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Endocrine 1 > Exercise > Flashcards

Exercise Flashcards

1
Q

Identify the exercise benefits with strongest evidence.

A
  • Lower risk of early death
  • Lower risk of coronary heart disease, stroke, high blood pressure, adverse blood lipid profile
  • Lower risk of type 2 diabetes and metabolic syndrome
  • Lower risk of cancer: colon and breast
  • Prevention of weight gain
  • Weight loss, particularly when combined with reduced calorie intake
  • Improved cardiorespiratory and muscular fitness
  • Prevention of falls
  • Reduced depression
  • Better cognitive function (for older adults)
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2
Q

Identify the exercise benefits with moderate-strong evidence.

A
  • Better functional health (for older adults)

- Reduced abdominal obesity

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3
Q

Identify the exercise benefits with moderate evidence.

A
  • Lower risk of hip fracture
  • Lower risk of lung cancer
  • Lower risk of endometrial cancer
  • Weight maintenance after weight loss
  • Increased bone density
  • Improved sleep quality
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4
Q

What impact does exercise have on mortality?

A
  • Regular exercise reduces risk of all-cause mortality for most individuals (all sexes & age populations)
  • Beneficial effects are dose-dependent
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5
Q

What is the significance of 100 minutes of exercise and mortality?

A

-Duration above 100 minutes/day for moderate-intensity physical activity in healthy individuals do not appear to be associated with additional reductions in mortality rates.

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6
Q

Impact of exercise on cardiovascular disease.

A

Strong inverse relationship between habitual exercise and the risk of coronary disease, cardiac events, and cardiovascular death for both primary and secondary prevention

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7
Q

Exercise impact on lipoproteins.

A

induces beneficial effects on lipoproteins (e.g., decrease in very low-density lipoprotein, increase in high density lipoprotein), body composition, and aerobic capacity, as well as improves hemostatic factors associated with thrombosis.

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8
Q

Impact on markers of inflammation.

A

Regular physical activity is associated with decreased levels of markers of inflammation (CRP and IL6).

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9
Q

Long-term aerobic exercise impacts

A
  • beneficial on systemic BP

- reduce risk of stroke

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10
Q

Impact on diabetes/prediabetes.

A
  • may improve glycemic control, insulin sensitivity, and may prevent the development of type 2 diabetes in high-risk groups.
  • exercise is one of the lifestyle changes that has been shown to reduce the risk of diabetes in people with high risk (multiple risk factors)
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11
Q

Impact on cancer prevention and treatment.

A
  • modest protection against breast, intestinal, prostate, endometrial, colorectal, and pancreatic cancer
  • observational studies have reported a link between survival and exercise, with most of the data coming from survivors with breast, colorectal, or prostate cancers
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12
Q

Impact on obesity.

A

Compared to a weight loss diet alone, diet coupled with either exercise or exercise and resistance training is associated with a greater reduction in body fat compared to diet alone

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13
Q

Impact on osteoporosis

A
  • weight-bearing exercise is associated with an increase in bone mineral density in men and women
  • among patients with osteoporosis, exercise is associated with a decreased risk of hip fractures
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14
Q

Impact on smoking cessation

A
  • vigorous exercise modestly facilitates short- and long-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program
  • vigorous exercise also delays weight gain following smoking cessation
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15
Q

Impact on gallstones

A

Associated with a decreased risk of symptomatic cholelithiasis

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16
Q

Impact on function and cognition

A
  • may reduce the risk of dementia and cognitive decline in older patients
  • also associated with improved cognitive function in young adults
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17
Q

Impact on psychological

A
  • regular exercise reduces stress, anxiety, and depression

- recommended in the treatment of depression.

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18
Q

What are the risks associated with exercise?

A
  • musculoskeletal injury
  • arrhythmia
  • sudden cardiac death (SCD)
  • myocardial infarction (MI)
  • rhabdomyolysis
  • bronchoconstriction
  • hyper/hypothermia
  • dehydration
  • amenorrhea
  • hyponatremia
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19
Q

What are the musculoskeletal injuries associated with exercise?

A
  • Acute strains and tears, inflammation of various types, chronic strain, stress fractures, traumatic fractures, nerve palsies, tendonitis, and bursitis all may occur during or as result of physical activity.
  • Many are secondary to overuse.
20
Q

Which patients are at risk for arrhythmia with exercise?

A

In patients with underlying heart disease or a prior history of arrhythmia.

*Exercise training may reduce atrial and ventricular arrhythmia risk by increasing myocardial oxygen supply and by reducing sympathetic nervous system activity.

21
Q

Identify sudden cardiac death (SCD) risk with exercise.

A
  • rare

- risk is less or may not be increased at all if there is habitual, heavy leisure-time physical activity

22
Q

Mechanism of SCD in exercise.

A
  • include coronary artery disease, arrhythmias (especially ventricular tachycardia and ventricular fibrillation), structural heart disease, and myocarditis.
  • causes of SCD in people who exercise can be divided according to age.
23
Q

What is SCD generally a result of?

A
  • SCD is generally a result of atherosclerotic coronary artery disease in those over age 35 years.
  • it is more likely to be due to congenital abnormalities such as hypertrophic cardiomyopathy, coronary anomalies, or to myocarditis in younger individuals.
24
Q

What are the myocardial infarction risks associated with exercise?

A

-exercise associated with a temporary increase in the risk of having a myocardial infarction (MI), particularly among those who exercise infrequently and have multiple cardiac risk factors.

25
Q

Pts with coronary disease are more likely…

A

to have a myocardial infarction at the time they are participating in strenuous exercise than when they are not.

26
Q

Pts with coronary disease are less likely…

A

to have an MI than those with coronary disease who do not exercise.

27
Q

Rhabdomyolysis may occur following…

A

extreme exertion in individuals with normal muscles when the energy supply to muscle is insufficient to meet demands

28
Q

What is common following physical exertion?

A
  • subclinical myoglobinemia, myoglobinuria, and elevation of creatine kinase (CK) are common following physical exertion
  • CK level can rise several fold, particularly after intense exercise for extended periods of time (e.g., marathon running)
29
Q

What are the severe complications of rhabdo?

A

include renal failure, electrolyte abnormalities (e.g., hyperkalemia, metabolic acidosis), and compartment syndrome.

30
Q

What are the risks of bronchoconstriction associated with exercise?

A
  • occurs in the majority of patients with current symptomatic asthma.
  • magnitude is correlated with the degree of airway hyperresponsiveness.
31
Q

Improving a patient’s cardiovascular fitness reduces…

A

the minute ventilation required for a given level of exercise, thereby decreasing the stimulus for bronchoconstriction.

32
Q

How can one prevent the onset of exercise-induced bronchoconstriction?

A

Regular, long-term exercise

33
Q

What are the heat-related risks associated with exercise?

A

Hyperthermia, hypothermia, and dehydration are potential preventable risks of physical activity.

34
Q

What are the risks of amenorrhea associated with exercise?

A

-intense exercise can lead to amenorrhea and infertility, particularly in women with low body weight.

35
Q

What is the “female triad”?

A
  • The “female athlete triad” consists of disordered eating, amenorrhea, and osteoporosis.
  • This is commonly seen in younger individuals, especially those who exercise regularly and intensely.
36
Q

What are the risks of exercise-induce hyponatremia?

A

primarily occurs in athletes participating in aerobic (endurance) events, such as marathons (42.2 km), triathlons (3.8 km swim, 180 km cycling, and 42.2 km running), and ultra-distance (100 km) races.

37
Q

Who should undergo pre-participation in exercise?

A
  • Asymptomatic individuals with multiple cardiovascular risk factors including hypercholesterolemia, hypertension, smoking, diabetes
  • H/o premature myocardial infarction or sudden cardiac death in a first-degree relative under age 60
38
Q

What should you include in a prescription for exercise?

A
  • type of exercise
  • frequency
  • duration
  • intensity
  • resistance training
  • modality
39
Q

What are the recommended exercises for adults regarding overall cardio health according to the current guidelines?

A

-at least 30 minutes of moderate-intensity aerobic activity at least 5 days per week for a total of 150
OR
-at least 25 minutes of vigorous aerobic activity at least 3 days per week for a total of 75 minutes (or a combination of moderate- and vigorous-intensity aerobic activity)
AND
-moderate- to high-intensity muscle-strengthening activity at least 2 days per week for additional health benefits.

40
Q

What are the recommended exercises for adults regarding lowering blood pressure according to the current guidelines?

A

An average 40 minutes of moderate- to vigorous-intensity aerobic activity 3 or 4 times per week

41
Q

Regular physical activity in children and adolescents…

A
  • has big benefits.
  • it not only makes them healthier and fit now, but it lowers their risk of chronic diseases and improves their chances of becoming healthy adults.
42
Q

What do the guidelines recommend for children and adolescents for daily physical activity?

A

children and adolescents ages 6 to 17 do 60 minutes (1 hour) or more of physical activity each day

43
Q

Children and adolescents

-aerobic activity

A

Most of the 60 or more minutes a day should be either moderate- or vigorous-intensity aerobic physical activity (such as running, dancing, or biking), and include vigorous-intensity physical activity at least 3 days a week

44
Q

Children and adolescents

-muscle-strengthening

A

As part of the 60 or more minutes of daily physical activity, include muscle-strengthening physical activity (such as climbing trees, using playground equipment, or lifting weights) on at least 3 days of the week

45
Q

Children and adolescents

-bone-strengthening

A

As part of the 60 or more minutes of daily physical activity, include bone-strengthening physical activity (such as running or jumping rope) on at least 3 days of the week

Endocrine 1 (18 decks)

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