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ALU 101

Medical and Non-medical life underwriting review

Terms

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In 2002, the American Diabetes Association indicate this many americans have diabetes
18.2 Million
DM complications include:
ketosis/ketoacidosis (not enough insulin)macrovascular (CAD, CVD, PVD), microvascular (nephropathy/kidney disease, retinopathy/eye vessels, neuropathy)
What are the receptors for smell
Chemorereceptors
The two major layers of skin
Epidermis and Statrum Corneum
What % of the population has HTN
20%
Type of diabetes inwhich the beta cells are damaged or destroyed
type 1
The three layers of the pericardial membrane are
fibrous pericardium, parietal pericardium and visceral pericardium
type 1 diabetes is treated with what?
insulin - injection or pump
Overweight definition in terms of BMI
25 - 29.9 kg/m2, or 20% or more above NL weight
What are the two types of sweat glands
Eccrine and Apocrine glands
Restrictive bariatric surgery includes what two types:
gastric banding and gastroplasty
Hemoglobin A1c is a measure of blood sugar averages for approximately how long prior to the testing
approximately 3 months
Approximately 80% of CVAs are caused by
A thrombus
dogs have a sense of smell how many times greater than people
200x
Normal BP, Stage 1 (clinical) HTN
120/80, over 140/90
Fructosamine is a measure of blood sugar averages for about how long previous to the test?
approx 3 weeks
The secretion of this hormone is one of the few positive feedback mechanisms in the body
Oxytocin
What is one cell type that is not part of the Dermis layer?
melanocytes
Complications of obesity
NIDDM, CAD, HTN, Metabolic syndrome, Cancer, Depression, eating disorders, IGT, CHF, stroke, Chol/trigs, Sleep apnea, arthritis
Tests to determine possible secondary causes of HTN
Funduscopic exam, EKG, Echo, Blood (HCT, Glucose, Electrolytes, BUN, Creat, lipids), UA (protein, blood, glucose, microscopic), renal eval, Special (catecholamines, cortisol or aldosterone for pheochromocytoma, Cushing's or primary aldosteronism)
What complications can occur from malabsorptive bariatric surgery
nutritional deficiencies, anemia, osteoporosis, dumping syndrome
Post bariatric surgery, what % gain the weight back?
5-10%
What % of the US population has diabetes?
6.3%
Complications of HTN
LVH, arrhythmias, ischemia and sudden death, stroke, renal failure, PVD, heart failure
What % of US adults over 30 are overweight or obese?
64%
Organic chemicals
Often complex, always contain carbon and hydrogen.
What percent of the diabetic population has type 2 vs type 1?
about 90% have type 2, 10% type 1
Diagnostic level for DM in IGT
2 hour glucose over 200 (IGT if 140-199)
Which bones are part of the shoulder and/or arm
clavicle, ulna, humerous
List categories of drugs to treat HTN
Thiazide diuretics (HCTZ - first line), Calcium channel antagonists (Norvasc, Cardizem-older adults), Beta blockers (atenolol, lopressor -w/CAD, not w/asthma, PVD, block, depression), Angiotensin converting enzyme (vasotec, altace, lisinopril, prinivil. w/heart failure), Angiotensin II blockers/ARBs (Cozaar, Diovan) Alpha blocker (cardura, for BPH), Vasodilators - older
Women with a history of gestational DM have a ___% chance of developing NIDDM in 5-10 years
20-50%
diagnostic level for DM in Fasting glucose
Over 126 (IFT between 110-125)
BMI formula
(weight in pounds/hight in inches/height in inches) x 703
The most effective way to lose weight
decrease caloric intake, increase physical activity
Two common weight loss drugs
Merida (works on the brain - increased pulse and BP) and Xenical (inhibits fat absorbtion)
The most powerful single predictor of future mortality
blood pressure level (systolic and diastolic are independent risk factors)
waist circumference that indicates increased risk
40" in men and 35" in women
Stable, underweight in healthy people has what effect on mortality
Lower mortality than average (If no sudden wt loss, not elderly, no eating disorder)
What is the result in the body of hperglycemia
cells cannot get energy needed to function, and excess glucose damages tissue at the cellular level
body habitus =
build
The function of the circulatory system is
to transport oxygen and nutrient's to body cells and to Carry away waste materials of cellular metabolism
Unfavorable causes of hypotension
autonomic nervouse system (parkinson's, diabetic or alcoholic neuropathy, MS, chronic renal or liver diseases, aortic stenosis, pericarditis, myocarditis, adverse drug reaction
When assessing the mortality risk for diabetics, one needs to evaluate what?
Type of diabetes, treatment, degree of control, duration, complications, co-morbidities
Symptoms of type 1 DM
hunger, wt loss, thirst/polydipsia, urination/polyuria, blurred vision, fatigue
Systolic/diastolic
top number = maximum contraction of the heart / bottom number = minimum pressure in relaxation phase
Name the five essential parts of a Reflex arc
Receptors, Sensory neurons, CNS, Motor neurons, Effector
What is an example of a microvascular complication associated with diabetes?
nephropathy
IGT test vs IFG
Elevated 2 hour oral glucose tolerance test, Elevated overnight/fasting blood sugar
Parkinson's Disease is a disorder of the
Basal ganglia
The Left Ventricle's function is to
pump blood to the rest of the body
Heart disease and stroke account for what % of deaths in diabetics?
65%
Pulse pressure
difference between systolic and diastolic pressure
Inorganic chemicals:
usually simple, 1-2 elements other than carbon. H2O, O2
The PNS consists of
spinal and cranial nerves
metabolic syndrome is a combination of what conditions
abdominal obesity, elevated BP, lipid abnormalities, elevated fasting glucose
The virus shingles is present in what kind of neuron
Sensory
With a first degree burn this part of the skin is damaged
The superficial epidermis
The skull consists of ___ cranial bones and ___ facial bones
18 and 14
Morbid obesity defined (BMI, % over normal and # over normal)
BMI >40 or 35kg/m2 with clinical complications, 50-100% over normal, over 100lbs over NL
Ambulatory BP monitoring
24 hour monitor, identifies white coat syndrome
These hormones are secreted in stressful situations and prepare the body for "fight or flight
Epinephrine and Norepinephrine
Fen-Phen was associated with what complication, and removed from the market
valvular heart disease
Malabsorptive bariatric surgery includes what two types:
RGB and BPD - both bypass a portion of the digestive tract
Insulin is produced in which cells in which organ?
beta cells in the pancreas
Shingles is caused by
The Herpes Varicella-Zoster virus, (Which is the same virus that causes chicken pox, a bacterial infection)
Bariatric surgery has two categories - name them and indicate which is more successful
restrictive and malabsorptive - Malabsorptive is generally more successful

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