5.5 - PEAT Exam 1 (Section 5)

Question 1

Should NMES be used for patients w/ myasthenia gravis?

Answer 1

No

MG is characterized by a failure of neural transmission at the neuromuscular junction. Thus, NMES would be ineffective

Question 2

Describe a myasthenia crisis

Answer 2

A life-threatening complication of myasthenia gravis that occurs when the muscles that control breathing become too weak to function

Question 3

Describe the clinical presentation of herpes zoster

Answer 3

“Shingles”
Pain & paresthesia followed by a unilateral rash along the affected dermatome

Rash, NOT scales
- Rash includes vesicular eruptions

Question 4

When should PT be scheduled for a patient w/ Parkinson disease?

Answer 4

1 hour after antiparkinsonian medications are given
- Assists in avoiding effects of end-of-dose akinesia

Question 5

Describe IFSP vs IEP

Answer 5

IFSP - Individualized Family Service Plan
- Used for children 36 months of age or younger (3 yo)

IEP - Individualized Education Plan
- Used for children older than 36 months (3 yo)

Question 6

According to IDEA regulations, where should services by providing?

Answer 6

In the child’s natural environment
- Ex: home

Question 7

What should be the primary emphasis during the first weak of treatment of a stage 3 pressure injury?

Answer 7

Removal of necrotic tissue!
- To prevent spread of infection and facilitate wound healing

Managing wound exudate would be secondary goal following this

Question 8

What are the components of complete decongestive therapy (CDT) for patients w/ lymphedema?

Answer 8

Manual lymphatic drainage
Compression therapy
Decongestive exercises

Question 9

Should BP ever be measured in an arm w/ lymphedema?

Answer 9

NO

Question 10

Should BP ever be monitored in an arm w/ an arteriovenous shunt?

Answer 10

NO

Question 11

If both arms are inappropriate for measuring BP, what is the next location to assess BP?

Answer 11

Thigh - auscultation at the popliteal artery

Alternatives LE sites - proximal to the popliteal artery; posterior tibial artery w/ auscultation proximal to the ankle

Can NOT assess BP at the femoral triangle because this is too high for placement of a BP cuff

Question 12

Describe sacral nutation vs counternutation

Answer 12

Nutation = anterior rotation (superior aspect of sacrum rotates anteriorly)

Counternutation = posterior rotation (superior aspect of sacrum rotates posteriorly)

Question 13

If an 18 yo patient is accompanied by his parents, who should sign the informed consent form?

Answer 13

The patient should, as he is not a minor

Question 14

Describe the function of the ductus deferens (vas deferns)

Answer 14

A tube that transports sperm from the epididymis to the urethra

Question 15

A patient w/ a recent prostatectomy has urinary incontinence. Loss of support to which structure is MOST likely contributing to the incontinence?

Answer 15

Urethra

Prostatectomy –> removal of the prostate gland
- Prostate gland provides mechanical support to the urethra between the bladder neck & the penis

Question 16

Describe the kinematics of the knee during heel off (terminal stance)

Answer 16

Knee extension at 0 deg

Question 17

For a patient w/ a lesion proximal to the dorsal root ganglion, a sensory nerve conduction velocity test will reveal that conduction times are…

Why?

Answer 17

within normal limits

• Sensory never conduction test only measures the distal component of a peripheral nerve
• This technique would not detect abnormalities in a lesion proximal to the dorsal root ganglion

Question 18

What muscles are affected first from corticosteroid-induced catabolism?

Answer 18

Proximal muscles of the LE & UE

Difficulty climbing stairs is often reported first

Distal musculature (ex: hand movements) are typically spared until the late stages of the steroid-induced myopathy

Question 19

Reiter Syndrome

What is it?

Answer 19

Reiter Syndrome - “Reactive Arthritis”

A form of reactive arthritis that can follow an infection

Infections that most often cause the disease are spread through sexual contact –> infections of the bladder, urethra, penis, or vagina

Clinical Presentation:
- Urethritis –> burning sensation during urination; discharge from penis; polyuria
- Conjunctivitis
- Arthritis

Question 20

Ankylosing Spondylitis

What is it?
Clinical Presentation

Answer 20

(Axial Spondyloarthritis)

An inflammatory disease that causes the vertebrae to fuse over time

Clinical Presentation
- Pain, stiffness, and loss of motion in the back
- Insidious onset of back pain in SI joints & gluteal regions –> progresses to involve entire spine
- Morning stiffness lasting >30 min

“Bamboo spine”

Question 21

Bipartite patella

What is it?
Clinical presentaiton

Answer 21

A congenital condition that occurs when the patella is made of two bones instead of a single bone
- Failure of the patella to fuse

Clinical Presentation:
- Often asymptomatic
- Typically occurs in CHILDHOOD
- Typically BIL
- Pain & tenderness at the distal pole of the patella

Question 22

What is a normal ejection fraction?

Answer 22

55-75%

“2/3rd”

Question 23

ST segment depression during activity is considered diagnostic of what?

Answer 23

Myocardial ischemia

Question 24

Describe how to ascend stairs with a SPC

Answer 24

Strong leg up first, followed by the cane and weaker LE