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Clinical Exercise Testing Flashcards

7 cards from real ACSM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which patient population most benefits from a ramp protocol during graded exercise testing compared to traditional staged protocols?

    Answer: Deconditioned patients with cardiovascular disease

    Ramp protocols allow continuous, gradual workload increases that can be individually tailored, making them ideal for deconditioned or cardiac patients who may not tolerate large stage jumps.

  2. During an exercise test, the patient develops new-onset left bundle branch block (LBBB). The appropriate action is to:

    Answer: Terminate the test immediately

    New exercise-induced LBBB is an absolute indication to stop the test because it can mask ischemic ST changes and may indicate serious conduction system disease.

  3. Oxygen pulse during a maximal GXT is defined as:

    Answer: VO2 divided by heart rate

    Oxygen pulse = VO2 / HR, and it is an indirect estimate of stroke volume × oxygen extraction per beat.

  4. A 55-year-old man has a resting ECG showing left ventricular hypertrophy with repolarization changes. How does this affect ST-segment interpretation during exercise?

    Answer: Baseline repolarization abnormalities make exercise ST changes uninterpretable for ischemia

    Pre-existing repolarization abnormalities (including LVH strain pattern) invalidate ST-segment analysis for ischemia detection during exercise ECG testing.

  5. Which gas exchange variable is used to determine the ventilatory equivalent for CO2 (VE/VCO2) and why is it clinically significant?

    Answer: It reflects ventilatory efficiency and is elevated in heart failure and pulmonary hypertension

    VE/VCO2 slope reflects ventilatory efficiency; values >34 are prognostically significant in heart failure and pulmonary arterial hypertension.

  6. When using the Fick principle to calculate cardiac output during exercise, which four variables are required?

    Answer: VO2, stroke volume, heart rate, and arteriovenous O2 difference

    The Fick equation is Q = VO2 / (CaO2 − CvO2), requiring VO2, stroke volume, HR (to get Q), and the arteriovenous oxygen difference.

  7. A patient with known coronary artery disease is on beta-blockers. How should the exercise physiologist adjust test interpretation?

    Answer: Use perceived exertion rather than heart rate to gauge intensity

    Beta-blockers blunt the heart rate response, making age-predicted HRmax unreliable; RPE and METs are used instead to assess effort and guide exercise intensity.