Deck 7: Cardiopulmonary Implications of Specific Diseases

Question 1

Which of the following strategies would MOST likely be an appropriate primary intervention for extreme obesity that is consistent with a stepped-care approach?

A)Caloric restriction
B)Increased physical activity
C)Bariatric surgery
D)Medications

Answer 1

C
A stepped-care approach involves choosing the level of intervention based on severity of obesity.Caloric restriction,increased activity,diet modifications,and stress management would be appropriate for mild to moderate obesity;all of the lifestyle modifications plus medications would be appropriate for severe obesity;all lifestyle modifications,medications,and bariatric surgery would be appropriate for extreme obesity.Bariatric surgery would be the primary intervention most likely at an extreme level.

Question 2

Which of the following components secreted by adipose tissue is considered a cytokine that may promote atherosclerosis and increase insulin resistance?

A)Adiponectin
B)Angiotensinogen
C)Interleukin 6
D)Resistin

Answer 2

C
Adiponectin,angiotensinogen,and resistin are hormones (proteins or enzymes)whereas interleukin 6 and tumor necrosis factor alpha are considered cytokines.

Question 3

Which of the following parameters of exercise is initially MOST appropriate to include in an exercise prescription for an obese patient who is referred for physical therapy to improve cardiovascular function?

A)Moderate-intensity exercise [40% to 60% of heart rate reserve (HRR)]
B)30 minutes of accumulate exercise per day
C)Only weight-bearing activities
D)Low-intensity exercise (<40% of heart rate reserve)

Answer 3

A
Moderate-intensity exercise (40% to 60% of HRR)is most appropriate due to it being lower than the anaerobic threshold,in order to utilize predominantly FFAs as fuel.Thirty minutes is not enough;45 to 60 minutes is recommended.Non-weight-bearing activities are good for those with joint arthritis;low intensity is not sufficient to effect stimulus to effect a change in weight management.

Question 4

Which of the following hormones MOST likely functions to reduce energy intake and induce weight loss?

A)Leptin
B)Ghrelin
C)Neuropeptide Y
D)Orexin

Question 5

A gastric hormone that signals hunger and is involved in long-term regulation of body weight BEST describes which of the following hormones?

A)Neuropeptide Y
B)Orexin
C)Ghrelin
D)Insulin

Question 6

Research evidence supports which of the following interventions as being the MOST likely have the greater short- and long-term weight loss among obese and overweight adults?

A)Moderate-intensity activity
B)Diet modifications
C)Moderate-intensity activity plus diet modifications
D)Behavior modifications

Question 7

In a person with type II DM,ketones are formed from the metabolism of what?

A)Proteins
B)Glycogen
C)Free fatty acids (FFAs)
D)Glucose

Question 8

Which of the following body mass index (BMI)values indicates normal weight?

A)<18.5 kg/m²
B)18.5 to 24.9 kg/m²
C)25.0 to 29.9 kg/m²
D)30.0 to 34.9 kg/m²

Question 9

What percentage of sustained weight loss is BEST associated with reducing many of the medical risk factors and complications associated with obesity?

A)2% of baseline weight
B)4% of baseline weight
C)8% of baseline weight
D)12% of baseline weight

Question 10

Which of the following measurements is MOST associated with very high disease risk?

A)Female gender,BMI = 27.8 kg/m²,and waist circumference = 40 inches
B)Female gender,BMI = 18.0 kg/m²,and waist circumference = 32 inches
C)Male gender,BMI = 37.4 kg/m²,and waist circumference = 38 inches
D)Male gender,BMI = 28.2 kg/m²,and waist circumference = 42 inches

Question 11

Obstructive sleep apnea hypopnea syndrome (OSAHS)is MOST likely caused by which of the following bodily changes?

A)Excess fat accumulation in the neck causing pharyngeal lumen narrowing
B)Excess fat accumulation in the abdomen causing the diaphragm to be elevated
C)Excess fat accumulation in the abdomen restricting chest wall expansion
D)Increased work of breathing due to rapid shallow breathing

Question 12

Which of the following would MOST likely cause obese persons to have dyspnea on exertion and their exercise capacity to be reduced?

A)Elevated blood pressure and resting heart rate
B)Reduced capacity to increase blood flow and oxygen to exercising muscles
C)Ventilatory limitation in uncomplicated obesity
D)Elevated absolute oxygen consumption at a given exercise load

Question 13

The process in which hypoglycemia stimulates the release of glucagon to promote the breakdown of glycogen is BEST termed by which of the following?

A)Glycogenolysis
B)Gluconeogenesis
C)Ketogenesis
D)Lipolyosis

Question 14

Sleep deprivation is associated with which of the following chronic conditions?

A)Obesity
B)Type II diabetes mellitus (DM)
C)Cardiovascular disease
D)All of the above

Question 15

Impaired glucose tolerance is defined by which of the following values?

A)Blood glucose of 85 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test
B)Blood glucose of 100 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test
C)Blood glucose of 130 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test
D)Blood glucose of 210 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test

Question 16

Which of the following pathological conditions is MOST likely to occur secondary to obesity-related chronic daytime alveolar hypoventilation (PaCO₂ ³45 mm Hg,PaO₂ <70 mm Hg)?

A)Respiratory alkalosis
B)Hypercapnia
C)Metabolic acidosis
D)Anemia

Question 17

Visceral adipose tissue (VAT)-induced increments of free fatty acids stimulate the production of which of the following?

A)High-density lipoproteins
B)Low-density lipoproteins
C)Interleukin-6
D)Leptin

Question 18

Measurement of the average level of glucose that a red blood cell has been exposed to during its life cycle of about 120 days is BEST recorded by which of the following tests?

A)Impaired fasting glucose test
B)Impaired glucose tolerance test
C)Glycosylated hemoglobin test (Hb A1c)
D)Fasting glucose level

Question 19

Which of the following factors is NOT considered to be recognized as a metabolic risk factor associated with metabolic syndrome (MetS)?

A)Visceral obesity
B)Dyslipidemia
C)Elevated C-reactive protein
D)Insulin resistance

Question 20

Which of the following cells are most impaired or less responsive to insulin when insulin resistance occurs?

A)Skeletal muscle cells
B)Liver cells
C)Adipose cells
D)All of the above

Question 21

The presence of an irreversible hypoventilation due to weakness of the intercostal muscles and diaphragm MOST likely occurs in which of the following neurological disorders?

A)Parkinson's disease
B)Amyotrophic lateral sclerosis
C)Multiple sclerosis
D)Myasthenia gravis

Question 22

In patients with end-stage renal disease,which of the following exercise recommendations has been demonstrated to be the MOST beneficial?

A)Low to moderate aerobic exercise sessions the day after dialysis
B)Low-resistance exercise session the day after dialysis
C)Low-resistance training during the first 1 to 2 hours of dialysis
D)Patients with end-stage renal disease (ESRD)on dialysis should not exercise

Question 23

A 75-year-old patient who is 1 week status post-multilevel laminectomy lumbar surgery is scheduled for an inpatient rehabilitation physical therapy session at 12 noon for 30 minutes.The patient has a history of type II diabetes mellitus.Her blood glucose 10 minutes before the physical therapy session was 75 mg/dL and the patient feels tired and weak.What should the physical therapist do next?

A)Explain to the patient that feeling tired and weak is normal after surgery and encourage the patient to attend the therapy session as scheduled at 12 noon.
B)Explain to the patient that fatigue could be related to low blood sugar and encourage the patient to eat lunch instead of attending the therapy session.
C)The patient's blood sugar is low.Encourage the patient to eat lunch,communicate with the nurse about insulin dose,and reschedule the therapy session later in the afternoon.
D)The patient's blood sugar is low.Provide the patient with some graham crackers to consume during transport to the therapy session to remain on time.

Question 24

A patient with type II diabetes mellitus has arrived in your clinic today for aerobic training on a treadmill.Prior to any exercise,blood sugar was 250 mg/dL,no ketones were detected,and insulin dose was taken.How should the physical therapist proceed?

A)Recommend that the patient not to exercise and reschedule the appointment.
B)If the patient feels good,proceed with low-intensity exercise for 10 minutes and recheck the blood sugar.
C)Proceed with the patient's normal routine of exercise and recheck the blood sugar post exercise.
D)Have the patient sit and rest in the clinic and recheck the blood sugar 30 minutes later.

Question 25

Cardiovascular disease is the MOST common cause of death in patients with which of the following types of connective tissue diseases?

A)Rheumatoid arthritis
B)Systemic lupus erythematosus
C)Scleroderma
D)Ankylosing spondylitis

Question 26

Which of the following pathological conditions associated with diabetes manifests as a reduced awareness of the signs and symptoms of hypoglycemia?

A)Hypertension
B)Congestive heart failure
C)Autonomic neuropathy
D)Coronary artery disease

Question 27

Microvascular disease manifested as slowed digestion of food in the stomach in a person with diabetes mellitus involves which of the following structures?

A)Kidney
B)Nerve
C)Eye
D)Skin

Question 28

Which of the following cardiac complications is the leading cause of death in persons with an eating disorder such as anorexia nervosa and bulimia?

A)Cardiac arrhythmias
B)Hypotension
C)Decreased cardiac mass
D)Mitral valve prolapse

Question 29

Slow progressing fibrosis and vascular obliteration of the skin,subcutaneous tissues,and often the visceral organs BEST describe which of the following connective tissue diseases?

A)Rheumatoid arthritis
B)Systemic lupus erythematosus
C)Scleroderma
D)Ankylosing spondylitis

Question 30

The MOST common cardiovascular problem in patients with human immunodeficiency virus (HIV)is which of the following?

A)Pericardial effusion
B)Biventricular hypertrophy
C)Hypertension
D)Cardiac arrhythmias

Question 31

Which of the following signs and symptoms MOST likely is manifested in a patient whose blood glucose is recorded as moderately elevated?

A)Irritability and abrupt mood changes
B)Nausea and vomiting
C)Tachycardia
D)Increased thirst and hunger

Question 32

If there is an excess of circulating insulin in a person with type I DM at the onset of physical activity,which of the following impairments may subsequently occur?

A)Impaired production of hepatic glucose and mobilization of free fatty acids.
B)Impaired peripheral glucose uptake by skeletal muscle.
C)Hyperglycemia will develop post exercise.
D)Catecholamine levels rise promoting ketone body production.

Question 33

Major pulmonary complications occur in patients who have had a stroke primarily due to which of the following residual effects?

A)Poor trunk posture associated with the hemiparesis
B)Muscular hypo- or hypertonicity associated with a stroke
C)Facial and pharyngeal muscle weakness
D)Physical inactivity

Question 34

Which of the following exercise prescription parameters should be considered that would be unique to a patient with ESRD receiving dialysis three times per week?

A)Mode
B)Intensity
C)Timing
D)Duration

Question 35

Microangiopathies refer to the thickening or damage to which of the following components of the vascular system?

A)Artery
B)Vein
C)Arterioles
D)Capillary beds