Quizzes Review (Does not include Quiz 3) Flashcards
Does not include Quiz 3
A patient presents to your clinic three months after a distal tibia fracture with a red, dry and swollen lower leg and foot. This is likely representative of which subtype of CRPS?
A. Major nerve damage subtype
B. Warm subtype
C. Psychoemotional subtype
D. Cold subtype
Warm Subtype
Evidence-based management for CRPS of the upper extremity includes all of the following except:
A. Limit activity as possible and advise rest
B. A multidisciplinary approach
C. Pain neuroscience education
D. Recommendations on smoking cessation
A. Limit activity as possible and advise rest
True or False. A characteristic of all CRPS cases is elevated sympathetic nervous system activity.
False.
Acute: Reduced SNS
Chronic: Elevated SNS
A distinguishing feature of Complex Regional Pain Syndrome (CRPS) is:
A. Proximal limb movement after a distal injury
B. Decreased reflexes for involved limbs
C. Pain that follows a specific dermatome
D. Pain disproportionate to the injury
D. Pain disproportionate to the injury
Which of the following is not likely “best practice” in the management of CRPS?
A. Use of modalities to manage pain and edema
B. Using psychotherapy to address stress management and emotional distress
C. Pharmacological intervention only when progress is not being made
D. Graded motor imagery and a stress loading program
C. Pharmacological intervention only when progress is not being made
Allodynia is indicated by:
A. An elevated pain response to a noxious stimulus
B. A sensation of pain from a non-painful stimulus
C. An increased sensitivity to an affected area
B. A sensation of pain from a non-painful stimulus
A patient presents to your clinic 7 weeks after sustaining a Smith fracture of the wrist and being immobilized in a cast that was removed a week ago. They complain of pain in the wrist, rated 10 out of 10 when the injury occurred, and 8 out of 10 at baseline today. Pain worsens to 10 out of 10 with any wrist movement. They also report a loss of hair on the back of their forearm, limited wrist ROM, swelling and profuse sweating in the hand. Your physical exam reveals a loss of active and passive ROM, loss of hair on the lower forearm compared to the uninvolved side, swelling in the wrist and hand, and sweating in the forearm and hand. Other objective findings are normal. Does this patient meet the criteria for a clinical diagnosis of CRPS?
Yes or No.
No
What is the most common type of scoliosis?
A. Congenital
B. Idiopathic
C. Neuropathic
D. Neuromuscular
A. Congenital
An 18 degree curve is considered:
A. Mild
B. Moderate
C. Severe
A. Mild
Which planes of motion are affected by scoliosis?
A. Coronal and sagittal planes
B. Coronal and transverse planes
C. Coronal, sagittal and transverse planes
D. Sagittal and transverse planes
C. Coronal, sagittal and transverse planes
A Risser Sign that would most likely be associated with scoliosis curve progression is:
1
3
5
1
A scoliosis curve that is still apparent with active ROM is called:
Structural
Non-structural
Congenital
Neuromuscular
Structural
For the health condition of scoliosis, how is the apex of the curve named?
A. According to the direction of the concavity
B. According to the direction of the convexity
C. According to the patient’s age
D. According to the secondary curve
B. According to the direction of the convexity
The sympathetic nervous system is responsible for emptying the bladder.
True or False
False
A typical physical therapy evaluation for a pelvic problem may include:
Assessment of bowel and bladder function
Posture
Muscle length assessment
Muscle activation/strength assessment
All of the above
All of the above
True or False. The best treatment to address stress incontinence is to educate the patient on how to perform a Valsalva maneuver.
False.
Which of the following is NOT a contraindication for internal assessment during a pelvic health physical examination?
No prior sexual activity
First trimester of pregnancy
No prior pelvic exam
A current urinary tract infection
No prior pelvic exam
A common characteristic of a person with urge incontinence is:
A. They leak when they sneeze
B. They try to urinate before leaving to go shopping
C. They urinate when they have a laughing fit
D. They are frequently constipated
B. They try to urinate before leaving to go shopping
A patient who suffers from constipation should receive which advice from a PT?
A. Instruction on using the Valsalva to evacuate stools
B. Exercise should be restricted to improve colon function
C. Increasing water intake to ½ of body weight in ounces
D. Restricting fiber intake to improve the condition
C. Increasing water intake to ½ of body weight in ounces
Which of the following is not a sign of abnormal bladder function?
A. Voiding 5-8 times per day
B. Staccato peeing
C. Post void dribble
D. Voiding >3 times per night
Voiding 5-8 times per day is normal
Which option could lead PTs to make the biggest impact on adults in preventing complications from osteoporosis?
A. Provide education on lifestyle (diet, avoiding smoking, etc.)
B. Prescribe hormone replacement for postmenopausal women
C. Prescription of medications for smoking cessation
D. Prescription of appropriate aerobic exercise intensity
A. Provide education on lifestyle (diet, avoiding smoking, etc.)
Which of the following is NOT a potential cause for the onset of delirium in an older adult?
Alcohol or drug withdrawal
Electrolyte imbalance
Genetics
Infection
Genetics
A 76-year-old female is in your skilled nursing facility following a lumbar fusion 5 days ago. Her medical history includes hypertension, breast cancer 12 years ago, and a previous wrist fracture from a fall three years ago. In your second PT session with her, she was able to move from supine to sitting on the edge of the bed and complete transfers with minimum assistance and ambulate modified-independent with a front wheeled walker. While attempting a 2-minute walk test, her vital signs were stable, but she complained of right calf pain. What would be the next step you should take in this session?
Assess her ability to complete stair ambulation
Screen for DVT using the Wells’ Criteria
Discuss an ambulation program with her nurse
Initiate ankle pumps as an exercise in her rehab
Screen for DVT using the Wells’ Criteria
Which is a possible reason for an elderly person to become dehydrated?
Dementia
Caffeine intake
Medication side effects
All of the above
All of the above
Which test would be most helpful in assessing for thoracic compression fracture in an elderly woman with acute onset of back pain?
BMI score < 21.1kg/m2
Rib-pelvis distance of > 3 finger widths
Waist-to-hip ratio of 0.7
Wall-occiput distance of 5.3cm
Wall-occiput distance of 5.3cm
Which of the following is NOT an important consideration in the PT evaluation process on the medical/surgical floor in acute care following the examination of a geriatric patient who fractured a hip and underwent surgical intervention?
Anticipated discharge destination
Meeting the criteria for homebound to receive PT services
Referral to other disciplines in the hospital
Equipment needs for the patient upon discharge from the hospital
Meeting the criteria for homebound to receive PT services
Older adults with a BMI of < 25kg/m2 typically recover from chronic illness is better because they have more muscle mass and “reserves.”
True
False
False. BMI > 25
A 61-year-old patient who had a posterior approach total hip replacement one day ago has hip precautions noted in the chart - no flexion > 90 degrees, no abduction and no internal rotation. He is very excited to go home. However, he had significant difficulty completing a transfer from a chair without breaking his hip precautions due to its low height, and he has a step over tub at home without grab bars to hold on to. His spouse works full time, and the patient will be alone most of his days after discharge. What should you include in your hand-off communication back to the nurse after your session?
He is motivated and is ready for discharge
A Montreal Cognitive Assessment (MoCA) is indicated
An OT should consult on the case before he is discharged
Outpatient therapy is recommended as soon as he can drive
An OT should consult on the case before he is discharged
An 80-year-old year old patient presents to your outpatient clinic with a chief complaint of right knee pain. During your patient interview, the patient reveals that they don’t go to exercise classes any longer because their friend fell at one and fractured her hip, and she doesn’t want that to happen to her. Based on that information, an important measure to include in your examination would be:
6-minute walk test
Lachman’s test
Body weight to assess BMI
Activities-specific Balance Confidence scale
Activities-specific Balance Confidence scale
In older adults, polypharmacy is a risk factor for __________________, particularly in the case of Potentially Inappropriate Medications (PIMs).
Increased fall risk
Shorter hospital stays
Better medication adherence
Decreased medication potency
Increased fall risk
A 64-year-old widower who lives at home alone in a ranch-level home with steps to the basement where the laundry facilities are. After falling and sustaining a hip fracture, they are initially non-weightbearing per the physician orders. After evaluating the patient in acute care, which of the following is the least important consideration for discharge planning?
Insurance/payer requirements
Availability of a PTA to treat the patient
The patient’s ability to transfer on/off a toilet
The preference of the patient and family
Availability of a PTA to treat the patient
Why does weakness occur in older adults?
Decrease in number of motor units
Neuromuscular junction changes
Type II muscle fibers decrease in size and number
All of the above
All of the above
Which of the following represent key documentation elements for a home health patient?
Assessment of vital signs (BP, HR, RR)
Needs moderate assistance to ascend 2 steps
Independent with shower transfers
Incision reveals mild redness, local swelling and increased temperature
All of the above
A concept central to providing care in the home is:
A. A nurse must first open a home health case
B. Safety of patient and provider are critical
C. A PT should always call the discharging physician at the hospital with concerns
B. Safety of patient and provider are critical
True or False
Improved recovery of ADL function is correlated with increased hospital readmissions following joint arthroplasty.
False
When a 10 year old patient comes to you for a PT examination of their significant non specific hip groin and knee pain, your differential diagnosis should consider all of the following except:
Proximal Femoral Focal Deficiency
Slipped Capital Femoral Epiphysis
Non-accidental trauma
Legg-Calve Perthes Disease
Proximal Femoral Focal Deficiency
Congenital muscular torticollis presents as:
Ipsilateral rotation and ipsilateral lateral flexion
Ipsilateral rotation and contralateral lateral flexion
Contralateral rotation and ipsilateral lateral flexion
Contralateral rotation and contralateral lateral flexion
Contralateral rotation and ipsilateral lateral flexion
The Clinical Practice Guidelines for torticollis recommend use of which of the following tests, described by Ohman, to objectively measure active lateral flexion/side bending:
Passive side bending with an arthrodial protractor
Visual inspection
Photography
Muscle function scale
Muscle function scale
It is often difficult to determine the cause of limping in children. There are three major categories of clinical questioning that will help move toward the correct differential diagnosis. Which one of the following questions is NOT a primary branch of the clinical decision tree for limping?
Does the child have a history of musculoskeletal trauma?
Does the child have a normal neurological exam?
Does the child’s family have a history of cancer?
Does the child have a history of fever?
Does the child’s family have a history of cancer?
Johnny, a 7-year old boy and his family have come to your clinic. His parents are concerned because his feet are turning in when he walks. You observe that Johnny has bilateral internal foot progression angles. You are concerned because internal foot progression is not normal at this age. Which of the following conditions would you hypothesize is most likely related to Johnny’s internal foot progression angle?
Genu varus
Femoral retroversion
Tibial torsion
Femoral anteversion
Femoral anteversion
Arthrogryposis is associated with:
Trauma at birth
3rd trimester maternal sleep position
Less movement in utero
Maternal smoking
Less movement in utero
Common characteristics of metatarsus adductus (Club Foot) include all of the following except:
Increased ankle dorsiflexion
Medially curved forefoot
Calf atrophy
Hindfoot varus
Increased ankle dorsiflexion
Physical therapy intervention for developmental hip dysplasia includes teaching parents to remove a Pavlik harness to facilitate play in different positions.
True or False
False. Harness should only be removed for 1hr/day, and play time should be performed with harness on
Which of the following has been correlated to the onset of low back pain in adolescents?
Scoliosis
Pain beliefs
Standing posture
Joint hypermobility
Scoliosis
Which of the following is considered appropriate treatment for apophysitis?
Surgical reduction and fixation of secondary growth plate
Eccentric loading program followed by long duration static stretching of tight musclesS. tretching, cross friction massage and cryotherapy
Stretching, cross friction massage and cryotherapy
Active rest (activity modification), correcting muscle length/strength imbalance and cryotherapy
Active rest (activity modification), correcting muscle length/strength imbalance and cryotherapy
Which of the following best describes Stage 1 osteochondritis dissecans?
Intact articular cartilage surface, but high signal in subchondral bone on MRI, managed with conservative care (PT and no impact for 3-6 months)
Intact articular cartilage with high signal in subchondral bone on MRI requiring immediate surgical intervention for optimal long term outcome
Articular cartilage breached/defect with high signal in subchondral bone on MRI managed with conservative care (PT and no impact for 3-6 months)
Articular cartilage defect that is a loose fragment in the joint, requiring immediate surgery for fixation
Intact articular cartilage surface, but high signal in subchondral bone on MRI, managed with conservative care (PT and no impact for 3-6 months)
An ACL reconstruction in a skeletally immature individual is surgically managed by the same techniques (graft type, tunnel placements and fixation method) as an adult.
True or False
False
