Exam 1 Stuff I Really Do Not Know

Question 1

what are the 5 findings of PAD?

Answer 1

• intermittent claudication
• if you elevate the legs, they become pale
• when you bring them down, blood pool in the capillaries…rubor
• impaired pulses
• cyanosis and cool to the touch

Question 2

what vessel is damaged if the skin is shiny, no hair, thin, pale and brittle nails

Answer 2

arteries

Question 3

what are normal ABI readings

Answer 3

normally over 1
under 0.9 is PAD
0.5-0.8 is claudication
less that 0.5 is ischemia.

Question 4

what is tugor

Answer 4

when you pull the skin away, and it does not go back right away

Question 5

with squatting, will you hear louder sounds in aortic stenosis or HOCM

Answer 5

squatting in aortic stenosis is louder.

Question 6

what are the systolic and diastolic values for stage 2 hypertension

Answer 6

140 and 90

Question 7

what is the difference between stable and unstable angina

Answer 7

stable lasts for only 2-5 minutes, maybe 5-10, and no more. Anything more, unstable.

Question 8

how do you decide what a patient with a pacemakers max heart rate should be?

Answer 8

if they know their max pacemaker setting, then do it 10 beats below that. If they do not know, add 40 to the resting HR to get the max. then still subtract 10.

Question 9

what is the difference between hypertensive emergency and urgency

Answer 9

urgency is over 180/110 and there is no signs of organ failure. emergency is 180/120 or higher and signs or organ failure.

Question 10

what is considered an exaggerated HR (hypertensive response)

Answer 10

220 for men, and 190 for women.

or, over 10 higher diastolic or over 90.

Question 11

how should systolic and diastolic BP change when you are exercising

Answer 11

systolic can increase by 10mmHg with 1 MET of activity, and diastolic can increase 0-10.

Question 12

what is considered a hypotensive response to exercise

Answer 12

when SBP drops by 10mmHg.

Question 13

how can you score pitting edema

Answer 13

(1+) you barely have an impression
(2+) slight indent, that lasts less than 15 seconds
(3+) lasts for 30 seconds
(4+) last for more than 30 seconds.

Question 14

describe a venous ulcer

Answer 14

blueish or brown in color, irregular margins, varicose veins and pitting edema, and even medial issues.

Question 15

describe an arterial ulcer

Answer 15

regular margins, thick gross nails, usually on the top of the foot, or malleoli, or toes. sharp and painful and pallor, with decreased hair.

Question 16

describe a neuropathic ulcer

Answer 16

planter surface, but the MTP heads, and look like little punch outs. they cannot feel them either!

Question 17

what is normal BNP values

Answer 17

0-100, can tell if you have had an MI

Question 18

during what phase does and S3 and S4 gallop happen

Answer 18

S3 is systolic, and S4 is diastolic

Question 19

if your BNP is over 300… you definitely have

Answer 19

HF

Question 20

what happens to SV with HF

Answer 20

it decreases

Question 21

it is counterintuitive to give vasodilators to patients with HF, but why do we do it

Answer 21

as resistance increases, the SV decrease a lot. So we want to open things up to decrease resistance and hopefully keep SV going.

Question 22

what is the muscle theory with HF

Answer 22

when we have HF, there is a decreased flow to the muscles, and they atrophy. We need to try to increase the flow to the muscles, so we can have these patients exercise.

Question 23

what do the respiratory muscles do in HF

Answer 23

they steal some of the blood flow away from muscles. the lungs need the extra blood for gas exchange to occur.

Question 24

TF: in HF, HR is abnormal whereas BP is higher

Answer 24

false, BP is abnormal and HR is higher.

Question 25

when exercising with HF, do you always use VO2 max or HR max

Answer 25

VO2 max because their HR are always elevated, and we may not get to the true max while we test.

Question 26

what are signs of decompensation to look for when exercising someone with HF

Answer 26

pulse narrowing, arrhythmia, fluid changes, like 3 pounds in 24 hours, or 5 pounds in a week

Question 27

what is the gold standard exercise intervention for HF

Answer 27

aerobic training.

Question 28

why do we want to exercise LE with RT

Answer 28

functional sympatholysis. If we work out the LE, we get dilation of the LE and constriction of the UE. this will increase BP less than if we worked with the UE. with the UE, there will be a high sympathetic response, and a higher increase in BP.

Question 29

what is the triple cocktail (+) you give HF patients

Answer 29

diuretics, ACEi, beta blockers

Spirolactone.

Question 30

TF: patients with symptomatic aortic stenosis are good candidates for exercise

Answer 30

false, if they were asymptomatic, you could start exercise, but you need to start slow and steady

Question 31

what are signs and symptoms of pericarditis.

Answer 31

sharp pain, fever, worse with breathing and coughing, and pain with laying flat, imported with sitting and learning forward and friction rub can be heard.

Question 32

can you use BP to monitor patients with valve issues

Answer 32

no, you want to use RPE

Question 33

a patient comes in with muffled heart sounds, dyspnea, dysphagia, friction rub, breathing pain and chest pain. also, JVD

Answer 33

pericardial effusion

Question 34

what do alpha 1 receptors do

Answer 34

vasoconstrict