ROR Flashcards
Your 48 year old cook has been complaining of shoulder pain for the past 6 months. She decided
to consult a doctor since the pain is increasing in intensity. There is no history of trauma.
If this pain is due to a rotator cuff tendinitis which will you note on PE?
A. Presence of taut bands on the lateral portion of the proximal aspect of the arm
B. Pain radiating to the lateral epicondyle with extension of the shoulder
C. Pain is increased as patient resists the force applied while she lifts the affected arm in slight
abduction
D. Range of motion in all planes is limited
C
With taut bands think MPS, lateral epicondyle = tennis elbow, limited ROM in all planes adhesive
capsulitis.
After passively extending the humerus by lifting the elbow posteriorly, which among the
following rotator cuff muscles is directly under the acromion?
A. Supraspinatus
B. Infraspinatus
C. Teres minor
D. Subscapularis
A
if the patient happens to have a pathology to the coracoid process of the scapula, which of the
following would be relatively weak because of the pain?
A. Shoulder abductors
B. Shoulder flexors
C. Shoulder extensors
D. Shoulder external rotators
B
Since the coracobrachialis and short head of the biceps brachii attach to the coracoid process,
muscles responsible for shoulder flexion
Which particular test will you order if you are suspecting a rotator cuff tendinitis?
A. X-ray of the shoulder
B. CT scan
C. DEXA (dual energy x-ray absorptiometry)
D. Diagnostic musculoskeletal ultrasound
D
You’d want the modality that can best visualize soft-tissue.
Which particular medication will you prescribe the patient if in the history you elicit that she has a kidney disease? A. Diclofenac B. Iburpofen C. Tramadol D. Naproxen
C
Medyo testmanship since tramadol is the only non-NSAID. Also, it is eliminated thru metabolism
in the liver.
In the evaluation of shoulder pain, which of the following historical data would be important to establish? A. Occupational hazards B. Smoking C. Family history of arthritis D. Exposure to chemicals
A
A 47 year old female programmer has been complaining of neck pain for the past 5 years. She
tells you that there is also numbness of the digits of her left hand.
Upon examination, you note that there is impaired sensation on the tip of the ring and little
finger as well as weakness of grip strength. If you are suspecting a left cervical radiculopathy,
which particular nerve roots may be involved?
A. C4, C5
B. C5, C6
C. C7, C8
D. C8, T1
D
You can figure out based on the pattern of the impaired sensation that there is ulnar nerve
involvement. The roots of the ulnar nerve are C8T1.
Which of the following is true with regard to cervical radiculopathy?
A. It often manifests with a positive ten second test
B. It is most often caused by tumors
C. It is an upper motor neuron lesion
D. It is provoked by Spurlings test
D
Spurlings is indicated exactly for determining the presence of cervical radiculopathy
How does one perform the Spurlings test? Tell the patient to A. Flex the neck and rotate it B. Laterally flex the neck C. Extend and laterally rotate the neck D. Extend the neck
C
You order an x-ray which reveals presence of foraminal stenosis of C6C7 and C7T1. Which particular nerve roots will be affected? A. C5, C6, C7, and T1 B. C5, C6, C7, C8 C. C6, C7, C7 D. C7, C8
D
Which among these tests will be helpful in determining the nerve root/s affected? A. CT scan B. Electrodiagnostic test C. Ultrasonography D. Functional MRI
B
EMG-NCV, in other words, which is the modality of choice in determining nerve conduction
pathologies.
If a patient with cervical radiculopathy tells you that she has trouble sleeping because of the
nagging pain and numbness, which drug will be most useful?
A. Baclofen
B. Naproxen
C. Paracetamol
D. Gabapentin
D
This is a weak opioid drug used for pain and one of its side effect is dizziness. A. Carbamazepine B. Tizanidine C. Ketoprofen D. Tramadol
D
A 52 year old homemaker complains of wrist pain on ulnar deviation. There is tenderness on the
radial aspect of the wrist.
Which maneuver will help you diagnose De Quervains tenosynovitis? A. Radially deviate the wrist B. Ulnarly deviate the wrist C. Flex the wrist and apply resistance D. Extend the wrist and apply resistance
B
Which of the tendons are affected in De Quervains tenosynovitis? A. Abductor pollicis longus B. Abductor pollicis brevis C. Adductor pollicis D. Extensor pollicis longus
A
YD, a 31 year old actress, consults you because she has been suffering from low back pain of 5
days duration. Upon further history taking, you did NOT note any red flag sign nor any history of
trauma
What is the most appropriate way of managing this particular patient?
A. Request for a lumbosacral spine x-ray in supine position
B. Request for lumbosacral spine upright
C. Do MRI of the lumbosacral spine
D. NOTA
D
Which of the following is NOT considered as a red flag sign in patients complaining of low back pain? A. Incontinence B. Paralumbar spasm C. Febrile episodes D. Weight loss
B
Which of the following medications for acute low back pain is LEAST effective according to the ACP guidelines? A. Paracetamol B. Diclofenac C. Tramadol D. Oral prednisone
D
If this patient develops numbness over the sole of the right foot and on examination ankle
reflex on the right is absent, you will suspect the following nerve root to be affected
A. L4
B. L5
C. S1
D. S2
B
MJ is a basketball superstar. He accidentally twisted his left knee upon rebounding, causing
immediate pain and tenderness. On examination the knee joint was swollen
If an audible click was demonstrated upon flexion and extension of the knee joint while
rotating the lower leg from the heel, this test will help you check for involvement of the
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial collateral ligament
D. Meniscus
D
Which of the following is an external rotator of the knee? A. Sartorius B. Gracilis C. Semitendinosus D. Biceps femoris
D
With the hip and knee flexed to 90 degrees, the tibia is pulled forward. You compare the
results of this maneuver also on the opposite extremity. Which structure is being assessed by the
test described?
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial collateral ligament
D. Tensor fascia latae
A
TW is a semi-pro golfer who complains of elbow pain. She claims that pain is localized and is
primarily elicited by resisted wrist extension. This is an enthesistis of the epicondyle.
What is your impression? A. Golfer’s elbow B. Tennis elbow C. Panner’s elbow D. Shooter’s elbow
B
Which muscle is affected in a patient with Golfer’s elbow? A. Brachioradialis B. Flexor carpi radialis C. Flexor pollicis longus D. Flexor digitorum profundus
B
Your 65 year old aunt who is an accountant complains of numbness on the left wrist and hand.
Numbness is described as affecting the radial 3 digits.
If the pathology is on the wrist, what nerve is affected? A. Posterior interosseus nerve B. Median nerve C. Ulnar nerve D. Musculocutaneous nerve
B
If you ask this patient to put both wrists in palmar flexion, numbness to the thumb and index finger is elicited. This is a positive A. Prayer tests B. Tinel’s test C. Phalen’s test D. Finkelstein’s test
B
Which particular examination will help clinch the diagnosis? A. Nerve conduction studies B. X-ray of the hand and wrist C. Bone scan D. CT scan of the hand
A
A 31 year old male sees you in the clinic because of back pain of several years duration. On
gross examination you note that trunk mobility is limited.
You do another maneuver called the Schober’s test which turns out positive. Which of the
following statement is true about this test?
A. The test shows limited mobility if the distance between the 2 points is less than 5 cm upon
extension
B. The test shows limited mobility if the distance between the 2 points is less than 5 cm upon
flexion
C. The ASIS is used as a landmark for the horizontal line
D. The PSIS is used as a landmark for the horizontal line
D
Limited mobility is the distance between the 2 points is less than 4 cm upon flexion. The PSIS is
the landmark used for the horizontal line.
If your primary working impression in this case is ankylosing spondylitis, which among the
following will be the least helpful in diagnosing this condition?
A. Adam’s test
B. Schober’s test
C. Checking chest expansion
D. FABERE test
A
Used for scoliosis, not AS
Due to the presence of the decrease in trunk mobility you decide to order for lumbosacral
xrays that showed a classic bamboo spine appearance. In which particular view of the xray will
the bamboo spine be best appreciated?
A. Lumber spine AP
B. Lumbar spine lateral
C. Lumbar spine oblique
D. Judet views
A
You request other laboratory tests and other imaging studies of the lumbar spine and pelvis
which were highly suggestive of sacroillitis. What is the minimum number of (SPa)
spondyloarthritis features needed to fulfill the ASAS criteria for axial spondyloarthritis?
A. 1
B. 2
C. 3
D. 4
A
A 67/F had been complaining of bilateral knee pains and difficulty in ambulation for 6 months.
This patient who has a BMI of 28 complains of pain especially after standing up from a prolonged
sitting position. On PE, both knees appear enlarged. There is no joint swelling, tenderness,, nor
erythema. Presence of crepitus is noted on active motion of the knees. You also note the
presence of a varus deformity of both legs.
Which of the following conditions is this patient suffering from? A. Gouty arthritis B. Osteoarthritis C. Rheumatoid arthritis D. Reactive arthritis
B
Which compartment of the knee joint is most likely affected? A. Lateral compartment B. Medial compartment C. Posterior compartment D. Patellofemoral compartment
B
Which particular special test will you do if the patient has a concomitant meniscal tear? A. Anterior drawers test B. Posterior drawers test C. McMurray’s test D. Faberes test
C
Which drug is recommended for this patient who also has GERD and hypertension if the pain
level most of the time is moderate to severe with a numerical rating score from 7 to 8?
A. Paracetamol
B. Naproxen
C. Celecoxib
D. Tramadol
D
The non-pharmacologic management for this condition is A. Using a R-sided cane B. Stair climbing exercises C. Jogging exercises D. Use of a walker
D
