Lab class 1 CVD preiction and pre-participation screening

Question 1

Name modifiable risk factors for CVD development

Answer 1

Inactivity 
BMI 
BP 
Cholesterol 
Smoking 
Alcohol intake 
Poor diet

Question 2

Name non-modifiable risk factors for CVD development

Answer 2

Age
sex
ethnicity
family history

Question 3

What does the outcome of the Framingham risk score shpw

Answer 3

Percentage chance of suffering CVD event over the next 10 years

Question 4

Above what score on the Framingham risk score would a person require intensive risk factor modification?

Answer 4

> 20%

Question 5

What 6 variables are used to calculate the Framingham risk score

Answer 5

Age
BP (systolic)
HDL 
Total cholesterol 
smoker?
diabetes?

Question 6

What are the 5 korakoff sounds

Answer 6

1) faint repetative tapping
2) sound fades
3) sound may become sharper again
4) muffled sound
5) absence of sound

Question 7

Define: FEV1
FVC
FEV1:FVC ratio
and give the cut off points, below which readings are abnormal for age, sex and gender

Answer 7

forced expiratory volume in one second, <80% abnormal

forced vital capacity <80% abnormal

ratio of the two less than 0.7 abnormal

Question 8

what are the limitations of the Framingam risk calculatir

Answer 8

developed during a time when CVD was at its peak so over-estimates european populations

not a very ethnically diverse study group, so for example underestimates risk of Asian people

Question 9

Name some additonal variables used in the Q-risk 2 calculator

Answer 9

BMI 
deprivation score 
AF 
kidney disease 
RA
Family history of premature death 
Ethnicity

Question 10

Why is a deprivation score used in the Q-risk 2 calculation

Answer 10

risk of CVD varies depending on where you live

generally more deprived areas = higher risk

Question 11

Why can you not use the Q-risk 2 calculator if you’re over 84

Answer 11

most of these people already have a greater than 20% risk of CVD

Question 12

Why would the Q risk 2 score be more appropriate to use

Answer 12

developed in UK so more representative of UK population

Question 13

Why is there a need to carry out exercise pre-participation screening?

Answer 13

single bouts of exercise increase the relative risk of sudden cardiac events

identify those who are at risk of these things happening and ensure they’re safe to exercise

Question 14

compare the relative risk and absoloute risk of CV events during exercise and explain how this changes as level of activity increases

Answer 14

absoloute risk still very low

risk greatest for habitually inactive

risk decreases as habitual level of activity increases

Question 15

What are the goals of the new ACSM guidelines on pre-participation screening

Answer 15

Identify those who should recieve medical clearance before exercise

identify those with clinically significant disease who may benefit from medically supervised exercise

identify people with conditions who require exclusion until symptoms resolve or are better controlled

Question 16

What are the factors which determine if someone needs to go on the pre-exercise screening pathway

Answer 16

current level of PA

signs or symptoms of CVD, metabolic or renal disease

their desired intensity of PA

Question 17

what were the problems with the previous over-rigorous screening process?

Answer 17

obsticle and deter participation

excessive physician refferal

generally exercise is safe for most people

Question 18

what causes exercise induced events in: young people and people over 35

Answer 18

young = structural abnormalities 
old = CAD

Question 19

What were the incidence rates for sudden cardiac death and cardiac arrests in marathon and half marathon runners, published by Kim et al 2012

Answer 19

0. 2 cardiac arrests per 100 000

0. 14 SCD per 100 000

Question 20

What is the purpose of the PAR-Q test

Answer 20

help people determine if they’re physically ready to undertake physical activity

series of questions relating to CVD symptoms

If yes is an answer then should consult Dr before exercise

Question 21

what are the ACSM criteria for athletes being considered to be low, moderate and high risk

Answer 21

low = no diagnosed disease, no signs or symptoms <2 risk factors

moderate = 2 or more risk factors with no signs, symptoms or diagnosis

high = signs , symptoms or diagnosis

Question 22

what are the guidelines for testing of high risk people

Answer 22

should undergo routine exercise testing

can be done by trained non-physician but physician needs to be available immediatly if needed