EXPH 4145-100 Lab Thirteen

Which of the following conditions would be least likely to cause the mean electrical axis to shift to the left? a. Pregnancy b. Lying down c. Left ventricular hypertrophy d. Inferior wall or right ventricular infarction e. All of the above could potentially cause mean electrical axis to shift to the left

e. All of the above could potentially cause mean electrical axis to shift to the left

2hr plasma glucose concentration during a glucose tolerance test (GTT) greater than ________ is associated with increased CAD risk.

200

Total cholesterol concentration greater than ________ is associated with increased CAD risk.

200

Bruce protocol for female

3 (Time) + 4 = VO2 max (mL/(kg*min))

Bruce protocol for male

3 (Time) + 8 = VO2 max (mL/(kg*min))

A BMI over ________ is associated with increased CAD risk.

30

On an EKG, the QRS represents the ________.

Depolarization of the ventricles

________ is a common symptom in subjects with PVD and it is associated with pain in their muscles (often in the calves) when they exercise.

Intermittent claudication

________ is a symptom suggested of cardiovascular or pulmonary disease associated with loss of consciousness due to reduced blood flow to the brain.

Syncope

Which of the following would be most likely to cause the mean electrical axis to shift to the right? a. Shifting from standing to lying down position b. Right ventricular hypertrophy c. Left ventricular hypertrophy d. Pregnancy e. Right ventricular myocardial infarction

b. Right ventricular hypertrophy

Orthopnea could suggest that the patient has: a. PVD b. Anemia c. Heart failure d. Syncope e. Three of these answers f. Mitral regurgitation

c. Heart failure

________ 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).

c. Palpitations

Which of the following is/are relative contraindications to maximal exercise testing? Select all that apply. a. Patient who experiences extreme pain in calves when walking (even very slow speeds) due to PVD b. Patient who recently started experiencing angina when they exercise c. Patient who had a stroke 10 days ago d. Patient with a third degree AV block and low BP e. Patient who comes to your office with a resting BP of 220/92 f. Patient with severe anemia g. Patient had myocardial infarction 36hrs ago

c. Patient who had a stroke 10 days ago e. Patient who comes to your office with a resting BP of 220/92 f. Patient with severe anemia

Fasting plasma glucose concentration greater than ________ is associated with increased CAD risk.

126

LDL concentration greater than ________ is associated with increased CAD risk.

130

HDL concentration less than ________ is associated with increased CAD risk.

40

Men over the age of ________ are at increased risk of developing CAD.

45

Father (or other male first degree relative; e.g., brother) having a myocardial infarction, revascularization surgery, or sudden death prior to the age of ________ are at increased risk of developing CAD.

55

Women over the age of ________ are at increased risk of developing CAD.

55

If your subject's PR interval is longer than normal, select the part of the conduction system that is most likely to be causing this problem?

AV node

On an EKG, the P wave represents the ________.

Depolarization of the atria

On an EKG, the T wave represents the ________.

Depolarization of the ventricles

Which of the following is NOT an absolute contraindication for exercise testing (you should NOT start an exercise test)? a. All of these ARE contraindications to stress testing b. Patient with heart failure who presents with severe bilateral ankle edema and shortness of breath at rest and when lying down c. Inflammation of the pericardium d. Chest pain that occurs at random times e. Third degree AV block accompanied by low BP

a. All of these ARE contraindications to stress testing

Which of the following is/are relative reasons for terminating a maximal GXT? a. 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 b. Angina increasing from three to four on a four point angina scale c. Patient who experiences SOB and who's SBP drops by 16mmHg after increasing from stage 1 to stage 2 of the Bruce protocol d. You are unable to hear the patient's Korotkoff sounds and cannot get their BP e. Patient's BP just increased to 260/110 at the end of the second stage of the Bruce protocol f. 2.0mm of ST depression 0.08s after the J point in a patient who has history of stable angina g. Patient has pain in their calves due to PVD and they are also wheezing and experiencing dyspnea h. Patient feels dizzy and their EKF has sawtooth like appearance with no P waves and HR of 150bpm

a. 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 e. Patient's BP just increased to 260/110 at the end of the second stage of the Bruce protocol f. 2.0mm of ST depression 0.08s after the J point in a patient who has history of stable angina g. Patient has pain in their calves due to PVD and they are also wheezing and experiencing dyspnea

Which of the following is/are absolute contraindications to maximal exercise testing? Select all that apply. a. Patient with a clot in one of their pulmonary blood vessels b. Patient with inflamed pericardium c. Patient who comes to your office with a resting BP of 220/92 d. Patient who had a stroke 10 days ago e. Patient with severe anemia f. Patient who recently started experiencing angina when they exercise g. Patient who experiences extreme pain in calves when walking (even very slow speeds) due to PVD

a. Patient with a clot in one of their pulmonary blood vessels b. Patient with inflamed pericardium

Which of the following is/are NOT absolute contraindications to maximal exercise testing? Select all that apply. a. Patient with severe anemia b. Patient who has evidence of recent aortic dissection c. Patient who has recently developed myocarditis secondary to COVID d. Patient who can feel their heart racing sometimes when they are at rest e. Patient who regularly experiences chest pain at random times when they are at rest f. Patient who feels lightheaded every time they stand up g. Patient who feels short of breath when lying down at night and has bilateral ankle edema

a. Patient with severe anemia d. Patient who can feel their heart racing sometimes when they are at rest f. Patient who feels lightheaded every time they stand up

Which of the following is/are relative reasons for terminating a maximal GXT? a. Patient's BP just increased to 260/110 at the end of the second stage of the Bruce protocol b. 2.0mm of ST depression 0.08s after the J point in a patient who has history of stable angina c. Patient's SaO2% drops to 79% d. Patient's EKG now has 1.2-1.6mm of ST elevation in three of the precordial leads e. Patient is starting to loose coordination. Their speech is slurred and they seem lightheaded and confused f. Your patient asks to stop but you are sure they can last a little longer g. Patient is at a high HR and their QRS complexes are now very wide; it is hard to tell if they have a bundle branch block or something else h. Patient's P waves and QRS complexes no longer seem to correspond to one another and are following different rates (P waves about 115bpm and QRS complexes about 50bpm), their BP is dropping, and they report feeling lightheaded

a. Patient's BP just increased to 260/110 at the end of the second stage of the Bruce protocol b. 2.0mm of ST depression 0.08s after the J point in a patient who has history of stable angina c. Patient's SaO2% drops to 79% g. Patient is at a high HR and their QRS complexes are now very wide; it is hard to tell if they have a bundle branch block or something else

A constricting sensation in the chest during exercise would most likely be associated with which of the following: a. Arrhythmias b. CAD c. Aortic stenosis d. Three of these answers e. PVD f. Heart failure

b. CAD

Physical inactivity is a CAD risk factor. Which of the following best describes how we define CAD risk-related physical inactivity? a. Doing less than 30min of moderate intensity exercise on at least five days per week for at least three months b. Doing less than 30min of moderate intensity exercise on at least three days per week for at least three months c. Doing less than 40min of moderate intensity exercise on at least three days per week for at least four months d. Doing less than 60min of moderate intensity exercise on at least three days per week for at least three months e. Doing less than 30min of moderate intensity exercise on at least two days per week for at least two months

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

Which of the following is/are NOT a possible sign that a patient may have heart failure? a. Bilateral ankle edema b. Intermittent claudication c. SOB when lying down d. Orthopnea e. Paroxysmal nocturnal dyspnea f. Three of these answers

b. Intermittent claudication

Which of the following is/are absolute reasons for terminating a maximal GXT? a. Patient's BP just increased to 260/110 at the end of the second stage of the Bruce protocol b. Patient feels dizzy and their EKF has sawtooth like appearance with no P waves and HR of 150bpm c. 2.0mm of ST depression 0.08s after the J point in a patient who has history of stable angina d. You are unable to hear the patient's Korotkoff sounds and cannot get their BP e. 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 f. Patient has pain in their calves due to PVD and they are also wheezing and experiencing dyspnea g. Angina increasing from three to four on a four point angina scale h. Patient who experiences SOB and who's SBP drops by 16mmHg after increasing from stage 1 to stage 2 of the Bruce protocol

b. Patient feels dizzy and their EKF has sawtooth like appearance with no P waves and HR of 150bpm d. You are unable to hear the patient's Korotkoff sounds and cannot get their BP g. Angina increasing from three to four on a four point angina scale h. Patient who experiences SOB and who's SBP drops by 16mmHg after increasing from stage 1 to stage 2 of the Bruce protocol

Which of the following is/are absolute contraindications to maximal exercise testing? Select all that apply. a. Patient who recently started experiencing angina when they exercise b. Patient had myocardial infarction 36hrs ago c. Patient with a third degree AV block and low BP d. Patient who experiences extreme pain in calves when walking (even very slow speeds) due to PVD e. Patient who comes to your office with a resting BP of 220/92 f. Patient who had a stroke 10 days ago g. Patient with severe anemia

b. Patient had myocardial infarction 36hrs ago c. Patient with a third degree AV block and low BP

Which of the following is/are NOT a sign/symptom suggestive of cardiovascular, pulmonary, or metabolic disease? a. Feeling one's heart racing at rest b. Intermittent claudication c. Breathing very deep after sprinting up three flights of stairs d. Orthopnea e. Aortic stenosis f. Three of these answers

c. Breathing very deep after sprinting up three flights of stairs

Which of the following findings in a patient would be associated with an increased risk of developing a cardiovascular disease? a. 2hr plasma glucose during glucose tolerance test = 189mg/dL b. LDL = 128 mg/dL c. BMI = 25.7 kg/m2 d. Fasting plasma glucose = 131 mg/dL e. HDL = 63 mg/dL

d. Fasting plasma glucose = 131 mg/dL

Which of the following findings in a patient would be associated with reduced risk of developing a cardiovascular disease? a. LDL = 144 mg/dL b. Exercising three days per week for fifteen to twenty minutes over the past half year c. Quit smoking almost 100 days ago d. HDL = 74 mg/dL e. Father having a myocardial infarction at the age of 54

d. HDL = 74 mg/dL

Which of the following findings would be associated with reduced risk of developing a cardiovascular disease? a. Exercising three days per week for fifteen to twenty minutes over the past half year b. Father having a myocardial infarction at the age of 54 c. Quit smoking almost 100 days ago d. HDL = 74 mg/dL e. LDL = 144 mg/dL

d. HDL = 74 mg/dL

Which of the following is NOT a sign/symptom of cardiac, pulmonary, or metabolic disease? a. Chest pain on exertion b. Unexplained severe pain in the calves during mild activity c. Unexplained loss of consciousness d. Sudden SOB when lying down e. All of these ARE signs/symptoms suggestive of cardiac, pulmonary, or metabolic disease f. Mitral regurgitation (Lub-swish-dup)

e. All of these ARE signs/symptoms suggestive of cardiac, pulmonary, or metabolic disease

Palpitations would most likely be associated with which of the following: a. PVD b. Three of these answers c. CAD d. Heart failure e. Arrhythmias f. COPD

e. Arrhythmias

Which of the following findings in a patient would be associated with dyslipidemia and an increased risk of developing a cardiovascular disease? a. LDL = 99 mg/dL b. LDL = 127 mg/dL c. HDL = 64 mg/dL d. Total cholesterol = 181 mg/dL e. HDL = 34 mg/dL

e. HDL = 34 mg/dL

Sudden SOB at night could suggest that the patient has: a. Mitral regurgitation b. Three of these answers c. Anemia d. Syncope e. PVD f. Heart failure

f. Heart failure

Which of the following is/are absolute contraindications to maximal exercise testing? Select all that apply. a. Patient who recently started experiencing angina when they exercise b. Patient with severe anemia c. Patient who had a stroke 10 days ago d. Patient who comes to your office with a resting BP of 220/92 e. Patient who experiences extreme pain in calves when walking (even very slow speeds) due to PVD f. Patient who regularly has spontaneous angina at rest g. Patient who feels lightheaded/dizzy and SOB with mild activity, has chest pain, and when you listened to their heart sounds, you hear lab-whistle-dup

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