Other Ortho Management Flashcards
Following a left CVA, Joe, a 67 year old retired assembly worker, is being treated by OT. Joe complains of pain and stiffness in his left hand while completing a woodworking activity. Which of the ff. conditions might the OTA suspect?
a. Osteoarthritis
b. Heterotopic ossification
c. Osteoporosis
d. Contractures
Osteoarthritis
The following is/are symptoms of Osteoarthritis except:
a. (-) Crepitus
b. Gelling
c. Movement related joint pain
d. (+) Nodes
e. Band C
(-) Crepitus
What is the effect of visco supplementation (injectable hyaluronic) to the body?
a. Increase Cell immunity
b. Decrease Inflammation
c. Increase joint lubrication
d. AOTA
Increase joint lubrication
The following is/are symptoms of Rheumatoid Arthritis:
a. (+) Crepitus
b. Gelling
c. Movement related joint pain
d. (+) Nodules
е. A and D
(+) Nodules
Methotrexate
a. NSAIDs
b. DMARDs
c. Both above
d. NOTA
NSAIDs
Steroids can be used for the following except:
a. Gout
b. SLE
c. RA
d. DM-PM
Gout
A client with systematic lupus erythematosus (SLE) has been on a high-dose oral corticosteroid for some time. Lately she has been complaining of increased fatigue when climbing steps and pain at rest in the right hip. What might your hypothesis be regarding these symptoms?
а. The client could have an infection, although no fever was reported. The therapist could ask the patient to call her doctor.
b. The client could have myopathy of the proximal muscles of the lower extremity secondary to the corticosteroid
c. The client has likely been overdoing her exercises and is fatigued, thus should take more rest periods, especially because of the corticosteroids
d. The client is not reporting symptoms fully. The therapist could ask family member what symptoms or client behavior changes they have noted
The client could have myopathy of the proximal muscles of the lower extremity secondary to the corticosteroid
Evaluation results for a person with arthritis will MOST accurately reflect true functional abilities if scheduled:
a. Early morning (8 to 10 am)
b. Afternoon
c. Late morning (10 to 11 am)
d. Early morning and again in the afternoon
Early morning and again in the afternoon
Type of joints affected in Osteoarthritis
a. Pinching joints only (DIPs, PIPs)
b. Pinching and weightbearing joints
c. Weightbearing joints only (Knee, MTP)
d. It affects joints randomly
Pinching and weightbearing joints
Which of the following describes the hand deformity of a patient with Rheumatoid Arthritis?
a. Radial drifting of the MCPs, Ulnar drifting of the wrist forming a Z deformity
b. Ulnar drifting of the MCPs, Radial drifting of the wrist forming a Z deformity
c. Boutonniere deformity
d. A and C
e. B and C
B and C
OT practitioner is assessing hand function in a man with arthritis by observing him as he makes a peanut butter sandwich. The individual is unable to move the lid from a 28-ounce peanut butter jar but is able to stand at the counter, spread peanut butter on the bread with a knife, and replace the lid when he has finished making the sandwich. These observations would MOST accurately reflect deficit in the performance component:
a. Range Of Motion
b. Coordination
c. Endurance
d. Strength
Strength
A patient with Rheumatoid Arthritis reported experiencing pain at the weightbearing part of their foot. What shoe modification would you recommend?
a. Sesamoid pad
b. Toe crest
c. U shaped pad
d. Metatarsal pad
e. Thomas heel
Metatarsal pad
An OTR is performing a UE functional assessment on an elderly client with rheumatoid arthritis. The OTR is MOST likely to determine that the client has limited internal rotation if the client is unable to touch the:
a. Back of the neck
b. Top of the head
c. Lower back
d. Opposite shoulder
Lower back
A patient with RA was referred to you for occupational therapy. He reported being able to perform self-care tasks only. The rest of his activities are limited.
What is his global functional status?
a. Class IV
b. Class III
c. Class II
d. Class I
Class III
When administering an evaluation of upper extremities function to a newly admitted patient with Fibromyalgia experiencing extreme pain and fatigue in doing self-care activities. it is MOST important to:
a. Test proximal muscle strength first
b. Perform the evaluation over several sessions.
c. Include sensory testing
d. Continue with the evaluation
Perform the evaluation over several sessions.
Direction of the wrist deformity in Z-deformity in RA:
a. Radial Deviation/Rotation
b. Ulnar Deviation/ Rotation
c. A and B
d. None of the above
e. NOTA
Radial Deviation/Rotation
Ajax, a 24-year-old male is asking for a shoe modification that can be used by his mother suffering from osteoarthritis. What would you recommend?
a. Medial Heel Wedge
b. Thomas heel
c. Reverse Thomas heel
d. Lateral Heel wedge
Lateral Heel wedge
Classification of OA:
a. Presence of Heberden’s nodes
b. Age more than 40 years old
c. Family history of nodes
d. Joint space narrowing at any finger joint
e. All of the above
All of the above
Limitation in avocational and vocational activities; Able to perform self-care:
a. Class I
b. Class Il
c. Class III
d. Class IV
Class III
Osteoporosis with slight bone destruction, adjacent muscle atrophy and rheumatoid nodules.
a. Mild
b. Moderate
c. Severe
d. Terminal
Moderate
An OT practitioner is fabricating a splint for a client who has rheumatoid arthritis. Which of the following splints is MOST appropriate for the purpose of resting the joints, decreasing pain, and preventing contractures?
a. A protective MP joint splint
b. A wrist stabilization splint
c. An ulnar drift positioning splint
d. A volar resting splint
A volar resting splint
During a home visit, a client with rheumatoid arthritis informs the OT practitioner that her joints have recently become very painful and inflamed. She reports she has been performing her activity program despite the pain and demonstrates a series of briskly executed active range of motion movements.
The BEST response of the OT practitioner is to instruct the client to:
a. Continue performing her program as she has been
b. Instruct her to perform gently active range of motion with weight as tolerated
c. Eliminate all range of motion exercises for a week
d. Perform only gentle active range of motion
Perform only gentle active range of motion
You are instructing Joint Protection techniques to a client with RA. When opening a jar counter-clockwise, which hand should be used?
a. Right hand will stabilize while left hand opens the jar
b. Right hand will open the jar while the left hand stabilizes
c. Either of two can be used to stabilize and open the jar
d. Ask for assistance to protect the radially joints
Right hand will open the jar while the left hand stabilizes
Which of the following techniques do you recommend when stirring?
a. Using your left hand stir counterclockwise
b. Using your right hand stir clockwise
c. Using your right hand stir counterclockwise
d. A and B
e. AOTA
Using your right hand stir counterclockwise
After completing yesterday’s independent exercise program of moist heat and active range of motion (AROM), a patient with rheumatoid arthritis states that she felt pain in her joints for 30 minutes after. What is the best treatment for today’s session?
a. Moist heat and passive range of motion (PROM) only
b. Moist heat and the same exercise program
c. Ice area and PROM only
d. Ice and immobilize
Moist heat and the same exercise program
The OT practitioner is instructing a patient who has had a myocardial infarction in energy conservation techniques. The BEST example of limiting the amount of work needed for a task is
a. using a side-loading washer
b. wearing permanent-press clothing
c. using an extended-handle dustpan
d. using good body mechanics
e. NOTA
wearing permanent-press clothing
Manual therapy techniques can be used to your 6g year old aunt with degenerative OA. She has genu varus and limitation towards full flexion and extension. Which of the following techniques is contraindicated:
a. PROM, accessory joint motion
b. Aggressive stretch
c. Massage technique
d. All of the above
Aggressive stretch
A client who has severe rheumatoid arthritis, but is currently in remission, wants to engage in strengthening program. What type of exercises would be most beneficial?
a. Concentric
b. Eccentric
c. Isotonic
d. Isometric
Isometric
An OT practitioner is interviewing a client who believes she is suffering from chronic low back pain. As part of the educational process, the OTR explains the differences between acute versus chronic pain to the client. Chronic pain is
a. Pain that is associated with an inflammation or irritation that lasts for a brief period of time
b. Pain as a result of disease or injury that persists for long segments of time and has not resolved itself in the anticipated time
c. Pain as a result of surgery that lasts for hours, days, or weeks
d. Pain that presents itself through motor behaviors such as limping
Pain as a result of disease or injury that persists for long segments of time and has not resolved itself in the anticipated time
A long-term goal for a 60-year-old client with back pain is to be able to return to work as an illustrator. The client has achieved the short-term goal of sitting at a work table for 20 minutes. The BEST example of a revised of a short-term goal for this client is:
a. “client will draw sitting at work table”
b. “client will draw for 1 hour, taking stretch breaks every 20 minutes”
c. “instruct client in stretching techniques to be performed every 20 minutes”
d. “instruct client in the use of proper body mechanics that applies to prolonged seating”
“client will draw for 1 hour, taking stretch breaks every 20 minutes”
Which movements should a patient with RA avoid?
a. Strong and sustained grips, heavy lifting, wrist ulnar positioning, key, tripod, and pinch grips
b. Strong and sustained grips, twisting heavy lifting, wrist ulnar positioning, key, tripod, and pinch grips
c. Strong and sustained grips, heavy lifting, wrist radial positioning, key, tripod, and pinch grips
d. Strong and sustained grips, twisting heavy lifting, wrist radial positioning, key, tripod, and pinch grips
Strong and sustained grips, twisting heavy lifting, wrist radial positioning, key, tripod, and pinch grips
Pathomechanics of wrist instability in patients with Rheumatoid Arthritis:
a. Carpals shift to the ulnar direction, MCPs rotate to the ulnar side
b. Carpals shift to the radial direction, MCPs rotate to the ulnar direction
c. Carpals shift to the ulnar direction, MCPs rotate to the radial direction
d. Carpals shift to the radial direction, MCPs rotate to the radial side
Carpals shift to the ulnar direction, MCPs rotate to the radial direction
Basic body mechanics assist both the patient and the therapist. All of the following are good body mechanics except:
a. When possible push, pull, or slide an object rather than pick it up
b. Slight body twisting will provide more lift when picking up a heavy object
c. Maintain your center of gravity (COG) close to the COG of the object you are holding
d. Widen your base of support to stabilize your vertical gravity line
e. NOTA
Slight body twisting will provide more lift when picking up a heavy object
In a work-hardening program, an OT practitioner teaching a man with an excessive anterior pelvic tilt how to use proper body mechanics during lifting tasks. The MOST appropriate emphasis of the instruction should be correction of:
a. stenosis
b. scoliosis
c. kyphosis
d. lordosis
lordosis
The OTR instructs a client with chronic neck pain to use psychosocial pain management techniques. Which of the following BEST represents psychosocial strategies commonly used by OT practitioners?
a. Biofeedback, distraction, relaxation techniques
b. Specific skill training
c. Strength-and endurance-building techniques
d. Cognitive retraining techniques
Biofeedback, distraction, relaxation techniques
A student OT practitioner needs to design an adaptation and decide to focus on gardening for a client with a back injury. The MOST appropriate adaptation for him to design would be
a. ergonomically correct hand tools
b. a wheelbarrow with elongated handles
c. a 12- inch-high seat with tool holders
d. a raised-bed garden
a raised-bed garden
Which of the following movements are contraindicated in pregnant women?
a. Pelvic floor exercises
b. Abdominal exercises
c. Straight leg raises
d. NOTA
Straight leg raises
After cesarean section what exercise to give except
a. Delay ambulation or mobilization
b. Pelvic and abdominal exercises
c. Bed exercises
d. NOTA
Delay ambulation or mobilization
In pregnant women, how long does LBP persist?
a. 8 months
b. 6 months
c. 10 months
d. 12 months
12 months
The following are contraindicated for pregnant women except
a. Deep heating agents
b. Superficial heating agents
c. Electrical stimulation
d. Ultrasound
e. Joint traction
Superficial heating agents
You are teaching a patient with osteoarthritis joint protection techniques, specifically avoiding positions of deformity, which of the following would you emphasize?
a. Avoid ulnar movements on their MCPs
b. Avoid radial movements on the wrist joint
c. Aand B
d. None of the above
None of the above
The following joint deformities are seen in RA except
a. Mutilans deformity
b. Nodules
c. Nodes
d. Ankylosis
e. All are seen in RA
Nodes
Tender point in Fibromyalgia
a. Teres minor
b. Infraspinatus
c. 3rdribs
d. Medial epicondyle
e. None of the above
3rd ribs
At which part of the day does stiffness get worse for patient with arthritis?
a. Evening
b. Afternoon
c. Early morning
d. Randomly throughout the day
Early morning
Complete destruction of bone resulting to bone deformity, extensive atrophy, and rheumatoid nodules
a. Mild
b. Moderate
c. Severe
d. Terminal
Terminal
The principal muscle involved in light hand closure
a. Lumbricals
b. Flexor digitorum profundus
c. Interossei
d. Flexor digitorum superficialis
Flexor digitorum profundus
In a flexor tendon injury, what is the position of the IP?
a. 90 degrees flexion
b. NOTA
c. 20-30 degrees flexion
d. Extension
Extension
The functional position of the ulna includes the following except
a. None of these
b. Slight extension of the wrist to 40 degrees
c. Radial deviation to 5 degrees
d. Ulnar deviation to 15 degrees
Slight extension of the wrist to 40 degrees
The muscle which has its distal attachment on the pisiform
a. Flexor carpi radialis
b. Extensor carpi radialis longus
c. Flexor carpi ulnaris
d. Extensor carpi radialis brevis
Flexor carpi ulnaris
Type of arthritis common to male than females
a. SLE
b. RA
c. OA
d. Gout
Gout
