ACSM CLINICAL EXERCISE PHYSIOLOGIST 2024-
2025
1 MET = - ANSWER-3.5 ml/kg/mig
1 large box - ANSWER-5mm or 0.2 seconds
1 small box - ANSWER-1mm or 0.04 sec
1 Rep Max (1RM) Procedure - ANSWER-1.) warm up with sub max reps (40-60% RM)
2.) 3-5 reps moderate wt (70-80% RM)
3.) 2 min rest then estimated max attempt
4.) 3-5 min rest attempt with added weight until achieved in 3-5 tries
5.) once attempt failed- attempt weight between last 2
Intraventricular conduction delay - ANSWER-- wide QRS = >0.1
- refers to disturbances in the intraventricular propagation of supraventricular impulses
resulting in changes in the QRS complex either in morphology or duration, or both
- abnormal activation the ventricle cause by conduction delay
Indicators of an old MI - ANSWER-- Abnormal/significant Q waves
- 1 box wide of > 1/3 of R-wave
Absolute Contraindications to Exercise Testing - ANSWER-1. recent change in ECG
2. unstable angina
3. uncontrolled dysrhythmia causing sxs
4. symptomatic severe AS
5. uncontrolled HF w/ sxs
6. acute PE or pulmonary infarct
7. acute myocarditis/pericarditis
8. suspected / known dissecting aneurysm
9. acute systemic infection
***Risk of testing outweigh the benefits***
Absolute indications to Terminate Exercise Testing - ANSWER-1. Drop in SBP > 10
mmHg w/ increased workload
2. Moderately severe angina
3. Increase in Dizziness
4. signs of poor perfusion
5. technical difficulties
6. Sustained V-TAch
7. ST elevation (+1mm) in leads w/o Q waves
,Blood Glucose Management with exercise - ANSWER-- Requires balance between
hepatic glucose production, peripheral glucose uptake, combined with effective insulin
response
- Continuous monitoring
- Regular PA
Dangers of BS of 250-300 mg/dl - ANSWER-- Urinary Ketones form as a result of
ineffective fat metabolism that contribute to diabetic ketoacidosis
Ideal blood glucose post Exercise - ANSWER-> 80 mg/dl
Ideal Blood Glucose before exercise - ANSWER-> 100 mg/dl
Normal BP response to Exercise - ANSWER-- Progressive increase in SBP with
workload until plateau in peak exercise
- No change or slight decrease in SP
Bi-ventricular pacemaker - ANSWER-Deliver innovative therapy- cardiac
resynchronization
Used for CHF to decrease symptoms and increase function
Benefits of PA as motivation - ANSWER-- decrease mortality
- decrease risk of metabolic disease
- weight control
- decrease depression and anxiety
- increase body image and self -esteem/ efficacy
- increase ability to do ADL's
Bradychardia - ANSWER-HR < 50 BPM
Bundle Branch Block - ANSWER-- Wide QRS
- usually result from disease in BB's or Ventricular abnormalities, drug use, or electrolyte
imbalance
Chronotropic Incompetence - ANSWER-- HR fails to increase with increased workload
- achieving <85 % age predicted max HR
- achieving <62% of age predicted max HR on beta blockers
- Predictive of CAD and increased risk of mortality
EKG Changes from metabolic diseases - ANSWER-- Hypothyroidism: Decreased sinus
rate
- Hyperthyroidsm: Increased sinus rate
- Obesity: Increased resting HR, BP; Increased PR, QRS, and QT intervals
- Hypothermia: J-point deflection
,EKG lead placement: V1 and V2 - ANSWER-Right and Left Sternal border at the 4th
intercostal space
EKG lead placement: V3 - ANSWER-Midpoint between V2 and V4
EKG Lead placement: V4 - ANSWER-Mid-clavicular line at 5th intercostal space
EKG lead placement: V5 - ANSWER-Anterior axillary line
EKG lead placement: V6 - ANSWER-Mid-axillary line, horizontal to V4 and V5
Effect of Exercise on dyslipidemia - ANSWER-- decrease triglycerides, LDL, total
cholesterol
- increase HDL
- can cause angina or claudication
- increase lipoprotein enzyme activity
- increase volume rather then intensity for best results
Effect of exercise on obesity - ANSWER-- long term exercise needed for weight
management
- decrease abdominal fat, decrease risk of disease associated with visceral body fat
distribution
Effect of exercise on PAD - ANSWER-- exercise can cause better redistribution of blood
flow and improved endothelial function
- claudication pain with exercise, relieved with rest
Effect of regular aerobic activity on SV - ANSWER-- increased SV at rest
- lower resting HR, prolonged diastole, increased end diastolic volume, increased SV
Effect of exercise on hypertension - ANSWER-- decrease BP for up to 22 hours post
exercise for those with normal BP
- decrease BP 10-12 mmHg for up to 1-2 hours post exercise for those with
hypertension
Bronchitis - ANSWER-**Inflammation of main air passages to lungs.**
- Acute bronchitis is a cough that can last several days or weeks.
- Chronic bronchitis is a type of COPD, characterized by presence of productive cough
that lasts >3 months per year for at least 2 years.
Approx anaerobic threshold at what % VO2 max in healthy untrained individual -
ANSWER-55%
light intensity activity - ANSWER-<3 METs
moderate intensity activity - ANSWER-3-6 METs
, vigorous intensity activity - ANSWER->6 METs
BMI (body mass index) - ANSWER-a person's weight in kilograms divided by the square
of height in meters
Underweight BMI - ANSWER-<18.5
Normal BMI - ANSWER-18.5-24.9
Overweight BMI - ANSWER-25-29.9
Obese 1 BMI - ANSWER-30-34.9
Obese 2 BMI - ANSWER-35-39.9
Obese 3 BMI - ANSWER->40
Waist-to-hip ratio (WHR): High Risk - ANSWER-- Young Men: > 0.95
- Young Women: > 0.86
- Men (60-69): >1.03
- Women (60-69): 0.9
Fat Free Mass Calculation - ANSWER-Weight (Kg) - Fat mass
Fat Mass Calculation - ANSWER-Weight x BF% = Fat mass
Target Body Weight Formula - ANSWER-Current FFM /(1 - Desired % BF)
METS to VO2 Conversion - ANSWER-METs x 3.5
ml/min to L/min - ANSWER-ml/min ÷ 1,000
L/min to Kcals - ANSWER-L/min x 5
Kcals per pound of fat - ANSWER-3,500 kcals per pound
VO2 reserve formula - ANSWER-([Vo2 max - rest] x intensity) + Vo2 rest
VO2 reserve - ANSWER-100 x (max workload - 1) ÷ (Max functional capacity)
HR Reserve - ANSWER-Target HR = ([HR max - rest] x intensity%) + HR rest
Benefits of Regular PA - CV and Respiratory Function - ANSWER-- increased max O2
uptake from both central an peripheral adaptations
2025
1 MET = - ANSWER-3.5 ml/kg/mig
1 large box - ANSWER-5mm or 0.2 seconds
1 small box - ANSWER-1mm or 0.04 sec
1 Rep Max (1RM) Procedure - ANSWER-1.) warm up with sub max reps (40-60% RM)
2.) 3-5 reps moderate wt (70-80% RM)
3.) 2 min rest then estimated max attempt
4.) 3-5 min rest attempt with added weight until achieved in 3-5 tries
5.) once attempt failed- attempt weight between last 2
Intraventricular conduction delay - ANSWER-- wide QRS = >0.1
- refers to disturbances in the intraventricular propagation of supraventricular impulses
resulting in changes in the QRS complex either in morphology or duration, or both
- abnormal activation the ventricle cause by conduction delay
Indicators of an old MI - ANSWER-- Abnormal/significant Q waves
- 1 box wide of > 1/3 of R-wave
Absolute Contraindications to Exercise Testing - ANSWER-1. recent change in ECG
2. unstable angina
3. uncontrolled dysrhythmia causing sxs
4. symptomatic severe AS
5. uncontrolled HF w/ sxs
6. acute PE or pulmonary infarct
7. acute myocarditis/pericarditis
8. suspected / known dissecting aneurysm
9. acute systemic infection
***Risk of testing outweigh the benefits***
Absolute indications to Terminate Exercise Testing - ANSWER-1. Drop in SBP > 10
mmHg w/ increased workload
2. Moderately severe angina
3. Increase in Dizziness
4. signs of poor perfusion
5. technical difficulties
6. Sustained V-TAch
7. ST elevation (+1mm) in leads w/o Q waves
,Blood Glucose Management with exercise - ANSWER-- Requires balance between
hepatic glucose production, peripheral glucose uptake, combined with effective insulin
response
- Continuous monitoring
- Regular PA
Dangers of BS of 250-300 mg/dl - ANSWER-- Urinary Ketones form as a result of
ineffective fat metabolism that contribute to diabetic ketoacidosis
Ideal blood glucose post Exercise - ANSWER-> 80 mg/dl
Ideal Blood Glucose before exercise - ANSWER-> 100 mg/dl
Normal BP response to Exercise - ANSWER-- Progressive increase in SBP with
workload until plateau in peak exercise
- No change or slight decrease in SP
Bi-ventricular pacemaker - ANSWER-Deliver innovative therapy- cardiac
resynchronization
Used for CHF to decrease symptoms and increase function
Benefits of PA as motivation - ANSWER-- decrease mortality
- decrease risk of metabolic disease
- weight control
- decrease depression and anxiety
- increase body image and self -esteem/ efficacy
- increase ability to do ADL's
Bradychardia - ANSWER-HR < 50 BPM
Bundle Branch Block - ANSWER-- Wide QRS
- usually result from disease in BB's or Ventricular abnormalities, drug use, or electrolyte
imbalance
Chronotropic Incompetence - ANSWER-- HR fails to increase with increased workload
- achieving <85 % age predicted max HR
- achieving <62% of age predicted max HR on beta blockers
- Predictive of CAD and increased risk of mortality
EKG Changes from metabolic diseases - ANSWER-- Hypothyroidism: Decreased sinus
rate
- Hyperthyroidsm: Increased sinus rate
- Obesity: Increased resting HR, BP; Increased PR, QRS, and QT intervals
- Hypothermia: J-point deflection
,EKG lead placement: V1 and V2 - ANSWER-Right and Left Sternal border at the 4th
intercostal space
EKG lead placement: V3 - ANSWER-Midpoint between V2 and V4
EKG Lead placement: V4 - ANSWER-Mid-clavicular line at 5th intercostal space
EKG lead placement: V5 - ANSWER-Anterior axillary line
EKG lead placement: V6 - ANSWER-Mid-axillary line, horizontal to V4 and V5
Effect of Exercise on dyslipidemia - ANSWER-- decrease triglycerides, LDL, total
cholesterol
- increase HDL
- can cause angina or claudication
- increase lipoprotein enzyme activity
- increase volume rather then intensity for best results
Effect of exercise on obesity - ANSWER-- long term exercise needed for weight
management
- decrease abdominal fat, decrease risk of disease associated with visceral body fat
distribution
Effect of exercise on PAD - ANSWER-- exercise can cause better redistribution of blood
flow and improved endothelial function
- claudication pain with exercise, relieved with rest
Effect of regular aerobic activity on SV - ANSWER-- increased SV at rest
- lower resting HR, prolonged diastole, increased end diastolic volume, increased SV
Effect of exercise on hypertension - ANSWER-- decrease BP for up to 22 hours post
exercise for those with normal BP
- decrease BP 10-12 mmHg for up to 1-2 hours post exercise for those with
hypertension
Bronchitis - ANSWER-**Inflammation of main air passages to lungs.**
- Acute bronchitis is a cough that can last several days or weeks.
- Chronic bronchitis is a type of COPD, characterized by presence of productive cough
that lasts >3 months per year for at least 2 years.
Approx anaerobic threshold at what % VO2 max in healthy untrained individual -
ANSWER-55%
light intensity activity - ANSWER-<3 METs
moderate intensity activity - ANSWER-3-6 METs
, vigorous intensity activity - ANSWER->6 METs
BMI (body mass index) - ANSWER-a person's weight in kilograms divided by the square
of height in meters
Underweight BMI - ANSWER-<18.5
Normal BMI - ANSWER-18.5-24.9
Overweight BMI - ANSWER-25-29.9
Obese 1 BMI - ANSWER-30-34.9
Obese 2 BMI - ANSWER-35-39.9
Obese 3 BMI - ANSWER->40
Waist-to-hip ratio (WHR): High Risk - ANSWER-- Young Men: > 0.95
- Young Women: > 0.86
- Men (60-69): >1.03
- Women (60-69): 0.9
Fat Free Mass Calculation - ANSWER-Weight (Kg) - Fat mass
Fat Mass Calculation - ANSWER-Weight x BF% = Fat mass
Target Body Weight Formula - ANSWER-Current FFM /(1 - Desired % BF)
METS to VO2 Conversion - ANSWER-METs x 3.5
ml/min to L/min - ANSWER-ml/min ÷ 1,000
L/min to Kcals - ANSWER-L/min x 5
Kcals per pound of fat - ANSWER-3,500 kcals per pound
VO2 reserve formula - ANSWER-([Vo2 max - rest] x intensity) + Vo2 rest
VO2 reserve - ANSWER-100 x (max workload - 1) ÷ (Max functional capacity)
HR Reserve - ANSWER-Target HR = ([HR max - rest] x intensity%) + HR rest
Benefits of Regular PA - CV and Respiratory Function - ANSWER-- increased max O2
uptake from both central an peripheral adaptations
