PMR qbank question review Flashcards by Carlye Reichert

how deep into the tissue does superficial heat penetrate?

1-2 cm

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US produces the highest temps in what tissue?

bone

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frequency of US is set at…

0.8 - 1.1 MHz

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How deep does US heat structures to >100F

8cm

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how deep does short wave diathermy penetrate

5cm

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what modality helps with hematomo resolution

microwave diathermy

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gate theory involves which nerve fibers

large myelinated Type A fibers

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most conventional TENS setting

high frequency, low intensity

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minimum amount of weight needed for cervical traction

25 lbs

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muscle contraction with greatest force

fast eccentric

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how much body weight is needed to help with lumbar traction

1/4-1/2 of body weight (atleast 50-100lbs)

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what % of patients with polymyositis have myalgies?

<30%

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what is Pannus

hypertrophied synovium

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polymyositis has a strong association with?

Malignancy

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what epitope is associated with RA

HLA-DR4

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what percent of RA patients are RF +

80%

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Pseudogout is associated with… (6)

amyloidosis
hypothyroidism
hypomagnesia
hypophosphatemia
hyperparathyroidism
hemochromatosis

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DISH is associated with

Metabolic syndrome

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average amount of time between gout attacks

11 months

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rupture of terminal portion of extensor hood?

what test to diagnose

Boutoneirre deformity

Elson test

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Podagra is seen in…. (3)

RA, sarcoid, gout

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where is the joint narrowed in hip OA

superolateral joint space narrowingon Xray

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which diseases are associated with HLA-B27

enteropathic arthropathy
ankylosing spondylitis
Reiters syndrome

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hand joint most affected by hand OA

first CMC joint

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most common A-A joint subluxation direction is

chest expansion less than _____ cm is predictive of respiratory difficulties in restrictive lung disease

7-8cm

organism associated with reactive arthritis

salmonella

what effect does methotrexate have on rheumatoid nodules

worsens them

what is Caplans syndrome

coal worker with pneumoconiosis and RA with RF+

what % of patients with psoriasis develop inflammatory joint disease

What is Feltys syndrome

RA, splenomegaly, and leukopenia

what test should be ordered before starting Plaquenil (Hydroxychloroquine)

eye exam

routine testing while on Methotrexate?

monthly CBC | LFT and renal every 1-3 months

Raynauds is associated with which autoimmune disorder

Scleroderma

what type of Myositis is associated with childhood

Type IV

cut off age to be diagnosed with JRA

Stills Disease characteristics

myalgias rash on truck with fever peak onset between 1-6 years, equal M and F

what is prognosis for most kids with JRA

most achieve remission

Most common bug associated with septic arthritis in neonates

S. aureus

disease with glucocerebrosidase deficiency

Gauchers disease

deficiency of enzyme homogenistic acid oxidase -

alkaptonuria - blue urine, cartilage, skin, and sclera

treatment for acute Charcot joint

total contact cast with eval q1-2 weeks

most common tendon rupture site in RA patients

Lister tubercle

myotonic muscular dystrophy affects which type of muscle fibers

skeletal, smooth, and cardiac

histologic findings of dermatomyositis

perivascular and interfascicular inflammatory infiltrates with adjoining groups of muscle fiber degeneration/regeneration

histologic findings of polymyositis

endomysial mononuclear inflammatory infiltrates and muscle fiber necrosis.

psoriatic arthritis most commonly affects which joints

DIPs

which medication can worsen psoriatic arthritis symptoms

hydroxycloroquine

second line treatment for raynauds

IV prostonoids

innervation of levator scapulae

C3/C4 nerve root and dorsal scapular nerve

pec minor insertion

coracoid process

innervation of teres major

lower subscapular nerve

brachialis insertion

coronoid process of ulna

FCR insertion

base of 2nd metacarpal

arterial supply of FCR

ulnar artery

FCU insertion

pisiform bone, hamate, and 5th metacarpal

FDP nerve roots

C8/T1

Innervation of FDP

ulnar nerve and anterior interosseous nerve

potential compression site of PIN syndrome

ECRB, supinator

PIN sensory distribution

No cutaneous innervation | Sensory fibers of dorsal wrist capsule

2 thenar muscles that are ulnarly innervated

adductor pollicis | 1/2 flexor pollicis brevis

origin of lumbricals

FDP tendon

innervation of iliacus

Femoral nerve L1, L2, L3

iliospoas insertion

lesser trochanter

vastus group origin

greater trochanter

glut max insertion

fascia lata

glut med insertion

Greater trochanter

glut min action

abducts and internally rotates hip

glut med and mad action

abduct and externally rotate hip

biceps femoris long head insertion

fibular head | some LCL and lateral tibial condyle

obturator externus action

adduction and external rotation of thigh

flexor digitorum brevis innervation

medial plantar nerve

lateral plantar nerve innervated which muscles

``` abductor digiti minimi adductor hallucus quadratus plantae plantar interossei dorsal interossei ```

what structure passes through the triangular space

scapular circumflex artery

what structure passes through the triangular interval

radial nerve

radial border of Gunyon canal

hook of hamate

ulnar border of Gunyon canal

pisiform and abductor digiti minimi muscle belly

lumbosacral plexus is made up of

ventral rami of T12-S3

anterior division of femoral nerve innervates what muscles

sartorius and pectineus

saphenous nerve branches from what nerve

posterior division of femoral nerve

posterior division of obturator nerve innervates

adductor magnus

superficial posterior compartment contains which muscles

gastroc soleus plantaris

normal femur head subtrochanteric angle is

135 deg

what type of collagen is found in all basal membranes

Type IV

what type of collagen is found in muscle

Type III

what type of collagen is found in bone, tendon and ligaments

Type I

What type of collagen is found in epiphyseal plate

Type X

In which brain structure does clonidine act on to reduce symptoms of opiate withdrawal?

Locus coeruleus

which nuclei helps with visual perception

lateral genicular nucleus of thalamus

space between pharyngeal surface of tongue and epiglottis

valleculae

which MCA branch supplies subcortical structures

vertebral arteries branch off the

subclavian arteries

Role of donepazil in mild/moderate/severe dementia

improve well being ( improve cognitive function and ADLs)

greatest modifiable risk factor for stroke

HTN

what % of strokes are ichemic

87%

left visual neglect and left homonymous hemianopsia

right PCA

what artery is indicated with amaurosis fugax

ICA

Anton syndrome is...

Bilateral visual field cuts that result in a denial of cortical blindness A transient inability to read faces A syndrome of nausea, vomiting and alexia An oculomotor palsy with a contralateral hemiplegia

decerebrate posturing is seen in lesions of the.... decorticate posturing is seen in lesions of the...

Brainstem cortex

presentation of lateral medullary syndrome

``` sensation changes on ipsilateral face, sensation changes on contralateral body ataxia dysphagia/hiccups etc NO motor weakness ```

presentation of Weber syndrome

ipsilateral CN3 palsy | contralateral hemiplegia

presentation of Medial medullary syndrome

Ipsilateral CN12 palsy contralateral hemiplegia contralateral tactile sensory loss

Presentation of Miller-Gubler syndrome

Ipsilateral CN6 paralysis contralateral hemiplegia contralateral sensory loss

Pure Motor hemiplegia stroke - where is the lesion

posterior limb of internal capsule

pure sensory stroke - where is the lesion

Thalamus

The mortality rate in the first 24 hours after a subarachnoid hemorrhage

25%

treatment for early posttraumatic seizure

IV valproic acid

uses spiral and diagonal components of movement rather than the traditional movements in cardinal planes of motion with the goal of facilitating movement patterns that will have more functional relevance than the traditional technique of strengthening individual group muscles.

NMF (neuromuscular facilitation)

encourage normal movement and tone, while suppressing the inhibitive movements patterns that arise after stroke. This approach is most commonly used.

Bobath

focuses on using abnormal movement in an attempt to improve motor control

Brunnstrom approach

Cantu return to play - how long should they sit out if loss consciousness for >5min

1 month

hemorrhagic stroke in which area is most likely to be associated with a seizure

Temporal

a coma can result from damage in which area?

brainstem of bilateral cerebral hemispheres

what type of exercise is used to treat ataxia

Frenkel exercises are used to treat ataxia. They usually consist of many repetitions of slow exercise.

Which Brunnstrom stage of motor recovery is defined as the stage of maximal spasticity?

Stage 3

A 60-year-old male with a past medical history of an MI with resultant cardiomyopathy, now presents with a large territory stroke. What is the most likely cause?

mural thrombus

Nearly 1/2 of intracerebral hemorrhages occur at what structure?

Putamen

Which is an environmental risk factor for the development of Parkinson's?

pesticide exposure

dysarthria and clumsy hand syndrome is found from a lesion in the?

pons and anterior limb of internal capsule

A patient with a Ranchos Los Amigos rating of VI will most likely require what level of assistance?

moderate assistance

In an upper division MCA stroke, which is most likely?

stronger legs than arms

Pure lower MCA division presentation

No weakness No sensory changes language, visual deficits and awareness of deficits are usually significant.

Alexia without agraphia is most likely to occur with an infarct in which location?

PCA

Presentation of Benedikt syndrome

contralateral chorea as it affects the red nucleus. The red nucleus contributes to coordination and body positioning.

This stroke rehabilitation approach utilizes a system of therapeutic exercises enhanced by cutaneous stimulation; in addition to, proprioceptive maneuvers to promote recovery.

Rood approach

first muscles to become weak with DMD

neck flexors

most common heart defect with Downs syndrome

VSD

a congenital deformity in which the limbs are extremely shortened so that the feet and hands arise close to the trunk

phocomelia

Sinding-Larsen-Johansenn disease

(patellar tendonitis) in pediatrics will present with anterior patella pain and similar x-ray findings.

is the most common cause of limping and pain in a child's hip.

Transient (toxic) synovitis of the hip

The most common level of a pars defect in children is at

L5`

Which type of JRA is associated with iridocyclitis?

pauciarticular

In JRA, which joint tends to be affected more in children?

cervical spine

where is osteosarcoma found in the bone

metaphysis

where is Ewing sarcoma found in the bone

diaphysis

Erbs or Klumpkes has the better prognosis

Erbs. Recovery often by age 2

what type of AC injury disrupts both the AC and CC ligaments

Type 3

primary vascular supple to knee

Popliteal arterty - which branches into the genicular arteries

highest center of gravity during gait -

mid stance

what type of collagen in annulus fibrosis

Type 1

define gunstock deformity

cubitus varus is an abnormal varus angle of the elbow that usually follows a distal humerus fracture.

lowest center of gravity during gait

loading response

first dorsal wrist compartment and syndrome associated

APL, EPB = De Quervain’s tenosynovitis

second dorsal wrist compartment and syndrome associated

ECRL, ECRB = Intersection syndrome

third dorsal wrist compartment and syndrome associated

EPL = Drummer’s wrist, traumatic rupture with distal radius fracture

fourth dorsal wrist compartment and syndrome associated

EI, EDC = Extensor tenosynovitis

fifth dorsal wrist compartment and syndrome associated

EDM = Vaughn-Jackson syndrome

sixth dorsal wrist compartment and syndrome associated

ECU = Snapping ECU(treat with immobilization)

What is the optimal degree of fixation in a bilateral elbow arthrodesis

110 and 65 degrees

treatment for jersey finger

urgent surgical referral

Where is the most common site of a hamstring rupture?

myotendinous junction

What is the optimal degree of fixation in a unilateral elbow arthrodesis?

90 degrees

What are the three main glenohumeral ligaments?

Superior glenohumeral, middle glenohumeral and inferior glenohumeral ligament

A posterolateral L4/L5 herniation affects which nerve root

name the 4 throwing phases

Biomechanics of throwing a baseball Cocking phase Acceleration early Acceleration late Follow-through Greatest forces in late cocking/early acceleration

far-lateral/foraminal L3/L4 disc herniation affects which nerve root

name the 6 determinants of gait

``` Pelvic Rotation Pelvic Tilt Knee Flexion in midstance Foot and Ankle motion Knee motion Lateral Pelvic motion ```

is due to inflammation at crossing point of 1st dorsal compartment (APL and EPB ) and 2nd dorsal compartment (ECRL, ECRB) and is often seen in rowers.

intersection syndrome

Treatment for gamekeeper thumb, if the thumb is unstable in flexion,

surgical referral

Housemaid's knee is inflammation of the:

prepatellar bursitis

Which rehabilitation program is best for a posterior-lateral herniation

Mckenzie

Which rehabiliation program is best for far lateral NPH

neutral and flexion based program

The Hill-Sachs Lesion is located:

posterolateral humeral head

The most common etiology of Vaughn-Jackson syndrome is:

This is a disruption of the extensor tendons associated with rheumatoid arthritis.

Jerk test

Posterior glenohumeral instability

An acute peroneal tendon subluxation is best treated with

Short leg cast immobilization and protected weight bearing for 6 weeks is the recommendation.

Which test assesses for inferioglenohumeral instability

sulcus sign

list 5 phases of gait cycle

``` Initial Contact Loading response Midstance Terminal stance Preswing ```

X-rays are obtained and demonstrate an oblique fracture-subluxation at the base of the thumb metacarpal. This type of fracture is termed a:

bennetts fracture

The most common muscle injured in an adductor muscle strain is the:

adductor longus

most commonly injured knee ligament

MCL

A prominence of the posterior superior calcaneal tuberosity that contributes to inflammation of the overlying tissues and the Achilles tendon is called a:

Haglund deformity

During the loading response, which muscles use eccentric force?

pre-tibial muscles

How soon can active range of motion begin after shoulder arthrodesis?

8-12 weeks

At what percent of increase in energy cost do most patients prefer to use a wheelchair to ambulate?

300%

The most common complication after a hip fracture is:

Heterotopic ossification

At what angle of knee flexion are the medial and lateral patella facets in contact with the sulcus?

45 deg

The recommended position for shoulder arthrodesis is

30 degrees abduction, 30 degrees flexion, 30 degrees internal rotation.

A fracture of the proximal ulna with a dislocation of the radial head is termed a

Monteggia fracture

The mainstay rehabilitation program for a vertebral compression fracture involves primarily:

extension exercises

Which nerve injury is considered after a Monteggia fracture?

posterior interosseous nerve

What is the most common type of elbow fracture seen in children?

supracondrylar

Strengthening which muscle group may be the most helpful in avoiding an ACL tear in women?

hamstrings

In slipped capital femoral epiphysis, the femoral head is displaced

posteriorly and inferiorly

Which is the most common type of spondylolisthesis in all adults?

degenerative

A nondisplaced 1mm fracture of the scaphoid bone at the proximal 3rd should be immobilized in a thumb spica splint for how long?

5 months

is a fracture of the C7 spinous process. There are no neurological deficits associated with this.

Clay Shoveler's fracture

The Lisfranc ligament attaches:

The medial cuneiform to the 2nd metatarsal

The iliacus inserts onto the:

lesser trochanter

Which muscle originates at the ischial spine, inserts onto the greater trochanter and abducts the flexed hip?

superior gamellus

X-ray of the 2nd DIP reveals volar subluxation of the distal phalanx with a non-displaced dorsal bony avulsion at the distal phalanx. What is the next best step in management?

reduction and pinning

Lumbar facets primarily prevent:

axial rotation

What is the most common surgical procedure performed for the treatment of medial tibial stress syndrome that has not improved with conservative treatment?

posterior fasciotoomy

posterolateral corner complex is made up of

the arcuate ligament, fibular collateral ligament, and popliteus muscle tendon.

Which humeral fracture has the highest risk of AVN?

anatomic neck

Dorsal displacement and angulation of a distal radial fracture is called a:

Colles fracture

Volar displacement and angulation of a distal radial fracture is called a:

Smith fracture

fracture of 5th metacarpal

Boxers fracture

fracture of 5th metatarsal

Jones fracture

After a shoulder arthroplasty, which movement is contraindicated?

external rotation

The history provided with a positive fulcrum test is most indicative of

a distal femoral stress fracture.

The most common complication after a shoulder arthroplasty is:

glenoid loosening

The recurrence rate of Dupuytren's Disease after surgery is approximately:

50%

A congenital condition with a small and undescended scapula is referred to as:

Sprengels deformity

The mainstay treatment of an osteoid osteoma is:

NSAIDS

Initial treatment of Hoffa's syndrome includes:

Hoffa's syndrome (infrapatellar fat pad irritation) is typically first treated with taping and physical therapy. A corticosteroid injection can be used in recalcitrant cases. If these measures fail, then orthopedic intervention is recommended.

Hueston tabletop tests

consists of placing your hand flat on a table. If the involved finger is unable to lie flat, then the test is positive. - Dupytren disease

Noble's test is positive with which pathology?

ITB syndrome

Patient lies supine Examiner's thumb at 2 cm proximal to the lateral femoral epicondyle Patient repeatedly flexes (to 60 degrees) and extends knee

Nobles test

You ask the patient to lie supine with her leg extended. You then place your hand on her thigh, cupping the patella. You then ask the patient to contract her quad. Which test did you just perform?

patellofemoral grind test

intrarticular fracture of the 1st metacarpal that extends into the CMC. This fracture typically results from a fist fight.

Bennet fracture

The most common pathogen associated with burn cellulitis prior to giving antibiotics is:

Strep Pyogenes

The resolution of inflammation in which collagen is laid down to form the scar represents which phase of wound healing?

maturation phase

``` expected healing time for: superficial partial thickness burn is Superficial wounds deep partial thickness full thickness burns ```

14 days 7 days 17-21 days >28 days

Which burns are the most painful initially?

2nd degree

how much pressure is needed to counteract a burn scar contraction force?

25mmhg

In a patient with a dorsal hand burn, how should the MCPs be splinted?

60-90 degrees

Which is the most common primary adult brain tumor?

glioma (gliobastoma)

What is the most common focal sign of brain cancer?

weakness

what emg findings are commonly seen in patients with multiple myeloma, lung cancer, colon and breast cancer who present with paresthesias, sensory loss and gait abnormalities.

Fibrillation and polyphasic potentials

Which is the most common presenting symptom of radiation plexopathy?

numbness and paresthesias

In a patient with cancer-related myopathy, which exercise program is likely to be the most beneficial?

isometric

Your 54-year-old new cancer rehabilitation patient is s/p mastectomy and has swelling in her left arm that you diagnose as lymphedema. How often does this occur?

33% (1/3)

Lymphedema that is pitting and reversible by elevation is described as a Grade:

grade 1

Which imaging modality is a poor choice in diagnosing/evaluating multiple myeloma?

bone scan - needs blastic activity and MM is lytic

During low-level graded stress testing, the American Heart Association suggests a Borg Rate of Perceived Exertion Rating of:

13-15

Which is an indication for terminating a low-level exercise test during cardiac rehabilitation?

A heart rate above 130 beats per minute drop in SBP >10 ST elevation in leads indicating pathology significant angina

Cardiac patients diagnosed with which condition should be excluded from resistance training?

Aerobic capacity less than 5 METs CHF Severe vascular disease

How much more energy does it take to ambulate with bilateral above-knee prostheses after traumatic injury?

200% likely use wheelchair for ambulation

How many of the day's total calories should come from fat on a Step I diet?

<30%

Overall, exercise training improves functional capacity in patients with heart failure and decreases ventricular systolic dysfunction secondary to:

Adaptations in the peripheral circulation that place less stress on the heart

Involuntary control of respiration originates in the:

medulla oblongata

Death rates from COPD are higher in men or women?

women

Exercise impairment develops when the FEV1 falls below:

A scoliotic angle greater than *** degrees would cause a patient to have dyspnea.

The normal rate of FEV1 loss per year is

30cc

A vital capacity less than *** would have an impaired ability to cough.

25 ml/kg

At what point should supplemental oxygen be used during exercise?

sats <90

You are on a consult regarding a patient with a cervical spinal cord injury. The respiratory therapist has the patient placed prone with her buttocks elevated. What area of the lung is the therapist attempting to drain?

superior segments of both lower lobes

In an upright patient, which lung zone has more ventilation than perfusion?

zone 1

The tracheal tube must be downsized to what diameter before considering decannulation?

8mm

What is the best modality for acute to subacute low back pain?

superficial heat

What does the "no fault" workman's comp system mean?

Neither employer or employee have to prove fault

Which rehab program replicates the duties of the job that the patient was performing?

work hardening

How many hours a day must an employee attend a work hardening program?

employee’s must stay for at least 4 hours 3-5 times per week.

What is the maximum punishment for violating HIPAA due to a reasonable cause and not willful neglect?

50,000$

What intervention is most effective in preventing a low back injury at work?

exercise

Which is a proven return to work barrier?

Lack of knowledge of the modified job negative employee attitudes

What is the Omnibus Reconciliation Act of 1993?

It prevents physicians from making self-referrals to DME, PT and other medical companies that they own.

Abdominal belts limit motion in:

lateral bending and rotation

How long should you wait to perform an MRI in a patient with continual low back pain without neurological deficit?

6 weeks

What is the maximum amount of weight that can be lifted with medium duty?

50 lbs

How much can a worker lift who is on light duty?

20lbs

Temporary worsening of a previous injury that happened at work is called:

exacerbation

Permanent worsening of a previous injury or condition at work is called:

aggravation

This low-frequency, postural tremor is often seen in a patient with multiple sclerosis:

cerebellaar

Which movement is correlated with a hemorrhage or infarction of the contralateral subthalmic nucleus?

hemiballismus

Reversible need for constant movement to relieve tension and anxiety

Akathisia

You are consulted on a 62 year old male for gait abnormalities. On exam you notice he has en bloc turns and that he has a shuffling pattern. While you are discussing plans to improve his gait you notice a low-frequency, pill-rolling motion of the fingers. What percentage of Parkinson's patients have this?

70%

The goal of medical management in Parkinson's disease is to:

increase dopamine | decrease cholinergic effect

Atrophy of the caudate nucleus

Huntingtons disease

Atrophy of the thalamus

Multiple Sclerosis

Cortical atrophy

Alzheimers disease

Atrophy of the cerebellum (3)

multiple sclerosis, friedreich's ataxia, and Creutzfeldt-Jakob disease.

Which describes the mechanism(s) of action of tricyclic antidepressants?

primarily act on inhibition of norepinephrine and serotonin uptake, but in increasing concentration they do have anticholinergic and alpha blocking action.

EKG finding associated with TCA toxicity.

widen QRS

Carbamazepine is indicated for: (2)

trigeminal neuralgia and epilepsy

Which medication potentially influences the effects of aspirin on platelet function?

Ibuprofen

inhibit the peripheral metabolism of dopamine.

COMT inhibitors

Which NSAID has the shortest half-life?

Aspirin

Which prolotherapy irritant is purported to act by the osmotic rupture of cells?

hypertonic dextrose (10%)

On imaging, there appears to be a stable jefferson fracture. How should it be managed?

Halo Vest | C1 burst fracture

Which is the most likely presentation of a patient with a Chance fracture?

normal neurological exam

Your T3 AIS A SCI patient is having a difficult time getting his bladder under control. After many days of charting his incontinences and bladder volumes, you believe his bladder contractions and sphincter relaxations are not coordinated. Which is responsible for this function?

pons

Which pathway stimulates cholinergic receptors to cause bladder contraction and emptying?

parasympathetics

Which pathway is responsible for storing urine via B-2 adrenergic receptors in the bladder body and alpha-1 adrenergic receptors in the base of the bladder and prostatic urethra to increase outflow resistance?

sympathetics efferents

Which pathway is responsible for voluntary contraction of the external sphincter to prevent leakage?

somatic efferent

Which pathway has myelinated A-delta fibers that stimulate parasympathetic fibers with bladder distension?

afferent fibers

The body of the bladder is innervated by the:

hypogastric and pelvic nerves

Intubation should be strongly considered when a patient's FVC is

<1L

At which minimal pulmonary function parameter can you justify removing your SCI patient off the ventilator?

FVC > 15-20 cc/kg

The majority of bladder complications in SCI can be prevented if bladder pressures stay below the target pressure of:

40 cm H2O

Which may be seen on EMG of a patient with neurosyphilis

absent H reflex

Beevors Sign

refers to the abnormal upward movement of the umbilicus on attempting to raise the head from a supine position by the patient being assessed

Beevor's sign is positive. At what level is the lesion?

T10

What percentage of patient's with a hip fracture secondary to osteoporosis will die secondary to related complications?

10-20%

A 54-year-old obese female comes to your clinic for routine follow up. She has many questions about health as she ages. She informs you she rarely exercises due to not having time with her busy work schedule and she has been often eating fast food for the same reason. She has a family history of coronary artery disease and breast cancer. She has many concerns around osteoporosis because her mother had a "severe case." Which has a primary role in determining bone strength and osteoporosis risk?

family history

Which has a reduced mineral content, resulting in "soft bones?"

osteomalacia

Renal hypercalciuria, an important cause of secondary osteoporosis, can be treated with which medication?

thiazides

A 48-year-old female was recently diagnosed with osteoporosis. She is trying to do everything she can to prevent this from progressing. How much calcium should she be taking daily?

1200-`1500mg

How much vitamin D should a patient with osteoporosis take dai

400-800 IU

Spinal bone mineral density is directly correlated to the strength of which muscle group?

spinal extensors

Which type of orthotic can be prescribed to decrease pain in a patient with a stable osteoporotic vertebral body fracture?

nonrigid brace

A 58-year-old female who had been diagnosed with osteoporosis, and is considered a high fracture risk, has been doing some reading on the internet. She read about a medication called denosumab. Denosumab is considered at which level of therapy to treat osteoporosis?

First line if high fracture risk

You have a patient with a right AKA and a prosthesis. When assessing his gait, you note a lateral trunk lean towards the prosthetic side. What do you suspec

prosthesis too short

An amputation of the tarsometatarsal junction is a:

LIsfranc

amputation through the talus and calceneus

chopart

amputation spares part of the calcaneus.

BOYD

amputation is an ankle disarticulatio

Symes

Bone overgrowth after an amputation is most frequently seen in the:

humerus

The preferred alignment of a BKA prosthesis is:

Knee flexion moment and varus foot alignment

Foot ulcers are responsible for what percentage of amputations?

85%

How is poliovirus spread?

fecal-oral and aerosol droplets

The cathode is:

the negative pole

What drug class is first-line in treating multiple sclerosis related pain?

TCAs

Which multiple sclerosis patient has the worse prognosis?

a male with primary progressive MS

Which EMG needle has a larger recording area?

monopolar

Muscles the PIN innervates: (7+1)

``` EDC EDM ECU APL EPB EPL EIP sometimes ERCB ```

sensory innervation of PIN

dorsal wrist capsule sensation

A stimulus intensity that is too high results in:

Decreased conduction times and shortened latencies

Findings in every median nerve innervated muscle likely stems from a lesion at th

Ligament of Struthers

What is the standard filter setting for sensory NCS?

20Hz-2kHz or 20Hz - 10kHz

contents of carpal tunnel (4)

FDP tendons, FDS tendons, FPL tendon, and median nerve.

What is the standard filter setting for EMG?

20Hz-10kHz

What is the standard filter setting for motor NCS?

2Hz-10kHz

Guyon canal compression symptoms for zone 1 zone 2 zone 3

1: motor and sensory 2: motor only 3. sensory only

What is the default sweep speed for EMG?

10ms

common causes of Guyon canal compression

MC nontraumatic : ganglion cyst | Traumatic: hook of Hamate fracture

What is the default gain that should be used to assess a normal recruitment pattern?

1mV

What is the default gain for motor NCS?

5mV

What is the default setting for the sensory NCS sweep speed?

2ms****

Which of the following is the most common form of thoracic outlet syndrome?

neurogenic

5 possible compression points in PIN sydrome

``` Arcade of Frohse supinator muscle extensor carpi radialis brevis muscle leash of Henry fibrous tissue anterior to the radiocapitellar joint. ```

What happens to the peak latency when the active and reference pickups are greater than 4cm during a sensory nerve conduction study?

increases

A sensory nerve action potential amplitude should be measured from:

peak to peak

You strongly suspect a piriformis syndrome in your patient. Which portion of the sciatic nerve do you expect to be the most affected?

peroneal division

When assessing the blink reflex, which nerve is the afferent nerve?

CN V (trigeminal)

An EMG that may be consistent with a paraneoplastic syndrome will show:

sensorimotoe axonal findings

A patient with HIV is expected to have EMG findings consistent with:

sensorimotor demyelination

Normal duration of insertional activity should be about:

max 300 ms

On EMG, you note a decreased recruitment interval but an increased recruitment frequency. The disorder is most likely:

neuropathic

A discharge appears "tornadic" on the screen with a rate of 200Hz. The sound is best described as continuous and high frequency. What is the most likely diagnosis?

Isaacs syndrome

Endplate potentials (EPPs) are irregular. T or F

True

The genetic inheritance pattern of ALS is most likely:

autosomal dominant

What is the initial treatment of choice for Isaac's syndrome?

phenytoin

Isaac's syndrome is caused by antibodies to:

potassium channels

classic triad of clinical manifestations of Miller Fisher Syndrome (MFS)

areflexia, external ophthalmoparesis, and ataxia. subtype of GBS (AIDP)

antibody seen in Miller Fisher Syndrome

Anti-GQ1b