Flashcards in all irats for final Deck (97):
A patient with bilateral symptoms of clumsiness of the hands, difficulty walking, possible urinary dysfunction and shooting pains into the arms is a classic presentation for myelopathy. t/f?
What is not a cause of spinal cord compression (myelopathy)
according to souza, a myelopathy is the most common spinal cord dysfunction in individuals older than ____ years of age and more comming in ____ and asians.
____ is the recommended management for cervical myelopathy where there are "hard" lesions such as spondylosis or ossification of the posterior longitudinal ligament.
according to souza, babinski sign may be present in cases of myelopathy t/f?
based on the symptoms of myelopathy which of hte following would be a good differential diagnosis
according to souza, an overlap of myelopathy symptoms probably will NOT include which of the following?
according to souza, patients with myelopathy due to anterior cord compression may have all the following symptoms EXCEPT
deep tendon hyporeflexia
according to souza, mixed finding of UMNL and LMNL may occur with myelopathy t/f?
According to Souza, radiographic measurement of the spinal canal diameter may be accomplished on the _______________ view of the cervical spine.
According to Souza, if spinal canal measurements are less than __________, a ________ should be ordered.
A patient diagnosed with myelopathy will probably NOT result in bilateral sensory loss including numbness and vibration loss. T/F?
According to Souza, most tests for cervical myelopathy are specific but not sensitive which means ______________
finding positives is good for ruling-in myelopathy, but not finding positives does not rule-out a myelopathy
According to Souza, myelopathy producing lower motor neuron problems is due to ____________.
all of these
According to Souza, patients with myelopathy due to posterior cord compression may have all the following symptoms EXCEPT:
According to Merck, medical management for cervical spondylosis leading to cervical myelopathy often require_____________ to relieve the spinal compression.
A & B
According to Souza, if there are mild myelopathic signs/symptoms or MRI evidence of compression with no T2 changes the patient should be managed using______________.
According to Dr. Mark Amos, Hoffman's test is performed by _______________.
flicking the index finger into extension
A spondylotic myelopathy that is caused by direct pressure on the posterior columns may produce _________________.
According to Souza, cervical myelopathy is present in ______ of individuals older than 70 years of age.
Labyrinthitis is the most common cause of vertigo T/F?
According to Souza, which of the following presentations IS NOT observed in cervicogenic vertigo.
associated ear fullness
According to Souza, vertigo often indicates a peripheral or central dysfunction. T/F?
if tinnitus is only audible to the patient, it is considered _____
According to Souza, slow onset of continuous or progressive tinnitus with possible minor vertigo and/or hearing loss should______________.
initially be evaluated for a buildup of cerumen
According to Souza, when a patient complains of local ear pain, what should the examiner look for________________?
all of these
According to Souza, a patient experiencing sudden hearing loss after a trauma with neurologic findings should__________________
receive a neurological examination to determine a possible vascular event
According to Merck, autoimmune disorders can cause sensorineural hearing loss at all ages and can cause other symptoms/signs. T/F?
According to Souza, dizziness may occur in as many as ______ of the elderly.
According to Merck, hearing deficits in early childhood can result in lifelong impairments in receptive and expressive language skills. The severity of the handicap can be determined by___________________.
all of these
according to souza, the dizzy patient may _____.
all of these
Benign Paroxysmal Positional Vertigo (BPPV) usually lasts at the most one to two minutes in a patient with a history of trauma or is older. t/f
According to Souza, a patient complaining about hearing a rhythmic or pulsed sound should be___________________.
all of these
According to Merck, all the following are TRUE about conductive hearing loss EXCEPT:
A cerebellaopontine angle tumor is a life-threatening cause of conductive hearing loss.
According to Souza, _____________ is a conservative approach to managing BPPV.
According to Souza, an overlap of cervicogenic vertigo symptoms probably will NOT include which of the following?
cervical ROM that is WNL
According to Souza, in older adults, hearing loss usually results from __________.
According to Souza, when vertigo has a peripheral cause the patient history may include all the following EXCEPT:
According to Souza, internal medicine and emergency departments, rank dizziness among the top three patient complaints. t/f?
According to Souza, which of the following pathologies are associated with hearing loss?
according to souza, all the following headache presentations are red flags EXCEPT:
a headache associated with exercise
In a chiropractic office one of most common headache presentations is associated with _____________________;
a headache patient with a history of head trauma should be ____.
referred for a medical consultation
According to Merck, neuroimaging, usually MRI, should be performed if a headache patient has which of the following?
-Focal neurologic deficit
-Age > 50 yr
-Change in an established headache pattern
According to Souza, tension-type and cervicogenic headache management should include the following EXCEPT:
avoidance of alcohol
According to Souza, a constant, progressive headache with associated symptoms such as _________ could indicate a tumor.
-persistent mild dizziness
Patients with cervicogenic headaches present with pain localized to the neck or suboccipital region and is provoked by specific shoulder movements. t/f?
According to Souza, a history of hypo or hyperthyroid disease or diabetes could indicate a ______________ headache
According to Souza, a _____________ is usually unilateral accompanied by lacrimation and a runny nose on the same side
According to Souza, vascular/neurological headaches include ______________.
-decreased blood to the brain
-increased pressure on vasculature
According to Merck, secondary headaches can be caused by all the following EXCEPT
According to Souza, chiropractic manipulative therapy (adjustment) is recommended for migraine, cervicogenic and tension type headaches t/f?
migraine headaches have a price tag of $13-$17 billion annually T/F?
According to Souza, patients taking NSAIDs or aspirin longer than 3 days may experience a _____________________.
According to Souza, 57% percent of men and _____ of women report at least one significant headache per month.
According to Souza, which of the following presentations IS NOT observed in a cluster headache
they are described as nonpulsatile tightening
According to Souza, a headache associated with exercise indicates is categorized as a ________headache
The presence of an aura separates a classic migraine from a common migraine t/f?
According to Souza, which of the following will NOT trigger a migraine with aura?
According to Souza, the following are secondary causes for a headache
According to Merck, medical evaluation of a possible stroke patient aims to establish the following
-what are the best strategies for preventing subsequent strokes
-whether a stroke has occured
-whether the stroke was ischemic or hemorrhagic
According to Merck, the following symptoms can occur in 48 to 72 hours suggesting increased intracranial pressure
According to Merck, initial symptoms of a stroke occur suddenly and may include the following
according to souza possible risk factor for VBI
-giant cell arteritis
According to Souza, the following adjustment techniques associated more with VBI occurrence are often misleading and overlapping including _____________________.
-10% rotation with extension
-4% rotation with flexion and hyper-extension
according to souza, a helpful mnemonic device for remembering VBI symptoms/ signs is:
the 5 D's and 3 N's
According to Souza, the most common symptom of a vertebrobasilar ischemia (VBI) is ________.
According to Merck, which is the most common stroke syndrome
middle cerebral artery
According to the Merck Manual, ______ % of strokes are typically resulting from a thrombus or embolism.
According to Souza, standard in-office testing cannot detect arterial anomalies, or pathology that predisposes patients to VBI T/F?
a patient who develops symptoms like dizziness, diplopia, dysarthria, numbness and /or nausea after a cervical adjustment _________________.
should have their vitals monitored and an ambulance called
Which of the following may NOT result in a hemorrhagic stroke
According to Merck, sudden severe headache suggests a(n) ______________.
According to Merck, Transient Ischemic Attacks (TIA) are _________________.
-not accompanied by permanent brain infarction
-the cause of sudden neurologic deficits
-similar to ischemic strokes but last <1 hour
According to Souza, the prognosis for patients who suffer VBI is______________________.
-33% of aneurysms decrease in size
-66% of occlusions are recanalized
-90% of stenosis resolves eventually
According to Souza, the following may cause a vertebrobasilar ischemia (VBI) EXCEPT
According to Merck, stroke complications can include the following EXCEPT
Alcoholism and hypertension are common risk factors for strokes t/f?
According to Souza, symptoms of VBI occur in the practitioner's office ________ of the time
According to Merck, ischemic stoke minicers which produce similar neurologic deficits are_________________..
According to Souza, evidence that multidisciplinary management was associated with slower claim closure for WAD compared to usual care. t/f?
According to Merck, diagnosis of TOS usually includes_________________.
all the above
Acceleration/deceleration injury of the cervical spine is an uncommon mechanism of injury in patients seeking chiropractic care t/f?
According to Souza, which of the following is NOT considered conservative management for TOS
Often TOS patients will describe arm symptoms that follow a path __________ .
down the inside arm to the fourth and fifth finger
a patient in a MVA trauma may experience a possible hangman’s fracture if the head was ______________________.
According to Souza, numbness caused by a ____________ presents bilaterally and may involve the central cord
According to Souza, a cervical rib revealed on a cervical spine series is pathognomonic for TOS t/f?
It is always important to perform a neurological examination in an attempt to differentiate TOS from all the following EXCEPT
According to Merck, treatment for Complex Regional Pain Syndrome (CRPS) includes multimodal therapy (eg, drugs, physical therapy, sympathetic blocking, psychologic treatments, neuromodulation, mirror therapy) t/f?
Asking if there are any low risk factors for safe assessment of range of motion is important for determining ______________.
if radiographic evaluation is needed for WAD patient
According to Souza, 40% of TOS cases are due to trauma t/f?
According to Souza, other necessary information needed from a post MVA patient include the following EXCEPT
whether the radio was on at the time of collision
According to Souza, there is no advantage for using soft or rigid collars compared to other approaches in acute WAD t/f?
If a patient is in an MVA it is important to acquire details such as__________.
if a patient complains of numbness, the chiropractor must first differentiate between objective and subjective numbness with a sensory examination. t/f?