ACSM-EP Pathophysiology 3

Question 1

Which pathophysiological change in osteoporosis most directly increases fracture risk during exercise?

Accepted Answer

Increased osteoclast activity reducing bone mineral density below fracture threshold

Answer

Excessive osteoclast resorption relative to osteoblast formation reduces bone mineral density to levels where normal mechanical loads exceed bone strength.

Question 2

A client with rheumatoid arthritis (RA) experiences morning stiffness lasting over one hour. This symptom results from which pathological process?

Accepted Answer

Synovial inflammation and pannus formation causing joint swelling overnight

Answer

RA-related synovitis causes synovial fluid accumulation and pannus formation; prolonged inactivity during sleep allows inflammatory exudate to thicken, causing stiffness that mobilizes with movement.

Question 3

Which pulmonary response to exercise is most abnormal in a patient with pulmonary hypertension?

Accepted Answer

Failure of pulmonary vascular resistance to decrease with increased cardiac output

Answer

Normally, pulmonary vascular resistance falls during exercise as vessels recruit and dilate; in pulmonary hypertension, vascular remodeling prevents this response, increasing right ventricular afterload.

Question 4

In a patient with autonomic neuropathy from long-standing diabetes, what exercise response would the EP expect?

Accepted Answer

Blunted heart rate response and orthostatic hypotension risk

Answer

Autonomic neuropathy damages sympathetic and parasympathetic fibers, impairing heart rate regulation and blood pressure response to positional changes.

Question 5

Which mechanism explains why patients with anemia have reduced exercise capacity?

Accepted Answer

Reduced oxygen-carrying capacity lowering maximal oxygen delivery to muscles

Answer

Hemoglobin concentration directly determines oxygen-carrying capacity; low hemoglobin reduces the amount of O2 delivered per unit of cardiac output, limiting VO2max.

ACSM Practice Test

ACSM Practice Test

ACSM-EP Pathophysiology 3