Exercise Testing and Prescription in Peds Flashcards Preview

PTRS 825 Final Exam > Exercise Testing and Prescription in Peds > Flashcards

Flashcards in Exercise Testing and Prescription in Peds Deck (58)
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31

EIA Management

Use Rx 10-20 min prior to exercise
Quick acting: beta agonists, albuterol, anticholinergics, atrovent
Long acting: anti-inflammatories, leukotriene modifiers corticosteroids

32

Treatment with Short Acting Beta Agonist

2/3 must be positive to ddx reversible airway obstruction:
1. FEV1 - 200 mL or 12% increase after abutter dose
2. FVC - 10+% increase
3. FEF 25-75% - 20% increase

33

Vocal Cord Dysfunction

Spirometry changes on inspiration, normal expiration
Paradoxical closure or adduction of vocal cords during inspiration
Mimics EIA but symptoms don't respond to asthma meds
Occur with high intensities, but not sport specific

34

VCD Triggers

Bronchitis/pneumonia
Fumes/odors
Smoke
Post nasal drip
Emotions
Singing

35

VCD Symptoms

Stridor (noise on inhale)
Tightness
Abrupt onset/resolution
Feeling faint

36

VCD Treatment

Education
Belly breathing
Throat relaxation
Swallow-breath technique

37

GERD

Treating can improve both EIA and VCD
Dehydration believe to increase incidence
Can lead to tracheal malacia

38

Spirometry Purpose

Classify lung function

39

Spirometry Contraindications

Pneumothorax
Thoracic aneurysms
Eye/ab/thoracic symptoms
MI/unstable angina

40

FVC

Max volume of air forcefully exhaled after deepest inhale
Decreased with restrictive
Decrease or normal with obstructive

41

FEV1

Forced expiratory volume in 1 sec
Indicator of large airway obstruction
>80% predicted

42

FEV1/FVC

Ratio to classify lung function
Obstructive =

43

FEF 25-75%

Mean forced expiratory flow during middle half of FVC
Indicator of SMALL airway function
Norm = >60-70%
Obstructive = decreased

44

EISOB Evaluation Protocol

Get HR to 160-180 bpm for 6-8 min
Perform flow-volume loops pre-exercise and 5/10/15 min post-exercise

45

Airway Obstruction

Any disease affecting diameter of airways
Low flow rate relative to lung volume

46

Obstruction Classification

Mild - 65-80%
Moderate - 50-60%
Severe -

47

Restricted Lung Disease

Restriction of lung tissue or capacity of lungs to expand and hold predicted volumes of air
Low volumes with normal flow rates

48

RLD Causes

Fibrosis
Scarring
Physical deformity

49

Combined Lung Disease

CF
Excessive mucous production and damage to lung tissue

50

Bethesda Guidelines

For which activities/sports can be participated in
Conservative, probably lower PA level than needed

51

Aortic Stenosis

Valves don't open/close properly allowing back flow into ventricles

52

Aortic Coarctation

"Kink in hose"
Elevated S/DPB
Better assessed with right arm BP
Typically treated with stent

53

Hypertrophic Cardiomyopathy

Strong, thick muscle that doesn't pump effectively, smaller ventricles, altered conduction

54

HTCM Evaluation

For ischemic changes, ventricular ectopy and abnormal BP response
ST depression
Decrease in SPB

55

Coronary Conditions

Kawasaki's
Anomalous origin/course of coronary artery
Transposition of great vessels

56

Single Ventricle

Blunted HR response
EKG abnormalities
Decrease O2

57

Dysrhythmia

Lack of sleep
Stress
Caffeine

58

Dysrhythmia Types

Ectopic: PVC, PAC
Sick Sinus Syndrome
Long QT Syndrome
Tachyarrhythmias