Phys of Ex Lab Final

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

- 2.0 mm of ST depresion 0.08 seconds after the J point in a - patient who has history of stable angina patient's SaO2% drops to 79% - patient's blood pressure just increased to 260/110 at the end of the second stage of the Bruce Protocol - patient is at a high heart rate and their QRS complexes are now very wide; it is hard to tell if they have a bundle branch block or something else

Based on pre-2017 guidelines a systolic blood pressure of __________ mmHg would be classified as pre-hypertensive (more than one acceptable answer)

130

Current guidelines in the United States use an SBP cutoff value of greater than or equal to ____________ to diagnose hypertension. (no units required)

130

Women over the age of ____ are at increased risk of developing coronary artery disease. (no units required)

55

HDL concentration greater than ____is associated with decreased CAD risk (no units required)

60

mother (or other female first degree relative; e.g. sister) having a myocardial infarction, revascularization surgery, or sudden death prior to the age of ____ are at increased risk of developing coronary artery disease. (no units required)

65

on EKG 4 is there any evidence of myocardial ischemia? if so, in what leads do you see significant evidence of ischemia? select all that apply

There is no evidence of ischemia on this EKG

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

a. Patient who regularly has spontaneous angina at rest e. 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

MAP would likely be highest for which of the following exercises? a. isometric knee extension at 90% of maximum b. cycling at 200 Watts (90% of max) c. dynamic knee extensions at 90% of maximum d. two of these would be tied e. arm crank at 60 Watts (90% of max)

a. isometric knee extension at 90% of maximum

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

arrhythmias

A 45-yr-old former collegiate swimmer turned lifelong triathlete requests assistance with run training. His only significant medical history is a series of overuse injuries to his shoulders and Achilles tendon. In recent weeks, he notes his workouts are unusually difficult and reports feeling constriction in his chest with exertion — something he attributes to deficiencies in core strength. Upon further questioning, he explains that the chest constriction is improved with rest and that he often feels dizzy during recovery. Select all that apply

- has signs or symptoms suggestive of disease - does not have known cardiovascular, metabolic, or renal disease - currently participates in regular exercise - needs to be medically cleared before performing desired activity - desired exercise intensity = vigorous

Based on current (after 2017) guidelines a systolic blood pressure of __________ mmHg would be classified as elevated (more than one acceptable answer)

125

What is a typical resting venous O2 content of an adult female human with average hemoglobin concentrations, arterial O2 saturation, and average resting a-vO2 difference (e.g. [Hb] of 13.5 g/dL, SaO2 of 98%)? No units required

13.4 vols% Resting arterial = 20 vols%

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

140

What is a typical maximal exercise a-vO2difference in an untrained subject?

15 vols% Trained = 18 vols%

What is a typical maximal exercise SBP for an adult female subject?

155

What is a typical maximal aerobic exercise SBP for an adult male subject?

182

What is a typical resting arterial O2 content of an adult male human with average hemoglobin concentrations and arterial O2 saturation ([Hb] of 15 g/dL and an SaO2 of 98%)? No units required

20

When you are using the auscultatory method for determining blood pressure, how high do you pump up the pressure in the cuff?

20-30 mmHg above the expected systolic blood pressure

2 hour plasma glucose concentration during a glucose tolerance test (GTT) greater than ____is associated with increased CAD risk (no units required)

200

total cholesterol concentration greater than ____is associated with increased CAD risk (no units required)

200

Which of the following is an appropriate value for maximal exercise TPR in (dyn/s.cm5) a young, untrained, healthy subject with a normal blood pressure response to exercise?

300

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

35

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

5

What is a typical resting venous return (in L/min) in an untrained subject?

5

hemoglobin A1c greater than ____is associated with increased CAD risk (no units required)

6.5

A diastolic blood pressure of __________ mmHg would be suggestive of hypotension

60

You are taking a subject's blood pressure by the auscultatory method on a hot day outside and they just finished exercising in the heat. When you have worked with this patient before, their blood pressure is usually around 116/82. You pump the cuff up until the pressure is 142 mmHg. You then release the pressure from the cuff, while listening for changes in sound as the pressure in the cuff gradually becomes lower. The needle on the sphygmomanometer is moving down and is at 117 mmHg when you hear a relatively loud sound, then it becomes a little softer at around 104, then a little louder again around 91, becomes muffled around 61, and then disappears at 0 mmHg. Based on this information what is their diastolic blood pressure?

61

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

68

Based on current (after 2017) guidelines hypertension could be diagnosed based on a diastolic blood pressure __________ mmHg

80

If your patient' s blood pressure was 132/78, which of the following is/are true

Based on new guidelines they have hypertension

Which of the following findings in a patient would be associated with dyslipidemia and an increased risk of developing a cardiovascular disease?

HDL = 34 mg/dL

Which of the following findings in a patient would be associated with reduced risk of developing a cardiovascular disease?

HDL = 74 mg/dL

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

RR interval 0.50 seconds every beat PR interval 0.12 seconds every third P wave QRS interval 0.10 seconds every beats Three P waves before each QRS complex QRS after every third P wave *no association b/w P waves and QRS*

Which of the following would be most suggestive of atrial flutter?

RR interval 0.50 seconds every beat PR interval 0.12 seconds every third P wave QRS interval 0.10 seconds every beats Three P waves before each QRS complexe QRS after every third P wave *RR constant & 3-4 P waves b/f QRS*

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 *because QRS is greater than 0.12*

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

a. patient has severe pain in their calves due to peripheral vascular disease and they are also wheezing and experiencing dyspnea b. patient's blood pressure just increased to 260/110 at the end of the second stage of the Bruce Protocol c. patient has had several beats that had no P wave and long, unusual QRS complexes; these complexes do not all look the same. These unusual beats are increasing in frequency and, at one point you observed three in a row. h. 2.0 mm of ST depression 0.08 seconds after the J point in a patient who has history of stable angina

Which of the following is NOT a sign/symptom suggestive of cardiac, pulmonary, or metabolic disease? a. sudden shortness of breath when lying down b. unexplained severe pain in the calves during mild activity c. unexplained loss of consciousness d. mitral regurgitation (lub-swish-dup) e. chest pain on exertion

all of these ARE signs/symptoms suggestive of cardiac, pulmonary, or metabolic disease

____________________________________ is a symptom suggestive of coronary artery disease. It is when the subject feels chest pain during exertion.

angina pectoris

DBP would likely be lowest for which of the following exercises? a. two of these would be tied b. cycling at 200 Watts (90% of max) c. isometric knee extension at 90% of maximum d. dynamic knee extensions at 90% of maximum e. arm crank at 60 Watts (90% of max)

b. cycling at 200 Watts (90% of max)

When we use a stethoscope and blood pressure cuff to determine blood pressure, we place the diaphragm of the stethoscope over which blood vessel?

brachial artery

Which of the following is/are NOT a sign/symptom suggestive of cardiovascular, pulmonary, or metabolic disease?

breathing very deep after sprinting up three flights of stairs

MAP would likely be lowest for which of the following exercises? a. isometric knee extension at 90% of maximum b. dynamic knee extensions at 90% of maximum c. cycling at 200 Watts (90% of max) d. two of these would be tied e. arm crank at 60 Watts (90% of max)

c. cycling at 200 Watts (90% of max)

A 50-yr-old nonsmoking male was recently invited by colleagues to participate in a 10-km trail run. He reports currently walking 40 min on Monday, Wednesday, and Friday — something he has done "for years." His goal is to run the entire race without stopping, and he is seeking training services. He reports having what he describes as a "mild heart attack" at 45 yr old, completed cardiac rehabilitation, and has had no problems since. He takes a statin (to lower his cholesterol), an angiotensin-converting enzyme (ACE) inhibitor (to lower his blood pressure), and aspirin (to reduce clot risk) daily. During the last visit with his cardiologist, which took place 2 yr ago, the cardiologist noted no changes in his medical condition. Select all that apply

c. has known cardiovascular, metabolic, or renal disease d. currently participates in regular exercise h. Does not have signs or symptoms suggestive of disease i. Needs to be medically cleared before performing desired activity j. desired exercise intensity = vigorous

Physical inactivity is a CAD risk factor. Which of the following best describes how we define CAD risk-related physical inactivity?

doing less than 30 min of moderate intensity exercise on at least three days per week for at least three months

Pulse pressure would likely be highest for which of the following exercises? a. two of these would be tied b. dynamic knee extensions at 90% of maximum c. isometric knee extension at 90% of maximum d. arm crank at 60 Watts (90% of max) e. cycling at 200 Watts (90% of max)

e. cycling at 200 Watts (90% of max)

Which of the following is/are NOT a possible sign that a patient may have heart failure?

intermittent claudication

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

Which of the following is/are NOT true about a-vO2 difference and its response to exercise?

it usually increases during exercise mostly due to increases in arterial oxygen content

When we use a stethoscope and blood pressure cuff to determine blood pressure, we place the diaphragm of the stethoscope where?

medial antecubital fossa

What does the 4th Korotkoff sound sound like?

muffled

____________________________________ is a symptom suggestive of cardiovascular disease where one has an unpleasant feeling that their heart is racing. This can be due to a variety of arrhythmias (tachycardia, bradycardia, or PVCs).

palpations

Pain in the lower extremities due to low blood flow during exercise would most likely be associated with which of the following:

peripheral vascular disease

Which of the following would be most likely to cause the mean electrical axis to shift to the right?

right ventricular hypertrophy

When we talk about a patient's blood pressure, if we do not say otherwise we are referring to pressure in what part of the circulatory system?

systemic arterial pressure at the level of the heart

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

three of these answers

During ACUTE exercise, which of the following would NOT be associated with an increase in EDV?

two of these answers - an increase in bolld volume would increase EDV with chronic exercise (training), ut blood volume decreases during an acute bout of exercise, so this would NOT contribute to increaaes in EDV during exercise. - an in increase in preload, not afterload, is associated with an increased EDV.

When we use the auscultatory method for determining blood pressure:

we are listening for Korotkoff sounds

21 year old female who smokes socially on weekends (~10-20 cigarettes). Drinks alcohol one or two nights a week, usually on weekends. Height = 63 in (160 cm), weight = 124 lb (56.4 kg),. BMI = 22.0 kg/m2 RHR = 76 beats· min-1, resting BP= 118/72 mm Hg. Total cholesterol = 178 mg/dL (4.61 mmol · L-1), 1DL-C = 98 mg ·· dL-1 (2.54 mmol · L-1), HDL-C = 62 mg ·· dL-1 (1.60 mmol · L-1), FBG = 96 mg· d.1 -l (5.33 mmol ·1 -l)_ Currently taking oral contraceptives. Attends group exercise class two to three times a week. Both parents living and in good healih. How many risk factors does this subject have?

zero