Variadas 7

Question 1

A 74 year old patient has recently undergone cemented THR on the left side.
A Quad cane was prescribed to her to navigate around.
How would you advise her to use the Quad Cane?

A) Hold the cane in the right hand with short legs of cane towards her.

B) Hold the cane in the left hand with the short legs of the cane towards her

C) Hold the cane in the right hand with long legs of cane towards her.

D) Hold the cane in the left hand with the long legs of cane towards her.

Answer 1

A

Question 2

A physical therapist is examining gait of a 60 year old patient. The therapist observes that the patient is leaning forward in the stance phase. Which of the following can be identified as a likely cause for this deviation?

A)Weakness of gluteus medius

B)Injury to superior gluteal nerve

C) Weakness of gluteus maximus

D)Weakness of Quadriceps

Answer 2

D

Forward trunk lean can be seen as a compensation for quadriceps muscle weakness.

Forward lean reduces knee extensor moment and thus demand on vastii.

Backward trunk lean is seen with weakness of gluteus maximus.

Lateral trunk lean is seen with weakness of gluteus medius.

Question 3

What is the average walking speed of community ambulators?

a) 0.8m/s
b) 1.0m/s
c) 1.3m/s
d)1.5m/s

Answer 3

C

Question 4

Patient presents with slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM.

What grade is this on the modified Ashworth scale?
a)1
b) 1+
C) 2
D)3

Answer 4

B

0:No increase in tone

1:Slight increase in tone and Catch/release at end ROM

1+:Slight increase in tone and Catch/release and resistance through rest ROM (1/2 ROM)

2: More marked increase in tone through ROM, but affected part moved easily

3: Considerable increase in tone, passive movement difficult

4: Affected part in rigid flexion and extension

Question 5

Which is a stroke-specific outcome measure?

a)MOCA
b) MMSE
c) Modified Tardieu
d) Fugl-Meyer

Answer 5

D

The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance-based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia.

MOCA: The Montreal Cognitive Assessment (MoCA) was designed as a rapid screening instrument for mild cognitive dysfunction.

MMSE: Mini Mental State Examination (MMSE) is a tool that can be used to systematically and thoroughly to assess the mental status.

Modified Tardieu: used clinically to measure spasticity in patients with neurological conditions.

Question 6

Damage to this cranial nerve can cause homonymous hemianopsia:
a)CNII

b) CNIII

с)CNIV

d) CNV

Answer 6

A

Question 7

Receptive aphasia results from damage to

a) Wernicke’s area; frontal

b) Wernicke’s area; temporal

c) Broca’s area; frontal

d) Broca’s area; temporal

Answer 7

B

Question 8

A physiotherapist, working at a private practice clinic, notices that their colleague often flirts with their patients when they are of a certain age and appearance. The physiotherapist has noticed this pattern since their colleagues recent employment at the clinic.

Question: Which of the following is the best course of action for the physiotherapist to take to address this issue?

Choose only ONE best answer.

A) The physiotherapist should meet directly with their colleague and let them know that this behaviour is unprofessional and needs to stop immediately.

B) Wait until there is concrete evidence of a boundary being crossed and then report their colleague to the College.

C)Immediately contact the College and report the issue.

D)Hold a team meeting and review professional boundaries to avoid a direct confrontation.

Answer 8

C

Question 9

A 3 year old kid diagnosed with cystic fibrosis, is being brought to the OPD for bronchial hygiene on a regular basis.
Q1. When is the Sweat chloride test considered positive for Cystic fibrosis?

A) Elevation ≥ 20 mEq/l
B) Elevation ≥ 40 mEq/l
C) Elevation ≥ 60 mEq/l
D) Elevation ≥ 80 mEq/l

Answer 9

C

Question 10

A 3 year old kid diagnosed with cystic fibrosis, is being brought to the OPD for bronchial hygiene on a regular basis.

Which of the following test can be used to measure the lung function in this patient?

A) Spirometry
B) ABG analysis
C) Genetic analysis
D) X - ray

Answer 10

B

Question 11

A 3 year old kid diagnosed with cystic fibrosis, is being brought to the OPD for bronchial hygiene on a regular basis.

Which of the following Airway clearance techniques (ACT) can be given to clear secretions in this patient?

A) Acapella
B) Autogenic drainage
C) Active cycle of breathing technique (ACBT)
D) Postural drainage

Answer 11

D

Question 12

A physical therapist positions a patient in prone position in preparation for postural drainage activities. Which lung segment would be indicated based on the patient’s position?

1Apical segment of the upper lobes

2Anterior segment of the upper lobes

3Lateral basal segment of the lower lobes

4Superior segments of the lower lobes

Answer 12

4

Postural drainage is performed in prone lying on a bed with two pillows under the hips for the superior segments of the lower lobes.

Apical segments of upper lobe are drained in sitting position.

Anterior segments of upper lobe are drained in supine position.

Lateral basal segments of the lower lobes are drained in side lying position

Question 13

The following tract is responsible for fine touch:

a) Lat spinothalamic
b) Ant spinothalamic
с)Dorsal column medial lemniscus
d) Lat corticospinal

Answer 13

C

Question 14

Which is the most severe type of spina bifida?

a) Spina bifida occulta
b) Spina bifida cystica
c) Meningocele
d) Myelomeningocele

Answer 14

D

Question 15

Which test is used to treat BPPV (Benign paroxysmal positional vertigo)

a) Dix-Hallpike
b) Modified Epley
c) Romberg
d) BERG

Answer 15

B

Dix-hallpike maneuver to test for BPPV:
• Head rotated 45 degrees to test ear and neck extended 30 degrees
• Patient lowered from sit to supine maintaining head position and keep for 30 sec
• Positive test: presence of transientnystagmus

: Treatment epley maneuver

Question 16

Which is not a sign of a cerebellar lesion?

a) Dysdiadochokinesia
b) Dysmetria
c) Falling to side of lesion
d) Falling to opposite side of lesion

Answer 16

D

Question 17

Which is described by an attack of neurons in brainstem and anterior horn cells?

a) Cretuzfeldt Jakob disease
b) Post-polio syndrome
c) Encephalitis
d) Guillain-Barre syndrome

Answer 17

B

Question 18

Patient with meningitis presents with Brudzinski’s sign, which is best described as:

a) Involuntary extension of hips and knees when neck is passively extended

b) Involuntary extension of hips and knees when neck is passively flexed

c) Involuntary flexion of hips and knees when neck is passively extended

d) Involuntary flexion of hips and knees when neck is passively flexed

Answer 18

D

Question 19

93. Which disease does not display lower motor neuron signs?
    a) ALS
    b) GBS
    c) MS
    d) Polio

Answer 19

C

Question 20

Which are classic signs of DMD?

a) Gower’s sign and Calf pseudohypertrophy

b) Gower’s sign and Battle sign

C)Battle sign and Calf pseudohypertrophy

d) X-link mutation on chromosome 21 and Gower’s sign

Answer 20

A

Question 21

SCI results in a decrease in all of the following except?

a) Inspiratory reserve volume
B)Expiratory reserve volume
c) Tidal volume
d) Residual volume

Answer 21

D

Question 22

A physiotherapist is treating a patient who was a pedestrian struck by a vehicle. They were taken to emergency and a CT scan of their head and neck revealed no brain or spine injuries. They were diagnosed with grade 2 whiplash-associated disorder and, as a result of their injuries, have been unable to work. The patient reports severe neck pain, limited range of motion, and significant functional limitations.
The physiotherapist has seen the patient 5 times over the last 3 weeks and, despite the physiotherapist’s efforts to provide appropriate treatment, the patient’s progress is minimal. The patient consistently reports heightened pain levels and increased disability.

Question: How should the physiotherapist proceed ?

A-Refer the patient back to their family physician for more investigations.

B-Discharge the patient from physiotherapy services given the suspicion of malingering.

C-Discuss the concerns of malingering directly with the patient to see if this changes their behaviour.

D-Continue to treat using an evidence based approach and document all assessments, treatments, observations and interactions in detail.

Answer 22

D

Question 23

A physiotherapist at a private practice clinic had their license suspended due to repeated privacy breaches. This physiotherapist was the main financial support for their family and brought in the greatest amount of revenue for the clinic. After a long talk with the clinic owner, it was decided that the physiotherapist could continue to practice if they followed all privacy regulations. To bill, they had the administration department use the owner’s name and registration number when billing. Patients were not notified that the physiotherapist was under suspension.

Question: Who is at fault here?

A)The clinic owner
B)The physiotherapist
C)The administration
DAll of the above

Answer 23

D

Question 24

Which is not a main radiographic feature of OA?
a) Osteophytes
b) Loss of joint space
c) Subchondral cyst formation
d) Decreased bone density

Answer 24

D

Question 25

Which grading system is used for diagnosing osteoporosis?
a) Bunnel-Littler
b) Hunter
c) Kellgren-Lawrence
D)BMI

Answer 25

C

Question 26

Which of the following is true?
a) Prevalence of RA is higher in men
b) Prevalence of OA is higher in men
c) Prevalence of 0A is higher in women
d) Prevalence of OA is equal in men and women

Answer 26

C

Question 27

A physiotherapist is working with a stroke patient in a Rehab facility. He suffered a MCA infarct 2 weeks back.
He is also a chronic hypertensive with a history of coronary artery disease(CAD).

PT follows the following precautions when rehab this pt?

A) Strengthening exercises given at 70% MVC (maximum voluntary contraction)

B) Use of isometric exercises

C) Perform dynamic exercises in a upright position

D) Perform exercises in supine position

Answer 27

C- Dynamic exercises performed in an upright position (sitting) produce less elevations in BP than recumbent/supine exercises.

Incorrect Answers:
A - exercises are given at submaximal intensity of 30% to 50% MVC in a stroke patient with risk factors.

B - isometric exercises are accompanied by valsalva manoeuvre which can cause dangerous elevations in BP in an hypertensive patient.

D - supine exercises can cause elevations in BP in at risk patients

Question 28

A gymnast presents with spondylolisthesis. Which of the following would be an easing factor?

a) Standing
b) Walking
c) Extension
D) flexion

Answer 28

D

Question 29

Which is best described by a large amplitude movement performed to the end of available range into resistance?

a Grade I
b) Grade II
c) Grade III
d) Grade IV

Answer 29

C

Question 30

Which is not part of the inner unit of the trunk?
a) Tranversus abdominus
b) Multifidus
c) Rectus abdominis
d) Pelvic floor

Answer 30

C

Question 31

Which is the most stable position for the SI joints?
a Nutation
b) Counternutation
c)Sacrum extension
d) Anterior pelvic tilt

Answer 31

A

Question 32

According to the Canadian c-spine x-ray rules, in which case is an x-ray not indicated?

a) Age 65 or older
b) Dangerous mechanism
c) Unable to achieve 45 deg side flexion right and left
d) Paraesthesia in extremities

Answer 32

C

Question 33

Patient presents with neck pain and MSK signs (decreased ROM and point tenderness).

What WAD grade is the patient?
a) Grade I
b) Grade II
c) Grade III
d) Grade IV

Answer 33

B

Whiplash Associated Disorder (WAD)*
Grade Classification

0- No complaint about the neck. No physical sign(s).

1-Complaint of neck pain, stiffness or tenderness only. No physical sign(s).

2-Neck complaint AND musculoskeletal sign(s). Musculoskeletal signs include decreased range of movement and point tenderness.

3-Neck complaint AND neurological sign(s). Neurological signs include decreased or absent tendon reflexes, weakness and sensory deft-cits.

4-Neck complaint AND fracture or dislocation.

Question 34

Which muscle does not elevate the mandible?
a) Temporalis
B)Masseter
c) Lateral pterygoid
d) Medial pterygoid

Answer 34

C

Question 35

All of the following are appropriate treatments for acute RA except?

a) Energy conservation
b) Ice
c) Stretching
d)Gentle ROM

Answer 35

C

Question 36

What is the correct order of a joint count assessment?

a) Joint effusion, stress pain, joint line tenderness

b) Joint line tenderness, stress pain, joint effusion

c) Joint effusion, joint line tenderness, stress pain

d) Stress pain, joint effusion, joint line tenderness

Answer 36

C

Question 37

Which is not a common special test for people with RA?
a) Piano key sign
b) Radial collateral ligament test
c) Ulnar collateral ligament test
d) Bunnel-Littler test

Answer 37

C

Question 38

What is the correct order of a joint count assessment?
a) Joint effusion, stress pain, joint line, tenderness
b) Joint line tenderness, stress pain, joint effusion
c) Joint effusion, joint line tenderness, stress pain
d) Stress pain, joint effusion, joint line tenderness

Answer 38

C

Question 39

While evaluating the gait cycle of a patient, physical therapist observes hip hiking in the swing phase of gait.

Which of the following condition is LEAST likely to cause the problem?

1Reduced hip flexion

2Inadequate knee flexion

3Lack of ankle dorsiflexion

4Ankle plantar flexor weakness

Answer 39

4

Rationale: Hip hiking (elevation of the ipsilateral pelvis during swing) is used to lift the foot of the swing leg off the ground and provide toe clearance.
Possible causes: Lack of shortening of the swing leg secondary to reduced hip flexion, reduced knee flexion, and/or lack of ankle dorsiflexion.
Functionally or anatomically short stance leg.

Question 40

Mr X is brought to emergency department after a motor vehicle accident. He was wearing a seat belt and did not lose conciousness, but has a laceration on stomach. He is diagnosed with multiple rib fractures on right side, right pneumothorax and stable T7 and T8 spinous process fractures. Currently he is in ICU with a chest drainage tube in situ, and on CPAP.

Q1. Which of the x-ray finding is consistent with diagnosis of pneumothorax?

A) Shift of mediastinum on right side
B) Increased radiolucency on right side
C) Increased vascular markings on right side
D) Air bronchogram on right side

Answer 40

Answer: B
Due to air in pleural cavity, there is increased radiolucency seen on right side.

Incorrect: A - As a pneumothorax is an area of increased pleural pressure, it pushes structures away. Therefore, the trachea, mediastinum, and/or hilar shadows will deviate away from the side o f the pneumothorax, which is on left side.

C - Increased vascular markings are seen on left side since the blood supply is diverted on the good side.

D - air bronchograms, which is found in consolidation is an appearance of a radiolucency (black shadow) of a relatively large airway against radio-opaque (white) consolidated lung tissue.

Question 41

Mr X is brought to emergency department after a motor vehicle accident. He was wearing a seat belt and did not lose conciousness, but has a laceration on stomach. He is diagnosed with multiple rib fractures on right side, right pneumothorax and stable T7 and T8 spinous process fractures. Currently he is in ICU with a chest drainage tube in situ, and on CPAP.

Which of the following should be considered while mobilising Mr X?

A) Do not lift the drain above insertion site
B) Drain can be disconnected from wall suction while mobilising
C) Postural drainage used for Atelectic segments
D) Full shoulder ROM exercises

Answer 41

A
Drain cannot be lifted above the level of the insertion site.

Incorrect: B - Drain can only be
disconnected after confirming with medical team or If not, a long section o f suction tubing can usually be used or the patient can perform marching exercise at the bedside.

C - Techniques such as chest wall percussion, shaking, or vibration should not be used as it is likely to compromise healing of the rib fractures.

D - Shoulder ROM should be restricted to 90° on right side since the tube is in situ and underlying rib fractures.

Question 42

Peripheral arterial disease occurs:

a) At site of narrowing or obstruction

b) Proximal to site of narrowing or obstruction

c) Distal to site of narrowing or obstruction

d) All of the above

Answer 42

C

Question 43

A C6 quadriplegic would have all of the following muscles innervated except the

A. biceps
B. deltoids
C. triceps
D. diaphragm

Answer 43

C

Question 44

At what level is it realistic for a spinal cord injured patient to functionally ambulate?

A.C7
B. T1
C.Т6
D. L1

Answer 44

D

Question 45

The primary area of the residual limb used for weightbearing in a below knee prosthesis is the

А.patella tendon
B.distal end of the residual limb
C.lateral tibial condyle
D.fibular head

Answer 45

A

Question 46

A patient one week status post left total hip replacement is diagnosed with an acute deep vein thrombosis in the left calf. The physical therapist’s role in the care of a deep vein thrombosis is

A. continued gait training with an assistive device and partial weightbearing

B. progressive resistive exercises for bilateral lower extremities

C. patient is on bedrest with no active therapy to the left leg

D. postural drainage and diaphragmatic breathing

Answer 46

C

Question 47

. A hemiplegic patient is observed during gait training. The patient performs side stepping towards the heriplegic side. The physical therapist may expect the patient to compensate for weakened abductors by?

А.hip hiking of the unaffected side

B. lateral trunk flexion towards the hemiplegic side

C. lateral trunk flexion toward the unaffected side

D. hip extension of the hemiplegic side

Answer 47

C

Question 48

What could cause the right side of the pelvis to drop during the left stance phase of gait on a patient with a left above knee prosthesis?

A. weak abdominal musculature
B. weak gluteus medius
C. weak gluteus maximus
D. weak hip flexors

Answer 48

B

Question 49

A therapist prepares for postural drainage activities to the lateral basal lung segments.
Standard positioning for the lung segments is contraindicated secondary to the patient’s inability to tolerate an increase in venous retum. This position would best be modified by?

А.raising the head and neck

B.lying the patient in supine with the lower extremities declined

C. positioning the patient in sidelying with a small decline in the head and chest

D. there is no possible modification to the positions which sre effective

Answer 49

C

Question 50

A C4 quadriplegic is able to adduct the scapula using the

A. middle trapezius

B. serratus anterior

C. subscapularis

D. rhomboids

Answer 50

A

Question 51

A patient in a pulmonary rehabilitation program is positioned in supine with a pillow under their knees. The therapist claps between the clavicle and nipple on each side. This technique would most effectively be utilized for postural drainage of the

A. anterior segments of the upper lobes

B. anterior basal segments of the lower lobes

C. superior segments of the lower lobes

D. posterior basal segments of the lower lobes

Answer 51

A

Question 52

A 35-year-old male was recently diagnosed with Ankylosing Spondylitis. He is in the early stages of the disease progression and has been referred to physiotherapy. During the assessment, the physiotherapist performs measurements of his axial spine to track the progression of his spinal changes. The physiotherapist performs the following measurements: AROM of the cervical spine, modified Schober’s, chest expansion and trunk rotation.

Given his recent diagnosis, which measurement do you expect to show the greatest loss of ROM?

a. AROM of the cervical spine
b. Modified Schober’s
c. Chest expansion
d. Trunk rotation

Answer 52

B

Modified Schober’s
The first symptoms of Ankylosing Spondylitis include insidious onset of low back, buttock, or hip pain and stiffness lasting for at least 3 months.

Inflammation and the associated
fusion typically start distally in the sacroiliac joints and lumbar spine and progress up the spine towards the neck. For this reason, the BEST answer for a patient with a new diagnosis who is early in their disease progression.

This patient will the have most notable changes in the lumbar spine. The modified Schober’s is the only test the specifically measures lumbar spine ROM.

Question 53

A patient is being treated for difficulty with overhead activities and subacromial bursitis. Which of the following strengthening activities will be MOST helpful?

1. Scapular retraction exercises
2. Shoulder flexion exercises
3. Shoulder shrugging exercises
4. Shoulder rotation exercises

Answer 53

4

1. This would strengthen the shoulder retractors, including the rhomboids and trapezius.
2. This would strengthen the deltoid and biceps primarily.
3. This would strengthen the scalenes and trapezius.
4. This is the correct answer. Shoulder rotation, especially external rotation, is the MOST helpful at strengthening the rotator cuff, which will be the MOST helpful at treating subacromial bursitis.

Question 54

A patient has just undergone anterior cruciate ligament reconstruction and presents for physical therapy seven days after surgery. Which of the following treatments will be MOST effective at speeding recovery?

1. Progressive active range of motion exercises
2. Isometric quadriceps strengthening
3. Resisted hamstring curls
4. Progressive increased weight bearing

Answer 54

2. This is the correct answer. Numerous studies indicate that maintaining quadricep function after knee surgery speeds recovery. This is the best initial treatment of the choices given, although extension stretching would also be a good one.

Question 55

A patient with a middle cerebral artery vascular lesion has difficulty raising his arm. Which of the following synergy patterns is MOST likely present in the patient’s involved upper extremity during elevation?

1. Scapular retraction, humeral abduction, elbow flexion, wrist supination
2. Scapular retraction, humeral adduction, elbow extension, wrist supination
3. Scapular protraction, humeral abduction, elbow flexion, wrist supination
4. Scapular protraction, humeral adduction, elbow extension, wrist supination

Answer 55

1. This is the correct answer. The typical flexion synergy pattern in patients after a stroke includes scapular retraction, humeral abduction, elbow flexion, wrist supination, and wrist and finger flexion.

Question 56

A patient reports feeling dizzy and lightheaded upon standing. The patient reports that the condition has been worsening over time and that he commonly sees dark spots when changing positions. Which of the following conditions is MOST likely present?

1. Benign paroxysmal positional vertigo
2. Meniere’s disease
3. Orthostatic hypotension
4. Transient ischemic attack

Answer 56

3-This is the correct answer. A sudden drop in blood pressure upon standing is the most common effect of this condition.

Question 57

physical therapist is treating a patient who had open heart surgery 2 weeks ago to perform a coronary artery bypass. Which of the following BEST describes a precaution following this surgery?

1.Limit left lower extremity to 50% weight bearing

2. Limit shoulder flexion to less than go degrees bilaterally
3. Limit cervical rotation less than 45 degrees bilaterally
4. Limit upper extremity lifting to less than 10 pounds

Answer 57

4. This is the correct answer. After an open heart surgery, typically there is a lifting limit placed on the upper extremities to decrease the stress on the
   sternum.

Question 58

During a physical therapy examination, the physical therapist notes pain and tenderness just inferior to the medial malleolus following what the patient reports as a sprained ankle. Which of the following structures is MOST likely sprained?

1. Anterior talofibular ligament
2. Posterior talofibular ligament
3. Calcaneofibular ligament
4. Deltoid ligament

Answer 58

4. This is the correct answer. The deltoid ligament is a beefy ligament located just inferior to the medial malleolus and is commonly injured in eversion sprains.