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CEP Exam Flashcards

1
Q

signs of myocardial ischemia (3)

A
  1. ECG abnormalities
  2. Angina
  3. Stiffening left ventricle
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2
Q

Angina pectoris

A

Chest pain, heart cramp

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3
Q

Modifiable factors to prevent CVD?

A

High Blood pressure
hyperlipidemia
obesity
smoking
physical inactivity

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4
Q

myocardial infarction

A

Heart attack. Not enough blood to the hear muscle

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5
Q

myocardial ischemia

A

reduced blood flow to the heart

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6
Q

chronic heart failure

A

function of the heart fails to meet the requirements

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7
Q

stroke

A

obstruction of bloodflow to the brain

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8
Q

Marie Tooth disease

A

muscle athrophy

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9
Q

Post-polio syndrome

A

muscle weakness, fatigue and pain

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10
Q

sarcopenia

A

loss of muscle mass and strength

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11
Q

geriatric

A

ilness and disease of old people

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12
Q

frailty

A

failure of multiple systems

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13
Q

What delays the process of frailty?

A

Physical activity, especially higher intensity

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14
Q

What happend during systolic heart faile

A
  • less blood pumped out of the ventricles
  • weakened heart muscle can’t squeeze as well
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15
Q

What happend during diastolic heart failure

A
  • less blood fills the ventricles
  • stiff heart can’t relax normally
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16
Q

Equation of Stroke Volume

A

SV = EDV - ESV

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17
Q

What is ejection fraction

A

How much blood is pumped away per pump.

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18
Q

Consequences for exercise measurements in CVD / Structural/functional changes in the heart in CVD? (5)

A
  • Cardiac athrophy
  • reduced blood volume
  • reduced vascular compliance(increased arterial stiffness)
  • weakened contractility heart
  • reduced capillarisation of active tissue
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19
Q

Consequences for exercise measurements in CVD / Structural/functional changes in the lungs in CVD? (5)

A
  • increase pulmonary vascular pressures
  • higher stiffnes
  • higher ventilation (VE)
  • higher respiratory muscle work
  • lower diffusion capacity
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20
Q

Consequences for exercise measurements in CVD / Structural/functional changes in the skeletal muscle in CVD? (4)

A
  • lower blood flow
  • lower mitochondrial volume
  • lower % type 1 fibers
  • higher glycolytic enzymes
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21
Q

What are the consequences of a CVD for the respiratory chain or energy metabolism

A
  • The fick’s equation predicts the consequences for energy expenditure
  • The lungs, muscles and heart affect this equation
  • a-v O2diff is smaller
  • aterial: lungs give less oxygen
  • venous: muscles use less oxygen
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22
Q

CPET results in CVD - cardiac responses

A
  • HRpeak not affected
  • O2 puls (VO2/HR) –> VO2 is lower
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23
Q

CPET results in CVD - functional capacity

A
  • VO2 peak is reduced
  • Peak WR is decline
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24
Q

CPET results in CVD - ventilation/gas exchange

A
  • MVV (no change)
  • VT1 & VT2 (lower exercise intensity)
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25
Q

What are the exercise responses in chronic heart failure?

A
  • reduced VO2peak
  • Abnormal delta VO2/WR
  • High HR/WR
  • Low VO2/WR
  • increase in HR vs VO2
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26
Q

What are the 5 Electrical phases heart cycle

A
  1. SA node activity
  2. stimulus spread to AV node
  3. Atria contraction begins
  4. impulse travels from purkinje fibers to right ventricle
  5. atria contraction completed. ventricular contraction begins
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27
Q

right atria

A

deoxygenated blood from body

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28
Q

right ventricle

A

pums deoxygenated blood to the lungs

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29
Q

left atria

A

receives oxygenated blood from the lungs

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30
Q

right atria

A

pumps oxygenated blood to the body

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31
Q

function of the SA-node

A

generates electrical activity

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32
Q

function of the AV-node

A

generates delay in the conduction system

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33
Q

What says an abnormality in the P-wave

A

something wrong with atria

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34
Q

What says an abnormality in the QRS-complex

A

slower conduction of the ventricular depolarization

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35
Q

What says an abnormality in the PR-interval

A

less/more time between contraction of atria and ventricles

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36
Q

bradycardia

A

abnormal low HR < 60

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37
Q

tachycardia

A

abnormal high HR > 100

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38
Q

Objective criteria to determine exercise intensity? (3)

A
  • VO2max Reserve or METs
  • HRReserve (karvonen)
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39
Q

Subjective criteria to determine exercise intensity? (2)

A
  • RPE
  • Talk Test
40
Q

What do you use to prescribe exercise?

A

Target VO2 - %VO2Reserve

41
Q

What is the equation of Target VO2?

A

Target VO2 = [(VO2max - VO2rest) x % + VO2rest]

42
Q

What is the equation of Target MET’s?

A

Target VO2/VO2rest (/3,5)

43
Q

When you don’t have gas analysis, how can you prescribe exercise?

A

Karvonen Formula
Use HR, HR/VO2 regression

44
Q

What is the Karvonen formula?

A

HRR
Target HR = [(HRmx - HRrest) x % - HRrest]

45
Q

What are problems when you use HRmethods to prescribe exercise? (4)

A
  1. HR estimated
  2. stress while taking pulse
  3. day-to-day variability
  4. HR/VO2 differs between modalities
46
Q

Problems of using RPE (5)

A
  • link RPE to exercise stage
  • people get distracted
  • compaire to others
  • people just don’t get is
  • assumes steady state exercise
47
Q

What is the Talk Test

A

estimation of VT

48
Q

How can you use VT?

A

VT is a relevant marker for exercise intensity

49
Q

What are the 3 principles of exercise prescription?

A
  1. Specifity
  2. Overload (FITT)
  3. Reversibility
50
Q

What does reversibility mean?

A

It’s the loss of previously exercise training adaptations because of inactivity

51
Q

FITT principels - Frequency

A

3-5 times per week

52
Q

FITT principels - intensity

A

40-85% of max capacity

53
Q

FITT principels - Time

54
Q

Type/mode (3)

A
  1. large muscle groups
  2. single joint
  3. free weights/functional training
55
Q

What are the benefits of CEPT? (3)

A
  1. determination of VO2peak
  2. simultaneous study of: cellular, cardiovascular and venilatory
  3. measurement of energy expenditure
56
Q

What are the steps for exercise testing? (5)

A
  1. indication/goal setting
  2. pre-screening
  3. test-execution
  4. terminate test
  5. analyse
57
Q

What is the reason to not do a CPET test?

A

Unstabe ischemic rythm or conditions

58
Q

in the CPET test-execution you measure 3 things?

A
  1. workload
  2. Cardiovascular
  3. Pulmonary
59
Q

When do you end a CPET test looking at Blood Circulation (2)?

A
  • BP > 250/120 mmHg
  • BP drops > 10 mmHg
60
Q

When do you enter a CPET test looking at Heart Rate/rhythm (2)?

A
  • ST elevation > 1mm
  • ST depresstion > 2mm
61
Q

When was a CPET test maximal? (6)

A
  • POmax achieved
  • HRmax achieved
  • VEmax achieved (no reserve)
  • RER > 1.15
  • RPE = 17
  • Predicted VO2peak achieved and plateaud
62
Q

What are the Wasserman plots?

A

analysis of cardioplumonary responses

63
Q

What are the 6 variables of the wasserman-plots?

A
  1. VO2
  2. VCO2
  3. HR
  4. WR
  5. VE
  6. TV
64
Q

What are the markers of - Function capacity (3)

A
  • peak WR
  • Peak VO2
  • delta VO2/delta WR
65
Q

What are the markers of - cardiovascular function (3)

A

HR peak
O2 pulse (VO2/HR)
Cardiac reserve

66
Q

What is the cardiac reserve?

A

difference between the predicted and measured HRpeak

67
Q

What are the markers of - pulmonary and metabolic function?

A
  • MVV (maximal voluntary ventilation)
  • VT
  • RCT
  • Breathing reserve
68
Q

what is breathing reserve?

A

difference between MVV and VO2peak

69
Q

How much lactate is available at VT1?

70
Q

How much lactate is available at RCP/VT2?

A

lactate > 4mmol/L

71
Q

What are the 4 available sources from where you can resynthesis ATP?

A
  1. fatty acids
  2. carbohydrates
  3. anaerobic glycolysis
  4. phosphocreatine
72
Q

Tell something about lactate in the Glycoltic system when there is sufficient O2 available

A

Lactate will always be produced. It’ll transformed to pyruvate. this enters the krebs cycle for oxidative phosphorylation

73
Q

Tell something about lactate in the Glycoltic system when there is insufficient O2 available

A

lactate starts to accumulate and enters the blood stream. doesn’t go into the kreb’s cycle

74
Q

for what can you use VO2max? (3)

A

prognosis
cardiorespiratory fitness
aerobic capacity

75
Q

What are the 3 components of muscle respiration?

A

lungs
heart
muscles

76
Q

give the Fick’s equation

A

VO2 = CO * (a-v)O2difference

77
Q

What is de cardiac output?

A

amount blood per min that’s pumped through the circulation

78
Q

Risk factor - age

A

men >45, women >55 years

79
Q

family history ages

A

dad/brother >55
mom/sister > 65

80
Q

participates in regular exercise - NO
Medical clearance -yes/no?

No CV, metabolic, renal disease
No symptoms

81
Q

Participates in regular exercise - NO
Medical clearance -yes/no?

Known CV, metabolic, renal disease
Asymptomatic

82
Q

Participates in regular exercise - NO
Medical clearance -yes/no?

signs of CV, metabolic, renal disease

83
Q

Participates in regular exercise - YES
Medical clearance -yes/no?

Signs of CV, metabolic, renal disease

A

discontinue

84
Q

Participates in regular exercise - YES
Medical clearance -yes/no?

Known CV, metabolic, renal disease
Asymptomatic

A

moderate - no
vigorous - yes

85
Q

Participates in regular exercise - YES
Medical clearance -yes/no?

No CV, metabolic, renal disease
No signs

86
Q

Physical activity reduces the risk of:

A

dementia
hip fractures
depression
all-cause mortality
cardiovascular disease
type 2 diabetes
cancer

87
Q

Benefits of PA for patients

A

better cardiorespiratory fitness
higher muscle strength and endurance
reduced fatigue and dyspnea
better QoL

88
Q

PA for patients with chronic disease because of the following 2 reasons:

A

increased health
improved functioning

89
Q

adaptations after aerobic exercise - respiratory

A
  • improved O2 diffusion
    -reduced VE at submax exercise
    -increased ventilation at max exercise
90
Q

adaptations after aerobic exercise - cardiovascular

A

higher SV, BV, bloodflow to muscles
lower HR rest

91
Q

adaptations after aerobic exercise - muscular

A

higher capillarisation, O2 diffusion in muscle, type IIa/I muscle fibers

92
Q

Guidelines Physical activity

A

150-300min moderate
75-150min vigurous

93
Q

What is the metabolic squeeze?

A

With ageing:
MET’s decrease
Energy cost increase

94
Q

Signs/symptoms of CV, metabolic or renal disease (4)

A
  1. angina
  2. dyspnea
  3. dizziness
  4. unusual fatigue or shortness of breath
95
Q

points to consider before starting to exercise (3)

A
  1. current activity level
  2. symptoms
  3. planned exercise intensity
96
Q

Benefits PA (4)

A

prevention disease
maintaining health
treatment of chronic diseases
better functioning

CEP (7 decks)

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