CCRP AACVPR QUESTIONS AND ANSWERS GRADED A

CCRP AACVPR QUESTIONS AND ANSWERS GRADED A What influences a persons metabolic rate? Exercise, gender, genetics, age Which is the macronutrient that provides more than twice as many calories as the other two Fat Foods that raise insulin levels have... added sugar When feeling stressed, you may feel relief after eating a piece of chocolate because... it will raise dopamine levels What reduces the number of receptors for dopamine insulin What percentage of Cardiac Rehab patients re overweight or obese 80% Why is fructose a promoter of obesity? promotes liver fat accumulation which promotes metabolic syndrome What reduces the rate of carbohydrate absorption thus reducing insulin response Fiber Depression among cardiac patients has been associated with higher risk of mortality When a patient scores in the depressed range on a sreening, which acion should be taken results to be discussed with patient and health care provider if a patient dense feeling of sadness they... may have non-dysphoric depression depression is relevant to CR because depression reduces recovery from exercise due to fatigue and low energy the relationship between anger and hostility is.. anger is the emotion, hostility is the thought social isolation is defined by how connected a patient feels in their relationships stress management is designed to respond to the "flight or fight" response What is the best approach to preventing exercise-induced hypoglycemia check blood sugar before and after exercise and respond to patterns appropriately What guideles for beginning exercise are correct for type 1 and type 2 diabetics (1)If BS is >250 check for ketones. If none are present, it is safe to exercise at low to moderate intensity. (2) Do not exercise if BS >400. If <300 ok to exercise Target HbA1c% for diabetic <7% Target Fasting BS for diabetic 70-130 Target 2 hour post prandial BS for diabetic <180 What insulin dose adjustment type would be most effective for preventing hypoglycemia during moderate exercise -Reduction of rapid acting insulin dose 2-3 hours prior to exercise -A temporary basal rate decrease 45-60 minutes prior to exercise Which medications place a patient at risk for hypoglycemia Insulin (Lantus, Novolog) and Sulfonyureas (Glipizide, glimepiride) How long can significant exercise induced enhancement of glucose uptake from muscle last 24-48 hours Recommended calories from carbs, protetin, and fats to better manage diabetes ~40% calories from fiber-rich carbs ~30% calories from lean protein ~30% calories from healthy fats Cardiac effects of nicotine modest increase in HR, BP and myocardial contractility The stethoscope for smoking is.. a carbon monoxide analyzer that measures the amount of CO the patient exhales Carbon monoxide binds more readily than oxygen to hemoglobin resulting in relative hypoxia The question regarding Time to First Cigarette is primarly used to.. determine the level of dependence The gold standard for improving smoking quit rates is pharmacotherapy which doubles quit rates Smoking cessation in patients with CVD reduces the risk of death by 36% In order to have the greatest benefit of lowering risk of MU or death, which should replase saturated fat in diet polyunsaturated fat What diet is recommended by AHA/ACC? DASH diet What are the benefits to be gained from a resistance training program for an okder adults with DM? -Increased insulin sensitivity -decreased fat mass -increase in lead body mass Recommended Reps, Sets, and RPE for resistance straining to enhance muscalr strenght and endurance in cardiac patients 10-15 repetitions 1 set RPE 11-13 What are the three components of total energy expenditure? -Thermic effect of food -resting metabolic rate -physical activity What percentage of thermic effect of food is composed of TEE ~10%` What percentage of resting metabolic rate is composed of TEE 60-75% What percentage of physical activity is composed of TEE 15-30% What has the greatest impact on a persons RMR lean body mass (skeletal muscle, organs, bones) What is classified as low carb diet less than 30 grams/day What is classified as high protein diet ~25-30% protein How long does it take for a drug to hit steady state 5-6 half lives to reach steady state What type of plaque is more prone to rupture and predispose to MI softer, less obstructive plaque When is it recommended to repeat lipid profile and why 4-12 weeks after starting statin therapy to assess treatment response Lipoproteins density from least to highest -Chylomicron -VLDL -LDL -HDL Desirable, borderline and high TC ranges Desirable <200 Borderline 200-240 High >240 Optimal, borderling, high and very high TG ranges Optimal <150 Borderline 150-199 High 200-499 Very High >500 Optimal in men and women HDL ranges Men > 40 Women >50 Optimal, near optimal, borderline, high, very high LDL ranges Optimal <100 Near Optimal 100-129 Borderline 130-159 High 160-189 Very high >190 Which lipoprotein caries the majority of cholesterol and is the most atherogenic LDL, 60-70% cholesterol VLDL-C is how much of triglyceride concentration 1/5 Abdominal obesity criteria for men >102 cm / >40in Abdominal obesity criteria for women >88 cm / >35in Hyperglycemia criteria FB ≥ 100 or drug treatment Rosuvastatin 5, 10mg moderate intensity Rosuvstatin 20, 40 mg High intensity Atorvastatin 10, 20 mg Moderate intensity Atorvastatin 40, 80 mg High intensity Simvastatin 10mg Low intensity Simvastatin 20, 40mg Moderate intensity Pravastatin 10, 20mg low intensity pravastatin 40, 80mg moderate intensity Lovastatin 20mg low intensity Lovastatin 40 mg moderate intensity Moderate-High intensity statins Rosuvastatin, Atorvastatin Low-Moderate intensity statins Simvastatin, Pravastatin, Lovastatin, Fluvastatin, Pitavastatin What four clinical groups benefit from statin therapy -Clinical ASCVD -LDL-C ≥190 -Diabetes aged 40-75, LDL-C 70-189 and no clinical ASCVD -Age 45-70, LDL-C 70-189, no DM or clinical ASCVD and 10 year risk for ASCVD ≥7.5% Non-statin therapy -Niacin -Bile acid sequestrates -Ezetemibe -Fibrates -Omega 3 fatty acids Daily saturated fat intake goal 5-6% of total calories Examples of saturated fat oils tropical oils - palm oil, palm kernel oil, coconut oil Examples of monounsaturated fat oils vegetable oils- olive oil, canola oil, peanut oil, sunflower oil, sesame oil examples of polyunsaturated fat oils Vegetable oils- soybean oil, corn oil, safflower oil