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EP4133: Exe for Clinical Populations > Test 2 lecture 6 > Flashcards

Test 2 lecture 6 Flashcards

1
Q

What is Peripheral Arterial Disease (PAD)?

A

Obstruction arteries of the legs

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2
Q

Peripheral arterial disease result in what? and what does this mean?

A
  1. Claudication

2. Pain weakness numbness or cramping in muscle due to decreased blood flow

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3
Q

What is the prevalence of PAD?

A

approximately 8 to 12 million people in the US

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4
Q

Direct medical cost in 2001 due to the impact of PAD

A

4.37 billion dollars

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5
Q

What group of people does PAD impact?

A

older people, men , African Americans , people with diabetes

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6
Q

What are the metabolic and neural effects of PAD

A 
1 impaired energy utilization
2 impaired resynthesis of ATP and CP 
3 low concentration of ATP and CP
4 loss of muscle fibers
5 lower metabolic efficiency of muscle 
6 mitochondrial damage
7 damage to peripheral nerves
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7
Q

what are the risk factors of PAD?

A 
1 older age
2 smoking 
3 diabetes 
4 dyslipidemia 
5 hypertension 
6 high C-reactive protein 
7 High homocysteine 
8 high fibrinogen 
9 high blood viscosity 
10 family history for cardiovascular disease
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8
Q

intermittent claudication happens to what percentage of PAD patients? It also progressively occurs during what?

A

1) 35-40 %

2) shorter activity bouts

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9
Q

What are the common comorbidities associated with PAD?

A

1 Heart disease
2 stroke or cerebrovascular disease
3 pulmonary disease and
4. diabetes

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10
Q

what diagnostic tests are used to identify pad

A 
blood test for risk factors,
 ankle-brachial index, 
exercise test, 
Doppler ultrasound, 
reactive hyperemia, 
CT or MR angiogram
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11
Q

What is the ratio used to find the ankle-brachial index or ABI?

A

SBP and Ankle / SBP in arm

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12
Q

Post-exercise ABI may help identify what?

A

severe ischemia

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13
Q

Prognosis for PAD is (worse / great) when intermittent claudication is present.

A

worse

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14
Q

prognosis is poor /great with critical limb ischemia.

A

poor

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15
Q

prognosis for PAD is (lower/greater) with low functional capacity.

A

lower

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16
Q

What are some lifestyle modifications that should take place in the treatment of PAD?

A

smoking cessation, diet, physical activity

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17
Q

What are the different forms of treatment for PAD?

A

lifestyle modification, medication revascularization, amputation

18
Q

What are the two forms of revascularization used to treat PAD?

A

bypass grafting and angioplasty

19
Q

What are some of the things exercise improves for PAD patients?

A

pain free walking time and distance
risk factor profile
functional capacity
quality of life

20
Q

true or false claudication disappears with exercise for PAD patients

A

false

21
Q

what are some of the adaptations to exercise for pad patients

A

improved oxidative metabolism in muscles improved walking biomechanics
reduced blood viscosity
greater collateral circulation
better endothelial function
greater pain tolerance
higher pain free walking distance and time

22
Q

true or false PAD patients have 115% increase in distance after 6 month

A

true

23
Q

What test is used to help identify severe ischemia in legs?

A

ABI

24
Q

Functional testing may not be true Preak __ ,but should record ____ and _____

A

1) GXT
2) time and distant prior to onset pain
3) time and distance prior to maximal pain

25
Q

What speed are test usually ran

A

2 miles per hour

26
Q

What are the most common protocols for exercise testing in Pat patients?

A

ramping protocols

27
Q

true or false discontinuous protocols may be used

A

true

28
Q

What is the relative indication for termination of a test for a PAD patient

A

3 on a 4 point Pain Scale

29
Q

what type of activities are usually prescribed to PAD patients?

A

large muscle activities and walking

30
Q

what is the frequency initially prescribed for pad patients.

A

two to three times a week

31
Q

What is the intensity prescribed to PAD patients? What is the percent VO2 Reserve or heart rate Reserve?

A

Moderate

40-60%

32
Q

what is the duration (for exercise) prescribed for pad patients and how long is the recovery?

A

intermittent; 2-5min exercise and 1-2 min recovery

33
Q

true or false? for strength and flexibility training PAD patients follow General guidelines

A

true

34
Q

true or false pad patients have a higher risk for cardiac and cerebrovascular events

A

true (5-7% per year)

35
Q

what are some of the ways people prevent pad

A

early evaluation of risk factors

modification of risk factor profile (medication and life style modifications)

36
Q

what are the two pain classification methods for PAD patients?

A

Fontaine stages and Rutherford

37
Q

true or false arteriosclerosis likely begins with endothelial dysfunction due to oxidative stress

A

true

38
Q

true or false arterial stenosis increases blood flow to musculature

A

false (lowers or decreases)

39
Q

true or false mild PAD is always symptomatic

A

false (mild PAD can be asymptomatic)

40
Q

What percent of PAD patients has intermittent claudication?

A

35-40%

41
Q

critical limb ischemia can include the presence of ischemic rest pain, foot ulcers, and gangrene.What is the percent of PAD patients with critical limb ischemia?

A

1 - 2%

42
Q

what are some signs and symptoms of PAD

A 
intermittent claudication, 
critical limb ischemia, 
noticeable differences from unaffected limb, sores or ulcers slow to heal,
 gangrene, 
and other symptoms of atherosclerosis

EP4133: Exe for Clinical Populations (10 decks)

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