Exam C

Question 1

limits on HR post MI, acute

Answer 1

70% HR max

Question 2

things measured by APGAR

Answer 2

HR, respiration, muscle tone, reflex irritability, color

Question 3

compensatory postures for fixed forefoot varus

Answer 3

excessive subtalar pronation, plantarflexed first ray, hallux valgus, excessive tibial, femoral, and/or pelvic internal rotation, contralateral lumbar spine rotation

Question 4

nail changes with psoriasis

Answer 4

small pits, circumscribed yellowish tan discoloration

Question 5

causes of nail clubbing

Answer 5

chronic hypoxia from heart disease/lung cancer, hepatic cirrhosis

Question 6

Signs/sxs of Addison’s disease (adrenal insufficiency)

Answer 6

bronze skin, weakness, anorexia, dehydration, weight loss, GI distrubances, anxiety, depression, decreased cold tolerance, stress intolerance

Question 7

signs/sxs of Cushing’s syndrome (excessive cortisol)

Answer 7

dec glucose tolerance, moon face, obesity (fat pads on chest and abdomen, buffalo hump), dec sex hormones, muscular atrophy, edema, hypokalemia, emotional changes

Question 8

signs/sxs of hypothyroidism (ex. Hashimoto’s)

Answer 8

metabolic processes are slowed

weight gain, mental and physical lethargy, dry skin and hair, low blood pressure, constipation, cold intolerance, goiter

can result in exercise intolerance, weakness, apathy, exercise induced myalgia, reduced cardiac output

Question 9

signs/sxs of hyperthyroidism (ex. Graves)

Answer 9

metabolic processes are increased

nervousness, hyperreflexia, tremor, hunger, weight loss, fatigue, heat intolerance, palpitations, tachycardia, diarrhea

can result in exercise intolerance, fatigue because of hypermetabolic state

Question 10

asthenia

Answer 10

abnormal weakness or loss of energy

Question 11

nursemaid’s elbow

Answer 11

inferior subluxation of radial head from annular ligament

Question 12

early sign of cystic fibrosis

Answer 12

inability to gain weight, excessive appetite

Question 13

excoriation

Answer 13

abrasion or scratch mark

Question 14

initial exercise prescription for asymptomatic individuals

Answer 14

60-90% HRmax, 50-85% VO2 max, interval training

Question 15

hip hiking compensation for _____

Answer 15

weak hip and knee flexors

Question 16

wound irrigation benefits

Answer 16

decrease colonization and prevent infection

Question 17

signs/sxs of Guillan Barre

Answer 17

rapidly progressive symmetrical weakness, distal to proximal, abnormal sensations of tingling and burning

can have UMN and LMN symptoms

Question 18

Valsalva effects

Answer 18

increased intrathoracic pressure, slowing pulse, decreased venous return, increased venous pressure

on relaxation, blood rushes to heart, can overload cardiac system resulting in cardiac arrest

Question 19

normal Functional Reach score

Answer 19

> 10 inches

Question 20

Tinetti (POMA) score

Answer 20

out of 28

<19 high risk for falls

Question 21

TUG scores (3 meter)

Answer 21

> 30 sec indicate increased fall risk

Question 22

criteria for reducing exercise intensity

Answer 22

• onset of angina or other exertional intolerance
• systolic BP >240
• diastolic BP >110
• > 1mm ST depression, horizontal or downsloping
• increased frequency of ventricular arrythmias
• 2nd or 3rd degree heart block
• other significant ECG disturbances

Question 23

standard wheelchair seat height

Answer 23

20 inches

Question 24

expected effects of atropine

Answer 24

blocks action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and CNS

produced increased HR and contractility, used to treat sinus bradycardia and exercise induced bronchospasm

Question 25

ambulation following DVT

Answer 25

after one dose of low molecular weight heparin, ambulation is encouraged. compression stockings with pressure gradient of 30-40 mmHg assist with pain and reduce risk of post-thrombolytic syndrome

Question 26

estim polarity for bactericidal effects

Answer 26

negative in wound

Question 27

estim polarity for wound healing

Answer 27

positive in wound

Question 28

optimal exercise tolerance test time

Answer 28

8-12 min

Question 29

reasons to stop exercise tolerance tests

Answer 29

``` >2mm change from baseline horizontal or downsloping ST segment depression >2mm rise in ST segment elevation -moderate to severe angina -drop in systolic BP -serious arrythmia -pallor, cyanosis, cold or clammy skin -unusual or severe shortness of breath -CNS signs -BP >260/115 ```

Question 30

Hep B transmission

Answer 30

all body fluids (including sweat, saliva) and blood Use contact precautions

Question 31

Hep A transmission

Answer 31

usually food/water, sexually transmitted Usually mild cases

Question 32

Hep C transmission

Answer 32

blood, contaminated injections

Question 33

Hep D transmission

Answer 33

only occurs with Hep B infection

Question 34

Hep E transmission

Answer 34

usually food/water

Question 35

normal TMJ opening

Answer 35

35-50mm (25-35mm functional)

Question 36

normal TMJ protrusion

Answer 36

3-6mm

Question 37

normal TMJ lateral deviation

Answer 37

10-15mm

Question 38

TMJ capsular pattern

Answer 38

limited opening, lateral deviation greater to uninvolved side, deviation upon opening to the involved side

Question 39

Horner's Syndrome

Answer 39

clinical triad of ptosis (droopy eyelid), miosis (pupillary constriction), anhydrosis (lack of sweating) - all on same side of face and ipsilateral to lesion caused by trauma, interruption of blood supply, tumor, cluster headaches affecting sympathetic pathway to the head

Question 40

Bell's palsy

Answer 40

idiopathic lesion to cranial nerve 7 (facial)

Question 41

trigeminal neuralgia

Answer 41

severe, sharp, stabbing pain in one or more branches of trigeminal nerve

Question 42

nevus

Answer 42

mole

Question 43

papule

Answer 43

elevated mole

Question 44

wheal

Answer 44

irregular, transient superficial area of localized skin edema (hive, mosquito bite)

Question 45

clinical manifestations of left ventricular failure

Answer 45

cough, tachycardia, LE edema, anxiety, S3, paroxysmal nocturnal dyspnea, orthopnea, pulmonary edema

Question 46

clinical manifestations of right ventricular failure

Answer 46

dependent edema (pitting), weight gain, fatigue, R upper quadrant pain, anorexia, nausea, bloating, S3 or S4, cyanosis of nail beds, decreased urine output

Question 47

signs of impeding MI

Answer 47

anginal pain, palpitations, tachycardia, unusual fatigue or dyspnea

Question 48

symptoms of pericarditis

Answer 48

substernal pain that may radiate to neck and upper back, difficulty swallowing, pain aggravated by movement or coughing, relieved by leaning forward or sitting upright, history of fever, chills, weakness, heart disease

Question 49

deep partial thickness healing time

Answer 49

3-5 weeks unless becomes infected, then can convert to full thickness burn

Question 50

complete SCI bowel training

Answer 50

digital stimulation of defecation reflexes

Question 51

ages for scoliosis screening

Answer 51

girls: 9-11 boys 11-13 aiming for time of greatest growth

Question 52

reduction of ___ makes symmetrical biphasic pulsed current estim more comfortable

Answer 52

intensity or pulse duration

Question 53

what organs refer to shoulder

Answer 53

spleen, diaphragm, heart

Question 54

where does esophagal pain refer?

Answer 54

mid-back, head, neck

Question 55

where does colon/appendix pain refer?

Answer 55

low back, pelvis, sacrum

Question 56

where does gallbladder pain refer?

Answer 56

mid-back, scapula

Question 57

sundowning

Answer 57

extreme restlessness, agitation, wandering that typically occur in late afternoon

Question 58

where does constipation/bowel impaction pain refer?

Answer 58

anterior hip, groin, thigh

Question 59

where does bladder pain refer?

Answer 59

medial thigh and leg

Question 60

UE spastisity pattern

Answer 60

scapular retraction, should adduction, depression, internal rotation, elbow flexion, forearm pronation, wrist and finger flexion

Question 61

Radiograph view needed to diagnose spondylolysis

Answer 61

bilateral oblique - looking for scottie dog sign

Question 62

time before weight bearing s/p meniscus repair surgery

Answer 62

3-6 weeks

Question 63

time before weight bearing s/p partial meniscectomy

Answer 63

partial weight bearing as soon as full extension is achieved