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AES > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What are some of the barriers to optimal practice patterns?

A
  1. Care based on Reimbursement instead of evidence-based
  2. Limited incentives for high-quality transitional care (lack of ACO’s)
  3. Fear of adverse events, penalties, or litigation
  4. Current emphasis is on returning pts to PLOF which was already low
  5. Lack of awareness of more effective clinical care strategies
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2
Q

Anaerobic Metabolism

A
  • doesn’t require O2
  • utilizes one molecule of glucose
  • occurs in the cytoplasm
  • by-product is lactic acid
  • yields net 2 ATP
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3
Q

Aerobic Metabolism

A
  • Uses carbs, fats and proteins
  • occurs in the mitochondria
  • by-products war H2O and CO2
  • Yields net 36 ATP per glucose molecule
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4
Q

Cells that use aerobic metabolism

A

heart, CNS, PNS, skeletal muscle (Type I)

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5
Q

Cells that use anaerobic metabolism

A

Connective tissue cells (bone, cartilage, RBC’s); Skeletal muscle (Type II)

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6
Q

VO2 is (equations)

A

CO x a-v O2 difference

Volume of O2 entering lungs -volume of O2 leaving lungs

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7
Q

At what % of VO2 max does aerobic threshold usually fall?

A

55%

Can increase w/ training and decrease with detraining

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8
Q

1 MET= ________VO2

A

3.5mLO2/Kg*min

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9
Q

______MET’s is considered moderate physical activity

A

3-6 MET’s

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10
Q

______MET’s is considered vigorous physical activity

A

> 6MET’s

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11
Q

What VO2/MET level is considered disabled by Social Security?

A

18mL/Kg*min or ~5 MET’s

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12
Q

Examples of Symptom limited graded tests

A

Treadmill–Bruce, modified Bruce, Balke, Naughton

Can use cycle ergometer for people w/ balance disorders, obesity or WBing precuations/restricitons

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13
Q

Drawback of Submax testing

A

Tend to udnerestimate VO2 max in untrained and overestimate in the trained

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14
Q

Cardiovascular Contraindications

A
  • Recent MI (w/in 3-6 weeks)
  • Pulmonary embolism/infarction (<6 weeks)
  • DVT detected – avoid affected limb only if they are otherwise appropriate
  • Myocarditis, endocarditis, pericarditis
  • recent cerebral shunting/aneurysm coil
  • resting HR <50 or >100
  • unstable angina
  • severe pulmonary hypertension (mean pulmonary arterial pressure >55 mmHG)
  • Severe and symptomatic aortic or valvular stenosis
  • fistula on UE for dialysis access
  • uncontrolled hypertension (Resting SBP>170, DBP>100)
  • Decompensated CHF
  • absent pulses in the limbs
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15
Q

Retinopathy Precautions

A

Avoid valsalva maneuvers.

  • Severe nonproliferative no SBP >170
  • Proliferative: exercise is contraindicated
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16
Q

Cancer possible Contraindications

A
  • Bone metastasis
  • Tumors in strength training area
  • medication effects (precaution)
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17
Q

MSK possible contraindications (9)

A
  • Fx in last 6 weeks
  • unstable fxs
  • osteomyelitis-no training in involved limb
  • Avascular necrosis - no training on involved limb
  • wounds with exposed tendons/muscles
  • compression fxs need to remain in neutral alignment
  • WBing restrictions
  • Marfan syndrome
  • Hernias
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18
Q

Surgical precautions

A

All: no lifting >10lbs, no valsalva
Craniotomy<6weeks: no bending over
Abdominal<6weeks: no sit-ups/crunches
Sternal<8weeks: no UE

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19
Q

Other medical conditions possible contraindications

A
  • acute infection
  • mono
  • hepatitis
  • AIDS
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20
Q

Possible precautions w/ steroids (5)

A
  • hypertension
  • immunosuppression
  • osteoporosis
  • muscle weakness and myopathy
  • thin skin and poor wound healing
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21
Q

Possible precautions w/ beta-blockers

A
  • hypotension
  • bradycardia
  • drowsiness
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22
Q

Normal tidal volume

A

0.5L at rest

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23
Q

Forced Vital Capacity (FVC)

A

3-5L, 80% predicted or better is normal

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24
Q

Forced expiratory volume (FEV1)

A

2.5-4L, 80% predicted or better is normal

25
Q

FEV1/FVC

A

> 80% in healthy adults

26
Q

Normal pH

A

7.40 (7.2-7.6)

27
Q

pCO2

A

35-45 mmHg

28
Q

pO2

A

80-100mmHg

29
Q

Ejection Fraction

A

> 55%

30
Q

normal fasting blood glucose levels

A

60-100 mg/dL

31
Q

Safe blood glucose levels for PT session

A

100-250 mg/dL

32
Q

Normal RBC count

A

Men: 4.7-5.5x10^6
Women: 4.1-4.9x10^6

33
Q

Normal WBC count

A

Exercise as tolerated:3,900-11,000

Caution w/ exercise: <3,900 with fever

34
Q

Normal Hb levels

A

Men: 14.4-16.6
Females: 12.2-14.7

35
Q

Hb level precautions

A

<8.0 Discuss w/ MD
8-10 Decreased exercise tolerance
10-12 low impact, low intensity resistance exercise

36
Q

Normal Hematocrit values

A

Males: 43-49%
Females: 38-44%

37
Q

Hematocrit precautions

A

30 reduced capacity for exercise begins
25-30 Markedly reduced exercise tolerance
<20 No exercise

38
Q

Platelet Count precautions

A

> 20k low impact, resistance OK
10k-20k no resistance, non-impact
<10k and/or temp >100.5 no exercise

39
Q

Normal platelet counts

A

150,000-400,000

40
Q

INR precautions

A

.9-1.1 Normal
2-3 Normal if on anticoagulation therapy
>5 Evaluate mobility and assess safety for discharge planning
>6 discuss w/ MD

41
Q

Neurological Stopping Points

A
  • dizziness/lightheadedness
  • confusion
  • ataxia
  • shaking/tremors
42
Q

Integument stopping points

A
  • cyanosis or palor

- diaphoresis or cold/clammy skin

43
Q

Pain stopping points

A
  • leg cramps or severe claudication
  • chest/arm/jaw pain
  • moderate to severe angina
44
Q

Respiratory stopping points

A
  • moderate to severe dyspnea
  • abnormal breathing pattern
  • drop in O2 stats >10% below baseline or <88%
45
Q

Endocrine/GI stopping points

A
  • Suspected hypoglycemia

- Nausea or vomiting

46
Q

How do you calculate VO2 from MET’s?

A

MET’s x 3.5 = VO2

47
Q

How do you calculate MABP?

A

DBP - 1/3(SPB-DBP)

48
Q

Angina Scale and where to stop exercise

A

1+ Light, barely noticeable
2+ Moderate, bothersome
3+ Severe, very uncomfortable (stopping point for exercise)
4+ Most severe pain ever experienced

49
Q

Borg Dyspnea Scale

A

0-10, 0.5 is just noticeable, 5 is severe, 7 is very severe

50
Q

Ranchos Los Amigos dyspnea levels

A 
Pt is able to count to 17 in 7.5-8 seconds: 
0 on a single breath
1 requires 2 breaths
2 requires 3 breaths
3 requires 4 breaths
4 unable to count
51
Q

Ventilation=?

A

Tidal volume x respiratory rate

52
Q

Chronic bronchitis

A

over production of mucus causes an occlusion of airways

53
Q

Emphysema

A

can be hereditary Alpha 1-antitrypsin deficiency or cause by smoking (most)
Alveoli merge into giant air sacs so gas exchange is limited and air gets trapped in the lungs

54
Q

Signs/symptoms of COPD (14)

A
  • SOB
  • DOE
  • orthopnea (only able to breathe in upright position)
  • wheezing
  • increased RR
  • peripheral cyanosis
  • digital clubbing
  • pursed lip breathing
  • malaise
  • chronic cough
  • barrel chest
  • weight loss
  • decreased FEV1/FVC
  • chronic anxiety or depression
55
Q

Karvonen formula for target HR

A

Target Heart Rate = [(max HR − resting HR) × %Intensity] + resting HR

56
Q

Defining parameters of aerobic HIIT

A

60s all out (75-85% max HR; 14-16/20 or 6-8/10), 30-60s rest (preferably active recovery) x20 mins

57
Q

PAD diagnoses based on ABI levels:

A

Normal=0.91+
Mild obstruction=0.70-0.90
Moderate obstruction=0.40-0.69
Severe obstruction <0.40 (may have sx at rest, at risk of amputation)

58
Q

Gait speeds for red, yellow, and green flags

A

Red flag <=0.6 m/s
yellow flag =0.6-1.0 m/s
Green flag >1.0m/s

59
Q

MDC for gait speed

A

0.1-0.2

AES (1 decks)

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