Review Questions

DIRECTIONS: Each of the numbered items or incomplete statements in this section is followed by answers or by completions of the statement. Select the ONE lettered answer or completion that is BEST in each case.

1. In an effort to strengthen selected muscles after surgery and immobilization has led to muscle atrophy, isometric exercise is recommended. The intensity of isometric exercise is best quantified

(A) Relative to the maximal oxygen uptake

(B) As mild, moderate, or strenuous

(C) As percentage of the maximum voluntary contraction

(D) In terms of anaerobic metabolism

(E) On the basis of the total muscle mass involved

2. Two people, one highly trained and one not, each exercising at 75% of the maximal oxygen uptake, become fatigued

(A) For similar physiological reasons

(B) Very slowly

(C) At different times

(D) While performing equally well for at least a short period of time

(E) Despite much higher circulating lactic acid levels in the trained person

3. A patient completes a graded, dynamic exercise test on a treadmill while showing a modest rise (25%) in mean arterial blood pressure. In contrast, during the highest level of exercise at the end of the test, an indirect method shows that cardiac output has risen 300% from rest. These results indicate that during graded, dynamic exercise to exhaustion, systemic vascular resistance

(A) Is constant

(B) Rises slightly

(C) Falls only if work is prolonged

(D) Falls dramatically

(E) Cannot be measured

4. A patient with inflammatory bowel disease and compromised kidney function asks if exercise will alter blood flow to either the gastrointestinal tract or to the kidneys. The answer is that vasoconstriction in both the renal and splanchnic vascular beds during exercise

(A) Rarely occurs

(B) Occurs only after prolonged training

(C) Helps maintain arterial blood pressure

(D) Allows renal and splanchnic flows to parallel cerebral blood flow

(E) Will be balanced by local dilation in these vascular beds

5. A young, healthy, highly trained individual enters a marathon (40 km) run on a warm, humid day (32°C, 70% humidity). The best medical advice for this individual is to be concerned about the possibility for

(A) Heat exhaustion

(B) Coronary ischemia

(C) Renal ischemia and anoxia

(D) Hypertension

(E) Gastric mucosal ischemia and increased risk for gastric ulceration

6. An individual with hypertension has been advised to increase physical activity. At the same time, this person has been counseled to avoid activities that substantially increase the systemic arterial blood pressure. In terms of dynamic exercise, this individual should avoid exercise that

(A) Causes fatigue

(B) Is prolonged

(C) Uses untrained muscle groups

(D) Is substituted for isometric exercise

(E) Involves an intermediate muscle mass

7. In a patient with heart disease, a treadmill test involving graded dynamic exercise results in falling blood pressure at each exercise level. Eventually, faintness and dizziness cause termination of the test. These results arise from inadequate cardiac output during exercise because the baroreceptors, during exercise,

(A) Reset blood pressure to a lower level

(B) Are "turned off"

(C) Are increased in sensitivity by training

(D) Are decreased in sensitivity by training

(E) Reset blood pressure to a higher level

8. A man with a family history of heart disease has both diabetes and hypertension. His total serum cholesterol is 270 mg/dL. In addition, his LDL cholesterol is elevated and his HDL cholesterol is reduced, compared with individuals with low cardiovascular disease risk. When exercise and diet are recommended, this individual asks what effect a long-term exercise program will have on the blood lipid profile. The answer is that exercise, over time, will

(A) Have no independent effect on blood cholesterol levels

(B) Elevate both HDL and LDL

(C) Lower HDL and LDL, thereby lowering total cholesterol

(D) Reduce risk of myocardial infarction despite elevated total cholesterol levels

(E) Elevate HDL and lower LDL

9. A healthy individual, aged 60, completes a 500 m freestyle swim at an age-group competition. Breathing hard after the race, she explains that her increased ventilation is a normal response to heavy, dynamic exercise. Her increased ventilation results in

(A) Clinically significant systemic arterial hypoxemia

(B) Normal or reduced arterial PCO2

(C) Respiratory alkalosis

(D) Respiratory acidosis

(E) Dizziness and decreased cerebral blood flow

10.A 33-year-old woman embarks on an extensive program of daily exercise, with both strenuous dynamic and isometric exercise included. After two years, her maximal voluntary contraction of many major muscle groups and her maximal oxygen uptake, are both increased 30%. Predictably, pulmonary function tests show

(A) A 30% rise in vital capacity

(B) No effect on lung elasticity, inspiratory or expiratory flow rates, or vital capacity

(C) An increase in resting pulmonary diffusing capacity of 30 to 50%

(D) A 25% increase in maximal forced expiratory flow rate

(E) Decreases in residual volume and airways resistance at rest

11. In older adults at risk for falls, osteoporosis, and fractures, a program of weight-bearing exercise

(A) Increases the risk of hip fracture

(B) Decreases bone mineral density

(C) Leaves gait, coordination, proprioception, and reaction time unaltered

(D) Reduces the risk of osteoporosis, falls, and fractures

(E) Is less valuable than dynamic exercise during water immersion

12.A 57-year-old woman, told that she is at risk for osteoporosis, starts an exercise class that emphasizes weight-bearing activities and development of muscle strength. She develops extensive muscle soreness after the first two sessions, indicating that the exercise that she performed

(A) Involved isometric contractions

(B) Produced muscle ischemia

(C) Was actually most effective for increasing muscle endurance

(D) Involved eccentric contractions

(E) Required at least 50% of the maximum voluntary contractile force

13.A high-school football player injures a knee early in the season. The knee requires immobilization for six weeks, after which time the athlete undergoes rehabilitation before joining the team. Immediately after rehabilitation begins, the individual notices that the flexors and extensors of the knee are much weaker than before the injury because during contraction at a fixed force

(A) Fewer motor units are involved

(B) There is a relative excess of contractile protein

(C) Muscle cells are small, so more cells are required to perform the same work

(D) Oxidative energy-producing systems are up-regulated

(E) Eccentric work is less, while concentric work is increased

14.A tenth-grade distance runner finishes in the top five of her statewide high school cross-country championships. Encouraged, she redoubles her training intensity, only to find that her menstrual periods cease for nearly a year. After finally visiting her doctor, her serum estrogen levels are found to be well below normal. In addition, it is predictable that this young woman will be found to have

(A) Dynamic exercise endurance less than an untrained person

(B) Weak leg muscles

(C) Normal body weight

(D) No risk for fractures as a result of her young age

(E) Low trabecular bone mass

15.A man with recently diagnosed type 2 diabetes asks for advice about exercise.

His specific concern is the impact that an acute episode of exercise will have on his blood glucose levels and insulin requirements. He is correctly informed that during exercise, an important factor to consider is that

(A) Muscle glucose uptake decreases in patients with either type 1 or type 2 diabetes

(B) The pancreas will release increased amounts of both insulin and glucagon

(C) Muscle glucose uptake will increase only if endogenous or exogenous insulin levels rise

(D) Muscle glucose transporters will be translocated to the plasma membrane, increasing insulin-dependent and insulin-independent glucose uptake

(E) Insulin-independent glucose uptake is reduced in active muscles

16.A highly active woman is pregnant for the first time. She asks what benefits might ensue from continued physical activity during pregnancy. Which of the following is a predictable effect of chronic, dynamic exercise during pregnancy?

(A) Increased average gestational length

(B) Increased fetal weight at term

(C) Decreased risk of maternal gestational diabetes

(D) Increased risk of spontaneous abortion during the first trimester

(E) Decreased neonatal responsiveness scores

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