Health 21 chapter 12, 13, 16

key components of "self-care"

- Diagnosing symptoms or conditions that occur frequently but do not require physician visits (e.g., the common cold, minor abrasions.) - Using over-the-counter remedies to treat mild, infrequent, and unambiguous pain and other symptoms. - Performing first aid for common, uncomplicated injuries and conditions - Having periodic checks for blood pressure, blood glucose, blood lipids, or other levels as prescribed by a physician. - Learning from reliable self-help books, websites, and videos - Performing meditation or other relaxation techniques - Maintaining a healthful diet, getting adequate rest, and exercising an appropriate amount

Modifiable risk factors for CVD

1) Avoiding tobacco use 2) Sufficient physical activity and exercise 3) Not consuming saturated and trans fat in diet 4) Controlling diabetes 5) Controlling blood pressure 6) Managing stress 7) Maintaining healthy body weight 8) Healthy diet 9) Adequate amount of sleep 10) Limited alcohol use

Non-modifiable risk factors for CVD

1) Hereditary 2) Age 3) Gender 4) Race and ethnicity

Prediabetes

A condition that involves higher than normal blood glucose levels, but not high enough to be classified as diabetes. Prediabetes is clearly linked to lifestyle, including overweight and obesity profiles constituting metabolic syndrome, a cluster of risk factors that contribute to several health problems. A person with metabolic syndrome is five times more likely to develop type 2 diabetes than is a person without it.

Acquired immunodeficiency syndrome (AIDS)

A disease caused by a retrovirus, the human immunodeficiency virus (HIV), that attacks the immune system, reducing the number of helper T cells and leaving the victim vulnerable to infections, malignancies, and neurological disorders.

Epidemic

A disease outbreak that affects many people in a community or region at the same time.

Physician assistant (Primary care practitioner)

A medical practitioner whom you can visit for routine ailments, preventative care, general medical advice, and appropriate referrals.

incidence of the major sexually transmitted infections

Although more than 20 million cases of sexually transmitted infections (STIs) are reported each year, many others are never diagnosed or reported, often because the people who are infected are asymptomatic.

Hypercholesteremia

An inherited condition in which cells lack LDL receptors, which leads to high blood cholesterol and early heart attack.

Carpal tunnel syndrome

An occupational injury in which the median nerve in the wrist becomes irritated, causing numbness, tingling, and pain in the fingers, wrists, and hands.

Allergic Response

Antibodies trigger the release of histamine, a chemical that dilates blood vessels; increases mucus secretions; causes tissues to swell; and produces rashes, difficulty breathing, and other allergy symptoms. Sometimes anaphylaxis can result.

Antigen

Any substance that is capable of triggering an immune response-a virus, a bacterium, a fungus, a parasite, a toxin, a tissue or cell from another organism, or even chemicals from the environment.

Hypertension

Blood pressure is a measure of how hard blood pushes against the walls of vessels as your heart pumps. Sustained high blood pressure is called hypertension.

Carcinoma

Epithelial tissues (tissues covering body surfaces and lining most body cavities) are the most common sites for cancers called carcinomas. These cancers affect the outer layer of the skin and mouth as well as the mucous membranes. They metastasize through the circulatory or lymphatic system initially and form solid tumors.

Congestive heart failure

Heart failure, or congestive heart failure is an abnormal cardiovascular condition that reflects impaired cardiac pumping and blood flow; pooling blood leads to congestion in body tissues.

Antibody

Immune-system proteins that are individually matched to specific antigens.

Modifiable (controllable) risk factors for staying healthy and combatting infectious diseases

Lack of stress, healthy diet, a high fitness level, adequate sleep, not misusing or abusing drugs, good personal hygiene, and protected sex are modifiable risk factors for staying healthy and combating infectious diseases.

cancer with the highest mortality rate in men and women

Skin cancer is the #1 cancer in men and women.

differences between a physician, registered nurse, nurse practitioner and a physician assistant

The difference between a registered nurse and a nurse practitioner is that a nurse practitioner is a nurse with advanced training and authority to conduct diagnostic tests and prescribe medications (in some states).

Cluster headaches

The severe pain of a cluster headache has been described as "killer" or "suicidal." Usually, these headaches cause excruciating, stabbing pain on one side of the head, behind the eye, or in one defined spot. Fortunately, cluster headaches are relatively rare, though adults between the ages of 20 and 40 tend to be particularly susceptible.

Human Immunodeficiency virus (HIV)

The virus that causes AIDS by infecting helper T cells.

signs and symptoms of asthma

Tiny airways in the lungs overreact with spasms, resulting in wheezing, difficulty breathing, shortness of breath, and coughing spasms.

Ischemia

When circulation is impaired and blood flow to the heart is limited, the heart may become starved for oxygen-a condition commonly referred to as ischemia.

Immunity

a condition of being able to resist a particular disease by counteracting the substance that produces the disease.

Candidiasis

a fungal disease, also sometimes called moniliasis or a yeast infection.

Asthma

a long-term, chronic disorder that inflames and blocks lung airflow.

Hypotension

abnormally low blood pressure

Chlamydia

an infection caused by the bacterium Chlamydia trachomatis, is the most commonly reported STI in the United States.

Syphilis

caused by a bacterium called Treponema pallidum.

Trichomoniasis

caused by a protozoan, Trichomonas viginalis.

Gonorrhea

caused by the bacterial pathogen Neisseria gonorrhoeae.

Allergies

characterised by an overreaction of the immune system to a foreign protein substance (allergen or antigen) that is swallowed, breathed into the lungs, injected or touched. When foreign pathogens such as bacteria or viruses enter the body, the body responds by producing antibodies to destroy them. Although antibody production is normally a good thing, however sometimes the body develops an overly elaborate protective mechanism against relatively harmless substances.

Herpes

general term for a family of infections characterized by sores or eruptions on the skin caused by the herpes simplex virus.

A1C or glycosylated hemoglobin test (HbA1C)

gives the average value of a patient's blood glucose over the past 2 to 3 months instead of just at one moment in time. In general, an A1C of 5.7 to 6.4 means a high risk for diabetes or prediabetes. If A1C is 6.5 or higher, then diabetes may be diagnosed. Estimated average glucose (eAG) shows how A1C numbers correspond to blood glucose numbers. For example, someone with an A1C value of 6.1 would be able to look at a chart and see that his or her average blood glucose was around 128-a high level that should prompt healthy lifestyle modifications.

Benign Tumors

harmless, noncancerous tumors

Bronchitis

involves inflammation and eventual scarring of the lining of the bronchial tubes (bronchi) that connect the windpipe to the lungs. When the bronchi become inflamed or infected, less air flows from the lungs, and heavy mucus begins to form.

Emphysema

involves the gradual, irreversible destruction of the lungs' alveoli (tiny air sacs through which gas exchange occurs). As the alveoli are destroyed, the affected person finds it increasingly difficult to exhale.

Pubic lice

often called "crabs," are small parasitic insects that are usually transmitted during sexual contact.

Human Papillomavirus (HPV)

one of a group of over 150 related viruses-each of which has a number indicating its type. HPV is the type that causes genital warts (also known as venereal warts or condylomas).

Bacteria

simple, single-celled organisms. There are three major types of bacteria, classified by shape: cocci, bacilli, and spirilla. Although there are several thousand known species of bacteria, they (and the toxins they produce) cause just over 100 human diseases.

Protozoans

single-celled organisms that cause diseases such as malaria and African sleeping sickness. These diseases are largely controlled in the U.S., though a common waterborne protozoan disease in many regions of the country is giardiasis. People who drink contaminated water may be exposed to the giardia pathogen and will suffer intestinal pain and discomfort weeks after initial infection. Protection of water supplies is the key to prevention.

Virulence

strong enough to overcome host resistance and cause disease

Cardio metabolic risk

the combined risks that indicate physical and biochemical metabolic changes that can lead to both CVD and type 2 diabetes. Some of these risks result from choices and behaviours and therefore are modifiable. Others are inherited or intrinsic (such as age and gender) and can't be modified

Malignant Tumors

very dangerous or harmful; refers to a cancerous tumor.

health complications of poorly controlled diabetes

- Diabetic coma: A coma from high blood acidity known as diabetic ketoacidosis can occur when, in the absence of glucose, body cells break down stored fat for energy. The process produces acidic molecules called ketones. Too many ketones can raise blood acid level dangerously high. The diabetic person slips into a coma and, without medical intervention, will die. - Cardiovascular disease: Because many diabetics are also overweight or obese, hypertension is often present. Blood vessels become damaged, and essential nutrients and other substances are not transported as effectively. - Kidney disease: Diabetes is the leading cause of kidney failure. The kidneys become scarred by overwork and high blood pressure. - Amputations: An impaired immune response, damaged blood vessels, and neuropathy in hands and feet makes it easier for people with diabetes not to notice injury until damage is extensive. Lack of circulation increases risk of infection and difficulty of treatment, leading to tissue death and amputation. - Eye disease and blindness: High blood glucose levels damage microvessels in the eye, leading to vision loss. Dry eyes and infections are also common. - Infectious diseases: People with diabetes have increased susceptibility to infectious diseases, particularly influenza and pneumonia. - Tooth and gum diseases: People with diabetes are more susceptible to bacterial infections of the mouth that can lead to gingivitis (an early stage of gum disease) and periodontitis-a more serious inflammation of the gums that can lead to decay, tooth loss, and a variety of other health risks. - Other complications: Many people with diabetes suffer from nerve damage known as diabetic neuropathy, which can be extremely painful and cause difficulty driving, walking and other activities. About half of all people with diabetes have some degree of nerve damage. People with diabetes are more likely to suffer from depression, making intervention and treatment more difficult, and depressed individuals are more likely to develop type 2 diabetes.

risks factors for developing cancer

- Smoking is associated with increased risk of at least 15 different types of cancer including liver cancer, colorectal polyps, oral cancer, and colorectal cancer. - Alcohol can be a risk factor for cancer, particularly cancers of the oral cavity and pharynx, esophagus, colon and rectum, liver, larynx, and female breast. Moderate to high levels of drinking are associated with pancreas and prostate cancer and melanoma. - Poor nutrition, physical inactivity, and obesity contribute to nearly one-third of annual cancer deaths in the U.S. A high BMI correlates with deaths from cancers of the esophagus, colon, rectum, liver, stomach, kidney, pancreas, and others, as well as a high risk of endometrial cancer among younger women age 18 to 25 with higher BMIs and rapid weight gain. - Stress and Psychosocial Risks: People under chronic, severe stress or who suffer from depression or other persistent emotional problems show higher rates of cancer than healthier counterparts because of weakened immune system. - Genetic and Physiological Risks: Scientists believe that between 5 and 10 percent of all cancers are strongly hereditary. Certain cancers, particularly those of the breast, stomach, colon, prostate, uterus, ovaries and lungs appear to run in families. - Reproductive and Hormonal Factors: Increased numbers of fertile or menstrual cycle years (early menarche, late menopause), not having children or having them later in life, recent use of birth control pills or hormone replacement therapy, and opting not to breast-feed all appear to increase risks of breast cancer. - Inflammation and Cancer Risks: According to some researchers, the vast majority of cancers (90%) are caused by cellular mutations and environmental factors that occur as a result of inflammation. - Occupational and Environmental Risks: Several workplace hazards are known to cause cancer when exposure levels are high or prolonged. Asbestos (a fibrous material once widely used in the construction, insulation, and automobile industries), nickel, chromate, and chemicals such as benzene, arsenic, and vinyl chloride have been shown to be carcinogens. - Radiation: Ionizing radiation (IR)-radiation from X-rays, radon, cosmic rays, and ultraviolet radiation (primarily ultraviolet B, or UVB, radiation)-is the only form of radiation that has been proven to cause human cancer. Radon exposure in homes can increase lung cancer risk, especially in cigarette smokers. - Chemicals in Foods

signs and symptoms of type 1 and type 2 diabetes

- Thirst: The kidneys filter excessive glucose by diluting it with water. This can pull too much water from the body and result in dehydration. - Excessive urination: For the same reason, the person with diabetes feels an increased need to urinate. - Increased hunger: Because so many calories are lost in the glucose that passes into the urine, a person with diabetes often feels hungry. - Weight loss: Despite eating more, weight loss is typical - Fatigue: When glucose can't enter cells, fatigue and weakness occur - Nerve damage: A high glucose concentration damages blood vessels, including those that supply the nerves in the hands and feet. This can cause numbness and tingling in the extremities. - Poor wound healing and increased infections: High levels of glucose can affect the body's ability to ward off infections and overall immune system.

Type 1 Diabetes

A form of diabetes mellitus in which the pancreas is not able to make insulin, and therefore blood glucose can't enter the cells to be used for energy. The more serious and less prevalent form of diabetes, called type 1 diabetes, called type 1 diabetes (T1D) (or insulin-dependent diabetes), is an autoimmune disease in which the individual's immune system attacks and destroys the pancreas's insulin-making cells. This causes a dramatic reduction or total cessation of insulin production. Without insulin, cells can't take up glucose, leaving blood glucose levels permanently elevated. Only about 5% of diabetic cases are type 1. People inherit a predisposition to type 1 diabetes, and something in the environment triggers it. Type 1 diabetes is more common in predominantly white European populations, people with a genetic predisposition, those living in cold climates, children who are not breastfed, and people with a history of certain viral infections. People with type 1 diabetes require daily insulin injections or infusions and must carefully monitor their diet and exercise levels. They often face particular challenges as the lesser-known diabetic type, with fewer research funds available and fewer treatment options.

Pandemic

A global epidemic of a disease

Metabolic syndrome

A group of metabolic conditions occurring together that increase a person's risk of heart disease, stroke and diabetes. Three or more of the following risks can make someone diagnosable with metabolic syndrome: 1) Abdominal obesity (waist measurement of more than 40 inches in men or 35 inches in women) 2) Elevated blood fat (triglycerides greater than 150) or on drug treatment for elevated triglyceride 3) Low levels of HDL ("good") cholesterol (less than 40 in men and less than 50 in women) or on drug treatment for HDL reduction 4) Elevated blood pressure greater than 130/85 mmHg or on drug treatment for blood pressure reduction 5) Elevated fasting glucose greater than 100 mg/dL (a sign of insulin resistance or glucose intolerance) or on drug treatment for elevated glucose

Nurse practitioner

A nurse with advanced training obtained through either a master's degree program or a specialized nurse practitioner program. Nurse practitioners have the advanced training and authority to conduct diagnostic tests and prescribe medications (in some states). They work in a variety of settings, including clinics and student health centers, and can specialize in areas such as pediatrics or acute care.

Physician

A person qualified to practice medicine, especially one who specializes in diagnosis and medical treatment as distinct from surgery.

Cerebrovascular accident

A stroke, also called a cerebrovascular accident, occurs when the blood supply to the brain is interrupted. Strokes may be either ischemic (caused by plaque formation that narrows a blood vessel or a clot that obstructs a blood vessel) or hemorrhagic (due to a weakening of a blood vessel that causes it to bulge or rupture).

Registered nurse

A trained health care professional who provide a wide range of services for patients and their families, including patient education, counseling, providing community health and disease prevention information, and administration of medications. Registered nurses (RNs) in the United States complete either a four-year program leading to a bachelor of science in nursing (BSN) degree or a two-year associate degree program, and must also pass a national certification exam.

warning signs of malignant melanoma

ABCDE rule: - Asymmetry: One half of the mole or lesion does not match the other half. - Border Irregularity: The edges are uneven, notched, or scalloped. - Color: Pigmentation is not uniform. Melanomas may vary in color from tan to deeper brown, reddish black, black, or deep bluish black. - Diameter: Diameter is greater than 6 millimeters (about the size of a pea). - Evolving: The symmetry, size, shape, color, border, or other characteristics have changed over time.

essential problems with the health care system in the United States

Access: The most significant factors in determining access to health care are the supply and proximity of providers and facilities and the availability of insurance coverage. Access to Providers, Facilities, and Treatments: There is an oversupply of higher-paid specialists and a shortage of lower-paid primary care physicians Moreover, the majority of nongovernmental hospitals in the U.S. are located in urban areas, leaving many rural communities underserved. Access to High-Quality Health Insurance: Key provisions in the Affordable Care Act (ACA) aim to increase access to quality health insurance among Americans. Cost: Both per capita and as a percentage of gross domestic product (GDP), the U.S. spends more on health care than any other nation. Health care expenditures are projected to grow by 5.6% each year to and climb to over 20% of our projected GDP by 2025. Many factors contribute to high health care costs: duplication of services; an ageing population, growing rates of obesity, inactivity, and related health problems; demand for new diagnostic and treatment technologies; an emphasis on crisis-oriented care instead of prevention; physician overtreatment, and inappropriate use of services. Our insurance system is also to blame. Currently, more than 2,000 companies provide health insurance in the U.S., each with different coverage structures and administrative requirements. This lack of uniformity prevents our system from achieving the economies of scale (bulk purchasing at a reduced cost) and administrative efficiency that are realized in countries with a single-payer delivery system. Quality: Although our health care spending far exceeds that of any other nation, the U.S. rank far below many other nations in key indicators of health care quality. For example, in 2017, the CIA ranked the U.S. 42nd in life expectancy among 224 nations ranked. And our infant mortality rate, at 5.8 deaths per every 1,000 live births, is higher than that of 56 other nations.

Migraine headaches

An inherited neurological disorder characterised by over excitability of specific areas of the brain, particularly the vascular network. Symptoms include moderate to severe pain on one or both sides of the head, pain with a pulsating or throbbing quality, pain that worsens with physical activity, nausea with or without vomiting, and sensitivity to light and sound.

modifiable risk factors for developing type 2 diabetes

Body weight, dietary choices, level of physical activity, sleep patterns, and stress level are all diabetes-related factors that people have some control over. In adults, a body mass index of 25 or greater increases risks, with significantly higher risks for each 5kg/m^2 increase. Excess weight around the waistline-a condition called central adiposity-is a significant risk factor for older women and younger adults. Inadequate sleep may contribute to the development of both obesity and type 2 diabetes, possibly because sleep-deprived people tend to engage in less physical activity. People who are routinely sleep deprived are also at higher risk for metabolic syndrome, a cluster of risk factors that include poor glucose metabolism. Research indicates that T2D risk increases among people who are experiencing trauma or stressful working conditions, those with chronically high inflammation levels, those with a history of depression, and those with confrontational personalities. In addition, diabetes is more common among people with low socio-economic status (SES) and members of racial and ethnic minorities, independent of current SES.

Transient ischemic attacks (TIAs)

Brief interruptions of the blood supply to the brain that cause only temporary impairment. Symptoms of TIAs include dizziness, particularly on first rising in the morning; weakness; temporary paralysis or numbness in the face or other regions; temporary memory loss; blurred vision; nausea, headache; slurred speech; or other unusual physiological reactions. While some people may experience unexpected falls or have blackouts, others may have no obvious symptoms. TIAs often indicate an impending major stroke.

Crohn's Disease

Can affect any area of the gastrointestinal tract from the mouth to the anus, particularly the small intestine. It causes major pain, inflammation, and bleeding and can lead to tears in the gastrointestinal tract. Intense stomach pain, fever, weight loss, joint pain, mouth ulcers, and watery diarrhea characterise it. Intestinal bleeding can be serious enough to cause anemia, fatigue, and immune system dysfunction. The most common complication is bowel obstruction due to swelling, scar tissue, and ulcers that erode and form little infection-prone pouches called fistulas.

Leukemia

Cancer of the blood-forming parts of the body, particularly the bone marrow and spleen, is called leukemia. A nonsolid tumor, leukemia is characterized by an abnormal increase in white blood cells.

the epidemiological triad of disease

First, the host (the person) must come into contact with a pathogen (infectious agent) that is virulent enough to overcome the body's elaborate defenses and capable of sustaining itself long enough to cause an infection. Second, the host must be susceptible, or in some way vulnerable to infection. In other words, the pathogen must be so virulent that it overcomes a typical healthy immune system, or, in an opportunistic infection, a normal pathogen overcomes an immunocompromised immune system-one that has been weakened or is nonfunctional. As an example, a person on antirejection drugs after an organ transplant may be severely immunocompromised and would be vulnerable to any number of pathogens, be they lurking in a hospital room or carried in on well-wishing visitors. Finally, the environment must be hospitable to the pathogen in terms of temperature, light, moisture, and other requirements. Although pathogens pose a threat if they gain entry and begin to grow in your body, the chances that they will do serious, long-term harm are normally quite small.

Type 2 Diabetes

In type 2, either the pancreas does not make sufficient insulin or body cells are resistant to its effects-a condition called insulin resistance-and don't use it efficiently. Type 2 diabetes usually develops slowly. In its early stages, cells throughout the body begin to resist the effects of insulin; over time, the body may not produce enough insulin. An overabundance of free fatty acids concentrated in a person's fat cells (as may be the case in an obese individual) inhibit glucose uptake by body cells and suppress the liver's sensitivity to insulin. As a result, the liver's ability to self-regulate its conversion of glucose into glycogen begins to fail, and blood levels of glucose gradually rise. The pancreas attempts to compensate by producing more insulin, but it can't maintain hyper-production indefinitely. More and more pancreatic insulin-producing cells become non-functional, insulin output declines, and blood glucose levels rise high enough to warrant a diagnosis of type 2 diabetes.

most commonly reported disability in the United States

Low Back Pain

#1 cancers in women and men

Lung cancer is the leading cause of cancer deaths for both men and women in the United States

Lymphoma

Lymphomas develop in the lymphatic system-the infection-fighting regions of the body-and metastasize through the lymphatic system. Hodgkin's disease is an example. Lymphomas also form solid tumors.

routes of transmission for infectious diseases

Pathogens may enter the body by direct contact between infected persons or by indirect contact, such as touching an object an infected person has touched. You may also auto inoculate yourself, or transmit a pathogen from one part of your body to another-for example, by touching a herpes sore on your lip with a finger and then touching your eye with that finger. Dogs, cats, livestock, and wild animals can directly or indirectly spread infections to each other and to humans, known as animal-borne (zoonotic) infections. Companion animals such as cats and dogs can carry fleas and ticks into homes; when these insects bite humans, diseases such as Lyme disease can occur. Untreated puppies and dogs can be infested with worms that can be transmitted to humans via saliva or through fecal residue on bedding, household carpets, or furniture. Although you can get some illnesses from your pet, such as certain forms of influenza, salmonellosis, leptospirosis, and rabies, interspecies transmission-transmission between humans and animals-is fairly rare, owing to vaccination of pets, basic hygiene, and using care in contacting with animal fluids.

Sarcoma

Sarcomas occur in the mesodermal, or middle, layers of tissue-for example, in bones, muscles, and general connective tissue. They metastasize primarily via the blood in the early stages of disease. These cancers are less common but generally more virulent than carcinomas. They also form solid tumors.

Tension-type headaches

The most common headache symptoms are dull, aching pain on either or both sides of the head; a sensation of tightness or pressure; tenderness of the scalp, neck, and shoulder muscles; and, occasionally, loss of appetite. Possible triggers include stress, depression and anxiety, jaw clenching, and poor posture. Red wine, lack of sleep, extreme fasting, hormonal changes, and certain food additives have also been implicated.

Metastasis

The process by which cancer spreads from one area to different areas of the body.

non-modifiable risk factors for developing type 2 diabetes

Type 2 diabetes is associated with a cluster of nonmodifiable risk factors including age, ethnicity, family history, and genetic and biological factors. Most experts believe type 2 diabetes is caused by a complex interaction between environmental factors, lifestyle, and genetic susceptibility. According to the most recent study, rates of T2D are up significantly among youth age 10 to 19, particularly among members of minorities. Rates for Hispanics, Native American, Asian/Pacific Islanders, non-Hispanic Blacks and non-Hispanic whites, in that order, have increased dramatically. Having a close relative with type 2 diabetes is a significant risk factor.

Ulcerative Colitis

a condition that occurs when the lining of the large intestine (colon) becomes inflamed. This happens when the immune system misfires and signals "invader" when food or pathogens are introduced, leading to inflammation and ulcers. Signs and symptoms include abdominal pain, diarrhea, which is often bloody, weight loss, and fatigue.

Irritable Bowel Syndrome

a functional bowel disorder (affecting how the bowel, including the colon and rectum, works). In individuals with IBS, the normal muscular contractions in the intestines don't work properly, and food isn't processed or eliminated, as it should be. Characterized by nausea, pain, gas, diarrhea, bloating, or cramps, IBS can be uncomfortable but usually does not permanently harm the intestines unless the symptoms are severe.

Chronic obstructive pulmonary disease (COPD)

a progressive lung disease that gradually makes it more difficult for the person to breathe. In the U.S., the term COPD refers to two specific diseases, chronic bronchitis and emphysema, which often occur together and can lead to problems with inhalation and exhalation.

Angina pectoris

a symptom of coronary heart disease (CHD) that occurs when not enough oxygen supplies the heart muscle and is an indication of underlying heart disease. Over 10 million people in the United States suffer from angina symptoms, ranging from heartburn-like symptoms to palpitations and crushing chest pain. Mild cases may be treated with rest. Drugs such as nitroglycerin can dilate veins and provide pain relief. Other medications such as calcium channel blockers can relieve cardiac spasms and arrhythmias, lower blood pressure, and slow heart rate. Beta-blockers can control potential over activity of the heart muscle.

Evidence-based practice

clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

Untreated hypertension

damages blood vessels and increases chance of angina, heart failure, peripheral artery disease, stroke, and heart attack. Hypertension can also cause kidney damage and contribute to vision loss, erectile dysfunction, and memory problems.

Fungi

have hundreds of species that exist. While many of these unicellular or multicellular organisms are beneficial-such as edible mushrooms, penicillin, and yeast used in bread-others are the causes of disease such as candidiasis, athlete's foot, ringworm, jock itch, and toenail fungus. Another fungal disease that is increasing in the U.S. is valley fever (coccidioidomycosis), a potentially life-threatening respiratory disease that is common in the desert Southwest, where the fungus lives in the soil.

A myocardial infarction (MI), or heart attack

involves an area of the heart that suffers permanent damage because its normal blood supply has been blocked, often by a coronary thrombosis (formation of a clot) or an atherosclerotic narrowing that blocks a coronary artery. When a clot, or thrombus, becomes dislodged and moves through the circulatory system, it is called an embolus. Whenever blood does not flow readily, there is a corresponding decrease in oxygen flow to tissue below the blockage. If the blockage is extremely minor, an otherwise healthy heart will adapt over time by enlarging existing blood vessels and growing new ones to reroute needed blood through other areas. This system, called collateral circulation, is a form of self-preservation that allows an affected heart muscle to cope with damage. When heart blockage is more severe, however, the body is unable to adapt on its own, and outside lifesaving support is critical.

fasting plasma glucose (FPG) test

requires fasting for 8 to 10 hours. Then a small blood sample is tested for glucose concentration. An FPG level of 100 mg/dL or more indicates prediabetes, and a level of 126 mg/dL or more indicates diabetes

oral glucose tolerance test (OGTT)

requires the patient to drink concentrated glucose 2 hours before having blood drawn. A reading of 140 mg/dL or more indicates prediabetes; a reading of 200 mg/dL or more indicates diabetes.

Informed consent

the full information on the treatment/procedure of the risks, benefits, and alternatives. It gives one the freedom to decide on the recommended treatment.

Parasitic Worms

the largest pathogens. Ranging in size from small pinworms, typically found in children, to large tapeworms that can stretch much of the length of the human intestines, most parasitic worms are more nuisances than threat. Of special note are the worm infestations associated with eating raw fish (as in some forms of sushi). You can prevent worm infestations by cooking fish and other foods to temperatures high enough to kill the worms and their eggs. Other preventative measures include getting your pets checked for worms, being careful while swimming in international areas known for these infections, and wearing shoes in parks or places where animal feces are present.

HIPPA

the patient's access to all medical records except psychotherapy notes and is the right to a second opinion.

Viruses

the smallest known pathogens, approximately 1/500th the size of bacteria; hundreds of viruses cause diseases in humans. Essentially, a virus consists of a protein structure that contains either ribonucleic acid (RNA) or deoxyribonucleic acid (DNA). Viruses are incapable of carrying out any life processes on their own. To reproduce, they must invade a host cell, inject their own DNA or RNA into it, and force the cell to make copies of itself containing the virus. The new viruses then erupt out of the host cell and seek other cells to invade. Viral diseases can be difficult to treat because many viruses can withstand heat, formaldehyde and large doses of radiation. Some viruses have incubation periods (the length of time required to develop fully and cause symptoms in their hosts) that last for years, which delays diagnosis. Drug treatment for viral infections is also limited. Drugs that are powerful enough to kill viruses generally kill the host cells too, although some medications block stages in viral reproduction without damaging the host cells.

Atherosclerosis

the thickening and hardening of the arteries, a type of arteriosclerosis in which fatty substances, cholesterol, cellular waste products, calcium, and fibrin (a clotting material in the blood) accumulate in the inner lining of an artery. Hyperlipidemia (abnormally high blood levels of lipids, which are non-water-soluble molecules such as fats and cholesterol) is a key factor in this process, and the resulting buildup is referred to as plaque. As plaque accumulates, it adheres to the inner lining of the blood vessels. Vessel walls become narrow and may eventually block blood flow or rupture. This is similar to putting your thumb over the end of a hose while water is running through the hose. Pressure builds within arteries just as pressure builds in the hose. If vessels are weakened and pressure persists, the artery may become weak and eventually burst. Fluctuation in the blood pressure levels within arteries may actually damage their internal walls, making it even more likely that plaque will accumulate. Atherosclerosis is the most common form of coronary artery disease (CAD). It occurs as plaques are deposited in vessel walls and restrict blood flow and oxygen to the body's main coronary arteries on the outer surface of the heart, often eventually resulting in a heart attack.