General Rehab Flashcards
The strenuousness of an activity relative to basal metabolic rate is defined as which of the following?
A Difference between arterial and venous oxygen levels
B Rate pressure product
C Cardiac output
D Metabolic equivalent
Answer: D
Explanation:
• The strenuousness of an activity relative to basal metabolic rate is defined as how many metabolic equivalents (METs) the activity is above basal metabolic rate.
• For example, lying flat is 1 MET, and walking on a treadmill is 3 METs (roughly).
The chief benefit obtained from cardiopulmonary exercise is?
A. Improved cardiac preload
B. Improved gas exchange in the lungs
C. Improved cardiac contractility
D. Improved oxygen uptake by the peripheral musculature
Answer: (D)
• The primary reason why cardiovascular exercise leads to a reduced HR and overall decreased work required of the heart and lungs is because the peripheral muscles engaged in this exercise become conditioned to take up oxygen from the blood better. In doing so, the heart essentially learns to pump less blood towards the skeletal muscles since they become so efficient at oxygen uptake. This has the end result of a reduced HR.
Which phase of cardiac rehabilitation involves very close outpatient monitoring? A. 4 B. 3 C. 2 D. 1
Answer: C
• Phase 1 of cardiac rehab involves 1-14 days of inpatient rehabilitation.
• Phase 2 involves very closely supervised outpatient activity for 3-6 months.
• Phase 3 involves less monitoring on the outpatient side.
• Phase 4 involves unsupervised maintenance activity by the patient.
During which phase of swallowing does aspiration typically occur? AOral preparatory BOral CPharyngeal DEsophageal
Answer: C
The oral preparatory phases precedes the oral phase; both of these are voluntary phases. The pharyngeal phase (involuntary) is next, in which the food bolus is transferred from the oral cavity to the esophagus. Aspiration is most likely to occur during this phase. The final phase of swallowing is the esophageal phase, which lasts the longest, and is also involuntary.
A patient requires assistance for transfers. This is defined as: • (A) Participation restriction • (B) Handicap • (C) Disability • (D) Impairment
Answer: Disability
• Impairment: A loss of structure or function (e.g. wrist drop)
• Disability: Inability to perform ADL’s (e.g. inability to ambulate or perform self care)
• Handicap: Patient’s ability to navigate societal constructs (e.g. cannot climb stairs to reach office at work; paraplegia resulting in loss of work as a professional cyclist)
- A 49 y/o M presents to your clinic. He is saddened that, due to a spinal cord infection resulting in paraplegia, he is no longer able to play golf with his friends on the weekends. This is an example of:
• (A) Permanent lack of satisfaction in life
• (B) Handicap/Participation restriction
• (C) Disability
• (D) Impairment
Answer: Handicap/Participation restriction
When deciding what type of work a patient is cleared to return to, “light duty work” is defined as lifting no more than how many lbs while on the job?
A 40
B 30
C 20
D 10
Answer: C
Explanation:
• Light duty is defined as no lifting over 20 lbs. Very light duty is lifting no more than 10 lbs.
The equation for cardiac output is which of the following? HR: heart rate. SV: stroke volume.
A SV/HR
B HR + SV
C HR/SV
D HR x SV
Answer: D
Explanation:
• Cardiac output = HR x SV.
• This is the amount of blood that can pump through the heart in a given cardiac cycle.
A patient who is status post orthotopic heart transplantation will be expected to demonstrate which of the following vital sign changes?
A Decreased atherosclerotic disease
B Lower peak exercise heart rate
C Faster return to resting heart rate after exercise
D Lower resting heart rate
Answer: B
Explanation:
• Orthotopic: describes tissue or an organ that is transplanted into its normal place in the body.
• Patients who have received a heart transplant develop:
○ Lower peak HR
○ Higher resting HR
○ Early atherosclerosis
An exercise prescription should include type of exercise, frequency, intensity, duration, number of sets and repetitions, and what else?
A All of the listed choices should be included in an exercise prescription
B Weather conditions
C Location to perform exercises
D Precautions
Answer: D
Explanation:
• An exercise prescription must include the factors listed in the question stem. In addition, it should include any medical precautions (e.g. sternal precautions in a patient status-post cardiac procedure).
• It may also include specifying whether you want open chain vs. closed chain, concentric vs. eccentric, and isometric vs. isotonic vs. isokinetic exercises.
In order to participate in constraint-induced movement therapy (CIMT) a patient must demonstrate which of the following?
A Moderate assistance or better in ADL performance
B A maximum Modified Ashworth Score (MAS) of 2/4 in all joints of the affected limb
C 5/5 strength in the unaffected limbs
D At least 10 degrees of active wrist extension
Answer: D
Explanation:
• Constraint-induced movement therpay (CIMT) requires a patient to possess at least 10 degrees of active wrist extension in the affected limb.
• It also requires the patient to NOT demonstrate hemineglect of the affected side. CIMT cannot work if the patient doesn’t recognize the affected limb in the first place.
VO2 max is defined as which of the following?
A None of these answers is correct
B The AVO2 difference at rest in an aerobically trained individual
C The maximum amount of oxygen that can diffuse across the alveolar membrane
D The maximum oxygen consumption a patient’s body can achieve during exercise
Answer: D
Explanation:
• VO2 max is defined as the maximum oxygen consumption a patient’s body can achieve during exercise
Which of the following is an example of an impairment?
A All of the answer choices are considered impairments
B A paraplegic being unable to enter a building due to lack of an access ramp
C Inability to dress independently
D Decreased hand strength
Answer: D
Explanation:
• In simpler terms, impairments, disabilities, and handicaps can be defined as follows.
• Impairment is essentially a loss of structure or function (e.g. wrist drop).
• Disability is inability to perform ADLs (e.g. inability to ambulate or perform self care).
• Handicap reflects the patient’s ability to navigate societal constructs (e.g. cannot climb stairs to reach office at work; paraplegia resulting in loss of work as a professional cyclist).
Normal forced expiratory volume in 1 second (FEV1) decreases by approximately how many cc/year?
A 30
B 20
C 15
D 10
Answer: A
Explanation:
• FEV1 normally decreases by 30 cc/year.
• In smokers it can be over double this rate.
MVO2 (cardiac oxygen consumption) is defined by which of the following formulae? CO: cardiac output. AVO2: arteriovenous oxygen difference. HR: heart rate. SV: stroke volume. SBP: systolic blood pressure.
A CO / AVO2
B HR x SBP
C HR x SV
D CO x AVO2
Answer: B
Explanation:
• Cardiac oxygen consumption: MVO2 = HR x SBP (also known the rate pressure product, an approximation of MVO2)
• HR x SV = cardiac output
• Cellular oxygen consumption: VO2 max = CO x AVO2
