelph.

question

Large population

answer

One of the requirements for Hardy-Weinberg equilibrium. Populations must be large enough to maintain Hardy-Weinberg equilibrium. Generally too arge to count all individuals.

question

Lethal allele

answer

An allele with an s value of 1. May actually be lethal to the animal, causing abortion or early death, or just that humans cull every single individual carrying the allele.

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Linkage

answer

When two or more loci are on the same chromosome.

question

Mammalian sex determination

answer

Female mammals: XX
Male mammals: XY

question

Marker

answer

Unimportant polymorphisms that occur nearby to QTL, so recombine with the QTL. They often have no genotypic effect on the phenotype. Used to locate QTLs. If the marker and QTL are separated by recombination, then it is useless.

question

Mass selection

answer

Used when there are many progeny, such as in fish or poultry.

question

Mean (X bar)

answer

aka Average
X bar = (? xi) / n

question

Meishan pig

answer

A pig that produces very large litters up to 30 piglets! The large litter size is due to a single SNP in the NCOA1 gene.

question

Melanocytes

answer

Cells that produce fur pigments in cats. They also affect the electrical transmission of electrical signals from the ear to the brain. As a result, white cats are often also deaf. White cats are only deaf if they have blue eyes. If just one eye is blue, the cat is deaf on that side.

question

Mendelian Genetics

answer

aka Classic genetics
Crossing two heterozygoes (Aa x Aa) gives 1AA : 2Aa : 1aa

question

Migration

answer

One of the limits of the Hardy-Weinberg equilibrium. The alleles move from one population to another. May be due to climate change, human activities, or humans shipping germplasm. Depends on the immigration rate and the difference in allele frequencies betwen the populations.
P' = allele frequency in migrant population
M = percentage of population that are migrants
P' = p₁ + m(p₂ - p₁)

question

Milk yield

answer

A phenotype in cows
h² = 0.43

question

Mutation

answer

A limit on Hardy-Weinberg equilibrium. New alleles are created. Most mutations are recessive. If the mutation phenotype has fitness at or above that of the wild type, the mutation will not go away.

question

Natural selection

answer

Selection by the environment. Individuals must adapt to the environment or perish. Includes evolution, bottlenecks, and extinction.

question

answer

The selected portion of the parent population in quantitative trait selection.

question

PCR

answer

aka "genetic horserace"
Endonuclease cleaves DNA at specific sequenes and then is put in a gel to determine genotype. Slower and more expensive than high density marker panels.

question

Persistence with other dogs

answer

A CARAT trait.
h² = 0.16

question

Phenotypic variance (?_P²)

answer

?_P²= (?_A²+?_D²+?_I²) +?_E²

question

Phenotype (?_P)

answer

Determined by a combination of genetics and environment.

question

Phenotypic selection

answer

Selection for quantitative traits. Selection based on phenotype. Indirectly influencing allele frequency. Tracking progress by change in phenotype.

question

Pleiotropy

answer

When one locus affects two or more traits. Example: white cats are often also deaf.

question

Polymorphism

answer

A differene in alleles. Example: SNPs.

question

Population design

answer

A factor affectin QTL detection. Inbred line crossing, and outbred populations.

question

Proportion method

answer

A method of calculating allele frequency. The genotypes of individuals are counted.
f(AA) = P
f(Aa) = H
f(aa) = Q
f(A) = P + 0.5H
f(a) = Q + 0.5H

question

Protein percentage

answer

A phenotype in cows
h² = 0.5

question

Protein yield

answer

A phenotype in cows.
h² = 0.4

question

Qualitative trait

answer

Controlled by one or few loci. Discrete phenotypes. Traits are selected with single locus selection. Easy to predict if the allele frequency is known. Genotype can be determined in a lab.

question

Quantitative trait

answer

aka Polygenic trait
Controlled by multiple loci, up to thousands. Most of the loci have small effects on the phenotype, so are difficult to pinpoint. Some of the loci may have a larger effect on phenotype, so may be located. Phenotypes occur on a continuous sliding scale. Include threshold traits. Traits are selected wth phenotypic selection.

question

Quantitative triat locus (QTL) detection

answer

Finding polymorphisms in a genome that is associated with a distinctive difference in phenotype. Can be complicated. Often QTL are discovered using markers. Two methods: candidate genes, and anonymous markers. Affected by inheritance and population design.

question

Race earnings

answer

A phenotype in horses
h² = 0.25

question

Racing speed

answer

A phenotype in horses
h² = 0.25

question

Random mating

answer

One of the requirements for Hardy-Weinberg equilibrium. All allele frequencies remain constant. This generally excludes human populations because random mating is not socially acceptable in human societies.

question

Red & White spotting

answer

An example of sex-influenced inheritance in Shorthorn cattle. Homozygous dominant (RR) cattle have red and white spotting. Homozygous recessive (rr) cattle are white. Heterozygous (Rr) cows are red and white spotted, and heterozygous (Rr) bulls are white.

question

Response (R)

answer

In quantitative trait selection, the deviation of the progeny from the original population average
R = [average of offspring] - [average of parent population (including unselected)]

question

Rump conformation

answer

A phenotype in cattle
h² = 0.23

question

SAS analysis

answer

A computer program that determines how well a model fits with the observed phenotypes. The smaller the Pr>F value, the more likely the model is valid.

question

Secretariat

answer

A racehorse who won races by a large margin. Lived in 1973. Turned out he was not above average in speed, but just looked fast compared to the other horses.

question

Selection

answer

A limit of Hardy-Weinberg equilibrium. The process which determines which individuals will become parents of the next generation. Includes natural and artificial selection. Allele frequencies are altered.
p₁ = (p₀(1 - s₁q₀) / (1 - 2s₁p₀q₀ - s₂p₀²)

question

Selection differential (S)

answer

In quantitative trait selection, the average of selected parents deviated from the population mean.
S = [average of selected parents] - [average of parent population]

question

Selection pressure (s)

answer

How many individuals in a phenotype survive and become parents.

question

Sex-influenced inheritance

answer

Heterozygoes express a different phenotype in males than in females.

question

Sex-limited inheritance

answer

Phenotypes can be observed only in one sex. Sexes may not even possess the necessary body parts for certain phenotypes.

question

Sex linkage

answer

When a gene is found on a sex chromosome.

question

Show jumping

answer

A phenotype in horses
h² = 0.45

question

Significance

answer

When Pr>F is less than 0.05. The hypothesis will be incorrect 5% of the time.

question

Single locus selection

answer

Selection of qualitative traits. Selecting based on alleles. Directly influencing allele frequency. Track progress with allele frequency.

question

Single nucleotide polymorphism (SNP)

answer

Pronounced "snip". A single change of base in DNA.

question

Social interactions with people

answer

A CARAT trait for service dogs.
h² = 0.47

question

Standard deviation

answer

The square root of variance.

question

Surgical

answer

aka Mal-presentation.
A class of calving ease. Cow needs surgery in birth. Calf pushed back, turned around, and then pushed out the right way.

question

Test cross

answer

Crossing a dominant phenotype indiviual with a recessive phenotype individual. If any of the offspring have the recessive phenotyp, the individual is heterozygous.

question

Threshold trait

answer

Quantitative traits that are categorized into discrete groups on the sliding scale. Includes calving ease and binary traits.

question

Ultimate selection pressure

answer

In qualitative trait selection, when one allele has a fitness level of zero in both homozygous and heterozygous forms. By the second generation, the allele frequency is zero.

question

Unassisted

answer

A class of calving ease. The cow gives birth without any human help.

question

Variance (?²)

answer

The measure of diversity and variety in a phenotype. The square root of variance is standard deviation.
?² = (? (x - x bar)²) / (n - 1)

question

Visual reactivity

answer

A CARAT trait in service dogs.
h2 = 0.18

question

Whining

answer

An unwanted CARAT trait in service dogs.
h² = 0.06

question

answer

The height of the standard distribution curve at the cut-off point.

STUDY

Coronary Artery Disease Fat Free Mass Muscular Strength And Endurance Physical Fitness

ACE Group Fitness Exam – Flashcards 179 terms

Misty Porter

179 terms

Preview

ACE Group Fitness Exam – Flashcards

question

What is the definition of a scope of practice?

answer

The legal range of services that professionals in a given field can provide, the settings in which they can be provided, and the guidelines or parameters that must be followed.

question

What member of the Allied Healthcare Continuum can evaluate patients to diagnose ailments and implement treatment plans?

answer

Physicians/Doctors

question

Name some reasons why there is expected growth in Group Fitness jobs between 2008 and 2018.

answer

Concerns about childhood obesity. Growing number of schools eliminating P.E. from curriculum Baby Boomers wanting to stay healthy, physically fit, and independent A growing elderly population that seeks relief from arthritis and osteoporosis through individualized exercises, pilates, and yoga To replace the number of GF instructors that leave the industry every year Growing number of club memberships among young adults concerned about physicial fitness

question

What member of the Allied Healthcare Continuum can teach clients proper nutrition through recipes, meal plans, food preparation methods, and implementation of special diets?

answer

Registered Dieticians

question

What member of the Allied Healthcare Continuum can lead patients through therapeutic exercise and teach them to perform additional exercises to facilitate rehabilitation?

answer

Physical therapists/Occupational therapists

question

What member of the Allied Healthcare Continuum can teach athletes exercises to prevent injury and take them through therapeutic exercises following injury.

answer

Athletic Trainer

question

ACE-certified Group Fitness Instructor Scope of Practice

answer

Develop and implement exercise programs that are safe, effective, and appropriate Conducting pre-exercise health screenings and stratifying risk for CVD Administering appropriate fitness assessments based on health screening, current fitness, lifestyle factors, and goals Teach correct exercise methods and progressions through demonstration, explanation, and proper cueing and leadership techniques Instructing class participants how to monitor HR Empowering people to begin and adhere to their exercise programs using guidance, support, motivation, lapse-prevention strategies, and effective feedback Assessing the class environment by evaluating/monitoring the room and eq before and during each class Educating participants about fitness and health-related topics to help them adopt healthful behaviors for long-term success Protecting client confidentiality according to HIPAA Always acting with professionalism, respect, and integrity Recognizing scope of practice and always referring participants to other healthcare professionals when appropriate Being prepared for emergency situations and responding properly when they occur

question

Guidelines under the ACE Code of Ethics

answer

Equal and fair treatment to all clients To provide safe and effective instruction Must maintain current CPR/AED and first-aid knowledge Uphold and enhance public appreciation and trust for the health and fitness industry Stay current on health and fitness research and understand its practical application To refer participants to other health care professionals when appropriate Comply with all business, employment, and intellectual property laws Maintain the confidentiality of client information Establish and maintain clean professional boundaries

question

What are the skill-related fitness components?

answer

Agility, coordination, balance, power, reaction time, speed

question

What are the health-related fitness measures?

answer

Body composition, cardiorespiratory endurance, muscular strength and balance, neuromuscular strength, and flexibility

question

Potential Physiological Benefits of Warm-Ups:

answer

Increased metabolic rate Gradual increase of blood flow to working muscles Increased force and speed of muscle contraction Decreased muscle relaxation time following contraction Increased elasticity in muscles, joints, and tendons Gradual energy production, preventing lactic acid build-up Decreased risk of abnormal heart rhythm

question

Group Fitness Trifecta

answer

Education Teamwork Class Value

question

Three factors that determine Class Value

answer

Class count Cost per head Penetration

question

What are the three broad groups of fitness?

answer

Cardio - meant to increase cardiorespiratory strength Strength training - increasing muscle strength by using a variety of muscle groups Mind/Body - works core strength, balance, flexibility, overall strength, and breathing along with techniques for increasing focus and relaxation

question

5 types of musculoskeletal injuries

answer

Strain Sprain Cartilage Damage Bone Fractures Overuse Conditions

question

Considerations for those exercising with sprains

answer

Choose exercises that do not involve the injured joint Gradually reintroduce activity involving joint Avoid movement in end ranges of motion Monitor for recurring symptoms of increase in severity of symptoms

question

Factors associated with injury

answer

Flooring Exercise Surface Footwear Equipment Movement Execution Class Intensity and Frequency of Participation Pre-Class Evaluation

question

What is a sprain and what are the symptoms of a sprain?

answer

A sprain is an acute injury to the ligament caused by sudden trauma to the join. Symptoms are pain, loss of mobility, localized swelling, loss of use, joint instability, and discoloration

question

Three Phases of Tissue Healing

answer

Inflammatory Phase - takes place for up to six days after injury occurs Fibroblastic/Proliferation Phase - takes place from about Day 3 to Day 21 Maturation/Remodeling Phase - takes place from about Day 21 to 2 years

question

Under the Stability portion of the 3 "S"'s, instructors should consider

answer

Keep high impact moves to a minimum Minimize join stress - limit one legged hops to fewer than 8 Lower heels to floor during most movements Stay within industry guidelines for music tempo Keep cycling below 110 rev/min Pay attention to position of spine in any movement Promote muscular balance in cardio strength, flexibility, and fusion classes Use anticipatory cues prior to movements

question

In the Cardiorespiratory Segment of a group exercise class, the GFI should:

answer

Increase intensity gradually Give options for impact and intensity Monitor intensity using heart rate and/or PRE Use music to create a motivational atmosphere Target a variety of muscle groups Promote independence/self-responsibility Include a post-cardio cooldown/stretch Build sequences logically and progressively

question

Areas of Responsibility (reducing liability)

answer

Health Screening Fitness Testing and Exercise Programming Instruction Supervision Facilities Equipment Risk Management

question

To legally substantiate a charge of negligence, four elements must be shown to exist:

answer

The defendant had a duty to protect the plaintiff The defendant failed to exercise the standard of care necessary to perform that duty That such failure was the proximate cause of an injury The injury caused damage to occur to the plaintiff

question

To legally substantiate a charge of negligence, the following four elements must be shown to exist:

answer

That the defendant had a duty to protect the plaintiff That the defendant failed to exercise the standard of care necessary to perform that duty That the failure to perform that duty was the proximate cause of injury to the plaintiff That the injury caused damage to the plaintiff

question

Cardiorespiratory Training, Moderate Intensity: frequency, duration, and exercises

answer

Less than or equal to 5 days a week Less than 30 minutes a day Aerobic activities or weightbearing exercises

question

Resistance Training, frequency, duration, intensity, and exercises

answer

2-3 days a week 60%-80% of 1 RM 2-4 sets of 8-25 repetitions 8-10 exercises that include all major muscle groups Muscular strength and endurance, calisthenics, and neuromuscular exercise

question

Combination of Moderate and Vigorous Intensity Cardiorespiratory Training

answer

3-5 days a week 20-30 minutes a day Aerobic activities or weightbearing exercise

question

Vigorous Cardiorespiratory Training

answer

Less than or equal to 3 days a week 20-25 minutes a day Aerobic activities or weightbearing exercise

question

40%-60% VO2R/HRR

answer

Moderate intensity cardiorespiratory training

question

General Exercise Recommendations for Healthy Adults: Flexibility

answer

Less than or equal to 2-3 days a week Less than 4 repetitions per muscle group Static stretches of 15-60 seconds per hold PNF: Hold 6 seconds, 10-30 second assisted stretch Stretch to limits of discomfort within a safe ROM All major muscle-tendon groups

question

What is the Chain of Survivial?

answer

Recognize signs of cardiac arrest and activate EMS Perform CPR, emphasizing chest compressions Rapid defibrillation Integrated post-cardiac arrest care

question

Under the ACE Integrated Fitness Training Model, what are the phases of Functional Movement and Resistance Training?

answer

Stability and Mobility Training Movement Training Load Training Performance Training

question

Under the ACE Integrated Fitness Training Model, what are the phases of Cardiorespiratory Training?

answer

Aerobic Base Training Aerobic Efficiency Training Anaerobic Endurance Training Anaerobic Power Training

question

What are the three determinants (categories) for physical activity:

answer

Environmental Factors Personal Attributes Physical-Activity Factors

question

What is considered the most important variable for program adherence?

answer

Activity History

question

Time and Access to Facilities is part of what determinant for physical activity?

answer

Environmental Factors

question

This type of motivation relies on external factors that are suggested by someone/something else. What feelings do they tend to experience in regards to their participation?

answer

Introjection Guilt, tension, pressure, being controlled

question

Self-efficacy

answer

The belief in ones capabilities to successfully engage in an exercise program

question

Adults should engage in at least ___ minutes of moderate intensity aerobic physical activity per week.

answer

150

question

During this stage of the TTM, the person is still sedentary but is considering becoming physically active. Bonus: What does TTM stand for?

answer

Contemplation Stage Transtheoretical model of behavioral change

question

During the Action stage of the TTM, what is the participant going through?

answer

They are engaging in regular physical activity and have been doing do for less than 6 months. They need reinforcement and feedback, as they may still be ambivalent towards sticking with the program and are likely to drop out.

question

A potential participant has a systolic bp of 130, LDL of 135, and is 35 years old. Are they at risk for CVD?

answer

No, they only show one risk factor (LDL choloesterol of 130 or higher).

question

What is claudication?

answer

Pain sensations or cramping in the lower extremities associated with inadequate blood supply

question

Risk Stratification for CVD: How many risk factors are there each for low, moderate, and high risk?

answer

Low: One or less Moderate: 2 or more High risk: Symptomatic (3+) or known cardiovascular, pulmonary, renal, or metabolic disease

question

Name the steps of pre-class preparation:

answer

Assess the Room Prepare Equipment Appropriate Attire and Equipment Know the Participants Orient New Participants and Preview Class Format Acknowledge Class Participants

question

What does RPE stand for?

answer

Ratings of perceived exertion

question

In what type of class would the use of HR monitors be best?

answer

Group cycling or running

question

How to figure out Maximum Heart Rate (MHR):

answer

208 - (Age X .70)

question

Figure out the MHR of a 37 year old.

answer

182 bpm

question

What is the target heart rate for a 20 year-old?

answer

107-175

question

What would be the target heart rate (55%-90%) of a 25 year old?

answer

Find the MHR first (208-(25X.70)) then multiple my .55 and .90. 104-171

question

What is the standard deviation for MHR?

answer

Plus or minus 12 bears per minute (bpm)

question

Overweight or deconditioned people reach their ___ more quickly and with less effort.

answer

THR

question

RPE scale goes from _ to __.

answer

6 to 20

question

The Dyspnea Scale

answer

+1 - Mild, noticeable only to exerciser +2 - Mild, some difficulty noticed by observer +3 - Moderate difficulty, participant can still exercise +4 - Severe difficulty, participate must stop exericising

question

What does the First Ventilatory Threshold (VT1) represent?

answer

A level of intensity where lactic acid begins to accumulate in the blood. It is the crossover point, where talking should not appear challenging or uncomfortable to the individual.

question

What does the Second Ventilatory Threshold (VT2) correspond with?

answer

The lactate, or anaerobic threshold, and it is the point at which lactic acid accumulates at rates faster than the body can buffer and remove it.

question

What do look for in lateral view posture:

answer

Suspended head Ears over shoulders Shoulders over hips Hips over knees Knees over ankles Three natural curves of the spine Knees should be unlocked

question

What to look for in posture in Anterior and Posterior views

answer

Feet shoulder width-apart (watch pronation or supination) No shifting or leaning to one side (hips, shoulders)

question

What to look for in posture for the Anterior View

answer

Arms should hang with equal space between torso Thumbs and index finger only should be visible Knees pointing forward

question

Skinfold Caliper measurements - percentage chart for obesity:

answer

Women - Athletes - 14-20% Men - Athletes - 6-13% Women - Fitness - 21-24% Men - Fitness 14-17% Women - Average - 25-31% Men - Average 18-24%

question

BMI reference chart

answer

Normal Weight 18.5-24.9 Overweight 25-29.9 Grade I Obesity - 30-34.9

question

What is an example of a cardiorespiratory endurance test once can administer in a group fitness atmosphere?

answer

YMCA submaximal step test

question

Give examples of student-centered instruction:

answer

Fostering Independence Encouragement Attainable goals Realism

question

Leadership Styles that can be applied to group exercise:

answer

Visionary: Inspires by sharing a heart-felt, shared goal Coaching: Taking people aside to learn their aspiration and gives feedback in the those terms and helps move towards those goals Democratic: Knowing when to listen and ask for input and draws on what others know to make better decisions Affiliative - the realization that having fun together is not a waste of time, but builds emotional capital and harmony

question

How can you recommend a participant use mirrors in the exercise space?

answer

Tell them to use the mirrors to keep an eye on their form, alignment, and posture.

question

General principles involved in each major segment of group exercise

answer

Pre-Class Preparation Warm-up Cardiorespiratory Muscle Strength and Endurance Flexibility/Cool-down

question

A few common principles guiding the warm-up for any group exercise class

answer

Use dynamic movements Movements should focus on rehearsal moves All major muscle groups are addressed through dynamic range of motion (ROM) movements. If stretching, hold briefly (5-10 seconds) Verbal directions are clear and concise and music volume, tempo, and atmosphere are appropriate

question

What are movements that are identical to but less intense than the movements that will be done during the work-out phase?

answer

Rehearsal Moves

question

What is Fartlek training?

answer

It's a form of interval training where the exerciser to change the intensity based on how he or she is feeling.

question

What is Interval Training?

answer

It's a form of cardiorespiratory training where the exerciser alternates working at high and low intensities.

question

In the muscular strength and endurance segment, it is suggested that a GFI should:

answer

Promote muscular balance, functional fitness, and proper progressions Maintain and observe participants' form and offer modifications for those with injuries or disabilities Give visual, verbal, and physical corrections on participant's body mechanics and posture/alignment Use eq safely and effectively Create a motivational and instructional atmosphere

question

What are some muscles that often need strengthening?

answer

Anterior Tibialis Hamstrings Rhomboids/Mid Traps Pec Minor/Lower Traps Shoulder external rotators Triceps Lattisimus Dorsi Gluteals Posterior Deltoid

question

What is proprioception?

answer

Proprioception is your bodies awareness of change in its external environment.

question

What are the sensory receptors in the muscle?

answer

The Golgi Tendon Organ (GTO) and the Muscle Spindles.

question

Posture/Gait muscles that often need strengthening

answer

Abdominals Adductors Abductors Erector Spinae

question

Muscles that often need stretching

answer

Gastrocnemius Quadriceps/iliopsoas Upper traps Hamstrings Pec Major Sternocleidmastoid Anterior/medial deltoids

question

Muscle Group that often needs strengthening AND stretching:

answer

Hamstrings

question

What can the use of 1-3 pound hand weights do to heart rate and O2 consumption?

answer

The use of 1-3 pound hand weights can increase heart rate by 5-10 bpm and O2 consumption by 5-15%.

question

Should you use weights above 3 pounds?

answer

No, because they can put undue stress on the arm and shoulder muscles and wrist and shoulder joints.

question

If using weighted vests during exercise, experts recommend:

answer

That your vest does not exceed 5-10% of your body weight to ensure safety and comfort.

question

What is the myotatic stretch reflex?

answer

It is a muscle contraction in response to stretching a muscle. For instance, if a person overstretches, the muscle shortens to protect itself.

question

How can you help participants enhance their stretching experience?

answer

Remind them of proper posture throughout stretching to promote overall body stability and balance.

question

Besides stretching, what can be included in the flexibility segment of class?

answer

Relaxation and Visualization

question

What is the cognitive domain?

answer

The brain's ability to gather and retain information and knowledge

question

What is the affective domain?

answer

This describes the emotional behaviors, beliefs, and attitudes of the participant. These all shape a person's feelings about exercise, and can be positively affected by the GFI.

question

What is the motor domain?

answer

This refers to those activities requiring movement (learning new motor and breathing skills, which form the basic foundation of exercise classes). Most instructors focus on this domain, but a well-rounded instructor pays close attention to all three domains for a more complete approach.

question

What are the three stages of learning?

answer

Cognitive Associative Autonomous

question

Three techniques GFIs can use to effectively teach a multi-level class:

answer

Motivation - Make the participants feel successful Progression Teaching - Transitioning from simple to compound movements Cueing and Correction - giving feedback.

question

Three steps in giving proper feedback:

answer

First, point out something positive the person is doing. Second, mention the needed correction, known as the performance standard of the movement or exercise. Third, offer positive reinforcement on the immediate correction.

question

When establishing class goals, effective group leaders work ________.

answer

Backwards.

question

The difference between truly amazing classes and mediocre ones usually returns to the topic of:

answer

Planning

question

Another word for the "cool-down" portion of class:

answer

Transition

question

First and foremost, group fitness classes should be arranged to ensure the ______ of __________.

answer

Safety, participants

question

What is "mirroring"?

answer

When an instructor faces the class and teaches by mirroring the movements of the class. I.E., to get the class to lift their left arm, instructor would lift their right arm.

question

The momentary absence of the teacher in front of the room promotes:

answer

kinesthetic awareness

question

What is considered good Pre-Class Leadership?

answer

Arriving to class early in order to access the safety and availability of equipment, checking the music as well as the bass, treble, volume, mic, and connections, and connecting with the participants as they arrive to class, establishing a rapport with them.

question

What are the four questions to ask when you do an exercise evaluation?

answer

What is the functional objective? Which joint actions (and other movements) achieve that objective safely? Does the exercise start from a point of stability and add mobility within a safe ROM? Who are my participants?

question

Name the five Teaching Techniques:

answer

Command Practice Self-Check Reciprocal Inclusion

question

Name the five Teaching Strategies:

answer

Part-to-Whole (isolation before integration) Spatial Simple-to-Complex Slow to Fast (Half-Time) Repetition Reduction

question

A _______ organizes beats into musical _______

answer

meter, patterns

question

A _______ is a group of beats formed by the _______ ________ of a heavy ______ on the downbeat of each group.

answer

measure, regular occurrence, accent

question

In yoga, flexibility, mind-body, and boot-camp classes, music is more of a _________.

answer

Motivator

question

Choose music with a consistent beat in _____-_____ cardiorespiratory training.

answer

Steady state

question

Tempo range for low-to-mid impact aerobics, some dance classes, aquatic and conditioning classes

answer

122-129

question

Tempo range for beginner step classes and low end low-impact classes

answer

100-122

question

"Cross phrases" or "split phrases" are:

answer

When linked movements take more or less than eight counts.

question

Common Group Fitness Safety Recommendations:

answer

Keep all one-legged hopping movements to fewer than 8 Keep high-impact moves to a minimum Lower heels to the floor during most movements Keep cycling RPM under 110 Keep music tempo and volume within industry standards Promote muscular balance in cardio strength, flexibility, and fusion classes Use anticipatory cues prior to movements Pay close attention to the position of the spine in any movement

question

Freestyle Choreography

answer

When an instructor teaches a movement or skill and then changes to a new movement or skill.

question

What is the strictest form of choreography?

answer

Scripted

question

What is the Linear Progression of Cardiorespiratory Choreography?

answer

Base Movement (8 counts of music) Add arms Add direction ------------------------ Change the Legs (16 counts of music) Change the Arms

question

Cueing - what does the acronym STEMS stand for?

answer

Safety - breathing, anatomical, alignment Timing - Numerical, counting, rhythm, tempo Education - Functional purpose, relevance, progressions and regressions Motivation - Positive reinforcement, encouragement, energetic, humor Structure - Cues relating to movements, such as directional and spatial cues, also involving equipment

question

What are the three methods of learning?

answer

Visual, Verbal, Kinesthetic

question

To teach effectively to verbal learners, what can you consider?

answer

Use specific, succinct cues Count down so participants can predict their intensity Take care of your voice - use your diaphragm to project, avoid excessive coughing, and drink plenty of water. Keep music volume low and avoid cueing at inopportune times

question

To teach effectively to visual learners, what can you consider?

answer

Palpate the specific muscle groups you are using Point to the direction you are speaking about Hold up numbers with fingers and incorporate Aerobic Q-signs

question

To teach effectively to kinesthetic learners, what can you consider?

answer

Refer to exercises as to how they should "feel" to the participant Use tactile corrections if you have permission

question

Use the following tips when making corrections in order to create a positive experience for participants:

answer

Cue to the solution, not the problem Cue to the solution in a general sense, then specifically to the person, then use a kinesthetic correction if possible Offer "Level 1" and "Level 3" movements while teaching to the "Level 2" movements rather than use words like "progression", "regression", and beginner, intermediate, advanced. Offer specific and immediate feedback

question

What is adherence?

answer

Voluntary and active involvement in an exercise program

question

What is motivation?

answer

The psychological drive that gives behavior direction and purpose.

question

Transtheoretical Model of Behavioral Change

answer

Pre-Contemplation Contemplation Preparation Action Maintenance

question

Most of the time, GFIs will work with people who are in the _________ stage of the TTM.

answer

Preparation

question

Wolf's Law

answer

Bones will respond to the stimulus places upon them

question

What you should do when a participant is in the contemplation phase of the TTM

answer

Provide opportunities to ask questions and express apprehensions Provide general info about exercise Provide info about different types of activities, fitness facilities, programs, and classes Provide cues for action such as passes to nearby facilities and invitations to open houses, tours, or information sessions

question

What you should do when a participant is in the maintenance phase of the TTM

answer

Identify early stages of staleness to prevent burnout Create reward systems of continued adherence Keep exercise environment enjoyable to fight boredom Provide continued education about barrier identification Maintain social support from family and friends and from within the exercise environment

question

What variables are under the Personal Attributes factors influencing exercise participation and adherence?

answer

Demographic Variables Activity History Biomedical Status Psychological Traits Knowledge, Attitudes, and Beliefs

question

People who have internalized motivation for exercise benefits are said to have __________ __________ and often don't actually enjoy the exercise itself.

answer

integrated regulation

question

Positive thinking is an important precursor to __________.

answer

Motivation

question

In the exercise context, self-efficacy is:

answer

The belief in one's own capabilities to successfully engage in a physical activity program.

question

Characteristics of an Ideal Group Fitness Instructor

answer

Punctuality and Dependability Professionalism Dedication Willingness to Plan Ahead Willingness to Take Responsibility Recognizing the signs of instructor burnout Good communication skills and sensitivity to participants' needs

question

Participants can be taught goal-setting strategies by applying SMART goals. What does this stand for and mean?

answer

S - Specific - What will you do, when, where, and with whom? M - Measurable - How will you know when you have reached your goals? A - Attainable - Can you perform this exercise/goal at this time? R - Relevant - Are your goals relevant to your needs, interests, and abilities? T - Time-bound - How soon, how often, for how long?

question

Signs of Exercise Dependence:

answer

Continuing to exercise despite injuries or illness Extreme levels of thinness Guilt, irritability, and depression when unable to exercise

question

The National Association of Anorexia Nervosa and Associated Disorders recommends you should approach someone you suspect has an eating disorder with what method?

answer

CONFRONT C - Concern O - Organize N - Needs F - Face the confrontation R - Respond O - Offer (help and suggestions) N - Negotiate (another time to talk) T - Time (problem won't be fixed overnight)

question

What do beta blockers do and what special population would take them?

answer

Beta blockers blunt the heart rate and people with Coronary Heart Disease are the most commonly prescribed.

question

What disorder is an important risk factor for myocardial infarction, stroke, and sudden death?

answer

Hypertension

question

What challenges are presented when exercising with excessive amounts of body fat?

answer

More stress on joints and muscles Individuals are most likely under-conditioned

question

Number one priority when instructing obese participants and how this can be prevented:

answer

Keeping the activity at an intensity levels that does not cause pain and soreness. Using a variety of activities that use the arms and legs together and emphasize low-intensity, high-duration activities.

question

Five Key Benefits of physical activity programs for children:

answer

Decreased feelings of depression and anxiety Decreased risk of Type 2 diabetes Decreased risk of hypertension and high blood pressure in youth Increased lean muscle and reduces fat Helps strengthen and maintain healthy joints, bones, and muscles

question

Seven considerations when creating exercise programs for participants with diabes:

answer

Know the timing and of medication Know the type of medication Make sure blood glucose levels are above 100/less than 300 before exercise Know timing of last meal and amount/type of food Be aware of the intensity, duration, and type of exercise the person can perform Be aware of secondary medications

question

The most common approaches for the management of risk potential are:

answer

Avoidance - (activity judged too hazardous) Reduction (make changes that render activities safer) Retention (risks of physical activity should result in minimal potential damage) Transer - (risk of participation is transferred to another party through a waiver or insurance)

question

Four strategies to increase class value:

answer

Music - Use music as motivation. Perceived effort and endurance increase up to 15% Exercise/Choreography Selection - Cont. education to refresh moves, learn new techniques, learn from other GFIs Equipment - Use new eq, use a variety, don't use too much and risk confusing/intimidating participants Member Interaction - Create bonds with partner exercises, encourage buddying up, create bonds by making eye contact, greeting participants

question

What are the three types of muscle tissue?

answer

Skeletal Smooth Cardiac

question

The sense of knowing where the body is in relation to its various segments and the external environment

answer

Proproception

question

The overall function of the nervous system:

answer

Collects information about conditions in the body's external state Analyzes the information Initializes appropriate responses to fulfill specific needs

question

Axial skeleton is comprised of __ bones.

answer

question

What are the axial skeleton's primary functions?

answer

To protect the nervous system To provide the main axial support for the body

question

How many bones are in the human skeleton total?

answer

206

question

What primary functions does the human skeleton perform?

answer

Support Movement Protection Storage Hemopoiesis

question

Hemopoeises

answer

The formation of blood cells

question

Four important functions of the lymphatic system:

answer

Destruction of bacteria and other foreign substances in lymph nodes Specific immune responses that aid in manufacturing antibodies to destroy bacteria and foreign substances Returns interstitial fluid to the bloodstream Prevents excessive accumulation of tissue fluid and proteins by draining into highly permeable lymphatic capillaries in the connective tissues

question

The digestive system carries out six basic processes:

answer

Ingestion of food into mouth Movement of food along the digestive tract Mechanical preparation of food for digestion Chemical Digestion of food Absorption of digested food into the circulatory and lymphatic systems Elimination of indigestible substances and waste products from the body by defecation

question

What system provides a means to replace oxygen and remove carbon dioxide from the blood?

answer

The respiratory system (what it provides for the body)

question

During exercise, the respiratory system regulates ____-____ balance.

answer

acid-base (what system regulates this balance during exercise)

question

The Cardiac Cycle

answer

The period from the beginning of one heartbeat to the beginning of the next.

question

The cardiovascular system is also called:

answer

The circulatory system (another name for it)

question

The ____________ system and the ___________ system work with each other to deliver oxygen and nutrients to the body's tissues.

answer

cardiovascular, respiratory (what do they do in tandem with each other)

question

Describe the Transverse Plane and name some common exercises that take place within the plane

answer

The transverse plane is divides the body into top and bottom halves. Horizontal wood chops, helicopters, and standing flys

question

Rotational Movement occurs in what plane?

answer

This type of movement occurs in the Transverse Plane

question

Describe the Frontal Plane and name some common exercises that take place within the plane

answer

The front plane divides the body into front and back halves. Hip abduction (side leg lifts), dumbbell lateral (side) raise

question

Lateral Movement occurs in what plane?

answer

This type of movement occurs in the Frontal Plane

question

Describe the Sagittal Plane and name some common exercises that take place within that plane

answer

The Sagittal Plane divides the body into left and right halves. Front or back leg lifts, bicep curls, front and back lunges

question

Forward and backward movements occur in what plane?

answer

This type of movement occurs in the Sagittal Plane

question

What are the three planes of movement?

answer

Sagittal Frontal Transverse

question

A participant is performing a bench press. What type of kinetic chain movement is this, and in what plane of movement does the exercise occur?

answer

This exercise is an open-chain movement and it occurs in the transverse plane.

question

How is an open-chain movement described?

answer

A movement where the distal aspect of the extremity moves freely and is not fixed to an object

question

How is a closed-chain movement described?

answer

A movement where the distal segment meets considerable external resistance and restrains movement.

question

Which chain of movement is more functional for daily living and also is more stable for joints?

answer

Closed-chain movement

question

A participant is performing forward lunges. What chain of movement is this categorized under and in what plane is it occurring?

answer

This type of movement is a closed-chain movement and it occurs in the sagittal place.

question

What are the three systems that synthesize ATP in our bodies during exercise?

answer

Phosphagen Anaerobic Aerobic

question

A long-distance runner would be pulling from what source of ATP in his or her body?

answer

This kind of athlete would primarily use the Aerobic System to synthesize ATP

question

For 100 meter sprinters or a gymnast performing on the vault, what system would he/she be using in his/her body to produce ATP?

answer

These are examples of athletes that would use the Phosphagen system to synthesize ATP

question

What system synthesizes ATP at a somewhat slow rate, lasting for anywhere between one to three minutes of energy?

answer

Anaerobic System

question

Steps to take if you suspect a fracture:

answer

Keep victim still to prevent movement of or weight bearing on injured part Remove clothes from injury to allow assessment of severity and prevent contamination Cover open fractures with sterile gauze or clean cloth. Activate EMS and have victim lay down. Leave protruding bones alone If victim must be transported, make a splint. If extremity is grossly deformed, just prevent the limb from moving

question

What is an isometric contraction?

answer

Holding the muscles still while resisting gravity or external resistance

question

What are the 4 types of shock?

answer

Hypovolemic - caused by severe bleeding Obstructive - caused by something obstructing blood flow to the heart like a blood clot Distributive - caused by abnormal blood distribution through dilated blood vessels, like from an allergic reaction/spinal injury Cardiogenic - failure of heart to pump effectively, like cardiac arrest or cardiomyopathy

question

Considerations when teaching participants with MS:

answer

Treatment strategy aims to slow the progression of disease Allow more time for the start and completion of movements Incorporate stretching as a major portion to combat spasticity Balance becomes an issue/ ensure precautions to prevent falling As balance worsens, create exercises that can be done sitting Swimming in water below 80 degrees is very beneficial; warmer water can cause premature fatigue Avoid high heat and humidity Void the bladder often, as bladder control worsens with MS

question

General Exercise Recommendations for Older Adults

answer

Design interventions that can be reproduced at home Tailor the interventions to performance needs, goals, health, and cognitive conditions Provide reinforcement for participant's progress Incorporate the key components of physical activity for elderly people: Endurance, strength, balance, flexibility

question

Benefits of exercise in pregnant women

answer

Improved posture and body mechanics Reduced pelvic and rectal pressure Increased energy levels Improved circulation

question

Considerations for those exercising with strains:

answer

Gentle stretching before and after exercise Avoid strenuous and ballistic moves Gradually increase the intensity of the activity Keep movements to a pain-free ROM Monitor for return in symptoms or increase in severity

question

How cost per head is calculated. What is this a component of?

answer

Divide the instructor's pay rate per class by the number of class participants. This is a component of Class Value.

STUDY

Coronary Artery Disease High Fiber Diet Human Life Span Long Term Memory Low Self Esteem Non Hispanic Whites People With Diabetes Sociology of Aging

Adult Developmental test 2 171 terms

John Smith

171 terms

Preview

Adult Developmental test 2

question

The absolute human life span is considered to be______ years.

answer

120

question

According to your text, ______ and _______ have longer life expectancies after the age of 65 than Americans.

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Japanese and French

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All of the following are observable body changes correlated with aging EXCEPT

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body cells absorb more calcuim

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Presbyopia is a condition in which______ is impaired

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near vision

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All of the following decrease with age EXCEPT

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reflex action

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Which group has a 30% higher risk of death than the white population?

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Black

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Which of the following statements more accurately depicts health status of older Americans today?

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Those over age 75 have noticeable physical declines compared with middle-age.

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___ percent of Americans 65 and over live successfully or nearly successfully in the community

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The majority of non institutionalized elders in the U.S. have

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relatively minor chronic conditions

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ADLs includes what tasks?

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washing, feeding, and dressing

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The major killing disease in the U.S. and other industrialized countries is?

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Coronary artery disease

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Artheroschlerosis occurs when

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fat and cholesterol crystals accumulate on the walls of the arteries.

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Which of the following contributes to atherosclerosis?

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high cholesterol and blood pressure A diet high in refined sugars and saturated fats obesity and stress

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An infarct is

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dead heart tissues due to deficient blood supply

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Gender comparisons regarding heart attacks show

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women are more likely to die from a heart attack

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Thrombosis is closely associated with

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Atherosclerosis

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What factor causes an increased risk of developing osteoporosis?

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large body frame

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What is considered as the risk factor for developing coronary heart disease?

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Excess body fat

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The most common cause of accudental death among the elderly is

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Falls

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Treatments for osteoarthritis include

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exercise anti inflammatory drugs and steroids reduction of strain

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The type of arthritis that most often poses problems for those 65 and older is

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osteoarthritis

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Osteoarthritis that occurs late in life is most likely to be

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in the large or overused joints

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Bone loss from inadequate diet, reduced calcium absorption efficiency, and inadequate physical activity can result in a condition called

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osteoporosis

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All of the following are believed to be causes of osteoporosis EXCEPT

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testosterone deficiency

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Among older adults falls are the most common cause of accidental death. Other major causes include

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Suffocation from objects ingested and burns

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Obesity increases problems off

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heart disease diabetes hypertension

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Senescence refers to

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onset of the degenerative process associated with age

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The life expectancy for a child born today is about

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80 years

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A major study of those over 100 years of age found that they died of organic failure due to all of the following EXCEPT

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old age

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Damage theories are based on the idea that

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Aging is the result of accumulated errors

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Our \"biological clock\" beings at

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Conception

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_____ theories of aging propose that as people age they develop a greater capacity to produce antibodies that destroy even normal cells

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Autoimmune

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____ theory of agin proposes that irreplaceable body parts simply wear out

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Cellular wear and tear

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Free radicals are

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highly reactive molecules that mangle vital enzymes and membranes

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Studies of caloric restriction and longevity in animals show that

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With caloric restrictions animals live longer and have a lower incidence of heart disease and cancer

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A nutritional study of elderly sportsmen demonstrated a correlation between maximum oxygen uptake as a measure of physical fitness and

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Vitamin C

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A high fiber diet protects an individual against what ailment(s)

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Constipation and intestinal disease gallstone and cancer diverticulitis

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All of the following factors contribute to nutritional difficulties for the very old EXCEPT

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high levels of cholesterol

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Because of reduced kidney function, elders should eat less______ to avoid kidney strain

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protein

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Exercise for people in late life is

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contributes to health even if not begun until later life

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According to your text, what kind of exercise is specifically stated to benefit the elderly?

answer

Strength training and flexibility excercises

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A longitudinal study of health and lifestyles of Harvard men found

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humility caused them to be healthy and lived longer

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A longitudinal study of master athletes predicts that athletic performance will not decline significantly until age

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question

Which of the following personality traits is LEAST likely to be life shortening?

answer

extrovertion

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A shortened life is statistically correlated with all the following EXCEPT

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divorce in women

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A study of centenarian cited in your text described them as

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having a high intake of saturated fats

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Absolute human life span is the maximum chronological age that a human can live

answer

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Presbyopia is a heart condition

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question

With aging, the body's immune system increases in its capacity to protect a person from disease

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Acute diseases decline with age

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Most of the major health problems of old age result from the aging process, rather than the presence of diseases

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A high waist-to-hip ratio of excess body fat was more strongly related to coronary heart disease among men than uniform excess weight over the body

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Coronary disease results in deficient blood supply to the heart

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question

Some general causes of cancer include an excess amount of fluid ingested

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A recent study of elders with cancer showed cancer substantially reduced their physical function

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question

Rheumatoid arthritis and gout are rare and more painful than just the general arthritis

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New bone formation is stimulated by medication and diet

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question

Cell damage is mainly due to changes in one dominate tissue

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Scientists believe that low caloric intake helps protect the immune system

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question

Women are more likely to live in poverty and have fewer chronic illness that men

answer

question

Physicians believe strength-training is inappropriate for elderly over 75 years old

answer

question

What factors cause depression in older adults?

answer

fear of death and constant pain lost of self esteem and confidence medications

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Metamory is

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a self appraisal or self monitoring of memory

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The five senses generally

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lose their sharpness with age

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Sensory memory

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takes in information so rapidly that most of it gets lost

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Selective attention involves

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focusing attention on certain stimuli and inhibiting responses to irrelevant information

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When comparing older and younger adults in task performances, studies have found

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older individuals are more distracted and unable to disregard clutter of irrelevant information

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_____ is the process of evaluating the sensory information carried to the brain

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Perception

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Differences in perception among age groups

answer

are frequently reported may be due to differences in social isolation may be caused by biological changes

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Which of the following illustrate motor performance?

answer

pressing a button to turn on a television

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Which of the following is LEAST likely to be affected by psychomotor speed?

answer

Recalling a happy event

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Reaction time

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differs depending on the task and not the age

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Cognitive pragmatics refers to

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knowledge and life experience

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Which of the following activities is most likely to increase reaction time?

answer

Aerobic exercise

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Which of the following is NOT a dimension of intelligence conceptualized by Guilford?

answer

Sensory memory, psychomotor speed, and reaction time

question

Measures of intelligence have ben criticized as being ageist because they

answer

are inadequate to measure applied knowledge

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The Wechsler Adult Intelligence test

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compensates for increasing age

question

Fluid intelligence measures

answer

innate ability to process information

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Crystalized intelligence is

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the measure of knowledge acquired through experience and education

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Longitudinal studies of IQ have found that_____ remain stable with time.

answer

Verbal skills

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Research suggests decline in intelligence begins to take on significance in the

answer

70s

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Evidence suggests the most age sensitive mental ability is

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perceptual speed

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Which of the following is more likely to be a problem with a cross sectional, than a longitudinal study?

answer

younger generations do not do as well on standardized tests.

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The theory of terminal decline or terminal drop proposes

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a precipitous decrease in cognitive functioning occurs one or two years before death.

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Which of the following is LEAST likely to hinder the learning old older adults?

answer

self-pacing

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Once information is transferred to _______, people of all ages are able to recall it.

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Primary memory

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Working memory refers to

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processing of sensory stimuli to give meaning and transfer to long term storage.

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Which of the following is most likely to illustrate tertiary memory?

answer

your sisters's birth

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_____ shows little change with age

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Primary memory

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Being unable to remember a phone number given to you orally long enough to dial the number illustrates a failure of

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Working memory

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TOT, \"Tip of the tongue\" syndrome refers to

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on the verge of recalling a name, date, or event and unable to do it

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In which kind of memory test are older people likely to do as well as if not better than younger people?

answer

tests of recognition

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Studies of long term memory have found age differences in

answer

perceptual speed of memory retrieval

question

Symptoms of senility are LEAST likely to be due to

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the biological aging process

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Functional disorders

answer

are of psychological, not physical, origin

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When a person who fears being robbed or mugged will not leave home, gets dozens of locks, and constantly checks them, he or she is most likely to suffer from

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Generalized anxiety disorder

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Constantly washing one's hands is a symptom of

answer

obsessive-compulsive disorder

question

Recent studies reveal that

answer

one or two percent of older adults are clinically (severely) depressed

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If a person is lethargic, has low self-esteem, and finds life confusing they may have which type of disorder?

answer

Affective disorder

question

The ______ personality tends to be a solitary person who lacks the capacity for warm, close social relationships

answer

introverted

question

Affective disorders

answer

are mood disorders

question

Speaking a language that seems to be self expression of disturbance in behavior is most likely to be a symptom of

answer

schizophrenia

question

All of the following characterize dementia EXCEPT

answer

it is a normal part of the aging process

question

A lack of awareness of oneself or one's surroundings is called

answer

delirium

question

Multi-infarct dementia (MID)

answer

rises from problems with blood flow to the brain

question

Dementia from _____ may result from lack of vitamin B12

answer

alcoholism

question

Examination of psychiatric services for the elderly in U.S. and Canada reveal all of the following EXCEPT

answer

psychiatric services for elders are more accessible in the United States because of universal health insurance.

question

Older adults are likely to have incorporated ageist beliefs about memory

answer

question

Memory starts our as a thought of recall

answer

question

Sensory threshold is the minimum intensity of a stimuli required for a person to perceive it

answer

question

The classic aging pattern is high verbal scores and declining performance scores of older adults

answer

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If someone can not remember something, it means learning has not adequately occured

answer

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T.O.T states for Top of the Tongue syndrome

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If used, memory will be maintained or even improve as an individual grows older.

answer

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Senility is an inevitable consequence of growing old

answer

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Most people over 65 who suffer from depression are not receiving and formal psychiatric treatment

answer

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Hypochondria is an indicator of emotional problems

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question

The most common form of chronic organic brain disease is Parkinson's disease

answer

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The incidence of Alzheimer's disease is increasing

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Alcoholism can lead to dementia

answer

question

Huntington's disease symptoms are very similar to Alzheimer disease symptoms

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question

Parkinson's disease is more common among women than men

answer

question

Which of the following illustrates a change in the American family today?

answer

The post parental stage of life lasts longer

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Bonds between___ tend to be second only to mother-child ties in intensity and complexity

answer

siblings

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The authors of your text predict that

answer

the family support system will become smaller

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A review of previous research on siblings contact reveals

answer

siblings generally maintain contact with each other

question

Research reports the bond of siblings to be_____ than in the past

answer

more forgiving

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Having more sisters in a family

answer

increases the level of care to the parents

question

Kin relationships in white-collar families differ from those of blue-collar families in which of the following ways?

answer

White collar families are more likely to geographically scattered

question

Urban elders, in contrast to rural elders

answer

interact more with their children

question

The _____ generation family is becoming common in the current population

answer

question

Reasons grandparents become parents to grandchildren, according to the text include all of the following EXCEPT

answer

parents death

question

Grandparents who have taken responsibility for raising their grandchildren are likely to experience all of the following EXCEPT

answer

stress from having little contact with the child's parent

question

Research suggests that, compared to grandparents in other societies, American grandparents

answer

play a background, supportive role, especially in times of crisis

question

Studies of grandparents whose children have divorced show

answer

about half were friendly with their child's former spouce

question

in a study by Dorothy Apple it was learned that the relationship between grandparents and grandchildren tended to be ______ and ______ in household where grandparents retained little control

answer

Friendly; informal

question

Legal visitation rights between grandparents and grandchildren

answer

are generally permitted if provisions for visiting the grandparents were made prior to the divorce

question

Studies of friendship among the elderly have found

answer

most elderly friends keep in touch weekly

question

Studies of equity and morale have found

answer

the equitably benefited women had the highest morale

question

In elderly women's friendship networks

answer

the essential elements of friendship-- understanding, affection, trust, and acceptance-- endure over time

question

According to your text, a confidant is described as

answer

someone to confide in and share personal problems

question

According to your text, a companion is defined as

answer

someone who regularly shares in activities with you

question

The elderly are most likely to join a

answer

lodge or fraternal organization

question

Studies of voluntary particular that controlled for social class found

answer

being a \"joiner\" is related to middle or upper class lifestyle, and aging does not necessarily change this lifestyle

question

Most senior centers operate under

answer

churches and unions

question

Which statement is correct about senior centers

answer

There will soon be one in every community

question

A convoy is

answer

a network of supportive family and friends

question

Studies of convoys found

answer

some people drop out and others join the convoy after it has begun

question

Women are most likely to be keepers of the networks of older people for all of the following reasons EXCEPT

answer

Elders tend to be both geographically closer to the women in their networks

question

The femaleness principle refers to the

answer

more central roles of women in the network of unmarried people

question

Religiosity refers to

answer

interaction with organized religion

question

Spiritual well being refers to

answer

having a psychological sense of purpose and meaning

question

A study of elderly people coping with cancer found hope and more positive mood states were associated with

answer

high intrinsic religiosity

question

Which ethnic group was found to traditionally use the church as a powerful source of social support?

answer

African Americans

question

People age 65 or older are

answer

most likely of any age group to belong to church-affiliated organizations

question

What are some of the factors that discourage remarriage in old age?

answer

pressure from children respect for the deceased spouse fear of ridicule

question

Later life tends to become isolated and stagnant for most elders

answer

question

Marriages are likely to last 40 to 70 years

answer

question

A persons confidant in life is typically a close friend, not a family member

answer

question

A persons relationship with siblings is likely to be the longest relationship in an individuals life

answer

question

The baby boomers will be the first cohort in history that has less offspring than siblings

answer

question

In terms of level of obligation within the family, siblings ties are more binding than that of marriage of parent to child

answer

question

Females maintain closer relationships with family members than do males

answer

question

The typical time for coming a grandparent is old age

answer

question

Women are more likely than men to look forward to the role of grandparent

answer

question

For some grandparents, stepgrandchildren are treated as biological grandchildren

answer

question

Older Americans are still likely to live in the communities in which they raised their children

answer

question

A companion is someone to confide in and share personal problems with

answer

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Social networks relate to how many online networks one is associated with

answer

question

Elders benefit from services of religion groups that minister to the needs of the sick, frail, disables, and homebound

answer

question

Religion is the fundamental motive for living of the intrinsically religious

answer

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