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Question 1

Major changes with CHF(Heart failure)

Answer 1

• Systolic dysfunction
• Pulmonary blood flow/pulmonary blood pressure
• Altered hormone levels (vasopressin, aldosterone
• Skeletal muscle metabolism
• Renal failure- leads to sodium and water retention

Ventilatory issues
• Pulmonary bl pressure
• Physiological dead space
• Worsened breathing patterns

Question 2

Signs and Symptoms of CHF

Answer 2

• Quick fatigue, reduced tolerance to exercise, dyspnea
  -Edema to the legs and ankles and swollen neck veins
  -tachycardia/arrythmias/palpations
• heart murmur
  cardiac enlargement

Question 3

Treatments for CHF

Answer 3

• Diuretics
• Digoxin
• ACE inhibitors
• beta blockers
• vasodilators
• angiotensin 2 receptor blockers
• physical activity

Question 4

what is CHF

Answer 4

When the heart is failing to pump adequate blood from ventricles

Question 5

What are the types of MI’s?(heart attacks)

Answer 5

Transmural- entire heart wall in the area is affected (Endocardium, myocardium, epicardium)
-Subendocardial- only a portion of the thickness (endocardium and myocardium) is damaged
-

Question 6

Medical name for stroke

Answer 6

Cerebral Infarction

caused by atherosclerosis, embolism or hemorrhage

Question 7

What are the signs and symptoms of stroke or TIA (Transient ischemic Attack)

Answer 7

• Paralysis
• Changes in behavior
• Memory Deficits
• changes depend on side of brain affected
• loss of sensation, speech coordination

Question 8

PAD (Peripheral Artery Disease)

Answer 8

• decreased bl flow
• increase leg pain usually below the knees
• lowered physical capacity
• stenose and or occlusions of the lower extremity

Question 9

Signs and Symptoms of PAD

Answer 9

• Leg pain with exercise (disappears with rest)

- coldness or numbness and tingling in lower legs and feet

Question 10

Determining the severity of PAD

Answer 10

-Time and or distance of onset of pain

ankle/brachial systolic pressure index

Question 11

Exercise Testing Procedures

Answer 11

1. Measure and calculate ABI after 15m supine test
2. exercise test with gradual increase in grade (2mph, 0% grade, then increase in grade every 2-3 min
3. use pain scale, record times to onset of each level of pain, record HR and BP
4. 15 min recovery (supine), record pain score

Question 12

Severity of PAD

Answer 12

Stage 1: asymptomatic
Stage 2A: Intermittent claudication (walking >200m)
Stage 2B: Intermittent Claudication (walking <200m) (no ischemic pain at rest for either 2a or 2b)
Stage 3: ischemic pain at rest
Stage 4: Ulceration or gangrene; or both

Question 13

Ventilatory issues that result from Heart Failure

Answer 13

Pulmonary congestion

hypertension

Question 14

2 direct causes of angiotensin 2

Answer 14

• sodium retention

- increased vasopressin

Question 15

NYHA HF Classifications

Answer 15

1. No symptoms w/ activity or rest
2. symptoms w/ grater than ordinary activities but comfy @ rest w/ mild exertion
3. symptoms w/ ordinary activities, comfy only @ rest
4. symptoms w/ any activity, symptoms may occur @ rest

Question 16

what is a healthy relative vo2?

Answer 16

Around 35, 40 and 60’s in trained people

Question 17

traditional cardiac rehab categories

Answer 17

• Inpatient- phase 1
• Early outpatient- Phase 2
• Maintenance and follow-up- Phase 3 (also outpatient)

Question 18

Fontaine Classifications

Answer 18

Stage 1: Asymptomatic
Stage 2a: Intermittent claudication (walking >200m)
Stage 2b: Intermittent claudication (<200m) no ischemic pain @ rest for either 2a or 2b
Stage 3: Ischemic pain @ rest
Stage 4: ulceration or gangrene or both ( minor or major tissue loss)

Question 19

CHF causes

Answer 19

• systolic dysfunction
• Pulmonary Bl flow/ Pulmonary BP
• Altered Hormone levels
  ~ vasopressin
  ~ Aldosterone

Question 20

what does ace inhibitors do?

Answer 20

Lower BP

Question 21

Changes w/ CHF

Answer 21

• Skeletal muscle metabolism
• decreased aerobic metabolic capacity= increased reliance on glycolysis= increased co2/lactate prod.
• Renal Failure