Deck 7: Cardiopulmonary Exercise Testing

Question 1

A subject has the following results of an exercise test: Which of the following best describes these findings?

A) Coronary artery disease
B) Chronic obstructive pulmonary disease
C) Mild deconditioning
D) Poor subject effort

Answer 1

A

Question 2

A 56-year-old male weighing 100 kg exercised on a cycle ergometer.His O₂ max was 2.8 L.How many METs of work did he perform?

A) 5.0
B) 6.0
C) 7.0
D) 8.0

Answer 2

D

Question 3

In a healthy adult subject with a resting BP of 120/80,which of the following responses would be expected during a maximal incremental exercise test?

A) Systolic pressure increases to 210,diastolic pressure increases to 95.
B) Systolic pressure increases to 300,diastolic pressure increases to 130.
C) Systolic pressure increases to 160,diastolic pressure increases to 130.
D) Systolic pressure remains at 120,diastolic pressure decreases to 60.

Answer 3

A

Question 4

What is the normal breathing reserve?

A) 20%-40%
B) 10%-20%
C) 30%-50%
D) 35%-45%

Question 5

A subject who has severe dyspnea on exertion performs a maximal exercise test with arterial line and exhaled gas analysis.The following data are obtained: Which of the following diagnoses best fits these findings?

A) Coronary artery disease
B) Pulmonary hypertension
C) Restrictive lung disease
D) Poor subject effort

Question 6

Which combination of gases would be most appropriate to check the linearity of the oxygen analyzer used for exhaled gas analysis during exercise?

A) 100% O₂,room air
B) 40% O₂,5% CO₂
C) Room air,24% O₂,7% CO₂
D) Room air,15% O₂,24% O₂

Question 7

The following image shows the subject's tidal volume plotted against the maximal flow-volume loop during exercise: Which of the following clinical conditions is most consistent with these findings?

A) Variable intrathoracic obstruction
B) Chronic obstructive pulmonary disease
C) Pulmonary fibrosis
D) Variable extrathoracic obstruction

Question 8

Which of the following is true concerning exercise testing performed with a cycle ergometer?

A) A higher maximum O₂ can be achieved than with a treadmill.
B) Workload can be changed in 1-minute intervals only.
C) O₂ can be estimated from pedaling speed and resistance.
D) Work performed depends on the subject's height and weight.

Question 9

What will typically happen to the end-expiratory lung volume during exercise in subjects with COPD?

A) Remain the same
B) Decrease
C) Increase
D) Initially increase and then decrease

Question 10

At high workloads,increasing cardiac output is achieved by:

A) Increasing stroke volume
B) Increasing vascular resistance
C) Increasing heart rate
D) Decreasing the V_D/V_T ratio

Question 11

Which of the following are contraindications for performing an exercise test?

A) PaO₂ less than 40 mm Hg on room air
B) FEV₁ less than 70% of predicted
C) Sinus tachycardia
D) Dyspnea when lying flat in bed

Question 12

Which of the following gas mixtures would be most appropriate for calibrating the analyzers used for exhaled gas analysis during exercise?

A) 100% O₂,room air
B) 40% O_2, 5% CO₂
C) Room air,24% O_2, 7% CO₂
D) Room air,12% O_2, 5% CO₂

Question 13

A 45-year-old female has a predicted O₂ of 2.8 L.She does not have any identified abnormalities other than being short of breath with exercise.What would be the most appropriate cycle incremental or ramp protocol to use for her study?

A) 35 watts
B) 30 watts
C) 25 watts
D) 15 watts

Question 14

A subject whose FEV₁ is 1.1 L has the following results of an exercise test (values in parentheses are percents of predicted): Which best describes these results?

A) Mild exercise impairment,poor effort
B) Moderate exercise impairment,probably deconditioning
C) Severe exercise impairment with cardiovascular limitation
D) Moderate to severe exercise impairment with ventilatory limitation

Question 15

One MET is equal to how many ml/min/kg of O₂?

A) 3.5 ml O₂/min/kg
B) 3.0 ml O₂/min/kg
C) 2.5 ml O₂/min/kg
D) 2.0 ml O₂/min/kg

Question 16

A subject has the following results of an exercise test: Which of the following clinical conditions is most consistent with these findings?

A) Cardiomyopathy
B) Chronic obstructive pulmonary disease
C) Marked deconditioning
D) Acute pulmonary embolism

Question 17

A 52-year-old male presents with a complaint of chest pain and shortness of breath.His spirometry results are FVC 3.8 L,FEV₁ 2.9 L,ratio 76.The subject performs a cardiopulmonary exercise test,and the following data are obtained: Which statement best describes these results?

A) Subject has a reduced ventilatory reserve.
B) Subject has a moderate reduction in exercise tolerance.
C) Subject has an inappropriate breathing strategy.
D) The study is submaximal.

Question 18

Which of the following exercise protocols can be described as a ramp test?

A) Treadmill,2 MPH,grade increase of 5% every 3 minutes
B) Treadmill,10% grade,speed increase of 2.5 MPH every 3 minutes
C) Cycle ergometer,continuous increase of 10 watts per minute
D) Cycle ergometer,increase in resistance of 50 watts every 2 minutes

Question 19

What is the predicted maximal heart rate for a 65-year-old female?

A) 140 beats/min
B) 155 beats/min
C) 170 beats/min
D) 175 beats/min

Question 20

A 54-year-old female with a history of hypertension has the following exercise test results: Which statement best describes these findings?

A) Subject has a reduced ventilatory reserve.
B) Subject has a moderate reduction in exercise tolerance.
C) Subject has chronotropic insufficiency.
D) The study is submaximal.

Question 21

A 65-year-old female presents with a complaint of shortness of breath.The subject performs a cardiopulmonary exercise test,and the following data are obtained: What is the subject's ventilatory reserve?

A) 81%
B) 15 L
C) 300 ml
D) 65 L

Question 22

What does the term phase delay pertain to?

A) Heart rate R to R intervals
B) Response time of the analyzer
C) Alignment of the gas analyzer with the flow signal
D) Amount of time the tidal volume exceeds flow limitation

Question 23

How many kilopond meters per minute (kpm/min)is 100 watts?

A) 100
B) 612
C) 306
D) 50

Question 24

A 50-year-old female complaining of shortness of breath with exercise tolerance has a predicted O₂ max of 1.8 L/min.What ramp protocol would you select to perform a maximal exercise test?

A) 15 watts
B) 25 watts
C) 5 watts
D) 30 watts

Question 25

A 12-year-old female with a history of prolonged QT syndrome and wheezing has the following exercise test and flow-volume loop data: Which of the following best describes these findings?

A) Variable intrathoracic obstruction
B) Flow limitation
C) Asthma
D) Variable extrathoracic obstruction

Question 26

A 62-year-old male presents with a complaint of shortness of breath.His spirometry results are FVC 3.3 L,FEV₁ 1.5 L,ratio 45.The subject performs a cardiopulmonary exercise test,and the following data are obtained: Which statement best describes these results?

A) Subject is ventilatory limited.
B) Subject has chronotropic insufficiency.
C) Subject has an inappropriate breathing strategy.
D) The study is submaximal.