Exercise Testing & Prescription in Peds Flashcards
The 3-4x increase in Q during exercise is due mostly to ____
HR, not SV
is there a gender difference in Q or a-VO2?
no
HR
- ___ is 10-20 bpm lower
- high temp/humidity can ________
- pharm
- boys
- increase HR by 10-20 bpm
- can cause change in HR by 10-30 bpm
BP
- rhythmic exercise __ SBP
- smaller children have _____ BP
- boys have __ BP
- DBP should change how much
- SBP> ___ is concerning
- increases SBP
- lower SBP and DBP
- higher
- +/-6-10 mmHg. Not > 20
- 220
Children have lower responses to exercise in all variables except
relative VO2 and HR
primary cause of fainting/dizziness
hypohydration
for older kids. Most traditional. Steep grades for young pts., large MET increase b/w patients, 3 min stages w/ grade starting at 10%. Increase by 2% with each stage. Slight speed increase
Bruce Protocol
good for younger kids. Don’t like kids to go over 12 min
CMH max protocol
several variations. Speed usually constant at 3.0 or 3.5 mph. Grade increases 2% every minute or 2.5% every 2 minutes. Good for children with perceived low aerobic capacity
Balke protocol
Tilt table testing indications
syncope or presyncope, persistent dizziness, tachycardia, extreme fatigue
- passive tilt table testing
- active tilt table testing
- 20 min supine, 20 min at 80 degree head up tilt
- exercise test followed by 20 at 80 degree head up tilt
passive tilt table indications
symptoms occur with change in position/standing. Common in slender, growing adolescents. usually girls who skip breakfast and drink little water
active tilt table indications
symptoms during/after exercise. competitive athletes and active teens
positive tilt test
loss of consciousness,symptomatic hypotension, symptomatic bradycardia/asystole, persistent tachycardia w/o decrease in BP, hypotension w/ inappropriate HR response
Pediatric chest pain and SOA
- cardiac causes
- noncardiac causes
- pericarditis, trauma (hemopericardium), arrhythmias
- pulmonary (pneumothorax, pneumonia, pleurodynia), Esophageal (acute esophagitis, foreign body)
Vocal cord dysfunction
- occurs more in ___
- what is it?
- females
- paradoxical closure of vocal cords during inspiration. Causes airflow obstruction, throat tightness, suffocation/choking
Symptoms of VCD
-stridor (like wheezing but on inhale), chest/throat tightness, can’t get air in, chronic cough, tingling arms/legs
Gerd
- ___ of asthma pts have it
- 95% of VCD have it and are ___
- treating it helps ____
- 2/3
- overachievers
- asthma
protocol for Ex induced SOA
elevate HR to 160-180 bpm and sustain for 6-8 min on tread or cycle. PFT pre and at 5, 10, 15 min post exercise
FEV1 in obstruction
- mild
- mod
- severe
-65-80%
-50-65%
-
Bethesda guidelines
physical activity guidelines for congenital defects
Single ventricle abnormal findings
blunted HR response, low fxnal capacity, ECG abnormalities, decreased O2 sat
when do dysrhythmias become a “big deal”
when they occur in groups
