A 42yo homecare nurse arrives for her initial evaluation at outpatient rehab. The doctor has diagnosed her with a right L4/L5 facet lock, supported by MRI results. Lumbar movement into ___________________ causes or increases neurological symptoms due to foraminal stenosis.

1. Contralateral Sidebending
2. Extension
3. Flexion
4. Ipsilateral Rotation

Answer

As the therapist, you are now conducting special tests to reconfirm the physician’s diagnosis of ‘facet lock’. You will expect which of the following tests to exacerbate your patient’s symptoms:

1. Babinski’s
2. Lachman
3. Ober’s
4. Quadrant

Answer

You are designing a plan of care (POC) for your 47yo patient who has a pathological facet segment. You will incorporate the following to ensure they receive the best quality of care:

1. Extension/Rotation biased exercises to decompress the pathological segment
2. Flexion biased therapeutic exercise combined with grade I/II joint mobilizations to reduce pain by inhibiting muscle guarding and increasing the synovial quality of the joint
3. Flexion biased therapeutic exercise combined with grade IV/V joint mobilizations to reduce pain by inhibiting muscle guarding and increasing the synovial quality of the joint
4. Start by applying a hot pack for 10 minutes to sooth the pain being sure to check for errythema every few minutes, follow that with a couple minutes of U/S, then the big-3 should be performed

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A 37yo construction worker arrives at your outpatient facility for his initial evaluation for low back pain. While taking his history, he mentions to you that he forgot to tell his PCP that there’s a slight pain in his abdomen which radiates to his back. He says it’s probably nothing serious which is why he had forgotten to mention it. Your best course of action would be to:

1. Ask patient to stay tough while you get through the evaluation
2. Call the PCP, leave a message of your findings, and then continue your evaluation and treatment
3. Continue evaluation, but just be aware that there may be secondary complications that may develop, so you must be able to act in case of emergency
4. Stop evaluation immediately and refer him out to see his PCP

Answer

Mrs. Q, a 57yo patient is here to see you for her initial evaluation. She attempts to make a great first impression by bringing a box of pastelitos y café con leche. As you begin the ‘subjective’ portion of your evaluation, she begins telling you about her husband who is a graphic designer, her sister who works in a bank but recently received a promotion, her children who are all married and living out-of-state, as well as nieces and nephews who are still in school. As you begin filtering the irrelevant information, she informs you that her low back has been ‘continuously throbbing’. She then begins to sob, and states that all she wants out of therapy is just to be pain free for once in her life. Your most appropriate course of action would be to:

1. Call 911, because Mrs. Q may be suffering a myocardial infarction.
2. Eat the food and drink the coffee she brought you as you finish your evaluation, then refer the patient back to her PCP, and inform the physician that you suspect a possible aortic aneurysm secondary to the patient’s statement.
3. Educate Mrs. Q on her diagnosis, plan of care at therapy and eventual prognosis. Then ensure her that she will be receiving the highest quality of service possible in order to reduce the pain she’s been continuously experiencing.
4. Refer the patient back to the PCP immediately, as it may be a possible aortic aneurysm.

Answer

An athlete was referred to your outpatient facility with diagnosis of displaced disk. The patient states that he works in a warehouse lifting boxes. What factor must you address first during your intervention _______.

1. Ignore the situation
2. Involve the patient in plyometric activities ASAP
3. Patient’s motivational level may be affected by psychological distress
4. Patient education on proper body mechanics

Answer

Patient comes in to your outpatient physical therapy facility with complains of low back pain for 3 days. Pt states that with activities such as: sitting for long periods, bending forward, coughing and sneezing causes him to have increased pain. During the observation part of the evaluation you noticed the patient is slightly shifted to the right. The physical therapist should rule out __________.

1. Disc displacement
2. Facet Condition
3. Hip bursitis
4. Osteoporosis

Answer

Patient comes in to your outpatient physical therapy facility with L4 disc displacement status-post day 3. The best intervention in the maximum protection phase would include:

1. Involving the patient in rigorous exercise program
2. Lifting weights
3. Modalities (massage, traction as needed)
4. Rotational exercises

Answer

Ms. Jones came in with a diagnosis of L4 disc displacement. During your evaluation special test (s) that would help you confirm diagnosis include:

a. H and I Stability Test
b. Slump test
c. SLR
d. SLR and Slump test

Answer

Ms. Jackson comes in to your clinic with complains of pain that radiates down the right leg. The patient states she’s been feeling the symptom for a couple of months. A possible diagnosis that may be creating this symptom includes:

1. muscle strain
2. disc displacement with nerve root involvement
3. bursitis of the hip
4. ACL sprain

1. 
   
   K
2. 
   
   Na
3. 
   
   Ca
4. 
   
   Cl
5. 
   
   Mg

1. 
   
   
   New military recruit who does 4 mile run, 100 push-ups in 95 degree weather
2. 
   
   
   Otherwise healthy 20 yo male who has influenza A
3. 
   
   
   Construction worker trapped under large plank for 5 hours
4. 
   
   
   25 yo woman who recently had unprotected anal intercourse with HIV positive male
5. 
   
   
   70 yo female with CAD recently started on statin and fibrate

1. 
   
   1.5 L/hr NS
2. 
   
   Acidify urine to pH <4.5
3. 
   
   Dialysis
4. 
   
   Maintain UOP >300 ml/hr
   

1. 
   
   Myoglobin precipitating in renal tubules leading to renal tubular obstruction
2. 
   
   Hypovolemia due to fluid shifting from intravascular space into damaged muscle and interstitum
3. 
   
   Toxic effects of free cheletable iron on tubules
4. 
   
   Obstruction of ureters due to kidney stones

1. 
   
   Hyperkalemia
2. 
   
   Hypokalemia
3. 
   
   Compartment syndrome
4. 
   
   DIC

A patient with tuberculosis develops bright orange-red urine and calls his physician in a panic because he is afraid he is bleeding into the urine. The patient has no other urinary tract symptoms. Which of the following medications is most likely to produce this side effect?

A. Ethambutol
B. Isoniazid
C. Pyridoxine
D. Rifampin
E. Streptomycin

Answer

Which of the following Starling force changes is the primary cause ofthe edema seen in patients with nephrotic syndrome?

A. Decreased capillary hydrostatic pressure (Pc)
B. Decreased capillary oncotic pressure (pc)
C. Decreased interstitial hydrostatic pressure (Pi)
D. Decreased interstitial oncotic pressure (pi)
E. Increased capillary hydrostatic pressure (Pc)
F. Increased capillary oncotic pressure (pc)
G. Increased interstitial hydrostatic pressure (Pi)
H. Increased interstitial oncotic pressure (pi)

Answer

A 37-year-old woman who was diagnosed with AIDS 3 years earlier is unable to work, is physically debilitated, and requests her physician to provide her with medications with which to take her own life. The most common emotional disorder that results in such requests by patients is

A. bipolar I disorder, manic type
B. borderline personality disorder
C. factitious disorder
D. major depressive disorder
E. schizophrenic disorder

Answer

IV administration of drug X to an anesthetized animal produces an increase in blood pressure. After administration of drug Y, readministration of drug X produces a decrease in blood pressure.
Which of the following pairs of drugs could produce this sequence of events?

.......Drug X............ Drug Y
A. Acetylcholine .....Neostigmine
B. Epinephrine........ Phentolamine
C. Isoproterenol .....Atropine
D. Norepinephrine.....Propranolol
E. Phenylephrine .....Hexamethonium

Answer

A 25-year-old woman with sickle cell anemia complains of steady pain in her right upper quadrant with radiation to the right shoulder, especially after large or fatty meals. Her physician diagnoses gallstones. Of which of the following compounds are these stones most likely composed?

A. Calcium bilirubinate
B. Calcium oxalate
C. Cholesterol
D. Cholesterol and calcium bilirubinate
E. Cystine

Answer

A patient with prolonged diarrhea undergoes esophagogastroduodenoscopy. Biopsy of the small intestine demonstrates numerous crescent-shaped protozoa adjacent to the epithelial brush border. Which of the following organisms is the most likely pathogen?
A. Entamoeba histolytica
B. Escherichia coli
C. Giardia lamblia
D. Naegleria fowleri
E. Trichomonas vaginalis

Answer

A patient is referred to a neurologist because of ataxia. Neurological examination reveals a loss of proprioception and a wide-based, slapping gate Magnetic resonance imaging reveals degeneration of the dorsal columns and dorsal roots of the spinal cord. Which of the following organisms is most likely to have caused this pattern of damage?

A. Haemophilus influenzae
B. Herpes simplex I
C. Neisseria gonorrhoeae
D. Neisseria meningitidis
E. Treponema pallidum

Answer

A 24-year-old woman in her third trimester of pregnancy presents with urinary frequency and burning for the past few days. She denies fever,nausea, vomiting, or chills. She takes no medications besides prenatal vitamins and is generally in good health. Physical examination is remarkable for mild suprapubic tenderness, and a urine dipstick is positive for white blood cells, protein, and a small amount of blood. Culture produces greater than 100,000 colonies of gram-negative bacilli. Which of the following attributes of this uropathogenic organism is most strongly associated with its virulence?

A. Bundle-forming pili
B. GVVPQ fimbriae
C. Heat labile toxins
D. Heat stable toxins
E. P pili
F. Type 1 pili

Answer

A 46-year-old woman visits her podiatrist to have several bunions removed from her right foot. She chooses conscious sedation rather than general anesthesia for this procedure. She is given intravenous midazolam to supplement the local anesthetics that are injected into her foot. Midway through the surgery, she suddenly becomes agitated, combative, and exhibits involuntary movements. The anesthesiologist determines that she is having a paradoxical reaction to the midazolam and immediately administers

A. flumazenil
B. glucagon
C. naloxone
D. nitrite
E. protamine

Answer

A 26-year-old man is admitted through the emergency department to the hospital for a heroin overdose. His heart rate is 45 beats/min, and his blood pressure is 75/40 mm Hg. Which of the following best depicts the results from an arterial blood sample ?

pH PaCO2 (mm Hg) HCO3- (mEq/L)
A. 7.22 66 26
B. 7.34 29 15
C. 7.40 40 24
D. 7.47 20 14
E. 7.49 48 35

Answer

All of the following statements concerning antianginal drugs are true EXCEPT:

A. The effect of calcium channel blockers on afterload is more than their effect on preload.

B. The beta-blockers are effective in treating exertional angina since they decrease cardiac oxygen consumption during exercise.

C. The dihydropyridines present no hazard when used alone in the treatment of angina.

D. Organic nitrates are effective in treating Printzmetal's angina because they decrease preload and dilate coronary arteries.

Answer

1. Name the movements of the eyeball and give, in the form of a table, the origin, insertion and nerve supply of the muscles responsible for these movements.

A 4-year-old girl is discovered pulling the tail of the family dog. Her mother, who had warned her previously that this behavior was unacceptable, now assigns the girl to a 5 minute time out period. A timer is set up so that the girl can keep track of the time period. After two minutes of the period, the girl begins to scream and cry. At this point, the mother's best response would be to


A. do nothing until the time out period has ended
B. explain to the child why this type of punishment is necessary
C. offer the child a choice between becoming quiet or "being paddled"
D. reset the timer to add an additional 5 minutes to the time out period
E. tell the child that if she quiets down she will be rewarded by a treat at the end of the time out period

Answer

A 48-year-old white female secretary presents with progressive difficulty typing over the past month. She also notes that her hands begin to feel numb and weak after typing for long periods of time. Upon testing, which of the following deficits would be predicted?


A. Difficulty in abducting the fifth finger
B. Difficulty in adducting the thumb
C. Difficulty in flexing digits two and three at the metacarpophalangeal joints
D. Loss of sensation over the lateral half of the dorsum of the hand
E. Loss of sensation over the lateral half of the palm
F. Loss of sensation over the medial half of the dorsum of the hand
G. Loss of sensation over the medial half of the palm

Answer

A 34-year-old woman is prescribed an antidepressant, which she has taken for the past 3 months. She is on no other medications and is in generally good health. After attending a party, at which she consumed wine and cheese, she is rushed to the emergency room with tachycardia, headache, and a blood pressure of 200/100. Which antidepressant is she most likely taking?

A. Amitriptyline
B. Fluoxetine
C. Phenelzine
D. Sertraline
E. Trazodone

Answer

Administration of an experimental drug that acts on PNS myelin is shown to increase the space constant of an axon in a peripheral nerve. Action potentials traveling down the axon would be predicted to be

A. faster
B. larger
C. slower
D. smaller
E. unchanged

Answer

A child psychiatrist would like to evaluate the intellectual ability of a 3-year-old patient. Which of the following is the most appropriate test for him to use?

A. Denver Developmental Scale
B. Stanford-Binet Scale
C. WAIS-R
D. WISC III
E. WPPSI

Answer

A 24-year-old woman in her third trimester of pregnancy presents with urinary frequency and burning for the past few days. She denies fever, nausea, vomiting, or chills. She takes no medications besides prenatal vitamins and is generally in good health. Physical examination is remarkable for mild suprapubic tenderness, and a urine dipstick is positive for white blood cells, protein, and a small amount of blood. Culture produces greater than 100,000 colonies of gram-negative bacilli. which of the following attributes of this uropathogenic organism is most strongly associated with its virulence?

A. Bundle-forming pili
B. GVVPQ fimbriae
C. Heat labile toxins
D. Heat stable toxins
E. P pili
F. Type 1 pili

Answer

A baby who was apparently normal at birth, develops persistent regurgitation and vomiting in the second and third weeks of life. No fever is present and hematologic studies and blood chemistries are normal. Which of the following therapies is most likely to be effective in this case?

A. Antacids
B. Barium enema
C. Gastric resection
D. Oral antibiotics
E. Pyloromyotomy

answer

An archaeologist who has been excavating a very old Middle Eastern site develops a pustule on his hand. The pustule then ruptures to form a black eschar surrounded by expanding brawny
edema. Which of the following organisms is the most likely cause of this condition?

A. Bacillus anthracis
B. Borrelia burgdorferi
C. Francisella tularensis
D. Spirillium minus
E. Yersinia pestis

Answer

A chronic alcoholic develops severe memory loss with marked confabulation. Deficiency of which of the following vitamins would be most likely to contribute to the neurologic damage underlying these symptoms?

A. Folic acid
B. Niacin
C. Riboflavin
D. Thiamine
E. Vitamin B12

Answer

A 72-year-old male is noted as having a 9-pound weight loss over the past few weeks. His past medical history is significant for oat cell carcinoma of the lung, without known metastases, for which he is currently undergoing treatment. The patient states that even though his wife is preparing his favorite meals, he is not hungry.

Which of the following would be the best treatment option to improve his eating habits?

A. Amitriptyline
B. Megestrol acetate
C. Methotrexate
D. Neostigmine
E. Prochlorperazine

Answer

A cardiovascular physiologist is performing experiments using a new alpha1 adrenergic agonist to determine the amount of vasoconstriction the new drug can produce compared with a phenylephrine control. Which of the labeled structures is the cellular target of both of these drugs?

A. A
B. B
C. C
D. D
E. E



Answer

A 35-year-old woman notices a change in the appearance of a mole on her neck. Physical examination reveals that the lesion is an irregular, nodular, superficial mass with a variegated appearance. Biopsy demonstrates a primary malignant tumor. Which of the following factors is most predictive of the patient's long term prognosis?

A. Circumference of lesion
B. Darkness of lesion
C. Degree of color variation
D. Depth of lesion
E. Sharpness of border between lesion and adjacent skin

Answer

A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an antihypertensive agent. Three days later, he measures his blood glucose at home and finds that it is 53 mg/dL. He recalibrates his glucose testing apparatus and repeats the test, only to find that the first reading was accurate. He is concerned that his hypoglycemia did not produce the normal premonitory signs and symptoms. Which of the following medications was most likely prescribed to treat his hypertension?

A. Captopril
B. Diltiazem
C. Methyldopa
D. Prazosin
E. Propranolol

Answer

A 33-year-old woman presents with fever, vomiting, severe irritative voiding symptoms, and pronounced costovertebral angle tenderness. Laboratory evaluation reveals leukocytosis with a left shift; blood cultures indicate bacteremia. Urinalysis shows pyuria, mild hematuria , and gram-negative bacteria. Which of the following drugs would best treat this patient's infection?

A. Ampicillin and gentamicin
B. Erythromycin
C. Gentamicin and vancomycin
D. Phenazopyridine and nitrofurantoin
E. Tetracycline

Answer

A 9 year old African child develops a high grade lymphoma of the jaw. Which of the following features would probably NOT be present?

a) CD4 positivity
b) CD10 positivity
c) Epstein-Barr virus
d) Starry sky pattern
e) t (8,14)

Answer

A 32-year-old, blood type A positive male receives a kidney transplant from a blood type B positive female donor with whom he had a 6-antigen HLA match. Once the kidney is anastomosed to the man's vasculature, the transplant team immediately begins to observe swelling and interstitial hemorrhage. After the surgery, the patient developed fever and leukocytosis and produced no urine. Which of the following is the most likely explanation?

A. Acute rejection due to antibody-mediated immunity
B. Acute rejection due to cell-mediated immunity
C. Chronic rejection due to cell-mediated immunity to minor HLA antigen
D. Hyperacute rejection due to lymphocyte and macrophage infiltration
E. Hyperacute rejection due to preformed ABO blood group antibodies

Answer

A previously healthy 11-year-old girl develops a gastrointestinal infection with cramping and watery stools. After several days, she begins to pass blood per rectum, and is hospitalized for dehydration. In the hospital, she is noted to have decreasing urine output with rising blood
urea nitrogen (BUN). Total blood count reveals anemia and thrombocytopenia, and the peripheral smear is remarkable for fragmented red cells (schistocytes). Infection with which of the following bacterial genera is most likely responsible for this syndrome?

A. Campylobacter
B. Clostridium
C. Salmonella
D. Shigella
E. Vibrio

Answer

In the clotting process, as the hemostatic plug develops, fibrin polymerizes into monomeric threads which are held together by noncovalent bonds. Which clotting protein increases the strength of the clot by crosslinking the newly formed fibrin threads?

A. Factor XIII
B. High molecular weight kininogen (HMWK)
C. Plasminogen
D. Thrombin
E. von Willebrand Factor (vWF)

Answer

Which one of the following blood cells contains large cytoplasmic structures that exhibit metachromatic staining with toluidine or methylene blue?

a) Basophil
b) Eosinophil
c) lymphocyte
d) monocyte
e) neutrophil

Answer

Adults with sickle cell anemia most commonly experience neurological complications as which of the following:

A. Intracranial hemorrhage

B. Cerebral infarction

C. Seizures

D. Visual changes

E. Ataxia

Answer

A 35 year old man with many immature leukocytes in his peripheral blood smear spontaneously develops DIC. Which translocation might his cells expected to show?

a) t(8,14)
b) t(8,22)
c) t( 9,22)
d) t( 11, 14)
e) t( 15,17)

Answer

A survey was done to study the effect of insulin dose and corresponding Hb_a1c levels corrected for age.What would be the best test to study the relation

Vision 2020 right to sight doesn’t include

a.Cataract
b.Trachoma
c.Epidemic conjunctivitis
d.Onchocerciasis

Answer

A man takes peanut and develops tongue swelling, neck swelling, and hoarseness of voice. What is the most probable diagnosis?

a. Angioneurotic edema
b. FB bronchus
c. Para pharyngeal abscess
d. FB in larynx

Answer

Treatment of choice for glue ear is?

a)Medical only
b)antibiotics
c)Myringoplasty with grommet insertion
d) Myringoplasty only
Answer

A 5 year old child has history of recurrent upper respiratory tract infections , mouth breathing and impaired hearing. What is the most appropriate treatment?

a.Tonsillectomy
b.Adenoidectomy with grommet insertion
c.Grommet insertion
d.myringoplasty with grommet insertion

Answer

A thirty year old female presented with history of progressive hearing loss,which became profound with pregnancy.The tympanogram will show which of the following curve?


a. A
b. B
c. As
d. Ad

Answer