PMR qbank question review Flashcards
how deep into the tissue does superficial heat penetrate?
1-2 cm
US produces the highest temps in what tissue?
bone
frequency of US is set at…
0.8 - 1.1 MHz
How deep does US heat structures to >100F
8cm
how deep does short wave diathermy penetrate
5cm
what modality helps with hematomo resolution
microwave diathermy
gate theory involves which nerve fibers
large myelinated Type A fibers
most conventional TENS setting
high frequency, low intensity
minimum amount of weight needed for cervical traction
25 lbs
muscle contraction with greatest force
fast eccentric
how much body weight is needed to help with lumbar traction
1/4-1/2 of body weight (atleast 50-100lbs)
what % of patients with polymyositis have myalgies?
<30%
what is Pannus
hypertrophied synovium
polymyositis has a strong association with?
Malignancy
what epitope is associated with RA
HLA-DR4
what percent of RA patients are RF +
80%
Pseudogout is associated with… (6)
amyloidosis hypothyroidism hypomagnesia hypophosphatemia hyperparathyroidism hemochromatosis
DISH is associated with
Metabolic syndrome
average amount of time between gout attacks
11 months
rupture of terminal portion of extensor hood?
what test to diagnose
Boutoneirre deformity
Elson test
Podagra is seen in…. (3)
RA, sarcoid, gout
where is the joint narrowed in hip OA
superolateral joint space narrowingon Xray
which diseases are associated with HLA-B27
enteropathic arthropathy
ankylosing spondylitis
Reiters syndrome
hand joint most affected by hand OA
first CMC joint
most common A-A joint subluxation direction is
anterior
chest expansion less than _____ cm is predictive of respiratory difficulties in restrictive lung disease
7-8cm
organism associated with reactive arthritis
salmonella
what effect does methotrexate have on rheumatoid nodules
worsens them
what is Caplans syndrome
coal worker with pneumoconiosis and RA with RF+
what % of patients with psoriasis develop inflammatory joint disease
5%
What is Feltys syndrome
RA, splenomegaly, and leukopenia
what test should be ordered before starting Plaquenil (Hydroxychloroquine)
eye exam
routine testing while on Methotrexate?
monthly CBC
LFT and renal every 1-3 months
Raynauds is associated with which autoimmune disorder
Scleroderma
what type of Myositis is associated with childhood
Type IV
cut off age to be diagnosed with JRA
16
Stills Disease characteristics
myalgias
rash on truck with fever
peak onset between 1-6 years, equal M and F
what is prognosis for most kids with JRA
most achieve remission
Most common bug associated with septic arthritis in neonates
S. aureus
disease with glucocerebrosidase deficiency
Gauchers disease
deficiency of enzyme homogenistic acid oxidase -
alkaptonuria - blue urine, cartilage, skin, and sclera
treatment for acute Charcot joint
total contact cast with eval q1-2 weeks
most common tendon rupture site in RA patients
Lister tubercle
myotonic muscular dystrophy affects which type of muscle fibers
skeletal, smooth, and cardiac
histologic findings of dermatomyositis
perivascular and interfascicular inflammatory infiltrates with adjoining groups of muscle fiber degeneration/regeneration
histologic findings of polymyositis
endomysial mononuclear inflammatory infiltrates and muscle fiber necrosis.
psoriatic arthritis most commonly affects which joints
DIPs
which medication can worsen psoriatic arthritis symptoms
hydroxycloroquine
second line treatment for raynauds
IV prostonoids
innervation of levator scapulae
C3/C4 nerve root and dorsal scapular nerve
pec minor insertion
coracoid process
innervation of teres major
lower subscapular nerve
brachialis insertion
coronoid process of ulna
FCR insertion
base of 2nd metacarpal
arterial supply of FCR
ulnar artery
FCU insertion
pisiform bone, hamate, and 5th metacarpal
FDP nerve roots
C8/T1
Innervation of FDP
ulnar nerve and anterior interosseous nerve
potential compression site of PIN syndrome
ECRB, supinator
PIN sensory distribution
No cutaneous innervation
Sensory fibers of dorsal wrist capsule
2 thenar muscles that are ulnarly innervated
adductor pollicis
1/2 flexor pollicis brevis
origin of lumbricals
FDP tendon
innervation of iliacus
Femoral nerve L1, L2, L3
iliospoas insertion
lesser trochanter
vastus group origin
greater trochanter
glut max insertion
fascia lata
glut med insertion
Greater trochanter
glut min action
abducts and internally rotates hip
glut med and mad action
abduct and externally rotate hip
biceps femoris long head insertion
fibular head
some LCL and lateral tibial condyle
obturator externus action
adduction and external rotation of thigh
flexor digitorum brevis innervation
medial plantar nerve
lateral plantar nerve innervated which muscles
abductor digiti minimi adductor hallucus quadratus plantae plantar interossei dorsal interossei
what structure passes through the triangular space
scapular circumflex artery
what structure passes through the triangular interval
radial nerve
radial border of Gunyon canal
hook of hamate
ulnar border of Gunyon canal
pisiform and abductor digiti minimi muscle belly
lumbosacral plexus is made up of
ventral rami of T12-S3
anterior division of femoral nerve innervates what muscles
sartorius and pectineus
saphenous nerve branches from what nerve
posterior division of femoral nerve
posterior division of obturator nerve innervates
adductor magnus
superficial posterior compartment contains which muscles
gastroc
soleus
plantaris
normal femur head subtrochanteric angle is
135 deg
what type of collagen is found in all basal membranes
Type IV
what type of collagen is found in muscle
Type III
what type of collagen is found in bone, tendon and ligaments
Type I
What type of collagen is found in epiphyseal plate
Type X
In which brain structure does clonidine act on to reduce symptoms of opiate withdrawal?
Locus coeruleus
which nuclei helps with visual perception
lateral genicular nucleus of thalamus
space between pharyngeal surface of tongue and epiglottis
valleculae
which MCA branch supplies subcortical structures
M1
vertebral arteries branch off the
subclavian arteries
Role of donepazil in mild/moderate/severe dementia
improve well being ( improve cognitive function and ADLs)
greatest modifiable risk factor for stroke
HTN
what % of strokes are ichemic
87%
left visual neglect and left homonymous hemianopsia
right PCA
what artery is indicated with amaurosis fugax
ICA
Anton syndrome is…
Bilateral visual field cuts that result in a denial of cortical blindness
A transient inability to read faces
A syndrome of nausea, vomiting and alexia
An oculomotor palsy with a contralateral hemiplegia
decerebrate posturing is seen in lesions of the….
decorticate posturing is seen in lesions of the…
Brainstem
cortex
presentation of lateral medullary syndrome
sensation changes on ipsilateral face, sensation changes on contralateral body ataxia dysphagia/hiccups etc NO motor weakness
presentation of Weber syndrome
ipsilateral CN3 palsy
contralateral hemiplegia
presentation of Medial medullary syndrome
Ipsilateral CN12 palsy
contralateral hemiplegia
contralateral tactile sensory loss
Presentation of Miller-Gubler syndrome
Ipsilateral CN6 paralysis
contralateral hemiplegia
contralateral sensory loss
Pure Motor hemiplegia stroke - where is the lesion
posterior limb of internal capsule
pure sensory stroke - where is the lesion
Thalamus
The mortality rate in the first 24 hours after a subarachnoid hemorrhage
25%
treatment for early posttraumatic seizure
IV valproic acid
uses spiral and diagonal components of movement rather than the traditional movements in cardinal planes of motion with the goal of facilitating movement patterns that will have more functional relevance than the traditional technique of strengthening individual group muscles.
NMF (neuromuscular facilitation)
encourage normal movement and tone, while suppressing the inhibitive movements patterns that arise after stroke. This approach is most commonly used.
Bobath
focuses on using abnormal movement in an attempt to improve motor control
Brunnstrom approach
Cantu return to play - how long should they sit out if loss consciousness for >5min
1 month
hemorrhagic stroke in which area is most likely to be associated with a seizure
Temporal
a coma can result from damage in which area?
brainstem of bilateral cerebral hemispheres
what type of exercise is used to treat ataxia
Frenkel exercises are used to treat ataxia. They usually consist of many repetitions of slow exercise.
Which Brunnstrom stage of motor recovery is defined as the stage of maximal spasticity?
Stage 3
A 60-year-old male with a past medical history of an MI with resultant cardiomyopathy, now presents with a large territory stroke. What is the most likely cause?
mural thrombus
Nearly 1/2 of intracerebral hemorrhages occur at what structure?
Putamen
Which is an environmental risk factor for the development of Parkinson’s?
pesticide exposure
dysarthria and clumsy hand syndrome is found from a lesion in the?
pons and anterior limb of internal capsule
A patient with a Ranchos Los Amigos rating of VI will most likely require what level of assistance?
moderate assistance
In an upper division MCA stroke, which is most likely?
stronger legs than arms
Pure lower MCA division presentation
No weakness
No sensory changes
language, visual deficits and awareness of deficits are usually significant.
Alexia without agraphia is most likely to occur with an infarct in which location?
PCA
Presentation of Benedikt syndrome
contralateral chorea as it affects the red nucleus. The red nucleus contributes to coordination and body positioning.
This stroke rehabilitation approach utilizes a system of therapeutic exercises enhanced by cutaneous stimulation; in addition to, proprioceptive maneuvers to promote recovery.
Rood approach
first muscles to become weak with DMD
neck flexors
most common heart defect with Downs syndrome
VSD
a congenital deformity in which the limbs are extremely shortened so that the feet and hands arise close to the trunk
phocomelia
Sinding-Larsen-Johansenn disease
(patellar tendonitis) in pediatrics will present with anterior patella pain and similar x-ray findings.
is the most common cause of limping and pain in a child’s hip.
Transient (toxic) synovitis of the hip
The most common level of a pars defect in children is at
L5`
Which type of JRA is associated with iridocyclitis?
pauciarticular
In JRA, which joint tends to be affected more in children?
cervical spine
where is osteosarcoma found in the bone
metaphysis
where is Ewing sarcoma found in the bone
diaphysis
Erbs or Klumpkes has the better prognosis
Erbs. Recovery often by age 2
what type of AC injury disrupts both the AC and CC ligaments
Type 3
primary vascular supple to knee
Popliteal arterty - which branches into the genicular arteries
highest center of gravity during gait -
mid stance
what type of collagen in annulus fibrosis
Type 1
define gunstock deformity
cubitus varus is an abnormal varus angle of the elbow that usually follows a distal humerus fracture.
lowest center of gravity during gait
loading response
first dorsal wrist compartment and syndrome associated
APL, EPB = De Quervain’s tenosynovitis
second dorsal wrist compartment and syndrome associated
ECRL, ECRB = Intersection syndrome
third dorsal wrist compartment and syndrome associated
EPL = Drummer’s wrist, traumatic rupture with distal radius fracture
fourth dorsal wrist compartment and syndrome associated
EI, EDC = Extensor tenosynovitis
fifth dorsal wrist compartment and syndrome associated
EDM = Vaughn-Jackson syndrome
sixth dorsal wrist compartment and syndrome associated
ECU = Snapping ECU(treat with immobilization)
What is the optimal degree of fixation in a bilateral elbow arthrodesis
110 and 65 degrees
treatment for jersey finger
urgent surgical referral
Where is the most common site of a hamstring rupture?
myotendinous junction
What is the optimal degree of fixation in a unilateral elbow arthrodesis?
90 degrees
What are the three main glenohumeral ligaments?
Superior glenohumeral, middle glenohumeral and inferior glenohumeral ligament
A posterolateral L4/L5 herniation affects which nerve root
L5
name the 4 throwing phases
Biomechanics of throwing a baseball
Cocking phase
Acceleration early
Acceleration late
Follow-through
Greatest forces in late cocking/early acceleration
far-lateral/foraminal L3/L4 disc herniation affects which nerve root
L3
name the 6 determinants of gait
Pelvic Rotation Pelvic Tilt Knee Flexion in midstance Foot and Ankle motion Knee motion Lateral Pelvic motion
is due to inflammation at crossing point of 1st dorsal compartment (APL and EPB ) and 2nd dorsal compartment (ECRL, ECRB) and is often seen in rowers.
intersection syndrome
Treatment for gamekeeper thumb, if the thumb is unstable in flexion,
surgical referral
Housemaid’s knee is inflammation of the:
prepatellar bursitis
Which rehabilitation program is best for a posterior-lateral herniation
Mckenzie
Which rehabiliation program is best for far lateral NPH
neutral and flexion based program
The Hill-Sachs Lesion is located:
posterolateral humeral head
The most common etiology of Vaughn-Jackson syndrome is:
This is a disruption of the extensor tendons associated with rheumatoid arthritis.
Jerk test
Posterior glenohumeral instability
An acute peroneal tendon subluxation is best treated with
Short leg cast immobilization and protected weight bearing for 6 weeks is the recommendation.
Which test assesses for inferioglenohumeral instability
sulcus sign
list 5 phases of gait cycle
Initial Contact Loading response Midstance Terminal stance Preswing
X-rays are obtained and demonstrate an oblique fracture-subluxation at the base of the thumb metacarpal. This type of fracture is termed a:
bennetts fracture
The most common muscle injured in an adductor muscle strain is the:
adductor longus
most commonly injured knee ligament
MCL
A prominence of the posterior superior calcaneal tuberosity that contributes to inflammation of the overlying tissues and the Achilles tendon is called a:
Haglund deformity
During the loading response, which muscles use eccentric force?
pre-tibial muscles
How soon can active range of motion begin after shoulder arthrodesis?
8-12 weeks
At what percent of increase in energy cost do most patients prefer to use a wheelchair to ambulate?
300%
The most common complication after a hip fracture is:
Heterotopic ossification
At what angle of knee flexion are the medial and lateral patella facets in contact with the sulcus?
45 deg
The recommended position for shoulder arthrodesis is
30 degrees abduction, 30 degrees flexion, 30 degrees internal rotation.
A fracture of the proximal ulna with a dislocation of the radial head is termed a
Monteggia fracture
The mainstay rehabilitation program for a vertebral compression fracture involves primarily:
extension exercises
Which nerve injury is considered after a Monteggia fracture?
posterior interosseous nerve
What is the most common type of elbow fracture seen in children?
supracondrylar
Strengthening which muscle group may be the most helpful in avoiding an ACL tear in women?
hamstrings
In slipped capital femoral epiphysis, the femoral head is displaced
posteriorly and inferiorly
Which is the most common type of spondylolisthesis in all adults?
degenerative
A nondisplaced 1mm fracture of the scaphoid bone at the proximal 3rd should be immobilized in a thumb spica splint for how long?
5 months
is a fracture of the C7 spinous process. There are no neurological deficits associated with this.
Clay Shoveler’s fracture
The Lisfranc ligament attaches:
The medial cuneiform to the 2nd metatarsal
The iliacus inserts onto the:
lesser trochanter
Which muscle originates at the ischial spine, inserts onto the greater trochanter and abducts the flexed hip?
superior gamellus
X-ray of the 2nd DIP reveals volar subluxation of the distal phalanx with a non-displaced dorsal bony avulsion at the distal phalanx. What is the next best step in management?
reduction and pinning
Lumbar facets primarily prevent:
axial rotation
What is the most common surgical procedure performed for the treatment of medial tibial stress syndrome that has not improved with conservative treatment?
posterior fasciotoomy
posterolateral corner complex is made up of
the arcuate ligament, fibular collateral ligament, and popliteus muscle tendon.
Which humeral fracture has the highest risk of AVN?
anatomic neck
Dorsal displacement and angulation of a distal radial fracture is called a:
Colles fracture
Volar displacement and angulation of a distal radial fracture is called a:
Smith fracture
fracture of 5th metacarpal
Boxers fracture
fracture of 5th metatarsal
Jones fracture
After a shoulder arthroplasty, which movement is contraindicated?
external rotation
The history provided with a positive fulcrum test is most indicative of
a distal femoral stress fracture.
The most common complication after a shoulder arthroplasty is:
glenoid loosening
The recurrence rate of Dupuytren’s Disease after surgery is approximately:
50%
A congenital condition with a small and undescended scapula is referred to as:
Sprengels deformity
The mainstay treatment of an osteoid osteoma is:
NSAIDS
Initial treatment of Hoffa’s syndrome includes:
Hoffa’s syndrome (infrapatellar fat pad irritation) is typically first treated with taping and physical therapy. A corticosteroid injection can be used in recalcitrant cases. If these measures fail, then orthopedic intervention is recommended.
Hueston tabletop tests
consists of placing your hand flat on a table. If the involved finger is unable to lie flat, then the test is positive. - Dupytren disease
Noble’s test is positive with which pathology?
ITB syndrome
Patient lies supine
Examiner’s thumb at 2 cm proximal to the lateral femoral epicondyle
Patient repeatedly flexes (to 60 degrees) and extends knee
Nobles test
You ask the patient to lie supine with her leg extended. You then place your hand on her thigh, cupping the patella. You then ask the patient to contract her quad. Which test did you just perform?
patellofemoral grind test
intrarticular fracture of the 1st metacarpal that extends into the CMC. This fracture typically results from a fist fight.
Bennet fracture
The most common pathogen associated with burn cellulitis prior to giving antibiotics is:
Strep Pyogenes
The resolution of inflammation in which collagen is laid down to form the scar represents which phase of wound healing?
maturation phase
expected healing time for: superficial partial thickness burn is Superficial wounds deep partial thickness full thickness burns
14 days
7 days
17-21 days
>28 days
Which burns are the most painful initially?
2nd degree
how much pressure is needed to counteract a burn scar contraction force?
25mmhg
In a patient with a dorsal hand burn, how should the MCPs be splinted?
60-90 degrees
Which is the most common primary adult brain tumor?
glioma (gliobastoma)
What is the most common focal sign of brain cancer?
weakness
what emg findings are commonly seen in patients with multiple myeloma, lung cancer, colon and breast cancer who present with paresthesias, sensory loss and gait abnormalities.
Fibrillation and polyphasic potentials
Which is the most common presenting symptom of radiation plexopathy?
numbness and paresthesias
In a patient with cancer-related myopathy, which exercise program is likely to be the most beneficial?
isometric
Your 54-year-old new cancer rehabilitation patient is s/p mastectomy and has swelling in her left arm that you diagnose as lymphedema. How often does this occur?
33% (1/3)
Lymphedema that is pitting and reversible by elevation is described as a Grade:
grade 1
Which imaging modality is a poor choice in diagnosing/evaluating multiple myeloma?
bone scan - needs blastic activity and MM is lytic
During low-level graded stress testing, the American Heart Association suggests a Borg Rate of Perceived Exertion Rating of:
13-15
Which is an indication for terminating a low-level exercise test during cardiac rehabilitation?
A heart rate above 130 beats per minute
drop in SBP >10
ST elevation in leads indicating pathology
significant angina
Cardiac patients diagnosed with which condition should be excluded from resistance training?
Aerobic capacity less than 5 METs
CHF
Severe vascular disease
How much more energy does it take to ambulate with bilateral above-knee prostheses after traumatic injury?
200% likely use wheelchair for ambulation
How many of the day’s total calories should come from fat on a Step I diet?
<30%
Overall, exercise training improves functional capacity in patients with heart failure and decreases ventricular systolic dysfunction secondary to:
Adaptations in the peripheral circulation that place less stress on the heart
Involuntary control of respiration originates in the:
medulla oblongata
Death rates from COPD are higher in men or women?
women
Exercise impairment develops when the FEV1 falls below:
3L
A scoliotic angle greater than *** degrees would cause a patient to have dyspnea.
90
The normal rate of FEV1 loss per year is
30cc
A vital capacity less than *** would have an impaired ability to cough.
25 ml/kg
At what point should supplemental oxygen be used during exercise?
sats <90
You are on a consult regarding a patient with a cervical spinal cord injury. The respiratory therapist has the patient placed prone with her buttocks elevated. What area of the lung is the therapist attempting to drain?
superior segments of both lower lobes
In an upright patient, which lung zone has more ventilation than perfusion?
zone 1
The tracheal tube must be downsized to what diameter before considering decannulation?
8mm
What is the best modality for acute to subacute low back pain?
superficial heat
What does the “no fault” workman’s comp system mean?
Neither employer or employee have to prove fault
Which rehab program replicates the duties of the job that the patient was performing?
work hardening
How many hours a day must an employee attend a work hardening program?
employee’s must stay for at least 4 hours 3-5 times per week.
What is the maximum punishment for violating HIPAA due to a reasonable cause and not willful neglect?
50,000$
What intervention is most effective in preventing a low back injury at work?
exercise
Which is a proven return to work barrier?
Lack of knowledge of the modified job
negative employee attitudes
What is the Omnibus Reconciliation Act of 1993?
It prevents physicians from making self-referrals to DME, PT and other medical companies that they own.
Abdominal belts limit motion in:
lateral bending and rotation
How long should you wait to perform an MRI in a patient with continual low back pain without neurological deficit?
6 weeks
What is the maximum amount of weight that can be lifted with medium duty?
50 lbs
How much can a worker lift who is on light duty?
20lbs
Temporary worsening of a previous injury that happened at work is called:
exacerbation
Permanent worsening of a previous injury or condition at work is called:
aggravation
This low-frequency, postural tremor is often seen in a patient with multiple sclerosis:
cerebellaar
Which movement is correlated with a hemorrhage or infarction of the contralateral subthalmic nucleus?
hemiballismus
Reversible need for constant movement to relieve tension and anxiety
Akathisia
You are consulted on a 62 year old male for gait abnormalities. On exam you notice he has en bloc turns and that he has a shuffling pattern. While you are discussing plans to improve his gait you notice a low-frequency, pill-rolling motion of the fingers. What percentage of Parkinson’s patients have this?
70%
The goal of medical management in Parkinson’s disease is to:
increase dopamine
decrease cholinergic effect
Atrophy of the caudate nucleus
Huntingtons disease
Atrophy of the thalamus
Multiple Sclerosis
Cortical atrophy
Alzheimers disease
Atrophy of the cerebellum (3)
multiple sclerosis, friedreich’s ataxia, and Creutzfeldt-Jakob disease.
Which describes the mechanism(s) of action of tricyclic antidepressants?
primarily act on inhibition of norepinephrine and serotonin uptake, but in increasing concentration they do have anticholinergic and alpha blocking action.
EKG finding associated with TCA toxicity.
widen QRS
Carbamazepine is indicated for: (2)
trigeminal neuralgia and epilepsy
Which medication potentially influences the effects of aspirin on platelet function?
Ibuprofen
inhibit the peripheral metabolism of dopamine.
COMT inhibitors
Which NSAID has the shortest half-life?
Aspirin
Which prolotherapy irritant is purported to act by the osmotic rupture of cells?
hypertonic dextrose (10%)
On imaging, there appears to be a stable jefferson fracture. How should it be managed?
Halo Vest
C1 burst fracture
Which is the most likely presentation of a patient with a Chance fracture?
normal neurological exam
Your T3 AIS A SCI patient is having a difficult time getting his bladder under control. After many days of charting his incontinences and bladder volumes, you believe his bladder contractions and sphincter relaxations are not coordinated. Which is responsible for this function?
pons
Which pathway stimulates cholinergic receptors to cause bladder contraction and emptying?
parasympathetics
Which pathway is responsible for storing urine via B-2 adrenergic receptors in the bladder body and alpha-1 adrenergic receptors in the base of the bladder and prostatic urethra to increase outflow resistance?
sympathetics efferents
Which pathway is responsible for voluntary contraction of the external sphincter to prevent leakage?
somatic efferent
Which pathway has myelinated A-delta fibers that stimulate parasympathetic fibers with bladder distension?
afferent fibers
The body of the bladder is innervated by the:
hypogastric and pelvic nerves
Intubation should be strongly considered when a patient’s FVC is
<1L
At which minimal pulmonary function parameter can you justify removing your SCI patient off the ventilator?
FVC > 15-20 cc/kg
The majority of bladder complications in SCI can be prevented if bladder pressures stay below the target pressure of:
40 cm H2O
Which may be seen on EMG of a patient with neurosyphilis
absent H reflex
Beevors Sign
refers to the abnormal upward movement of the umbilicus on attempting to raise the head from a supine position by the patient being assessed
Beevor’s sign is positive. At what level is the lesion?
T10
What percentage of patient’s with a hip fracture secondary to osteoporosis will die secondary to related complications?
10-20%
A 54-year-old obese female comes to your clinic for routine follow up. She has many questions about health as she ages. She informs you she rarely exercises due to not having time with her busy work schedule and she has been often eating fast food for the same reason. She has a family history of coronary artery disease and breast cancer. She has many concerns around osteoporosis because her mother had a “severe case.” Which has a primary role in determining bone strength and osteoporosis risk?
family history
Which has a reduced mineral content, resulting in “soft bones?”
osteomalacia
Renal hypercalciuria, an important cause of secondary osteoporosis, can be treated with which medication?
thiazides
A 48-year-old female was recently diagnosed with osteoporosis. She is trying to do everything she can to prevent this from progressing. How much calcium should she be taking daily?
1200-`1500mg
How much vitamin D should a patient with osteoporosis take dai
400-800 IU
Spinal bone mineral density is directly correlated to the strength of which muscle group?
spinal extensors
Which type of orthotic can be prescribed to decrease pain in a patient with a stable osteoporotic vertebral body fracture?
nonrigid brace
A 58-year-old female who had been diagnosed with osteoporosis, and is considered a high fracture risk, has been doing some reading on the internet. She read about a medication called denosumab. Denosumab is considered at which level of therapy to treat osteoporosis?
First line if high fracture risk
You have a patient with a right AKA and a prosthesis. When assessing his gait, you note a lateral trunk lean towards the prosthetic side. What do you suspec
prosthesis too short
An amputation of the tarsometatarsal junction is a:
LIsfranc
amputation through the talus and calceneus
chopart
amputation spares part of the calcaneus.
BOYD
amputation is an ankle disarticulatio
Symes
Bone overgrowth after an amputation is most frequently seen in the:
humerus
The preferred alignment of a BKA prosthesis is:
Knee flexion moment and varus foot alignment
Foot ulcers are responsible for what percentage of amputations?
85%
How is poliovirus spread?
fecal-oral and aerosol droplets
The cathode is:
the negative pole
What drug class is first-line in treating multiple sclerosis related pain?
TCAs
Which multiple sclerosis patient has the worse prognosis?
a male with primary progressive MS
Which EMG needle has a larger recording area?
monopolar
Muscles the PIN innervates: (7+1)
EDC EDM ECU APL EPB EPL EIP sometimes ERCB
sensory innervation of PIN
dorsal wrist capsule sensation
A stimulus intensity that is too high results in:
Decreased conduction times and shortened latencies
Findings in every median nerve innervated muscle likely stems from a lesion at th
Ligament of Struthers
What is the standard filter setting for sensory NCS?
20Hz-2kHz
or
20Hz - 10kHz
contents of carpal tunnel (4)
FDP tendons, FDS tendons, FPL tendon, and median nerve.
What is the standard filter setting for EMG?
20Hz-10kHz
What is the standard filter setting for motor NCS?
2Hz-10kHz
Guyon canal compression symptoms for
zone 1
zone 2
zone 3
1: motor and sensory
2: motor only
3. sensory only
What is the default sweep speed for EMG?
10ms
common causes of Guyon canal compression
MC nontraumatic : ganglion cyst
Traumatic: hook of Hamate fracture
What is the default gain that should be used to assess a normal recruitment pattern?
1mV
What is the default gain for motor NCS?
5mV
What is the default setting for the sensory NCS sweep speed?
2ms**
Which of the following is the most common form of thoracic outlet syndrome?
neurogenic
5 possible compression points in PIN sydrome
Arcade of Frohse supinator muscle extensor carpi radialis brevis muscle leash of Henry fibrous tissue anterior to the radiocapitellar joint.
What happens to the peak latency when the active and reference pickups are greater than 4cm during a sensory nerve conduction study?
increases
A sensory nerve action potential amplitude should be measured from:
peak to peak
You strongly suspect a piriformis syndrome in your patient. Which portion of the sciatic nerve do you expect to be the most affected?
peroneal division
When assessing the blink reflex, which nerve is the afferent nerve?
CN V (trigeminal)
An EMG that may be consistent with a paraneoplastic syndrome will show:
sensorimotoe axonal findings
A patient with HIV is expected to have EMG findings consistent with:
sensorimotor demyelination
Normal duration of insertional activity should be about:
max 300 ms
On EMG, you note a decreased recruitment interval but an increased recruitment frequency. The disorder is most likely:
neuropathic
A discharge appears “tornadic” on the screen with a rate of 200Hz. The sound is best described as continuous and high frequency. What is the most likely diagnosis?
Isaacs syndrome
Endplate potentials (EPPs) are irregular. T or F
True
The genetic inheritance pattern of ALS is most likely:
autosomal dominant
What is the initial treatment of choice for Isaac’s syndrome?
phenytoin
Isaac’s syndrome is caused by antibodies to:
potassium channels
classic triad of clinical manifestations of Miller Fisher Syndrome (MFS)
areflexia, external ophthalmoparesis, and ataxia.
subtype of GBS (AIDP)
antibody seen in Miller Fisher Syndrome
Anti-GQ1b
