FORTINBERRY CH3 Flashcards
The most serious complication of lower extremity thrombophlebitis is
A. Cerebral infarction
B. Pulmonary infarction
C. Myocardial infarction
D. Kidney infection
B.
Thromboembolus formation is a common complication of thrombophlebitis in lower legveins. Thrombi can pass through the heart and obstruct major pulmonary arteries.
A 50-year-old man has a persistent cough, purulent sputum, abnormal dilation of bronchi, more frequent involvement of the left lower lobe than the right, hemoptysis, and reduced forced vital capacity. What is the most likely pulmonary dysfunction?
A. Chronic bronchitis
B. Emphysema
C. Asthma
D. Bronchiectasis
D.
These are signs and symptoms of a patient with bronchiectasis.
Which of the following are tests for peripheral arterial involvement in a patient with complaints of calf musculature pain?
A. Claudication time
B. Homan’s sign
C. Percussion test
D. Hoffa’s test
A.
Claudication is a lack of blood flow. This testis performed byhaving a patient walk on a treadmill and recording how long the patient can walk before the onset of claudication.
Homan’s signs a test performed to see whether a patient may have a deep vein thrombosis. The percussion test is designed to assess the integrity of the greater saphenous vein. Hoffa’s test checks the integrity of the Achilles tendon.
A patient presents to a clinicwith decreased tidal volume (TV). What is the most likely cause of this change in normal pulmonary function?
A. Chronic obstructive pulmonary disease
B. Restrictive lung dysfunction
C. Emphysema
D. Asthma
B.
A decreased tidal volume is caused by a
restrictive lung dysfunction. An increased tidal volume is caused by an obstructive lung dvsfunction. Choices C and D are in the family of obstructive pulmonary disease.
A patient presents with tachypnea, corpulmonale, hypoxemia, rales on inspiration, and decreased diffusing capacity. What is the probable cause?
A. Restrictive lung dysfunction
B. Chronic obstructive pulmonary disease
C. Asthma
D. Emphysema
A.
These signs are consistent with restrictive lung dysfunction. All other choices are obstructive lung dysfunctions.
A physician instructs the therapist to educate a patient about the risk factors of atherosclerosis.
Which of the following is the most inappropriate list?
A. Diabetes, male gender, and excessive alcohol
B. Genetic predisposition, smoking, and sedentary lifestyle
C. Stress and inadequate exercise
D. Obesity, smoking, and hypotension
D.
Hypertension is a risk factor in atherosclerosis.
A therapists ordered by a physician to treat a patient with congestive heart failure in an outpatient cardiac rehabilitation facility. Which of the following signs and symptoms should the therapist not expect?
A. Stenosis of the mitral valve
B. Orthopnea
C. Decreased preload of the right heart
D. Pulmonary edema
C.
Patients with congestive heart failure often develop an enlarged heart because of the burden of an increased preload and afterload.
At team meeting, the respiratory therapist informs the rest of the team that the patient, just admitted to the subacute floor, experienced breathing difficulty in the acute care department. The respiratory therapist describes the breathing problem as a pause before exhaling after a full inspiration. Which of the following is the therapist describing?
A. Apnea
B. Orthopnea
C. Eupnea
D. Apneusis
D.
Apneusis can be described as an inspiratory cramp. Orthopnea is difficulty with breathing in a lying position. Eupnea is normal breathing. Apnea is the absence of breathing.
A therapist is performing chest physiotherapy on a patient who is coughing up a significant amount of sputum. The therapist later describes the quality of the sputum in his notes as mucoid.
This description tells other personnel which of the following?
A. The sputum is thick.
B. The sputum has a foul odor.
C. The sputum is clear or white in color.
D. The patient has a possible bronchopulmonary infection.
C.
Mucoid sputum is clear or white and is not usually associated with infection. Thick sputum is referred to as tenacious. Foul-smelling sputum is called fetid and is often associated with infection.
A therapist is sent to provide passive range of motion to a patient in the intensive care unit.
The chart reveals that the patient is suffering from pulmonary edema. The charge nurse informs the therapist that the patient is coughing up a thin, white sputum with a pink tint. Which of the following terms best describes this sputum?
A. Purulent
B. Frothy
C. Mucopurulent
D. Rusty
B.
Frothy sputum is thin and white or has a slight pink color. This type of sputum is commonly present with pulmonary edema.
Purulent sputum resembles pus, with a vellow or green color. Mucopurulent sputum is yellow to light green in color. Rusty sputum is a rust-colored sputum often associated with pneumonia.
Strengthening exercises for persons with hemophilia should
A. Begin as soon as a joint bleed is recognized
B. Never include isokinetic exercises
C. Be increased using high repetition, low load PREs
D. Only occur in joints that demonstrate muscle weakness
C.
All exercises for this population should
avoid the possibility of joint bleeding. High velocity isokinetics or high weight. low repetition exercises are a contraindication.
Provided there is no active bleeding, exercise to any joint is indicated.
A patient with cryoglobulinemia presents to outpatient physical therapy with complaints of lumbar pain. Which of the following should the physical therapist avoid during intervention for this diagnosis?
A. Moist heat packs
B. Weight-bearing exercises
C. Muscle energy techniques
D. Cold pack application
D. In cryoglobulinemia, ischemia can be caused by abnormal blood proteins gelling at low temperatures. Moist heat will not affect this condition.
A physical therapist is assessing the endurance of a 12-year-old female with cystic fibrosis.
Which objective screening tool would be most appropriate to quantify the patient’s endurance level?
A. Six-minute walk test
B. Tinetti Performance-Oriented Mobility
Assessment
C. VOMax Test
D. Rombergtest
A.
The six-minute-walk-testis used to determine a patient’s functional exercise capacity.
A physical therapist is performing an examination for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would not likely be present?
A. Bradvcardia
B. Poor weight gain
C. Decreased respiratory rate
D. Lower extremity swelling
A.
An infant with a congenital heart defect often has a labored breathing pattern, increased respiratory rate, diaphoresis, tachycardia, edema, and feeding difficulties.
Besides the anterolateral abdominal muscles, which muscle assists in forced expiration, coughing, sneezing, vomiting, urinating, defecating, and fixation of the trunk during strong movements of the upper limb?
A. Piriformis
B. Pelvic diaphragm
C. Trapezius
D. Gluteus maximus
B.
The pelvic diaphragm is composed of the levatorani and coccygeus muscles. This pelvic diaphragm assists in forced expiration, coughing, sneezing, vomiting, urinating, defecating, and fixation of the trunk during strong movements of the upper limb.
Which muscle does NOT flex the knee and extend the hip?
A. Semitendinosus
B. Hamstring portion of the adductor magnus
C. Long head of the biceps femoris
D. Semimembranosus
B.
All four muscles are hamstring muscles of the posterior thigh. All four muscles extend the hip. Only the hamstring portion of adductor magnus does not cross the knee. It inserts on the adductor tubercle of the femur. The other three muscles cross the knee posteriorly and therefore flex the knee.
History taking revealed that a patient experiences pain after horseback riding or skating. The pain is located over the anteromedial thigh and is aggravated by resisted abduction. What is the MOST likely preliminary diagnosis?
A. Piriformis svndrome
B. Trochanteric bursitis
C. Adductor longus strain /tendonitis /tendinosis
D. Avascular necrosis
C.
Adductor longus, rectus femoris, and iliopsoas are the muscles typically involved in hip muscle strain/tendonitis/tendinosis. Pain is aggravated by activity or in resistance testing.
Adductor strains arise in horseback riders, skiers, and skaters.
A patient has dull posterior hip pain radiating down the leg. He says that he has a limp and that his painis aggravated by turning his leg outside or with deep pressure near the middle of the right buttock. What is the MOST likely preliminary diagnosis?
A. Piriformis syndrome
B. Trochanteric bursitis
C. Adductor longus strain/tendonitis /tendinosis
D. Avascular necrosis
A.
History and type/site of pain are the most important features to direct the examination. Piriformis irritation often presents as dull posterior hip pain radiating down the leg, mimicking radicular symptoms. Limping, pain aggravated by active external rotation, or passive internal rotation on palpation of sciatic notch is a salient feature.
What is the BEST imaging modality for detecting the changes in the articular cartilage seen with chondromalacia patella?
A. Plain film radiography
B. Bone scan
C. Magnetic resonance imaging (MRI)
D. Computed tomography (CT)
C.
While direct visualization of articular cartilage is possible with both MRI and CT, MRI gives better resolution and detail. Neither bone scan nor plain film radiography will show the cartilage.
Which of the following imaging modalities does
NOT give a radiation dose to the patient?
A. MRI
B. СТ
C. Mammography
D. Bone scan
A.
MRI does not provide any form of radiation to the patient.
A therapist is examining a 3-year-old child, who is positioned as follows: supine, hips flexed to 90 degrees, hips fully adducted, and knees flexed. The therapist passively abducts and raises the thigh, applying an anterior shear force to the hip joint. A click at 30 degrees of abduction is noted by the therapist. What orthopedic test is the therapist performing, and what is its significance?
A. Ortolani’s test, hip dislocation
B. Appley’s compression/distraction test.
cartilage damage
C. McMurray test, cartilage damage
D. Piston test, hip dislocation
A.
Ortolani’s test is used to detect a congenitally dislocated hip in an infant. Choices B and C are common meniscus damage tests for the knee. Choice D is performed by placing the infant in supine position with the hip at 90 degrees of flexion and slight abduction and the knee flexed to 90 degrees. The examiner then moves the infant’s hip anterior and posterior in an effort to detect abnormal joint mobility.
A teenager comes to an outpatient facility with complaints of pain at the tibial tubercle when playing basketball. The therapist notices that the tubercles are abnormally pronounced on bilateral knees. What condition does the patient most likelv have?
A. Jumper’sknees
B. Anterior cruciate ligament sprain
C. Osgood-Schlatter disease
D. Sever’s disease
C.
Osgood-Schlatter disease is severe tendinitis of the patellar tendon. It is characterized by pronounced tibial tubercles.
The increased size of the tubercles is attributed to the patellatendon pulling away from its insertion. Jumper’s knees (or normal patella tendinitis) does not necessarily present with tubercle enlargement. Sever’s disease involves the Achilles tendon pulling away from its insertion on the calcaneus.
A patient presents to physical therapy with complaints of pain in the right hip due to osteoarthritis. Which of the following is not true about this type of arthritis?
A. Osteoarthritis causes pain that is usually svmmetric because it is a systemic condition.
B. Osteoarthritis is not usually more painful in the morning.
C. Osteoarthritis commonly involves the distal interphalangeal joint.
D. Osteoarthritis mainly involves weight-bearing joints.
A.
Choice A describes rheumatoid arthritis, a systemic condition. All of the other choices are signs and symptoms of osteoarthritis (OA). Sometimes 0A can involve symmetric joints, but it is not systemic.
Which of the following is used to treat a patient referred to physical therapy with a diagnosis of
Dupuytren’s contracture?
A. Knee continuous passive motion (CPM)
B. Work simulator set for squatting activities
C. Hand splint
D. A 2-pound dumbbell
C.
Dupuytren’s contracture is a
progressive thickening of the palmar aponeurosis of the hand. The progression is gradual, and the interphalangeal joints are pulled into flexion.