Final exam

Question 1

Acute stroke vs Transient Ischemic Attack

Answer 1

Both involve neurological symptoms, but TIA can not be imaged as is generally shorter in duration, with symptoms disappearing after an hour.

Question 2

__% of stroke patients experience mod to severe disability.

Answer 2

40%

Question 3

Someone who has a stroke has _% chance of experiencing a second one within __ years,

Answer 3

30%, 5 years

Question 4

Two types of stroke

Answer 4

Ischemic (80%) and hemorrhagic

Question 5

Main clinical treatment targets for HFrEF

Answer 5

Lower blood pressure
Reduce blood volume
Improve perfusion to improve contractility

Question 6

Main effects of angiotensin 2

Answer 6

Increases SNS activity, constricts blood vessels, and increases sodium and water absorption (directly and indirectly through the release of aldosterone and ADH)

Question 7

Sympathetic vs parasympathetic innervation of the heart

Answer 7

Parasympathetic routes act only on the SA node and AV node to slow HR, while sympathetic routes act on the nodes to increase HR and directly on myocardial tissue to increase inotropy.

Question 8

ACE inhibitors. What do they do and what is the effect?

Answer 8

ACE inhibitors act on angiotensin converting enzyme to decrease A2 production. Decreases all the actions of A2.

Question 9

“pril” drugs

Answer 9

ACE Inhibitors

Question 10

Beta-blockers function and effect

Answer 10

Block the sympathetic influence on the heart, decreasing contractility and HR.

Question 11

“lol” drugs

Answer 11

Beta-blockers

Question 12

MCRAs (Mineralocorticoid receptor antagonists) function and effect.

Answer 12

Block aldosterone’s actions, reducing reabsorption of Na and promotes diuresis.

Question 13

“one” drugs

Answer 13

MCRAs

Question 14

Diuretics function and effect

Answer 14

Promote appropriate plasma levels.

Question 15

“ide” drugs

Answer 15

Diuretics

Question 16

A2 receptor blockers function and effect

Answer 16

Block receptors for A2 in the vasculature to prevent constriction and blood pressure. Used by patients with ACE inhibitor side effects.

Question 17

“sartan” drugs

Answer 17

A2 receptor blockers

Question 18

AR-Neprilysin blockers

Answer 18

Combo of A2 receptor blocker and neprilysin blocker which reduces degradation of BNP and ANP

Question 19

Funny channel blocker Ivabradine

Answer 19

Used for those on beta-blockers with HR over 70. Acts on the SA node to decrease HR without affecting contractility.

Question 20

What pharmaceutical treatments are available for HFpEF?

Answer 20

None. This type of HF has permanent structural damage, so the treatment focus become underlying conditions and comorbidities + diuresis to reduce congestion.

Question 21

Implantable cardioverter defibrillator (ICD)

Answer 21

Implant able to give small shocks to correct arrhythmias or larger shocks for defibrillation.

Question 22

Cardiac resynchronization therapy (CRT)

Answer 22

Pace maker sets rhythm of the heart. Used when individuals have QRS widening and EF

Question 23

Coronary revascularization

Answer 23

Removal of veins from the lower leg to bridge blockages in the heart’s vasculature.

Question 24

How is CKD classified?

Answer 24

Based on GFR. Above 60 ml/min is considered normal, 15-60 is kidney disease, and below 15 is failure

Question 25

What are the two main causes of CKD?

Answer 25

Diabetes and hypertension

Question 26

What is PD?

Answer 26

A condition occuring when the cells producing dopamine die. Common symptoms include resting tremor, slow movement*, and hunched posture.

Question 27

5 goals of clinical or exercise treatment of HF

Answer 27

Improve QoL, Improve staging, Improve FC, Decrease hospital admissions, and decrease mortality.

Question 28

3 useful informations from stress testing in HF

Answer 28

ECG (ST depression indicating ischemia), Hemodynamics (HR, SBP), Symptoms (angina, SOB)

Question 29

Training can increase VO2 peak by __-__%

Answer 29

15-20%

Question 30

Central adaptations to EX in HF patients

Answer 30

• Eccentric hypertrophy
• Increased vascularization
• Lower HR rest and submax
• Improved endothelial function

Question 31

Peripheral adaptations to EX in HF patients

Answer 31

• decreased symp activity = decreased vasoconstriction
• Improved endothelial function
• Decrease anaerobic reliance
• Increase mitochondrial density
• Increase capillarization

Question 32

What does the research say about EX outcomes in HF?

Answer 32

• No effect on 12 month all cause mortality (may have an effect >12)
• Improve QoL
• Decrease Hosp ads 12 months (not >12)

Question 33

How long should someone be stable before doing IT?

Answer 33

2 months

Question 34

How common is CKD?

Answer 34

1/10, but very few progress to failure and need dialysis (generally die of other factors first - CVD)

Question 35

EX outcomes for PD

Answer 35

Decrease disease severity, Slow progression, Improve strength and exercise capacity, Improve balance and mobility.

Question 36

Diagnosis cutoffs for diabetes?

Answer 36

HbA1C >6.5, resting plasma glucose >7, 2hPG 75ml >11.1

Question 37

Exercise training in T1D vs T2D

Answer 37

Both can receive general benefits, but disease specific benefits are greater for T2D. Ex is also safer in T2D, and effective for decreasing insulin resistance. T1Ds should manage their blood sugar (Reduce insulin dose pre EX, consume CHO during EX) and check it often during exercise.

Question 38

How does blood sugar normally respond to EX

Answer 38

Increases in high intensity, anaerobic exercise and decrease in aerobic exercise.

Question 39

T2D exercise recommendations?

Answer 39

150 min/week, on 3 separate days, and no more than 2 consecutive days without EX. Strength training twice a week. IT can be effective. Supervise when feasible and those over 40 should receive a stress test before starting high intensity exercise.