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.
Read the first 7 Clinical Exercise Testing flashcards as text
Which criterion best confirms that true VO2max has been achieved during a maximal exercise test?
Answer: VO2 plateaus (<150 mL/min increase) despite increasing workload
A plateau in VO2 (<150 mL/min rise) despite increased workload is the gold-standard criterion for true VO2max, indicating maximal oxygen transport capacity.
Cardiopulmonary exercise testing (CPET) is most valuable for differentiating exercise limitation caused by:
Answer: Cardiac versus pulmonary etiology
CPET simultaneously measures ventilation, gas exchange, and cardiovascular responses, allowing clinicians to distinguish cardiac from pulmonary causes of exertional dyspnea.
During a field-based VO2max estimation using the 1.5-mile run test, which factor most strongly affects result accuracy?
Answer: Subject's pacing strategy
Pacing is critical in time-trial field tests; starting too fast causes early fatigue and underestimates VO2max, while starting too slow produces an overestimate.
A patient on digoxin therapy shows ST-segment depression at rest. During exercise testing, additional ST depression develops. The correct interpretation is:
Answer: Digoxin can cause ST depression at rest and during exercise, making ischemia interpretation unreliable
Digoxin produces ST-segment changes at rest and exaggerates them during exercise, confounding ischemia interpretation and lowering test specificity.
What is the recommended lead configuration for detecting ST-segment changes during a standard clinical exercise test?
Answer: 12-lead ECG system
A full 12-lead ECG provides the greatest sensitivity for detecting regional ischemic ST changes during exercise testing.
Which statement accurately describes the relationship between exercise testing sensitivity and specificity for detecting CAD?
Answer: Increasing the ST depression threshold for a positive test decreases sensitivity but increases specificity
Raising the ST threshold (e.g., from 1 mm to 2 mm) reduces false positives and increases specificity, but misses more true positives, lowering sensitivity.
In a symptom-limited exercise test for a post-MI patient 4 weeks after discharge, which endpoint is most appropriate to use?
Answer: Onset of moderate angina (4/10 on angina scale) or significant ST changes
Post-MI submaximal or symptom-limited tests are stopped at the onset of moderate angina or significant ischemic ECG changes to minimize risk in a recently infarcted myocardium.