CPRs

Question 1

Anterior Shoulder Instability (D)

Answer 1

apprehension
relocation
anterior drawer

Question 2

AS

Answer 2

Berlin (V)
- AM stiffness > 30 min, alt butt pain, LBP better with exercise, awakening 2nd half of night

IBP (V)
- > 40, insidious, improves with exercise (not with rest), pain at night (improves with getting up)

Question 3

Canadian Cervical Spine Rules (V)

Answer 3

High
- > 65, paresthesia in extremities, dangerous MOI (fall > 1m/5 stairs, axial load to load, high speed MVA, motorized recreational vehicle, bike collision)

Low
- simple rear-end MVA, normal sitting posture in ED, ambulatory, delayed onset of pain, midline tender absent

able to rot > 45 B
high or low with inability to rotate = radiographs

Question 4

CTS (D)

Answer 4

shaking hands with symptom relief
wrist ratio index > .67
> 45
reduced median sensory field of digit 1
symptom severity scale > 1.9

Question 5

Cervical Myelopathy (D)

Answer 5

gait deviation
> 45
(+) Hoffman, inverted supinator sign, Babinski

Question 6

Cervical Radiculopathy (D)

Answer 6

(+) ULTT A, distraction, Spurling’s

involved cervical rotation < 60

Question 7

Closed Cervical Fx (D)

Answer 7

< 55, single, acute

condition involved trauma, ER visit

Question 8

DVT

Answer 8

> 3 high, 1-2 mod, 0 low

• active cancer (within 6 mo)
• paralysis, paresis, recent plaster immob of LE
• bedridden 3+ days or major surgery within 12 wks
• local tender along deep venous system
• entire leg swollen
• calf swelling > 3 cm than symptomatic side (10 cm below tib tube)
• pitting edema confined to symptomatic leg
• collateral superficial vein (nonvaricose)
• previous documented DVT
• alt dx just as likely as DVT (-2)

Question 9

Hip OA (D)

Answer 9

squatting aggravates
active hip flex (lat pain)
painful ext
(+) Scour for groin or lat pain
passive IR < 25

Question 10

Lumbar Spinal Stenosis (D)

Answer 10

> 48
B
leg pain > back pain
pain during walk/stand, relief with sit

Question 11

MCL (D)

Answer 11

trauma by external force to leg
rotational trauma
pain and/or laxity with valgus stress at 30

Question 12

Meniscal (D)

Answer 12

history of catching or locking
jt line tender
pain with forced hyperext (modified bounce home test), max passive flex
pain/click with McMurray

Question 13

Ottawa Ankle Rules

Answer 13

pain in malleolar or midfoot AND

• 4 steps OR
• bone tender at post edge of tib/fib/tip of med/lat mall
• bone tender at nav or prox base of 5th MT

Question 14

Ottawa Knee Rules (V)

Answer 14

> 55
tender - fib head, isolated at pat during palpation
can’t flex > 90
4 steps

Question 15

Pittsburgh Knee Rules (V)

Answer 15

blunt trauma or fall as MOI AND either

> 50 or < 12
4 steps

Question 16

PE (V)

Answer 16

high > 10, med 4-10, low < 4

1 pt > 65
2 pt - surgery/fx within 1 mo, active malignant condition, haemoptysis
3 pt - previous DVT/PE, uni lower limb pain, HR 74-94 bpm
4 pt - pain on deep palpation of lower limb and uni edema
5 pt - HR 95+ bpm

Question 17

RTC Pathology (D)

Answer 17

test cluster - painful arc, drop arm, infra MMT

> 65, wear ER, night pain

Question 18

SIJ Pain (V)

Answer 18

SI distraction/compression, thigh thrust, Gaenslen’s

sacral thrust OR Patrick’s (FABER)

Question 19

SAI (D)

Answer 19

test cluster - HK, painful arc, infra MMT

Question 20

Vertebral Compression Fx (D)

Answer 20

A - < 52, BMI > 22, female, no presence of leg pain, does not exercise regularly

B - female, > 70, significant trauma (major in young, minor in elderly), prolonged use of corticosteroids

Question 21

Cervical Manip for Neck Pain (D)

Answer 21

A - symptoms < 38, positive expectations, rotational difference > 10 deg, pain with PA spring test of middle cervical spine

B - NDI < 11.5, not performing sedentary work > 5 hr/day, not worse with ext, B, feelx better with neck movement, dx of spondy w/o radic

Question 22

CT Manip for Shoulder Pain (I)

Answer 22

pain free flex < 127
(-) Neer
symptoms < 90 days
IR < 53 at 90 deg abd
not taking meds for pain

Question 23

Exercise for AS

Answer 23

SF-36 physical role > 37, bodily pain > 27

bath AS disease activity index > 31

Question 24

Hip Mob for Knee OA (D)

Answer 24

hip or groin pain for paresthesia
pain knee flex < 112, hip IR < 17
ant thigh pain
pain with hip distraction

Question 25

Manip (lumbopelvic) for PFPS (I)

Answer 25

hip IR diff > 14 deg
DF with knee flex > 16 deg
squatting most painful
nav drop > 3 mm
no stiff with sitting 30 min

Question 26

Manip LBP (I)

Answer 26

symptoms < 16 days
lumbar hypomobility
no symptoms distal to knee
hip IR > 35 deg
FABQ < 19

Question 27

Manual/Exercise for Acute Lateral Ankle Sprain (D)

Answer 27

symptoms worse when standing, in evening
nav drop > 5 mm
distal tibfib hypomobility

Question 28

Mechanical Traction LBP (D)

Answer 28

FABQ < 21
no neurological deficit
> 30
non manual work job status

Question 29

Manual Traction Neck (D)

Answer 29

> 55
peripheralization with lower cervical spine (C4-C7) mobility testing
(+) shoulder abd, ULTT A, neck distraction

Question 30

MVM Lateral Epi (D)

Answer 30

< 49
change in pain >25% after MVM
affected painfree grip > 112 N (25.5 lbs)
unaffected < 335 N (75.3 lbs)

Question 31

Orthotics (foot) for PFPS (D)

Answer 31

A - > 25, height < 165 cm, worst pain < 53.25 mm (100 mm VAS), mid foot width difference > 10.96 m

B - motion control properties (weighted mean) > 5, usual pain > 22 mm, ankle DF (knee flex) > 41.3 deg, reduced pain during SLS with foot orthoses

Question 32

Patellar Taping (D)

Answer 32

tib angulation > 5 deg

(+) patellar tilt

Question 33

Stabilization for LBP (I)

Answer 33

stabilization
- < 40, ASLR > 91, aberrant movement present, (+) PITT

modified
- aberrant movement present, (+) PITT

Question 34

Thoracic Manip for Neck Pain (I)

Answer 34

symptoms < 30 days
no symptoms distal to shoulder
diminished upper thoracic kyphosis
FABQ < 12
looking up not aggravating
cervical ext < 30 deg