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AAPMR questions review > Rehab problems > Flashcards

Rehab problems Flashcards

1
Q

Which of the following is the most useful single modality for the diagnosis of osteomyelitis in a pressure ulcer?

A

bone biopsy

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2
Q

What is an advantage of using botulinum toxin for upper extremity spasticity?

A

clinical effects for about 3 months

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3
Q

Which of the following has been shown to decrease the risk of development of post-thoracotomy pain following chest wall surgery?

A

Epidural analgesia

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4
Q

Which of the following is true about the use of total-contact casting for a diabetic patient with a nonhealing foot ulcer?

A

active soft tissue infection or OM

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5
Q

how often is the total-contact casting for a diabetic patient with a nonhealing foot ulcer changed?

A

The initial cast is changed within 2 to 7 days, and then approximately every 7 days if no complications develop.

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6
Q

Frailty can be described as:

A

Age- and disease-related loss of adaptation

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7
Q

A 22-year-old with complete paraplegia presents to your office with complaints of a new wound. On exam he is found to have skin breakdown over the coccyx through the skin with partial slough, but no bone, tendon or muscles is exposed. What is the stage of this pressure injury?

A

stage 3

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8
Q

A 35-year-old patient presents with a concern of intermittent visual disturbances and hearing loss which started shortly after the patient witnessed a traumatic event. All diagnostic studies thus far have been unremarkable. The patient’s symptoms resolved after extensive psychotherapy. What was the most likely diagnosis for this patient?

A

Functional neurological symptom disorder

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9
Q

Which diagnosis is associated with the highest risk of post-traumatic hydrocephalus?

A

SAH

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10
Q

Excess angles of greater than 15 degrees are not recommended in wheelchair seating systems because they:

A

flatten the lumbar curve

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11
Q

Symptoms of opioid withdrawal include:

A

eye watering, runny nose, yawning, sweating, restlessness, piloerection, tremors, irritability, anorexia, bone and joint pain and stomach cramps.

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12
Q

Which of the following is least likely to control knee hyperextension during stance phase in the presence of genu recurvatum and normal ankle range of motion?

A

KAFO with single axis unlocked knee joint

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13
Q

A 27-year-old female patient presents to her primary care physician for follow-up. She has had a three-year history of bilateral hip, knee and wrist pain, abdominal pain and nausea, headache, and menstrual irregularities. Extensive workup has not been able to explain these patient’s complaints. According to criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), what is the most likely diagnosis?

A

somatic symptom disorder

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14
Q

What is the most common cause of low back pain in the adolescent athlete?

A

Spondylolysis

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15
Q

A 13-year-old has recently been diagnosed with limb-girdle muscular dystrophy. Routine evaluation of which organ system is recommended?

A

cardiac

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16
Q

A patient presents with pain radiating across the left flank that started eight weeks ago after she fell on her back. Upon examination, you find tenderness along the left T9 distribution. She denies any history of vesicular lesions. MRI of the thoracic spine shows mild thoracic spondylosis with absence of disc disease. Which of the following is the most likely diagnosis?

A

intercostal neuralgia

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17
Q

Which of the following is an FDA approved indication for use of botulinum toxin?

A

lower limb spasticity

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18
Q

On the videofluoroscopic swallow study of a patient with right hemiplegia after a stroke, pharyngeal weakness with significant pharyngeal residue was noted on the right side. As a swallow strategy for this patient, the speech therapist recommends:

A

Turning the head to the right side or tilting head to left side

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19
Q

A 46-year-old female is admitted to inpatient rehabilitation following a motor vehicle crash in which she sustained a severe traumatic brain injury and several extremity fractures. She develops nausea and vomiting that persists following discontinuation of physical therapy. What is the next best step in management?

A

order head CT

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20
Q

A 5-year-old male sustains a traumatic spinal cord injury resulting in tetraplegia. Which complication is most likely?

A

scoliosis

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21
Q

An 82-year-old woman is evaluated for increased falls. One year ago she suffered a mild hemorrhagic stroke, but made a full recovery and was discharged to home from inpatient rehabilitation at an independent level. Six months later she had an unwitnessed fall at home. CT head on evaluation in the emergency department was negative. Since then the patient has experienced progressive gait instability and is now using a walker for safety. Her daughter is considering placing her in a nursing home as the patient is also becoming more forgetful and having frequent urinary incontinence. When asked to ambulate in the hallway, the patient stops upon reaching the door and states “my legs feel stuck.” What test will confirm the most likely diagnosis?

A

lumbar puncture

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22
Q

Patient presents with a wound with slough coverage of the entire wound bed. This will be consistent with which stage of pressure injury?

A

unstageable

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23
Q

complications of spasticity include:

A

interference with function, disfigurement, increased risk of pressure ulcers, interference with nursing care and hygiene, contractures, increased risk of heterotopic ossification and joint subluxation/dislocation

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24
Q

Maximum Medical Improvement (MMI) is:

A

Achieved when patients are not progressing after being offered the current standard of care

25
Q

What is the most common mechanism of hydrocephalus in patients admitted to inpatient rehabilitation after traumatic brain injury?

A

Decreased reabsorption of cerebrospinal fluid

26
Q

A significant deviation, loss, or loss of use of any body structure or body function in an individual with a health condition, disorder, or disease is called:

A

impairment

27
Q

What medical term describes a lack or shortage of something that may cause illness or impairment, e.g., limb deficiency, color vision deficiency, iron deficiency anemia.

A

deficiency

28
Q

In an inpatient rehabilitation setting, greater functional gains are typically seen in which individuals with which diagnosis?

A

TBI

29
Q

risk factors for developing venous thromboembolic disease in the setting of brain tumor are:

A

larger tumors, supratentorial location, presence of intraluminal thrombosis in the tumor pathologic specimen, age older than 60 years, presence of hemiparesis, and use of chemotherapy.

30
Q

During a normal walking gait cycle, the portion designated as the loading response:

A

Ends once the contralateral foot leaves the ground

31
Q

Which of the following is a sympathetically mediated pain?

A

Complex Regional Pain Syndrome (CRPS), posttraumatic neuralgia, phantom limb pain, and acute herpes zoster.

32
Q

The process in which an inpatient rehabilitation unit receives information about outcomes as compared to centers in the geographic region is referred to as:

A

benchmarking

33
Q

Which statement best describes anosognosia?

A

Lack of recognition of disability or illness in oneself

34
Q

Brain tumors in which lobes are the LEAST likely to be associated with seizures?

A

occipital

35
Q

What percentage of institutionalized elderly persons is estimated to suffer from chronic pain?

A

80%

36
Q

A 56-year-old man is referred for post-stroke rehabilitative care. During the assessment, the patient provides full medical history with fluent and intelligible speech, and he answers all questions appropriately. When asked to repeat a short phrase, however, he is unable to do so. To evaluate this further he is asked to write down what he had for breakfast and then read it back, both of which he does successfully. Where is the likely lesion for the type of aphasia this patient is experiencing?

A

Arcuate fasciculus (conduction aphasia)

37
Q

Where is the aphasia located that is characterized by normal fluency, but deficits in repetition, comprehension, reading (alexia) and writing (agraphia).

A

posterior superior temporal gyrus (Wernickes”

38
Q

where is the aphasia that is characterized by impaired fluency, repetition, and writing, but typically normal comprehension and reading located?

A

inferior frontal gyrus (brocas)

39
Q

A 16-year-old male with severe traumatic brain injury withdraws to pain in each extremity and opens his eyes spontaneously. He does not fixate, track, or follow commands. His current state of consciousness is best described as:

A

Vegetative

40
Q

Which is the best single predictor of falling in the elderly based on gait characteristics?

A

Stride-to-stride variability

41
Q

Which of the following is a risk factor for the development of late post-traumatic seizures after traumatic brain injury?

A

Age, pre-injury alcohol abuse, family history of seizures, depressed skull fracture, focal neurological deficits, retained bone or metal fragments, dural penetration, intracranial hemorrhage, severe TBI, prolonged PTA, and early post-traumatic seizures are all risk factors for developing late post-traumatic seizure

42
Q

With chronic use, which drug has the longest half-life in regard to toxicology screening?

A

marijuana

43
Q

how long is methadone detectable in the blood after use?

A

Methadone is detectable for up to 2 weeks.

44
Q

how long is cocaine detectable in the blood after use?

A

1-3 days

45
Q

Which of the following responses signals emergence from a minimally conscious state (MCS)?

A

functional object use

46
Q

The most common cause of dizziness after traumatic brain injury (TBI) is:

A

BPPV

47
Q

On evaluating a patient with known Parkinson’s disease, the speech therapist observed the patient to have breathy phonation, low volume monotone, imprecise articulation and occasional excess rate of speech. What type of dysarthria is this?

A

hypokinetic

48
Q

Which statement about hydrocephalus is correct?

A

Infection is the most common complication of ventriculoperitoneal shunting.

49
Q

The trim lines of a posterior leaf ankle foot orthosis should be posterior to the malleoli to

A

Allow dorsiflexion in stance and plantar flexion in push-off.

50
Q

Following a right hip fracture due to a fall, a healthy elderly patient was on bed rest for a week prior to undergoing intramedullary pinning of his fracture, and being allowed to weight bear as tolerated on his right leg. At this point, the effects of the inactivity on his system include a decline in:

A

reduced hydrostatic pressure and decreased antidiuretic hormone secretion, resulting in increased diuresis, which leads to a maximum decline in blood volume in the first 1 to 2 weeks of inactivity.

51
Q

An individual presents to your office with a Stage II sacral pressure ulcer, which appears clean, with no necrotic tissue or fibrinous exudate, and only a slight amount of serosanguinous drainage. In order to optimize wound healing, you suggest:

A

an occlusive dressing

52
Q

when is wet to dry dressing used?

A

when debridement is necessary

53
Q

Which of these has the strongest correlation with functional outcome after stroke?

A

baseline NIHSS score

54
Q

A patient with a dissection of the descending aorta is undergoing a thoracic endovascular aortic repair (TEVAR) repair and intra-operative neurologic monitoring is concerning for spinal cord ischemia. Which of the following is the most appropriate next step in management to help prevent severe spinal cord injury?

A

lumbar drain placement

55
Q

A 7-year-old boy with cerebral palsy, spastic quadriplegia, presents with a history of snoring at night, excessive daytime somnolence and increased secretions. What is the next best step in management?

A

sleep study to evaluate for apnea

56
Q

A patient fell off his roof, striking his head with a severe traumatic brain injury and generalized tonic-clonic seizure. The seizure was witnessed at the time of the initial injury and resolved after a few minutes. How long should he be treated with an antiepileptic drug (AED)?

A

1 week

57
Q

Criteria to define frailty include slowness on the 15-foot walk test, unintentional weight loss ≥ 5% over the past year and:

A

weakness with decreased grip strength

58
Q

Which of the following is independently and negatively associated with return to work after a stroke?

A

aphasia

AAPMR questions review (9 decks)

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