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EP4133: Exe for Clinical Populations > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Prevalence of HTN:

_____ million Americans aged ≥ 20 yr

  • About _____
  • Prevalence will ___ with age
  • More common with what race______
A

Prevalence of HTN:

76 million Americans aged ≥ 20 yr

  • About 1-3
  • Prevalence will increase with age
  • More common with what race?
    • Black
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2
Q

Aerobic Exercise Program:

Frequency:______

Intensity:________

Time:______

Type:______

Progression______

A

Aerobic Exercise Program:

  • 3-7 Days per week
  • VO2 R or HRR:40-60%
  • 30-60 min
    • continious or intervial
  • Type: Large muscle groups rhythmic
  • Progresson:Working to a goal.
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3
Q

________ ________ will decrease BP

A

Endurance Exercise

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4
Q

A _____ contraindicaton would that the GXT test can not be preformed.

A

Absolute

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5
Q

No resistance exercise if resting BP is _______

A

>180/110

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6
Q

_____ % of the population or aprox. ____ currenly diagnosed with diabetes.

A

8.3 % of the population or aprox. 26 million currently diagnosed with diabetes.

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7
Q

What are the key components of the 08 PA guidelines for americans:

A
  • Everyone can benifit from PA
  • Benifits outway the risks
  • guidelines where provided for:
    • ​Children& Adults
    • older adults
    • women during preagnancy
    • individuals with disabilitys
      *
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8
Q

Fitness, Fatness, & Mortality:

Who as more or less risk of death?

A

Fitness, Fatness, & Mortality:

Who as more or less risk of death?

Fitness over Fatness!

Fitness plays a role in decreasing the risk of death you can still be overweight but be fit at the same time with less risk

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9
Q

You should not have someone preform aerobic exercise if resting BP is >_____/>_______

A

200/110mm

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10
Q

would this be an absoulute or relative Contraindication for exercise testing?

A Significant change on the resting ECG suggesting ischemia, acute myocardial infarction,or other acute cardiac event.

A

Absolute

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11
Q

A persons fasting blood glucose is 115mg.dL-1

This person is has _________

A

Pre-Diabetes

=fasting Blood glucose

>100mg.dL-1

<126mg.dL-1

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12
Q

What is the time recomended time for adults per week for aerobic exercise?

A

(150) min moderate intensity/ week

or

(75) min of vigorus activity

in longer than 10min intervals

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13
Q

RER=_______/______

A

Co2 produced / VO2

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14
Q

The test should be stoped if angina reaches __ on the scale

A

3

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15
Q

Diabetes is the ___th leading casue of DEATH in the U.S.

A

7th

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16
Q

A __-__ on the angina scale when preforming a GXT is enough info to stop the test.

A

3-4

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17
Q

_______-______ is when someones blood glucose is higher than normal but below diabetic levels.

What is diabetic fasting glucose level?

A

Pre- Diabetes

>126 mg.dL-1 is considered to be diabetic

<100mg.dL-1 is normal level

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18
Q

______________ is a group of metabolic diseases characterized by an inability to produce sufficient insulin or use it properly, resulting in hyperglycemia.

A

Diabetes Mellitus

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19
Q

_________- Ability to apply force at a given velocity

A

Muscular Power

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20
Q

would this be an absoulute or relative Contraindication for exercise testing?

severe arterial hypertension at rest

A

Relative

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21
Q

A blood pressure of 250/115 would be considered what?

A

Relative indication:

“Hypertensice response”

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22
Q

a drop in systolic BP of ≧ 10mm with an increase of work rate or if systolic BP decreases below the values obtained in the same position prior to resting when accompanied by other evidence of ischemia would be an ______ indication.

A

Absolute

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23
Q

______ is used to measure o2 uptake.

A

Open Circut Spirometry

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24
Q

Diagnosis of HTN:

What method is used _______-

  • during sitting & arm supported at Heart level
  • after 5min of rest
  • NO caffeine, Exercise, and smoking for 30 min prior.
  • Phase 1- Korotkoff sound
    • SBP
  • Phase 5- Korotkoff sound
    • DBP
A

Ausculitatory

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25
Q

______=rate of heart at systole

A

RPP- Rate pressure product.

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26
Q

_______ is the maximum ability to develop force by a muscle

A

Muscular strength

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27
Q

picture of electrical signal in the heart

A

Electrocardiogram

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28
Q

How many days per week should children have vigerous activity?

A

3 days per week

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29
Q

What would you use to measure multiple joints?

A

Inclinometer

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30
Q

GXTs must be conducted by _______ and ______-_____ professionals

A

Knowledgeable and well trained professionals

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31
Q

__________- when the resting systolic BP is ≥140mm/Hg

and diastolic BP is ≥ 90mm/Hg

A

Hypertension

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32
Q

________- the ability to maintain submitmal force over extended time.

A

Muscular Endruance

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33
Q

Resistance Exercise Program:

American Heart Assocation Guidelines:

  • _____Days per week
  • _____ exercises
  • ________
  • _______ Reps
    • _____ reps for more frail people
  • ________ __
    • Before,during and after resistance training
A

American Heart Assocation Guidelines:

  • 2-3 per week
  • 8-10 exercises
  • at leasts 1 set moderate intensity
  • 8-12 Reps
    • 10-15 reps for more frail people
  • Monior BP
    • Before,during and after resistance training
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34
Q

would this be an absoulute or relative Contraindication for exercise testing?

Uncontrolled cardiac arrhymia causing symptoms or hemodynamic compromise

A

Absolute

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35
Q

An approperate GXT test sould take about how many min long?

A

8-12 min long

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36
Q

would this be an absoulute or relative Contraindication for exercise testing?

left main coronary stenosis

A

Relative

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37
Q

How many new cases of diabetes where found in 2011?

A

1,600,000

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38
Q

About ___-___% of Americans with diabetes have Type 2

A

90-95%

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39
Q

_______ is difficulty breathing

A

Dyspnea

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40
Q

A _____ contraindicaton would be a sugestion that the GXT test souldnt be preformed.

A

Relative

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41
Q

The Role of PA in diabetes: Indirect

  • Higher ________
  • Lower_________
  • Better ________
  • _________
  • Lower_______
A

The Role of PA in diabetes: Indirect

  • Higher cardio-respiratory fitness
  • Lower Blood pressure
  • Better Blood lipid profile
  • Weight Loss
  • Lower Abdominal Fat
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42
Q

_____ _____ ____ - Any degree of glucose intolerance with onset or first recogniton during pregnacy.

A

Gestational Diabetes Mellitus

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43
Q

_________- is the ability ot move a joint through a full range of motion

A

Flexibility

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44
Q

What are signs and symptoms of HTN?

A
  • Often there are no symptoms “silent killer”
  • Headache
  • Dizzy
  • Palpatations
  • Epistaxis-Nose blead
  • Hematuria- Blood in the urine
45
Q

This protocal test is popluar with doctors

A

Bruce test

46
Q

What are the risk factors assocated with HTN?

A
  • CAD
  • MI
  • Heart failure
  • Stroke
    • Direct and indirect economic cost 43.5 billion
47
Q

What type of diabetes is insulin dependent?

The body does not make insulin*

A

Type 1

48
Q

Direct medical cost of diabetes yearly is > $____

The Indirect cost due to disability is $____

A

$116 Billion

$58 Billion

49
Q

This ergometer yeilds watts

A

Electronically breaked

50
Q

Pathophysiology of HTN:

  • Essential- factors are?
A

Pathophysiology of HTN:

  • Essential- factors:
    • ​Genetic factors
    • Salt sensitivity
    • inappropriate renin secretion
    • environment
51
Q

What factors control BP?

  • _________
    • ​_______
    • _____________
  • ​___________
    • ​epinephrine
    • angiotenstin II
    • aldosterone
    • atrial natriuretic peptide
    • Argine Vasopressin
  • ​Local vascular factors
    • ​Nitric oxide
A
  • Autonomic Neural Control
    • Medulla
    • Excite=Sympathetic vs vagal= Rest
  • Hormone Control
    • epinephrine
    • angiotenstin II
    • aldosterone
    • atrial natriuretic peptide
    • Argine Vasopressin
  • ​Local vascular factors
    • ​Nitric oxide
52
Q

What is the formula for HRR or VO2 R?

A

[(HR peak- Rest) x precent as decimal] + Rest HR

53
Q

Acute Hypoglycemia complications:

  • Low Glycogen in the blood
  • Fainting
  • Increased HR
  • Neuroglycopenic Pain

These can be treated how?

A
  • Test Glucose level
  • Consume 15 grams of carbs
    • 120 ml orange juice
  • ​If patient is unconcius give glucogon injection.

​More likely to be in a person with type 1.

54
Q

An inverted T wave is an indication for what?

A

Myocardial infarctoin

55
Q

_____ inhibits the SNS?

A

Vagal

56
Q

Gestational diabetes occurs during ___% to ___% of pregnancies.

A

2%-10%

57
Q

____ are important in the medical evaluation of individuals with clinical conditons.

A

GXTs

58
Q

____= COxTPR

A

Blood pressure(BP)=

Cardiac Output x Total peripherial Resistance

59
Q

What all can be found in a GXT report?

A
  1. Angina status
  2. ECG findings pertaining to ischemia
  3. ECG findings pertaining to arythmia
  4. functional capacity
  5. HR response
  6. BP response
60
Q

What would you use to measure an isolated joint directly?

A

Goniometer

61
Q

About ____ have no idea they have diabetes!

A

5 Million

62
Q

_____: produced by endothelial cells

A

Nitric Oxide

63
Q

____ # of new cases of diabetes in 2011

A

1.9 Million

64
Q

What are the 3 stages of progression:

A
  1. intial
  2. Improvement
  3. Maintance
    - Reversability is important in the maintance stage.
65
Q

The slope of the prevelance of diabetes between white,black,and asian are the same why?

A

The disease is more prevalent as the years go on, and people are living longer. However the ammount of Black americans is more prevalent than white or asian

66
Q

____- means respiratory exchange ratio

A

RER

67
Q

Someone with >___ mg.dL-1 fasting blood glucose level has Diabetes

A

>126 mg.dL-1 = Diabetes

68
Q

The RA and LA electrodes should be placed_________

A

Just below the right and left clavical

69
Q

Causes of Hypertension:

Essential Cause:

_________

Secconday cause:

_________

A

Essential: Hardening of the arteries

Secondary causes:

Renal- decrease in urine excretion

Endocrine “adrenal glands”

70
Q

A Depression in the ST segment means that

A

ischemia is occuring or has occured

71
Q

Children should have how many min of PA daily?

A

60 Min

72
Q

_______ _______ plays an imporant role in the management of many clinical conditions

A

Exercise training

73
Q

In ____% of cases diabetes goes undiagnosed

A

25%

74
Q

HTN: is #___ leading casue of death in 2010.

A

#13

75
Q

BP is greater on the left or right side?

A

Left Side- has to pump blood to the rest of the body that requires a greater force

76
Q

___-___% of people with pre-diabetes will develop type 2 diabetes

A

15-30%

77
Q

___ is recorded during the last 15 seconds fo each 2 min period during the test

A

ECG,RPE

78
Q

This type of ergometers yields kgm/m and has a knob

A

Mechanicaly breaked

79
Q

______ is when blood flow is reduced to the heart

A

Angina/ Ischima

80
Q

RL and LL electrodes should be placed on the _______ or at the level of the _______

A

the lower edge of the rib cage

umbilicus of the mid clavicular line

81
Q

____ is often conducted with patients off medications

A

GXT or graded exercise test

82
Q

giving a the patient medicatoin to increase HR to simulate exercise level HR

A

Pharmacologic stress Testing

83
Q

What are common symptoms of type 2 diabetes?

A
  • unusual thirst
  • frequent qrine
  • unsual weight loss
  • extreme fatigue & irritability
  • Frequent infectoins
  • cuts/bruises heal slow
  • blurred vision
84
Q

__________ protocols:

Work rate is gradually increased

ramping bruce

and is to be used to individualize the test.

A

Ramping protocols

85
Q

_______ ______ is when normal amounts of insulin are inadequate to produce a normal cell response.

A

Insulin Resistance

86
Q

_______ is responsable for vasoconstricton and diolaton of vessels

A

Nitric Oxide

87
Q

would this be an absoulute or relative Contraindication for exercise testing?

Moderate stenotic valvular heart disease

A

relative

88
Q

and elivated ST segement could be an indication for

A

acute heart attack

89
Q

What is the time recomended time for adults per week for muscular strengthing exercise?

A

Muscle strengthening should be done

  • 2 or more days a week.
  • All major muscle groups should be worked.
    • These are the legs, hips, back, abdomen, chest, shoulders, and arms.
  • Exercises for each muscle group should be repeated 8 to 12 times per set.
  • As exercises become easier, increase the weight or do another set.
90
Q

___________causes Keytone bodies to be released in the blood and causes the cells to reject insulin.

This will result in a higher producton of insulin.

A

Fat metabolism

91
Q

_____ is monitored continously before the test

A

ECG, Signs and symptoms

92
Q

Diagnosis of HTN:

A medical professional will have to take the patients BP __ or more times, and over __ different visits

A

2

93
Q

Pathophysiology of HTN:

  • Secondary- factors are?
A

Pathophysiology of HTN:

  • Secondary- factors:
    • Renal handeling of Na+
    • may increase blood volume
    • altered renal secretion of vaso-active substances
    • endocine
      • _​_problems in adrenall glands
94
Q

What type of diabetes fails to properly respond to it’s own insulin, does not make enough insulin or both?

A

Type 2

95
Q

______ is the same as vo2 but in METS

A

functional capacity

96
Q

Who is the Most important Ex. Phys epidemiologist today?

A

Steven Blair

97
Q

Neuro-Hormonal Control:

What 2 Neuro/Humoral factors will decrease the blood volume,decrease the cardiac output,and decrease the arterial pressure?

A
  • Vagal activity can decrease cardiac output
    • and arterial pressure
  • Atrial natriuretic Peptide
98
Q

About ____-____% of americans with diabetes have type 1 diabetes

A

5-10%

99
Q

Acute Hyperglycemia complications:

  • Diabetic Ketoacidosis
  • Hyperosmolar nonketotic syndrome

These can be treated how?

A
  • Drink Water
  • Monitor Blood Glucose levels
  • Possibly increse Meds
100
Q

Somone who has low glycogen in blood could have and increase in HR why?

A

To get blood moving through the body quickly

101
Q

Complications of HTN:

Name the 6 Complicatoins found with HTN

A
  1. Endothelial Dysfuncton
  2. athersclerosis
  3. ventrical hypertrophy(growth of the ventricals)
  4. Congestive heart failure
  5. Stroke
  6. Renal Disease
102
Q

Pre-diabetes effects about _____ Americans

A

57 Million

103
Q

What are some risk factors for Type 2 Diabetes?

A
  • Overweight
  • High level of abdominal Fat
  • Family History
  • Physical Inactivity
  • Race/ethnicity
    • ​African American,American Indian,asian american,pacific islander,hispanic american/latino
  • Hypertension
  • dyslipidemia
  • Older Age
104
Q

What is the Role of PA in diabetes: Direct Effects:

  • Improves _______
    • acute
    • long term
  • Pancreas
    • Reduced ______
  • Liver
    • Decreased Glucose productoin
  • Adipose Tissue
    • Greater fatty acid metabolism
  • Skeletal Muscle
    • Greater expression of glut-4
A

Glucose homeostasis

Reduced insulin secretion

105
Q

The estimated annual cost of diabetes in the U.S. in 2007 was $_______

A

$174 Billion

With a “B”

106
Q

would this be an absoulute or relative Contraindication for exercise testing?

Unstable angina not controlled by medical therapy

A

Absolute

107
Q

When the artery allows for more blood flow the BP ______

A

Decreases

and vice versa

108
Q

Diabetes can cause other chronic complications.

What are examples of thoese complications?

A
  • Macrovascular:
    • Coronary artery disease
    • Leads to Myocardial infarction
  • MicroVascular:
    • inner lining of blood vessels loose elasticity
    • decrease in endothelial response

EP4133: Exe for Clinical Populations (10 decks)

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