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.
Contralateral Sidebending Extension Flexion 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:
Babinski’s Lachman Ober’s 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:
Extension/Rotation biased exercises to decompress the pathological segment 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 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 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

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:
Ask patient to stay tough while you get through the evaluation Call the PCP, leave a message of your findings, and then continue your evaluation and treatment 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 Stop evaluation immediately and refer him out to see his PCP

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:

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 _______.
Ignore the situation Involve the patient in plyometric activities ASAP Patient’s motivational level may be affected by psychological distress 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 __________.
Disc displacement Facet Condition Hip bursitis 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:
Involving the patient in rigorous exercise program Lifting weights Modalities (massage, traction as needed) 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:
muscle strain disc displacement with nerve root involvement bursitis of the hip ACL sprain
Answer

Which electrolyte is responsible for muscle injury and death?
K
Na
Ca
Cl
Mg
Answer

Which of the following patients is least likely to get rhabdomyolysis?
New military recruit who does 4 mile run, 100 push-ups in 95 degree weather
Otherwise healthy 20 yo male who has influenza A
Construction worker trapped under large plank for 5 hours
25 yo woman who recently had unprotected anal intercourse with HIV positive male
70 yo female with CAD recently started on statin and fibrate
Answer

Which of the following is NOT considered appropriate treatment for rhabdomyolysis?
1.5 L/hr NS
Acidify urine to pH <4.5
Dialysis
Maintain UOP >300 ml/hr
Answer

Which of the following is NOT an mechanism for acute renal failure?
Myoglobin precipitating in renal tubules leading to renal tubular obstruction
Hypovolemia due to fluid shifting from intravascular space into damaged muscle and interstitum
Toxic effects of free cheletable iron on tubules
Obstruction of ureters due to kidney stones
Answer

Which of these can be an early or late feature of rhabdomyolysis?
Hyperkalemia
Hypokalemia
Compartment syndrome
DIC
Answer

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 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
Tags: Acidosis, Multiple Choice

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.

Section A - 40 Marks
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.
(3+3+3+3 = 12 marks)
2. Draw and label the horizontal section of the cerebral hemispheres at the level of the interventricular foramen.
12 marks
3. Write short notes on:
Maxillary air sinusInternal capsuleOrbital fissureLymphatic drainage of tongue4x4=16 marks

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

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

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 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

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

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 Hba1c levels corrected for age.What would be the best test to study the relation
a. Linear regression
b. Logistic regression
c. Pearson correlation
d. Student t test
Answer

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

The preganglionic parasympathetic fibers to the parotid gland travel in
a. Lesser petrosal nerve
b. Great petrosal nerve
c. Deep petrosal nerve
d. Internal carotid nerve
Answer
Tags: Parotid gland

Hind milk is richer in
a. Carbohydrate
b. protine
c. Fat
d. Minerals
Answer
Tags: Hind milk

The test of choice to detect peri-valvular abscess of the aortic valve is
a. MRI of heart
b. Transesophageal Echo with doppler
c. Ventriculography
d. CT Chest
Answer
Tags: Aortic valve

The commonest site of lymphoma in the gastrointestinal system is
a. Small bowel
b. Stomach
c. Large intestine
d. Esophagus
Answer
Tags: Lymphoma

Adequate recovery of neuromuscular function after reversal is indicated by
a. Minute volume
b. Respiratory rate
c. Tidal volume
d. Headlift for 3 seconds
Answer
Tags: Reversal

The form of vascular disease responsible for malignant hypertension is
a. hyaline arteriolosclerosis
b. Arteriosclerosis obliterans
c. Hyperplastic Arteriolosclerosis
d. Medial calcific sclerosis
Answer
Tags: Malignant hypertension

Photopsiae occurs in
a. Iritis
b. Cyclitis
c. Choroiditis
d. Retinitis
Answer
Tags: Photopsia

Stomach derives its blood supply from all these arteries directly or indirectly EXCEPT:
a. Splenic artery
b. Hepatic artery
c. Superior mesenteric artery
d. Coeliac axis
Answer
Tags: Stomach

A 2 yr old child with a head circumference of 55 cms is likely to have had intrauterine infection due to
a. Rubella
b. Toxoplasmosis
c. Herpes
d. Hepatitis B
Answer
Tags: Intrauterine infection

Bell's palsy is paralysis of
a. UMN V nerve
b. UMN VII nerve
c. LMN V Nerve
d. LMN VII nerve
Answer
Tags: Bell's palsy

The center of ossification of which of the following is used as medico legal evidence for fetal viability?
a. Head of femur
b. Distal end of femur
c. Greater trochanter
d. Lesser trochanter
Answer

All of the following are inhibitors of Cytochrome oxidase except
a. Carbon monoxide
b. Amytal
c. Cyanide
d. Azide
Answer 
 
Tags: Cytochrome oxide

von willebrand factor is produced by
a. liver
b. platelets
c. endothelial cells
d. Spleen
Answer
Tags: von Willebrand factor

The definitive diagnosis of Pneumocystis Carinii Pneumonia is
a. Serological tests
b. Chest X-ray
c. Finding cysts in tissue specimen
d. CT scan of thorax
Answer
Tags: Pneumocystis Carinii

Myositis ossificans is
a. worm calcification
b. Callus formation
c. Regenerate
d. Post traumatic ossification
Answer
Tags: Myositis ossificans

Which vessel is most commonly associated with posterior Duodenal ulcer?
a. Right gastroepiploic artery
b. Common hepatic artery
c. Gastroduodenal artery
d. Superior mesenteric artery
Answer
Tags: Duodenal ulcer

Depressive delusions that the world and everything related to it cease to exist is called
a. Persecutory delusion
b. Delusion of infidelity
c. Nihilistic delusion
d. Delusion of reference
Answer
Tags: Depression, delusion

In triage, green color indicates
a. Ambulatory patients
b. Dead/Moribund patients
c. High priority treatment or transfer
d. Medium priority or transfer
Answer
Tags: Triage

Chlamydia trachomatis infection causes the following EXCEPT
a. Pneumonitis
b. Rhinitis
c. Conjunctivitis
d. Urethritis
Answer
Tags: Chlamydia trachomatis

Which of the following types of nerve fibres carry pain?
a. A alpha
b. A beta
c. A gamma
d. A delta
Answer
Tags: Nerve physiology

Vossius ring is seen in
a. Cornea
b. Lens
c. Vitreous
d. Retina
Answer
Tags: Vossius ring

Anti histone antibodies are characteristic of
a. drug induced lupus
b. cardiac lupus
c. lupus nephritis
d. MCTD
Answer
Tags: Anti histone antibodies