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CHSC midterm review.docx

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Brock University
Health Sciences
Brent Faught

CHSC Midterm Review Attributable Risk: subtracting the percentage of exposure of the non-exposed from the exposed groups gives the estimate of the attributable risk, or proportion of disease occurrences that are attributable to exposure Variant sexual behavior: sexual behaviors not engaged in by most people. Group sex, transvestitism, transsexualism, fetishism, voyeurism, sadomasochism, and pedophilia Psychological Need: need for approval and sense of purpose in life, intimacy, social integration, nurturing, being nurtured, reassurance or affirmation of our own worth Puberty and Development: during puberty, sex hormones play major roles in further development. Hormones released by the pituitary gland, called gonadotropins, stimulate the testes and ovaries to make appropriate sex hormones. Increased production of estrogen in females and testosterone in males leads to development of secondary sex characteristics (vocal pitch, degree of body hair, and genital development) Types of Families: Definition – any combination of two or more persons bound together over time by ties of mutual consent. Single-parent families, communal families, extended families etc… Contraceptive effectiveness: Condoms – 98%; Pills – 99.7%; BC patch – 99.7%; Depo- Provera - 97-99%, NuvaRing – 92-99.7%; Emergency pills – 75%; Spermicides – 82%; Female condom – 79-95%; Diaphragm – 84-94%; Sponge – 80-91%; IUD – 99%; Withdrawal – 73-96%; Sterilization – tubal ligation (cutting and tying off fallopian tubes), hysterectomy (removal of uterus), vasectomy (cutting, and tying off vasa differentia) Triangular theory of love: Passion + intimacy = romantic love; Intimacy + commitment = compassionate love; Passion + commitment = fatuous love; Intimacy + passion + commitment = consumable love Living together without being married: cohabitation Partnering relationships: monogamy (one partner), serial monogamy (one person before moving to another), open-relationship (sexual involvement outside), partnering scripts (family based, largest influence) Social integration: ability to share our worries and concerns with someone else Intimacy: emotional component, which involves feelings of closeness (liking) Nurturance: physical and emotional support and care Assistance: seeking help outside the relationship in hopes to repair it; seeking assistance from family, friends and medical professionals after finding out you have cancer Trial separations: when a relationship becomes so dysfunctional that even counseling cannot bring change, couples may move apart for a period of time which may or may not allow healing Breast cancer: type of carcinoma cancer (ductal and lobular), spreads through circulatory and lymph systems, and 1/9 woman get this, treatment: lumpectomy, more advanced stage is a mastectomy (partial or complete removal of breast) Skin cancer: type of carcinoma cancer, A – asymmetry, B – border irregularity, C – colour, D – diameter, E - evolving Lung cancer: two types: small cell (grow quickly) & non-small cell (slow process), treatment: chemotherapy or surgery, 90% related to smoking, 1/3 of all cancers are from smoking, 460 people are diagnosed each week, 390 die each week, lifetime – 1 in 2 men, 1 in 6 women Testicular cancer: 17-34, age is factor, pain in scrotum & enlarged testicle, treatment - surgery Young person’s cancer: testicular cancer and skin cancer Expectations of a man and who he should marry: men tend to select their mates primarily on the basis of youth and physical attractiveness Hormones that signals the ovaries: FSH – hormone that signals ovaries to prepare to release egg and to begin to produce estrogen; LH – hormone that signals ovaries to release egg and to begin producing progesterone; Estrogen – hormone that controls menstrual cycle; Progesterone – hormone secreted by ovaries and helps keep the endometrium developing in order to nourish fertilized egg, helps maintain pregnancy Recover from a major loss in a relationship: reflecting and identifying problems to prevent in the future, consider negative aspects of an ex-partner to get in touch with emotions and equally important to spend time remembering what you loved (evaluating your life). Takes at least 1 year to fully recover which also takes time, support and professional help Cohabitation: living together without being married, after 6 months you and your partner are considered to be in a common-law marriage Excitement and passion that is gone in marriage: trial separation Infatuation: liking someone Sexual involvement outside a relationship: open relationship Intimate relationships: close relationships with other people in which you offer, and are offered, validation, understanding, and a sense of being valued intellectually, emotionally, and physically Loyalty: staying together, not breaching trust Love: two kinds; companionate (friends and family), passionate (high arousal filled with ecstasy). Fidelity: loyalty or faithfulness Trust: reliance on another person or degree of confidence in a relationship Declining relationships: should probably seek a counselor Bisexuality: attraction to both sexes Heterosexuality: attraction to opposite sex Homosexuality: attraction to same sex Pre-orgasmic: in women, the state of never having experienced an orgasm. Women can learn to become orgasmic Men that are allowed to contact their deeper emotional states: sexual activity carries the major burden or emotional expression for many males and may explain the urgency with which some men approach sex. May have a hard time expressing emotion state in other circumstances Proximity of relationships: it’s a factor in partner selection – for males and females. If you live in a closer proximity you are more likely to see an individual more often (social gatherings etc…) and therefore you are more likely to interact and develop a relationship with that person Sharing feelings freely: Intimacy Surviving breast cancer: 1/9 woman get breast cancer. Better chance of surviving because of the treatments available and because of self-exams and mammograms Cuddle chemical: oxytocin; released by both sexes during orgasms, responsible for contractions during childbirth and milk expressions when breastfeeding. “Falling in love phase” Oral contraceptives: reversible form of birth control and are pills taken daily for 3 weeks of the menstrual cycle that prevent ovulation by regulating hormones. Since the levels of estrogen in the pill are higher than those produced by the body, the pituitary gland is not signaled to produce FSH Measure and fit and insert of this form of birth control: IUD. A physician must fit and insert the IUD, and he must measure the depth of the uterus and then uses these measurements to place the IUD correctly Type of physician that can deliver a baby: obstetrician-gynecologist aka OB/GYNs Diaphragm: should be used with spermicide; a latex, saucer-shaped device designed to cover cervix and block access to uterus; 84-94% effective Condoms: female condom: a single-use polyurethane sheath for internal use by women Temporary method of birth control for men: condom Outer course: 100% effective for birth control as long as male does not ejaculate near vagina. Unlike abstinence, there still is a risk of STI’s; oral-genital contact can result in STI’s Alcohol consumption during pregnancy: fetal alcohol spectrum disorders (FASD) – a number of disorders related to alcohol consumption during pregnancy (including fetal alcohol syndrome, fetal alcohol effects etc…) that result in lifelong development and cognitive disabilities in children Ultrasound during pregnancy: can detect defects as well as size and position of unborn child Weight gain during pregnancy: weight gain helps nourish a growing baby. For a normal weighted woman before pregnancy, the recommended weight gain during pregnancy is about 11-16 kgs. Carrying twins: 16-20 kgs. +5 kgs during first 20 weeks. Abortion: 14 abortions/1000 women in Canada. Vacuum aspiration (first trimester) - the use of gently suction to remove fetal tissue from the uterus, D&E (second trimester) - combines vacuum aspiration with dilation and curettage; fetal tissue is sucked and scraped out of uterus, D&C (second trimester) – cervix is dilated with laminaria for one to two days and the uterine walls are scraped clean, Hystertomy – surgical removal of fetus from uterus, Induction (second trimester) – chemicals are injected into uterus through the uterine wall; labor begins and the woman delivers a dead fetus Cat litter box during pregnancy: pregnant woman should not clean cat-litter boxes because cat feces can contain organisms that cause a disease called toxoplasmosis. If a pregnant woman contracts this disease, her baby may be stillborn or have cognitive disabilities or other birth defects Sperm damage: tight boxers, drugs, alcohol, radiation Birth defects: many of them Newborn infants and signs of deafness: woman with rubella put a fatal risk on their infant also causing hearing disabilities Baby’s weight: low weight can lead to health problems Birth control injections: Depo-Provera is a long-acting synthetic drug injected intramuscularly every three months. Researchers believe that the drug prevents ovulation Birth control in earliest form: male – condom, female – cervical cap (made from beeswax, silver or copper) Second trimester abortion: pregnancies that progress into the second trimester can be terminated through Dilation & Evacuation (D&E), a procedure that combines vacuum aspiration with a technique called Dilation and Curettage (D&C) and is usually done under general anesthetic. Two other methods not as common are prostaglandin or saline induction abortions (chemicals injected, and go through labor) Risks involved in IUDs: when in place, the device can cause heavy menstrual flow and severe cramps with a risk of uterine perforation. Woman using IUDs have a higher risk of ectopic pregnancy, pelvic inflammatory disease, infertility and tubal infections. Detecting congenital problems: the process of amniocentesis (medical test in which a small amount of fluid is drawn from the amniotic sac) can detect certain congenital problems as well as the sex of the fetus Last fertile unsafe days of monthly cycle: to determine the last unsafe day of the cycle, she subtracts 11 from the number of days in the longest cycle Problems with oral contraceptives: can react negatively with other drugs and decrease effectiveness Problems with non-oral contraceptive users: infertility, chance of getting pregnant Bacteria in tampons: Toxic Shock Syndrome (TSS) Condom effectiveness: male – perfect 98%, typical 85%. Female – perfect 95%, typical 79% Third trimester fetus requirements: during the third trimester, the fetus must get large amounts of calcium, iron, and nitrogen from the food the mother eats. 85% of calcium and iron the mother digests goes into fetal bloodstream Smoking during pregnancy: smoking has more predictable effects than alcohol. 25-50 % higher rate of fetal and infant deaths among women who smoke during pregnancy than those who don’t. Babies whose parents smoke can be twice as susceptible to pneumonia and bronchitis Exercise during pregnancy: physical activity is an important factor in overall maternal health as well as in weight control during pregnancy. Regular, moderate intensity PA of 45 minutes, three days per week has been associated in one study with heavier-birth weight babies, fewer surgical births etc… Do not engage in a new routine or try and build physical fitness at this time Female sterilization: tubal ligation – involves cutting and tying off the fallopian tubes, hysterectomy – removal of uterus Oral contraceptives and the pituitary gland: because the levels of estrogen in the pill are higher than those produced by the body, the pituitary gland s not signaled to produce FSH, without which ova will not develop in the ovaries Risk of having a baby with downs syndrome: researches believe that there is a decline in the quality and viability of eggs produced after age 35. Incidence of down syndrome in babies both to mothers aged 20 is 1 in 10000 births; it rises to 1 in 365 births when mother is 35, to 1 in 109 when she is 40 and to 1 in 32 when she is 45 Excess fat accumulating around a person’s upper body and waist: if excess fat accumulates around your upper body and waist (apple-shaped), you are at greater risk for CHD than if your excess fat accumulates around your hips and thighs (pear-shaped). Waist girth greater than 102 cm for men and 88 for woman significantly relates to bad shit Chemotherapy treatment: the use of drugs to kill cancerous cells. When cancer has spread throughout the body, it is necessary to use some form of chemo. Chemotherapy attacks and kills cancerous and healthy cells. Side effects: extreme nausea, nutritional deficiencies, hair loss and general fatigue. Long-term damage to the cardiovascular system and many other systems Heart muscle and pooling of blood: when exercising, your heart is pumping large amounts of blood to the working muscles. This blood is carrying both oxygen and nutrients to the muscles and then returns to the heart for oxygen. However, when the exercise stops, so does the force that pushes the blood back to the heart. If you don’t cool down, lactic acid stays in the muscles, which in turn causes swelling and pain. This is known as “blood pooling”. Cooling down keeps the blood circulating, this in turn helps to prevent blood pooling and the removal of waste products from the muscles. Pooling of blood causes enlargement of the heart and decreases the amount of blood that can be circulated Cancer cells in the brain and how quickly they divide: normal cells take 5-7 days to divide but cancer cells can divide every 12 hours Fibrous carcinogen: carcinogens made of fibres such as asbestos, caused cancer when used as insulation Development of atherosclerosis: evidence suggests that atherosclerotic plaque begins to form in the womb, and worsens as the years pass. The process of plaque buildup begins when the protective inner lining of the artery (endothelium) becomes damaged, allowing fat, cholesterol, and other substances in the blood to affix to the arterial walls, eventually obstructing blood flow. The three major causes of such damages are 1) dramatic fluctuations in blood pressure, 2) elevated levels of cholesterol, triglycerides and glucose in the blood, and 3) cigarette smoking. Koch’s Postulates: used to grow bacteria, see how viruses create disease etc… used in microbiology. Criteria used to determine an infectious disease Hearts oxygen supply is reduced: myocardial infarction Cholesterol: a fatty diet elevates the amount of cholesterol in the blood, contributing to atherosclerosis. A total cholesterol concentration of less than 5.2 millimoles per litre or 200 milligrams per deciliter indicates a low risk for heart disease, while values greater than 5.2 indicate high risk. Values between 200 and 240 mg/dL are considered moderate risk. LDLs are bad cholesterol because they tend to build up or accumulate on artery walls. In contrast HDLs or good cholesterol remove cholesterol from artery walls, thus serving as a protector. If LDL levels get too high (greater than or equal to 3.4 mmol/L) or HDL levels too low (less than 0.9 mmol/L) cholesterol will accumulate on arterial walls and lead to CVD Risk rate for heart disease: CVD account for more than 32 percent of all deaths. Rates decreased from 47% to 32% since 1979 Mechanical pacemaker: a pacemaker is a small device that's placed in the chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate Sodium nitrates: in processed food, the preservatives – makes the food stay fresh (once broken down become sodium amines – carcinogenic agent aka really red meat) Capillaries: minute blood vessels that branch out from the arterioles; through which the exchange of oxygen, carbon dioxide, nutrients, and waste products happen Venuals: transports carbon dioxide and waste products to the lungs and kidneys Arteries: vessels that carry blood away from heart Veins: vessels that carry blood back to heart Arterials: small arteries Blood flow that is redirected: collateral circulation: following the complete occlusion of a coronary artery, rerouting of needed blood through unused or underused blood vessels Controlling lifestyle behavior and cancer death: 45% of men and 40% woman are at risk for developing cancer in their lifetime. Dietary intake, sedentary lifestyle, consumption of alcohol or cigarettes and stress all are factors that impact your cancer rate Hypertension: chronic high blood pressure; 140/80 mmHg < Why does obesity put a strain on the heart? A body with excessive fat causes strain to the heart in its efforts to push blood through many kilometers of capillaries that supply each kilogram of fat when needed nutrients Healthy cholesterol value: <5.2 mmol/L or 200 mg/dL Endothelial damage: there are 3 major causes, fluctuation in your blood pressure, high cholesterol, and smoking. Occurs when the artery lining becomes damaged letting in cholesterol, fat and other substances into the blood to attach to arterial walls, obstructing blood flow Cerebral vascular accidents (stroke): also known as strokes; occurs when the blood supply to the brain is cut off. May be caused by thrombus (blood clot), embolus (wandering clot) or aneurysm (weakening blood vessel that bulges and can burst). Effects: Left Brain Injury Right-Brain Injury Paralyzed right side Paralyzed left side Speech language deficits Spatial perceptual deficits Slow, cautious behavioral style Quick, impulsive behavioral style Memory deficits Memory deficits Sexually transmitted virus in cancer: HBV, HCV are believed to stimulate cancer cell in the liver because they are chronic diseases that cause inflammation of liver tissue. Nearly 100% of women with cervical cancer have evidence of HPV infection Rheumatic heart disease: attributed to rheumatic fever, an inflammatory disease caused by an unresolved streptococcal infection of the throat (strep throat) that may affect many connective tissues of the body, especially those of the heart, joints, brain or skin. Streptococcal infection can lead to an immune response in which antibodies attack the heart as well as bacteria Silent killer: high blood pressure aka hypertension Angioplasty surgery: a needle-thin catheter is threaded through blocked heart arteries. The catheter has a balloon at the tip, which is inflated to flatten fatty deposits against the artery walls, allowing blood to flow more freely Benign tumors: harmless refers to a non-cancerous tumour Radiation cancer: radiation is a carcinogen (agent that causes cancer) because it suppresses the normal functioning of the immune system. Radiation is a negative environmental factor Three dimensional images of the heart: positron emission tomography (PET scan): method for measuring heart activity by injecting the patient with a radioactive tracer scanned electronically to produce 3-D image of heart and arteries Number one cause of death in Canada: heart disease and cancer Cardiovascular reaction to a stressful stimulation: 1 out of 5 people experience the alarm and resistance phase so strong that their bodies (called hot reactors) produce a stress chemical that puts a strain on the cardiovascular system. Also “fight or flight” response which increases heart rate (heart beat) due to the release of adrenaline and cortisol Valve and valve defects: pulmonary valve – prevents the back flow of blood as it is pumped from the right ventricle to the pulmonary artery. Tricuspid valve – prevents the back flow of blood as it is pumped from the right atrium to the right ventricle. Valve defects: congenital heart disease can be caused by slight murmurs caused by valve irregularities which some children out grow, and others become serious complications in heart function that can be corrected with surgery Heart murmurs: a heart murmur is an extra or unusual sound heard during a heartbeat. Murmurs range from very faint to very loud. Sometimes they sound like a whooshing or swishing noise. Normal heartbeats make a "lub-DUPP" or "lub-DUB" sound. This is the sound of the heart contracting and valves closing as blood moves through the heart. Doctors can hear these sounds and heart murmurs using a stethoscope Cohort studies : a group related by some similar demographic variable such as age, gender, or occupation in its natural setting for a given time through past records, at the immediate time through observational notes or surveys, or into the future recording relevant changes in incidence of morbidity or mortality Case control studies: time line based, comparing someone with and without disease Cross sectional studies: single point in time (fast/cheap, limitation: no past factors included) Randomized controlled trials:method that is most preferred for research; however these studies are very expensive and difficult to contr
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