Exercise and Diabetes/Obesity/Pregnancy/Postpartum/ Flashcards
Which of the following methods of body composition analysis is considered the most accurate but may be limited by cost and accessibility?
A. Bioelectrical Impedance Analysis (BIA)
B. Skinfold Measurements
C. Dual-Energy X-ray Absorptiometry (DEXA)
D. Waist-to-Hip Ratio
Answer:
C. Dual-Energy X-ray Absorptiometry (DEXA)
Correct: DEXA is the gold standard for precision in body composition analysis, though limited by cost and accessibility.
What it does: Measures body composition, including fat mass, lean mass, and bone density, with high precision. It is considered the gold standard but is expensive and less accessible.
Incorrect:
A. BIA: Non-invasive but less accurate due to variability in hydration levels.
What it does: Uses electrical currents to estimate body fat percentage. Accuracy can vary due to factors such as hydration status, making it less reliable than DEXA.
B. Skinfold Measurements: Practical but highly operator-dependent.
What it does: Estimates body fat percentage by measuring subcutaneous fat at specific sites. Accuracy depends heavily on the skill of the person performing the measurement.
D. Waist-to-Hip Ratio: Measures central adiposity, not full body composition.
What it does: Assesses central adiposity (fat distribution around the waist compared to the hips). It is a strong predictor of cardiovascular and diabetes risks but does not measure total body composition.
For a patient with Type 1 diabetes, which blood glucose range is considered ideal for pre-exercise monitoring?
A. 4.4–6.1 mmol/L (79–110 mg/dL)
B. 6.6–10 mmol/L (119–180 mg/dL)
C. 10.1–14.5 mmol/L (182–261 mg/dL)
D. ≥16.5 mmol/L (297 mg/dL or more)
Answer:
B. 6.6–10 mmol/L (119–180 mg/dL)
Correct: This range minimizes the risk of hypoglycemia and ensures safe glucose levels for physical activity.
Incorrect:
A. 4.4–6.1 mmol/L (79–110 mg/dL): Too low; there is a high risk of hypoglycemia, which can occur during or after exercise.
C. 10.1–14.5 mmol/L (182–261 mg/dL): Slightly elevated but may still be acceptable for some individuals with appropriate precautions.
D. ≥16.5 mmol/L (297 mg/dL or more): Indicates hyperglycemia; exercise is unsafe, especially if ketones are present, as it can worsen the condition.
What is a primary benefit of resistance training in managing Type 2 diabetes?
A. Reduces systolic blood pressure.
B. Enhances muscle glycogen uptake and insulin sensitivity.
C. Decreases ketone production.
D. Prevents retinopathy-related complications.
Answer:
B. Enhances muscle glycogen uptake and insulin sensitivity
Correct: Resistance training improves metabolic health and supports glycemic control.
Incorrect:
A. Reduces systolic blood pressure: More commonly linked with aerobic exercise.
C. Decreases ketone production: Ketone management is more relevant for diet and glucose control.
D. Prevents retinopathy-related complications: Retinopathy management involves avoiding exercises that elevate systolic BP more than 170 systolically.
Which of the following is a key consideration when prescribing exercise for older adults with diabetes?
A. High-intensity interval training to maximize glycemic control.
B. Avoidance of resistance training to minimize injury risk.
C. Incorporating balance training to reduce fall risks.
D. Prioritizing aerobic training only.
C. Incorporating balance training to reduce fall risks
Correct: Balance training is critical for older adults to prevent falls and injuries.
Incorrect:
A. High-intensity interval training: High-intensity activities may not be suitable for all older adults.
B. Avoidance of resistance training: Resistance training helps prevent sarcopenia and maintain strength.
D. Prioritizing aerobic training only: A holistic approach, including flexibility and resistance, is better.
What is the recommended carbohydrate intake during exercise for a diabetic patient to prevent hypoglycemia?
A. 5–10 g every 30 minutes.
B. 15–30 g every 30 minutes.
C. 40–50 g every hour.
D. No carbohydrate intake is necessary during exercise.
Answer:
B. 15–30 g every 30 minutes
Correct: This amount helps maintain blood glucose levels during prolonged exercise.
Incorrect:
A. 5–10 g every 30 minutes: Insufficient to prevent hypoglycemia during extended activity.
C. 40–50 g every hour: May lead to overconsumption and hyperglycemia.
D. No carbohydrate intake: Essential for preventing hypoglycemia, especially in insulin-dependent patients.
Which exercise prescription is most appropriate for a patient with obesity and joint pain?
A. High-impact exercises like running.
B. Resistance training three times a week targeting all muscle groups.
C. Low-impact exercises such as swimming or cycling.
D. Vigorous aerobic exercise for 150 minutes per week.
Answer:
C. Low-impact exercises such as swimming or cycling.
Correct: Low-impact exercises reduce joint strain, making them suitable for patients with obesity who often experience joint pain.
Incorrect:
A. High-impact exercises like running: Can exacerbate joint issues and lead to injuries.
B. Resistance training three times a week: Beneficial but should be combined with low-impact aerobic exercises for comprehensive benefits.
D. Vigorous aerobic exercise for 150 minutes: May be too challenging for a beginner and could increase the risk of injury.
What is the most important consideration when prescribing exercise for a patient with diabetic peripheral neuropathy?
A. Emphasizing high-impact weight-bearing exercises.
B. Focusing on flexibility training exclusively.
C. Prioritizing non-weight-bearing exercises, like swimming.
D. Avoiding exercise altogether to prevent complications.
Answer:
C. Prioritizing non-weight-bearing exercises, like swimming.
Correct: Non-weight-bearing exercises reduce the risk of foot ulcers or injuries in patients with peripheral neuropathy.
Incorrect:
A. High-impact weight-bearing exercises: Can increase the risk of injuries and complications.
B. Flexibility training exclusively: While important, it is insufficient on its own for glycemic control or overall fitness.
D. Avoiding exercise: Would lead to missed benefits such as improved glycemic control and cardiovascular health.
Which strategy best supports patient adherence to an exercise prescription?
A. Recommending only individual exercises.
B. Incorporating wearable technology to track activity.
C. Emphasizing strict and inflexible workout routines.
D. Avoiding follow-ups to reduce patient pressure.
Answer:
B. Incorporating wearable technology to track activity.
Correct: Wearable technology can provide motivation and help patients monitor their progress, encouraging adherence.
Incorrect:
A. Recommending only individual exercises: Group settings can enhance motivation and support.
C. Emphasizing strict and inflexible workout routines: Unrealistic for most patients, leading to non-adherence.
D. Avoiding follow-ups: Misses the opportunity to refine prescriptions and address barriers.
Which is a long-term benefit of consistent exercise in patients with Type 2 diabetes?
A. Reduced need for glucose monitoring.
B. Sustained improvements in HbA1c levels.
C. Elimination of cardiovascular risk.
D. Permanent reversal of diabetes symptoms.
Answer:
B. Sustained improvements in HbA1c levels.
Correct: Regular exercise helps maintain glycemic control and reduces HbA1c over time.
Incorrect:
A. Reduced need for glucose monitoring: Monitoring remains essential to avoid complications.
C. Elimination of cardiovascular risk: Exercise reduces but does not eliminate cardiovascular risk.
D. Permanent reversal of diabetes symptoms: While symptoms can improve, diabetes management requires ongoing effort.
Which population-specific adaptation is most appropriate for postpartum women with obesity?
A. High-intensity interval training to maximize fat loss.
B. Immediate return to pre-pregnancy exercise levels.
C. Gradual reintroduction to physical activity.
D. Avoidance of exercise for six months postpartum
Answer:
C. Gradual reintroduction to physical activity.
Correct: A gradual approach ensures safety and prevents injury as the body recovers postpartum.
Incorrect:
A. High-intensity interval training: Too intense for immediate postpartum recovery.
B. Immediate return to pre-pregnancy levels: Unrealistic and may risk injury or complications.
D. Avoidance of exercise: Misses benefits like improved mental health and weight management.
Which of the following statements about physical activity and sexual activity in pregnancy is TRUE?
A) Physical activity during pregnancy should include high-impact exercises to strengthen joints and muscles.
B) Specialized exercise classes tailored for pregnancy are recommended to improve safety and comfort.
C) Sexual activity should be avoided entirely during pregnancy to prevent adverse outcomes.
D) Pregnant individuals should avoid low-impact aerobic exercises such as walking and swimming
B) Specialized exercise classes tailored for pregnancy are recommended to improve safety and comfort.
Correct: These classes are designed with pregnancy-related physical changes in mind, focusing on safety, comfort, and appropriate intensity levels. They also provide an opportunity for supervised exercise routines.
A) Physical activity during pregnancy should include high-impact exercises to strengthen joints and muscles.
Incorrect: High-impact activities are discouraged during pregnancy due to the risk of joint strain and potential abdominal trauma. Low-impact activities like walking, swimming, and yoga are safer choices.
C) Sexual activity should be avoided entirely during pregnancy to prevent adverse outcomes.
Incorrect: In a healthy pregnancy, sexual activity is generally safe and not associated with adverse outcomes. However, it should be avoided in cases of preterm labor, vaginal bleeding, or other high-risk conditions.
Sex should be avoided when a patient is at risk for preterm labor because its due to the release of oxytocin during orgasm, and prostaglandins in semen, both of which can increase uterine activity.
D) Pregnant individuals should avoid low-impact aerobic exercises such as walking and swimming.
Incorrect: Low-impact aerobic exercises are encouraged during pregnancy as they are gentle on joints, help maintain cardiovascular health, and promote overall well-being.
Which of the following is a safe and recommended physical activity for pregnant women?
A) Contact sports like basketball.
B) Pregnancy yoga for flexibility and relaxation.
C) Skiing to promote cardiovascular health.
D) High-intensity interval training (HIIT).
Correct Answer: B) Pregnancy yoga for flexibility and relaxation. Pregnancy yoga is specifically mentioned as beneficial for flexibility, relaxation, and joint protection.
A) Contact sports should be avoided due to the risk of injury or trauma.
C) Skiing poses a risk of abdominal trauma and should be avoided.
D) HIIT may not be suitable for many pregnant women unless specifically tailored and supervised.
Why is physical exercise recommended during pregnancy?
A. To ensure the baby receives adequate oxygen through maternal activity.
B. To reduce the risk of complications such as gestational diabetes and preeclampsia.
C. To increase the likelihood of delivering before the due date.
D. To help the baby gain more weight during gestation.
** B. To reduce the risk of complications such as gestational diabetes and preeclampsia: Correct. Regular exercise has been shown to improve glucose metabolism, reduce blood pressure, and decrease the risk of these pregnancy complications.**
Explanation:
A. To ensure the baby receives adequate oxygen through maternal activity: Incorrect. While exercise does improve circulation, this is not the main reason it’s recommended.
C. To increase the likelihood of delivering before the due date: Incorrect. Exercise does not cause preterm labor in a healthy pregnancy.
D. To help the baby gain more weight during gestation: Incorrect. Exercise typically promotes a healthy pregnancy weight rather than excessive fetal growth.
Which of the following statements about physical activity in pregnancy is TRUE?
A. Pregnant women should avoid any activity that raises their heart rate above 100 bpm.
B. Strength training is unsafe during pregnancy.
C. Pregnant women should aim for at least 150 minutes of moderate-intensity aerobic activity per week.
D. Swimming and yoga should be avoided to prevent overstretching ligaments.
C. Pregnant women should aim for at least 150 minutes of moderate-intensity aerobic activity per week: Correct. This is the standard guideline for physical activity in pregnancy.
Explanation:
A. Pregnant women should avoid any activity that raises their heart rate above 100 bpm: Incorrect. Heart rate can safely increase during exercise within a moderate range.
B. Strength training is unsafe during pregnancy: Incorrect. Strength training is safe when done with proper technique and appropriate resistance.
D. Swimming and yoga should be avoided to prevent overstretching ligaments: Incorrect. Both activities are generally safe and beneficial during pregnancy.
: Which of the following is TRUE about sexual activity during a normal pregnancy?
A. It is safe unless there are specific medical contraindications.
B. It should be avoided during the first trimester to prevent miscarriage.
C. It should only occur during the second trimester when the pregnancy is stable.
D. It increases the risk of preterm labor in all pregnancies.
A. It is safe unless there are specific medical contraindications
Correct: Sexual activity is safe for most pregnancies unless there are complications like preterm labor, placenta previa, or unexplained bleeding.
B. It should be avoided during the first trimester to prevent miscarriage
Incorrect: There is no evidence linking sexual activity to miscarriage in normal pregnancies.
C. It should only occur during the second trimester when the pregnancy is stable
Incorrect: Sexual activity is safe during all trimesters unless contraindicated by a specific medical issue.
D. It increases the risk of preterm labor in all pregnancies
Incorrect: Sexual activity does not universally increase the risk of preterm labor. It may be avoided in high-risk pregnancies.
What is the first-line management for low back pain in pregnancy?
A. Epidural steroids
B. Osteopathic manipulative treatment (OMT)
C. Acetaminophen
D. Physical therapy and exercises
D. Physical therapy and exercises – Correct. Exercises and physical therapy are the first-line strategies for managing pregnancy-related low back pain.
- Prioritize non-drug measures before medication:
- TENS (Transcutaneous Electrical Nerve Stimulation)
- Acupuncture with eletrostimulation
- Heat and cooling therapies
- Physical therapy
- Rest
A. Epidural steroids – Incorrect. These are reserved for severe or refractory cases.
B. Osteopathic manipulative treatment (OMT) – Incorrect. OMT is effective * May improve, function. Reduces pelvic girdle and low back pain during and after pregnancy.
but not considered the first-line treatment.
C. Acetaminophen – Incorrect. While safe and commonly used, it is an adjunct rather than a primary treatment.
What is the most common physiological cause of gastrointestinal symptoms during exercise?
A) Dehydration
B) Altered gastric emptying
C) Jarring motions from running
D) Anxiety
Exercise puts the body in a symptathetic state
Altered gastric emptying refers to the delayed or irregular movement of food and liquids from the stomach into the small intestine. Normally, the stomach empties at a consistent rate, but during exercise, this process can slow down or become disrupted.
Why does this happen during exercise?
Blood flow shifts: When you exercise, your body prioritizes sending blood to muscles and vital organs involved in the activity (like the heart and lungs), which means less blood is available for the digestive system. This reduction in blood flow slows the stomach’s ability to process food.
Hormonal changes: Exercise also causes hormonal changes that can affect motility (the movement of the digestive tract), such as an increase in adrenaline, which inhibits digestive processes.
Increased abdominal pressure: Physical activity, especially high-intensity activities or running, can put pressure on the stomach and intestines, interfering with digestion and causing symptoms like bloating and nausea.
Which of the following is a recommended strategy for managing upper GI symptoms during exercise?
A) Increase dietary fiber before exercise
B) Avoid solid meals 3 hours before exercise
C) Engage in high-fat meals pre-exercise
D) Avoid antacids
B) Avoid solid meals 3 hours before exercise: Correct. To prevent symptoms like heartburn or nausea, athletes should avoid solid meals for at least 3 hours before exercise.
A) Increase dietary fiber before exercise: Increasing fiber could worsen symptoms like bloating or gas, which would not help manage upper GI symptoms.
C) Engage in high-fat meals pre-exercise: High-fat meals can exacerbate reflux and nausea, so this would not be advisable for managing upper GI symptoms.
D) Avoid antacids: Antacids are sometimes recommended for managing reflux and heartburn, making this an incorrect choice.
Explanation
Mechanism: Solid meals take longer to digest than liquids and require more blood flow to the stomach and intestines for proper digestion. Eating solid meals close to exercise can divert blood away from the muscles and lead to delayed gastric emptying (meaning food stays in your stomach longer than usual). This can cause discomfort like nausea, bloating, and even vomiting during exercise.
When solid meals are eaten too close to exercise, the body has to work harder to digest, which is not ideal when you’re also trying to exert energy during physical activity. By allowing at least 3 hours for digestion, the stomach can empty, reducing the risk of GI distress during exercise.
Which of the following symptoms is most commonly associated with lower GI issues during exercise?
A) Heartburn
B) Bloating
C) Cramps and diarrhea
D) Reflux
C) Cramps and diarrhea: Correct. Cramps, diarrhea, urgency, and rectal bleeding are common symptoms of lower GI issues, especially during exercise.
A) Heartburn: Heartburn is a symptom associated with upper GI issues, not lower GI.
B) Bloating: Bloating can occur with both upper and lower GI issues but is more commonly associated with upper GI symptoms.
D) Reflux: Reflux is an upper GI symptom, not a lower GI issue.
**Explanation: **
Bloating occurs when there is excess gas or air in the stomach or intestines. While it can happen in both the upper and lower GI tract, it’s more commonly linked with upper GI issues due to the following reasons:
Upper GI issues (e.g., heartburn, reflux) are often associated with a disruption in the stomach’s normal function, which leads to the production of gas or trapped air.
Bloating in the upper GI tract is often caused by delayed gastric emptying (as mentioned above), where food stays in the stomach for too long and ferments, producing gas.
In contrast, lower GI symptoms like cramping and diarrhea are more often due to issues in the intestines, and bloating tends to be secondary to these problems rather than a primary symptom. Therefore, bloating is more commonly a concern for upper GI symptoms.
How does exercise affect the gut through the nervous system and hormones?
1. Exercise activates the sympathetic nervous system (SNS)
The sympathetic response (“fight or flight”) prioritizes blood flow to the muscles and heart while reducing blood flow to the intestines.
This usually slows down digestion during exercise.
2. So why does diarrhea still happen?
The key is how the body compensates post-exercise and how different hormones affect the gut:
Hormonal Effects on the Gut During Exercise
Adrenaline (epinephrine) → Decreases digestion during exercise
Blood is diverted from the intestines to muscles.
This slows digestion but can also cause an irregular pattern of gut motility.
Cortisol (stress hormone) → Can increase gut sensitivity
In chronic stress (including prolonged exercise), cortisol can increase gut permeability (leading to more water loss into the intestines, which contributes to diarrhea).
It also disrupts normal gut microbiota, which can make digestion less stable.
Gastrointestinal Reflex Responses → Post-Exercise Overcompensation
After exercise, the body shifts back to the parasympathetic (“rest and digest”) mode, which can lead to a rebound increase in motility, sometimes causing urgent diarrhea.
This is why some runners or cyclists experience diarrhea right after finishing exercise rather than during.
💡 The contradiction you pointed out makes sense!
During high-intensity exercise: Sympathetic activation slows digestion.
During prolonged endurance exercise or immediately after: Stress hormones and reflex responses can trigger diarrhea.
Final takeaway:
In short, diarrhea is not due to the “fight or flight” mode itself but rather a combination of intestinal irritation, reduced blood flow, hormone fluctuations, and post-exercise rebound effects.
For a patient with multiple sclerosis (MS), which of the following exercise modifications is most beneficial?
A) Avoid aquatic therapy
B) Incorporate cooling strategies
C) Engage in high-intensity aerobic exercises
D) Focus on long, continuous exercise sessions
B) Incorporate cooling strategies: Correct. MS patients are particularly sensitive to overheating, which can exacerbate symptoms. Cooling strategies are key to managing exercise for these patients.
A) Avoid aquatic therapy: Aquatic therapy is actually beneficial for MS patients as the water helps support their body weight and reduce fatigue, making this incorrect.
C) Engage in high-intensity aerobic exercises: MS patients may struggle with high-intensity exercises due to fatigue and other barriers, so it’s not the most suitable option.
D) Focus on long, continuous exercise sessions: Shorter, more frequent sessions are recommended for MS patients to avoid excessive fatigue and overheating.
Explanation:
Cooling strategies are methods used to manage or reduce the heat stress that occurs in multiple sclerosis (MS) patients during exercise. MS patients are particularly sensitive to overheating because it can exacerbate their symptoms, including fatigue, muscle weakness, and loss of motor function.
Examples of cooling strategies include:
Wearing cooling vests or ice packs during exercise to help regulate body temperature.
Exercising in cooler environments, such as swimming pools (aquatic therapy), where water naturally cools the body.
Using fans or air conditioning during exercise.
Staying hydrated with cool drinks to assist with internal temperature regulation.
These strategies help prevent the worsening of MS symptoms, which can be triggered by elevated body temperature.
Which type of exercise is particularly beneficial for patients with Parkinson’s disease?
A) High-intensity strength training
B) Tai chi and rhythmic exercises
C) Heavy weight lifting
D) Static stretching
B) Tai chi and rhythmic exercises: Correct. These types of exercises are highly beneficial for Parkinson’s patients as they improve balance, mobility, and reduce symptoms such as rigidity and bradykinesia.
A) High-intensity strength training: While strength training is beneficial, high-intensity exercises may not be suitable for all Parkinson’s patients due to balance issues and rigidity.
C) Heavy weight lifting: Heavy weight lifting may be too challenging for Parkinson’s patients, especially those with motor difficulties and bradykinesia.
D) Static stretching: Static stretching alone isn’t as beneficial for Parkinson’s patients as more dynamic exercises that address mobility and balance.
Explanation:
Exercise and neurological conditions: For patients with neurological conditions like Parkinson’s disease, stroke, or MS, physical activity can greatly enhance functional ability, mobility, and quality of life. However, because neurological conditions often involve issues with movement, balance, coordination, and strength, it’s important to use a well-rounded exercise approach.
Balance exercises help improve postural control and prevent falls, which is especially important in conditions like Parkinson’s disease.
Range of motion exercises help maintain flexibility and reduce stiffness, which can be a concern in neurological conditions like MS and Parkinson’s.
Aerobic exercise helps with overall cardiovascular health and can improve endurance, energy levels, and mood. Aerobic exercise also supports neural plasticity, which is the brain’s ability to adapt and reorganize itself after injury, such as following a stroke.
A well-rounded program helps to target all these aspects and ensures that the patient maintains or improves their functional abilities, reducing the impact of neurological symptoms and promoting long-term health.
When prescribing exercise for a stroke patient, which of the following should be emphasized?
A) High-intensity sprint training
B) Gradual aerobic and resistance exercises
C) Flexibility and yoga only
D) Short, intense exercise sessions
B) Gradual aerobic and resistance exercises: Correct. Stroke patients benefit from a gradual progression of aerobic and resistance exercises to enhance mobility and neural plasticity, improving both motor function and secondary prevention.
A) High-intensity sprint training: High-intensity exercises may be too difficult and potentially unsafe for stroke patients early in recovery.
C) Flexibility and yoga only: While flexibility is important, focusing solely on yoga wouldn’t address the broader physical needs of stroke patients, such as strength and cardiovascular health.
D) Short, intense exercise sessions: Short, intense sessions may be too demanding for stroke patients, especially early in their recovery process.
What is a key challenge when prescribing exercise for patients with multiple sclerosis (MS)?
A) Managing muscle rigidity
B) Preventing overheating
C) Improving posture
D) Addressing balance issues
B) Preventing overheating: Correct. MS patients are highly susceptible to heat sensitivity, which can worsen symptoms, so preventing overheating is key when prescribing exercise.
A) Managing muscle rigidity: While muscle rigidity is a challenge, it is typically managed with medication and specific exercises, so it’s not the most crucial factor in prescribing exercise.
C) Improving posture: Posture can be an issue in MS, but it is not the main challenge in prescribing exercise for these patients.
D) Addressing balance issues: While balance is important, overheating is more directly related to exercise prescriptions for MS patients.
Which of the following tools would be used for the non-invasive diagnosis of gastrointestinal issues?
A) Endoscopy
B) Stool analysis
C) Colonoscopy
D) Barium swallow
B) Stool analysis: Correct. Stool analysis is a non-invasive method used to diagnose a variety of GI issues, including infections and malabsorption.
A) Endoscopy: Endoscopy is an invasive procedure, typically used for chronic or more severe GI symptoms, not a non-invasive diagnostic tool.
C) Colonoscopy: Colonoscopy is an invasive procedure, typically used for more detailed assessment, often for conditions like colorectal cancer or severe inflammatory bowel disease.
D) Barium swallow: Barium swallow is an imaging technique but is invasive in the sense that it requires the ingestion of contrast material.
