CEP Exam Flashcards
1
Q
signs of myocardial ischemia (3)
A
- ECG abnormalities
- Angina
- Stiffening left ventricle
2
Q
Angina pectoris
A
Chest pain, heart cramp
3
Q
Modifiable factors to prevent CVD?
A
High Blood pressure
hyperlipidemia
obesity
smoking
physical inactivity
4
Q
myocardial infarction
A
Heart attack. Not enough blood to the hear muscle
5
Q
myocardial ischemia
A
reduced blood flow to the heart
6
Q
chronic heart failure
A
function of the heart fails to meet the requirements
7
Q
stroke
A
obstruction of bloodflow to the brain
8
Q
Marie Tooth disease
A
muscle athrophy
9
Q
Post-polio syndrome
A
muscle weakness, fatigue and pain
10
Q
sarcopenia
A
loss of muscle mass and strength
11
Q
geriatric
A
ilness and disease of old people
12
Q
frailty
A
failure of multiple systems
13
Q
What delays the process of frailty?
A
Physical activity, especially higher intensity
14
Q
What happend during systolic heart faile
A
- less blood pumped out of the ventricles
- weakened heart muscle can’t squeeze as well
15
Q
What happend during diastolic heart failure
A
- less blood fills the ventricles
- stiff heart can’t relax normally
16
Q
Equation of Stroke Volume
A
SV = EDV - ESV
17
Q
What is ejection fraction
A
How much blood is pumped away per pump.
18
Q
Consequences for exercise measurements in CVD / Structural/functional changes in the heart in CVD? (5)
A
- Cardiac athrophy
- reduced blood volume
- reduced vascular compliance(increased arterial stiffness)
- weakened contractility heart
- reduced capillarisation of active tissue
19
Q
Consequences for exercise measurements in CVD / Structural/functional changes in the lungs in CVD? (5)
A
- increase pulmonary vascular pressures
- higher stiffnes
- higher ventilation (VE)
- higher respiratory muscle work
- lower diffusion capacity
20
Q
Consequences for exercise measurements in CVD / Structural/functional changes in the skeletal muscle in CVD? (4)
A
- lower blood flow
- lower mitochondrial volume
- lower % type 1 fibers
- higher glycolytic enzymes
21
Q
What are the consequences of a CVD for the respiratory chain or energy metabolism
A
- The fick’s equation predicts the consequences for energy expenditure
- The lungs, muscles and heart affect this equation
- a-v O2diff is smaller
- aterial: lungs give less oxygen
- venous: muscles use less oxygen
22
Q
CPET results in CVD - cardiac responses
A
- HRpeak not affected
- O2 puls (VO2/HR) –> VO2 is lower
23
Q
CPET results in CVD - functional capacity
A
- VO2 peak is reduced
- Peak WR is decline
24
Q
CPET results in CVD - ventilation/gas exchange
A
- MVV (no change)
- VT1 & VT2 (lower exercise intensity)
25
What are the exercise responses in chronic heart failure?
- reduced VO2peak
- Abnormal delta VO2/WR
- High HR/WR
- Low VO2/WR
- increase in HR vs VO2
26
What are the 5 Electrical phases heart cycle
1. SA node activity
2. stimulus spread to AV node
3. Atria contraction begins
4. impulse travels from purkinje fibers to right ventricle
5. atria contraction completed. ventricular contraction begins
27
right atria
deoxygenated blood from body
28
right ventricle
pums deoxygenated blood to the lungs
29
left atria
receives oxygenated blood from the lungs
30
right atria
pumps oxygenated blood to the body
31
function of the SA-node
generates electrical activity
32
function of the AV-node
generates delay in the conduction system
33
What says an abnormality in the P-wave
something wrong with atria
34
What says an abnormality in the QRS-complex
slower conduction of the ventricular depolarization
35
What says an abnormality in the PR-interval
less/more time between contraction of atria and ventricles
36
bradycardia
abnormal low HR < 60
37
tachycardia
abnormal high HR > 100
38
Objective criteria to determine exercise intensity? (3)
- VO2max Reserve or METs
- HRReserve (karvonen)
39
Subjective criteria to determine exercise intensity? (2)
- RPE
- Talk Test
40
What do you use to prescribe exercise?
Target VO2 - %VO2Reserve
41
What is the equation of Target VO2?
Target VO2 = [(VO2max - VO2rest) x % + VO2rest]
42
What is the equation of Target MET's?
Target VO2/VO2rest (/3,5)
43
When you don't have gas analysis, how can you prescribe exercise?
Karvonen Formula
Use HR, HR/VO2 regression
44
What is the Karvonen formula?
HRR
Target HR = [(HRmx - HRrest) x % - HRrest]
45
What are problems when you use HRmethods to prescribe exercise? (4)
1. HR estimated
2. stress while taking pulse
3. day-to-day variability
4. HR/VO2 differs between modalities
46
Problems of using RPE (5)
- link RPE to exercise stage
- people get distracted
- compaire to others
- people just don't get is
- assumes steady state exercise
47
What is the Talk Test
estimation of VT
48
How can you use VT?
VT is a relevant marker for exercise intensity
49
What are the 3 principles of exercise prescription?
1. Specifity
2. Overload (FITT)
3. Reversibility
50
What does reversibility mean?
It's the loss of previously exercise training adaptations because of inactivity
51
FITT principels - Frequency
3-5 times per week
52
FITT principels - intensity
40-85% of max capacity
53
FITT principels - Time
20-60min
54
Type/mode (3)
1. large muscle groups
2. single joint
3. free weights/functional training
55
What are the benefits of CEPT? (3)
1. determination of VO2peak
2. simultaneous study of: cellular, cardiovascular and venilatory
3. measurement of energy expenditure
56
What are the steps for exercise testing? (5)
1. indication/goal setting
2. pre-screening
3. test-execution
4. terminate test
5. analyse
57
What is the reason to not do a CPET test?
Unstabe ischemic rythm or conditions
58
in the CPET test-execution you measure 3 things?
1. workload
2. Cardiovascular
3. Pulmonary
59
When do you end a CPET test looking at Blood Circulation (2)?
- BP > 250/120 mmHg
- BP drops > 10 mmHg
60
When do you enter a CPET test looking at Heart Rate/rhythm (2)?
- ST elevation > 1mm
- ST depresstion > 2mm
61
When was a CPET test maximal? (6)
- POmax achieved
- HRmax achieved
- VEmax achieved (no reserve)
- RER > 1.15
- RPE = 17
- Predicted VO2peak achieved and plateaud
62
What are the Wasserman plots?
analysis of cardioplumonary responses
63
What are the 6 variables of the wasserman-plots?
1. VO2
2. VCO2
3. HR
4. WR
5. VE
6. TV
64
What are the markers of - Function capacity (3)
- peak WR
- Peak VO2
- delta VO2/delta WR
65
What are the markers of - cardiovascular function (3)
HR peak
O2 pulse (VO2/HR)
Cardiac reserve
66
What is the cardiac reserve?
difference between the predicted and measured HRpeak
67
What are the markers of - pulmonary and metabolic function?
- MVV (maximal voluntary ventilation)
- VT
- RCT
- Breathing reserve
68
what is breathing reserve?
difference between MVV and VO2peak
69
How much lactate is available at VT1?
< 1mmol/L
70
How much lactate is available at RCP/VT2?
lactate > 4mmol/L
71
What are the 4 available sources from where you can resynthesis ATP?
1. fatty acids
2. carbohydrates
3. anaerobic glycolysis
4. phosphocreatine
72
Tell something about lactate in the Glycoltic system when there is sufficient O2 available
Lactate will always be produced. It'll transformed to pyruvate. this enters the krebs cycle for oxidative phosphorylation
73
Tell something about lactate in the Glycoltic system when there is insufficient O2 available
lactate starts to accumulate and enters the blood stream. doesn't go into the kreb's cycle
74
for what can you use VO2max? (3)
prognosis
cardiorespiratory fitness
aerobic capacity
75
What are the 3 components of muscle respiration?
lungs
heart
muscles
76
give the Fick's equation
VO2 = CO * (a-v)O2difference
77
What is de cardiac output?
amount blood per min that's pumped through the circulation
78
Risk factor - age
men >45, women >55 years
79
family history ages
dad/brother >55
mom/sister > 65
80
participates in regular exercise - NO
Medical clearance -yes/no?
No CV, metabolic, renal disease
No symptoms
no
81
Participates in regular exercise - NO
Medical clearance -yes/no?
Known CV, metabolic, renal disease
Asymptomatic
yes
82
Participates in regular exercise - NO
Medical clearance -yes/no?
signs of CV, metabolic, renal disease
yes
83
Participates in regular exercise - YES
Medical clearance -yes/no?
Signs of CV, metabolic, renal disease
discontinue
84
Participates in regular exercise - YES
Medical clearance -yes/no?
Known CV, metabolic, renal disease
Asymptomatic
moderate - no
vigorous - yes
85
Participates in regular exercise - YES
Medical clearance -yes/no?
No CV, metabolic, renal disease
No signs
no
86
Physical activity reduces the risk of:
dementia
hip fractures
depression
all-cause mortality
cardiovascular disease
type 2 diabetes
cancer
87
Benefits of PA for patients
better cardiorespiratory fitness
higher muscle strength and endurance
reduced fatigue and dyspnea
better QoL
88
PA for patients with chronic disease because of the following 2 reasons:
increased health
improved functioning
89
adaptations after aerobic exercise - respiratory
- improved O2 diffusion
-reduced VE at submax exercise
-increased ventilation at max exercise
90
adaptations after aerobic exercise - cardiovascular
higher SV, BV, bloodflow to muscles
lower HR rest
91
adaptations after aerobic exercise - muscular
higher capillarisation, O2 diffusion in muscle, type IIa/I muscle fibers
92
Guidelines Physical activity
150-300min moderate
75-150min vigurous
93
What is the metabolic squeeze?
With ageing:
MET's decrease
Energy cost increase
94
Signs/symptoms of CV, metabolic or renal disease (4)
1. angina
2. dyspnea
3. dizziness
4. unusual fatigue or shortness of breath
95
points to consider before starting to exercise (3)
1. current activity level
2. symptoms
3. planned exercise intensity
96
Benefits PA (4)
prevention disease
maintaining health
treatment of chronic diseases
better functioning
