Learning Module Eleven: Women's Health


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Learning Unit on Chronic Disease

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Learning Module Eleven: Women's Health

  1. 1. Chapter 11Other Chronic Diseases and Conditions
  2. 2. Chronic Diseases: What Are They, and Why Are They Important?• Diseases that persist for a long time• Rarely cured completely• Biggest cause of death and disability around the world.
  3. 3. Chronic diseases are common, and they also affect women more than men.• Chronic diseases are responsible for 70% of deaths in the U.S. (men and women).• Greater rates of arthritis, immune diseases, Alzheimer’s disease for women• Lupus afflicts women 9X more often than men• Hypothyroidism is 50X more common in womenWomen are also more likely to be caretakers for other people with chronic diseases.
  4. 4. Racial/Ethnic and Socioeconomic Dimensions• White and Asian women have osteoporosis more often than African American women• African American women are more likely than white women to die following a hip fracture• American Indians and Alaskan Natives have the highest prevalence rates of diabetes• Blacks and whites have somewhat equal rates of arthritis, but blacks have a higher rate of activity limitations due to arthritis and a higher prevalence of severe pain
  5. 5. Economic Dimensions Estimated Annual Costs Conditions CostsArthritis $128 billionDiabetes $132 billionAlzheimer’s disease $100 billionCardiovascular $300 billiondiseaseBone fractures $12–18 billion
  6. 6. Osteoporosis Nonmodifiable Risk Factors for Osteoporosis• Being female• Increased age/postmenopausal• Small frame and thin-boned• White or Asian• Family history of osteoporosis or fractures © Ron Chapple/Thinkstock/PictureQuest
  7. 7. Modifiable Risk Factors for Osteoporosis• Diet low in calcium and vitamin D• Sedentary lifestyle• Cigarette smoking• Estrogen deficiency• Low weight and body mass index• Certain medications – Glucocorticoids, anticonvulsants• Amenorrhea• Anorexia nervosa or bulimia
  8. 8. Screening and Diagnosis for OsteoporosisWomen who should be tested:• All postmenopausal women younger than age 65 who have one or more additional risk factors for osteoporosis besides menopause• All women age 65 and older• Postmenopausal women with fractures• Women who are considering therapy for osteoporosis or who want to monitor the effectiveness of certain osteoporosis treatments
  9. 9. Treatment and Prevention of Osteoporosis• Adequate supply of calcium• Vitamin D• Participate in weight-bearing and muscle- strengthening exercises• Estrogen replacement therapy• Drugs: alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista), teriparatide (Forteo), nasal calcitonin spray• Fall-prevention strategies
  10. 10. Arthritis• Arthritis—inflammation of the joints—affects an estimated 43 million Americans (1 of 6 people) – Osteoarthritis: degenerative joint disease – Rheumatoid: chronic inflammatory disease – Gout: excess uric acid in the body
  11. 11. Healthy Joint vs. OsteoarthriticJoint vs. Rheumatoid Arthritis
  12. 12. Risk Factors for Arthritis
  13. 13. Symptoms of Arthritis• Achy, stiff joints• Small bony knobs on fingers (osteoarthritis) Diagnosis of Arthritis• No single test can diagnose arthritis• Family history and physical exam to check joints, reflexes, and muscle strength• Radiographs• Blood tests• Joint aspiration
  14. 14. Prevention and Treatment of Arthritis• Maintaining weight through diet and exercise• Avoiding contact sports and repetitive joint motion• Preventing Lyme disease (vaccine, insect repellent)• Drugs: NSAIDs, topical pain relievers, corticosteroids, hyaluronic acid, disease- modifying antirheumatic drugs, biologic response modifiers, immunosuppressants• Surgery is another treatment option
  15. 15. Diabetes Mellitus• 18.6 million cases of diabetes—half of the cases are womenTypes of diabetes• Type 1: Usually appears during childhood• Type 2: Most cases of diabetes• Gestational diabetes: Develops in 2% to 5% of pregnant women
  16. 16. Risk Factors for Diabetes• Having a first-degree relative with diabetes• Being overweight• Having hypertension, abnormal high-density lipoprotein (HDL) or triglyceride levels• Racial groups: African American, Hispanics, American Indians/Alaskan Natives
  17. 17. Symptoms of DiabetesType 1 Type 2• Frequent urination • Any type 1 symptoms• Unusual thirst • Frequent infections• Extreme hunger • Cuts/bruises that are hard to heal• Unusual weight• Extreme fatigue• Blurred vision
  18. 18. Complications of Diabetes
  19. 19. Diagnosis of DiabetesRoutine tests• Fasting plasma glucose test/oral glucose tolerance test• Normal sugar level = 70–110 mg/DL; blood sugar level above 126 mg/dL on at least two occasionsTreatment and prevention of diabetes• Daily insulin injections• Diet control• Physical activity• Home blood glucose testing several times a day
  20. 20. Autoimmune Diseases• Diseases in which the body’s immune system turns inward rather than outward.• More than 80 different illnesses, usually occurring among women.• Hormone related?
  21. 21. Autoimmune Diseases Lupus: A Poorly Understood Disease• Immune system forms antibodies that target healthy tissues and organs• Primarily a disease of young women of childbearing age (affects women 10 to 15 times more often than men), more likely to affect African American women• Symptoms can go away and then return• Types – Discoid (cutaneous) lupus – Systemic lupus erythematosus (SLE) – Drug-induced lupus
  22. 22. Lupus (cont.)Risk factors of lupus• Exact cause is unknown—genetic, hormonal, and environmental factors involvedSymptoms of lupus• Painful, swollen joints or arthritis• Skin rash – Butterfly-shaped across face – Triggered by sun exposure• Frequent fevers• Prolonged or extreme fatigue• Anemia• Kidney involvement
  23. 23. Lupus (cont.)Diagnosis of lupus • Take note of symptoms – Skin rash, joint pain, chest pain, seizures, photosensitivity, review of history of medications • Complete blood count • Antinuclear antibody test (ANA) • Urinalysis
  24. 24. Lupus (cont.)Treatment and prevention of lupus• Avoid sun exposure and use sunscreen• Exercise• Nonsteroidal anti-inflammatory drugs (NSAIDs)• Corticosteroids• Antimalarial agents• Immunosuppressant drugs• Steroids
  25. 25. Thyroid DiseaseThyroiditis: inflammation of the thyroid, the gland controlling the body’s metabolismTwo forms:• Hypothyroidism: underactive thyroid—body burnsenergy too quickly• Hyperthyroidism: overactive thyroid—body burnsenergy too slowly
  26. 26. Risk Factors for Thyroid Disease• Age and gender (women over age 20)• Family history of a family member with thyroid disease• Previous thyroid concerns or conditions
  27. 27. Symptoms of Hashimoto’s Disease and Graves’ Disease Hashimoto’s Disease (Hypo) Graves’ Disease (Hyper)• Weight gain • Weight loss• Fatigue and listlessness • Increased energy expenditure• Difficulty concentrating • Nervousness and irritability• Dry skin • Sweating more than normal• Sensitivity to cold • Heat intolerance• Constipation • Diarrhea• Goiter • Bulging of the eyes
  28. 28. Diagnosing and Treating Thyroid DiseaseDiagnosis of thyroid disease• Thyroid-stimulating hormone (TSH) test• Blood tests measuring levels of thyroxine (T4) can confirm presence of diseaseTreatment and prevention of thyroid disease• Annual checkups• Thyroxine for Hashimoto’s disease• Antithyroid drugs for Graves’ disease
  29. 29. Alzheimer’s Disease© Photodisc
  30. 30. Alzheimer’s Disease (cont.)Risk factors for Alzheimer’s disease• Age• Female gender• Genetic background – Familial Alzheimer’s disease (FAD)• Other possible factors – Lifestyle – Severe or repeated head injuries – Lower education levels – Environmental agents
  31. 31. Alzheimer’s Disease (cont.)Symptoms of Alzheimer’s disease• Memory loss• Decline in ability to perform simple tasks• Less clear thinking and forgetfulness• Affected language and reasoning skills• Lack of ability to make judgments• Personality changes• Emotional outbursts• Wandering and agitation
  32. 32. Alzheimer’s Disease (cont.)Diagnosis of Alzheimer’s disease• Person’s history, complete physical exam; various laboratory tests; brain scans; tests for measuring memory, language skills, and other brain activitiesTreatment of Alzheimer’s disease• Controlling symptoms and delaying memory loss with drugs• Maintaining a calm, safe, structured environment
  33. 33. Discussion: Informed Decision Making• Prevention, when possible• If prevention isn’t possible, find the disease early, and manage it to reduce symptoms and promote healthier living• Examples?