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Cardiopulmonary > Midterm > Flashcards

Midterm Flashcards

1
Q

Do you need to gain medical clearance to exercise a patient that does not regularly exercise and does not have any signs and symptoms of CVD?

A

-No

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2
Q

What type of exercise can you perform with someone who does not regularly exercise and does not have any signs or symptoms of CVD?

A

-light to moderate

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3
Q

Do you need to gain medical clearance to exercise a patient who does not regularly exercise, has a CVD?

A

-It is recommended (even if they are asymptomatic)

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4
Q

Excercise testing can be used to test for what type of diseases?

A

-Ischemia, CAD

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5
Q

What is exercise testing not a good predictor of?

A

-acute events

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6
Q

How much does HR increase with exercise?

A

-10 beats per met

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7
Q

How much does systolic BP increase with exercise?

A

-10 mmHg per met

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8
Q

How much does diastolic BP increase with exercise?

A

-it doesnt

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9
Q

How should O2 sats change with exercise?

A

-it shouldnt

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10
Q

How does breathing change with exercise?

A

-tidal volume increases until it reaches 40-50% of vital capacity then RR increases

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11
Q

How much can cardiac output increase until maximum exericse?

A

-about 4 times

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12
Q

How much can HR increase from rest with maximum exercise?

A

-about 3 times

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13
Q

How much can SV increase with maximum exercise?

A

-about 1.5 times

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14
Q

CO stops increasing at about percent of maximum exercise?

A

-40%

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15
Q

VO2 can increase about how much at max exercise?

A

-3 times

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16
Q

What is the MET?

A

-The ratio of the rate of energy expended during an activity to the rate of energy expended at rest

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17
Q

what is 1 MET equal to?

A

-3.5; or 1 kcal

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18
Q

Where does the normal aerobic threshold occur?

A

-at 55% of VO2 max

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19
Q

How does anaerobic training improve the lactate thresh hold?

A

-improving muscle alkaline reserves

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20
Q

What type of PVCs are contraindications to exercise testing?

A

-multifocal or more than 10 in a minute

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21
Q

What type of angina is a contraindication for exercise testing?

A

-unstable

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22
Q

What type of heart failure is a contraindication for exercise testing?

A

-decompensated

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23
Q

New onset Afib with what is a contraindication for exercise testing?

A

-RVR >100

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24
Q

What degree heart block is a contraindication for exercise testing?

A

-2nd degree with PVCs, or 3rd degree

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25
Q

BP over what is a contraindication for exercise testing?

A

-180/105

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26
Q

What coronary artery supplies the right atrium, right ventricle and the inferior left ventricle?

A

-The RCA

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27
Q

An RCA infarct will be in what location?

A

-Inferior

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28
Q

What are the common complications of an RCA?

A

-AV block, Arrhythmia, RV infarct

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29
Q

What coronary artery supplies the anterior LV?

A

-The left coronary artery

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30
Q

What coronary artery supplies the left atrium, and lateral/posterior LV?

A

-Circumflex

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31
Q

ECG changes will be seen on what leads with an RCA infarct?

A

-II, III and avF

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32
Q

A left main coronary infarct will cause changes where?

A

-anterior and lateral

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33
Q

ECG changes with a left main artery infarct will be seen on what leads?

A

-V1-V6 and aVL

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34
Q

What are the common complications of a left main infarct?

A

-pump dysfunction/failure

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35
Q

What is the most commonly coronary artery infarct?

A

-LAD

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36
Q

ECG changes from an LAD infarct will be seen on what leads?

A

-V5, V6, aVL and I

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37
Q

What causes cardiac tamponade?

A

-more than 20mL of fluid in the pericardial space

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38
Q

Cardiac Tamponade can eventually cause what?

A

-CHF

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39
Q

What is the most common cause of CHF?

A

-MI

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40
Q

What is elevated BP?

A

-120-129/<80

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41
Q

What is stage I hypertension?

A

-130-139/80-90

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42
Q

What is stage II hypertension?

A

-140 or higher/90 or higher

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43
Q

What is a hypertensive crisis?

A

->180/>120

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44
Q

Angina is cause by what?

A

-A partial CA block

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45
Q

MI is cause by what?

A

-A total CA block

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46
Q

What does smoking cause that increases risk for CAD? (3)

A

-increased BP, Decreases HDLs, enhances platelet aggregation

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47
Q

Exercise can improve what to lessen risk of CAD?(4)

A

-improves lipid profile, improves insulin sensitivity, improves glucose control, and reduced BP

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48
Q

How does hypertension increase the risk of artherosclerosis?

A

-causes mechanical damage to endothelial cells, and increases the permeability of lipids and promotes plaque formation

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49
Q

SBPs of 140-150 increase risk of CAD by what?

A

-6- to 70%

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50
Q

SPB greater than 160% increase the risk of CAD by what?

A

-100-130%

51
Q

What cholesterol is responible for atherosclerotic deposites?

A

-LDL

52
Q

What are the 3 major risks for artherosclerosis?

A

-LDLs >190, diabetes and age 40-75

53
Q

What fasting glucose levels are contraindicated for exercise?

A

-above 250 or less than 60

54
Q

What is the Avg age for MI in males?

A

-65

55
Q

What is the Avg age of MI in females?

A

-72

56
Q

What gender is more likely to have a fatal MI?

A

-women

57
Q

How does stress increase risk of arthersclerosis?

A

-causes sympathetic stimulation that increases BP and HR and increases clotting activation

58
Q

What is sudden cardiac death?

A

-caused by vfib, initial presenting syndrome in 40-50% of CHD patients

59
Q

What is unstable angina?

A

-inadequate blood flow to the heart without conditions to provoke it

60
Q

Acute MI causes an increase in what levels?

A

-toponin

61
Q

What type of MI is commonly causes by a partial block to a major artery or a total block or a minor artery?

A

-Non-STEMI

62
Q

What type of damage will be caused by a Non-STEMI?

A

-Partial Thickness, subendocardial

63
Q

What ECG changes will be seen with a Non-STEMI?

A

-ST depression, or T wave inversion

64
Q

What type of MI is caused by a total occlusion of a major artery?

A

-STEMI

65
Q

What ECG changes will be seen with a STEMI?

A

-ST segment elevation

66
Q

What else is seen with a STEMI?

A

-Troponin levels increase (gold standard)

67
Q

What limitations does a stage I NYHA have?

A

-No limitations, ordinary activity does not cause undue fatigue, patient is asymptomatic (can perform METs above 7)

68
Q

What limitations does a Class II NYHA have?

A

-slight limitations of physical activity, ordinary physical activity leads to symptoms (5 METs)

69
Q

What type of limitations will Class III NYHA have?

A

-marked limitations; less than ordinary activity causes symptoms (2-3 METs)

70
Q

What limitations does Class IV NYHA have?

A

-Unable to carry any physical activity without symptoms (Sever CHF) (1.6 METs)

71
Q

A patient who recently had a hemorrhage and has acute low Hbg, what might be their response to exercise?

A

-They wont tolerate it well

72
Q

A person with chronicly low Hgb respond to exercise how?

A

-they might be able to tolerate it

73
Q

If a person has Hct values of what should you use a system based approach to determine if exercise is okay?

A

-<25

74
Q

If a person has a central line, what should you wait for before exercise?

A

-Xray, to confirm proper placement and rule out pneumothorax

75
Q

What should you not use on an extremity with a central line?

A

-BP cuff

76
Q

What should you encourage for a limb with a central line placed in it?

A

-AROM with precautions

77
Q

What two things should increase linearly with exercise?

A

-HR and VO2

78
Q

What is the best way yo calculate HR max?

A

-208- (0.7 x age)

79
Q

What is a 0 on the borg scale?

A

-nothing

80
Q

What is a 0.5 on the borg scale?

A

-very very slightly (Just noticable)

81
Q

What is a 2 on the borg scale?

A

-slight breathlessness

82
Q

What is a 3 on the borg scale?

A

-moderate breathlessness

83
Q

What is a 4 on the borg scale?

A

-somewhat severe breathlessness

84
Q

What is a 5 on the borg scale?

A

-severe breathless ness

85
Q

What is a 7 on the borg scale?

A

-very severe breathlessness

86
Q

What is a 9 on the borg scale?

A

-very, very severe breathlessness

87
Q

What is a 10 on the borg scale?

A

-maximum effort

88
Q

How many sessions per day are recommended for inpatient cardiac rehab in the first three days?

A

-2 to 4 session per day

89
Q

For a patient s/p MI, what HR is reccomended for inpatient cardiac rehab?

A

-20 BPM over resting

90
Q

For a patient s/p surgury, what HR is reccomended for inpatient cardiac rehab?

A

-30 BPM over resting

91
Q

What frequency is reccomended for outpatient cardiac rehab aerobic training?

A

->/= 3 days per week, 5 reccomended

92
Q

What intensity is recommended for outpatient cardiac rehab aerobic training?

A

-40-80% of exercise capacity, 20-30 BPM over resting, or 12-15 RPE

93
Q

What frequency is recommended for strength training in outpatient cardiac rehab?

A

-2-3 non consecutive days per week

94
Q

What intensity is recommended for strength training in outpatient cardiac rehab?

A

-20-15 reps of each exercise without significant fatigue, RPE 11-13, or 40-60% RPE

95
Q

What is recommended for strength training in outpatient cardiac rehab?

A

-1 to 3 sets of 8-10 exercises, focus on major muscle groups

96
Q

What is normal Right Atrial Pressure?

A

-0-8 mmHg

97
Q

What is normal RV pressure?

A

-15 to 30/0 to 8

98
Q

What is normal pulmonary artery pressure?

A
  • 15-30/5-15
99
Q

What is normal pulmonary capillary wedge pressure?

A

-4 to 15 mmHg

100
Q

What is the normal BUN level?

A

-8 to 23

101
Q

What is normal mean arterial pressure norms?

A

-70 to 110 mmHg

102
Q

What are cardiac index norms?

A
  • 25 to 4
103
Q

What is the main complication of aortic stenosis?

A

-atrial fibrillation; has a high mortality rate

104
Q

How long does the P wave last?

A

-.11 seconds (2 small boxes)

105
Q

How long does the PR interval normally last?

A
  • .12-.2 seconds (5 small boxes)
106
Q

How long does the QRS complex normally take?

A
  • .06-.1 seconds (2 small boxes)
107
Q

What leads give a view of the heart in the horizontal plane?

A

-pericordial leads

108
Q

What will an ectopic foci look like on an ECG?

A

-a large QRS complex

109
Q

How can you tell is there a muliple ectopic foci?

A

-The abnormal QRS complexes will look different

110
Q

How will atrial flutter apear on an ECG?

A

-Mutiple PVCs, Saw tooth pattern

111
Q

How will atrial fibrilation appear on an ECG?

A

-Squigly lines before QRS

112
Q

What will ischemia cause on an ECG?

A

-ST depression for 2 small boxes

113
Q

What will a non-stemi cause on an ECG?

A

-Persistent ST depression

114
Q

What is the first thing you will see on an ECG with a STEMI?

A

-ST elevation

115
Q

With a STEMI, what will appear on a ECG after ST elevation?

A

-Q wave

116
Q

What appears on an ECG with a STEMI after ST elevation and Q wave?

A

-T wave inversion

117
Q

What remains chronically in a ECG with a STEMI?

A

-Q wave

118
Q

How will a 1st degree AV block occur on an ECG?

A

-Stable PR interval prolongation

119
Q

How will a type I second degree heart block appear on an ECG?

A

-Progressive prolongation of the PR interval

120
Q

Where do 1st degree, and Type I 2nd degree AV blocks occur?

A

-At the AV node

121
Q

Where does a Type II second degree AV block occur?

A

-below the bundle of his

122
Q

How will a 2nd degree heart block appear on an ECG?

A

-Stable PR interval with some conduction getting through

123
Q

What is a 3rd degree AV block?

A

-No conduction

Cardiopulmonary (7 decks)

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