Mosby Part 2 Flashcards
Study
1
Q
(CaseHx) Many disease processes have premonitory symptoms that help identify the disease by the clinical pattern. WOTF disease processes often present with premonitory symptoms?
a. concussion, cord contusion, disc herniation
b. migraine, epilepsy, syncope
c. whiplash, compression fracture, facet syndrome
d. stroke, vertebrobasilar ischemia, transient ischemic attack
A
B. migraine, epilepsy, syncope
2
Q
(CaseHx) A pt states that he recently had a benign mass removed from his upper neck and that a nerve was damaged during the surgery. His formerly deep voice has become very “raspy” and he is having difficulty swallowing. Which nerve was most likely damaged?
a. facial
b. trigeminal
c. hypoglossal
d. vagus
A
D. vagus
3
Q
(CaseHx) A 41 y/o woman presents with sudden onset of numbness and drooping of the left side of her face and pain directly behind her left ear. Further questioning and a general assessment of the pt revealed asymmetrical facial expression lateralizing to the right side, mild slurring of speech, dysgeusia, hyperacusis and difficulty drinking noted as the “dribbling” of a beverage. She was recently diagnosed with a viral upper respiratory infection 3 days ago and treatment consisted of rest and fluids. She denies a traumatic episode, headache, vertigo, lightheadedness, tinnitus, use of oral contraceptives, and smoking of cigarettes. What is most likely the diagnosis?
a. Guillain-Barré syndrome
b. Bell’s palsy
c. Lyme disease
d. Stroke
A
B. Bell’s palsy
4
Q
(CaseHx) WOTF is the preferred way of inquiring about precipitating factors of a pt’s chest pain?
a. What brings on your chest pain?
b. What types of activities cause your chest pain?
c. Is your chest pain caused by walking rapidly?
d. Does your chest pain occur with activity or when you are upset?
A
A. What brings on your chest pain?
5
Q
(CaseHx) WOTF best describes objectivity when interviewing a pt?
a. multiple interviewers would obtain a reasonably similar history
b. the physician accurately understands and interprets the pt’s history
c. the interviewer sets aside preconceived conclusions about the pt
d. the physician is able to determine the diagnosis from the history
A
C. The interviewer sets aside preconceived conclusions about the pt
6
Q
(CaseHx) WOTF is the definition of respect during a pt interview?
a. the physician behaves naturally “being herself”
b. the physician accepts the pt as he is without judgement
c. the physician understands the pt’s complaint
d. the physician feels sorry for the pt’s suffering
A
B. The physician accepts the pt as his is without judgement
7
Q
Xanthelasmas are indicative of:
a. cerebrovascular accident
b. hypercholesterolemia
c. angina pectoris
d. hypertension
A
B. hypercholesterolemia
8
Q
(V.S.) WOTF is the generally accepted correct measurement range for the stated vital function, assuming all measurements are obtained with the patient awake and at rest?
a. systolic BP: a maximum of 140 mmhg and a minimum of 60 mmhg
b. oral temperature: a maximum of 101 F and a minimum of 94 F
c. Respirations: a maximum of 24 breaths per minute and a minimum of 10 breaths per minute
d. Pulse: a maximum of 100 BPM and a minimum of 60 BPM
A
D. Pulse: max of 100 BPM, min of 60 BPM
9
Q
(V.S.) When taking the pt’s BP, the auscultatory gap is defined as:
a. the period of silence from phase 1 to phase 2 of Korotkoff’s sounds
b. the difference between the right and left arm systolic BP readings
c. the period of silence between the first diastolic sound and the second diastolic sound
d. the difference between systolic BP readings from the seated to the standing position
A
A. The period of silence from phase 1 to phase 2 of Korotkoff’s sounds
10
Q
(H&N) A pale optic cup that is greater than one half of the optic disc diameter is characteristic of:
a. papilledema
b. proliferative diabetic retinopathy
c. stage IV hypertensive retinopathy
d. glaucoma
A
D. Glaucoma
11
Q
(H&N) A pt exhibits a large smooth goiter with exophthalmos. WOTF exam findings would also be expected in this pt?
a. thick tongue and hoarseness
b. loss of the outer third of the eyebrows
c. hyperreflexia
d. weight gain
A
C. hyperreflexia
12
Q
(H&N) DeMussette’s sign is ___ and is associated with ___?
a. bruising around the mastoid process; skull fracture
b. fine, thin hair and bulging eyes; hyperthyroidism
c. jerking and bobbing of the head; tremor or aortic insufficiency
d. masklike rash or pigmentation of the face; pregnancy or SLE
A
C. jerking and bobbing of the head; tremor or aortic insufficiency
13
Q
(H&N) When determining whether the trachea is midline, WOTF is evaluated?
a. the space between the trachea and the trapezius muscle
b. the space between the trachea and sternocleidomastoid muscle
c. the space between the trachea and the clavicle
d. the space between the trachea and the episternal notch
A
B. the space between the trachea and sternocleidomastoid muscle
14
Q
(Thorax) The presence of a slowly developing intraspinal mass of the thoracic spine (neurofibroma) may not produce “red flag” signs until late in the disease. WOTF clinical patterns would be the LEAST valuable to warn of the development of this type of disease?
a. bilateral lower limb symptoms (foot drop)
b. lower motor neuron pattern (areflexia, atrophy, weakness)
c. unilateral clonus and hyperreflexia
d. numbness and paresthesia in both feet
If this pt developed bladder symptoms, what neurologic bladder pattern would be present?
a. uninhibited bladder
b. spastic reflex bladder
c. peripheral neurogenic bladder
d. frontal bladder
A
B. lower motor neuron pattern (areflexia, atrophy, weakness)
D. Frontal bladder
15
Q
(Thorax) What is Kussmaul breathing and with which condition is it most commonly associated?
a. increased difficult with expiration; pulmonary obstruction
b. respiration rate that is less than 12 BPM; electrolyte imbalance
c. rapid, deep, and labored breathing; metabolic acidosis
d. respiration rate that is greater than 20 BPM; anxiety
A
C. rapid, deep and labored breathing; metabolic acidosis
16
Q
(Thorax) Bronchial breath sounds heard over the right lung base is indicative of:
a. a normal right lower lobe
b. emphysema
c. consolidation at the right lung base
d. bronchial spasm
A
C. consolidation at the right lung base
17
Q
(Thorax) “Flail chest” is most likely to be seen along with which situation?
a. an enlarged, failing heart
b. fractured ribs
c. pulmonary embolism
d. bronchopneumonia
A
B. Fractured ribs
18
Q
(Abdomen) The normal vertical span of the liver at the midclavicular line is:
a. 4-8 cm
b. 6-8 cm
c. 6-12 cm
d. 8-15 cm
A
C. 6-12 cm
19
Q
(Abdomen) What is Murphy’s sign?
a. rebound tenderness over the RLQ of the abdomen
b. RLQ pain that is intensified when the LLQ is palpated
c. pain over the pt’s stomach when palpating McBurney’s point
d. pain with inspiration during deep palpation over the area of the gallbladder
A
D. pain with inspiration during deep palpation over the area of the gallbladder
20
Q
(Abdomen) An infant with an acute abdominal condition who develops periodic colicky pain ,vomiting and rectal bleeding (“red currant jelly” stool) would be suspected of having:
a. testicular torsion
b. acute gastroenteritis
c. intussusception
d. appendicitis
A
C. Intussusception
21
Q
(R&U) To aid in confirming the diagnosis of renal cysts, WOTF diagnostic imaging examinations should be ordered?
a. intravenous pyelogram
b. KUB
c. plain film of the abdomen
d. retrograde pyelogram
A
A. Intravenous pyelogram
22
Q
(ClinDx) WOTF makes the diagnosis of myocardial infarction MORE likely in a pt with chest pain?
a. the pain can be reproduced by palpation
b. the pain can be reproduced by certain movements
c. the pain is accompanied by nausea and vomiting
d. the pain radiates down the left arm
A
C. the pain is accompanied by nausea and vomiting
23
Q
(ClinDx) WOTF is MOST likely diagnosis in a pt with sharp substernal chest pain, worsening of the pain when the pt lays supine or coughs, shortness of breath, rapid pulse, and a history of a recent viral infection?
a. acute pericarditis
b. acute endocarditis
c. acute costochondritis
d. acute myocardial infarction
A
A. acute pericarditis
24
Q
(ClinDx) A 15 y/o girl is a highly successful soccer player. She has recently been complaining of chest pressure and shortness of breath during practices and games. WOTF findings should be searched for, directly related to the complaint?
a. prolonged exhalation phase of respiration
b. rales and ronchi
c. harsh systolic murmur
d. pericardial friction rub
A
C. harsh systolic murmur
25
(ClinDx) A 55 y/o overweight smoker with a 120 pack/year smoking history has dyspnea and cough with abundant sputum. This complain is 5 years old, and the pt often gets lung infections. There is mild cyanosis. WOTF is the MOST likely diagnosis?
a. emphysema
b. asthma
c. cystic fibrosis
d. chronic bronchitis
D. chronic bronchitis
26
(ClinDx) When comparing chronic bronchitis with emphysema, WOTF primarily relates to emphysema?
a. history of cigarette smoking
b. dyspnea during exertion
c. abundant sputum production
d. development of lung bullae
D. development of lung bullae
27
(ClinDx) A pt develops jaundice with no other symptoms. WOTF is the primary suspicion until proven otherwise?
a. hepatic cirrhosis
b. pancreatic cancer
c. acute hepatitis
d. acute cholecystitis
B. pancreatic cancer
28
(ClinDx) Korsakoff's syndrome will MOST likely be associated with WOTF conditions?
a. hyperthyroidism
b. pancreatitis
c. Addison's disease
d. osteomalacia
B. pancreatitis
29
(ClinDx) WOTF is the most common cause of pancreatitis?
a. cholelithiasis
b. pancreatic pseudocyst
c. hepatitis
d. diabetes mellitus
A. cholelithiasis
30
(ClinDx) Exacerbations and remissions of progressive muscle weakness and fatigue of skeletal muscles, most commonly those innervated by the cranial nerves, with repetitive use and exercise, without alteration in sensation, reflexes, or coordination, would MOST likely be the result of which condition?
a. amyotrophic lateral sclerosis
b. myasthenia gravis
c. hyperthyroidism
d. Lamber-Eaton myasthenic syndrome (LEMS)
B. myasthenia gravis
31
(ClinDx) Which condition will MOST likely lead to a pulmonary embolism?
a. prolonged immobilization
b. cerebrovascular accident
c. primary hyperparathyroidism
d. dyspareunia
A. prolonged immobilization
32
(ClinDx) Carpal tunnel syndrome is NOT an associated complication of which condition?
a. pregnancy
b. acromegaly
c. hyperthyroidism
d. rheumatoid arthritis
C. hyperthyroidism
33
(ClinDx) Unintentional weight gain can be a clinical manifestation of which condition?
a. tuberculosis
b. hypothyroidism
c. depression
d. malignancy
B. hypothyroidism
34
(ClinDx) Inadequate intake of which vitamin may lead to pellagra?
a. niacin
b. thiamine
c. vitamin C
d. vitamin D
A. niacin
35
(ClinDx) A 35 y/o woman complain of weakness; she is having more difficulty picking up her 3 y/o son. She also states that she has lost 15lbs over the past month with no change in her diet and that she is always warm. What is MOST likely diagnosis?
a. hyperthyroidism
b. hypothyroidism
c. Cushing's syndrome
d. Addison's disease
A. hyperthyroidism
36
(ClinDx) A 33 y/o woman complains of being tired and has the inability or desire to perform her normal daily routine. She also states that she has gained 25lbs over the past 2 months with no change in her diet. Upon exam the following is noted: she has coarse and brittle hair; there is delayed relaxation of her deep tendon reflexes; there is good muscle strength. She also complains of being cold all the time. What is MOST likely diagnosis?
a. anemia
b. hypothyroidism
c. Cushing's syndrome
d. hyperthyroidism
B. Hypothyroidism
37
(ClinDx) When examining a pt's tongue, you note left deviation of the tongue when he attempts to stick the tongue straight out. Where is the MOST likely site of the lesion?
a. right CN X
b. right CN XII
c. left CN IX
d. left CN XII
D. left CN XII
38
(ClinDx) Upon examining a pt, you not on passive movement the presence of lead-pipe rigidity. This type of rigidity is MOST commonly associated with WOTF conditions?
a. disorder of the neuromuscular junction
b. lesion within the anterior horn cells
c. basal ganglia lesion
d. peripheral neuropathy
C. basal ganglia lesion
39
(ClinDx) With wotf would you expect the pt to have bilateral and asymmetrical loss of pain and temperature sensations but normal function of all other sensory modalities?
a. cord hemisection
b. posterior cord lesion
c. anterior cord lesion
d. syringomyelia
D. syringomyelia
40
(ClinDx) 45 y/o male presents with muscle weakness in biceps. EMG study demonstrates increased muscle response to repetitive stimuli to the biceps. What is MOST likely diagnosis?
a. myasthenia gravis
b. Eaton-Lambert syndrome
c. cervical disc prolapse
d. Duchenne muscular dystrophy
B. Eaton-Lambert syndrome
41
(ClinDx) Chronic nerve root disease may render innervated muscles tender to the touch due to:
a. tender motor points
b. phantom pain
c. disuse atrophy
d. hysteresis and creep
A. Tender motor points
42
(ClinDx) Where is the "autonomous zone" for the axillary nerve?
a. mid-biceps area
b. mid-triceps area
c. lateral shoulder area
d. superior trapezius area
C. Lateral shoulder area
43
(ClinDx) Spinal nerve root compression will reveal the most sensory deficit in what part of the dermatome?
a. autonomous zone
b. anesthetized area
c. all dermatomes of the peripheral nerve
d. signature area
D. Signature area
44
(ClinDx) What would a muscle test feel like where there is POOR recruitment of motor units?
a. flaccid contraction
b. weak and feeble contraction
c. ratchetlike contraction
d. giving-out weakness with exertion
C. ratchetlike contraction
45
(ClinDx) A 5 y/o child is strapped into a car seat with a three-point seat belt. After a MVA (motor vehicle accident), he sustains a "submarining" injury. What mechanism of injury has occurred?
a. child was projected out of the harness
b. child slipped down low under the lap belt
c. belt compression injury to local subcutaneous tissue and fat necrosis
d. chest belt applied submandibular pressure to cause choking
A. child was projected out of the harness
46
(ClinDx) wotf offers a theoretical rationale for chiropractic care of the child with inner ear fluid build-up?
a. TMJ dysfunction compresses eustachian tube
b. normalize ciliary function in the ear canal and tragus
c. C1 dysfunction blocks the eustachian tube
d. normalize tone of tensor veli palatini
D. normalize tone of tensor veli palatini
47
(ClinDx) What is the characteristic differentation between spasmotic torticollis (ST) and wry neck (capsular joint sprain)?
a. ST is painful and position aggravated
b. wry neck develops as a painless torticollis
c. ST is self-limiting pain condition
d. wry neck is due to a facet-mediated pain
D. wry neck is due to a facet-mediated pain
48
(ClinDx) Clonus is an example of:
a. diminished cortical control of the lower motor neuron
b. inhibition of the lower motor neuron by cortical controls
c. repetitive stimulation and inhibition by cortical controls
d. lower motor neuron lesion
A. diminished cortical control of the lower motor neuron
49
(ClinDx) What does Sherrington's law of reciprocal inhibition help to explain?
a. antagonistic muscle relaxation during agonist contraction
b. inhibition of antagonist if agonist is short and tight
c. co-contraction of antagonist and agonist
d. stabilizer muscle inhibition with core muscle stabilization
B. inhibition of antagonist if agonist is short and tight
50
(ClinDx) 55 y/o smoker presents with left shoulder pain of 8 months' duration. Pain radiates down the medial arm. Has partial ptosis on the left along with a miotic pupil. You should suspect:
a. angina pectoris
b. adhesive capsulitis
c. superior sulcus tumor
d. scalenus anticus syndrome
C. superior sulcus tumor
51
(ClinDx) A pt presents with rapidly worsening polyuria and excessive thirst, accompanied by weight loss despite an increased appetite, what is MOST likely diagnosis?
a. Grave's disease
b. type 1 diabetes mellitus
c. type 2 diabetes mellitus
d. diabetes insipidus
B. type 1 diabetes mellitus
52
(ClinDx) 30 y/o woman presents with tingling and numbness in the first 3 digits of the right hand. You suspect carpal tunnel syndrome. She also reports dry skin, a recent onset of constipation and a lack of energy. You note she has slow speech, is wearing a thick sweater on a warm day, and is modestly overweight. You suspect that carpal tunnel syndrome is secondary to:
a. type 2 diabetes mellitus
b. acromegaly
c. primary hyperparathyroidism
d. hypothyroidism
D. hypothyroidism
53
(ClinDx) 62 y/o cab driver, 35 pack/year cigarette smoker has right hip and thigh pain of 3 days' duration. Describes pain as tightness that is worse in a dependent position. Yesterday, he developed a sudden onset of left subscapular pain and dyspnea. This presentation is MOST likely due to:
a. pulmonary thromboembolism
b. spontaneous pneumothorax
c. congestive heart failure
d. thromboangitis obliterans
A. pulmonary thromboembolism
54
(ClinDx) 66 /yo man has orthopnea, exertional dyspnea and pedal edema. He has distended jugular veins while sitting. Auscultation of the lungs reveals bibasilar crackles. wotf is MOST likely to have caused this condition?
a. hypertension
b. tuberculosis
c. endocarditis
d. ventricular septal defect
A. Hypertension
55
(ClinDx) 55 y/o smoker brought in by her husband because of dizziness and lethargy. He also mentions that his wife has been behaving "irrationally" during the past few days. No other symptoms are reported. wotf conditions BEST explains this presentation?
a. dehydration secondary to diabetes mellitus
b. upper cervical subluxation
c. syndrome of inappropriate antidiuretic hormone secretion secondary to lung cancer
d. pheochromocytoma
C. syndrome of inappropriate antidiuretic hormone secretion secondary to lung cancer
56
(ClinDx) A pt has a cough and erythema nodosum in the pretibial regions bilaterally. Chest radiographs reveal bilateral hilar adenopathy. The MOST likely diagnosis is?
a. lung cancer
b. Pneumocystis carinii pneumonia
c. sarcoidosis
d. asbestosis
C. sarcoidosis
57
(ClinDx) In virtually all areas, a pt with nephrolithiasis will have:
a. flank or groin pain
b. hematuria
c. pyuria
d. fever
B. Hematuria
58
(ClinDx) Blue coloration around the umbilicus is evidence of:
a. metastatic carcinoma
b. intra-abdominal bleeding
c. appendicitis
d. portal hypertension
B. intra-abdominal bleeding
59
(ClinDx) What type of lesion is BEST described as "irregularly-shaped, elevated, progressively enlarging scar; grows beyond boundaries of wound; caused by excessive collagen formation during healing"?
a. cicatrix
b. keloid
c. excoriation
d. these are usual characteristics of scars
B. keloid
60
(ClinDx) A pt's breath has an odd musty odor to it. This may be indicative of:
a. severe liver disease
b. intestinal obstruction
c. tonsil or dental infections
d. diabetes mellitus
A. severe liver disease
61
(ClinDx) One sign of infectious disease is the presence of several lymph nodes that are enlarged and close together such that they feel somewhat like a large mass. These nodes are called:
a. matted
b. discrete
c. moveable
d. connected
A. matted
62
(ClinDx) For a pt who admits to having had a long-term, undiagnosed infection with syphilis, the fingernails could be expected to appear:
a. bent upward toward the tips
b. pitted with small indentations
c. with a significant convex curvature
d. very wide and flat
D. very wide and flat
63
(ClinDx) In a pt with a know chronic venous obstruction in a thigh or leg, you would NOT expect to find what in the affected extremity?
a. normal pulse amplitude
b. cool skin temperature
c. rough skin texture
d. a cyanotic appearance
B. cool skin temperature
64
(ClinDx) wotf examination findings would NOT be a sign of emphysema?
a. during inspection of the pt, ribs appear nearly horizontal
b. in percussion of the lung fields, diaphragmatic excursion is decreased
c. in auscultation of the chest, spoken words sound loud through a stethoscope
d. tactile fremitus feels diminished during palpation of the thorax
C. in auscultation of the chest, spoken words sound loud through a stethoscope
65
(LabInt) The clinical use of the laboratory analysis of a hair sample has been highly criticized, but it is still considered an accurate method to assess for:
a. heavy and toxic metals
b. water and lipid-soluble vitamins
c. calcium and fat-soluble vitamins
d. protein and manganese
A. heavy and toxic metals
66
(LabInt) Cold water ear irrigation would normally cause:
a. consensual eye motion to opposite side
b. nystagmus away from the cold side
c. optokinetic nystagmus
d. rotatory nystagmus
B. nystagmus away from the cold side
67
(LabInt) The most common causes of megaloblastosis are:
a. folic acid and cobalamine deficiency
b. niacin and folic acid deficiency
c. thiamine and cobalamine deficiency
d. thiamine and niacin deficiency
A. folic acid and cobalamine deficiency
68
(LabInt) What lab test aids in confirming the diagnosis of myasthenia gravis?
a. alanine aminotransferase
b. CA-125
c. carcinoembryonic antigen
d. Tensilon test
D. Tensilon test
69
(LabInt) In general the earliest sign of renal parenchymal disease is:
a. hematuria
b. elevated BUN and creatinine
c. proteinuria
d. hypoalbuminemia
C. Proteinuria
70
(LabInt) A decreased RBC count, decreased hemoglobin concentration, and increased MCV may be caused by:
a. iron deficiency
b. thalassemai minor
c. folate/B12 deficiency
d. acute blood loss
C. folate/B12 deficiency
71
(LabInt) wotf is the primary diagnostic blood test for acute pancreatitis?
a. serum aspartate transaminase
b. serum glucose
c. serum gastrin
d. serum amylase
D. Serum amylase
72
(CaseHx) A pt presents complaining of posterior neck pain following a car accident. What component of the case history would BEST describe how the tissue was injured?
a. character of complaint of the symptoms
b. date of the accident and onset of symptoms
c. factor that make the symptoms worse
d. mechanism of injury
D. mechanism of injury
73
(CaseHx) wotf is NOT an indication for taking radiographs?
a. persistent localized pain (10 days)
b. symptoms associated with neurologic signs in the lower extremities
c. rapidly progressing or atypical scoliosis and other spinal deformities
d. predisposition for ascending aortic aneurysm
A. persistent localized pain (10 days)
74
(CaseHx) wotf is NOT an indicator of possible severe underlying pathology?
a. age over 50
b. high-risk ligament laxity populations
c. neck pain in the sagittal plain in the absence of trauma
d. arm or leg pain with neck movements
C. neck pain in the sagittal plain in the absence of trauma
75
(CaseHx) Which information from the case history is NOT a likely contraindication for manipulation?
a. peripheral nervous system signs and symptoms
b. no response to care after 4-7 weeks
c. dysphasia, impaired consciousness
d. sudden onset of acute and unusual neck pain and/or headache (typically occipital) with or without neurologic symptoms
A. peripheral nervous system signs and symptoms
76
(CaseHx) wotf is an indicator of function overlay in low back pain pt's?
a. LBP on moderate cervical compression
b. radiating pain to the leg
c. restricted range of motion
d. inability to stand for a prolonged period of time
A. LBP on moderate cervical compression
77
(CaseHx) What does the term "yellow flag" mean?
a. relative contraindication for SMT; proceed with caution
b. physical barrier to recovery
c. Waddell's signs
d. psychosocial barrier to recovery
D. psychosocial barrier to recovery
78
(CaseHx) Which information obtained in the case history is NOT a risk factor for osteoarthritis?
a. Caucasian female
b. weight of 190lbs in a female measuring 5'5"
c. occupation as a farmer
d. history of a slipped femoral capital epiphysis
A. Caucasian female
79
(CaseHx) Which information obtained in the case history will NOT help in differentiating between an inflammatory and a noninflammatory spinal condition?
a. presence of morning stiffness
b. pain location
c. presence of gelling phenomenon
d. pt's response to exercise
B. pain location
80
(EvoChiroPrin) What was published in 1996 representing a series of statements describing the nature of chiropractic and its professional attributes. Has been adopted by the ACA, ICA and World Federation of Chiropractic.
a. Magna Report
b. Agency for Health Policy and Research Report
c. Consortium for Chiropractic Research Consensus Statement
d. Association of Chiropractic Colleges' Chiropractic Paradigm
D. Association of chiropractic colleges' chiropractic paradigm
81
(EvoChiroPrin) wotf early chiropractic authors perpetuated the theory that subluxations would reduce the flow of mental impulses from brain cell to tissue cell?
a. Solon Langworthy
b. Ralph W Stephenson
c. Oakley Smith
d. none of the above
D. none of the above
82
(EvoChiroPrin) From a review of BJ Palmers' writings, it has been suggested that his primary reason to hold firm to innate philosophy was to:
a. contrast chiropractic and medicine
b. provide legal defense
c. reject contemporary mechanistic theory
d. prove the validity of subluxation
B. provide legal defense
83
(EvoChiroPrin) What discipline did DD Palmer attempt to merge with science that became the early foundation of vitalism?
a. osteopathy
b. occultism
c. metaphysics
d. naprapathy
C. metaphysics
84
(Sublux/Lesions) Which component of the hierarchic organization of the vertebral subluxation complex is the "central goal" in chiropractic clinical practice?
a. neuropathology
b. myopathology
c. kinesiopathology
d. histopathology
C. Kinesiopathology
85
(Sublux/Lesions) What is the central theme of neurodystrophic hypothesis, which can modify the immune system and alter nerve function?
a. Chemical irritation
b. lowered tissue resistance
c. converging pain fibers
d. referred pain
B. lowered tissue resistance
86
(Sublux/Lesions) Mild neurologic complications occur secondary to cervical manipulation in 1 of ___ cases?
a. 400
b. 4,000
c. 40,000
d. 400,000
C. 40,000
87
(Sublux/Lesions) woft statements is NOT true of helper T cell response?
a. B cells proliferate and become plasma cells
b. T cells synthesize antibodies
c. antibodies are Y-shaped proteins
d. the shaft of the antibody attaches to macrophages
B. T cells synthesize antibodies
88
(Sublux/Lesions) Which researcher is credited with laying the groundwork for the subluxation theory that chiropractors call the "proprioceptive insult hypothesis"?
a. Irvin Korr
b. Major DeJarnette
c. C.O. Watkins
d. Willard Carver
A. Irvin Korr
89
(Sublux/Lesions) Pain and inflammation are typically associated with spinal subluxation. What is the term used to describe the state in which C-fibers and local tissue cells perpetuate inflammation?
a. acute inflammation
b. chronic inflammation
c. neurogenic inflammation
d. reflex sympathetic dystrophy
C. neurogenic inflammation
90
(Sublux/Lesions) Which neurologic concept related to vertebral subluxation is INACCURATE and MISLEADING?
a. neurocompression
b. altered afferent input
c. somatovisceral
d. proprioceptive insult hypothesis
D. proprioceptive insult hypothesis
91
(Sublux/Lesions) wotf are considered to be subluxation syndromes?
a. intervertebral disc syndrome
b. sacroiliac syndrome
c. facet syndrome
d. all of the above
D. all of the above
92
(Sublux/Lesions) Which term is used to describe a putative (generally considered) mechanism by which a neurocompressive spinal subluxation will influence the nervous system?
a. altered axoplasmic transport
b. proprioceptive irritation
c. somatovisceral reflex
d. disc herniation
A. altered axoplasmic flow
93
(Sublux/Lesions) wotf terms is used to describe a physiologic mechanism by which spinal subluxation can influence the central nervous system in a general fashion and lead to nonpain symptoms such as clumsiness, depression and fatigue?
a. brain hibernation
b. psychosomatic responses
c. neurodystrophy
d. dystopia
A. brain hibernation
94
(Sublux/Lesions) wotf is the MOST accurate statement to describe a reduction of pain after a spinal adjustment?
a. a subluxation has been corrected
b. mechanoreceptors were stimulated, leading to segmental nociceptive inhibition
c. nerve interference has been corrected
d. the chiropractic encounter can often result in an analgesic response
D. the chiropractic encounter can often result in an analgesic response
95
(Sublux/Lesions) name the mechanism associated with articular structural dysfunction capable of mimicking the signs and symptoms of internal organ disease.
a. viscersomatic reflex
b. facilitative lesion
c. simulated visceral disease model
d. primary visceral dysfunction
C. simulated visceral disease model
96
(Sublux/Lesions) which is NOT considered to be a result of joint fixation?
a. change in nociceptive reflexes
b. pain
c. regenerative change
d. muscle spasticity
C. regenerative change
97
(Sublux/Lesions) The neuropathophysiologic component of the Faye model of vertebral subluxation complex is MOST associated with:
a. irritation/compression
b. muscle spasticity
c. joint hypomobility
d. histamine/prostaglandin changes
A. irritation/compression
98
(Sublux/Lesions) Which term would NOT be used is a static definition of vertebral subluxation?
a. retrolisthesis
b. extension malposition
c. segmental hypomobility
d. altered intersegmental spacing
C. segmental hypomobility
99
(Sublux/Lesions) Cervical subluxation at what level is most often associated with cerebrovascular accident or stroke?
a. C0-C1
b. C3-C4
c. C5-C6
d. C7-T1
A. C0-C1
100
(Sublux/Lesions) Name the third stage of spinal degeneration.
a. stabilization
b. hypomobility
c. instability
d. dysfunction
A. stabilization
101
(Sublux/Lesions) The hypothesis in which subluxation is proposed to irritate somatic afferent nerves resulting in the mimicry of visceral disease is referred to as:
a. decreased axoplasmic transport
b. neurodystrophic
c. disease simulation model
d. joint dysafferentation
C. disease simulation model
102
(Sublux/Lesions) According to what hypothesis, spinal biomechanical insult to nerves may affect intraneuronal axoplasmic transport mechanisms and in turn affect the quality of trophic influences and molecular (chemical) changes in the cells?
a. nerve compression
b. aberrant spinal reflex
c. somatosomatic reflex
d. neurodystrophic
D. neurodystrophic
103
(Sublux/Lesions) which subluxation hypothesis is NEST describe by the phrase "lowered tissue resistance is the cause of disease"?
a. decreased axoplasmic transport
b. neurodystrophic
c. disease simulation model
d. joint dysafferentation
B. neurodystrophic
104
(Sublux/Lesions) the earliest of chiropractic explanations or hypotheses regarding the proposed effects of vertebral subluxation on nerve function and chiropractic case management is the:
a. nerve compression
b. aberrant spinal reflex
c. somatosomatic reflex
d. decreased axoplasmic transport
A. nerve compression
105
(Sublux/Lesions) identify the component of the PARTS acronym that is most closely associated with the histopathologic component of vertebral subluxation complex.
a. pain and tenderness
b. asymmetry
c. range of motion abnormality
d. tissue, tone, texture and temperature abnormality
D. tissue, tone, texture and temperature abnormality
106
(Sublux/Lesions) identify the component of the PARTS acronym that is most closely associated with the neuropathophysiologic component of vertebral subluxation complex.
a. pain and tenderness
b. asymmetry
c. range of motion abnormality
d. tissue, tone, texture and temperature abnormality
A. pain and tenderness
107
(Sublux/Lesions) all of the following are associated with segmental dysfunction except:
a. loss of normal motion
b. signs or neuromuscular dysfunction
c. misalignment of the motion segment
d. point tenderness or altered pain threshold
C. misalignment of the motion segment
108
(Sublux/Lesions) An aggregate of signs and symptoms of spinal and pelvic motion segments or to peripheral joints is:
a. subluxation complex
b. subluxation syndrome
c. manipulable subluxation
d. vertebral subluxation
B. subluxation syndrome
109
(Sublux/Lesions) The unified model of vertebral subluxation complex does NOT include which phase?
a. phase of segmental dysfunction
b. phase of rehabilitation
c. phase of instability
d. phase of stabilization
B. phase of rehabilitation
110
(Sublux/Lesions) which 2 components of the vertebral subluxation complex are common to concepts of subluxation? (choose 2)
a. kinesiopathology
b. myopathology
c. histopathology
d. neuropathology
A/D
A. kinesiopathology
D. neuropathology
111
(Sublux/Lesions) Clinical features of facet syndrome usually present with all of the following EXCEPT:
a. hip pain
b. buttock pain
c. calf pain
d. back pain
C. Calf pain
112
(BasicScienceConcepts) the posterior aspect of the intervertebral discs is innervated by:
a. recurrent meningeal
b. medial branch of the posterior primary division (dorsal ramus)
c. the lateral branch of the anterior primary division
d. vagus nerve
A. recurrent meningeal
113
(BasicScienceConcepts) 3 pathways for pain are considered discriminative. The primary of these pathways for the transmission of nociception is:
a. paleospinothalamic tract
b. neospinothalamic tract
c. nociceptothalamic tract
d. thalamoreticular tract
B. neospinothalamic tract
114
(BasicScienceConcepts) reliability is a measurement of all of the following EXCEPT:
a. reproducibility
b. accuracy
c. consistency
d. sameness
B. accuracy
115
(BasicScienceConcepts) Algometry refers to the measurement of:
a. angles
b. temperature
c. pain
d. force
C. Pain
116
(BasicScienceConcepts) According to Giles, wotf structures is NOT innervated?
a. zygapophyseal joint
b. synovila fold
c. ligamentum flavum
d. intervertebral disc
C. ligamentum flavum
117
(BasicScienceConcepts) Reflexes whose afferent and efferent pathways are visceral sensory fibers and autonomic nerve fibers would be termed:
a. somatosomatic
b. viscerovisceral
c. somatovisceral
d. vicerosomatic
B. viscerovisceral
118
(BasicScienceConcepts) Reflexes who afferents are somatic sensory fibers and whose efferents are autonomic efferent fibers are termed:
a. somatosomatic
b. viscerovisceral
c. somatovisceral
d. vicerosomatic
C. somatovisceral
119
(BasicScienceConcepts) An explanation for the adaptive behavior used to distract the nervous system from the perception of pain through such acts as rubbing an elbow that has just been bumped, scratching an itch or shaking off a traumatized joint is:
a. stimulus-induced paresthesia
b. somatosympathetic reflex
c. efferent inhibition
d. gate-control theory
D. gate-control theory
120
(BasicScienceConcepts) what is the relationship in size of the cervical IVF to the nerves and nerve roots in that region?
a. completely fill the anteroposterior diameter of the cervical IVF
b. the IVF is 5-6 times the diameter of the nerves
c. completely fill the vertical diameter of the cervical IVF
d. IVF is approximately 12 times the diameter of the nerves
A. completely fill the anteroposterior diameter of the cervical IVF
121
(BasicScienceConcepts) a nerve that includes preganglionic and postganglionic fibers would be:
a. visceral afferent
b. visceral efferent
c. somatic afferent
d. somatic efferent
B. visceral efferent
122
(BasicScienceConcepts) these two vertebral ligaments are likely the MOST stabilizing in preventing or decreasing hyperflexion in the cervical spine:
a. ligamentum nuchae/ligamentum flavum
b. ALL/PLL
c. supraspinous ligament/ligamentum nuchae
d. intertransverse ligament/ ALL
C. supraspinous/ligamentum nuchae
123
(BasicScienceConcepts) wotf structures does NOT traverse the IVF?
a. mixed spinal nerve
b. lymphatic channels
c. communicating veins between the internal and external vertebral venous plexuses
d. gray communicating ramus
D. gray communicating ramus
124
(BasicScienceConcepts) wotf identifies type III receptor nerve endings?
a. unmyelinated nerve endings weaving throughout the capsule; nociceptors
b. larger joint ligament corpuscles; thinly capsulated
c. fibrous capsule containing conical corpuscles in the deep layers; thickly encapsulated mechanoreceptors
d. globular corpuscles in the fibrous capsule; thinly encapsulated mechanoreceptors
B. larger joint ligament corpuscles; thinly capsulated
125
(BasicScienceConcepts) according to Gatterman/Goe model of segmental dysfunction, the release of platelets and serotonin does what to nerve endings?
a. sensitizes
b. desensitizes
c. liberates
d. depletes
A. sensitizes
126
(BasicScienceConcepts) of the afferent fibers innervating musculoskeletal tissues, which is the MOST abundant?
a. group I (A-alpha fibers)
b. group II (A-beta fibers)
c. group III (A-delta fibers)
d. group IV (C fibers)
D. group IV (C fibers)
127
(BasicScienceConcepts) wotf nerve fibers function to regulate local tissue homeostasis?
a. group Ia afferents
b. C-fibers
c. A-beta fibers
d. group IV afferents
B. C-fibers
128
(BasicScienceConcepts) the posterior aspect of the intervertebral disc is innervated by:
a. dorsal ramus
b. sinuvertebral nerve
c. group II, III and IV afferents and gray rami
d. A fibers and C-fibers
C. group II, III and IV afferents and gray rami
129
(AppliedChiroPrinc) the common palpatory/observable characteristics of a PI ilium include:
a. higher iliac crest (standing)
b. functionally shorter leg (sitting)
c. superior PSIS
d. functionally long leg (sitting)
D. functionally long leg (sitting)
130
(AppliedChiroPrinc) wotf disc herniations would you expect to respond MOST favorably to traction therapy?
a. medial to the nerve root
b. lateral to the nerve root
c. anterior to the nerve root
d. posterior to the nerve root
B. lateral to the nerve root
131
(AppliedChiroPrinc) when delivering an HV-LA thrust to the upper cervical spine, which combined ranges of motion should be avoided as much as possible?
a. flexion/extension
b. extension/rotation
c. lateral flexion/extension
d. flexion/rotation
B. extension/rotation
132
(AppliedChiroPrinc) increasing the tension significantly on the table pads before performing a drop table-assisted adjustment will change the delivery of the adjustment in what way?
a. requires less force utilization by the adjuster
b. patient experiences decreased application of force by the adjuster
c. requires greater force utilization by the adjuster
d. patient experiences no difference in the force appiled by the adjuster
C. requires greater force utilization by the adjuster
133
(AppliedChiroPrinc) why is it important to rule out cervical spine subluxation on a pt displaying leg length inequality before adjusting for a PI ilium?
a. leg length growth is not always bilaterally symmetrical
b. the PI ilium may cause cervical subluxation
c. leg length inequality may be physiologic and not anatomic
d. cervical subluxation may cause leg length inequality
D. cervical subluxation may cause leg length inequality
134
(AppliedChiroPrinc) why is leg length inequality often an unreliable indicator of subluxation in a pediatric pt?
a. leg length growth is not always bilaterally symmetrical
b. the PI ilium may cause cervical subluxation
c. leg length inequality may be physiologic and not anatomic
d. cervical subluxation may cause leg length inequality
A. leg length growth is not always bilaterally symmetrical
135
(AppliedChiroPrinc) this segmental contact should not be used in the lumbar spine:
a. mammillary process
b. spinous process
c. transverse process
d. lamina
C. transverse process
136
(AppliedChiroPrinc) wotf statements describes the connective tissue component of the vertebral subluxation complex?
a. plays the central role as mediator of all subluxation effects
b. synovial fluid undergoes fibrofatty consolidation
c. disuse atrophy is a consequence of immobilization
d. retrograde venous flow can bring toxins to the site of immobilization
B. synovial fluid undergoes fibrofatty consolidation
137
(AppliedChiroPrinc) wotf symptoms is NOT associated with reflex sympathetic dystrophy?
a. spontaneous burning pain
b. hyperpathia
c. peripheral tissue dystrophic changes
d. hypoalgesia
D. hypoalgesia
138
(AppliedChiroPrinc) Panjabi and White have shown that a 10.8 mph rear-end collision with impact duration of 0.1 second will accelerate the lead vehicle ___ times the force of gravity:
a. 2
b. 3
c. 4
d. 5
D. 5
139
(AppliedChiroPrinc) wotf symptoms of thoracic outlet syndrome is NOT an initial management indication for surgical consultation?
a. chronic pain
b. vascular ischemia
c. embolic complication
d. muscle wasting
A. chronic pain
140
(AppliedChiroPrinc) wotf terms is INCONSISTENT with an intervertebral disc?
a. herniation
b. degeneration
c. inflammation
d. exostosis
D. exostosis
141
(AppliedChiroPrinc) which nucleus receives nociceptive input from cervical structures innervated by the upper/mid cervical nerves and can lead to cervicogenic headache?
a. nucleus cuneatus
b. sentral cervical nucleus
c. trigeminocervical nucleus
d. substantia gelatinosa
A. nucleus cuneatus
142
(AppliedChiroPrinc) the term "facilitated segment" is used in relation to spinal dysfunction. wotf is synonymous with "facilitated segment"?
a. central sensitization
b. neurogenic inflammation
c. central excitatory state
d. hyperexcitable segment
A. central sensitization
143
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(AppliedChiroPrinc) the atlas was adjusted and pain in the right hand, left foot and low back improved. wotf antinociceptive mechanisms can explain this outcome?
a facilitated segement
b. sentral sensitization
c. diffuse noxious inhibition
d. allodynia
```
C. diffuse noxious inhibition
144
(AppliedChiroPrinc) wotf is an example of a neuroendocrine response to nociception that may influence subluxation processes?
a. hypercortisolemia
b. substance P release
c. opiate release from white cells
d. cytokine release from histiocytes and fibroblasts
A. hypercortisolemia
145
(AppliedChiroPrinc) wotf "theoretic models" of subluxation can represent a medical emergency that should be referred for a surgical consult?
a. dysafferentation
b. spinal cord compression
c. somatovisceral reflex
d. IVF encroachment
B. spinal cord compression
