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NPTE > Practice Exam > Flashcards

Practice Exam Flashcards

1
Q

Extra-articular complications of RA

A

vasculitis

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2
Q

Extra-articular complications of psoriatic arthritis

A

Psoriatic skin and nail changes
Conjuctivitis
Iritis

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3
Q

Extra-articular complications of degenerative disc disease

A

disc degerneration

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4
Q

Changes in skin composition associated with aging

A 
decrease sensitivity to touch
decreased perception of pain/temp
increased risk of injury
decreased elasticity
inflammatory responses are weakened
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5
Q

Breathing pattern of ASIA A C5

A

rising of abdomen due to no abdominal m tone on the abdominal viscera

m weakness is symmetric
diaphragm - innervated by C3-5 (so it still fxns)
m weakness will cause a restrictive disorder not obstructive

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6
Q

Criteria for dx of metabolic syndrome

A 
abdominal obesity (>40in men, >35in women)
elevated triglycerides (>150)
low HDL (<40 M; <50 F)
fasting plasma glucose >110
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7
Q

Limitations of US

A

difficulty penetrating bone

US usually used for tendon tears, bleeding/fluid in mm/bursae/joints; soft tissue tumors; early RA; masses/lumps

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8
Q

Disorders associated with obesity

A

HTN; dyslipidemia; hyperinsulinemia (type 2), hyperglycemia

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9
Q

Normal composite motion of of shoulder ABD to 150 degrees

A

100 deg GH; 50 deg scapulothoracic motion

2:1 ratio (So 150 = 100+50)

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10
Q

Mm to strengthen for crutch use

A

Lower traps, Lats, pect major

Mm : shoulder depressors and extensors and elbow extensors

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11
Q

Scoliosis: breathing abnormalities

A

increased lateral costal expansion on side of curve
ribs would elevate normally more on curved side
shortened side would have shortened m length and decreased aeration

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12
Q

Anterior glide of shoulder

A

increase ER and late flexion

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13
Q

Inferior glide of shouler

A

inreases shoulder ABD

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14
Q

Tx: break up LE synergey patterns in hemiplegic pt

A

high kneeling, ball throwing

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15
Q

What’s carried in dorsal column-medial lemniscus tracts

A

light touch, 2-point discrimination; stereognosis (3D touch recognition); barognosis (discern weight)

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16
Q

Where is pain/temp carried?

A

anterolateral spinothalamic pathways`

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17
Q

Most important factor in amputation treatment

A

wound healing

also: hip flexor contracture, residual limb shape, m atrophy

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18
Q

Tx: address tightness of lumbricals in hand

A

exercise: MCP EXT; IP FLX (lumbrical do opposite)

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19
Q

Adhesive capsulitits: capsular pattern; Dx characteristics

A

shouler ER > FLX > IR

  • thickening of synovial capsule
  • adhesions within the subacromial/subdeltoid bursa
  • adhesions to the biceps tendon
  • and/or obliteration of the axillary fold secondary to adhesions

*commonly associated with other systemic and nonsystemic conditions

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20
Q

Most common comorbid condition of DM?

A

adhesive capsulitis

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21
Q

PTA: pt records

A

pt has right to see notes; no need for PT permission

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22
Q

Chest tube: what happens if dislodged and not fixed?

A

pneumothorax (+ pressure on lung tissue - lung can’t inflate - collapses)

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23
Q

Pulmonary edema: cause

A

increased hydrostatic pressure within pulmonary vascular system
OR
changes in vascular membrane

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24
Q

Atelectasis: tx

A

facilitate deep breathing

- by reducing pain, segmental breathing (prolonged inspiration with breath hold), incentive spirometry

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25
Q

Post-op flexor tendon repair (hand)

A

wait 48-72 hrs prior to ROM
wait 1-3 weeks before active flexion
passive extension after adequate strength of repair

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26
Q

Phantom limb pain

A

result of nn being cut

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27
Q

Iontophoreis: current used

A

direct current with negative pole (acetate ion is negative)

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28
Q

PCL: mechanism of injury

A

MVA - dashboard injury

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29
Q

ACL: mechanism of injury

A

noncontact deceleration producing valgus twist injury
eg: athlete pivoting in opp direction

hyperEXT with severe medial tib ROT

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30
Q

patella dislocation: mechanism of injury

A

powerful quad contraction with sudden FLX and ER of tibia on femur

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31
Q

rupture of popliteal a: mechanism of injury

A

severe trama resulting in dislocation of tibia on femur

most common: force on tibia while knee is FLXed (dashboard)

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32
Q

Patellofemoral syndrome

A

runners knee
most common overuse injury in runners
cause: mistracking of patella within intercondylar groove

Sx:

  • knee pain, especially sitting with knee FLX
  • occasional buckling of knee possible
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33
Q

Primary reason a compression garment reduced edema?

A

external pressure caused by compression garment increases amt of pressure on the tissue –> causes relative increase in hydrostatic pressure in extravascular spaced compared with the intravascular space

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34
Q

classic TMJ unilateral capsular restriction: Tx

chin deviated to R in terminal opening

A

right TMJ, inferior glide manip

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35
Q

Akinesia: tx

A

(freezing of gait)

identification of triggers

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36
Q

Adrenal insufficiency: associated metabolic abnormalities

A
  • hyponatremia (2ary to renal loss of Na+ )
  • inability to regulate potassium and sodium (2ary to decrease in cortisol)

pts will be hyperkalemic, hypoglycemic, may have acidosis

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37
Q

HepB precautions

A

transmitted in blood, body fluid, body tissues

  • avoid direct contact with blood
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38
Q

Scoliosis: screening test

A

Adam’s forward bend (Standing)

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39
Q

Continuous ultrasound: use?

A

thermal effects
higher intensity = greater chance of tissue temp rise
results in increased metabolic rate of tissue
- would decrease stiffness of collagen

contraindicated for acute inflammation

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40
Q

Lyme disease: stage III

A

late or chronic Lyme disease

characterized by intermittent arthritis with marked pain/swelling

large joint primarily affected, esp knee

permanent joint damage can occur

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41
Q

Heart sound: S3

A

abnormal

cause: poor ventricular compliance and turbulence
sound: low-freq sound during early diastole

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42
Q

Heart sound: S4

A

abnormal

cause: exagerated atrial contraction and subsequent turbulence
sound: low-freq sound in late diastole

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43
Q

Heart sound: murmur

A

sound: swishing sound in systole, diastole, or both

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44
Q

Heart sound: pericardial rub

A

sound: leathery sound during systole

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45
Q

Full-term infant in NICU: reasons

A

low Apgar scores
resp distress
specific diagnoses (many)

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46
Q

Normal tone of full-term infant

A

initial tone and posturing: some FLX of limbs

decreased FLX at 1 month

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47
Q

Osteoporosis: tx

A

goal: bone stimulus
WBing exercises
standing > high load, short duration (running, jumping, weights)

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48
Q

Stemmer’s sign

A

tests for lymphedema
pull up on base of 2nd toe/finger
+: unable to opull skin up

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49
Q

Anterior walker

A

enhances forward lean posture

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50
Q

McBurney’s point

A

pain/tenderness with palpation = acute appendicitis

location: btwn ASIS and umbilicus (R lower quadrant)

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51
Q

Murphy’s sign

A

+ : associated with acute cholecystitis or acute pyelonephritis

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52
Q

Hiatal hernia Sx

A

sharp pain localized to lower esophagus/upper stomach area

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53
Q

Beta blocker: exercise response

A

decrease sympathetic response to activity = decrease HR, blunt HR response to activity

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54
Q

Apgar scores

A
  • HR over 100bpm
  • good respiration and crying
  • cough or sneeze
  • pink color
  • active movements
    (2 points each)

1 minute after birth: 8-10 points normal

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55
Q

Vertebral artery test

A

Position: passively move head/neck into EXT and side FLX, rotation to same side
Hold 30 seconds

+ : dizziness/nystagmus occur, indicating the opposite side artery is being compressed

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56
Q

Opisthotonos

A

extreme hyperEXT of neck
LE FLXed
heels touching buttocks

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57
Q

Semi-Fowler position

A

supine, head and torso elevated 30 deg

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58
Q

Berg Balance Test: what does it include?

A

sit<>stand
functional reach
tandem standing

*does not include gait

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59
Q

Clubfoot: stretching

A

Plantar flexion and eversion

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60
Q

Pursed lip breathing

A

increases resistance to airways on exhalation

–> increase pressure –> prevents airway collaspe

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61
Q

What does the HS do during gait?

A

Controls forward swing of leg during terminal swing

Loss of strength = abrupt knee extension and increased hip flexion

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62
Q

Loose pack position: humeroulnar jt / humeroradial jt

A

ulnar: 70 deg flexion
radial: 70 deg flexion, 35 deg supination

63
Q

ASIA A C6: transfers

A

no triceps
arms anterior to hips; shoulder ER, elbow/wrist EXT; forearm SUP, finger FLX

requires: ant deltoid, shoulder ERs, clavicular portion of pec major –> flexes and adducts humers –> elbow EXT

64
Q

Compartment syndrome

A

occurs when pressure within the mm builds to dangerous levels; pressure can decrease blood flow
can be acute or chronic
ACUTE = MEDICAL EMERGENCY
chronic aka exertional compartment syndrome; usually not emergency; often caused by athletic exertion
complaint = bursting type of pressure and pain

65
Q

Shin splints

A

aka medial tibial stress syndrome
nonfocal tenderness (diffuse along mid-distal, posteromedial tibia)
no edema

66
Q

Reliability coefficients

A 
>.75 = good reliability
.5-.75 = mod reliability
67
Q

hemosiderin changes and increased LE edema Sx consistent with ____.

A

chronic venous insufficiency

68
Q

Chronic arterial insufficiency: Sx

A
  • pain
  • decreased/absent pulses
  • dependent rubor
  • trophic changes (nail changes/loss of hair, pale/shiny skin)
69
Q

Percussion and shaking: precautions

A

platelet count of 30,000 (where’s the exact cut off??) = increased risk for bleeding

70
Q

Hip: Capular patterns

A

2 classical capsular patterns: FAME and MEAL

FAME: FLX, ABD, IR, EXT
MEAL: IR, EXT, ABD

71
Q

Hip OA practice guildelines

A
  • pt report of hip pain
  • present with either one of the following:
    • hip IR <15 AND hip FLX <115 AND age >50
    • hip IR >=15 AND pain with IR, am stiffness <=60min AND age >50
72
Q

Spondylolisthesis

A

= forward translation of vertebral body

73
Q

Spondylolysis

A

break in the vertebra typically in the region of pars interarticularis
may or may not be associated with spondylolithesis

74
Q

Bamboo appearance of the spine on radiograph is an indicator of what?

A

Ankylosing spondylitis

75
Q

PTA: what to do if PT not in room

A

okay to continue tx plan

76
Q

Boutonniere deformity

A

MCP EXT
DIP EXT
PIP FLX

central extensor tendon rupture

77
Q

Most likely prosthetic cause for circumduction during swing

A
  • long prosthesis
  • locked knee jt
  • loose knee friction
  • inadequate suspention
  • small or loose socket
  • plantar flexed foot
78
Q

Lhermitte’s sign

A

= sudden, transient, electric-like shocks speading down body when head is FLXed forward
occurs mostly in MS patients, can also be seen in compression disorders of c-spine

79
Q

Head jolt test

A

turn head at freq of 2-3x/second
+ : worsening of baseline HA
indicadive of meningeal irritation

80
Q

Kernig’s sign

A

for: meningeal irritation

supine, LE flexed at hip/knee; straighten knee
+ : resistance to knee straightening

81
Q

Tinel’s test

A

percussion of nerve at sit of compression

+ : distal tingling sensation

82
Q

Airway clearance technique frequency in CF pt with acute respiratory failure

A

as often as possible

  • clear secretions
  • assist with gas exchange
83
Q

Arterial ulcer: typical location

A
  • distal lower leg (toes, foot)
  • lateral malleolus
  • anterior tibial area
84
Q

Venous ulcer: typical location

A
  • medial malleolus

- distal lower leg

85
Q

Sublingual nitroglycerin: primary effects

A
  • increases coronary blood flow by dilating coronary aa and improving flow to ischemic areas
  • in low doses - produces vasodilation (venous > arterial) and is used in acute and long-term prophylactic mgmt of angina pectoris
  • decreases L ventricular end-diastolic pressure
  • reduces myocardial O2 consumption
86
Q

Arm positioning for pt s/p CVA

A 
= opposite to expected posturing and spastic patterns
shoulder protraction, ABD, ER
elbow EXT
writst neutral
fingers EXT
87
Q

Statin: possible side effect

A

statins: atorvastatin, LIpitor…

<5% experience myalgia, cramps, stiffness, spasm, weakness affecting exercise tolerance
send to PCP

88
Q

Spastic bladder

A

UMN problem
contracts and reflexively empties in response to a certain level of filling pressure
reflex emptying can be triggered by manual stim techniques (stroking, kneading, tapping suprapubic area)

89
Q

stage I pressure ulcer

A

nonblanchable erythema of intact skin

90
Q

stage II pressure ulcer

A

partial-thickness skin loss involving the epidermis or dermis
superficial, presents clinically as an abrasion, blister or shallow crater

91
Q

stage III pressure ulcer

A

full-thickness skin loss with damage to or necrosis of subcutaneous tissue
presents clinically as a crater

92
Q

stage IV pressure ulcer

A

full-thickness skin loss with extensive destruction, tissue necrosis, damage to m/bone/supporting structures
undermining or sinus tracts may be present

93
Q

Duchenne’s MD

A

rapidly progressive disorder
muscle wasting/atrophy
common: contracture hip/knee/PF/ITB
scoliosis at age 11/12

main focus: prevent contractures, maintain ADLs / energy conservation, family ed, positioning

94
Q

neoprene sleeve

A

for warmth, maybe good for arthritis

95
Q

rhythmic stabilization

A

proprioceptive neuromuscular facilitation (PNF) technique used to improve postural stability

96
Q

Quad / HS torque relationship

A

65% at 60deg/sec
69% at 180
71% at 300

97
Q

Supracondylar fx

A

most common pediatric elbow fx; 3-10 yrs of age
extension fx = 95% of supracondylar fxs
mech of injury: fall, hand outstretched / elbow hyper EXT

98
Q

Thoracic outlet Sx

A
  • wasting in the thenar area
  • numbness or tingling in the fingers
  • pain in the shoulder/neck
  • ache in the arm/hand
  • weakening grip
99
Q

vertebral a occlusion: Sx

A

varies with area of ischemia and cause of occlusion
most common: vertigo, dizziness, nausea, vomiting head/neck pain
other signs: weakness, hemiparesis, ataxia, diplopia, pupillary abnormalities, speech difficulties, altered metnal status

100
Q

complex regional pain syndrome

A

chronic pain condition
believed to be the result of dyxfxn in CNS or PNS
Sx: dramatic changes in color/temp of skin with intense burning pain, skin sensitivity, sweating, swelling
key Sx = continuous, intense pain out of propportion to the severity of the injury; get worse vs better with time

101
Q

Mm involved in mouth opening

A

lateral pterygoid
anterior head of the digastric m
suprahyoid mm

102
Q

Mm involved in mouth closing

A

masseter
temporalis
medial pterygoid
lateral pterygoid

103
Q

Mm involed in mouth retrusion

A

temporalis

suprahyoid

104
Q

Pancreatitis pain

A

midline or L of epigastrium, just below xiphoid process

pain referred to mid/lower back, rarely to upper back

105
Q

Small intestine pain

A

midabdominal (umbilicus level)

pain referred to back if intense

106
Q

Large intestine / colon pain

A

poorly localized to midabdominal area

pain can be reffered to sacrum

107
Q

appendicial pain

A

R lower quadrant

pain can be referred to periumbilical area or R hip

108
Q

Rolling walker contraindication

A

forward flexed posture (typical in PD)

109
Q

Appearance: pallor

A

indicative of anemia, internal hemorrhage, lack of sunlight exposure

110
Q

Appearance: yellowish

A

indicative of jaundice (liver disease)

111
Q

Appearance: cherry-red

A

indicative of carbon monoxide poisoning

112
Q

Appearance: bluish, slate colored

A

indicative of hypoxia

113
Q

Put fibular/peroneal n on stretch

A

SLR with ankle PF and inversion

114
Q

Put tibial n on stretch

A

SLR with DF and eversion

115
Q

Put sural n on stretch

A

SLR with DF and inversion

116
Q

MS: diagnostic imaging

A

MRI: detects MS plaques in white matter of brain/spinal cord

117
Q

UTI: Sx

A

lethargic
nausea
painful urination
feverish

118
Q

Accessory mm of respiration

A

scalenes

sternocleidomastoid

119
Q

Stutter test

A

for: plica condition

pt seated, extend knee

+: patella jump/stutters btween 60-45 deg flexion

120
Q

Diff Dx: Myositis ossificans vs tumor

A

Myositis ossificans:
happens 2-4 weeks after injury
lesions begin to calcify at periphery and work towards center
at <3 weeks post trauma, bone scan demonstrates increased uptake in the area

Osteosarcoma:
calcifies at center, continues to periphery

121
Q

Stress Rxn: radiographic signs

A

Osteal bone: endosteal or periosteal callus formatin wtihout fx line. circumferential periosteal rxn with fracture line through one cortex. Frank fx
Cancellous bone: flake-like patches of new bone formation (2-3 weeks)
Cloudlike area of mineralized bone. Focal linear area of sclerosis, perpendicular to the trabeculae.

122
Q

Effects of Valsalva maneuver

A

initial increase in BP followed by a drop, slowing of HR, decreased return of blood to heart, increased venous pressure

123
Q

General exercise guidelines

A

10 min: min recommended work interaval duration for non deconditioned adult performing aerobic activity
20min: lowest end of the acceptable amt of exercise time per day
30 min: total recommended daily exercise time; can be broken to 3x10min

124
Q

Prevent delayed hypoglycemia with ___.

A

Crackers/bread = slowly absorbed carbs

125
Q

Acromioclavicular sprain

A

pain at extremes of AROM, esp horizontal ADD and full elevation, pain on passive horzontal ADD and elevation

special tests

  • AC shear test: + if abnormal mvmt of AC joint or pain
  • passive cross-chest ADD
  • OBrien test
126
Q

Calcific tendonitis

A

found on imaging
no Sx
if symptomatic: may present as :
- chronic, relatively mild pain similar to shoulder impingement syndrome
- large calcific deposit that may interfere with elevation of the arm
- more severe acute pain attributed to the inflammatory process

127
Q

Peabody Developmental Motor Scale

A 
norm-referenced
standardized
for: gross motor / fine motor skills
6 sutests
age: 1-72 months
128
Q

WeeFIM

A 
comprehenvisve
criterion-referenced
for: fxnal performance
18 items, 6 subscales
age: 6mo-8yr
129
Q

Denver II

A

norm-referenced
standardized test of development
for: fxnal performance (self-care, sphincter control transfers, locomotion, cogn fxn)
age: 1 week to 6.5 yrs

130
Q

Movement Assessment of Infants (MAI)

A

criterion referenced

for: m tone, reflexes, automatic rxns, volitional vmmt
age: birth to 12 mo

131
Q

Flat foot deformity can result from injury to _____ tendon.

A

posterior tib

132
Q

Raynauds Disease

A

vasospastic disorder
intermittent episodes of small artery constriction of the digits of the fingers/ rarely the toes
temporary pallor and cyanosis

133
Q

Pressure tolerant areas of WBing of tpical transtibial limb

A

patellar tendon,
medial tibial plateau
tibial and fibular shafts
distal end

134
Q

Position for max compressive forces on patella

A

hip EXT, knee FLX –>max rectus length

135
Q

Loose pack position of GH joint

A

30-40 degrees in scapular plane

136
Q

Closed pack positon of GH joint

A

full ABD, full ER

137
Q

Thompson test

A

for: integrity of Achilles tendon
pt prone, squeeze calf
+ : foot doesn’t move

138
Q

Congenital muscular torticolis

A

shortened sternocleidomastoid with weakened contralateral SCM –> lateral FLX of head to involved side and ROT of head to noninvolved side

139
Q

Osteoporosis risk factors

A
  • postmenopausal
  • low body weight
  • loss of height
  • sedentary lifestyle
  • tobacco use
  • hyperthyroidism (Grave’s disease)
140
Q

Osteoporosis: sx

A
  • severe/localized thoracic-lumbar pain
  • increased pain with prolonged upright posture
  • decreased pain in hook-lying
  • loss of height
  • kyphosis
141
Q

R ventricular failure: most common early sign?

A

increased fluid backs up, travels backwards from R ventricle –> edema goes to R atrium and then the periphery
–>causes dependent edema

142
Q

Juvenille RA: Sx

A 
swollen, stiff, painful joints usually worse in morning
fatigue
fever
swollen lymph nodes
poor weight gain/slow growth
143
Q

Position of c-spine for traction

A

C1-2 : 0-5deg FLX
C3-4 : 10-20
C5-7 : 25-30

144
Q

Glossopharangeal breathing technique

A

forces air in to lungs; does not assist with coughing/force output

145
Q

complex regional pain sydrome: sx

A

stage I : hyperalgesia, allodynia, hyperpathia with edema, increased sweating, and thin/shiny skin
stage II : increased pain with edema and atrophic skin and nail changes
stage III : speading pain, hardening of edema, cool/dry/cyanotic skin, developing osteoporosis and anklyoyls

146
Q

Pain after thoracic mobs - how to modify?

A

change to low amp oscillations for pain

147
Q

Use of heat with MS?

A

MS pt have heat intolerance

148
Q

Accessory motions for knee FLX/EXT

A

FLX: posterior glide and IR
EXT: anterior glide and ER

149
Q

Exercise modifications post cardiac transplant

A

Longer warm up/cool down periods bc physiological responses to exercise/recovery will take longer. Can perform low-mod intensity resistance training. Aerobic exercise shoulder be performed 4-6x/week while progressively increasing duration of training from 15-60 min per session

150
Q

EMG activity

A

*useful for Dx LMN disease, deficits in transmittion at neuromuscular jxn

needle insertion: insertion activity (bursts of activity)
after insertion: electrical silence (no sound)

Filbrillation potentials: spontaneous activity seen in relaxed denervated muscle
Polyphasic potentials: produced in the contracted m undergoing reorganization
Fasiculation: spontaneous contractions of all/most fibers in a motor unit; m twitches can been seen/felt; present with LMN disorders/denervation

Alterations in MUP size/shape/duration: reinnervation

Complete LMN lesion: only fibrillation
partial LMN lesions: fibrillation and fasciculations

151
Q

Contraindications for exercise in CA pts

A

Exercise contraindicated for CA pts with:
platelets <50,000
WBC <3,000
Hg <10

  • significant body mets
  • severe cachexia,
  • severe fatigue
  • poor fxnal status
152
Q

Thoracic outlet syndrome

A

= compression to neurovascular structures in scalene trirangle (anterior/middle scalenes between clavicle and 1st rib)
compression result of shortened pect minor and scalene mm

153
Q

clinical manifestations of postpolio syndrome

A

myalgias
new weakness
atrophy
excessive fatigue with min activity

NPTE (12 decks)

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