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Cardiopulmonary > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Which of the following examples best describe the relationship between vascular resistance, blood flow and blood pressure?
A. As vascular resistance increases, in order to maintain consistent blood flow, blood pressure must increase.
B. As vascular resistance decreases, in order to maintain consistent blood flow, blood pressure must increase.
C. Vascular Resistance and Blood Flow are inversely related
D. Both A and C are true

A

D. Both A and C are true

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2
Q

Which of the following is the fast adapting system used to maintain arterial blood pressure?
A. The Baroreflex
B. Natriuretic Peptides
C. The Renin Angiotensin Aldosterone System

A

A. Baroreflex

B & C are SLOW systems
B. vasodilators in atria and ventricles
C. controlled by kidneys

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3
Q

Which statement best describes the blood pressure response to physical activity and exercise?
A. Global vasodilation in arteries of working tissue, mediated by the sympathetic nervous system.
B. Global vasoconstriction in arteries throughout the body, mediated by the sympathetic nervous system and local vasodilation in arteries of working tissue mediated by metabolites and by-products.
C. Global vasoconstriction in arteries throughout the body, mediated by the sympathetic nervous system and local vasodilation in arteries of working tissue mediated by parasympathetic nervous system

A

B. Functional Sympatholysis

Local dilation to offset global constriction to redirect blood flow from viscera to working tissues
Higher BP response doing upper body erg compared to lower body

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4
Q

Which of the following may lead to an inaccurate blood pressure Measurement? A. Seated with legs uncrossed
B. Empty bladder
C. Cuff placed over clothing
D. Back Supported

What are some other errors to avoid?

A

C. Bare skin! Also keep them quiet, arm supported at heart level

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5
Q

A patient presents to your clinic with a blood pressure of 140/90mmHg, he has a normal BMI and unremarkable past medical history.

What signs and symptoms would this patient most likely demonstrate?
A. Headache
B. Chest Pain
C. Shortness of Breath
D. None

A

D. Probably won’t show any symptoms at this point; Hypertensive Stage 2

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6
Q

A patient presents to your clinic with a blood pressure of 196/118mmHg, he has a normal BMI and otherwise unremarkable past medical history.
What signs and symptoms would this patient most likely demonstrate?
A. Headache
B. Chest Pain
C. Shortness of Breath
D. None

A

D. None; body able to adapt well; patient is in hypertensitve URGENCY since they are in HTN crisis but showing no sxs
Retake BP, HOLD treatment and send to PCP

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7
Q

You are conducting a maximal aerobic fitness test on a patient. Which of the following is NOT a common occurrence during testing?
A. Rise in diastolic blood pressure
B. Heart rate increases
C. Tidal volume increases
D. Increase in systolic blood pressure

A

A. Diastolic BP should either decrease or stay the same due to vasodilation at local tissues

BIG problem if systolic does NOT increase

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8
Q

What are some of the advantages of measuring blood pressure during exercise?

What are some things to consider when measuring blood pressure during exercise?

A
  1. Gauge response to stress; bad cardiac events typically happen when the body is under stress (1 MET = 10 mm increase in systolic)
    Masked HTN - patients have normal in clinic and high at home so exercise can unmask it
    DO NOT USE automatic cuff bc they use vibrations - alot during exercise
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9
Q

Which of the following is a significant barrier to BP screening in PT practice?
A. Lack of Equipment
B. Inability to Take Blood Pressure Accurately
C. Lack of Perceived importance

What are some other potential barriers?
What are some potential facilitators?

A

C. Don’t view as important in their population
Lack of policy or equipment or time
Clinic policy, perceived importance

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10
Q

Do physical therapists have a role in screening for HTN?
A. Yes
B. No
Do they have a profession duty to screen to measure BP on new patients?

A

YES! Can catch things others may not with the time we have with patient’s

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11
Q

Adipose tissue is a passive tissue with no influence on other structures
A. True
B. False

A

False!

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12
Q

Perivascular adipose tissue always has negative impacts on vascular function
A. True
B. False

A

B. False

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13
Q

What are some of the limitations of BMI?
What are some of the benefits of BMI?
What are some other methods to measure body composition?
Are there are other outcomes or measurements that might be more clinically useful for the physical therapy management of obesity?

A

Benefits - easy pretty accurate for BMI over 40
Limits - does not take composition of muscle and bone into account
Methods - bod pod, calipers, hydrostatic weigh, waist circumference
Other outcomes - FITNESS, VO2 max, vitals, endurance, FUNCTION

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14
Q

What are some factors that may contribute to obesity?
A. Health Literacy
B. Socioeconomic Status
C. Eating Behaviors of Parents
D. All of the above

A

D. All of the above!

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15
Q

Which of the following would be a reasonable and effective goals for an obese patient enrolled in a healthy living program?
A. Attaining a weight loss of 5-10% excess body weight in 4-6 months
B. Improving 30 second chair rise test by 1 MCID in 4-6 weeks
C. Attaining a weight loss of 20% excess body weight in 4-6 weeks
D. Both A and B

A

D. Attainable within that period - weight loss and function!

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16
Q

Which of the following is associated with Type 2 Diabetes
A. Typically diagnosed in childhood
B. Characterized by a lack of production of insulin
C. Insulin Resistance
D. Hemoglobin A1C level of 4%

A

C. All others are indicative to Type 1 diabetes or normal

17
Q

You are scheduled to treat a 77 year oldfemale with type 2 diabetes admitted for a fall, on the general medical wing of the hospital. You review her lab values prior to treatment and notice that her Glucose is 425mg/L.
What is the most appropriate course of action for this case?
A. Treat the patient, she is not at risk for an adverse event, exercise will likely reduce her glucose levels.
B. Treat the patient but closely monitor her response to treatment as her blood glucose is elevated.
C. Hold treatment until her blood glucose is better controlled
D. Treat the patient, her blood glucose levels are within normal limits.

A

C. Want to be between 100 and 250; want to ask what their normal levels are
Long term - exercise can help with control
Short term - can spike glucose levels

18
Q

What about a hypoglycemic patient?

A

Use 15-15 rule

Measure blood glucose
If below 100mg/dL take 15 grams of carbs
•4 glucose tablets (4 grams per tablet(
•1 glucose gel tube (15 grams per tube)
•4 ounces (1/2 cup) of juice or regular soda (not diet)
•1 tablespoon of sugar or honey.

•Wait 15 min and recheck blood glucose.
•If it is still below 100 mg/dL, take another serving of 15 grams of carbs.
•Repeat these steps every 15 minutes until blood glucose is at least 100 mg/dL.

19
Q

Why do we focus so much on the endothelium for arterial diseases (PAD, CAD, CVA) etc?

A

Healthy is preventative for disease
Dysfunction leads to HTN, atherosclerosis, and clots

20
Q

True or False: Myocardial infarctions are caused by progressive total stenosis due to atherosclerosis?
A.True
B.False

A

False; more from fibrous cap of plaque rupturing and traveling to the brain or heart instead of just progressively closing off from stenosis

21
Q

Which of the following plaques is likely more prone to rupture?
A. 75% occlusion in an 85 year oldpatient with a 50 yearhistory of coronary artery disease
B. 50% occlusion in a 55 year oldpatient with a 10 yearhistory of coronary artery disease
C. 50% occlusion in an 85 year oldpatient with a 50 yearhistory of coronary artery disease.
D. 10% occlusion in a 55 year oldpatient with a 10 yearhistory of coronary artery disease.

A

B. After years and years it will actually calcify and form a cap so less likely to rupture. >50% occlusion and newer is always more riskier

22
Q

A 35 year old overweight male patient reports to your clinic with a report of sharp left chest pain which started an hour ago while working in a factory as a laborer. He states that this pain spreads from his chest to his shoulder. His pain is reproducible with palpation to his chest and worsens when he exerts himself. What is the most likely cause of his symptoms?
A. Myocardial Infarction
B. Pulmonary Embolism
C. Musculoskeletal Disorder (Pec major strain)
D. Pericarditis

A

C. MSK
Would’ve been in sooner than an hour if it were MI
Palpation recreates pain (- for MI)
Referred pain and increase with exertion (+ for MI)
Sharp, not pressure (- for MI)

Not PE since he is pretty active and didn’t have surgery or remain immobilized; also would have SOB or chest pain
Pericarditis - would have more signs of inflammation or hx of virus or infection

23
Q

True or False: The absence of angina always rule out the presence of acute myocardial infarction?
A. True
B. False

A

False! Can have other sxs like jaw pain or arm pain or SOB
In women, chronic pain pts, and elderly pop

24
Q

What diagnostic test is used to confirm the diagnosis of myocardial infarction in patient with unstable angina?
A. Electrocardiogram
B. Chest Radiograph
C. Echocardiogram
D. Cardiac Biomarkers (Troponins, CKMB, LDH)

A

D. Since there may not be an elevated/depressed ST wave or inverted t wave on EKG; necrosis of tissue releases those biomarkers
EKG findings can also be due to ischemia instead of MI

25
Q

68-year old female office administrator who had been suffering from persistent swelling in her bilateral lower extremities for several years. She demonstrates bilateral +3 pitting edema swelling at the ankles, up to her lower leg and browning of her skin. She reports a feeling of tightness or heaviness in the lower leg bilaterally, and soreness/pain during walking and after sitting too long at her desk. Her medical history is remarkable for bilateral osteoarthritis of the hips, hypertension, and morbid obesity. Due to her swelling mobility is very limited.
What is the most likely diagnosis?
A. Deep Vein Thrombosis
B. Pulmonary Embolism
C. Chronic Venous Insufficiency
D. Peripheral Arterial Disease

A

C. Chronic venous insufficiency; bilateral and chronic swelling as well as browning of the skin

26
Q

A 65 year oldmale patient reports your clinic for bilateral lower leg pain and deconditioning. He reports a 30 yearsmoking history and cardiovascular disease. His leg pain is cramping like and worsened both with walking and cycling, which forces him to rest after about 5minutes. What is the most likely causes of his symptoms?
A. Central Spinal Stenosis
B. Bilateral Achilles Tendinopathy
C. Peripheral Arterial Disease
D. Chronic Venous Insufficiency

A

C. Intermiitent claudication, risk factors, cramping

Lost functional sympatholysis and hyperemia since they have endothelial dysfunction

Cardiopulmonary (2 decks)

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