Mordor / NPTE Part 2

Question 1

What are some common symptoms of sclerodoma?

Answer 1

tightening of the skin and connective tissues, Raynaud’s - leads to joint pain

Question 2

What is normal hallux ext ROM?

Answer 2

70 deg

Question 3

What is a normal triglyceride level?

Answer 3

150 mg/dL

Question 4

What is a junctional rhythm and what are its implications?

Answer 4

no P wave bc the rhythm starts with the AV rather than SA node.

Question 5

What is a O2 intake different for UE exercise than LE?

Answer 5

30-40% less

Question 6

What is normal ABI? What is a severe blockage?

Answer 6

1.0-1.3, 0.4

Question 7

For an insulin pump, what level does blood glucose need to be at for exercise? What might you need to do the insulin level if blood glucose level is too low?

Answer 7

100mg/dL, decrease the insulin level to raise glucose!

Question 8

What is recommended for reducing the formation of hypertrophic scars?

Answer 8

Pressure garments worn 23 hours / day

Question 9

If someone can’t reach their hand between their shoulder blades what is limited in the shoulder?

Answer 9

posterior capsule tightness + tight external rotators

Question 10

What direction should you mobilize a shoulder to improve flexion? What if it’s a frozen shoulder?

Answer 10

posterior to improve flexion unless last bit of flexion in which case anterior, posterior

Question 11

What are some signs of liver dysfunction?

Answer 11

jaundice, dark urine, clay-colored stools, easy bruising, R shoulder pain

Question 12

How might diverticulitis present?

Answer 12

L sided Lower Quad Pain

Question 13

What are the 4 levels of burns?

Answer 13

1. Superficial Thickness - erythema w/ cap refill, painful, takes 1-2 weeks to heal
2. Superficial Partial Thickness - wet, pink blisters, fast cap refill, VERY painful, 2-4 weeks to heal.
3. Deep Partial Thickness - not as wet, red blisters, slow or no cap refill, 3-8 weeks *REQUIRES GRAFTING
4. Full Thickness - DRY. WHITE. NO REFILL. NO PAIN. *NEEDS GRAFTING.

Question 14

What’s the differential diagnosis between radial tunnel syndrome and lateral epicondylalgia?

Answer 14

RTS: weak supinator and finger extensors, radial nerve distribution paresthesias, thumb weakness or pain, referred lateral elbow pain

vs.

LE: extensor carpi radialis brevis weakness / difficulty w/ extension

Question 15

What is normal ejection fraction?

Answer 15

55-75%

Question 16

What is maceration of a wound site? What kind of dressing might be used in a case where this is present?

Answer 16

When exudate (fluid) from a wound contains proteases which prevent healing. A foam dressing.

Question 17

What is dessication?

Answer 17

extreme wound dryness, usually associated with eschar

Question 18

What are some signs of LEFT ventricular failure?

Answer 18

dry cough/weakness
tachycardia
lightheadedness
decrease in CO
pallor/cyanosis
proxysmal nocturnal dyspnea
*BASICALLY BLOOD IS BACKING UP INTO PULMONARY SYSTEM

Question 19

What are some signs of RIGHT ventricular failure?

Answer 19

jugular vein distention
ascites
bilateral pedal edema
*BASICALLY BLOOD IS BACKING UP INTO THE VENOUS SYSTEM

Question 20

What are normal respiratory rates for an infant, toddler, elementary aged kid, and an adult?

Answer 20

infant: 30-60
toddler: 24-40
elementary: 18-30
adult: 12-20

Question 21

When is multi layer compression ok for wounds? And what is one instance where it isn’t?

Answer 21

Venous ulcers and lymphedema are ok but arterial wounds are not.

Question 22

How do differentiate between Radial Tunnel Syndrome and Pronator Teres Syndrome?

Answer 22

Basically PTS is median nerve entrapment at the PT level, so difficulty w/ pronation differentiates + median nerve signs vs. in RTS radial nerve signs and issues with extension of arm and fingers.

Question 23

What are some signs of Cubital Tunnel Syndrome?

Answer 23

Ulnar nerve signs, weak ulnar intrinsics of the hand, Tinel’s positive.

Question 24

How might AIN be differentiated from pronator teres syndrome?

Answer 24

In AIN there are NO parasthesias.

Question 25

What is one lab feature of chronic kidney disease?

Answer 25

anemia due to drop in RBC / iron absorption

Question 26

What is pulsus paradoxus and what cardiac condition it is associated with?

Answer 26

a fall of 10mmhg SBP w/ inspiration, associated w/ cardiac tamponade / pericardial sac uptick in pressure

Question 27

What are normal levels of PaCO2 and what might anything above or below that indicate?

Answer 27

35-45mmhg is normal
if low = hypocapnea / hyperventilation / need to get air out
if high = hypercapnea / hypoventilation / need to get air in

Question 28

During estim which motor units are recruited first: large or small diameter?

Answer 28

larger, physiologically, we recruit smaller first

Question 29

What large muscle group does the obturator nerve innervate? Howsabout the femoral nerve?

Answer 29

adductors, abductors

Question 30

Why might you use a calcium alginate substance?

Answer 30

To handle heavy exudate

Question 31

Why might you choose a hydrocolloid dressing for a wound over a transparent film?

Answer 31

Transparent Film is used in Stage 1/Stage 2 wounds only bc this helps wounds resist shear. Hydrocolloids are used in Stage 2/3 wounds to keep wounds moist.

Question 32

What are some signs of cervical myelopathy?

Answer 32

UMN sx (ataxic gait)
decreased fine motor skills w/ no particular myo/dem pattern
HA

Question 33

For a deep partial thickness wound what sensations will intact? For a superficial partial thickness wound what will occur w/ sensations?

Answer 33

DPT - Vib and pressure intact

SPT - highly sensitive to temp and light touch

Question 34

How large does a mole have to be to begin to cause concern?

Answer 34

6mm

Question 35

What is a pleural effusion and what kind of lung disease does it manifest as? If you have a pleural effusion on the RIGHT what direction will your trachea deviate to?

Answer 35

water in the lining around the lungs which increases the volume making this restrictive which means if this was on the RIGHT your trachea would drift LEFT.