PHTH 7111 Quiz 2 Review

What is the minimum waist circumference for men to be a component of Metabolic Syndrome?

≥102 cm

What is the minimum waist circumference for women to be a component of Metabolic Syndrome?

≥88 cm

What is the minimum triglyceride level to be a component of Metabolic Syndrome?

≥150 mg/dL

What is the maximum HDL cholesterol level for men to be a component of Metabolic Syndrome?

<40 mg/dL

What is the maximum HDL cholesterol level for women to be a component of Metabolic Syndrome?

<50 mg/dL

What is the minimum systolic blood pressure (BP) to be a component of Metabolic Syndrome?

≥130 mmHg

What is the minimum diastolic blood pressure (BP) to be a component of Metabolic Syndrome?

≥85 mmHg

What is the minimum fasting glucose level to be a component of Metabolic Syndrome?

≥100 mg/dL

How many features are required for a diagnosis of Metabolic Syndrome?

Any 3 of the 5 features above

How is Atherosclerosis characterized?

Accumulation of fatty deposits (plaque) inside the artery wall, leading to progressive narrowing of vessels, decreased blood flow, and hardening of arteries (decreased compliance)

What is a major cause of cardiovascular disease (CVD)?

Atherosclerosis

What cardiovascular conditions does Atherosclerosis cause?

Coronary artery disease (CAD)/coronary heart disease (CHD) and stroke

What are the effects of Atherosclerosis on the heart?

Coronary arteries partial occlusion: Angina Pectoris (Ischemic heart disease); Total occlusion: Myocardial Infarction (MI)

What are the effects of Atherosclerosis on the brain?

Carotid or cerebral arteries partial occlusion: Transient Ischemic Attack (TIA); Total occlusion: Cerebrovascular Accident (CVA)

What are the effects of Atherosclerosis on peripheral arteries?

Aorta: Aneurysm - Rupture and hemorrhage; Iliac arteries (Legs): Peripheral Vascular Disease - Gangrene and amputation

How can individuals with Hypertension (HTN) lower their risk of CVD?

By increasing cardiovascular fitness

What is the recommended moderate physical activity per week for patients with HTN?

At least 150 minutes

What is the recommended vigorous physical activity per week for patients with HTN?

75 minutes

How much is exercise capacity often reduced by in individuals with HTN?

15-30%

Why is exercise capacity reduced in individuals with HTN?

Due to decreased cardiac output (CO) lower stroke volume (SV) and peak heart rate (HR)

How do medications modify physiological responses to exercise in HTN patients?

Often reducing the BP response to exercise, which may result in post-exercise hypotension

Do medications affect HR response (at rest or during exercise) in HTN patients?

No, they will not affect HR response (at rest or during exercise)

What is post-exercise hypotension in HTN patients?

BP is shown to be reduced in HTN patients following mild to moderate exercise

What is Angina?

Substernal chest pain resulting from decreased blood flow to the heart

What is Angina commonly associated with?

Coronary Heart Disease (CHD)

Describe Stable Angina.

Predictable, occurs with physical activity, and is controlled with rest and medication (nitroglycerin)

Describe Unstable Angina.

Unpredictable, occurs at rest, and is a precursor to Myocardial Infarction (MI)

What is the relationship between Atrial Fibrillation and cardiac output?

Erratic quivering of the atria caused by multiple ectopic foci within the atrial musculature; The AV node determines ventricular response; Increased risk of CVA or thromboembolic events secondary to blood pooling in the atria

What is the relationship between Ventricular Dysrhythmias and cardiac output?

Poor ventricular contractility can decrease Cardiac Output (CO) and Blood Pressure (BP); May lead to asystole (cessation of electrical and mechanical activity)

What is the relationship between Ventricular Fibrillation and cardiac output?

Characterized by uncoordinated electrical activity and ventricular contraction, resulting in no CO; Most common cause of sudden cardiac death

What is Left Ventricular Hypertrophy (LVH)?

An increase in left ventricular mass that makes it harder to pump blood

What are common causes of Left Ventricular Hypertrophy (LVH)?

Hypertension (HTN); Aortic stenosis

How do HTN and aortic stenosis affect Afterload?

These conditions increase Afterload

How can Deep Vein Thrombosis (DVT) be assessed?

Using the Wells Criteria for DVT

What ia?

1 point

What are the Wells Criteria for assessing DVT?

Active cancer (1 pt), immobility > 3 days or major surgery </= 4 wks (1 pt), calf swelling > 3 cm v. other calf (1 pt), collateral (non-varicose) superficial veins present (1 pt), entire leg swollen (1 pt), localized tenderness along deep venous system (1 pt), pitting edema greater in symptomatic leg (1 pt), paralysis/paresis/recent plaster immobilization of LE (1 pt), previously documented DVT (1 pt), and alternative diagnosis (-2 pts).

What DVT risk category is 0-1 points in the Wells Criteria?

Low risk for DVT

What DVT risk category is 1-2 points in the Wells Criteria?

Moderate risk for DVT

What DVT risk category is >=3 points in the Wells Criteria?

High risk for DVT

What can Jugular Vein Distention (JVD) be a sign of?

Congestive Heart Failure (CHF); Cardiac tamponade (from Pericardial Effusion)

What is a Cerebrovascular Accident (CVA)?

An interruption of blood flow to the brain

Describe Transient Ischemic Attack (TIA).

Symptoms resolve in <24 hours, but there is an increased risk of stroke in the next 90 days

Describe Ischemic Stroke.

Restricted or reduced blood flow; Most common type (87% of all strokes), typically a result of a blood clot (e.g., from Atrial Fibrillation)

Describe Hemorrhagic Stroke.

Bleeding from a ruptured blood vessel due to causes such as aneurysm, hypertension (HTN), or arteriovenous malformation

Does the provided text offer specific prevalence rates for types of valvular disease?

No, the provided text describes types of valvular disease but does not offer specific prevalence rates for each type

What is Stenosis in valvular disease?

Narrowing of valve opening (e.g., Aortic Valve Stenosis - most common type)

What is Prolapse in valvular disease?

Valve is out of place or does not close properly (e.g., Mitral Valve Prolapse)

What is Regurgitation in valvular disease?

Blood leaks backward (e.g., Mitral Regurgitation)

How is Chest Wall Pain described?

Arises from the thoracic cage structures; Described as superficial and well-localized; Usually occurs after exertion; Associated/reproducible with trunk motions

How is Visceral Pain described?

Arises from the heart, pericardium, aorta, mediastinum; Described as a build-up of deep and diffuse pain

What is Emphysema?

An obstructive lung disorder resulting from damage or destruction of alveoli

How does Emphysema impact the lungs?

Reduces lung surface area; Prevents gas exchange; Increases lung compliance ("flabby lungs"); Reduction in elastic recoil

What does Emphysema make harder and what does it increase?

Makes it harder to initiate ventilation and increases the respiratory rate

How is Tidal Volume (VT) affected in obstructive conditions?

Increases

How is Tidal Volume (VT) affected in restrictive conditions?

Decreases

Is Tidal Volume (VT) a valid indicator of pulmonary disease?

No

How is Inspiratory Reserve Volume affected in obstructive conditions?

Decreased

How is Inspiratory Reserve Volume affected in restrictive conditions?

Decreased

How is Expiratory Reserve Volume affected in obstructive conditions?

Decreased

How is Expiratory Reserve Volume affected in restrictive conditions?

Decreased

How is Residual Volume (RV) affected in obstructive conditions?

Increased

How is Residual Volume (RV) affected in restrictive conditions?

Decreased

What is the normal range for Residual Volume (RV)?

Normally 1+ L (About 20% of TLC)

How is Inspiratory Capacity affected in obstructive conditions?

Decreased

How is Inspiratory Capacity affected in restrictive conditions?

Decreased

What is the normal range for Inspiratory Capacity?

Normally 3-4 L

How is Functional Residual Capacity affected in obstructive conditions?

Increases

How is Functional Residual Capacity affected in restrictive conditions?

Decreased

How is Vital Capacity affected in early obstructive conditions?

May be normal

How is Vital Capacity affected in advanced obstructive conditions?

Reduced

How is Vital Capacity affected in restrictive conditions?

Decreased

What is the normal range for Vital Capacity?

Normal 4-5 L (80% of TLC)

How is Total Lung Capacity affected in obstructive conditions?

Increased

How is Total Lung Capacity affected in restrictive conditions?

Decreased

What is the normal range for Total Lung Capacity?

Normally 5-6 L

How is Forced Vital Capacity (FVC) affected in both obstructive and restrictive conditions?

Decreased

How is Forced Expiratory Volume (FEV1) affected in obstructive conditions?

Decreased

How is Forced Expiratory Volume (FEV1) affected in restrictive conditions?

Decreased

What is the FEV1 range for normal obstruction?

2-4L = normal

What is the FEV1 range for mild/moderate obstruction?

1-2L = mild/mod obstruction

What is the FEV1 range for severe obstruction?

< 1L = severe obstruction

How is FEV1/FVC affected in obstructive conditions?

Decreased

How is FEV1/FVC affected in restrictive conditions?

Normal/near normal (Low FEV1/low FVC)

What is the normal FEV1/FVC ratio?

Normal > 75%

What is the FEV1/FVC ratio for young adults?

97%

What is the FEV1/FVC ratio for COPD?

< 70%

What is Restrictive Lung Disease?

Category of conditions that reduce expansion of the lungs

In Restrictive Lung Disease, how is airflow and lung volume affected?

Airflow is okay, but changes in lung volume are reduced

What are the characteristics of the lungs/chest wall in Restrictive Lung Disease?

Decreased compliance, increased stiffness in chest wall, increased elasticity, and increased surface tension

What are the overall results of Restrictive Lung Disease on ventilation and work?

Results in decreased ventilation and increased work

What are some types of Restrictive Lung Disease?

Pulmonary Fibrosis, Pulmonary Edema, Acute Respiratory Distress Syndrome (ARDS), Infant Respiratory Distress Syndrome (IRDS), Thoracic spine dysfunction (Kyphosis, scoliosis, ankylosing spondylitis), Obesity, and Abdominal conditions

What are the signs/symptoms of Restrictive Lung Disease?

Tachypnea, Hypoxemia, Ventilation/Perfusion Mismatch, Decreased Breath Sounds (dry rales), Decreased Lung Volumes & Capacities, Decreased Diffusion Capacity, Cor Pulmonale, Right Sided Heart Failure

What is Chronic Obstructive Pulmonary Disease (COPD)?

A group of lung diseases that inhibit air flow

What happens to the lungs in COPD?

Results in incomplete emptying of the lungs and hyperinflation of the lungs

What can cause obstructions in COPD?

Retained secretions, inflammation of the airways, bronchial constriction, weakened airways, and alveolar sac destruction

What conditions are included under COPD?

Emphysema, Chronic Bronchitis, Asthma (Bronchoconstriction), and Cystic Fibrosis

What are the two main causes of COPD?

Inhalation factors (cigarette smoke is primary cause) and genetics (Alpha1-antitrypsin deficiency, decreased surfactant production, early onset emphysema)

What are the signs/symptoms of COPD?

Dyspnea with exertion (may be severe enough to cause anxiety), persistent/wet cough, frequent chest infections, wheezing, fatigue (decreased activity tolerance)

What are the signs of Lung Hyperinflation in COPD?

Elevation of the shoulder girdle, horizontal ribs, barrel-shaped thorax, low, flattened diaphragm

What are the signs/symptoms of Pulmonary Embolism (PE)?

Dyspnea; Chest pain (visceral); Cough (may produce bloody mucus); Dizziness, lightheadedness; Increased Heart Rate (HR) & Respiratory Rate (RR)