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Flashcards in all irats for final Deck (97):
1

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?

true

2

What is not a cause of spinal cord compression (myelopathy)

angioma

3

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.

55

males

4

____ is the recommended management for cervical myelopathy where there are "hard" lesions such as spondylosis or ossification of the posterior longitudinal ligament.

surgery

5

according to souza, babinski sign may be present in cases of myelopathy t/f?

true

6

based on the symptoms of myelopathy which of hte following would be a good differential diagnosis

multiple sclerosis

7

according to souza, an overlap of myelopathy symptoms probably will NOT include which of the following?

vascular symptoms

8

according to souza, patients with myelopathy due to anterior cord compression may have all the following symptoms EXCEPT

deep tendon hyporeflexia

9

according to souza, mixed finding of UMNL and LMNL may occur with myelopathy t/f?

true

10

According to Souza, radiographic measurement of the spinal canal diameter may be accomplished on the _______________ view of the cervical spine.

lateral

11

According to Souza, if spinal canal measurements are less than __________, a ________ should be ordered.

13 mm

MRI

12

A patient diagnosed with myelopathy will probably NOT result in bilateral sensory loss including numbness and vibration loss. T/F?

false

13

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

14

According to Souza, myelopathy producing lower motor neuron problems is due to ____________.

all of these

15

According to Souza, patients with myelopathy due to posterior cord compression may have all the following symptoms EXCEPT:

increased dexterity

16

According to Merck, medical management for cervical spondylosis leading to cervical myelopathy often require_____________ to relieve the spinal compression.

A & B

17

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______________.

HVLA adjusting

18

According to Dr. Mark Amos, Hoffman's test is performed by _______________.

flicking the index finger into extension

19

A spondylotic myelopathy that is caused by direct pressure on the posterior columns may produce _________________.

A&B

20

According to Souza, cervical myelopathy is present in ______ of individuals older than 70 years of age.

90%

21

Labyrinthitis is the most common cause of vertigo T/F?

false

22

According to Souza, which of the following presentations IS NOT observed in cervicogenic vertigo.

associated ear fullness

23

According to Souza, vertigo often indicates a peripheral or central dysfunction. T/F?

true

24

if tinnitus is only audible to the patient, it is considered _____

subjective tinnitus

25

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

26

According to Souza, when a patient complains of local ear pain, what should the examiner look for________________?

all of these

27

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

28

According to Merck, autoimmune disorders can cause sensorineural hearing loss at all ages and can cause other symptoms/signs. T/F?

true

29

According to Souza, dizziness may occur in as many as ______ of the elderly.

50%

30

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

31

according to souza, the dizzy patient may _____.

all of these

32

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

true

33

According to Souza, a patient complaining about hearing a rhythmic or pulsed sound should be___________________.

all of these

34

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.

35

According to Souza, _____________ is a conservative approach to managing BPPV.

habituation exercises

36

According to Souza, an overlap of cervicogenic vertigo symptoms probably will NOT include which of the following?

cervical ROM that is WNL

37

According to Souza, in older adults, hearing loss usually results from __________.

presbycusis

38

According to Souza, when vertigo has a peripheral cause the patient history may include all the following EXCEPT:

constant dizziness

39

According to Souza, internal medicine and emergency departments, rank dizziness among the top three patient complaints. t/f?

True

40

According to Souza, which of the following pathologies are associated with hearing loss?

B&C

41

according to souza, all the following headache presentations are red flags EXCEPT:

a headache associated with exercise

42

In a chiropractic office one of most common headache presentations is associated with _____________________;

whiplash

43

a headache patient with a history of head trauma should be ____.

referred for a medical consultation

44

According to Merck, neuroimaging, usually MRI, should be performed if a headache patient has which of the following?

-Focal neurologic deficit
-Weight loss
-Age > 50 yr
-Change in an established headache pattern

45

According to Souza, tension-type and cervicogenic headache management should include the following EXCEPT:

avoidance of alcohol

46

According to Souza, a constant, progressive headache with associated symptoms such as _________ could indicate a tumor.

-persistent mild dizziness
-mood changes
-diplopia

47

Patients with cervicogenic headaches present with pain localized to the neck or suboccipital region and is provoked by specific shoulder movements. t/f?

false

48

According to Souza, a history of hypo or hyperthyroid disease or diabetes could indicate a ______________ headache

metabolic

49

According to Souza, a _____________ is usually unilateral accompanied by lacrimation and a runny nose on the same side

cluster headache

50

According to Souza, vascular/neurological headaches include ______________.

-decreased blood to the brain
-cluster headaches
-increased pressure on vasculature

51

According to Merck, secondary headaches can be caused by all the following EXCEPT

tension

52

According to Souza, chiropractic manipulative therapy (adjustment) is recommended for migraine, cervicogenic and tension type headaches t/f?

true

53

migraine headaches have a price tag of $13-$17 billion annually T/F?

true

54

According to Souza, patients taking NSAIDs or aspirin longer than 3 days may experience a _____________________.

rebound migraine

55

According to Souza, 57% percent of men and _____ of women report at least one significant headache per month.

76%

56

According to Souza, which of the following presentations IS NOT observed in a cluster headache

they are described as nonpulsatile tightening

57

According to Souza, a headache associated with exercise indicates is categorized as a ________headache

miscellaneous

58

The presence of an aura separates a classic migraine from a common migraine t/f?

true

59

According to Souza, which of the following will NOT trigger a migraine with aura?

aerobic exercise

60

According to Souza, the following are secondary causes for a headache

-Metabolic disease
-trauma
-intercranial pathology

61

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

62

According to Merck, the following symptoms can occur in 48 to 72 hours suggesting increased intracranial pressure

nausea
vomiting
headache

63

According to Merck, initial symptoms of a stroke occur suddenly and may include the following

headache
aphasia
dizziness
visual disturbances

64

according to souza possible risk factor for VBI

-ligamentous hyper-mobility
-giant cell arteritis
-precursor lesions
-rheumatoid arthritis

65

According to Souza, the following adjustment techniques associated more with VBI occurrence are often misleading and overlapping including _____________________.

-60% rotation
-10% rotation with extension
-4% rotation with flexion and hyper-extension

66

according to souza, a helpful mnemonic device for remembering VBI symptoms/ signs is:

the 5 D's and 3 N's

67

According to Souza, the most common symptom of a vertebrobasilar ischemia (VBI) is ________.

dizziness

68

According to Merck, which is the most common stroke syndrome

middle cerebral artery

69

According to the Merck Manual, ______ % of strokes are typically resulting from a thrombus or embolism.

80

70

According to Souza, standard in-office testing cannot detect arterial anomalies, or pathology that predisposes patients to VBI T/F?

true

71

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

72

Which of the following may NOT result in a hemorrhagic stroke

TIA

73

According to Merck, sudden severe headache suggests a(n) ______________.

subarachnoid hemorrhage

74

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

75

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

76

According to Souza, the following may cause a vertebrobasilar ischemia (VBI) EXCEPT

femoral emboli

77

According to Merck, stroke complications can include the following EXCEPT

urinary continence

78

Alcoholism and hypertension are common risk factors for strokes t/f?

true

79

According to Souza, symptoms of VBI occur in the practitioner's office ________ of the time

69%

80

According to Merck, ischemic stoke minicers which produce similar neurologic deficits are_________________..

-hemorrhagic stroke
-migraine
-hypoglycemia
-hemorrahagic stroke

81

According to Souza, evidence that multidisciplinary management was associated with slower claim closure for WAD compared to usual care. t/f?

false

82

According to Merck, diagnosis of TOS usually includes_________________.

all the above

83

Acceleration/deceleration injury of the cervical spine is an uncommon mechanism of injury in patients seeking chiropractic care t/f?

false

84

According to Souza, which of the following is NOT considered conservative management for TOS

cervical traction

85

Often TOS patients will describe arm symptoms that follow a path __________ .

down the inside arm to the fourth and fifth finger

86

a patient in a MVA trauma may experience a possible hangman’s fracture if the head was ______________________.

forced backward

87

According to Souza, numbness caused by a ____________ presents bilaterally and may involve the central cord

CNS

88

According to Souza, a cervical rib revealed on a cervical spine series is pathognomonic for TOS t/f?

false

89

It is always important to perform a neurological examination in an attempt to differentiate TOS from all the following EXCEPT

cervical myelopathy

90

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?

true

91

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

92

According to Souza, 40% of TOS cases are due to trauma t/f?

true

93

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

94

According to Souza, there is no advantage for using soft or rigid collars compared to other approaches in acute WAD t/f?

true

95

If a patient is in an MVA it is important to acquire details such as__________.

everything

96

if a patient complains of numbness, the chiropractor must first differentiate between objective and subjective numbness with a sensory examination. t/f?

true

97

According to Souza, patients presenting with positionally related arm numbness/tingling and secondary neck complaints should be _______________.

tested for TOS + something else