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527 > cardio pulmonary exercise testing > Flashcards

cardio pulmonary exercise testing Flashcards

1
Q

whats CPET stand for

A

cardiopulmonary exercise testing

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2
Q

whats CPET

A

global assessment of exercise response in pulmonary, vardivalsult , nearo and skeletal systems

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3
Q

indicated for CPET

A

determine causes of dyspnea, chest pain, exercise inteolerance

exercise prescription (training intensities)

evaluate functional impairment

evaluate effectiveness of therapy

determine disease severity/ prognosis

pre op eval

assessment of disability for workers compensation

can occupation demands be safely met

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4
Q

T?F resting measurements always support physiological capacity

A

false, not always

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5
Q

components of effective CPEt protocol

A

large mm exercises

measure pulmonary gas exchange from rest to peak

fixed increments in work rate (magnitude and duration) to peak

6-20 mins

measure symptom intensity

post exercise questioning

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6
Q

recommended CPET exercise machines

A

bikes treadmill , arm ergomerty if needed, sport specific

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7
Q 
Bike vs treadmille
vo2 max
safety
leg fatigue
quantifying work rate
blood gas measure 
blood pressure measure
noise artificant
weight bearing
A 
vo2 max - lower 
safety - safer
leg fatigue - more
quantifying work rate: yes
blood gas measure: easy
blood pressure measure: easy
noise artificant: less
weight bearing: less
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8
Q

how to determine work rate increase

A

jones approach

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9
Q

jones approach

A

standardized increments (10 watts in diseased, 25 in norm)

1-2 min stages
total test aimed 10-20 min

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10
Q

symptoms to measure

A

breathing discomfort
mm fatigue
chest / mm pain

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11
Q

most common reason for stopping exercise

A

dyspnea

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12
Q

Dyspnea in COPD Grades

A 
1 - can't breath when exerting
2 - breathless when hurrying / hil
3 - have to go slower than most
4- need to stop to breath after 100yds
5- too breathless to leave home
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13
Q

reasons for stopping exercise example questions

A

dynpnea
leg fatigue
combination

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14
Q

measurements during CPET

A 
external work
metabolic gas exchange
cardiovascular
ventilatory
pulmonary gas ex
symptoms
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15
Q

how to measure external work

A

work rate

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16
Q

measuring metabolic gas exchange

A

v02
RER
Lactate

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17
Q

measuring cardiovascular

A

HR, ECG, BP, 02 pulse

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18
Q

measuring ventilatory

A

Ve (minute ventilation)

tidal volume

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19
Q

Pulmonary Gas exchange measurement

A

Spo02

Sa02

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20
Q

symptoms that you are measuring

A

dyspnea
fatigue
chest pain

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21
Q

what values are considered evidence of reduced exercise capacity

A

<80-85%

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22
Q

when is peak v02

A

clear plateau of vo2

or estimated if listed

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23
Q

reduced v02 peak is problems o f?

A 
02 transport / extraction 
pulmonary limits
neuro limits
mm limits
effort
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24
Q

measure Q by

A

HRx stroke volume

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25
Q

02 extraction determined by

A

02 carrying capacity, mm 02 extraction

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26
Q

02 carrying capacity effected by

A

hemoglobin concentration
pa02
02 dissociation curve (affinity)

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27
Q

mm 02 extraction effected by

A

cap density
mitochondrial density
tissue perfusion

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28
Q

fick equation

A

Q x 02 extraction

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29
Q

inc in v02 does what to Q and CavDo2

A

increase

30
Q

anything that dec Q or Cavd02 does what to v02

A

dec

31
Q

T/f dec in Q can be compensated by Cav?

A

yes, maintains v02 then

32
Q

HRR =

A

predicted HR max - HR max

33
Q

if patient reached predicted HR max ?

A

max effort used

cardio might be exercise limitation

34
Q

HR max normal

A

> 90% predicted

35
Q

HRR normal

A

<15bpm

36
Q

when does Sv plate

A

near end of exercise

37
Q

Sv determined by

A

pre load
contractibty
after load

38
Q

how can Sv b estimated

A

02 pulse

39
Q

whats 02 pulse

A

among of 02 extracted per heart beat

40
Q

calc 02 pulse

A

Vo2 / HR

41
Q

02 pulse inc, what happen Sv cavDo2

A

inc

42
Q

flat 02 means ? Sv cavd02

A

dec or abdonral

43
Q

T/f 02 extraation abnormalities are common

A

no

44
Q

is SBp does not incase or decrease during exercise?

A

cardio limitation or abnormality of BP

45
Q

anaerobic threshold

A

reflect onset of lactic during exercise
upper limit of exercise
% of predicted v02 max

46
Q

RER stands for

A

respiratory exchange ratio

47
Q

cal RER

A

VCo2/ V02

48
Q

RER is

A

estimated % contribution of CHO or fat to energy

49
Q

RER >1.1 means

A

they gave a good effort

50
Q

when does tidal volume plateau

A

at 60-70% of vital capacity

51
Q

incase in VE after Vt plateaus caused by

A

breathing frequency

52
Q

ventilitaroy reserve

A

relationship b/w peak exercise VE and maximal voluntary

max air inhaled exhaled 1 min

53
Q

Vemax/ MVV norm

A

<80-85%

54
Q

MVV - VE max normal

A

> 11 L/min

55
Q

normal Vd/Vt

A

.3-4

56
Q

Ve/Vco2 normal

A

<32-34

<36-50 at peak exercise

57
Q

Vo2 / cycle work rate normal

A

> 80-85% predicted

58
Q

AT or T vent threshold normal

A

> 40% of predicted v02 max

59
Q

HR norm

A

> 90% age predicted

60
Q

HRR normal

A

<15 beat/mmin

61
Q

02 pulse normal

A

> 80% predicted

62
Q

ventilitaroy reserve normal

A

> 11 l/min or <80-85 MVV

63
Q

breathing frequency norm

A

<60 breaths/min

64
Q

Ve/Vco2 ratio norm

A

<32-34, or <36-40

65
Q

Vd/Vt normal

A

<0.28

66
Q

Sa02 normal

A

> 95% or <4 of baseine

67
Q

vd/vt during exercise

A

dec

68
Q

vd/vt inc what happens gas exchange

A

dec

69
Q

ve/vc02 is what

A

vent efficiency

70
Q

ve/vco2 during exercise

A

dec early , increase near end

71
Q

why ve/vco2 increase at end

A

vent compensation for metabolic acidosis

527 (18 decks)

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