Final

Question 1

Approximately ——— manipulations occur each year

Answer 1

250,000,000

Question 2

Approximately what percentage of manipulation in the USA are performed by chiropractors

Answer 2

95%

Question 3

True or false. Chiropractors receive more training in manipulation than any other provider type in the USA

Answer 3

True

Question 4

Categories of injury

Answer 4

Benign (self-limiting)
Intermediate
Severe

Question 5

Category of injury that is brief in duration, requiring no further assessment or treatment needed

Answer 5

Benign (self limiting)

Question 6

Soreness of muscles, Local tenderness in the area of manipulation and Headache are examples of what category of injury?

Answer 6

Benign (self limiting)

Question 7

Category of injury where symptoms are sustained beyond 48 hours, often requiring additional assessment or treatment focused on the complication

Answer 7

Intermediate

Question 8

Nonspecific pain that radiates into an extremity (may resolve spontaneously or require additional
care), Sprain/strain to specific tissues that can be identified and Iatrogenic fracture are examples of what category of injury

Answer 8

Intermediate

Question 9

In which category of injury do up to 50% of

patients have one or more symptom

Answer 9

Benign (self limiting)

Question 10

Liberal estimate of percentage of patients that experience intermediate injury from manipulation

Answer 10

10%

Question 11

Cauda equina syndrome, disc protrusion and vertebrobasilar stroke are examples of what category of injury from manipulation?

Answer 11

Severe

Question 12

Incidence of cauda equina syndrome resulting from manipulation is estimated at?

Answer 12

1:100,000,000 to 1:128,000,000 manipulations

Question 13

Incidence of disc protrusion resulting from manipulation is estimated at?

Answer 13

3-6:10,000,000

Question 14

Vertebrobasilar artery dissection or thrombosis results in ———

Answer 14

Vertebrobasilar stroke

Question 15

Of VBA dissection cases, chiropractors have performed manipulation proximate to the event what percentage of the time

Answer 15

about 55%

Question 16

True or false. The risk of vertebrobasilar stroke is greater in patients having seen a chiropractor than it is in patients having seen a family practice MD.

Answer 16

False, there is NO difference in risk

Question 17

True or false. Non-manipulation causes of VBA dissection are more common than manipulation-induced VBA dissection cases

Answer 17

True

Question 18

the highest quality estimates suggest the incidence of Vertebrobasilar stroke caused by manipulation to be ————

Answer 18

1/ 2-3 million manipulations

Question 19

The incidence of dissection or rupture of the aorta during lumbar spine manipulation is exceedingly rare at ———-

Answer 19

1:500,000 to 1:10,000,000

Question 20

What percentage of chiropractic visits are pediatric patients?

Answer 20

17%

Question 21

The cited complications to kids and manipulation include:

Answer 21

• serious (e.g. subarachnoidal hemorrhage, paraplegia, missed neoplasm, missed meningitis)
• minor (e.g. mid-back soreness)
• moderate, requiring medical attention (e.g. severe headache)

Question 22

What accounts for more cases than injury caused by manipulation?

Answer 22

Missed diagnoses

Question 23

Chiropractor induced serious injury/death incident in pediatric patients is around?

Answer 23

58%

Question 24

What percentage of pregnant women with LBP seek chiropractic care?

Answer 24

5.2 - 11%

Question 25

True or false. All clinical trials involving manipulation for back pain in pregnant women demonstrated statistically significant benefit to patients

Answer 25

True

Question 26

Arguments against chiropractors treating pregnant women include:

Answer 26

- Chiropractors’ competency to adequately screen for complications and in general, to provide prenatal care - Substantially altered hormonal status - Ligamentous laxity secondary to hormonal effects - Hemodynamic variation from normal - Thrombophilia (thrombosis & thromboembolism) is a risk for manipulation in general

Question 27

The most important source of jurisdictional control is?

Answer 27

The profession itself

Question 28

Other influencers of jurisdictional control, other than the profession itself?

Answer 28

- public at large - competitor professions - governmental/legislative bodies

Question 29

True or false, because the Profession itself holds the greatest influence over the “prevailing viewpoint”, it is critical that the profession manage its factions (strata) of intra-professional claims?

Answer 29

True

Question 30

What percentage of the profession subscribes to the “general problems tribe”?

Answer 30

17.1%

Question 31

What percentage of the profession subscribes to the “biomechanical and general problems tribe”?

Answer 31

9.2%

Question 32

What percentage of the profession subscribes to the “biomechanical and limited organic problems tribe”?

Answer 32

4.2%

Question 33

What percentage of the profession subscribes to the “biomechanical tribe”?

Answer 33

43.1%

Question 34

What percentage of the profession subscribes to the “somatic dysfunction tribe”?

Answer 34

7.7%

Question 35

What percentage of the profession subscribes to the “chiropractic subluxation tribe”?

Answer 35

18.8%

Question 36

MSK/NMS/Spine related complaints comprise what percentage of the primary reasons patients visit chiropractors?

Answer 36

Over 80%

Question 37

the only group within chiropractic that is considered | “unorthodox”

Answer 37

Those who believe subluxation is an obstruction to human health

Question 38

expressing beliefs either inconsistent, or in conflict with current evidence and concepts in health care & public health is called?

Answer 38

Unorthodox

Question 39

What are considered unorthodox chiropractic views?

Answer 39

- minimized role of scientific evidence in practice - Negative attitudes towards vaccination - Willingness to use X-rays outside generally accepted guidelines

Question 40

approximately what percentage of surveyed public considers chiropractors high or very high on trustworthiness

Answer 40

38%

Question 41

True or false? The surveyed public considers chiropractors more trustworthiness than medicine and teachers.

Answer 41

False, chiropractors are considered less trustworthy

Question 42

True or false. Negative perceptions of chiropractic care are more common than negative perceptions of chiropractors?

Answer 42

True

Question 43

Which has a greater positive influence on DC utilization, perceptions of chiropractic care or perceptions of DCs

Answer 43

Perceptions of chiropractic care

Question 44

True or false. Most of the profession’s perceived shortcomings are either misconceptions or message confusion emanating from the profession itself.

Answer 44

True

Question 45

Common themes of profession-generated misconceptions and message confusion are what?

Answer 45

- failure of internal consensus - Fractured and inconsistent efforts to portray the profession as “one body with multiple strata” - Claims exceed evidence base supporting them

Question 46

Approximately what percentage of chiropractors are in solo practice

Answer 46

75%

Question 47

Approximately what percentage of the chiropractic profession is Caucasian/white

Answer 47

90%

Question 48

Approximately what percentage of DC’s identify as male

Answer 48

73%

Question 49

Approximately what percentage of the profession reports seeing greater than 150 patient visits per week, on average

Answer 49

10%

Question 50

The most common reported patient volume is between _____ and _____ patient visits per week on average

Answer 50

50-100

Question 51

Over 40% of surveyed practitioners report gross annual income of ________

Answer 51

$81,000- $200,000

Question 52

overhead runs between ____ and ____ of gross income

Answer 52

50-75%

Question 53

In 2009, approximately what percentage of practicing chiropractors hold staff privileges at a hospital and this has been trending up over time?

Answer 53

6.9%

Question 54

How many D C’s are employed to provide chiropractic care to active or retired military personnel?

Answer 54

100

Question 55

What percentage of DC’s treat patients 30-39 hours per week ?

Answer 55

Almost 50%

Question 56

What is the #1 priority of every state board?

Answer 56

protection of the public

Question 57

Boards are empowered to authorize practice through_____ and to restrict practice through ____ and ____ as well as through ____ ____ taken against individual licensees who fail to comply with the laws, rules and regulations pursuant to practice

Answer 57

licensure rules and regulations disciplinary actions

Question 58

True or false. Chiropractic boards can jail a doctor?

Answer 58

False, chiropractic boards cannot jail a doctor. They can only restrict, suspend or revoke a doctor’s license.

Question 59

True or false. Disciplinary actions of the board can limit the rights of the courts and police?

Answer 59

False, All courts can potentially have a crack at a bad doctor for the same offense, depending on the situation

Question 60

How many states consider chiropractors “physicians”? What other agency also considers the physicians?

Answer 60

32, Medicare

Question 61

Regarding diagnostic procedures allowed in various states, the most restrictive states were:

Answer 61

New Hampshire Hawaii Michigan

Question 62

All but how many states allow DC’s to order or perform venipuncture

Answer 62

All but 1

Question 63

PT modalities can be performed in all states except _____, where it can be ordered but not performed by a DC

Answer 63

Washington

Question 64

True or false, CT/MRI can be ordered or performed in all states?

Answer 64

True

Question 65

How many states allow DC’s to perform barium studies of the GI tract? How many prohibit it?

Answer 65

8 allow | 11 prohibit

Question 66

How many states allow DC’s to sign birth certificates? Death certificates?

Answer 66

10 for birth certificates | 19 for death certificates

Question 67

Which states prohibit performing an abdominal exam?

Answer 67

Michigan and Texas

Question 68

Which states prohibit EENT exam?

Answer 68

Michigan, Missouri, New Jersey and Texas

Question 69

Which states prohibits the use of a stethoscope by a DC?

Answer 69

Michigan

Question 70

How many states prohibit a DC from doing or ordering a female pelvic exam?

Answer 70

11

Question 71

Which states allows DCs to perform minor surgeries?

Answer 71

Oregon

Question 72

Which states allow vitamin injections?

Answer 72

Alabama, Louisiana, Massachusetts, Oklahoma, Tennessee

Question 73

True or false, all states allow diet formulation, vitamin supplementation & botanical therapies

Answer 73

True

Question 74

Which state prohibits DC’s to perform rehabilitation procedures?

Answer 74

Rhode Island

Question 75

Which states have the most liberal scopes of practice?

Answer 75

``` Oregon & Missouri New Mexico Kansas Utah Oklahoma Illinois Alabama ```

Question 76

Which states have the most restrictive scopes of practice?

Answer 76

``` New Hampshire Hawaii Michigan New Jersey Texas Mississippi ```

Question 77

Which states allow DC to hire a MD, PA, NP and order the minor procedures done under their license (SC, SD, WA)

Answer 77

South Caroline South Dakota Washington

Question 78

How many states allow DCs to do veterinary chiropractic, but most require working in conjunction with a veterinarian?

Answer 78

20

Question 79

How many states prohibit doing or ordering vaginal examination?

Answer 79

11

Question 80

How many states specifically prohibit performing a PAP test?

Answer 80

12

Question 81

Which state allows DC’s to order prescription medications with additional training?

Answer 81

New Mexico