ExRx for those with Cardiovascular and Pulmonary Diseases Exam Questions With Correct Answers
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ExRx
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ExRx
ExRx for those with Cardiovascular and
Pulmonary Diseases Exam Questions With
Correct Answers
Injury to the endothelium (many causes) → .......
-2 main causes? - answerendothelial dysfunction...
-high Blood Pressure (results in higher turbulent flow - excessive pounding on endothelial cells)...
ExRx for those with Cardiovascular and
Pulmonary Diseases Exam Questions With
Correct Answers
Injury to the endothelium (many causes) → .......
-2 main causes? - answer✔✔endothelial dysfunction...
-high Blood Pressure (results in higher turbulent flow - excessive pounding on endothelial cells)
-glycosolated haemoglobin = HbA1c (% of Hb that has glycogen attached) (spikes of the glucose
rake the endothelial layer causing it to become damaged)
Endothelial dysfunction causes .....
-5 step process? - answer✔✔-disturbed blood flow which causes
-endothelial cell activation (since the cells have been damaged)
-recruitment of inflammatory cells to vessel wall (WBCs arrive here)
-cell signaling facilitates LDL retention in tunica intima (LDL is used to help the endothelial
layer heal but if too much LDL is retained, it can lead to blood clotting).
-oxidative modification by ROS and inflammatory enzymes
What is the problem with hypertension/diabetes in terms of the effect on endothelial
dysfunction? - answer✔✔Can cause accumulation of lipids as endothelial layer is constantly
being damaged
Accumulation of lipids
-5 step process? - answer✔✔↳ monocytes become macrophages which try to digest mLDL.
When the macrophages cannot digest any more mLDL, they become foam cells
↳endoplasmic reticulum stress triggers foam cell apoptosis (organised programmed cell death)
↳Efferocytic program (burying of cells) cannot keep up with source of apoptotic formation
↳Apoptotic cells that aren't being destroyed properly undergo secondary necrosis forming
necotic core = atherosclerotic plaque (purple blob on my pic)
2 effects of atherosclerotic plaques developing - answer✔✔-can cause clotting at site of plaque
in response to internal bleeding
-plaque can break off and travel in blood to cause clotting elsewhere
Where in the blood vessels are clots most likely? - answer✔✔Where there is branching?
Cardiac Rehabilitation (CR)
• Ex and lifestyle interventions
• Currently, ........... insurance reimburses for CR for MI/acute coronary syndrome, CABG,
PTCA, stable angina, valve repair/replacement, CHF, and heart transplant.
• ..... and ..... (2 phases of CR) - answer✔✔-Medicare/private
-Inpatient and Outpatient
Inpatient Cardiac Rehabilitation: Guidelines
• Current clinical status ..........
• Mobilization
• Identification and provision of information regarding modifiable ..... factors and .....
• Discharge planning with a home ..... and .....
￮ Note: diagnosis, current medical status, comorbidities, CVD risk factors, personalized goals, as
well as readiness for PA and learning.
• Supervised daily .......
￮ Intermittent ....... or ........ 12-24hrs after MI
⁃ purpose of this?
⁃ Should include documentation of .....
￮ known
Inpatient Cardiac Rehabilitation: Guidelines
• Before discharge:
￮ Need to know ........ activities (Heavy lifting, climbing stairs, yard work, etc)
￮ Need to have a ..... plan of exercise
￮ Individuals should know how to identify ...... signs and symptoms
￮ Individuals should be strongly encouraged to participate in .......... - answer✔✔-permissible
(what they can do and what they want to do and help them achieve these things)
-safe
-abnormal
-outpatient CR program
American Association of Cardiovascular and
Pulmonary Rehabilitation (AACVPR) Parameters
for Inpatient Cardiac Rehabilitation Daily
Ambulation
- No new or recurrent ....... in previous 8 h
- Stable or falling ................. (indicative of damage if CK high) and troponin values
- No indication of decompensated (worsening of) .............. (e.g., resting dyspnea and bibasilar
rales)
- Normal cardiac rhythm and stable electrocardiogram for previous ..... hours - answer✔✔- chest
pain
- creatine kinase
- heart failure
- 8 hours
Indications and Contraindications for Inpatient and Outpatient Cardiac Rehabilitation
*Indications = conditions with which you SHOULD got to CR outpatient*
• Medically ...... postmyocardial infarction
• ...... angina
• Coronary artery ......... graft (surgery)
• Percutaneous transluminal coronary angioplasty - what is this?
• Stable .......... caused by either systolic or diastolic dysfunction
(cardiomyopathy)
• ...... transplantation
• ......... heart disease/surgery
• .......... arterial disease
• At risk for ............. artery disease with diagnoses of diabetes mellitus, dyslipidemia,
hypertension, or obesity
• Other individuals who may benefit from structured exercise and/or
individual education based on ......... referral and consensus of the .......... team - answer✔✔•
stable
• Stable
• bypass
• a minimally invasive procedure that opens blocked coronary arteries to improve blood flow to
the heart muscle
• heart failure
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