Additional General Medical Conditions
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zsmitheman on January 11, 2012
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54 terms
Terms | Definitions |
|---|---|
 Antigen | invading agent |
| Active immunity | as a result of natural infection of invasion o fantigents |
| Passive Immunity | inoculation |
| Cell-mediated response | lymphocytes (T cells) are produced by the thymus in response to antigen exposure |
| Humoral immune response | plasma lymphocytes (B cells) are produced with subsequent formation of antibodies |
| Nonspecific immune response/inflammation | reaction of the tissues to injury form trauma, chemicals, or ischemia |
| Autoimmune Response | directed against an individual's own tissues (diabetes mellitus, rheumatoid arthritis) |
| Rhinovirus (Common Cold) | • Etiology: transmitted by direct or indirect contact; spread by droplets expelled by sneezing, coughing, or speaking • Symptoms/Signs: starts with a scratchy or sore throat, watery discharge/stopped-up nose, and sneezing o Secondary bacterial infection is possible (thickened yellowish nasal discharge, watering eyes, mild fever, sore throat, headache, malaise, myalgia, and dry cough) o Complications: laryngitis, tracheitis, acute bronchitis, sinusitis, otitis media (inner ear inflammation) • Management: Symptomatic treatment (most last 5-10 days regardless of type of treatment) o Avoidance: stay out of crowds, wash hands frequently, avoid sharing personal items, eat a balanced diet and drink plenty of water (emotional stress and extreme fatigue should be avoided) o Pleconaril: possibly shortens duration and severity of cold |
| Influenza | • Etiology: caused by myoviruses (types *A, B, C, D); virus enters cell through genetic material, multiplies and is spread throughout the body (athletes in winter sports, basketball, wrestling, and swimming should get vaccine) • Symptoms/Signs: fever, cough, headache, malaise, and inflamed respiratory mucous membranes with coryza (profuse nasal discharge) o incubation period of 48 hours and comes on suddenly with chills and fever (102-103°F) o may develop photophobia and aching in back of skull o acute stage lasts 5 days; weakness, sweating, and fatigue may continue for several days • Management: bed rest and supportive care (avoid aspirin for under 18 years - Reye's syndrome) o Amantadine & Relenza may be used for influenza A for individuals at risk o Steam inhalation, cough medicines, and gargles |
| Infectious mononucleosis | • Etiology: caused by the Epstein-Barr virus (EBV); incubation is 4-6 weeks; EBV is carried in the throat and transmitted to another person through saliva (bad for athletes - severe fatigue and possible splenic rupture) • Symptoms/Signs: 3-5 day prodrome of headache, fatigue, loss of appetite, and myalgia o day 5-15: fever, swollen lymph glands, and a sore throat o second week: enlarged spleen, jaundice (10-15%), skin rash (5-15%), flushed cheeks, & puffy eyelids o blood test will reveal elevated white blood cell count o complications: ruptured spleen, meningitis, encephalitis, hepatitis, and anemia • Management: supportive and symptomatic o Acetaminophen for headache, fever, malaise o May return 3 weeks after onset if: 1) spleen is not enlarged function; 4) pharygitis and any complication have resolved |
| Rubella (German Measles) | • Etiology: highly contagious childhood viral disease; infection 13-24 days following exposure • Symptoms/Signs: slight fever, sore throat, drowsiness, swollen lymph glands, and appearance of red spots on the palate (occur 1-5 days prior to appearance of rash that occurs 50% of the time - rash begins on face/forehead and spreads down trunk and extremities, lasting for about 3 days) • Management: may be prevented by childhood immunization (combo vaccine: measles, mumps, rubella - MMR) |
| Rubeola (Measles) | • Etiology: highly contagious childhood viral disease (after having disease, individual has acquired immunity) • Symptoms/Signs: onset causes sneezing, nasal congestion, coughing, malaise, photophobia, spots in the mouth, conjunctivitis, and fever that may elevate to 104°F at about 4 days o Onset of high fever: rash appears, face trunk/extremities (small red spots that rapidly increase in size) Rash lasts for about 5 days, may cause itching • Management: every child should receive the MMR vaccine; bed rest, isolation in dark room, and antipyretic and anti-itching medication to provide relief while disease runs its course |
| Mumps (Parotitis) | • Etiology: contagious viral disease that results in inflammation of the parotid and other salivary glands o Usually appear within 12-25 days following exposure • Symptoms/Signs: malaise, headache, chills, and a moderate fever. Pain in the neck below and in front of the ear that progresses to marked swelling on one or both sides (may last for as long as 7 days); painful to move jaw and swallowing may be difficult. Saliva production may be increased or decreased. • Management: immunization with MMR. Patient should be isolated while contagious, confined to bed rest andgiven a soft diet; analgesics may be used with cold applications to control swelling (later heat can be used) |
| Varicella (Chicken Pox) | • Etiology: highly contagious viral disease caused by varicella-zoster virus. Also causes herpes zoster. Most likely to occur in children under 15 years of age; average incubation is 13-17 days following exposure. Individual is contagious for approximately 11 days (beginning 5 days before the first signs of rash appear) • Symptoms/Signs: begins with slight elevation of temperature for 24 hours, followed by eruption of rash o Rash first appears as individual red crops or spots; each evolves through stages of macules, papules, vesicles, and crusts over a period of 2-3 days. o Rash begins on the back/chest (not many spots on extremities) o Disease lasts 2-3 weeks • Management: administration of varicella-zoster immune globulin (VZIg) within 96 hours of exposure will prevent clinical symptoms in normal healthy children. Acyclovir should be administered to adolescents and adults within 24-hours following appearance of symptoms. |
| Sinusitis | • Etiology: can stem from a URI caused by a variety of bacteria; nasal mucous membranes well and block the ostium of the paranasal sinus (pressure from accumulation of mucus causes pain) • Symptoms/Signs: sinus area may be swollen and painful to touch; headache, malaise, purulent nasal discharge • Management: antibiotics; steam inhalation & other nasal topical sprays can produce vasoconstriction & drainage |
| Pharyngitis (Sore Throat) | • Etiology: acute inflammation of the pharyngitis (may be related to common cold, influenza, or mono) • Symptoms/Signs: pain on swallowing, fever, inflamed and swollen lymph glands (lymphandentitis), sollen tonsils, malaise, weakness, and anorexia o Mucous membranes of throat may be inflamed with a covering of purulent matter o Throat culture to rule out strep throat is necessary • Management: topical gargles and rest, antibiotic therapy (for strep, to prevent scarlet fever or rheumatic fever) |
| Tonsillitis | • Etiology: Tonsils are pieces of lymphatic tissue covered by epithelium; within each tonsil are deep clefts/pits lined by lymphatic nodules (pathogens collect in pits and penetrate epithelium, where they contact lymphocytes and cause an acute inflammation and bacterial infection) o Complications: sinusitis, middle ear infections (otitis media), or tonsillar abcesses • Symptoms/Signs: tonsils appear inflamed, red, and swollen with a yellowish exudate in the pits; difficulty swallowing and possibly high fever with chills. Headache, pain in neck and back may also be present. • Management: throat culture to r/o streptococcal infection (if positive, antibiotics); gargling with warm saline solution, liquid diet, and antipyretic medication. Frequent bouts may require surgical removal of tonsils |
| Seasonal Atopic (Allergic) Rhinitis (Hay Fever) | • Etiology: an acute seasonal allergic condition that results from airborne pollens. o Spring: pollens from trees (oak, elm, maple, alder, birch, cottonwood) o Summer: grass and weed pollens; Fall: ragweed pollen o Airborne fungal spores can also cause hay fever o Body's immune system produces allergic antibodies that release histamine (thus causing symptoms) • Symptoms/Signs: early stages: itchy eyes, throat, mouth and nose; followed by watery eyes, sneezing, and clear, watery nasal discharge. Sinus-type headache, emotional irritability, difficulty sleeping, red and swollen eyes and nasal mucous membranes, and a wheezing cough • Management: oral antihistamines (be aware of sedating side effect); decongestants (stimulating effect) |
| Acute Bronchitis | • Etiology: usually occurs as an infectious winter disease that follows a common cold or other viral infection of the respiratory tract. A secondary bacterial infection may follow this inflammation (from overexposure to air pollution); fatigue, malnutrition, or becoming chilled could be predisposing factors • Symptoms/Signs: usually start with URI, nasal inflammation and profuse discharge, slight fever, sore throat and back and muscle pains. A cough signals the beginning of bronchitis. At first the cough is dry, but within a few hours or days, a clear mucus secretion begins which becomes yellowish, indicating an infection. o Usually fever lasts 3-5 days, cough lasts 2-3 weeks or longer. o Athlete may wheeze and rales may be present when auscultation of chest is performed o Avoidance: do not sleep in an area that is extremely cold or exercise in extremely cold air • Management: rest until fever subsides, drink 3-4 liters of water per day, and ingest an antipyretic analgesic, cough suppressant, and an antibiotic (when sever lung infection is present) on a daily basis |
| Pneumonia | • Etiology: infection of the alveoli and bronchioles that may be caused by viral, bacterial, or fungal microorganisms; may also be caused by irritation from chemicals, aspiration of vomit, or other agents. Alveolar spaces become filled with exudate, inflammatory cells, and fibrin • Symptoms/Signs: bacterial pneumonia - rapid onset, high fever with chills, pain on inspiration, decreased breath sounds and rhonchi on auscultation, coughing up of purulent, yellowish colored sputum • Management: antibiotics (for bacterial pneumonia). Deep breathing exercises and removal of sputum through a productive cough are helpful. Analgesics and antipyretics may be useful for controlling pain and fever. |
| Exercise-Induced Bronchial Obstruction (Asthma) | • Etiology: can be stimulated by exercise, or may be provoked only on rare occasions during moderate exercise. The exact cause in not clear. Loss of heat and water causes the greatest loss of airway reactivity. Sinusitis can also trigger an attack in an individual with chronic asthma • Symptoms/Signs: airway narrowing caused by bronchial-wall spasm and excess production of mucus o Chest tightness, breathlessness, coughing, and wheezing o Signs of nausea, hypertension, fatigue, respiratory stridor (high pitched noise), headaches and redness of the skin o Symptoms usually occur within 3-8 minutes of strenuous activity • Management: a regular exercise program, conditioning and running longer distances, exercise intensity and length should be graduated slowly, exercise in warm, humid conditions, Albuterol (B2 agonist, acts for 2 hours) |
| Cystic Fibrosis | • Etiology: genetic disorder that may manifest as: 1) a type of chronic obstructive pulmonary disease; 2) pancreatic deficiency; 3) urogenital dysfunction; 4) increased electrolytes in sweat. Usually begins in infancy and is a major cause of severe chronic lung disease in children (maximum life expectancy is 30 years) • Symptoms/Signs: bronchitis, pneumonia, respiratory failure, gallbladder diseases, pancreatitis diabetes, and nutritional deficiencies. Abnormally high production of mucus secretions in the lungs. • Management: drug therapy (ibu) can help slow progression of disease; antibiotics used to control pulmonary disease. Constant postural drainage to mobilize secretions. High fluid intake, breathing of humidified air |
| Duchenne Muscular Dystrophy | • Etiology: hereditary disease in which there is a degeneration of skeletal muscle with associated loss of strength. Muscle tissue is gradually replaced by adipose and fibrous connective tissue (connective tissue impedes circulation, which accelerates the degenerative process). Onset is usually between 2-10 years • Symptoms/Signs: problem manifests when child begins to walk; frequent falls and difficulty standing up; progressive degeneration hips legs abdominal and spinal musculature (muscles shorten as they atrophy, causing postural abnormalities) • Management: no cure; exercise to delay atrophy; death before age of 20 |
| Myasthenia Gravis | • Etiology: autoimmine disease in which antibodies attack the synaptic junctions between nerves and muscles. Acetylcholine deficiency creates an abnormality that produces early fatigue in skeletal muscle (females 20-40 y) • Symptoms/Signs: drooping of upper eyelid and double vision due to weakness in extraocular muscles. Difficulty chewing and swallowing, weakness of the extremities, and general decrease in muscular endurance • Management: drugs that inhibit breakdown of acetylcholine; corticosteroids to suppress immune system |
| Meningitis | • Etiology: inflammation of the meninges that surround the spinal cord and brain (usually due to meningococcus bacteria - enter through the nose of throat). Causes swelling of the brain, enlargement of ventricles, and hemorrhage of the brain stem • Symptoms/Signs: high fever, stiff neck, intense headache, sensitivity to light and sound; progress to vomiting, convulsions, and coma • Management: cerebrospinal fluid must be analyzed (spinal tap); intravenous antibiotics |
| Multiple Sclerosis | • Etiology: autoimmune inflammatory disease of the CNS that causes deterioration and permanent damage to the myelin sheath that surrounds a nerve cell axon (nerve conduction disrupted); exact cause is uncertain • Symptoms/Signs: depend on the part of the nervous system affected; blurred vision with blind spots, speech defects, tremors, and muscle weakness and numbness in the extremities are common; disease may progress steadily or there may be acute attacks followed by partial or complete temporary remission of symptoms • Management: dealing with symptoms as they appear and disappear; avoid overexertion and fatigue, exposure to extreme temperature, and stressful situations |
| Amyotrophic Lateral Sclerosis | • Etiology: also known as Lou Gehrig's disease; sclerosis of the lateral region of the spinal cord along with degeneration of motor neurons and significant atrophy of muscles • Symptoms/Signs: difficulty in speaking, swallowing, and use of the hands; sensory and intellectual function remain intact; rapid progression of muscle atrophy • Management: no cure; individual still has normal intellectual function but is unable to communicate feelings and ideas |
| Reflex Sympathetic Dystrophy | • Etiology: abnormal and excessive response of the sympathetic portion of the autonomic nervous system that occurs following injury. Most often, it is seen in the hand or foot resulting from the immobilization of an injured part due to pain (associated with injuries to bone, soft tissue, nerves, or blood vessels) • Symptoms/Signs: extreme hypersensitivity to touch, redness, sweating, burning/aching type pain, swelling with palpable tightness and shining of the skin, and atrophy. Symptoms may persist for months up to one year • Management: treatment should be directed at disrupting the abnormal sympathetic response; sympathetic ganglion nerve block administered by a physician is critical; pain-free AROM exercises and therapeutic modalities for decreasing pain and reducing swelling |
| Iron-Deficiency Anemia | • Etiology: iron mainly stored in hemoglobin (64%) and bone marrow (27%) Erythrocytes are too small, hemoglobin is decreased, and ferritin concentration is low (ferritin is an iron-phosphorus-protein complex that contains 23% iron). Ways of losing iron include bowel ischemia, aspirin or NSAIDs, inadequate dietary intake • Symptoms/Signs: decline in athletic performance, burning thighs/nausea from becoming anaerobic, ice craving. Most accurate test of iron status is serum ferritin test • Management: eat a proper diet (more red meat or dark poultry), avoid coffee and tea (hamper iron absorption from grains), ingest vitamin C (enhance iron absorption), take an iron supplement |
| Runners' Anemia (Hemolysis) | • Etiology: cause is the impact of the foot as it strikes the surface; impact forces destroy normal erythrocytes • Symptoms/Signs: mildly enlarged red cells, increased circulatory reticulocytes, decrease in concentration of haptoglobin (glycoprotein bound to hemoglobin) • Management: running on soft surfaces, wearing well-cushioned shoes and insoles, and running "light" |
| Sickle-Cell Anemia | • Etiology: chronic hereditary hemolytic disease; most common in African-Americans, Native Americans, and Mediterranean populations; red cells are sickle-shaped, in which an abnormal type of hemoglobin exists; sickle cell has less potential for transporting oxygen and is fragile when compared with normal cells (15-20 day life span, vs. 120 days of normal cell) - short life of red cell often results in anemia; sickle-shape can cause clustering of cells and clogging of blood vessels; death may occur from stroke, heart disease, or an embolus in the lungs • Symptoms/Signs: a sickle-cell crisis may be brought on by high altitudes or overheating of the skin; crisis symptoms include fever, severe fatigue, skin pallor, muscle weakness, and severe pain in the limbs and abdomen. • Management: symptomatic treatment; anticoagulants and analgesics for pain |
| Hemophilia | • Etiology: hereditary disease characterized by a deficiency in a clotting factor in the blood, prolonged coagulation time, failure of the blood to clot, and abnormal bleeding (predominantly a male disease) • Symptoms/Signs: physical exertion can cause bleeding into muscles and joints, which can be extremely painful. • Management: concentrated clotting factors can control bleeding for several days; hemophilacs should avoid trauma and wear a medical alert bracelet |
| Lymphangitis | • Etiology: inflammation of the lymphatic channels that is most often caused by strep; bacterial infection may occur in the blood (bacteremia) • Symptoms/Signs: usually occurs in extremities; deep reddening of skin, warmth, lymphandentitis, and a raised border over the affected area; chills, high fever, moderate pain and swelling • Management: patient should be hospitalized and vital signs should be closely monitored. Affected extremity should be elevated and warm, moist compresses applied. Antibiotics should be administered, fluid intake. |
| Diabetes Mellitus | • Etiology: Diabetics should eat before exercise and should have hourly glucose supplementation. Type I (insulin-dependent) and Type II (non-insulin dependent) - Type I commonly to those under 35 years of age. Syndrome that results from an interaction of physical and environmental factors. Complete or partial decrease of insulin by the pancreas. • Symptoms/Signs: Type I usually occurs in childhood: frequent urination, constant thirst, weight loss, constant hunger tiredness and weakness, itchy dry skin, and blurred vision. Type II occurs later in life: associated with being overweight, pancreas does not produce enough insulin, or body resists the insulin that is produced. • Management: blood glucose levels must be controlled (balanced diet, doses of insulin if needed); exercise can enhance glucose tolerance (Type I - increases sensitivity; Type II - decreases insulin resistance). |
| Diabetic Coma (ketoacidosis) | • Etiology: if an athlete is not treated adequately through proper diet or too little insulin is produced, the diabetic athlete can develop acidosis • Symptoms/Signs: labored breathing/gasping for air, fruity-smelling breath caused by acetone, nausea and vomiting, thirst, dry mucous membrane of the mouth, flushed skin, and mental confusion or unconsciousness followed by coma • Management: early detection of ketoacidosis is essential - injection of insulin into the athlete may prevent coma |
| Insulin Shock (hypoglycemia) | • Etiology: occurs when the body has too much insulin and too little blood sugar (hypoglycemia results) • Symptoms/Signs: tingling in the mouth, hands, or other body parts; physical weakness; headaches; abdominal pain. Normal or shallow respirations; rapid heartbeat; tremors along with irritability and drowsiness • Management: athlete must adhere to a carefully planned diet that includes just a snack before exercise (complex carbs and protein) |
| Epilepsy | • Etiology: causes include genetics, altered brain metabolism or a history of injury. • Symptoms/Signs: if an individual has daily or weekly seizures, collision sports should be prohibited (blow during participation that causes unconsciousness could result in a serious injury). If seizures are properly controlled, little sports restriction is necessary (except scuba diving, swimming alone, or activities at high altitudes) • Management: anti-convulsant medication (side effects may occur). When an epileptic becomes aware of an impending seizure, he/she should immediately sit or lie down. AT should cushion athlete's fall, loosen restrictive clothing, place a soft cloth between the teeth, allow athlete to awaken normally after seizure (do not restrain athlete during seizure) |
| Hypertension | • Etiology: primary/essential (no associated disease) o secondary (related to a specific underlying cause - kidney disorder, overactive adrenal glands increased blood volume, hormone-producing tumor, narrowing of aorta, pregnancy, medications) o Prolonged hypertension increases chances of coronary artery disease, congestive heart failure & stroke • Symptoms/Signs: primary is usually asymptomatic until complications occur; HBP may cause dizziness, flushed appearance, headache, fatigue, epistaxis, and nervousness • Management: risk of death from heart disease doubles with every 20/10 mm/Hg increase in BP. o Normal: 120/80 mm Hg o Pre-hypertension: 120-139/80-89 mm Hg Make lifestyle changes: lose weight, be physically active, limit alcohol, quit smoking o Stage 1 hypertension: 140-159/90-99 mm Hg (meds) o Stage 2 hypertension: at or greater than 160/100 mm Hg (meds) |
| Cancer | • Etiology: 2 leading cause of death; 30% of Americans will get cancer, 25% of Americans will die from cancer o Condition in which cellular behavior becomes abnormal and cells no longer perform normal functions o The cells' genetic makeup is altered and changes the way it functions; the abnormal cell then divides, forming additional cancer cells, and this collection of cells invades and eventually takes over normal tissue o Tumors: -Benign: pose a small threat to tissue and tend to remain confined in a limited space -Malignant: grow out of control and spread within a specific tissue; may spread via blood and lymph systems (metastasize) to the entire body • Classified according to type of tissue in which they occur and how fast they grow • Skin cancer - easiest to detect and to cure • Males: highest incidence of cancer in prostate, lung, colon/rectal, urinary, and leukemias/lymphomas • Females: breast, colon/rectal, lung, uterus, leukemias/lymphomas o Causes of cancer: -More than 100 types of cancer have genetic origins -Environmental factors: viruses, exposure to UN light, radiation, certain chemicals (tobacco) and alcohol use -Fatty diet • Symptoms/Signs: classic warning signs - change in bowel and bladder habits, sore throat that does not heal, unusual bleeding or discharge, thickening or a lump somewhere in the body, ingestion or difficulty swallowing, change in a wart or mole, nagging cough or hoarseness • Management: early detection and treatment improves chances of survival; most effective forms of treatment include surgery, radiation, and chemotherapy |
| Chlamydia Trachomatis | • Etiology: in females, may result in pelvic inflammatory disease (cause of infertility & ectopic pregnancy) • Symptoms/Signs: males (inflammation and purulent discharge 7-28 days after intercourse; possibly painful urination and traces of blood in urine); females (asymptomatic, may experience vaginal discharge, painful urination, pelvic pain, and pain and inflammation in other sites) • Management: organism identification and treatment; must be treated immediately in pregnant women; uncomplicated cases treated with antibiotics |
| Genital Herpes | • Etiology: Type 2 herpes simplex virus; signs of disease appear 4-7 days after sexual contact; primary genital herpes crusts in 14-17 days, secondary cases crust in 10 days • Symptoms/Signs: first signs - males have itching and soreness, females may be asymptomatic; 50-60% of all sufferers will never experience a second episode; lesions become ulcerated and then crust and heal in 10 days, leaving a scar; can be fatal to a newborn child • Management: no cure (system antiviral medications may lessen early symptoms of disease) |
| Trichomomiais | • Etiology: caused by the flagellate protozoan Trichomonas vaginalis; affects 20% of all females during their reproductive years and 5-10% of all males • Symptoms/Signs: Females experience greenish yellow and frothy discharge; causes irritation of vulva, perineum, and thighs, and may experience painful urination. Males are often asymptomatic, some experience a frothy, purulent urethral discharge • Management: two grams of metronidazole in one dose for females; 500mg 2x/day for 5-7 days for males |
| Genital Candidiais | • Etiology: Candida occurs naturally in the vagina; several causes exist, may be transmitted sexually • Symptoms/Signs: vulval irritation that begins with redness, severe pain, and vaginal discharge. Males are usually asymptomatic but could develop some irritation and soreness of the glans penis • Management: antifungal cream should be applied for 3 days |
| Condyloma Acuminata (Venereal Warts) | • Etiology: venereal warts transmitted through sexual activity; appear on the glans penis, vulva, or anus • Symptoms/Signs: wart produces nodules that have a cauliflower-like lesion or can be singular; early the nodules are soft, moist, pink or red swellings that develop a stem with a flowerlike head • Management: treated by a physician with a solution of 20-25% podophyllin; dry warts may be treated with liquid nitrogen |
| Gonorrhea | • Etiology: acute venereal disease that can infect the urethra, cervix, and rectum; caused by gonococcal bacteria Neisseria gonorrhoea which is usually spread through sexual intercourse • Symptoms/Signs: males - incubation period of 2-10 days, tingling sensation in urethra, greenish-yellow discharge of pus and painful urination. Females - 60% are aysymptomatic, onset is 7-21 days, vaginal discharge • Management: untreated gonorrhea will become latent and manifest itself in later years, usually causes sterility or arthritis; treatment is antibiotics and immediate physician referral |
| Syphilis | • Etiology: caused by a spirochete bacteria Treponema pallidum; enters body by mucous membranes or lesions • Symptoms/Signs: has 4 stages (primary, secondary, latent, late/tertiary). Incubation period is 3-4 weeks o Primary: a painless chancre (ulceration) develops and heals within 4-8 weeks; highly contagious, ulcerations can occur on the penis, urethra, vagina, cervix, mouth, hand, foot o Secondary: 6-12 weeks after infection; skin rash, lymph swelling, body aches, mild flulike symptoms o Latent: no or few symptoms; if untreated, approximately 33% of persons with latent syphilis will develop late/tertiary syphilis o Late/tertiary: develops within 3-10 years of infection. Deep penetration of spirochetes that damage skin, bond, and cardiovascular and nervous systems. Neurosyphilis can progress into severe muscle weakness, paralysis, and various types of psychoses. • Management: antibiotics (penicillin). Air drying and cleaning with soap and water will destroy it. |
| Physiology of the Menstrual Cycle | • Menarche (the onset of menses) o Normally occur between ages 9-17 years (majority between 13-15 years) o Strenuous sports training and competition will delay onset of menarche o Delayed menarche/primary amenorrhea: menstruation not occurring by age 16 or a failure to develop secondary sexual characteristics by age 14 -Late maturing girl often has longer legs, narrower hips, and less adiposity and body weight |
| Menstruation | o 28 day cycles consists of follicular and luteal phases (each 14 days long) o Menses varies from 3-7 days o FSH: stimulates maturation of an ovarian follicle o LH: stimulates the development of the corpus luteum and the endocrine structure that secretes progesterone and estrogens o Ovulation: release of the egg from the mature follicle at midcycle o FSH production is inhibited when follicle reaches maturity due to estrogenic steroids produced by ovaries o LH production is eventually inhibited by progesterone o Estrogen secreted principally by luteal cells |
| Amenorrhea | a. Etiology: cause is often a hypothalamic dysfunction (GnRH gonadotropin-releasing hormone is often deficient). Pregnancy, abnormalities of reproductive/genital tract and cancer should be ruled out. b. Symptoms/Signs: many factors may contribute to exercise-induced amenorrhea: i. Competition such as long-distance running, gymnastics, professional ballet, cycling, or swimming ii. Low body weight with weight loss after beginning of training iii. Total calorie intake inadequate for energy needs iv. Eating disorder v. High incidence of menstrual abnormalities before vigorous training vi. Higher levels of stress when compared with those experiencing normal menses vii. Likely to have begun training at an early age viii. A rapid increase in high-intensity exercise c. Management: reestablish normal hormone levels to return normal menstrual cycle. Nutritional counseling, reduction of exercise intensity. Estrogen replacement may be considered. |
| Dysmenorrhea | a. Etiology: inconclusive whether sports participation can alleviate or produce dysmenorrheal; pathological conditions should be ruled out b. Symptoms/Signs: cramps, nausea, lower abdominal pain, headache, and sometimes emotional lability c. Management: mild to vigorous exercise; most often occurs in swimmers or those athletes who perform for a long period of time |
| The Femal Athlete Triad | a. Etiology: the young woman athlete is pressured to fit an image, which results in disordered eating, which may lead to menstrual dysfunction and subsequent premature osteoporosis b. Symptoms/Signs: premature bone loss and inadequate bone development that results in low bone mass, micro-architectural destruction, increased skeletal fragility, and increased risk of fracture. Special concern should be used for those athletes whose sport focuses on an ideal body type and weight c. Management: *prevention, education, identify those at risk |
| Bone health | • Prolonged decrease of FSH, LH, estrogen and progesterone may cause osteoporosis • Low bone mass leads to bone fragility and increased susceptibility to stress fractures in female athletes with premature osteoporosis (calcium nutrition is needed) • Loss of periods with low bone mass - decrease training intensity & volume, increase total calories, ingest calcium |
| Contraceptive and Reproduction | • Athletes should not take extra oral contraceptives to delay menstruation during competition (may cause nausea, vomiting, fluid retention, amenorrhea, hypertension, double vision, and thrombophlebitis) |
| Pregnancy | • Can participate in physical activity well into the 3 month; may continue into 7 month if no problems arise • It is during the first 3 months of pregnancy that dangers of harming the fetus are greatest • Exercise and Pregnancy o Extreme exercise may lower birth weight o Physicians recommend that contact sports should be avoided o Contraindications: pregnancy-induced hypertension, preterm rupture of membranes, preterm labor during the prior or current pregnancy, incompetent cervix or cerclage, persistent second or third trimester bleeding, intrauterine growth retardation • Ectopic Pregnancy o Fertilized egg is implanted outside the uterine cavity due to inflammation of the fallopian tubes or some mechanical blockage to the normal downward movement of the ovum o Symptoms: amenorrhea, tenderness, soreness and pain on affected side, referred pain in the shoulders, pallor, and potentially signs of shock and hemorrhage |
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