EHR519 Study Guide - Final Guide: Aldosterone, Vasoconstriction, Medical Imaging
MULTIPLE CHOICE
Epidemiology Statistics
Pulmonary Diseases
Statistics on Australian data
1/10 Australians have lung disease
2.3 million have asthma
1.49 million Australians >40 have some form of airflow limitation
11,270 Australians are diagnosed with lung cancer each year
667 Australians are diagnosed with pleural mesothelioma each year
14% of all deaths are caused by lung disease
indigenous people are three times more likely to die of lung disease compared to non
-indigenous
Prevalence of disease
1.6 million people around the world are diagnosed with lung cancer each year
Morbidity and mortality rates
Morbidity:
Mortality: 13,258 registered deaths in 2012 more males than females (82.7 years and 85.1
years, respectively)
Hospital admissions
Length of stay in hospital
Economic costs
In 2010, economic costs were $50 billion USD for COPD
Re-admissions
Cardiovascular Diseases
Statistics on Australian data
5.2% (1.2 million) had heart disease – 5.7% men and 4.7% women
1/3 (30.7% aged >75 years have heart disease
11.3% reported hypertension but 23% was determined from measurement
Prevalence of disease
>37.7 million individuals globally
predicted to increase by 46% between 2012 and 2030
Morbidity and mortality rates
Morbidity: As of 2011, approx. 5.7 million individuals live with the disease and 870,000 are
diagnosed every year. In 2012, there were 915,000 new cases
Mortality: approx. 17.3 million people died from cardiovascular causes in 2013 (41% increase
from 1990)
Hospital admissions
Tripled from 1.27 million in 1979 to 3.86 million in 2004
1 million discharges every year between 2000 and 2010
Length of stay in hospital
Average length of stay shortened from 3.1 days to 1.9 days
Economic costs
In 2012, $108billion USD was spent on CVD globally
Re-admissions
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In 2013, the 30-day median readmission rate was 21.9% and ranged from 17% to 28.2%
The median hospital readmission rate decreased by 1.5% between 2010-2013
Pathophysiology – Cardiovascular Disease
What do you know about excessive sugar consumption and atherosclerosis?
High amounts of sugar in the blood due to insulin resistance or diabetes can cause damage to
the inner layers of the arteries
Therefore, atheroma occurs (accumulation of degenerative material) and forms into
atherosclerosis (hardening of the arteries)
Describe the aetiology (causes) of rheumatic heart disease
Stage 1: GAS infection – 1-3 weeks after initial GAS infection susceptibility to developing
ARF common in children aged 5-14 still occurs in adults
Stage 2: ARF – untreated GAS infection (usually pharyngeal) may lead to ARF
Stage 3: Recurrent ARF – multiple episodes of ARF (stage 2) progressive damage to the
mitral and aortic valves
Stage 4: RHD – multiple episodes of recurrent ARF RHD due to significant dysfunction of
the affected heart valves
What are some common symptoms of heart valve disease?
Breathless
Angina
Syncope (fainting)
Palpitations
Decreased activity
Notable fatigue
What are positive risk factors for atherosclerosis disease development?
High blood pressure
Diabetes
Obesity
Smoking
Lack of physical activity
Age
Family history
Unhealthy diet
Insulin resistance
ECG terminology (STEMI vs NSTEMI). Explain the conductive abnormality of a Premature Ventricular
Contraction (PVC)?
STEMI = ST elevation myocardial infarction
oA major heart attack where one of the hearts major arteries is 100% blocked
NSTEMI = Non-ST-elevation myocardial infarction
oA type of heart attack but the artery of the heart is not completely blocked
Conductive abnormality of a PVC
oRR interval is shorter than normal
oThere is no P wave prior to the QRS complex
oThe QRS complex is prolonged and bizarrely-shaped
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oT wave is abnormal
oThere is a compensatory pause after the PVC
Pathophysiology – Pulmonary Disease
Anatomically, what regions of the lungs produce the most resistance to airflow?
Resistance is greatest in medium sized bronchi
True/False? Chronic bronchitis is characterised as a persistence cough and sputum for >6 months a
year?
False
Chronic bronchitis: inflammation and eventual scarring of the large airways
oCough/sputum production >3 months of 2 consecutive years
Describe the aetiology (causes) of sleep apnea
Obesity
Alcohol
Medications
Nasal congestion/obstruction
Large tonsils
Premature birth
Heart or kidney failure
Neuromuscular disorders
How is the Bronchiectasis Severity Index (BSI) used?
BSI uses a combination of clinical, radiological and microbiological features. It is a strong
predictor of morbidity and mortality and predicts one and four-year morbidity and mortality
for patients with non-CF (Cystic Fibrosis) bronchiectasis
oAssessment of severity of bronchiectasis
ABCDEFGH
oAge
oBMI
oColonization status
oDyspnea index
oExacerbations in last 12 months
oFEV1% predicted
oGrading radiologically
oHospital admissions in past 2 years
Scoring
o0-4 points: Mild bronchiectasis
o5-8 points: Moderate bronchiectasis
o9+ points: Severe bronchiectasis
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Document Summary
1. 49 million australians >40 have some form of airflow limitation. 11,270 australians are diagnosed with lung cancer each year. 667 australians are diagnosed with pleural mesothelioma each year. 14% of all deaths are caused by lung disease. Indigenous people are three times more likely to die of lung disease compared to non. 1. 6 million people around the world are diagnosed with lung cancer each year. Mortality: 13,258 registered deaths in 2012 more males than females (82. 7 years and 85. 1 years, respectively) In 2010, economic costs were billion usd for copd. 5. 2% (1. 2 million) had heart disease 5. 7% men and 4. 7% women. 1/3 (30. 7% aged >75 years have heart disease. 11. 3% reported hypertension but 23% was determined from measurement. Predicted to increase by 46% between 2012 and 2030. 5. 7 million individuals live with the disease and 870,000 are diagnosed every year. 17. 3 million people died from cardiovascular causes in 2013 (41% increase from 1990)
