Review Flashcards
What is the most common artery occluded in the heart?
Left anterior descending artery LAD
It is acceptable not to perform warm-up in patients with severe lung disease when they are prescribed short bouts of high intensity exercise. (True/False)
True
Ideally, the minimum MET requirement to consider an activity as being able to promote endurance is:
3-4 METS
Which part of an ECG tracing corresponds to ventricular depolarization?
QRS complex
(True/False) Pulmonary edema is characteristic of left sided heart failure.
True
(True/False) Pitting edema is more severe than non-pitting
False
Which of the following normally decreases as a response to exercise?
total peripheral resistance
minute ventilation
blood pressure
heart rate
VO2
Total peripheral resistance
Which of the following normally decreases as a response to exercise?
total peripheral resistance
minute ventilation
blood pressure
heart rate
VO2
Total peripheral resistance
Which of the following is an indicator that a patient with heart failure can begin exercise?
Resting heart rate <120 BPM
Development of an S3 heart sound
A respiratory rate > 40 cycles/min
A decrease in heart rate of 10 BPM during steady state activity
Resting heart rate <120 BPM
Which of the following is not true regarding endurance testing for cardiac rehabilitation patients?
For patients with particularly low exercise tolerance, the 10 meter walk test can be utilized
When performing endurance testing, you continue to time even if the patient is resting
Leg pain is a valid reason to terminate or modify an exercise tolerance test
A 6 minute walk test value of less then 400m at discharge is statistically likely to lead to readmission within 30 days
For patients with particularly low exercise tolerance, the 10 meter walk test can be utilized
What is the normal ejection fraction?
50-75%
Where is the blood coming from the left side of the heart?
From the lungs (Pulmonary)
A patient complains of LE pain while doing a cycling stress test, but notes that the pain goes away when he bends over a little bit on the cycling machine. Should you document this as intermittent claudication?
YES
NO
NO. (Neurogenic claudication; Intermittent pain is only relieved with rest)
The most common ulceration is:
Venous
The least appropriate wound dressing is:
hydrocolloids
foam
gauze
films
Gauze
Which of the following are recommended to assess strength in a patient with pulmonary dysfunction?
5 times sit to stand test
Manual muscle testing
6 minute pegboard and ring test
5 times sit to stand test
6 minute pegboard and ring test
The following are considered selective debridement: (choose all that apply)
whirlpool
maggot
wet to dry
sharp
maggot
sharp
Which of the following test/s can be useful to assess for the presence of venous insufficiency? (check all that apply)
percussion test stemmer sign ankle brachial index rubor of dependency homan sign
percussion test
stemmer sign
rubor of dependency
homan sign
Which of the following are true regarding grafting? (check all that apply)
grafts taken from a patient’s own unburned skin and transplanted onto the burned area are called homografts
split thickness grafts provide a better cosmetic appearance
common donor sites include the thigh, buttocks, and back
when instituting ROM following grafting, AROME is done before PROME
a skin graft is secure once host vessels penetrate the graft in 24 hours
common donor sites include the thigh, buttocks, and back
when instituting ROM following grafting, AROME is done before PROME
What is the histologic hallmark of Chronic Bronchitis?
Mucous gland enlargement
What condition is defined by the presence of a chronic productive cough for 3 months during each of 2 consecutive years (other causes of cough being excluded)?
Chronic Bronchitis
What condition is the abnormal, permanent enlargement of the air spaces distal to the terminal bronchioles?
Emphysema
What COPD condition may have signs of right heart failure (cor pulmonale) such as edema and cyanosis?
Chronic Bronchitis
Prominent productive cough is typically a characteristic of:
a. neither condition
b. both conditions
c. emphysema
d. chronic bronchitis
d. chronic bronchitis
The gold standard for the diagnosis of COPD is made through
spirometry
What breathing pattern is more likely to be a pulmonary rather than a neurological condition?
Orthopnea
Green or yellow tinged sputum is most likely to be associated with which of the following conditions:
a. chronic bronchitis
b. cystic fibrosis
c. smoking
d. pleural effusion
e. malignancy
a. chronic bronchitis
You notice your patient practicing pursed lip breathing, you infer that the patient is least likely to have:
a. chronic bronchitis
b. refractory asthma
c. panacinar emphysema
d. a pneumothorax
d. a pneumothorax
Maximum amount of sputum in a day that can still be considered normal:
100ml
This adventitious sound is caused by the presence of fluid or exudate in the small airways or alveoli.
a. stridor
b. rubs
c. wheezing
d. crackles
d. crackles
Tracheal deviation deviates AWAY from the following conditions EXCEPT:
a. pleural effusion
b. pneumothorax
c. infiltrating tumor
d. atelectasis
d. atelectasis
Match the following findings to the most likely condition:
OI: barrel chested
Fremitus: decreased
Percussion: hyper resonant
Auscultation: decreased lung sounds
a. chronic bronchitis
b. pneumonia
c. emphysema
d. pneumothorax
c. emphysema
When doing percussion, the following sound is never a normal finding:
a. tympany
b. flat
c. dull
d. hyper resonance
d. hyper resonance
What is the normal chest expansion measurement?
1 to 3 inches
in postural drainage, if an increase in intracranial pressure is a concern:
a. reschedule the session for when it is no longer contraindicated to the head down position
b. continue the session but modify the bed to remain flat instead
c. continue with the session but watch out for signs of increased ICP
b. continue the session but modify the bed to remain flat instead
The emphasis during this phase is on inspiration. The patient is instructed to take in a deep breath to inspiratory reserve and expiration is passive and relaxed.
a. forced expiration
b. breathing control
c. thoracic expansion
c. thoracic expansion
During the inspiratory phase of the costophrenic cough assist, the quick stretch should be applied in a
a. downward outward direction
b. upward inward direction
c. upward outward direction
d. downward inward direction
a. downward outward direction
The diameter of the bronchopulmonary airways are increased when upright compared to the recumbent positions:
a. True
b. False
a. True
What condition has the X-ray finding: Increased bronchovesicular markings (Emphysema or Chronic Bronchitis)
Chronic Bronchitis
What condition has the X-ray finding: Increased AP diameter (Emphysema or Chronic Bronchitis)
Emphysema
What condition has the X-ray finding: Decreased cardiac silhouette (Emphysema or Chronic Bronchitis)
Emphysema
What condition has the X-ray finding: Enlarged heart (Emphysema or Chronic Bronchitis)
Chronic Bronchitis
The physiologically least justifiable position for ill patients is:
a. Upright
b. Side lying
c. Prone
d. Supine
d. Supine
Influenza vaccine is given to COPD patients to prevent exacerbation of symptoms.
a. True
b. False
a. True
The restrictive condition, scoliosis, is considered as:
a. extrinsic
b. intrinsic
a. extrinsic
The most common administration of medications for COPD to reduce systemic side effects is thru:
a. topical
b. intravenous
c. oral
d. inhaler
d. inhaler
The restrictive condition, lung abscess is considered:
a. extrinsic
b. intrinsic
b. intrinsic
In a patient with asthma, all are expected findings EXCEPT:
a. decreased breath sounds on auscultation
b. wheezes on expiration
c. barrel chest
d. decreased resonance on percussion
e. decreased fremitus
d. decreased resonance on percussion
Upon assessing the respiratory rate of an 11 year old child, you count a rate of 32 cycles per minute. you document this as:
a. both eupnea and tachypnea are possibly correct
b. tachypnea
c. bradypnea
d. both eupnea and bradypnea are possibly
correct
e. eupnea
Tachypnea
You expect decreased chest wall vibration from fremitus in all of the following circumstances EXCEPT:
a. pneumothorax
b. chronic obstructive disease
c. atelectasis
d. voice is too soft
e. pleural effusion
Atelectasis
When doing percussion, you expect decreased resonance notes in all of the following circumstances EXCEPT:
a. pneumonia
b. percussing over the scapula
c. pleural effusion
d. percussing over the stomach
e. percussing over the liver
d. percussing over the stomach
the following complications are likely to be associated with chronic pulmonary dysfunction EXCEPT:
a. central cyanosis
b. right sided heart failure
c. accessory muscle hypertrophy
d. digital clubbing
e. pulmonary edema
e. pulmonary edema
All in all, how many positions are there for postural drainage?
11
The physiologically least justifiable position for ill patients is:
a. Upright
b. Side lying
c. Prone
d. Supine
d. Supine
True of percussion EXCEPT:
a. use a steady phase of around 100 to 480 times per minute
b. take care to avoid bony prominences, the floating ribs, and breast tissue
c. done during the expiration phase of breathing
d. use of a one or two hand technique is acceptable
c. done during the expiration phase of breathing
When assessing a patient’s cough, you note that the patient has trouble creating intrathoracic and abdominal pressure. you instruct the patient to:
a. hold his breath between inspiration and coughing
b. perform abdominal thrust assisted cough
c. straighten the back and retract the scapula to augment the amount of inspired air
d. instruct the patient in huffing rather than coughing techniques
b. perform abdominal thrust assisted cough
Which of the following are termination criteria when conducting a graded exercise tolerance test? (check all that apply)
a. A decrease in blood pressure
b. Pallor
c. A fall in pO2 to below 80mmHg
d. An increase in pCO2 greater than 10mmHg
e. Maximal SOB
a. A decrease in blood pressure
b. Pallor
d. An increase in pCO2 greater than 10mmHg
e. Maximal SOB
What condition has the X-ray finding: Flat hemidiaphragm (Emphysema or Chronic Bronchitis)?
Emphysema
Upon checking the chart of a patient with arterial disease, you noted that the ABI was 0.2, which of the following do you expect to be true during assessment?
a. Absence of Pallor during elevated positions
b. Pain may be present at rest
c. Walking distance without claudication will exceed 200m comfortably
d. Presence of Cancer in PMHx
b. Pain may be present at rest
Given that the patient with PAD presents with difficulty in walking more than 200m, due to onset of intermittent claudication. What would this be classified as using Fontaine?
a. I
b. IIA
c. III
d. IIB
a. I
Upon checking the posterior tibial artery pulse, you note a very faint pulse but still detectable, what would you grade this as?
a. 3
b. 0
c. 1
d. 2
c. 1
In sensory testing, which of the following sensations would most likely be affected in more severe arterial disease?
a. Graphesthesia
b. Stereognosis
c. Temperature
c. Temperature
What landmark is usually used to locate the dorsalis pedis pulse?
a. Extensor Hallucis Longus Muscle Belly
b. Peroneus Longus Tendon
c. Extensor Hallucis Longus Tendon
d. Peroneus Longus Muscle Belly
c. Extensor Hallucis Longus Tendon
Which of the following is the expected response while doing a rubor of dependency for a person diagnosed with PAD?
a. Redness of affected limb before placing it in a dependent position
b. Redness of affected limb a few seconds after placing it in a dependent position
c. Redness of affected limb before placing it in an elevated position
d. Redness of affected limb after placing it in an elevated position
b. Redness of affected limb a few seconds after placing it in a dependent position
A pregnant woman in her 3rd trimester presenting with edema of both feet most likely has:
a. thromboangiitis obliterans
b. venous insufficiency
c. acute arterial occlusion
d. acute venous thrombosis
b. venous insufficiency
The most specific symptom of deep venous thrombosis is:
a. tenderness of the calf area
b. edema of the affected extremity
c. warmth over the calf area
d. calf pain
b. edema of the affected extremity
The most common cause of lymphedema worldwide is _____
Filariasis
In aortic dissection, the layer of the artery affected is the:
a. tunica media
b. tunica intima
c. tunica adventitia
b. tunica intima
Match the condition with the characteristics. (ASO, TAO or both)
a. associated with smoking:
b. usually occurs in the older age group:
c. involves the medium and large sized
arteries:
d. affects also the veins of the UE and LE:
e. Buerger disease:
a. associated with smoking: both
b. usually occurs in the older age group:
ASO
c. involves the medium and large sized
arteries: ASO
d. affects also the veins of the UE and LE:
TAO
e. Buerger disease: TAO
The chest pain that occurs with aortic dissection is most commonly described as ____
Tearing
