fin study guide

Question 1

your 26 year old patient presents after attending a wellness talk that you gabe two days before. they have no significant history of previous low back pain. Upon inspection the patient has what you estimate to be at least 30 degree lumbar scoliosis. The exam is unremarkable. Are xrays of hte lumbar spine indicated?

Answer 1

no

Question 2

you have been treating an acute disc herniation patient for 3 weeks and the patient is concerned that htey are not improving as quickly as they had hoped. they are wondering if they should continue with care in your office. As discussed in class, which one of the following would be the best person to send to for a second opinion regarding your care?

Answer 2

neurologist

(because they don’t do anything besides diagnose so no drugs or surgery, and therefore they wont sell them on a different care plan option they will just verify what you told the patient)

Question 3

you have a 41 year old female patient who comes in with 2 week history of LBP which began 4 days after the funeral of their mother who died from spinal metastasis secondary to breast carcinoma. your patient is convinced that she also has cancer and has barely been able to sleep for the last week because of this fear. your exam is unremarkable. are lumbar x-rays indicated?

Answer 3

yes

Question 4

when viewing digital x-rays, the viewing area should be as bright as possible:

Answer 4

false

Question 5

all of the following are signs of suspected lumbar neoplasm

Answer 5

• intractable pain
• ESR > mm/hr
• unexplained weight loss

Question 6

regarding xray fees, which one of the following satisfies the professional component:

Answer 6

creating a typed ABCS report

Question 7

your 25 year old patient enters 4 days after a motor vehicle accident. she backed into a guard rail pulling out of a parking space with an estimated speed of 5-7 mph. she had no pain that day but upon waking she had neck pain 8-9/10. palpation revealed significant discomfort in both SCM’s but nowhere else. Flexion/extension is limited to 10 degrees in each direction but all other ROM’s are within normal limits. compression and distraction both produce considerable neck pain. neurologic exam is unremarkable. are xrays of the cervical spine indicated?

Answer 7

no

Question 8

according to Y&R, failure to have a written report when using the global fee constitutes fraud:

Answer 8

true

Question 9

you have a 24 y/o male who presents with a 6 week history of pain and stiffness in the pelvis/lumbosacral region which is present each morning he wakes up and lasts for about an hour until he is up and around at which time things seem to loosen up. Gaenslen’s test and the belt test are positive. both of his siblings have been diagnosed with isthmic spondylolisthesis. which one of the following is the most likely:

Answer 9

possible AS/lumbopelvic X-rays indicated

Question 10

according to GA law and X-ray interpretation, a DC is only held responsible to the same standard of care as a local DC with the same degree of education:

Answer 10

false

Question 11

a 43 year old overweight female comes in complaining primarily of leg pain and secondarily of LBP 3 days after lifting heavy boxes while helping a friend move into a new apartment. she rates the pain 9/10. the leg pain starts in the buttock, goes down the side of hte thigh, crosses over the knee and heads to the great toe. SLR and Bowstring’s reproduce the leg pain. sensation to the pinwheel is decreased in the same leg pain distribution and the foot/great toe dorsiflexors are week. are Xrays indicated?

Answer 11

no

Question 12

you have a 21 y/o male who presents with a 6 week history of insidious neck pain. he really hasnt done anything for it treatment wise thinking that it would go away as quickly as it started. your exam is rather unremarkable. are X-rays of the cervical spine indicated?

Answer 12

yes

INSIDIOUS!!!!

Question 13

malpractice cases always result in board of examiner action:

Answer 13

false

Question 14

a 32 year old female presents with low back and leg pain of 1 week duration. the leg pain seems worse than the low back pain. SLR and Kemps produce significant LBP. she states that sitting seems to reduce the symptoms. are X-rays of hte lumbar spine indicated?

Answer 14

no

Question 15

punitive actions by the board of examiners can occur from inaccurate diagnosis of an X-ray without a malpractice case being filed:

Answer 15

true

Question 16

a patient presents the same day they suffered a direct trauma to the posterior ribs. your exam indicates possible posterior rib fractures in the mid thorax. Xrays are indicated. which one of hte following best identifies the views you should take:

Answer 16

AP and a 10 ° and 30 ° poterior and 10 ° and 30 ° anterior oblique

Question 17

as discussed in class, the oblique views in he vervical spine are very accurate regarding the degree of IVF stenosis that is present

Answer 17

false

Question 18

a 20 year old female presents with a 3 day history of neck pain and stiffness. your exam is unremarkable other than some suboccipital tenderness. she says this has occurred every 3-4 months since she turned 16. are xrays indicated?

Answer 18

yes

Question 19

you have a 42 year old patient who presents with a 2 week history of an insidious onset of neck pain. other palpable midline tenderness the exam is unremarkable. there is no real history of neck pain other than a whiplash from a motor vehicle accident 5 years ago which was treated with pain killers, muscle relaxants and anti-inflammatories. are xrays indicated?

Answer 19

no?

Question 20

which one of the following would not be appripriate to put in the body of an xray report

Answer 20

a grade II spondylolisthesis is noted at L5

Question 21

a 48 year old female presents with neck and arm pain/paresthesia of 1 week duration. the exam is for the most part unremarkable. are xrays indicated?

Answer 21

yes

Question 22

it is considered acceptable and is legal to take a digital photograph of an xray and email it to a radiologist for interpretation

Answer 22

false

Question 23

on examining a new patient you palpate a nodule in the thyroid. an endocrinologist would be an excellent person to refer to for further assessment since they frequently treat thyroid issues:

Answer 23

true

Question 24

you take xrays on a 65 year old and see a 5 cm abdominal aortic aneurysm which is confirmed by a DACBR. which one of the following providers should you send this patient to:

Answer 24

vascular surgeon

Question 25

a 49 year old female presnts 2 days after MVA. in the history she says she had her ovaries removed 8 years earlier and her recent DEXA shows she is osteoporotic. she had delayed onset of neck pain but now her traps and lateral neck musculature are very tender and she has a tension type head ache. the lateral musculature and traps are tender to palpation. the remainder of the exam is basically normal. are xrays indicated?

Answer 25

yes

Question 26

a 58 year old male comes in for wellness care following a “back talk” you gave 1 week earlier. He has never had neck pain. on exam the swallowing test is positive and on further questioning he does have some discomfort when he swallows. his cervical exam is otherwise completely unremarable. which one of the following would represent the next best step:

Answer 26

x-ray the cervical spine

Question 27

a patient presents with a known history of RA, she is seeking care form you neck pain that had an insidious onset 6 says ago. your neck exam is unremarkable. which xrays of hte cervical spine should you take, if indicated?

Answer 27

APOM, AP lower cervical, Neutral/ flexion/ extension laterals

Question 28

a 29 year old male presents with LBP after helping a friend move furniture into an apartment. other than decreased ROM, generalized low back tenderness and spasm the exam and history are unremarkable. are xrays indicated?

Answer 28

yes

Question 29

a patient presents with a 1 week history of LBP after cleaning out a garage. they have some palpable pain and spasm but the exam is otherwise unremarkable. although they had a lot of back pain years ago, they have had little to no problems since having a lumbar surgical fusion with the use of metal screws 6 years ago. are xrays indicated?

Answer 29

yes

Question 30

a long time 32 year old patient comes in for a normally scheduled appointment. you notice they are quite flustered and on questioning they say they just slipped and fell on the ice in the parking lot. they have 1/10 pain around L2 but little to no tenderness or spasm. are xrays indicated

Answer 30

no

Question 31

you are leaseing space in an office that des not have an xray machine but is adjacent to a lab. a 68 year old male you have been treating complains of worsening low back. SI pain and asks if you can order some lab work. the ESR comes back at 58mm/hour. are xrays indicated?

Answer 31

yes

Question 32

given the results/circumstance in question number 32, which one of the following is the most likely diagnosis:

Answer 32

skeletal mets

Question 33

on an ap lumbar you see a calcification to the right of L2. you are not sure if it is in the kidney or gall bladder. you take posterior oblique and it moves closer to the spine. therefore it is most likely in the gall bladder

Answer 33

false

Question 34

your patient has been diagnosed with prostate carcinoma and wants a surgical opinion. which one of hte following would be the most apporpriate referral

Answer 34

urologist

Question 35

in which portion of hte report should the following be placed? “increased density is noted within the entire vertebral body of L2 without a change in size or shape to the segment”

Answer 35

B

Question 36

in which portion of hte report should the following be placed? “anterolisthesis is noted at C3”

Answer 36

A