Phys of Ex Exam 3

Palpitations would most likely be associated with which of the following:

arrhythmias

a constricting sensation in the chest during exercise would most likely be associated with which of the following:

coronary artery disease

If graph v depicts the changes in end systolic volume (y axis) between rest and maximal intensity cycling exercise in a healthy untrained subject, what factors could be contributing to this change?

two of them

If graph i depicts the changes in a-vO2 difference (y axis) between rest and maximal intensity cycling exercise, what would be appropriate values for a and b on the Y axis in a highly trained healthy adult male?

a = 5.2 b = 17.9

If graph i depicts the changes in a-vO2 difference (y axis) between rest and maximal intensity cycling exercise, what factors could be causing this change?

an increase in body temperature

3rd degree av block

no association between p wave and qrs

Which of the following is/are possible sign(s) that a patient may have heart failure? A. bilateral ankle edema B. intermittent claudication C. shortness of breath when lying down D. orthopnea E. palpitations

three

If graph i depicts the changes in heart rate (y axis) between rest and maximal intensity cycling exercise, what is causing this change?

three of these answers

If graph iv depicts the changes in cardiac output (y axis) during prolonged cylcling exercise (time on the x axis), what factors explain this lack of change?

two of these answers inc HR Dec SV

MAP would likely be highest for which of the following exercises?

isometric knee extension at 90% of maximum

What is a typical maximal exercise a-vO2difference in a trained subject?

16-18

Which of the following would be most suggestive of a bundle branch block?

RR interval 0.75 seconds every beat PR interval 0.16 seconds every beat QRS interval 0.14 seconds every beat P before each QRS QRS after each P wave

Which of the following would be most suggestive of a 3AV block?

RR interval 1.2 seconds and pretty consistent PR interval hypervariable QRS interval 0.10 seconds every beat P before some QRS complexes P waves have a very regular rhythm at around 75x/min

If graph i depicts the changes in DBP (y axis) between rest and maximal isometric knee extensions, what other cardiovascular response(s) to exercise contribute to this change?

an increase in TPR during thist type of activity

If graph i depicts the changes in a-vO2 difference (y axis) between rest and maximal intensity cycling exercise, what factors could be causing this change?

an increase in hemoglobin concentration during this type of activity

One of the following graphs depicts the changes in mean arterial blood pressure (Y axis) from rest to maximal intensity cycing exercise (on the X axis) in a young healthy subject. Which graph best illustrates the trend for this variable?

i

This likely depicts the SBP, DBP, and MAP response to which type of exercise?

none of these; this graph is wrong and does not reflect the blood pressure response to these exercises

What is a typical maximal exercise stroke volume in a trained subject? (use ml)

180 healthy untrained=70, 100-120 during ex

What is a typical maximal exercise cardiac output in an untrained subject? (use L)

25

What is a typical maximal exercise cardiac output in a trained subject? (use L)

35

Our body is a little like Goldilocks; it wants everything just right. Which of the following is/are true about hypertension, normotension, and hypotension?

40-50% of all US adults have hypertension a blood pressure of 80 over 40 could cause syncope severe hypotension may be a more immediate threat to a pateint's life than hypertension hypertension increases the risk of having a stroke

What is a typical maximal aerobic exercise DBP for a young, healthy, adult subject?

68 (60-76)

According to the current American College of Sports Medicine (ACSM) Guidelines for Exercise Testing and Prescription (i.g. the handout we used), diastolic blood pressure greater than ____is associated with decreased CAD risk (no units required)

90

Which of the following is/are absolute contraindications to maximal exercise testing? Select all that apply

Patient who regularly has spontaneous angina at rest Patient who feels lightheaded/dizzy and SOB with mild activity, has chest pain, and when you listened to their heart sounds you hear lub-whistle-dup

When we use a stethoscope and blood pressure cuff to determine blood pressure, what is true of the first sound we hear?

it is called the first Korotkoff sound

If graph v depicts the changes in TPR (y axis) between rest and maximal intensity cycling exercise, how would this change influence the blood pressure response to exercise?

it is why DBP decreases slightly in young healthy subjects during this type of activity

If graph ii depicts the changes in stroke volume (y axis) between rest and maximal intensity cycling exercise in a healthy untrained subject, how would this figure look different if we obtained the same data from an elite endurance athlete?

it start at a higher value and may continuously increase

If graph ii depicts the changes in stroke volume (y axis) between rest and maximal intensity cycling exercise, how would this figure look different if the subject were performing arm crank exercise?

it would still increase, but not as much

If graph v depicts the changes in TPR (y axis) between rest and maximal intensity cycling exercise, what factors could be contributing to this change?

local metabolic factors acting on arteriolar smooth muscle in the active muscles

If graph i depicts the changes in a-vO2 difference (y axis) between rest and maximal intensity cycling exercise, what factors could be causing this change?

loss plasma volume

Which of the following is/are absolute reasons for terminating a maximal GXT?

patient's EKG now has 1.2-1.6 mm of ST elevation in three of the precordial leads. Your patient asks to stop but you are sure they can last a little longer patient is starting to loose coordination. Their speach is slurred and they seem lightheaded and confused patient's SaO2% drops to 79% Patient's P waves and QRS complexes no longer seem to correspond to one another and are following different rates (P waves about 115 bpm and QRS about 50 bpm) and their blood pressure is dropping and they report feeling lightheaded

2nd deg av block

pr gets longer and longer

1st degree av block

pr longer then .2

buncle branch

qrs longer than .12

TPR

rest=1500 ex=300

Which of the following is/are absolute reasons for terminating a maximal GXT?

you are unable to hear the patient's korotkoff sounds and cannot get their blood pressure Patient feels dizzy and their EKG has sawtooth like appearance with no p waves and heart rate of 150bpm patient who is experiencing shortness of breath and who's SBP drops by 16 mmHg after increasing from stage 1 to stage 2 of the Bruce protocol. Angia increasing from 3 to 4 on a 4 point angina scale