MOCK exam2

Question 1

Active RA. What would you include and avoid in your AX?

Think RA knee

Answer 1

Strength testing- avoid

Circumferential measurement- Include

AROM - include PROM-avoid

Gait-include even if it’s painful. Walking is not something we can avoid hence, including it during flared up RA would provide us with an idea of what gait aid or braces to give to protect the joint.

Joint count to be done during follow up. Usually in flared up RA the joints tend to be visibly swollen (look for the hint in the vignette, if not then you would need to include this to know if the joint is active or not) Hence, it would be appropriate to check it on follow up Ax to monitor the changes

Question 1

What things to keep in mind before prescribing an initial ex for meniscal injury or any lower limb injury?

Answer 1

The first choice would always be either gait training with an aid or activity mods.

Second rx would depend on the patient’s ROM post inj.

Like after meniscal inj. CKC is avoided but recumbent biking if patient has the range can help improve ROM than any other OKC exs

Question 2

What exercise should be preferred to initiate strength training normally?

Answer 2

Resisted isometrics always first!!!!

Question 3

How to check patient orientation in the hospital post acute TBI

Answer 3

Orientation level X3

X1 person
X2 time(date/year)
x3 place (current location)

Question 4

Acute OH (other than in SCI) in the patients standing for the first time. Course of action?

Answer 4

Since it results in dizziness have the patient into the safe position first.

This should be followed by taking vitals or checking up on patient or asking them to take a few deep breaths

Gradually increase the tolerance by using compression stocking, short bouts of standing, tilt table etc

Question 5

ACUTE OH IN SCI?

Answer 5

Abdominal binder plus compression stocking would be the most useful to prevent OH

Question 6

What to do when parents does a lot of talking and the patient is not saying anything? Will you listen to them only or will you ask them to leave the room

Answer 6

Acknowledge the parent’s concern and their active role in child’s rehab but politely explain them why the kid’s participation is important and the concept of autonomy especially if the child understands.

We can only ask them to leave the room if the child said.

Question 7

What to do in MS patient experience flare with aerobic exs?

Answer 7

Prefer doing light resistance training as aerobics can cause an increase in body temp

Question 8

What should you be mindful of when staging any disease?

How would you stage CRPS? Would you look at the s/s, or would you look a

Answer 8

Remember to stage the disease through what you can observe objectively and not something that would require an additional investigation like BMD to stage reduce bone mineral density.

Refer to CRPS question in mock exam 2 for more

Question 9

Best Rx for CRPS

Answer 9

Education would take the forefront since it will change overtime and patient needs to know what is happening.

Protection and avoid overstimulation is also important but not more than education first. Also, do not choose an option which asks you to avoid the movt altogether. Protecting the part but still moving as disuse atrophy is common in CRPS

Question 10

Lymphedema education post mastectomy

Answer 10

All the points discussed in the manual.

Prefer choosing an option which says elevating the arm frequently throughout the day rather than just saying to avoid letting the arms hang by the side all day as that is not something that can be avoided.

Question 11

Define psychomotor impairment

Answer 11

Slowing down of thought and reduction in physical movements. Usually associated with depression.

Question 12

Is it okay to use the term mental retardation ?

Answer 12

Never!

You can use cognitive deficits or developmental disability

Question 13

Some ways to improve scholastic performance of children suffering from developmental d/o

Answer 13

Allow more time to take test.

Allow repeated tasks to aid them in learning.

Avoid unstructured activity to allow them some flexibility and control than structured activity.

Sending them off to the disability school is never an option

Question 14

Exercise for pre rehab patient undergoing joint replacement and are having excessive pain

Answer 14

Yielding isometrics and not overcoming isometrics would be the least painful and would still maintain strength post op.

Question 15

Cast and all the complications that comes with it.

What to do when the patient complains of increasing pain and tightness while in cast?

Answer 15

This is a sign of tight cast. Check capillary refill in the fingers. Compare with the other arm’s finger to check if both are equal for this patient. If not and the refill is reduced that means the cast is too tight. Ask the patient to go to ER

Question 16

What would youchoose first in case of cast tightness?
Capillary refill or check neurological func?

Why is one more important than other?

Answer 16

Capillary refill

Gangrene could essentially result in amputation