Deck 21

Question 1

A patient with right hip pain is examined by a physical therapist for hip osteoarthritis. The patient has generalized hip pain during many movements and indicates that any squatting will aggravate the symptoms. Active hip flexion and extension cause pain in the hip region, and a scour test performed by the physical therapist with adduction provoked the patient’s hip symptoms. The physical therapist performs passive range of motion for internal rotation and feels that he can safely determine this patient’s right hip pain is hip osteoarthritis. What amount of hip internal rotation would allow the physical therapist to be confident in his diagnosis?

A. 5˚
B. < 15˚
C. < 25˚
D. 35˚

Answer 1

C. < 25˚

Question 2

A female patient with pelvic and low back pain, who also reports some left shoulder pain sporadically, is being seen in physical therapy. The physical therapist suspects a systemic issue, not a musculoskeletal condition. Based on the patient’s clinical presentation, what is one of the first areas that should be followed up on?

A. Asking the patient about any changes/problems with urination
B. Asking the patient about a family history of cancer
C. Asking the patient if she has any difficulty swallowing or has recently felt an increase in heartburn or indigestion
D. Asking the patient if she has had a recent trauma or accident

Answer 2

A. Asking the patient about any changes/problems with urination

Question 3

The combination of pelvic, low back, and L shoulder pain is a sign of involvement from which system?

Answer 3

renal

Question 4

Which of the following is a risk factor for development of ankylosing spondylitis?

A. Crohn’s disease
B. Eczema
C. Gout
D. OA

Answer 4

A. Crohn’s disease

Question 5

Crohn’s disease along with this is one of the largest risk factors for AS

Answer 5

IBS

Question 6

Diagnostic imaging shows a Hill–Sachs lesion in a patient with right shoulder pain after a shoulder dislocation. Where is a Hill–Sachs lesion located?

A. Anterior humerus
B. Anterior labrum
C. Posterior humerus
D. Posterior labrum

Answer 6

C. Posterior humerus

Question 7

Which of the following is true of those with rheumatoid arthritis?

A. It is not typical to see constitutional symptoms, such as a fever or fatigue, in those with rheumatoid arthritis
B. No consideration should be given to conservation of energy in patients with rheumatoid arthritis because they need activity to relieve symptoms
C. Onset is typical in patients 60 years of age or above
D. Pericarditis is a possible systemic pathology that can occur due to rheumatoid arthritis

Answer 7

D. Pericarditis is a possible systemic pathology that can occur due to rheumatoid arthritis

Question 8

A 75-year-old active female is referred to physical therapy for osteoporosis in bilateral hips. The physical therapist is most concerned with being able to reverse or reduce the impact of the loss of bone mineral density. Based on evidence, which of the following interventions can reverse or reduce the impact of loss of bone mineral density?

A. High-intensity aerobic exercise
B. Low-intensity aerobic exercise
C. Low-load, high-repetition strength training
D. Postural and balance exercise

Answer 8

A. High-intensity aerobic exercise

Question 9

A patient with low back pain is suspected of having cauda equina, and the physical therapist has performed a thorough screen to determine this before referring the patient to a physician for immediate medical attention. Which of the following is most helpful in the diagnosis of cauda equina due to its high sensitivity?

A. Motor deficits in the lower extremity either unilaterally or bilaterally
B. Sensory deficits in the lower extremity either unilaterally or bilaterally
C. Sexual dysfunction
D. Urinary retention

Answer 9

D. Urinary retention

Question 10

A physical therapist is screening a patient with low back pain for appropriateness of physical therapy. The patient’s prior medical history is unremarkable. The current symptoms are in the lower abdomen and middle lumbar spine, sometimes radiating to the buttock region. The symptoms the patient describes do not match up with what the physical therapist believes is a musculoskeletal condition, so the physical therapist plans to refer the patient for further medical care. Which of the following is the most likely generator of the patient’s low back pain?

A. Gallbladder
B. Large intestine
C. Liver
D. Stomach

Answer 10

B. Large intestine

Question 11

A physical therapist is questioning a patient regarding low back pain symptoms and feels that the issues may be related to the gastrointestinal system instead of the musculoskeletal system. Which of the following is not a symptom of a lower-GI pathology?

A. Bloody diarrhea
B. Central low back pain
C. Fecal incontinence
D. Upper thigh pain with low back pain

Answer 11

D. Upper thigh pain with low back pain

Question 12

Upper thigh pain is more closely related to what types of pathologies (NOT GI)?

Answer 12

reproductive

urinary tract

Question 13

A patient with chronic low back pain is given the Oswestry Disability Index on her first day of treatment. She scores 26 points. At discharge, the patient scores 15 points. The physical therapist is deciding whether this person met or exceeded the minimal clinically important difference (MCID). What is the MCID for the Oswestry Disability Index for patients with chronic low back pain?

A. 7 pts
B. 10 pts
C. 15 pts
D. 20 pts

Answer 13

B. 10 pts

Question 14

A 72-year-old female with a fifteen-year history of low back pain is being seen in physical therapy for several impairments and an inability to ambulate. She has difficulty with push-off of the big toe on her right and has difficulty with plantar flexion in general because of weakness on the right side. There is also atrophy of the gastroc-soleus complex on her right side. Which of the following structures is likely causing the patient’s symptoms?

A. Deep peroneal nerve
B. L5 nerve root
C. Sciatic nerve
D. S1 nerve root

Answer 14

D. S1 nerve root

Question 15

An 80-year-old female with low back pain is referred to physical therapy. She has a history of osteoporosis and breast cancer and has been taking medication for hypertension for 20 years. She states that along with the low back pain, she has been experiencing a high amount of stress because her husband of 50 years just passed away. She has lost her appetite, feels very tired all the time, and is noticing that she is very anxious. This has all occurred over the last few months. What should the physical therapist include in the intervention plan?

A. Referral to medical doctor for possible recurrence of cancer
B. Referral for psychological assistance while continuing to treat the musculoskeletal symptoms present
C. Treatment for mechanical low back pain and a pamphlet on yellow flags
D. Treatment for mechanical low back pain only

Answer 15

B. Referral for psychological assistance while continuing to treat the musculoskeletal symptoms present

Question 16

A physical therapist is performing an examination/evaluation on a patient with low back pain that radiates to the posterior thigh. During the active range of motion assessment, the patient has a replication of symptoms during lumbar flexion. What should the physical therapist’s next step be?

A. Assess a neurological examination since this patient is exhibiting radicular symptoms
B. Defer any further range of motion and move to a joint play assessment
C. Have the patient perform repeated flexion to see if symptoms change during a repeated motion assessment
D. Trial prone press-ups to see if the patient centralizes with extension

Answer 16

C. Have the patient perform repeated flexion to see if symptoms change during a repeated motion assessment

Question 17

Which of the following special tests is most helpful in determining if lumbar mechanical traction is an appropriate intervention?

A. Crossed straight-leg raise test
B. Prone knee bend
C. Slump test
D. SLR test

Answer 17

A. Crossed straight-leg raise test

Question 18

A 48-year-old male with a five-year history of low back pain has experienced an acute on chronic episode of low back pain. He was recently working as a welder, bent over and twisted, when he got up and felt a twinge in his back. A day after the injury, he noticed that the pain was moving into his left gluteal region, and he also had some pain that radiated down to his lateral knee region. He felt that he was having difficulty walking at times because he “felt weak” and “couldn’t always pick up” his foot. The patient felt a “weird sensation” on the dorsum of his foot. With range-of-motion testing, the patient felt pain to the lateral knee region on the left with both flexion and extension. Which of the following interventions would be most appropriate for this patient?

A. Flexion-oriented exercises
B. Joint manipulation
C. Lumbar stabilization exercises
D. Lumbar traction

Answer 18

D. Lumbar traction

Question 19

When the physical therapist sets the patient up on mechanical lumbar traction, what parameters are most appropriate?

A. 20%–40% of body weight for a maximum of 12 minutes
B. 20%–40% of body weight for a maximum of 20 minutes
C. 40%–60% of body weight for a maximum of 12 minutes
D. 40%–60% of body weight for a maximum of 20 minutes

Answer 19

C. 40%–60% of body weight for a maximum of 12 minutes

Question 20

What therapeutic exercise would be most beneficial after using mechanical traction in a prone position?

A. Abdominal draw-in
B. Double knee to chest stretch
C. Prone press-ups
D. Standing back extension

Answer 20

C. Prone press-ups

Question 21

A femoral nerve lesion is responsible for a patient’s lower-extremity weakness. Which of the following muscles may be weak due to the lesion?

A. Gracilis
B. Obturator externus
C. Pectineus
D. Transverse abdominis

Answer 21

C. Pectineus

Question 22

Pectineus is innervated by what nerve

Answer 22

femoral

Question 23

iliacus is innervated by which nerve

Answer 23

femoral

Question 24

gracilis is innervated by which nerve

Answer 24

obturator

Question 25

The TrA is innervated by which nerves

Answer 25

iliohypogastric

ilioinguinal

Question 26

Which of the following is the gold standard for diagnosis of cervicogenic headaches?

A. C2 nerve block
B. C3 nerve block
C. Onset of pain with cervical motions
D. Cervical passive accessory segmental hypomobility

Answer 26

A. C2 nerve block

Question 27

A physical therapist wishes to perform optimal screening to rule out circulatory insufficiency for patients with head and neck pain. Which of the following represents a best practice approach to this?

A. Perform the vertebral artery test on each patient
B. Assume all patients with dizziness have posterior circulatory insufficiency
C. Screen for prodromal signs such as dizziness or nausea, head or neck ache, hemiparesis, or diplopia.
D. Stratify patients into high, medium, or low risk categories based on historical risk factors and results from special tests or the presence of prodromal symptoms.

Answer 27

D. Stratify patients into high, medium, or low risk categories based on historical risk factors and results from special tests or the presence of prodromal symptoms.