CPHM WEEK 13 AND 14

Non-communicable disease

a prevention and control program aimed at preventing the 4 major NCD or chronic diseases or lifestyle-related diseases,

TRUE

T o F: Cardiovascular diseases, cancer, chronic obstructive pulmonary disease, and diabetes mellitus are the 4 major NCDs

Tobacco smoking, physical inactivity, and unhealthy diet

what are the three major risk factors in NCDs

NCD

its goal is to reduce the toll of morbidity, disability, and premature deaths due to chronic, NCD, lifestyle related disease 

objectives of NCDS

1\. Analyze the social, economic, political, and behavioral determinants

a. develop policy guidelines

b. provide financial measures

2\. Reduce exposure of individuals and population

3\. Strengthen health care

Health Educator

Essential tool to achieve community health; concern with promoting health as well as reducing behavior-induced diseases

FALSE (inform, motivated, and guide)

T o F: the health educator aims to disinform the people, unmotivate the people, and mislead the people into action

Cardiovascular diseases

Disease of the heart and blood vessels 

Hypertension (HPN)

sustained elevation in mean arterial pressure

Normal (JNC 7)

Prehypertension (JNC)

120-129 and

Prehypertension (JNC 2)

130-139 or 80-89 (JNC)

Stage 1 hypertension (JNC)

140-159 or 90-99 (JNC)

Stage 2 hypertension (JNC)

≥ 160 or ≥ 100 (JNC)

Normal (ACC/AHA)

Elevated BP (ACC)

120-129 and < 80 (ACC/AHA)

Stage 1 hypertension (ACC/AHA)

130-139 or 80-89 (ACC)

Stage 2 hypertension (ACC)

140-159 or 90-99 (ACC)

Stage 2 hypertension (AHA)

≥ 160 or ≥ 100 (AHA)

TRUE

T or F: the etiology of hpn (there is no single cause for HPN are twice at risk have been implicated in its development)

Family History

twice at risk than those with no history

Age

older person are at greater risk

obesity

**twice greater risk among overweight/obese** 

Excessive alcohol intake

**regular consumption of 3 or more drinks per day increase risk of HPN** 

Coronary Artery Disease (CAD)

Impaired coronary blood flow; When the coronary arteries become narrowed or clogged, supply of blood and oxygen to the heart muscle is affected; chest pain occurs (angina pectoris)

CAD

can cause myocardial infarction (heart attack), arrhythmias, heart failure and sudden death

etiology or cause of CAD

thickening of the inside wall of the arteries due to deposition of fat-like substance (atherosclerosis).

modifiable risk factors of CAD

\

* High lipid and cholesterol level in the blood= high LDL


* Smoking
* obesity
* Physical inactivity or sedentary lifestyle 
* stress

Non-modifiable risk factors

\
* Hereditary or family history
* Gender
* Age

Cerebrovascular disease or Stroke

insufficient supply of blood to some parts of the brain; If blood is obstructed for more than several minutes, injury to the brain cells becomes permanent and tissue dies in the affected region resulting in cerebral infarction.

Thrombolytic stroke, Embolic stroke, and hemorrhagic stroke

3 types of stroke

Thrombolytic stroke

antherosclerotic blood vessel 

Embolic stroke

\
moving blood clot

Hemorrhagic stroke

rupture of intracerebral blood vessel

 **High RBC count**

 thicken the blood and make clots more likely 

Cancer

cells in a part of the body begin to grow out of control.; outlive normal cells and continue from new abnormal cells; compete with normal cells for the blood supply and nutrients

Cancer cells

often travel to other parts of the body where they begin to grow and replace normal tissue

Metastasis

replace normal tissue

what is the ranking of cancer in mortality in developed countries

Second and has 2.7 million death annually

tumor (neoplasm)

often forms in cancer; solid mass

Tumorigenesis

formation of tumor

Metastasis

spreading of tumors

Angiogenesis

development of new blood vessels to supply oxygen and nutrients to cells

Apoptosis

programmed cell death 

Neoplasm

uncontrolled tissue growth “Gr. For new formation” 

Oncogene

 encodes a protein that, when mutated, promotes uncontrolled cell growth 

Tumor suppressor gene

\
encodes a protein involved in protecting cells from unregulated growth 

Cancer Progression

\
1\. localized primary tumor

2\. Migration of tumor into regional lymph nodes

3\. metastasis and invitation of tumor to distant 

Hereditary and carcinogen

causes of cancer

Carcinogens

agent capable of causing cancer, maybe chemical, environmental agent, radiation

Polycyclic hydrocarbon

found in cigarette smoke, industrial agents and in smoked foods. 

Benzopyrene

charcoal broiled or smoked

Nitrosamines

tocino, longanisa, bacon, hotdogs

Radiations

UV rays from sunlight, x-rays 

Aflatoxin

\
peanuts and peanut butter

Diabetes mellitus

glucose intolerance with hyperglycemia present at time of diagnosis

genetic predisposition and environment/lifestyle

etiology or cause of diabetes mellitus

**TYPE I - Insulin dependent diabetes mellitus (IDDM)**

\

1. absolute lack of insulin due to damaged pancreas
2. Dependent on insulin injections
3. Genetic, environmental or maybe acquired

**TYPE II - Non-insulin dependent diabetes mellitus (NIDDM)**

\

1. More common, 90-95% of all person with obesity and diet
2. impaired insulin secretion and increased hepatic glucose production


1. Usually in older and overweight persons

\
__*Risk factors of TYPE II DM*__

\

1. Family history
2. overweight and obesity
3. sedentary lifestyle
4. hypertension 

Gestational Diabetes

\
develops during pregnancy and may lead to type II DM

family history, polyuria, polydipsia, polyphagia, unexplained weight loss

screening for diabetes mellitus (20 yrs and above)

polyuria

a condition where the body urinates more than usual and passes excessive or abnormally large amounts of urine each time you urinate

Polydipsia

excessive thirst

polyphagia

eats excessive amounts of food 

\

1. **Fasting blood sugar (FBS)**
2. **2 hours postprandial test**

2 blood tests

\
__**CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)**__

\
It is a disease characterized by __airflow limitation that is not fully reversible.__ The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases

What is the ranking of COPD in the cause of mortality

Fourth

Smoking

primary cause of COPD

\
chronic bronchitis and emphysema and age

usual cause and risk of COPD

Respiratory failure and cardiovascular disease

complications of COPD

Smoking cessation

\

1. harmful substance in tobacco
2. tar
3. nicotine
4. carbon monoxide

4000 and 43

tobacco contains ____ __chemicals,__ ______ have been proven carcinogenic

Acetone

used in nail polish remover

Acetic acid

used in vinegar

Ammonia

used in food and toilet cleaners

Arsenic

 used to make rat poison

Butane

used in cigarette lighter fluid

Cadmium

used on rechargeable batteries

Carbon monoxide

found in exhaust fumes 

Formaldehyde

used to preserve dead bodies

Hexamine

used in lighter fluid

Hydrogen cyanide

used in gas chambers

Methane

used in gasoline

Naphthalene

 used to make moth balls N

Nicotine

used in insecticides

Nitrobenzene

used in gasoline additive.

Nitrous oxide

used in disinfectants

Dieldrin

used in insecticides

Ethanol

alcohol

Stearic acid

used in candle wax

Toluene

used in industrial solvent

Vinyl Chloride

used to make PVC pipe

National Prevention of Blindness Program

**Vision** - global initiative to eliminate avoidable blindness by the year 2020

Vision 2030

long term aim to develop a sustainable comprehensive health care system to ensure the best possible vision for all people and thereby improve quality of life.

Cataract, refractive errors and low vision, trachoma, onchocerciasis, and childhood blindness

5 preventable/treatable conditions

75%

_____% of blindness in the PH is a result of three preventable/treatable conditions of cataract, refractive errors and low vision, and childhood blindness

Cataract

\

1. Opacification of the normally clear lens of the eye
2. Most common cause of blindness worldwide
3. Found mostly in older groups
4. *Surgery* is the only cure for this

Errors of refraction

\

1. Common cause of visual impairment in the country
2. Corrected either with spectacle glasses , contact lenses and *surgery*

**Childhood blindness**

1. Highly specialized services that are needed to diagnose and treat

Screening of children for any sign of visual impairment can be done by *pediatricians, school clinics and health workers.*