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29 Jul 2019

Consider the following regarding Lactate Threshold:

Hannah is a 23 yr old female runner, who runs in 5K and 10K races in the Houston Metro Area.

She asks you, "What exactly is Lactate Threshold?" And later, "How can I improve mine?"

How would you describe Lactate Threshold (LT) to Hannah, and how could Hannah improve her LT?

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Sixta KovacekLv2

29 Jul 2019

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Exercise Pharmacology

Chapter 1

1. Distinguish between pharmacokinetics, pharmacodynamics, and pharmacology.

2. How would you determine a drugâs doseâresponse curve?

3. What is meant by drug efï¬cacy? Potency?

4. How would you determine equipotent doses for two drugs of the same class?

5. What features of a drugâs action may make its pharmacokinetic properties more sensitive to exercise?

6. How might a drugâs volume of distribution be altered in the case of a person who is obese? A person who is elderly?

7. How might you explain an antagonist with partial agonist activity?

8. What are some of the ways that taking a second drug can affect the activity of the ï¬rst drugâor either drug?

Chapter 2

1. Bill is 60 years old and in reasonable shape. Working out on an elliptical machine, Bill sees that his heart rate is 135 bpm. Can you determine his ap-proximate exercise intensity without hooking him to a metabolic cart? What is he primarily burning for energy?

2. Your mother asks your advice about starting an exercise program. She is in pretty good health, but wants to drop some weight besides improving her cardiovascular health. What kind of exercise plan would you recommend to get her started? How would you explain to her the beneï¬ts of such a plan? After the initial couple of weeks, would you recommend any changes that might help her with her long-term ï¬tness goals?

3. Compare and contrast the three major muscle ï¬ber types in terms of their metabolism and fuel preference.

4. You are a graduate student working in an exercise physiology lab. You see a claim in a bodybuilding magazine about a supplement that rapidly increases power, strength, and muscle mass. How would you set up an experiment to test whether these claims are true?

5. Obesity is now considered by some to be reaching epidemic proportions. What is contributing to this trend, and what can be done?

Chapter 3

1. Compare and contrast the sympathetic and parasympathetic nervous systems.

2. What is meant by allostatic load, and how does it differ from stressing over a single test?

3. Explain three ways drugs can affect the signals transmitted by nerve cells.

4. How might exercise lessen the effects of stress?

5. Describe some of the theories that attempt to explain the bodyâs paradoxical response to exercise.

6. What are the key physiological changes that occur during the ï¬ght or ï¬ight response? How do they help in survival?

Chapter 4

1. What is meant by âbeta-blockers with ISAâ? What advantages might these drugs have? Disadvantages?

2. What property makes some beta-blockers cardio selective?

3. What are the effects of beta-blockers on exercise physiology?

4. A serious walker (5 miles/day) notices that she has stopped losing weight since starting her new prescription of propranolol (non-cardio selective, without ISA). She also fatigues more quickly than she used to. What can you offer her as an explanation?

5. The NCAA and USOC have banned beta-blockers from many types of com-petition. Why?

Chapter 5

1. Bill, a deconditioned, recently divorced 50-something exec driving that new BMW, wants to drop some weight and look good. He has high blood pressure. What kind of exercise regime would you recommend?

2. Why do calcium channel blockers mostly affect smooth muscle, with little effect on skeletal muscle?

3. How do calcium channel blockers reduce blood pressure?

4. Mary enjoys running and likes to compete in 10K races and half marathons. She also is diagnosed with high blood pressure. What are her options for regulating her blood pressure while maintaining a training schedule and remaining competitive?

5. How do ACE inhibitors affect blood pressure?

6. How do ARBs affect blood pressure?

brownalpaca148

Medical History:
Mrs. KY is a 45 yr old Caucasian female, married with two teenage sons. She is employed as a senior manager at a large bank and reports experiencing an âabove averageâ level of tension and stress. She presents at the referral of her primary care physician, who has observed that the client has elevated blood pressure and cholesterol levels that may be attributed to her stressful and highly sedentary job. In addition, the client admits that she would like to lose 30 to 40 lb (14 to 18 kg) and improve her fitness so that she can ride her bike with her husband on a community rail trail recently installed by her neighborhood.

Diagnosis:
Mrs. KY is a sedentary but otherwise healthy middle-aged female with significant risk factors for cardiovascular disease including obesity, dyslipidemia, and psychosocial stress. At the request of her physician she seeks to start exercising as part of a disease prevention program.

Exercise Test Results:
The client is 5 feet 6 in. tall (168 cm) and weighs 196 lb (89 kg), with a body mass index of 31.7. She has a resting heart rate of 85 beats Â· minâ1 and a resting blood pressure of 136/89 mmHg. Her total cholesterol is 198 mg Â· dlâ1 untreated, and her high-density lipoproteins are 34 mg Â· dlâ1. Her graded treadmill stress test revealed that she has a V.O2max of 20.5 ml Â· kgâ1 Â· minâ1, which is normal for an unfit woman of her age range. Her electrocardiogram was also unremarkable at rest, as well as during and following her test. In addition, she reported smoking from ages 17 to 40. She also complains of occasional joint stiffness in her hands and ankles. The client describes herself as nonathletic and admits to never participating in an organized sport or exercise setting. She is aware of the benefits of exercise but did not feel an incentive to begin a formal program until her doctorâs recommendation. The client jokes that although her workday is highly organized and structured, the rest of her life is chaotic and that it is due only to the support of her husband and kids that anything gets done at home. She laments that her eating habits are atrocious and that she is so tired when she gets home from work that she has only enough energy to make dinner before crashing in front of the television. She presents to you to start a workout program that will help achieve her goals.

Exercise Prescription:
The exercise plan including the traditional componentsâfrequency, intensity, duration, and modality (discussed in detail in later chapters)âmay be tailored to address specific risk factors. The subjectâs medical history, however, clearly indicates that this person had not prioritized exercise participation until she received her doctorâs recommendation. Moreover, she presents with numerous potential barriers to engaging in a physically active lifestyle, as well as behaviors that contribute to her overweight status. The clinician should assist the participant in establishing awareness and developing strategies to address those barriers. Furthermore, the clinician should consider tailoring strategies for motivating the participant toward the adoption of a healthy, physically active lifestyle.

Questions:
1. Applying the transtheoretical model, at what stage of exercise adoption is this client?

2. Based on your response to question 1, what types of interventions are most appropriate for this stage of change and why?

3. If you used the health belief model, what factors would you emphasize to achieve optimal exercise adherence?

4. How would Banduraâs social cognitive theory be relevant to fostering exercise adherence for this client?

Medical Terminology Case Study

Gretchen is a 42 year old female that has a medical history of cardiovascular disease. She has just been admitted due to a suspected stroke. She is suffering from paralysis of her left side and is aspirating food. She seems to be struggling with decisions and this causes concern because she can only respond with âno and âyes.â In addition, her responses are not consistent. This is causing a split between the attending physician, who feels that she has lost the capacity to make decisions, and the patientâs husband and son, who feel that she is still capable of making her own decisions. Furthermore, after looking at her brain, there is obvious dense damage to the cerebral cortex. This leads the staff to believe that recovery, if possible, would be minimal and severe disability will be the result.

Gretchen and her husband never discussed what to do if one of them were in a position to require life-sustaining treatment. He is conflicted because he doesnât believe she would want to live in a disabled state and is unsure of he should ask for a feeding tube for her. Her 4 children are split in the decision. Two of them are completely against it and the other two say that no doing so would âseal her fate.â This makes it even harder for Gretchenâs husband to decided but in the end he asks that they use the tube.

To add to the scenario, the treatment team along with the attending physician do not see placing the feeding tube as a solution. They believe that because patient has minimal alertness and consciousness that the will not improve. They do not see a realistic scenario for recover. Gretchenâs previous hospitalization history also plays a role. Two nurses mention that in these previous stays, Gretchen stated that she would not want to have life sustained through artificial processes, including renal dialysis, tube feeding, and ventilator. The staff views this as Gretchen expressing what her preferences are in a dire situation. The family has now requested an ethics consultation to come to a conclusion.

Using critical thought, research and respond to the question below with a minimum of 3-5 sentences.

1. There is a great deal to consider in this case. First, we should decide on the communication ability of the patient. How should this be done? What should be considered?

2. There is a great deal of discussion over the feeding tube. Are the comments by Gretchen in her previous hospital stay enough to make the decision? What about Gretchenâs husband and 2 children that want the tube put in?

3.What conclusion do you foresee the ethics consultation leading to?