Cardiopulmonary Implications of Specific Diseases

Question 1

Calculation of BMI:

Answer 1

weight(kg)/height (m2)

[Weight (lbs)/height (in2)]x701

Question 2

Resting energy expenditure

Answer 2

energy required for basic physiologic functions

60-75% of total daily expenditure

Question 3

Diet induced themogenesis

Answer 3

increase in metabolic rate associated with processing of ingested food
10% of TDE

Question 4

Physical activity

Answer 4

energy expended on volitional and nonvocational activities

10-30%

Question 5

BMI underweight

Answer 5

less than 18.5

Question 6

BMI normal weight

Answer 6

18.5-24.9

Question 7

BMI overweight

Answer 7

25.0-29.9

Question 8

BMI obese class I

Answer 8

30-34.9

Question 9

BMI obese class II

Answer 9

35.0-39.9

Question 10

BMI obese class III

Answer 10

greater than 40

Question 11

Endurance training for obese patients

Answer 11

moderate intensity (40% to 60% of HRR); emphasize duration

Question 12

Metabolic Syndrome

Answer 12

Refers to a cluster of interrelated risk factors that includes central obesity, atherogenic dyslipidemia, HTN, insulin resistance, IGT

Question 13

What is visceral obesity associated with?

Answer 13

development of insulin resistance

Question 14

How is metabolic syndrome diagnosed?

Answer 14

three of five criteria must be present:
Central obesity
Elevated triglycerides
Low HDL
HTN 
Elevated Fasting Blood Glucose

Question 15

Type 1 DM

Answer 15

Autoimmune destruction of beta cells in pancreas

Lack of insulin secretion

Question 16

Type 2 DM

Answer 16

Genetically heterogeneous disease characterized by insulin resistance, relative insulin deficiency, progressive decline in beta cell function
Hyperglycemia due to increased rate of hepatic glucose production

Question 17

Mild to moderate hyperglycemia adrenergic:

Answer 17

frequent urination

dry mouth, increased thirst

Question 18

Mild to moderate hyperglycemia neuroglycopenic

Answer 18

weakness or fatigue

Question 19

More marked hyperglycemia adrenergic

Answer 19

increased hunger

flulike achiness

Question 20

More marked hyperglycemia

neuroglycopenic:

Answer 20

headache

blurred vision

Question 21

Serious ketoacidosis

adrenergic

Answer 21

facial flushing
dry skin
nausea or vomiting
abdominal pain
deep, rapid breathing
fruity-smelling breath

Question 22

Serious ketoacidosis

neuroglycopenic

Answer 22

coma

death

Question 23

Kidney function

Answer 23

control of extracellular fluid volume, regulation of serum osmolality, electrolyte and acid-base balances, secretion of hormones

Question 24

Risk factors for chronic kidney disease

Answer 24

DM, HTN, CVD, and obesity

Question 25

Stage 1 Kidney Disease

Answer 25

kidney damage with normal or increased GFR

Question 26

Stage 2 Kidney Disease

Answer 26

kidney damage with mildly decreased GFR

Question 27

Stage 3 Kidney Disease

Answer 27

moderately decreased GFR

Question 28

Stage 4 kidney disease

Answer 28

severely decreased GFR

Question 29

Stage 5 kidney disease

Answer 29

kidney failure

Question 30

Cardiovascular and Pulmonary Complications of Chronic Kidney Disease

Answer 30

Chronic kidney disease increases risk of major CV events Patients on dialysis – 40% have evidence of CAD and 85% have abnormal LV structure and mass HTN is both a cause and a consequence Accelerated atherosclerosis Heart failure is prevalent Pulmonary edema is most serious problem Fibrinous pleuritis Pulmonary calcification Treatment of ESRD (hemodialysis) is associated with pulmonary complications – decrease in arterial PaO2 Peritoneal dialysis is associated with pleural effusions and elevated diaphragm

Question 31

Treatment of Chronic Renal Failure

Answer 31

Goals include retard the rate of progressive deterioration in renal function, minimize complications of CRF Preventive measures using medications Primary and secondary prevention of CVD Renal replacement therapy using hemodialysis or peritoneal dialysis Kidney transplantation

Question 32

What lab values should be reviewed prior to each session with patients with chronic kidney disease?

Answer 32

Hgb, Hct, glucose, potassium, calcium, creatinine and BUN, WBC, platelets

Question 33

Connective Tissue Diseases

Answer 33

``` Connective tissue cells or extracellular matrix proteins, particularly collagens, proteoglycans, and elastins are damaged Often diffuse systemic effects Autoimmune rheumatic diseases Rheumatoid arthritis Systemic lupus erythematosus Scleroderma (systemic sclerosis) Ankylosing spondylitis Mixed connective tissue disease Inflammatory myopathies Inherited connective tissue diseases ```

Question 34

Infiltrative Diseases

Answer 34

Affect heart and/or lungs through infiltration or deposition of various substances within large organs Amyloidosis Sarcoidosis Hemochromatosis

Question 35

Neuromuscular Diseases and Neurological Disorders

Answer 35

``` Spinal cord injury Parkinson Disease Amyotrophic Lateral Sclerosis Guillain-Barré Syndrome Multiple Sclerosis Myasthenia Gravis Duchenne Muscular Dystrophy Additional types of muscular dystrophy Myotonic dystrophy Postpolio syndrome Friedreich ataxia ```