What influences a persons metabolic rate?
Exercise, gender, genetics, age
Which is the macronutrient that provides more than twice as many calories
... [Show More] 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 [Show Less]