question

HIV/AIDs exercise recommendations

answer

-postpone exercise testing during acute infections -frequency: 3-4 days/week -intensity of aerobic exercise: 40-<60% VO2R or HRR -resistance exercise: moderate levels, weights can be lifted 8-10 times -time: total of aerobic and resistance exercise: 30-60 min/day -avoid exhaustive exercise with symptomatic individuals, possible immune suppression can occur with more intense exercise -avoid contact sports due to inc risk of bleeding

question

name the 2 criteria and the 8 symptoms to diagnose CFS

answer

must have 2: 1.new onset of persistent or relapsing fatigue;must be present for at least 6 months; does not resolve with bed rest and reduces daily activity by at least 50% 2.exclusion of other chronic conditions must have 4/8: 1.profound or prolonged fatigue; post-exertional malaise lasting more than 24 hours 2.sore throat that is frequent or recurring 3.tender lymph nodes 4.muscle pain 5.sleep that is not refreshing 6.HA of new type, pattern, or severity 7.multijoint arthralgia without swelling or redness 8.significant impairments of short term memory or concentration

question

chronic fatigue syndrome exercise recommendations

answer

1.aerobic exercise like walking -intensity: low to moderate levels of intensity (9-12/20), progress gradually -frequency: 3-5d/wk -duration: to tolerance, 5min/session initially progressing to 40-60min 2.maintain flexibility 3.maintain or improve muscle strength 4.maintain function of individualized activities

question

fibromyalgia characteristics

answer

1.myalgia 2.generalized aching 3.sleep disturbances 4.multiple tender points 5.HA,cold intolerance, irritable bladder or bowel, cognitive problems, restless legs, atypical patterns of numbness and tingling (sensory amplication) 6.anxiety and depression

question

fibromyalgia diagnosis

answer

-widespread pain >3mo -11/18 tender points

question

fibromyalgia exercise recommendations

answer

1.aerobic exercise like walking everyday -intensity: mild to moderate 2-30 min duration progressing from 30-40min -frequency: 2d/wk -duration: to tolerance, 5min/session initially progressing to 40-60min 2.maintain flexibility 3.maintain or improve muscle strength 4.maintain function of individualized activities

question

hypercoaguability disorders caused by increased platelet functions are seen in pts with:

answer

1.atherosclerosis 2.diabetes mellitus 3.elevated blood lipids and cholesterol

question

hypercoaguability disorders caused by accelerated activity of the clotting system are seen in pts with:

answer

1.congestive heart failure 2.malignant disease 3.pregnancy 4.use of oral contraceptives

question

hypocoagulopathy disorders are caused by

answer

-platelet defects -hemophilia -von Willebrand's disease -vascular disorders as seen in hemorrhagic telangiectasia -vit C deficiency -Cushing's disease -senile purpura

question

what are the red flags for hematological disorders?

answer

-manual therapy -strenuous exercise

question

red flags for pt with anemia

answer

use perceived exertion levels

question

anemia clinical symptoms

answer

-fatigue and weakness with minimal exertion -dyspnea on exertion -pallor or yellow skin of face, hands, nail beds, and lips -tachycardia -bleeding of gums, mucous membranes, or skin in absence of trauma -severe anemia can produce hypoxic damage to liver and kidney, heart failure

question

sickle cell crisis symtoms

answer

-acute abdominal pain -painful swelling of soft tissue of hands and feet (hand-foot syndrome) -persistent HA -bone and joint crises: migratory, recurrent joint pain, extremity and back pain -neurological manifestations: dizziness, convulsions, coma, nystagmus -pulmonary: chest pain, coughing, dyspnea, tachypnea

question

sickle cell event red flags

answer

-cold

question

sickle cell pt considerations

answer

-exercise intolerance common: exaggerated HR response to exercise -low to moderate level exercise indicated -ensure adequate fluid intake -high level exercise and dehydration may increase risk of sickle cell crisis -teach joint protection strategies

question

complications of hemophilia

answer

-joint contractures (hip, knee, elbow, ankle plantar flexion) -muscle weakness around affected joints -leg length descrepancies -postural scoliosis -dec aerobic fitness -gait deviations: equinus gait, lack of knee extensor torque

question

hemophilia PT interventions

answer

1.pain management: TENS, massage, relaxation techniques, ice, biofeedback 2.active assistive exercise => active=> isokinetic=> open chain resistance (closed chain risks putting too much compressive force through joint) 3.PROM rarely, if ever used 4.important to strengthen hip, knee, elbow extensors, and ankle dorsiflexors 5.contracture management: manual traction, mobilization techniques, serial casting, dynamic splinting during day, resting splints during night

question

hemophilia red flags

answer

-passive stretching has risk of myositis ossificans

question

Hemophilia therapy recommendations (subacute)

answer

-pain management: TENS, biofeedback, ice -AAROM , isokinetic, open chain resistive -contracture management: manual traction, mobilization tech, serial casting dynamic splinting (day), resting splints (night)

question

Cancer exercise contraindications (10)

answer

1.<1,000 cells/mm3 WBC 2.<8 g/dL Hgb 3.<25% HCT 4.100F) 7.unusual or extreme fatigue, recent bone pain 8. chest pain, rapid or slow HR, elevated BP, swelling of ankles 9.severe dyspnea, pain with deep breath, cough/wheezing 10.dizziness/lightheadedness, disorientation, confusion, blurred vision, ataxia

question

early warning signs of cancer (8)

answer

1.change in bowel and bladder 2.indigestion or difficulty swallowing 3.a persistent cough or hoarseness 4.unusual bleeding or discharge 5.lump or thickening of any area 6.changing in wart or mole 7. sore that does not heal 8.unexplained weight loss

question

cancer staging

answer

stage 0 - carcinoma in situ stage I - tumor is localized, equal to or less than 2 cm; has not spread to lymph nodes stage II - tumor is locally advanced; 2 cm to 5cm with or without lymph node involvement stage III - tumor is locally more advanced; spread to lymph nodes; cancer is designated stage II or III depending upon specific type of cancer stage IV - tumor has metastasized or spread to other organs throughout the body

question

cancer grading

answer

grade I (low grade) - cancer cells resemble normal cells (well differentiated) and are slow growing grade II (intermediate grade) - cancer cells look more abnormal (moderately differentiated) and are slightly faster growing grade III (high grade) - cancer cells are abnormal (poorly differentiated); grow or spread more aggresively grade IV (high grade) - cancer cells are abnormal (undifferentiated)

question

red flags for pts with radiation therapy

answer

-pain and fatigue -radiation sickness -immunosuppression -fibrosis -burns -delayed wound healing -edema -hair loss -CNS effects (radiation encephalopathy)

question

red flags for pts with chemotherapy

answer

- fatigue -GI (anorexia, nausea, vomiting, diarrhea, ulcers, hemorrhage) -bone marrow suppression (anemia, leukopenia, thrombocytopenia) -skin rashes -neuropathies -phlebitis -hair loss

question

red flags for pts hormonal therapy

answer

-GI issues -HTN -steroid induced diabetes -myopathy -weight gain -hot flashes and sweating -altered mental status -impotence

question

what are outcome measures for Cancer related fatigue?

answer

1.brief fatigue inventory 2.qualifty of life scales

question

red flags for pts with significant bony metastases, osteoporosis, or low platelet count (<20,000)

answer

1.AROM, ADL exercise only 2.weight bearing may be restricted; provide appropriate ambulatory aids, orthoses 3. high risk of vertebral compression and other fx of metastatic disease = light exercise only!

question

exercise recommendations for cancer pts

answer

-low to moderate intensities (40-60% O2 uptake reserve or heart rate reserve; or Borg RPE scale 11-13/20 20-60 min/session -utilize warm up and cool down before and after each session

question

platelet count indications for 1.normal exercise, 2.some limitations, 3.moderate exercise, 4.light exercise, 5.ADLs, ROM, light walking with physician approval

answer

1. 150,000 - 450,000 cells/mm^3 2. 50,000 - 150,000 3. 30,000 - 50,000 4. 20,000 - 30,000 5.<20,000

question

white blood cell count indications for 1.normal exercise, 2.light or regular exercise, 3.no exercise, 4.no exercise, and protective mask required

answer

1. 4,800 - 10,800 cells/mm^3 2. >5,000 3. <5,000 with fever 4. <1,000

question

hemoglobin (Hgb) indications for 1.normal exercise, 2.regular, 3.light, 4.no exercise

answer

1. women 12-16 g/dL; men 13-18 g/dL 2. >10 3. <8-10 4. <8

question

Hemtocrit (HCT) % of RBC of whole blood indications for: 1.normal exercise, 2.light or regular exercise, 3.no exercise

answer

1. women 37-48%; men 45-52% 2.>25% 3.<25%

question

referred GI patterns and sympathetic nerve distributions

answer

epigastric region (T3-5), periumbilical region (T0), lower abdominal region (T10-L2)

question

visceral pain referring to the right shoulder

answer

liver, stomach, and gallbladder

question

visceral pain referring to left shoulder

answer

heart, lung, diaphragm, pancreas

question

what is Blumberg's sign?

answer

rebound tenderness, often in case of peritonitis (inflammation of peritoneum, sometimes due to appendicitis)

question

Metabolic syndrome (Syndrome X) criteria 3/5:

answer

1.men >40in waist/ women >35in 2.150mg/dL triglycerides or on cholesterol meds 3.HDL levels <40mg/dL and 100mg/dL

question

Diabetes diagnosis: fasting/casual plasma glucose concentration

answer

>126mg/dL >200mg/dL

question

diabetes glucose exercise contraindications

answer

hypo: 300mg/dL do not exercise w/o eating at least 2 hours before

question

diabetes precautions for exercise

answer

-retinopathy: BP should not exceed >170mmHg and jarring activities -autonomic neuropathy: silent ischemia (testing tachycardia) -lack of thermoregulation

question

side effects of tricyclic antidepressant drugs

answer

-disturbed balance -postural hypotension -inc HR -dysrhythmias -ataxia -seizures

question

diastasis recti abdominis exercise precautions: resume abdominal exercises when separation is <?cm

answer

2 cm, utilizing hand to support abdominal wall

question

metabolic acidosis 1.cause, 2.compensations, 3.symptoms

answer

1.depletion of bases or accummulation of acids <7.35; diabetes, renal insufficiency, diarrhea 2.hyperventilation 3.weakness, muscle twitching, nausea, vomiting, diarrhea, HA, dry skin and mucous membranes, poor skin turgor

question

metabolic alkalosis 1.causes, 2.compensation, 3.sx

answer

1.loss of acids or accumulation of bases >7.45; excess vomiting, excess diuretics, hypokalemia, peptic ulcer, excessive antacids 2.hypoventilation 3.weakness, muscle twitching, muscle cramps, prolonged vomiting, diarrhea, convulsions, arrhythmias

question

respiratory acidosis 1.causes, 2.sx

answer

1.hypoventilation => accumulation of CO2; chronic pulmonary disease, respiratory suppression via drugs 2.dyspnea, hyperventilation cyanosis, restlessness, HA

question

respiratory alkalosis 1.causes, 2.sx

answer

1.hyperventilation => excessive loss of CO2; congestive heart failure 2.tachypnea, dizziness, numbness and tingling, blurred vision, diaphoresis, arrhythmias

question

in the case of stress incontinence, what muscle should be targeted and strengthened?

answer

pubococcygeus muscle

question

what are PT interventions for stress incontinence?

answer

1.Kegel's exercises 2.functional electrical stimulation 3.biofeedback 4.progressive strengthening

question

side effects of tricyclic antidepressants

answer

-disturbed balance, postural hypotension, falls, inc HR, dysrhythmias, ataxia, seizures

question

what are treatments for GERD?

answer

1.avoid head lower than stomach positions, and valsalva 2.proton pump inhibitors, H2 blockers, and antacids

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