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66 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Does a normal aging person have an increase in expiratory air flow resistance
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Yes so do people with emphysema and bronchitis
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Does fev1 decline with normal aging?
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Yes
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What is the most significant age-related change in the pulmonary system
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Partial pressure difference between the alveoli and the systemic arterial blood
this is due to a decrease in diffusion and also an increase mismatch between alveolar ventilation and perfusion |
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Does lung tissue compliance increases with age
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Yes this is the same thing as saying loss of lung recoil
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When is total lung capacity decreased
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With restrictive lung disease like idiopathic pulmonary fibrosis
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What are the primary signs of pulmonary hypertension
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Hypoxemia and dyspnea on exertion
then the right sided heart begins to fail causing peripheral edema and maybe jugular venous distention |
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What could be the cause of crackles low pitched wheezes( rhonchi) or diminished bronchial lung sounds
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Pneumonia from a patient with a nursing home
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Do anticholinergic medication block the parasympathetic or the sympathetic nervous system
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They block the parasympathetic nervous system
this medication would be used as a bronchodilator like Ipratropium- atrovent short acting and spiriva long-acting combivent is albuterol and ipratropium which is a combination short acting beta 2 agonist and anticholinergic and one inhaler |
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What has more side effects like higher heart rates and increased nausea with albuterol administration
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Nebulizer over metered dose inhaler
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When does albuterol peak
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It starts 10 minutes post-treatment peaks in 1 hour and lasts for 4 hours
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What kind of weakness would you see from glucocorticosteroids
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Usually proximal lower extremities first
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Furosemide
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Lasix
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fluroquionolones
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Cipro
Levaquin |
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What is the first line treatment of pulmonary edema
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Lasix, furosomide
Which is a loop diuretic and you lose potassium |
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Based on the HOAC II examination strategy should be developed based on what
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Initial data like the medical record and the patient identified problem especially activity limitations and partition restriction
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How often do you give encouragement on the six minute walk test
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Every 60 seconds
Also if you walk less than 350 metres your 5 year survival rate is 75 percent if you walk under 250 meters your survival rate is only 40% |
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MDC for the six minute walk test
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54 meters or 180 feet though some people said that was too much
so in 2008 they suggested as an MCID :35 meters or a hundred fifteen feet for people with moderate to severe COPD or 10 percent increase over baseline distance |
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DVT clinical decision rule
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Doe scale
This scale does not quantified dyspnea it quantifies either dyspnea that occurs when it should or should not or the associated activity limitation |
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Borg CR 10
Categorical ratio scale that is not linear in nature this allows more specificity and quantifying dyspnea |
MCID is one unit
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What provides the best measurement of oxygenation
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Pa 02
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Diminished breath sounds are heard with mild atelectasis due to shallow breathing or mucus plugging as well as with
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Emphysema and hyperinflation
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According to the guide the practice patterns selected during the evaluation should be directly related to
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Intervention strategy and tactics selected
for instance someone with a joint replacements may require interventions like ankle pumps to prevent complications so their primary practice pattern would be modified to be risk reduction for venous thrombosis |
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What is the best way to predict heart rate max
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208 - 0.7 times age
In a pulmonary patient target heart rate would be 5 beats before the threshold where they desat |
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What heart rate max is equivalent to moderate intensity
What about for heart rate reserve |
60 to 80 percent
50 to 75 percent |
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If you're in pulmonary rehab and you're performing 80 percent of your rep max which is your 10 rep max how do you know when to increase the weight
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When you can do 20 repetitions with good form
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Does pursed lip breathing increase VT
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Yes
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Is chest physical therapy a routine intervention for those with pneumonia or chronic bronchitis
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No but oscillating positive expiratory pressure with the acapella can help clear Airways with COPD
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Based on the HOAC II, goals should be based on what
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Function
with impairment level testing criteria for each goal |
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What is the primary reason that PLB helps relieve dyspnea on exertion
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Increased end expiratory long volume is inhibited
also oxygen saturation is the most important physiological response to assess during exercise |
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Fyi
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What Mets relate to moderate intensity
vigorous? |
3-6
greater than 7 |
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ACSM evidence categories
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Level a= is overwhelming evidence from an RCT or observational studies
level B = strong evidence from RCT or observational studies, some studies are inconsistent with conclusion level c = generally positive or suggestive observational level d = panel consensus judgment at the strength of the evidence is insufficient to take place in the other category |
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American Dietetic Association evidence grading system
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Level a= well conducted generalizable RCT or compelling nonexperimental evidence
level B = well conducted cohort studies or case-control level c = poorly controlled studies or an RCT with major flaws level e = expert consensus or clinical experience |
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Does physical activity improve systemic insulin action
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Yes for 2 to 72 hours
level A |
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How many hours a week of moderate to vigorous exercise should be undertaken as a part of lifestyle changes to prevent type 2 diabetes
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Two and a half hours
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The acronym smart can be used to help individuals that appropriate goals
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Specific
measurable attainable realistic time frame specific |
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Metformin is the generic name for the class of drug biguanide, what is the brand name that is common
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Glucophage
it decreases hepatic glucose production and decreases insulin resistance |
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Glipizide is a generic name from the class of drugs sulfonylureas, what does it do
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Stimulates beta cells to release insulin
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Cycloset is a dopamine agonist
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That improves glycemic control in an unknown way working in the brain
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What consists of have drugs absorb distribute metabolize and excrete
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Pharmacokinetics
in most people absorption is not a problem unless you have gastroparesis |
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What drug is a Verapamil from calcium channel blocker for hypertension it can cause edema
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Yeah I need mistake making this card
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What is glycosylation?
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It occurs as glucose in the plasma attaches itself to the haemoglobin component of the red blood cell
this is irreversible increases A1C test values |
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A tremor, palpation, or anxiety or pallor from hypoglycemia is this neurogenic neuroglycopenic
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This is a neurogenic stage 1
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How do Ages affect the body
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Decrease tissue extensibility due to cross linking of proteins in soft tissues
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What is the fastest growing population with diabetes diagnosis
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65 to 74 and it's not uncommon that they already had the disease for 4-7 years before being diagnosed
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Amylin
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Decrease glucose
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Dm is characterized by
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Hyperglycemia due to detect in insulin secretion, action or both
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Does smoking have anything to do with pathogenesis of Dm?
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No
Does: genetics, lifestyle, sarcopenia |
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Most reliable indicator of poor nutritional status in older adults
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Significant acute weightloss
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Most common complication for older adult with diabetes
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Medication induced hypoglycemia
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3 issues when Dm has autonomic neuropathy
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Oh
Uti Gastroparesis |
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osteoporosis occurs initially in what bone
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Trabecular example vertebral bodies proximal femur distal radius
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Describe tissue content that can resist high tensile forces
High compressive forces |
High tensile forces are resisted with high collagen content and low proteoglycans
high compressive force have high proteoglycans and low collagen |
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Describe specificity and sensitivity with the Berg balance scale
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High specificity for determining those who are not risk
low sensitivity for predicting those who are at risk |
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What is the cutoff score for falls on the Fullerton advanced balance scale
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Under 25 of the possible 40
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What is normal heel rise test for people between 61 and 80 years old female then male
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4 = men
2 = women |
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Recommended protein amounts for each gender
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46 : female
56 for men |
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What term is lacking in the guide
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Diagnosis component
It is logical and well defined but efforts to delineate a comprehensive diagnostic system are ongoing |
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What is the cardiovascular med that has no change really with exercise capacity
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ACE inhibitor maybe a little increase with CHF this is also the same for vasodilator
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Calcium channel blockers decrease the amount of calcium to Promote relaxation
What drug does the opposite? |
Digitalis
(also Inhibits sympathetic) Thereby making the heart stronger and reducing its stress Calcium channel blocker : limit calcium and also decrease si node rate |
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Is aspirin an anticoagulant or an anti thrombotic
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Anti thrombotic- same as plavix (inhibitors platlets)
heparin is an anticoagulant (control synthesis of clots) |
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Explain how to use the karvonen method
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First karvonen is to find your exercise range, your target heart rate
HR max-HR test X %intensity To find heart rate max use : 208 - 0. 7 X age This is the recommended formula for healthy persons The best fit formula for HR max accounts for weight 210-50%age-5%WT + 4(male) or 0 if female |
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Relate these from the 6-20 borg to the normal 0-10 borg
55-64% HR max 70-85% HR max |
12-13 and 5-6 (3-4 on the CR 10)
14-16 and 7-8 |
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Which is better multi joint exercises or single joint
machines or free weights? |
You should choose multi joint exercises before single joint
and use machines when available instead of free weights as machines require less skill and allow one to begin at lower resistance and increase by small increments |
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