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ACSM-CEP > CEP test > Flashcards

CEP test Flashcards

1
Q

What is VO2?

A

The volume of oxygen the body consumes.

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2
Q

What is VO2 max?

A

The highest volume of oxygen the body can consume.

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3
Q

The volume of blood the heart ejects with each beat is known as __________

A

Stroke volume

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4
Q

How does stroke volume increase with workload?

A

Similar to heart rate, it increases as workload increases, but only up to 40-60% of the Vo2 max.

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5
Q

What happens to resting heart rate as stroke volume increases?

A

It decreases as more blood being pumped per beat allows the heart to beat less often

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6
Q

A measure of blood pumped per minute is ___________. It is also the product of stroke volume and heart rate

A

cardiac output

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7
Q

What does the diastolic blood pressure do during exercise?

A

Remains stable or decreases slightly

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8
Q

____________ serves as a estimate of myocardial oxygen demand. It is the product of heart rate & systolic blood pressure.

A

Rate pressure product

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9
Q

What is the gold standard to measure cardiorespiratory fitness?

A

VO2 max during circuit spirometry

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10
Q

How does a submax exercise test work?

A

It estimates the VO2 max from the heart rate response to submaximal single stage or graded exercise

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11
Q

________ oxygen consumption is the raw volume of consumed oxygen by the body

A

absolute oxygen consumption

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12
Q

________ oxygen consumption is the volume of oxygen consumed relative to the body weight. *Useful to compare fitness levels between individuals.

A

Relative oxygen consumption

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13
Q

What are the 5 health related physical fitness components?

A
  1. cardiorespiratory endurance
  2. body composition
  3. muscular strength
  4. muscular endurance
  5. flexabilty
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14
Q

What are the 6 performance related physical fitness components?

A
  1. agility
  2. coordination
  3. Balance
  4. Power
  5. Reaction time
  6. speed
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15
Q

________ is the ability of the circulatory system & respiratory system to supply O2 during sustained physical activity

A

cardiorespiratory endurance

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16
Q

________ is relative amounts of muscle, fat, bone & other vital parts of the body

A

body composition

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17
Q

_________ is the ability of muscle to exert force

A

muscle strength

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18
Q

________ is the ability of muscle to continue to preform without fatigue

A

muscular endurance

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19
Q

________ is range of motion at a joint.

A

Flexibility

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20
Q

_______ is the ability to change position of the body in space with speed and accuracy

A

Agility

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21
Q

_______ is the Ability to use the senses together with body parts to preform tasks smoothly and accurately

A

coordination

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22
Q

________ is the maintenance of equilibrium while stationary or moving

A

balance

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23
Q

_________ is the time elapsed between stimulation & the beginning of the reactions to said stimulus

A

reaction time

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24
Q

Vigorous intensity RPE = __________

A

RPE > 14

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25
Q

What is used as a pre-participation screening tool by a professional for cardiac rehab & other medical fitness facilities?

A

Risk stratification assessment

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26
Q

What are the 4 lowest risk components during exercise test & recovery?

A
  1. no complex ventricular dysrhythmia
  2. No angina or other significant symptoms
  3. Normal hemodynamics
  4. Functional capacity > 7 mets
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27
Q

What are the 6 lowest risk components during rest? * Must have all of these to be considered low risk*

A
  1. no complex ventricular dysrhythmias
  2. Resting EF> 50%
  3. Uncomplicated MI or re-vascularization
  4. No congestive heart failure
  5. No signs or symptoms of post event/ procedure ischemia
  6. no clinical depression
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28
Q

What is ejection fraction to be classified as low risk?

A

> 50%

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29
Q

Who is at most risk for sudden cardiac death?

A

Sedentary individuals performing infrequent exercise

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30
Q

What BMI is considered a risk factor for CVD (Obesity)

A

BMI > 30 kg/m2

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31
Q

What is used as a pre-participation health screen in absence of professionals help?

A

The 2014 Par-Qt , physical activity readiness questionnaire for everyone

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32
Q

What are some signs and symptoms of CV, renal & metabolic disease

A
  • pain/discomfort in neck, chest, jaw & arm
    -SOB at rest with mild exertion
    -dizziness or syncope
    -orthopnea or paroxysmal nocturnal dyspnea
    -ankle edema
    -Palpitations or tachycardia
    -intermittent claudication
    -known heart murmur
    -unusual fatigue or SOB with usual activities.
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33
Q

Metabolic disease consist of at least 3 of these things/symptoms

A

-increased weight circumference (m >40in, W >35in)
-increased triglycerides >150 mg/dl
-decreased HDL (m<49 mg/dl, W<50)
-increased BP (SBP >130 or BPB >85)
-increased tasting glucose >100 mg/dl

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34
Q

<3 mets is defined as __________ level of physical activity

A

light

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35
Q

3-6 mets is defined as _________ level of physical activity

A

moderate

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36
Q

> /= 6 mets is defined as _________ level of physical activity

A

vigorous

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37
Q

What is 1 met mean?

A

1 met= the relative oxygen consumption at rest, or 3.5ml per Kg/per min.

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38
Q

Why do we use mets?

A

It is an easy way for the general public to gauge their exercise intensity. Also it used to calculate energy expenditure overtime.

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39
Q

What is a kilocalorie? What is it also known as?

A

A calorie
Estimate of energy cost that can be directly related to physical activity & exercise.

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40
Q

Weight gain, loss & maintenance can be estimated by __________

A

3500 kcal = 1lb fat

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41
Q

Is the ACSM’s weekly recommended physical activity sufficient to prevent weight gain in the typical american lifestyle?

A

No, they have to go beyond the weekly recommendations.

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42
Q

What is the Par-Q limitation?

A

A minimal standard for entry into moderate-intensity exercise programs.
-allows individuals to gauge their own medical readiness to participate.
-Does not screen well for those at low to moderate risk

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43
Q

What is a pre participation screening questionnaire?

A

Useful for clients to assess their health readiness more comprehensive & recognizes signs and symptoms of CVD & other risk factor thresholds.

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44
Q

What are the ACSM coronary artery risk factors?

A

-age (men 45 & older, women 55 & older)
-family history
-smoker
-sedentary
-obesity
-hypertension
-pre-diabetes
-Dyslipidemia (elevated fat/cholesterol)

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45
Q

What is the negative risk factor for coronary heart disease?

A

HDL-cholesterol value great than or = to 60
** This is the reverse cholesterol transport & reduces the risk of CVD

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46
Q

__________ is the term for shortness of breath

A

Dyspnea

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47
Q

_________ is when a patient has trouble breathing while lying down

A

orthopnea

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48
Q

_________ is difficulty breathing while sleeping

A

paroxysmal nocturnal dyspnea

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49
Q

What classifies a patient as low risk?

A

<2 risk factors, asymptomatic

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50
Q

What classifies a patient as moderate risk?

A

2 or more risk factors & asymptomatic

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51
Q

What classifies a patient as high risk?

A

Symptomatic or known CVD, CPD, renal or metabolic disease

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52
Q

What is the exception to missing risk factor information?

A

pre-diabetes is counted as a positive risk factor only if the person is 45 or older OR the bi is 25 or more ( and they have additional risks for pre-diabetes)

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53
Q

What is contraindication?

A

Individuals characteristics that make physical activity more risky?

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54
Q

What is absolute contraindications to exercise?

A

absolute cannot participate in any physical activity program and/or assessment & should consult with their doc first.

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55
Q

What is relative contraindications to exercise?

A
  • The benefit of exercise outweighs the risk of testing.
  • heart issues, most disorders exacerbated by exercise, chronic infections disease, AV block, mental impairment.
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56
Q

Exercise testing is recommended for individuals and what risk?

A

High risk

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57
Q

What BP is considered prehypertension?

A

80-89 DBP

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58
Q

BP for stage 2 hypertension

A

160 + SBP
_______
100+ DBP

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59
Q

BP for stage 1 hypertension

A

140-159 SBP
__________
90-99 DBP

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60
Q

Normal BP range

A

<120/<80

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61
Q

Optimal LDL

A

<100

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62
Q

Optimal HDL

A

<40

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63
Q

Optimal triglyceride levels

A

<150

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64
Q

Optimal total cholesterol

A

<200

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65
Q

3 assessments for muscle endurance

A
  1. bench press
  2. curl up
  3. push up
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66
Q

When a motor unit is stimulated by a single nerve impulse it is known as a _________

A

twitch

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67
Q

Motor unit stimulated constantly is known as ________

A

tetanus

68
Q

A motor unit that has more than 1 stimulus is known as a __________

A

summation

69
Q

What is the “SAID” Principle? What is it dependent on?

A

The specificity principle
-specific exercise elicits specific adaptions, creating specific training effects.
-Dependent on the type & mode of exercise

70
Q

7 ways to determine exercise intensity

A
  1. heart rate reserve method
  2. peak HR methods
  3. Peak VO2 method
  4. peak Mets method
  5. VO2 reserve method
  6. Talk test method
  7. RPE method
71
Q

(HRR) heart rate reserve method karvonen formula

A
  • The difference between max HR & resting HR.
    HR max - Resting HR x % exercise intensity (in decimal form, divide by 100) + HR rest
72
Q

Target HR formula

A

Target HR = max HR x % intensity desired (in decimal form, divide by 100)

73
Q

Peak HR method formula

A

220-age = Max HR ——-> low estimate
210- (age x 5) = Max HR ——-> high estimate

74
Q

Target VO2 formula

A

Target VO2= VO2 max x % intensity desired

75
Q

Target mets formula

A

Target mets= (% intensity desired)

76
Q

_______ is the difference between VO2 max and VO2 rest

A

VO2 reserve

77
Q

Target VO2 reserve formula

A

Target VO2 reserve= (VO2 max- VO2 rest) x % intensity desired + VO2 Rest

78
Q

The talk to test method Differentiates between moderate & vigorous activity. How can you tell?

A

If they can talk but not sing, it is moderate. If they are unable to say more than a few words without pausing for a breath it is vigorous.

79
Q

On the Borgs RPE scale, what level is recommended to improve cardiorespiratory fitness?

A

11-16 To improve CRF

80
Q

Borgs RPE scale ranges from levels ____ to ______

A

6 to 20. No exertion at all to maximal exertion.

81
Q

What is the CR-10 scale of exertion? (Borgs category ratio scale)

A

-scale from 0-10
-0 is sitting & 10 is max effort
-5-6 moderate
7-8 vigorous

82
Q

What symptoms identified during an exercise test should require the test to be stopped?

A
  1. Drop in SBP 10 or below
  2. Rise in BP above 250 & or 115
  3. Failure of HR to increase
  4. Failure to test equipment
83
Q

What is rate pressure product?

A

serves as an estimate of myocardial oxygen demand product of HR & systolic BP.
Equation: HR X SBP

84
Q

____________ is an inadequate blood supply to an organ or part of the body, especially the heart muscles.

A

Ischemia

85
Q

AACVRP moderate risk components during exercise test and recovery are:

A

-Angina or other symptoms only when >7 mets.
-Mild-moderate silent ischemia
-Functional capacity <5 mets

86
Q

If a patient has angina or significant symptoms, what qualifies them at moderate risk? What qualifies them at high risk?

A

Moderate- only occurring at high levels of exertion or during recovery (>7 mets)

High Risk- occurring at low levels of exertion or during recovery (<5 mets)

87
Q

What are considered significant symptoms by the AACVRP?

A

-angina
-Unusual SOB
-Dizziness
-Light headedness

88
Q

What amount of silent ischemia qualifies a clinical patient for moderate risk? What about high risk?

A

Moderate: mild-moderate silent ischemia (ST depressions <2mm)

High risk: High levels of silent ischemia (ST depression > 2mm)

89
Q

What functional capacity qualifies a clinical patient for moderate risk?

A

< 5 mets

90
Q

AACVPR moderate risk ejection function = ________

A

ejection function 40-49%

91
Q

AACVPR high risk components during exercise test & recovery

A

-complex ventricular dysrhythmias
-Angina or other significant symptoms at <5 mets
-abnormal hemodynamics
(i.e. flat or drop in SBP with
-high levels of silent ischemia (ST depressions > 2mm)

92
Q

Patient has a complex ventricular dysrhythmia during an exercise test, what is the risk category?

A

High risk

93
Q

Patients SBP does not respond to increased meds, what risk category?

A

high risk

94
Q

At what resting ejection function does a patient qualify as high risk?

A

<40%

95
Q

When is age risk factor for CVD?

A

men > 45 yr
women > 55 yr

96
Q

What weight CF is a risk factor for CVD (obesity) ?

A

Men > 40in (102 cm)
Women > 35in (88cm)

97
Q

vigorous intensity mets =

A

> 6 mets

98
Q

Vigorous intensity VO2 or HRR =

A

> 60% HRR or VO2 reserve

99
Q

Moderate intensity RPE =

A

RPE 12-13

100
Q

Moderate intensity mets=

A

3-5.9 mets

101
Q

Moderate intensity HRR or VO2R=

A

40-59% HRR or VO2 reserve

102
Q

Light intensity RPE=

A

RPE 9-11

103
Q

Light intensity mets=

A

2-2.9 mets

104
Q

Light intensity VO2R & HRR =

A

30-39% HRR

105
Q

Ability to perform a movement with a short period of time is known as _____

A

speed

106
Q

ACSM’s weekly/daily physical activity recommendations

A

150 minutes moderate physical activity per week (30 min or more most of the days the week), 75 minutes of vigorous intensity.

107
Q

Can most sedentary individuals safely begin a low to moderate intensity PA program without the need for baseline testing or medical clearance?

A

yes

108
Q

Most common musculoskeletal injuries occur in what area of the body?

A

lower body- particularly knee and foot

109
Q

Active versus sedentary

A

Active- exercised for at least 30 min / day, 3 day/week, for the last 3 months

110
Q

Patient is active, known CV, metabolic or renal disease has signs or symptoms is medical clearance recommended at what intensity?

A

Discontinue exercise and seek clearance before continuation

111
Q

Patient is active, known CV, metabolic or renal disease, no signs or symptoms. Is a medical clearance recommended? At what intensity?

A

Medical clearance is not necessary for light to moderate, but necessary before vigorous

112
Q

Patient is active, no known CV, metabolic or renal disease. No signs or symptoms. Is medical clearance recommended? At what intensity?

A

Medical clearance not necessary, light to vigorous intensity.

113
Q

Patient is sedentary. Known CV, metabolic or renal disease, has signs and/or symptoms. Is medical clearance recommended & at what intensity ?

A

Medical clearance is recommended. Light to moderate, progress to tolerated

114
Q

patient is sedentary. No known cv, metabolic or renal disease, no signs or symptoms, is medical clearance recommended at what intensity

A

Medical clearance is not necessary, light to moderate, progress to vigorous.

115
Q

patient is sedentary. Known cv, metabolic or renal disease. No signs or symptoms. Is Medical clearance recommended? or what intensity?

A

Medical clearance is recommended, light-moderate, progress as tolerated

116
Q

What is used as pre-participation health screening tool by a professional for the general (non-clinical) population?

A

The ACSM algorithm

117
Q

any bodily movement produced by contracting skeletal muscles, with an increase in energy expenditure.

A

physical activity

118
Q

small amounts of CP are stored within each cell. Simple one to one trade off that allows for the rapid production of ATP. Only for use during short bouts of exercise, less than secs. What system is this?

A

Creatine phosphate system

119
Q

What are the 3 metabolic pathways the body uses to create ATP?

A
  1. creatine phosphate
  2. Anaerobic glycolysis
  3. Oxidative system
120
Q

Pain in the leg induced by exercise, usually because of an artery obstruction is known as _________

A

Claudication

121
Q

No oxygen required, next most immediate energy source is _______.
-Breakdown carbs into pyruvate.
-used during medium duration exercise.&raquo_space; No more than 90 seconds

A

anaerobic glycolysis

122
Q

Attributes or characteristics that individuals have achieved that related to their ability to perform physical activity

A

physical fitness

123
Q

Pt case:
1.5 mm of ST depression
Functional capacity is 4 mets
No symptoms

What risk category according to AACVRP

A

moderate

124
Q

Which of the following procedures provides the least sensitivity & specificity in the diagnosis of coronary artery disease?

A) coronary angiography
B) Echocardiography
C) Electrocardiography
D) Radionuclide imaging

A

C) electrocardiography

-Least sensitive & specific of all of these test.
-Directly visualization of the coronary arteries using coronary angiography provides the highest sensitivity & specificity.

125
Q

Which of the following is the thickest, middle layer of the artery wall that is composed predominantly of smooth muscle cells & is responsible for vasoconstriction & vasodilation?

A) endothelium
B) intima
C) Media
D) Adventitia

A

C) Media

The media contains most of the sooth muscle cells, which maintain arterial tone.

126
Q

The _______ comprises a single layer of cells that forms a tight barrier between blood and the arterial wall to resist thrombosis, promote vasodilation & inhibit smooth muscle cells

A

endothelium

127
Q

The ________ is the very thin innermost layer of the artery wall & is composed mainly of connective tissue with some smooth muscle cells.

A

intima

128
Q

The _______ is the outermost layer of the arterial wall & consists of connective tissue, fibroblasts & a few smooth muscle cells.

  • Highly vascularized & provides the media & intima with oxygen & other nutrients.
A

Adventitia

129
Q

Orthopnea is ____________.

A

Dyspnea at rest in a recumbent position that is relieved by sitting upright or standing.

130
Q

_________ ____________ dyspnea refers to dyspnea that begins usually 2-5 hr. after the onset sleep, which may be relieved by sitting on the side of the bed or standing to get out of bed.

—-> symptom of left ventricular dysfunction.

A

Paroxysmal nocturnal dyspnea

131
Q

What condition is characterized by an inflammation & edema of the trachea & bronchial tubes, hypertrophy of the mucous glands that narrows the airway, arterial hypoxemia that leads vasoconstriction of smooth muscle in the pulmonary arterioles & venules & in the presence of continued vasoconstriction results in pulmonary hypertension.

A

bronchitis

132
Q

___________ ____________ is a mean pulmonary artery pressure at rest >25mm hg or >30mm hg with exercise.

A

pulmonary hypertension

133
Q

Which of the following statements concerning the surgical treatment of coronary artery disease is true?

A) a coronary artery stent carries a lower rate a re-vascularization than does PTCA.
B) Atherectomy is a prerequisite requirement for PTCA.
C) Venous grafts are significantly superior to arterial grafts in terms of potency.
D) Long term outcome of laser angioplasty is unknown and thus rarely used.

A

A) A coronary artery stent carries a lower rate of re-vascularization that does PTCA.

134
Q

Which of the following is not true for an individual who suffered a cerebral vascular accident & wishes to return to work?

A) patients should be educated on avoidance & precautions
B) Assessments of muscular strength & endurance are needed.
C) they should not be encouraged to return to work.
D) Exercise programs should be specific to occupational requirements

A

C) they should not be encouraged to return to work

135
Q

Which of the following is a reversible pulmonary condition caused by some type of irritant & characterized by bronchial airway narrowing, dyspnea, coughing & possibly hypoxia & hypercapnia.

A) emphysema
B) Bronchitis
C) Asthma
D) pulmonary vascular disease

A

asthma

136
Q

During a medical emergency, which of the following medications in an endogenous catecholamine that could be used to increase blood flow to the heart and brain?

A) lidocaine
B) oxygen
C) atropine
D) epinephrine

A

Epinephrine.

Epinephrine is an endogenous catecholamine that optimizes blood flow to the heart and brain by increasing aortic diastolic pressure and preferentially shunting blood to the internal carotid artery.

137
Q

what category of meds reduces myocardial ischemia by lowering myocardial oxygen demand, is used to treat typical & variant angina, but has not been shown to reduce post myocardial infarction mortality?

A

Nitrates:

Nitrates relax peripheral venous vessels, which decrease preload, oxygen demand & alleviate ischemia.

138
Q

___________ blockers reduce myocardial ischemia by lowering myocardial oxygen demand.

A

Beta Adrenergic (beat agonist)

139
Q

___________ is a parasympathetic blocking agent used to treat brady arrthymias

A

atropine- cam be useful for treating symptomatic sinus bradycardia and may be beneficial for any type of AV Block at the nodal level.

140
Q

___________ is an anti-rythmic agent that can decease automatically in ventricular myocardium as well as raise the fibrillation threshold

A

lidocaine- injection

141
Q

Which of the following medication does not affect exercise HR response?

A

angiotensin- converting enzyme (ace) inhibitors and angiotensin 2 blockers

142
Q

Ace inhibitors & angio-tension 2 receptors blockers do what to the heart rate?

A

Level heart rate

143
Q

Calcium channel blockers do what to the heart rate?

A

Raise or level heart rate

144
Q

Beta blockers do what to the heart rate?

A

Lower heart rate

145
Q

Thyroid meds do what to the heart rate?

A

Raise the heart rate

146
Q

Medications may directly alter the ECG response during exercise & result in false positive tests. Assuming no change in underlying disease status, the drug most likely to have this effect is_________

A

Digitalis (Lanoxin)

147
Q

_________ can modify the ST-T contour & Slow AV conduction

A

Digitalis (lonoxin)

148
Q

Compared with data obtained during a previous graded exercise test when no medications were taken, a new patient now taking propranol (inderal) would have what response to submaximal exercise intensity during a second test.

A
149
Q

___________ is the process where fatty streaks develop causing the artery wall to thicken while reducing luminal diameter (plaque build up)

A

atherosclerosis

150
Q

____________ defines complete obstruction of blood flow to the cardiac myocardial tissue. Heart attack & results in tissue death or narcosis.

A

Myocardial infarction

151
Q

____________ is defined as rapid beating or fluttering of the heart

A

tachycardia

152
Q

__________ is defined as pain and or cramping in the lower leg due to inadequate blood flow to the muscles

A

claudication

153
Q

_________ is defined as shortage of oxygenated blood flow to the heart myocardium

A

ischemia

154
Q

___________ is defined as fainting & dizziness during exercise that may indicate poor blood flow to the brain because of inadequate cardiac output from a number of cardiac disorders

A

syncope

155
Q

__________ is defined as the ability of the circulatory and respiratory system to supply oxygen during sustained physical activity

A

cardiorespiratory endurace

156
Q

What effect do anti-arrhythmic agents have on a person with an arrhythmia?

A

All anti-arrhythmic agents may cause new or worsened arrhythmias

157
Q

What effect does bronchodilators have on a person?
HR:
BP:
ECG:
Ex capacity:

A

HR: the same at rest and exercise
BP: The same at rest & exercise
ECG: the same at rest & exercise
EX capacity: the same VO2 max for patients limited by bronchospasm

158
Q

What effect does alpha blockers have on a person?

A
  • same cardiac output
  • increase or the same HR
  • Decrease BP
    -increase resting HR/exercise HR
    -Decrease exercise ischemia
    -increase exercise capacity for patients with angina and CHF; the same for patients without angina
159
Q

____________ is defined as shortness of breath

A

dyspnea

160
Q

_________ is ability of a muscle to continue to perform without fatigue

A

Muscular endurance

161
Q

Before exercise testing, what vitals and info needs to be taken from the patient?

A

Resting HR, resting BP, height & size weight and body composition done first

162
Q

_________ is the ability of muscle to exert force

A

muscular strength

163
Q

________ is defined as relative amounts of muscle, fat, bone & other vital parts of the body

A

Body composition

164
Q

What is the blood pressure response to exercise?

A

SBP: progressive increase, typical 10 +/- 2 mmHg/MET with a possible plateau at peak exercise.

DBP: no change or slight decrease

165
Q

__________ is a technique used to express or validate how hard a client feels he/she is working during exercise

A

The rating of perceived exertion (RPE)

ACSM-CEP (1 decks)

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