1 Exercise and Disease Study Guide 3 Cystic Fibrosis:1. Pathophysiology- Cystic fibrosis resembles COPD in that it lowers lung function, and severely shortens one’s life. It is a recessive disorder, meaning both recessive genes have to inherit from each parent. If someone has one, they don’t have the condition, but they are a carrier. If one inherits both genes, a protein that controls Na intake in and out of the cells is altered. This results in a thick mucus that affects lung function. It will also increase Na inthe sweat since the movement with the cells is messed up.2. What are the other complications?- The thicky mucus is the main symptom of cystic fibrosis, and this causes loss of pulmonary function by clogging the lung. So just like COPD, they can’t exhale all the air with every breathe like healthy people, and thus their residual volume will increase (bad), which will lower their lung capacity. This can lead to bronchiectasis, which is inflammation of the bronchioles and present flabby and dysfunctional aveoli. They can get a collapsed lung, or infection, or polyps.- The pancreas is also affected because the excess Na clogs the release of the digestive enzymes. Since the pancreas can’t release the enzymes, food can’t be digested, leading to malabsorption. Insulin also can’t be released, since it is released from the pancreas, so they can become indirectly diabetic. This will also present liver problems, since the bile duct is blocked from the mucous. With the liver problems, intussusception can happen (intestine fold onto itself, this is not good….)- The vas deferens can be blocked (tube that send sperm to outside body) so men can become infertile- Osteoporosis is possible, since vitamin D can’t be absorbed- There are electrolyte problems because Na regulation is messed up. 3. What is the diagnostic testing?- To diagnose one with cystic fibrosis, you would want to test for the recessive genes. You could also do a sweat test, which is more practical , or a spirometry test to determine lung function. Ablood test would be a IRT test.4. What are the management and medication?Tony Berardi2- There is no cure, but with medication one can manage their symptoms.  You could take antibiotics, mucolytics (thin the mucus), hypertonic saline (this will absorb water into the airway based on osmosis), bronchodilators, and some pancreaticenzymes since the mucus blocks the bodys An easy way to manage could be to perform an airway clearing technique. This will help dislodge some of the mucus. This just involves forcefully hitting someone’s chest to loosen up the mucus. 5. What are the exercise testing and prescription guidelines?- In this population, pulmonary declines, they will be have malnutrition, so this means they are probably pretty deconditioned already.  For testing, you would want to be aware that we would have to perform a maximal test to get their heart rate, because everyone’s lungs might be clogged differently. You would want to monitor their oxygen saturation level just like you would for COPD clients, again you want it tobe above 90%. For aerobic testing, you could go with a cycle test or treadmill, and for endurance, a 6 min walk would be best. A wingate test would be best for anaerobic. o For prescription: Aerobic you want 3-4 days for 10 min. Obviously cardiopulmonary function is severely limitedo For resistance you want the regular 2-3 days with light weight- As always, modify the exercise with their symptoms. Arthritis:1. What is the pathophsyiology?- This is basically inflammation of the joints. There can be multiple forms, such as osteoarthritis, rheumatoid, and ankleloying. This is a degenerative disease and there is no cure.  The disease affects the synovial joints, which is the space between every joint that contains fluid, and the fluid serves as a lubricant so the bones don’t rub together. With arthritis, the synovial fluid is absent. This can leads to bone spurs and cysts, or a build-up of useless tissue. Some possible causes our thought to be the normal wear and tear of simply aging, and a possible autoimmune disorder. Injury, obesity, and a history in the family also seem to predispose one.o With osteoarthritis (literally meaning inflammation of the bone and joints) there is a loss of cartilage, leading to bone rubbing together. This forms the bone spurs and cysts. This seems to be from the normal wear and tear of aging.o Rheumatoid is also inflammation of the joints and it forms pannus tissue in the joints affected. Individuals with this form have a high amount of rheumatoid antibodies, so we think it might be of an autoimmune origin. Tony Berardi3o Anklylosing involves the spine and sacroiliac joint (lower back). There will be a spinal fusion when healing occurs. 2. What are the signs, symptoms, and what are the diagnostic tests?- Individuals could be classified as having acute, chronic, or chronic/acute arthritis. Acute would be someone displaying the symptoms and signs, but they are reversible. Chronic is ongoing pain(stable) that is irreversible. Chronic/acute is chronic pain, but there are periods with increased pain and a decreased ROM. - The signs and symptoms would a restricted ROM, because of the bone rubbing. The axis of the joint would be tender to the touch, fusion of the joints, and synovitis.- You can test with radiography to look at the joints. With osteoarthritis, you could see the bone spurs to help diagnose. There bone space would narrow, because of the lack of synovial fluid. With rheumatoid, you could see erosions of the joint margins. And with ankylosing you could see the vertebra squaring on the sides.3. What are the management and medication?- The obvious goals are to improve the clients QOL by maintaining their function, improve the disease impairment, and to control the inflammation. - You would prescribe analgesics (pain relieve medicine), NSAIDS (no-steroidal, like ibuprofen), corticosteroids (important to only take every 4-6 months; side effects), anti-rheamatics, biologicresponse modifiers, and maybe sulfate. 4. What are the complications in exercise?- Because their arthritis symptoms, they will have limited exercise capacity. This limited capacity will make them stop because of the pain from the arthritis, so if they have CVD problems going on, these will not be able to be seen. You would want to avoid vigorous and high rep exercise (I would