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Quiz

Exercise testing

Usuário eliminado 16 perguntas

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Perguntas do quiz (16)

  1. 1Indications for Exercise Testing
    Chief complaint of [blank_start]dyspnea[blank_end] on exertion
    To determine ventilator [blank_start]limitations[blank_end] to work
    To determine [blank_start]cardiac[blank_end] limitations to work
    To determine [blank_start]maximum[blank_end] workloads for developing or adjusting exercise plan or [blank_start]activities[blank_end]
    [blank_start]Disability[blank_end] Purposes
    1. Adyspnea
    2. Blimitations
    3. Ccardiac
    4. Dmaximum
    5. Eactivities
    6. FDisability
  2. 2Contraindications
    PaO2 < [blank_start]45[blank_end] on RA
    PaCO2 > [blank_start]70[blank_end]
    FEV1 <[blank_start]30[blank_end]%
    Recent [blank_start]MI[blank_end]
    Unstable [blank_start]angina[blank_end]
    2nd or 3rd degree [blank_start]heart[blank_end] block
    [blank_start]Rapid[blank_end] ventricular or atrial [blank_start]arrhythmia[blank_end]
    Orthopedic problems that impairs activity
    Severe Aortic [blank_start]Stenosis[blank_end]
    CHF
    [blank_start]Uncontrolled[blank_end] HTN
    Neurological Disorders
    Dissecting [blank_start]Aneurysm[blank_end]
    Severe Pulmonary [blank_start]Hypertension[blank_end]
    1. A45
    2. B70
    3. C30
    4. DMI
    5. Eangina
    6. Fheart
    7. Garrhythmia
    8. HRapid
    9. IStenosis
    10. JUncontrolled
    11. KAneurysm
    12. LHypertension
  3. 3Normal response to stress Test
    Heart rate will [blank_start]increase[blank_end] linearly with increased workload
    Increased heart rate without ECG changes indicates [blank_start]deconditioning[blank_end]
    ST depressions >[blank_start]1[blank_end] mm for [blank_start].8[blank_end] seconds indicates ischemia
    PVCs with exercise are associated with ischemia if >[blank_start]10[blank_end] per [blank_start]minute[blank_end]
    If systolic blood pressure [blank_start]doesn’t[blank_end] rise, cardiac output is not [blank_start]increasing[blank_end]
    Respiratory rate, tidal volume and minute volume will [blank_start]increase[blank_end] during testing
    VCO2 and VO2 will rise together to keep RER near [blank_start].8[blank_end]
    pH will initially [blank_start]increase[blank_end] but will [blank_start]decrease[blank_end] at anaerobic threshold
    VD/VT will [blank_start]decrease[blank_end] because of increased [blank_start]perfusion[blank_end]
    Pulmonary Artery pressure will remain [blank_start]constant[blank_end] in normal patients.
    1. Aincrease
    2. Bdeconditioning
    3. C1
    4. D.8
    5. E10
    6. Fminute
    7. Gdoesn’t
    8. Hincreasing
    9. I.8
    10. Jincrease
    11. Kincrease
    12. Ldecrease
    13. Mdecrease
    14. Nperfusion
    15. Oconstant
  4. 4Limitations to Exercise testing

    Ventilatory Limitations @ low/mod workload:
    Maximum minute ventilation = FEV1 x [blank_start]35[blank_end]
    Ve/VO2 >[blank_start]30[blank_end] L/LO2
    Respiratory [blank_start]Acidosis[blank_end]
    Increased [blank_start]RER[blank_end]
    Decrease in O2 Sat
    [blank_start]Increased[blank_end] PAP
    Normal [blank_start]ECG[blank_end] and HR
    1. A35
    2. B30
    3. CAcidosis
    4. DRER
    5. EIncreased
    6. FECG
  5. 5Limitations to Exercise testing
    Cardiac Limitation @ low/mod workload:
    Significant [blank_start]ECG[blank_end] Changes
    Diastolic Pressure [blank_start]falls[blank_end]
    Systolic Pressure does not [blank_start]rise[blank_end]
    O2 pulse [blank_start]decreases[blank_end]
    Vt, RR, Ve is less than [blank_start]70[blank_end]% of MMV
    1. AECG
    2. Bfalls
    3. Crise
    4. Ddecreases
    5. E70
  6. 6Limitations to Exercise testing

    Poor Conditioning
    Present with [blank_start]increased[blank_end] HR and low/mod workloads with normal ECG and Vt, RR, Ve <[blank_start]70[blank_end]% MMV


    Poor Effort
    Present when ECG, SaO2 and HR are [blank_start]normal[blank_end] and anaerobic threshold is [blank_start]not[blank_end] achieved and Ve <[blank_start]70[blank_end]% MMV

    1. Aincreased
    2. B70
    3. Cnormal
    4. Dnot
    5. E70
  7. 7Workload: Amount of [blank_start]energy[blank_end] being generated by patient during exercise. Measure in kilopond meters (kpm)

    Power: Amount of [blank_start]work[blank_end] per minute. Measure in [blank_start]watts[blank_end]. 1 watt = 6.12 kpm/min


    Metabolic Equivalents (METS) – Unit that measures O2 [blank_start]consumption[blank_end] per kg of body weight. 1 met = 3.5 mL/O2/kg (normal at rest) VO2 is measured during test and [blank_start]divided[blank_end] by pt weight in kg, then divided by 3.5 to get METS.

    Anaerobic Threshold – Level of exercise or VO2 at which [blank_start]anaerobic[blank_end] metabolism will begin to supplement aerobic metabolism. Lactic acid increases, pH decreases, HR is stable, Ventilatory equivalent for O2 and CO2 changes.

    O2 Max – [blank_start]Work[blank_end] continues to increase but [blank_start]VO2[blank_end] does not.
    1. Aenergy
    2. Bwork
    3. Cwatts
    4. Dconsumption
    5. Edivided
    6. Fanaerobic
    7. GVO2
    8. HWork
  8. 8Steady State Vs Multistage Testing
    Steady State – Pt is exercised at [blank_start]submaximal[blank_end] level for 5-8 minutes at 50-[blank_start]75[blank_end]% of max load.
    (220-age = max HR)
    Once that target is reached, timing begins, measurements are made during final [blank_start]1[blank_end]-[blank_start]2[blank_end] minutes.

    Multistage – Workloads are [blank_start]increased[blank_end] and measurement made at the end of each [blank_start]stage[blank_end] (increase at 15 watts/min)
    <50 watts – [blank_start]low[blank_end]
    50-100 watts – [blank_start]medium[blank_end]
    >100 watts – [blank_start]high[blank_end]
    200 watts [blank_start]too[blank_end] high for stress testing.
    Can be changed every [blank_start]1[blank_end]-[blank_start]6[blank_end] minutes by increasing [blank_start]speed[blank_end], grade, or [blank_start]resistance[blank_end].

    To verify treadmill is at a 10% incline – take a [blank_start]30[blank_end]” carpenter’s level and place on treadmill. The High end should be [blank_start]3[blank_end]” above the low end.
    3” Rise / 30” run = 10
    Set workload at [blank_start]10[blank_end] – [blank_start]15[blank_end] watts/min to reach 100 -150 watts in 10 min.

    1. Asubmaximal
    2. B75
    3. C1
    4. D2
    5. Eincreased
    6. Fstage
    7. Glow
    8. Hmedium
    9. Ihigh
    10. Jtoo
    11. K1
    12. L6
    13. Mspeed
    14. Nresistance
    15. O30
    16. P3
    17. Q10
    18. R15
  9. 9Stress Test without Gas Analysis (Multistage)
    Prepare Patient: 12 lead [blank_start]ECG[blank_end] – resting. Hx and physical exam. Informed consent
    Equipment: Treadmill, cycle or step
    Pt is stressed until [blank_start]Max[blank_end] HR achieved or pt develops [blank_start]symptoms[blank_end] that indicate to stop.
    Workload should gradually be [blank_start]decreased[blank_end] and pt monitored until vitals return to [blank_start]normal[blank_end]


    Stress testing with Gas Analysis (Steady State)
    Pt is prepared and stressed at [blank_start]sub[blank_end] maximal level for 5-8 minutes
    Expired gas is collected near [blank_start]end[blank_end] of each stage and during final [blank_start]1[blank_end] – [blank_start]2[blank_end] minutes of testing
    Collected using: Volume Spirometer, pneumotach, or breath by breath analysis.
    Measurement Includes: Exhaled [blank_start]Volume[blank_end], Temperature, Time of collection, respiratory [blank_start]rate[blank_end], [blank_start]Fe[blank_end]O2, [blank_start]Fe[blank_end]CO2
    Allows for calculation of: [blank_start]Minute[blank_end] ventilation, Vt, [blank_start]VO2[blank_end], CO2 Production, Respiratory Exchange [blank_start]Ratio[blank_end], VE/VO2, VE/VCO2
    1. AECG
    2. BMax
    3. Csymptoms
    4. Ddecreased
    5. Enormal
    6. Fsub
    7. G1
    8. H2
    9. Iend
    10. JVolume
    11. Krate
    12. LFe
    13. MFe
    14. NMinute
    15. OVO2
    16. PRatio
  10. 10Stress Testing with Gas Analysis and ABG
    ABG is performed [blank_start]same[blank_end] time as gas analysis
    Inability to stabilize arm for [blank_start]puncture[blank_end] is a problem. Arterial line would be [blank_start]preferred[blank_end]
    Indicated for patients with primary [blank_start]pulmonary[blank_end] problems
    Additional measurements: Physiologic [blank_start]Deadspace[blank_end], [blank_start]VA[blank_end], VD/Vt, [blank_start]Cardiac[blank_end] Output
    1. Asame
    2. Bpuncture
    3. Cpreferred
    4. Dpulmonary
    5. EVA
    6. FCardiac
    7. GDeadspace

Informações

Descrição
O usuário eliminou as informações de disciplina Quiz sobre Exercise testing, criado por Usuário eliminado em 19-08-2016.
Autor
Usuário eliminado
Idioma
English
Visualizações
28

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