SPT3 Flashcards
(190 cards)
1
Q
Which gas is considered an important vasodilator of the blood vessels?
A
Nitric oxide
2
Q
T/F: In a successfully revascularized patient, the exercise test provides additional
information before the patient starts a cardiac rehabilitation program
A
False
3
Q
A typical treadmill graded exercise test for an individual with PAD would
begin at which speed?
A
2 mph
4
Q
T/F: A small number of patients with myocardial ischemia present with silent
ischemia
A
True
5
Q
T/F: Home-based programs have been considered successful interventions in
patients with PAD
A
False
6
Q
Which of the following sequences are correct in the development of angina
pectoris?
A
Stiff left ventricle, Systolic emptying of left ventricle is
impaired, ECG abnormalities, Symptoms of angina
7
Q
Design a clinical exercise test for the aerobic assessment of heart failure
A
For a patient with heart failure, I would have them do a 6
minute walk. I would make sure to record their distance
travelled, HR and RPE’s this is so that we can tell just how hard
it is for the patient and ensure that they are not going to put
themselves at risk. Another thing that could be measured
would be their gas exchange to determine peak oxygen uptake.
8
Q
Typical symptoms of leg pain in patients with claudication include
A
A and B correct
A. Fatigue
B. Cramping
9
Q
Which of the following benefits are possible after exercise training in
patients with coronary revascularization?
A
All of the above
- Greater total work performed
- Improved exercise capacity
- Improved cardiac performance at rest
- Increased peripheral muscular adaptations
10
Q
T/F: Pacemakers that use an accelerometer may have a difficult time in
determining the heart rate response in exercise with an increased treadmill
slope
A
True
11
Q
T/F: Patients with heart failure may be able to weight train with resistances that
would allow one set of 12-15 repetitions to be completed
A
True
12
Q
In ECG of patients with heart failure, which of the following are present?
A
Changes in Q-wave in leads V1, V2, V3, V4
13
Q
T/F: In an ECG of a myocardial infarction, the ST segment will be at the
isoelectric line
A
False
14
Q
T/F: High-intensity interval training (HIIT) programs may be used as an exercise
program for individuals in early stages of cardiac rehabilitation
A
False
15
Q
In the management of a myocardial infarction, which drug is considered an
anti-coagulant?
A
Heparin
16
Q
There is an __ increase in mortality at 1 year for every 30-minute delay in
opening an infarct-related artery once symptoms begin
A
8%
17
Q
T/F: The United States contributes almost a third of the worldwide economic
burden of heart failure
A
True
18
Q
T/F: Blood pressure should be monitored in individuals with a pacemaker while
exercising
A
True
19
Q
T/F: Exercise testing is useful in determining the degree of functional limitations
in patients with PAD
A
True
20
Q
Signs and symptoms such as difficulty sleeping flat are often found in
patients with
A
Heart failure
21
Q
Why would a bench press be contraindicated in early phase cardiac
rehabilitation?
A
The valsalva maneuver must be avoided when patients are just
out of the hospital/starting cardiac rehab. If the patient was to
do a bench press they would be putting a lot of strain on their
chest. This is especially bad for those who have had open heart
surgery. This is because they have had their chest cracked open
and they should not be completing any upper body exercise for
at least the !rst 6 weeks.
22
Q
The main contributor to a coronary syndrome is
A
Atherosclerosis
23
Q
T/F: Rhythm disorders that involve the SA node are classified as sick sinus
syndrome
A
True
24
Q
Which of the following frequencies of exercise is recommended for
someone exercising at a low intensity?
A
Daily activity
25
Stent therapy has a success rate of
95%
26
Which of the following is the predominant factor responsible for increasing
cardiac output during exercise?
Heart rate
27
T/F: Individuals with PAD are at an increased risk for kidney disease
True
28
Which of the following should guide an exercise professional in the
development of an exercise prescription in an individual with a pacemaker?
RPE
29
T/F: Approximately 50% of all cardiovascular deaths are due to coronary heart
disease
True
30
In a 6-minute walking test, which of the following is the test outcome?
Distance traveled
31
T/F: Pharmacological treatment of claudication in patients with PAD has been
largely ineffective
True
32
Describe the process of atherogenesis
Smooth muscle cells and !broblasts migrate from the media to
the intima. Monocytes also migrate into the intima after they
have adhered to the injured endothelium. The LDLc enters the
arterial wall and undergoes the process of oxidation. Forming
foam cells that may release their cholesterol into extracellular
space, giving rise to fatty streaks, the earliest visually detectable
lesion of atherosclerosis. Immune system cells, T lymphocytes,
are in the fatty streaks and they are part of the inflammatory
33
T/F: Chronic anticoagulation therapy is still required after a stent placement
False
34
Which of the following pathophysiologies is present in heart failure?
All of the above
- Reduced ejection fraction
- Increased left ventricle mass
- Edema
- Imbalance of autonomic nervous system
35
Which of the following is an example of a failure of the heart to relay the
impulse to the ventricles?
Block at the AV node
36
T/F: Ischemic heart disease is the underlying cause of HF in about 60% of the
cases
True
37
T/F: Poor limb functioning in patients with PAD is not related to disability or mortality
False
38
Identify 2 of the arteries for palpating lower extremity pulses in individuals
with PAD
femoral and popliteal arteries
39
T/F: A poor response to exercise training may be indicative of restenosis
True
40
In which condition is it possible to hear a third heart beat?
Heart failure
41
Which of the following arrhythmias is most common in individuals with
pacemakers?
None of the above
42
T/F: Performing a graded exercise test after stent therapy is not considered safe
for the patient
False
43
T/F: It is important for the clinical exercise physiologist to understand the
dynamics of a pacemaker
True
44
Mechanism(s) for improving walking distance in patients with PAD include
All of the above
- Increased pain tolerance
- Attenuation of atherosclerosis
- Reduction in blood viscosity
- Increased collateral circulation
45
Mechanism(s) for improving walking distance in patients with PAD include
All of the above
- Increased pain tolerance
- Attenuation of atherosclerosis
- Reduction in blood viscosity
- Increased collateral circulation
46
Which process involves the use of a venous graft from the arm or leg to
increase blood flow to the heart?
CABS
47
T/F: Performing a graded exercise test after stent therapy is not considered safe
for the patient.
False
48
Which of the following pathophysiologies is present in heart failure?
All of the above
- Reduced ejection fraction
- Increased left ventricle mass
- Edema
- Imbalance of autonomic nervous system
49
Which gas is considered an important vasodilator of the blood vessels?
Nitric oxide
50
T/F: Outpatient cardiac rehabilitation should being within 4-6 weeks after
discharge from the hospital for an acute myocardial infarction.
False
51
T/F: High-intensity interval training (HIIT) programs may be used as an exercise
program for individuals in later stages of cardiac rehabilitation.
True
52
In ECG of patients with heart failure, which of the following are present?
Changes in Q-wave in leads V1, V2, V3, V4
53
T/F: Ischemic heart disease is the underlying cause of HF in about 60% of the
cases.
True
54
T/F: Patients with heart failure can see benefits by engaging in walking and
cycling exercise.
True
55
T/F: Approximately 50% of all cardiovascular deaths are due to coronary heart
disease.
True
56
The main contributor to a coronary syndrome is
Atherosclerosis
57
Which of the following benefits are possible after exercise training in
patients with coronary revascularization?
All of the above
- Greater total work performed
- Improved exercise capacity
- Improved cardiac performance at rest
- Increased peripheral muscular adaptations
58
T/F: History of symptoms for acute coronary syndromes includes chest pain,
sweating, and anxiety
True
59
In early-phase rehabilitation, which of the following exercises are
contraindicated?
Dumbbell bench press
60
TF: Patients with heart failure may be able to weight train with resistances that
would allow one set of 12-15 repetitions to be completed.
True
61
TF: In patients with HFrEF, an abnormal third heart sound can be heard.
True
62
TF: Following stent therapy, the risk of thrombosis is greater.
True
63
Patients with chronic heart failure may be able to perform ___ minutes of
moderate intensity physical activity.
Up to 60 minutes
64
Which of the following sequences are correct in the development of angina
pectoris?
Stiff left ventricle, Systolic emptying of left ventricle is
| impaired, ECG abnormalities, Symptoms of angina
65
Patients with heart failure should exercise at an intensity of
A and B correct
A. 60% of heart rate reserve
B. RPE of 11-14
66
Typical symptoms of leg pain in patients with claudication include
A and B
A. Fatigue
B. Cramping
67
Which of the following is used to determine the severity of PAD?
Ankle-brachial index
68
In a 6-minute walking test, which of the following is the test outcome?
Distance traveled
69
Which of the following is the preferable mode of exercise for patients with
PAD?
Walking
70
Mechanism(s) for improving walking distance in patients with PAD include
All of the above
- Increased pain tolerance
- Attenuation of atherosclerosis
- Reduction in blood viscosity
- Increased collateral circulation
71
Which of the following is an example of a failure of the heart to relay the
impulse to the ventricles?
Block at the AV node
72
Which of the following arrhythmias is most common in individuals with
pacemakers?
Atrial fibrillation
73
Which of the following should guide an exercise professional in the
development of an exercise prescription in an individual with a pacemaker?
RPE
74
Which of the following frequencies of exercise is recommended for
someone exercising at a low intensity?
Daily activity
75
Which of the following testing protocols is typically used when assessing
patients with a pacemaker?
Chronotropic assessment exercise protocol
76
TF: The majority of patients with PAD are asymptomatic
True
77
TF: Hemodynamic measurement of PAD provides anatomic detail of the
vascular obstruction
False
78
TF: Exercise testing is useful in determining the degree of functional limitations
in patients with PAD
True
79
TF: Pharmacological treatment of claudication in patients with PAD has been
largely ineffective
True
80
TF: Home-based programs have been considered successful interventions in
patients with PAD
False
81
TF: A single-chamber pacemaker is typically used when both the atria and
ventricles need external pacing
False
82
TF: Accelerometers are used in pacemakers to detect motion in response to
physical activity
True
83
TF: Contact sports are recommended for individuals with pacemakers
False
84
TF: Pacemakers that use an accelerometer may have a difficult time in
determining the heart rate response in exercise with an increased treadmill
slope
True
85
TF: Blood pressure should be monitored in individuals with a pacemaker while
exercising
True
86
Which of the following conditions is considered under the umbrella of cardiovascular disease?
All of the above
a. Coronary heart disease
b. Hypertension
c. Heart failure
87
Which of the following plays a critical role in maintaining the degree of vasoconstriction?
Endothelium
88
Which of the following is a cause of atherosclerosis?
All of the above
a. Diabetes mellitus
b. Plasma homocysteine
c. High levels of LDL-C
d. Tobacco use
89
Which of the following indicates a prothrombotic, vasoconstrictive state?
All of the above
a. Platelet aggregation
b. Mural thrombi
c. Release of growth factors
90
TF: Approximately 75% of all cardiovascular deaths are a result of coronary heart disease.
False
91
TF: Men and women have their first myocardial infarction at the same age.
False
92
TF: The endothelium produces nitric oxide, which is a vasoconstrictor of the blood vessel.
False
93
TF: HDL-C undergoes oxidation and contributes to atherosclerotic plaque formation after entering the arterial wall.
False
94
Which of the following is the second abnormality in the ischemic cascade?
Systolic dysfunction
95
Which of the following may be causes of a reduction in the lumen diameter?
All of the above
a. Significant atherosclerotic plaque
b. Vasospasm without underlying plaque
c. Vasospasm superimposed over a plaque
d. Thrombus associated with plaque rupture
96
Which of the following is described by cardiac pain that is reproducible and predictable in onset, severity, and means of relief?
Stable angina
97
Which of the following may be triggered by ischemia resulting from an atherothrombotic vessel being occluded?
All of the above
a. Ventricular tachycardia
b. Ventricular fibrillation
c. Sudden cardiac death
98
TF: The heart contains very few mitochondria and is adapted to anaerobic energy production.
False
99
TF: Myocardial tissue is different from skeletal muscle tissue in that it is able to extract nearly all oxygen from the capillary blood flow.
True
100
TF: Atypical angina has no relationship with exertion which set is apart from typical angina.
True
101
TF: When a coronary blood vessel is occluded for more than 60 minutes, a myocardial infarction ensues.
True
102
Which of the following conditions involves a buildup of lipids, macrophages, platelets, and fibrous connective within the coronary arteries?
Coronary artery disease
103
Which of the following involves revascularization using a venous graft from an arm or leg to provide blood flow to the myocardium beyond the site of the occluded area in a coronary artery?
Coronary artery bypass surgery
104
Which of the following describes the reasons for an individual to elect coronary artery bypass surgery?
All of the above
a. Significant left main CAD
b. Three-vessel disease
c. Two-vessel disease with a proximal left anterior descending stenosis
d. Two-vessel disease and impaired left ventricular function
105
Which of the following describes the occlusion rate of a graft after 11 years?
40%
106
TF: Coronary artery bypass surgery is reserved for patients with multivessel disease that is not appropriate for angioplasty or stenting
True
107
TF: Stent procedures require a multi-night stay in the hospital.
False
108
TF: Percutaneous transluminal coronary angioplasty has a low success rate in cases of unstable angina.
False
109
TF: Chronic anticoagulation therapy is still required when stent therapy is used to treat CAD.
False
110
Which of the following training modes is beneficial for individuals who are severely deconditioned?
Moderate-intensity interval training
111
Which of the following may be adaptations that occur in revascularized patients who participate in a supervised exercise program?
A and B correct
A. Improved cardiac performance at rest and during exercise
B. Improved aerobic and strength exercise capacity
112
Which of the following should be topics asked about the patient’s surgery at the initial interview with the clinical exercise physiologist?
All of the above
a. Excessive or unusual soreness/stiffness
b. Cracking, grinding, or motion in the sternal region
c. Sleep patterns at night
d. Incisions and their responses to activities of daily living
113
Which of the following are improvements in the patient’s tolerance to acute bouts of exercise after surgery?
All of the above
a. Improved myocardial blood flow
b. increased maximal heart rate
c. Reduction in ST-segment depression
d. Reduction in exertional hypotension
114
TF: A graded exercise test is required for individuals after a successful bypass surgery for creating an exercise program.
False
115
TF: Bed rest after surgery typically leads to a loss of lean body mass in individuals.
True
116
TF: Patients in a supervised exercise program typically have fewer hospital readmissions.
True
117
TF: 4. Resistance training should be utilized with a light weight that can be performed for 12-15 repetitions.
True
118
Which of the following are reasons for the increased in incidence and prevalence of heart failure?
A and B correct
a. Aging population
b. Improved survival of patients with CVD
119
Which of the following describes the 5 year mortality rate for heart failure?
None of the above
(50%) is the answer
120
Which of the following describes the predominant cause of heart failure due to a reduced ejection fraction?
Ischemic heart disease
121
Which of the following describes difficulty sleeping flat or awakening suddenly during the night to “catch my breath?”
Paroxysmal nocturnal dyspnea
122
TF: Diastolic dysfunction involves a stiff or less compliant left ventricle that is unable to relax and expand as blood flows during diastole
True
123
TF: The left ventricle end-diastolic and end-systolic volumes remain the same with a reduced ejection fraction in patients with heart failure with preserved ejection fraction.
False
124
TF: Sympathetic nervous system activity is increased in diastolic heart failure.
False
125
TF: A third sound of the heart is not heard in patients with heart failure due to a reduced ejection fraction.
False
126
Which of the following is the percentage of reduction of left ventricle ejection fraction?
45%
127
Which of the following is calculated as the slope of the relationship of minute ventilation to CO2 production?
Ventilatory efficiency
128
Which of the following is the suggested rate of increase in exercise intensity during a GXT in a patient with chronic heart failure?
10-15 W/min
129
Which of the following classes of drugs used to treat heart failure can result in nonspecific ST-T wave changes in resting ECG?
Digitalis
130
TF: The decrease in ejection fraction is proportional to the amount of myocardium that is no longer functional.
True
131
TF: Prediction equations of VO2 are discouraged in patients with chronic heart failure because they tend to overestimate functional capacity.
True
132
TF: Patients with stable heart failure may undergo a symptom-limited maximum cardiopulmonary exercise test.
True
133
TF: Individuals with heart failure need to engage in cardiorespiratory exercise 4-5 times per week.
True
134
Which of the following describes the percentage of patients with PAD that have claudication?
35-40%
135
Which of the following is a common risk factor for PAD?
All of the above
- Diabetes
- Smoking
- Increased blood viscosity
- Elevated C-reactive protein
136
Which of the following locations is the most commonly reported area for leg pain?
Calf
137
Which of the following arteries would be compromised if the individual experienced pain in the thigh?
All of the above
- Internal iliac artery
- Common iliac artery
- Profunda femoral artery
- Common femoral artery
138
TF: The prevalence rate of PAD is higher in males than females
True
139
TF: Abnormal blood flow in the lower extremities is predicated on the severity of the stenosis in PAD
True
140
TF: Supervised exercise training is considered a second-line therapy for claudication.
False
| First-line
141
TF: Noninvasive angiography is needed to diagnose the specific disease location and severity of PAD.
True
142
Which of the following provides an objective measure of the severity of PAD?
Ankle-brachial index
143
Which of the following arteries is used in the ankle-brachial index?
A and B are correct
A. Dorsalis pedis
B. Posterior tibial
144
Which of the following is the first-line option for noninvasive imaging?
Computed tomography angiography
145
Which of the following is the most important evaluation for patients with PAD?
All of the above
- Cardiorespiratory endurance
- Knee extension
- Handgrip
- Plantar flexion isometric strength
146
TF: Exercise testing is useful for determining the degree of functional limitation in patients with PAD.
True
147
TF: Patients with PAD have lower plantar flexion strength and lower knee extension power than patients without PAD.
True
148
TF: The exercise prescription is set according to the individual limitations of the patients with PAD.
True
149
TF: Low-intensity exercise training programs have been shown to be similar to high-intensity exercise rehabilitation for improving initial claudication onset.
True
150
Which of the following are the most common indicators for a pacemaker implantation?
A and B correct
A. SA node dysfunction
B. Conduction block in the AV node
151
Which of the following is the most important component for increasing cardiac output?
Heart rate
152
Which of the following symptoms may a person exhibit with SA node dysfunction?
A, B, and C correct
A. Fatigue
B. Light-headedness
C. Syncope
153
Which of the following is a complication of heart block if left untreated?
All the above
- Presyncope
- Syncope
- Loss of AV synchrony
- Death
154
TF: Clinical exercise physiologists should understand how a pacemaker will affect the patient’s physiologic response to exercise
True
155
TF: AV asynchrony may not allow the ventricles to fill with enough blood before contracting
True
156
TF: There is an equal distribution among men and women who need a pacemaker.
True
157
TF: The loss of atrial function increases atrial pressure and pulmonary congestion.
True
158
Which of the following does AV synchrony and stroke volume provide their most important contributions to cardiac output?
At rest
159
Which of the following arrhythmia is most common in patients with sinus node dysfunction?
Atrial fibrillation
160
Which of the following is described by the highest rate at which the pacemaker will pace the ventricle in response to a sensor-driven rate?
Maximal sensor rate
161
Which of the following is important for the sensors in the pacemaker?
All of the above
- Sensors should rapidly detect acceleration and deceleration
- The response should be proportionate to the exercise workload and metabolic demands
- The response should be sensitive to both exercise and non-exercise requirements
- The response should be specific and not be falsely triggered
162
TF: The pacemaker can set the AV interval based on the heart rate.
True
163
TF: In response to exercise, increasing heart rate is the most important factor for increasing cardiac output and oxygen uptake.
True
164
TF: The graded exercise test protocol does not need special consideration for formal exercise testing of patients with a pacemaker.
False
165
TF: RPE should be used to guide exercise intensity in the exercise prescription.
True
166
This layer of the artery has a critical role in maintaining the degree of vasoconstriction
Endothelium
167
These are risk factors for the development of atherosclerosis
Tobacco, Dyslipidemia, Hypertension, Obesity, Sedentary lifestyle, Diabetes, Metabolic syndrome
168
A myocardial infarction in this chamber of the heart is associated with a high-degree AV block and increased in-hospital morbidity and mortality
Right ventricle
169
This drug when used to help treat coronary syndromes increases the risk of bleeding and has no effect on exercise
Anti-platelet (aspirin)
170
The is the process of the development of angina pectoris
Stiffening of the left ventricle, which impairs diastolic filling of the heart. Systolic emptying of left ventricle is impaired. Localized areas of myocardium develop abnormal contraction patterns. ECG abnormalities associated with altered repolarization occur.
171
This is the 5 year mortality rate for an individual newly diagnosed with heart failure
50%
172
This is the common cause of heart failure with reduced ejection fraction
Ischemic heart disease (coronary atherosclerosis)
173
This is the recommended frequency of exercise in patients with heart failure
4-5 times per week
174
This is the condition that is found when peak heart rate response is less than 62% of age predicted max
Chronotropic incompetence
175
This diagnostic test uses expired gases to determine and is an excellent predictor of future risk of death
Ventilatory efficiency
176
These are complications of angioplasty
Acute vessel closure, thrombotic distal embolism, MI, arrhythmias, dissection of the coronary artery, and bleeding
177
Signs of coronary artery disease include
Buildup of lipids, macrophages, platelets, calcium, and fibrous connective tissue within the coronary arteries
178
Coronary artery bypass surgery is beneficial for patents with these conditions
Significant left main coronary artery disease, Three-vessel disease, Two-vessel disease with a proximal left anterior descending stenosis, Two-vessel disease and impaired left ventricular function
179
This is the optimal amount of time to wait after bypass surgery to begin exercise testing
At least 4 weeks
180
These exercises are recommended 4-6 weeks post-surgery
Dumbbell bent-over row, Seated row, Lateral dumbbell raise, Shoulder press, Triceps kickback
181
This is the prevalence of patients with PAD and claudication
~35%-40%
182
This process starts the development of PAD
Endothelial damage in the arteries of the periphery
183
This is the goal exercise duration for patients with PAD
50 minutes
184
These are improvements observed in patients with PAD from a walking program
Improved biomechanics, Increased angiogenesis, Reduction in blood viscosity, Attenuation of atherosclerosis, Increased pain tolerance, Improved endothelial function, Activation of fibrinolysis
185
Comorbidities that accompany PAD include these
Diabetes, Cardiac disease, Cerebrovascular disease, Heart failure, Pulmonary disease
186
This is the prevalence of pacemakers in individuals over age 65
85%
187
Exercise prescription in patients should be based on this variable
RPE
188
This is the expected increase in cardiac output from rest to exercise
15%-20%
189
Single-lead pacemakers can be used in these situations
SA node sends signals too slowly with conduction pathway still intact, Slow ventricular rate in the setting of permanent atrial fibrillation
190
The ideal energy expenditure for an individual with a pacemaker
1,000 kcal/week
