Miscellaneous Flashcards
Who does medicare provide medical coverage to?
- individuals > 65 y/o
- disabled
- those with ESRD
What is Medicare’s prospective payment system based on?
Diagnostic-related groups (DRGs)
Places patients into disease categories or groups
(true/false) Medicare A covers all medical expenses of long-term or custodial care.
True
(true/false) Medicaid benefits are the same in all states
False
individual states determine the scope, duration, and amount of services provided
(true/false) preauthorization is needed for medicare and not medicaid.
FALSE (required for medicaid)
What must a person pay for medicare A?
Annual deductible fee
What must a person pay for medicare B?
Monthly premium
(true/false) With medicare, PT provided by a PT aide is reimbersable regardless of supervision
FALSE
Only SPTs
Insurance type that includes commercial insurance, fee-for-service / traditional indemnity plans, or employers who are self-insured
private health insurance
What is a HMO?
Form of managed care that provides a broad spectrum of health services for a preset amount of money
Allow members to seek healthcare outside of the network but at a higher or additional cost to the patient
Has a small copay for members using providers within the network
(true/false) With a HMO, a patient that is seeking additional care (such as PT), must have authorization through their PCP (“gatekeeper”)
true
(true/false) The numer of PT visits when a person is part of an HMO is unlimited
FALSE - limited number of visits
What are the two types of HMOs?
- **Individual practice associations (IPA) **- contract independently with the HMO and work out of their own office
- Prepaid Group plan (PGP) - physicians practice in a central facility
What is a PPO?
Group of providers that offer healthcare services as an entity to their employers - discount their fees to attract patients
Pts are not locked into the PPO providers but receive financial incentives to use services through that network
Preauthorization is needed before services can be provided
Definition:
A flat bundled reimbursement rate that is established based on the diagnosis- predetermined dollar amount:
- per diem / per day
- per visit
- per episode of service
Case-based rate
Definition:
Tax-free savings account that can be used to pay for health-related expenses and reiree health expenses
Health Savings Account
(true/false) Those who have a health savings account must have a high-deductible health plan
–> insurance product that covers catastrophic health occurrences
true
Stage of RA
- joint pain and stiffness
- no visible bone damage on XR
- slight swelling (primarily in fingers and toes)
- fatigue and malaise
stage I
early RA
stage of RA
- cartilage damage, stiffness, and decreased ROM
- persistent symptoms
- joint swelling that is more noticeable in the morning
stage II
moderate RA
stage of RA
- bone damage, cartilage loss, and joint deformity
- progressed pain, stiffness, and loss of mobility
- thickened knuckles
- twisted fingers
- higher risk of CTS
Stage III
severe RA
stage of RA
- bony or fibrous ankylosis
- severe pain, swelling, and stiffness
- loss of mobility
stage IV
end-stage RA
What is the RPE for light exertion?
11-12
What is the RPE for hard exertion?
15-16
What is the RPE for very hard exertion?
17-18
What is the RPE for extremely hard exertion?
19
What is the RPE for max exertion?
20
What is the RPE for no exertion?
6
(true/false) With dehydration, the pinch skin test (turgor) will present with no raising of the skin
FALSE
raised skin for >5 seconds
What is scheuermann disease?
Kyphosis of the spine that develops in early adolesence
juvenile kyphosis, juvenile discogenic disease
Describe bigemity
every second beat is a PVC
trigemity: every third beat is a PVC (wide QRS)
diagnosis
- irregular vertebral end plates
- anterior wedging of 3+ consecutive vertebrae that measures > 5 degrees
- painful EXT and ROT
- lordosis and kyphosis
- hunchback appearance
- disc space narrowing
scheuermann’s disease
(true/false) EXT acitivities should be avoided in those with osteoporosis
FALSE
FLX should be avoided due to increased risk of vertebral compression fx
definition
inability to localize a sensation
atopognosia
definition
loss of all pain
analgesia
definition
rhythmic oscillations of the head
titubation
commonly seen with cerebellar pathology
Those with cerebellar pathology will have (increased/decreased) DTRs and tone
decreased
What is pendular nystagmus a symptom of?
central vestibular pathology
General outline for low-rate TENS.
Pulse freq:
Pulse duration:
frequency: 2-10 pps
duration: 200-300 microseconds
General outline for high-rate TENS.
pulse freq:
pulse duration
frequency: 100-150 pps
duration: 50-80 microseconds
What is the cullen sign? What diagnosis does it rule in?
Blue discoloration of the periumbilical area
Indicates acute pancreatitis
What is the Grey Turner’s sign? What diagnosis does it rule in?
red-brown coloring of the abdomen
indicates hemorrhagic pancreatitis
What gait deviation can a lesion of the superior gluteal nerve cause?
ipsilateral trunk lean
What gait deviation can a lesion of the inferior gluteal nerve cause?
posterior thrust of the trunk at initial contact
What is Blumberg’s sign? What does it indicate?
Rebound tenderness indicating appendicitis
What is the pinch an inch test for appendicitis?
Pinch a fold of skin over McBurney’s point and look for pain
What happens to the piriformis at 120 degrees of FLX
Switches actions
becomes a IR and ABD
What causes cushing’s disease?
tumor on the pituitary gland causing an increased level of ACTH and cortisol to bbe released from the adrenal gland
What drug class is candesartan from?
angiotensin receptor blockers (ARB)
regulates HTN, HF, and A-fib
Side effects: hypotension and increased potassium
What is telangiectasia?
Spider web-like skin condition
What is the presentation of homonymous hemianopsia with a R CVA?
Left homonymous hemianopsia with the image displayed on the right side of visual field
What are meissner’s corpuscles used for?
discriminative touch and movement of objects over the skin
What are ruffini endings used for?
joint position
What are krause’s end bulbs used for?
touch and pressure
What are pacinian corpuscles used for?
deep touch and vibration
What type of cough will be present with an aortic aneurysm?
Brassy
What is the correct exsc prescription for inspiratory muscle training?
minimum 4-5 x/wk with 30% max inspiratory pressure measured at FRC
2x15 min/day
What structures are affected by horner’s syndrome?
- descending sympathetic tracts
- CN IX
- CN X
- spinothalamic tract
What is the triad for horner’s syndrome?
miosis (constricted pupils), ptosis, decreased sweating
What causes locked-in syndrome?
complete block of the basilar artery
causes tetraplegia and coma with NO impact to cognition
What movements must you avoid with anterior THA?
FABER
Also transfer to sound side
Describe homan’s sign
passive DF with knee EXT
(+) discomfort = indicates possible DVT
What is homan’s sign used to identify?
DVT
What is Cozens test? What is it used for?
Resisted wrist EXT
lateral epicondylitis
What are the aggs of spondylolisthesis?
repetitive EXT and standing/bending to lift objects
What alleviates pain caused by spondylisthesis?
sitting
(true/false) A side effect of TB medication is red-orange discoloration of body fluid
true
What movements are limited with avascular necrosis of the hip?
FABIR
(true/false) Maternal RR during pregnancy adapts to mild exercise and increases proportionately with moderate and high intensity exercise
False: RR adapts to mild exercise but will NOT increase proportionately with moderate or high intensity exercise
Maternal hematocrit (increases/decreases) during pregnancy.
decreases
will increase with vigorous exercise
What will occur with maternal cardiac reserve during exercise while pregnant?
will decrease
What will occur with maternal CO and SV during steady state exercise while pregnant?
increase
What are calcium channel blockers commonly used for?
arrythmias
diagnosis
- net-like pattern on XR
- dry cough
- fatigue
- weakness
- SOB
- weight loss and decreased appetite
pulmonary fibrosis
How long does normal bone healing occur in children?
4-8 wks
How long does normal bone healing occur in adults?
10-18 wks
What degree of burn is most likely to develop a keloid scar?
deep-partial thickness
Atelectasis pulls the trachea to the (Same/opposite) side
same
Pneumothorax pushes the trachea to the (same/opposite) side
opposite
What nerve injury causes the hand of benediction?
median nerve
2nd and 3rd digits are stuck in EXT
What is milroy’s disease?
genetic condition that affects the lymphatic system and causes fluid build up in the body resulting in swelling
Type I hereditary lymphedema, congenital familial lymphedema
For a pt with a meniscus tear, do not perform FLX > ___ degrees for the first 4 weeks
> 45
A persistent _____ reflex will interfere with the crawling milestone of an infant
STNR
A persistent ____ reflex will interfere with hand-mouth activities and predisposes the child to developing scoliosis
ATNR
A persistent ____ reflex will interfere with rolling activities in an infant?
Tonic labyrinthine
Type of posture
- pelvis shifts anteriorly causing the hips and knees to be hyperEXT causing a flat back
- favored leg tends to be longer in standing
- elongated neck flexors
swayback
diagnosis
- hypotension
- bradycardia
- cyanosis
- decreased CO
- peripheral vasodilation
neurogenic shock
can be mistaken as autonomic dysreflexia (increased BP and tachycardia)
What is V-tach?
3+ consecutive PVCs
emergency
Terminate exercise if there is more than ____ PVCs within one minute
6+
Describe the stork test and what it is used for.
Pt stands on ipsilateral leg resulting in pain within the lumbar region
Identifies possible pars interarticularis Fx (spondylothesis)
Chronic pedal edema is an important symptom to identify with what type of insufficiency?
chronic venous insufficiency
What are side effects of thiazides?
- frequent urination
- cramps
- weakness
- nausea
- hyperglycemia
- hypokalemia
- postural hypotension
- flat or inverted T waves
What structure regulates the stimulation of the SNS?
hypothalamus
What is aldosterone used for?
regulation of fluid balance and BP
What acute changes occur after aerobic exercise?
SV
CO
minute ventilation
total peripheral resistance
increased
increased
increased
decreased
central cord syndrome has greater (motor/sensory) deficits
motor > sensory
central cord syndrome has more (LE/UE) neuro involvement
UE
paralysis agitans
PD
uncoordinated goal-directed action
dysmetria
March Fx
metatarsal stress FX
Peroneal nerve palsy
drop foot
radial nerve palsy
wrist drop
acute inflammatory demyelinating polyradiculopathy
GBS
iliopsoas muscle test
thomas test
Paratendonitis of APL and EPB
de quervain’s
Bamboo spine
ankylosing spondylitis
Marie strumpell disease
ankylosing spondylitis
Crutch palsy
radial nerve compression
athletic pubalgia
sports hernia
FDP tendon rupture
jersey finger
