CI: PT APPS 3
42. A patient with right lateral epicondylitis reports that symptoms are the same after 2 weeks of treatment. PT evaluated the patient and found out that the left biceps reflex is 1+. The PT's next strategy is to conduct a complete examination of the region. a. midcervical b. cervico thoracic c. upper cervical d. cervicocranial
A.
55. Which of the statements about developmental motor control is NOT TRUE? a. isotonic control develops before isometric control b. gross motor control develops prior to fine motor control C. eccentric movement develops prior to concentric movement d. trunk control develops prior to distal extremity control
A.
60. A PT will apply electrical stimulation to a patient with venous stasis ulcer on the right lower extremity. The correct type of electrical stimulation to promote wound healing is: a. direct b. biphasic pulsed c. interferential d. TENS
A.
64. A patient status medial meniscus repair is referred to PT. The responsibility of the physician post operatively is: a. determine weight bearing status b. select an appropriate resistive exercise program c. specify the frequency and duration of ROM exercises d. specify the parameter for superficial modality application
A.
74. Patient is able to accomplish only 60 degrees of passive straight leg raising. To improve the range of motion, the hold-relax technique should be applied to: a. hamstrings and hip extensors b. adductors and hip extensors C. abductors and hip flexors d. quadriceps and hip flexors
A.
77. This is an exercise technique designed to facilitate contraction and stability through joint compression. The compression force is most often applied to joints through gravity acting on body weight, manual contacts or weight belts. a. approximation b. alternating isometrics c. traction d. rhythmic inhalation
A.
80. A patient who sustained a CVA a month ago is starting to exhibit ability to produce movement patterns outside the limb synergies. According to Brunnstom, this is in the stage of recovery. (LESTER) a. fourth b. fifth C. third d. second
A.
34. For a research study to be ethical, which of the following should take place FIRST? a. patient should be informed that he has the right to terminate the experiment at any time b. end results of the experiment should be explained to the patient c. have patient sign the informed consent document d. patient should be debriefed following the experiment
C.
40. A sports PT was conducting evaluation of female varsity volleyball players. One of them complained of a chronic right knee pain and recurrent effusion. The PT performed an apprehension test and patient immediately grimaced and contracted her quadriceps maximally. The PT would suspect the presence of: a. chondromalacia patella b. internal knee derangement c. recurrent patellar dislocation d. rheumatoid arthritis
C.
43. Patient figured in a traction injury to the anterior division of the brachial plexus. PT expected to see weakness of the elbow flexors, wrist flexors and forearm pronation. The PT would also expect to find more weakness in: a. wrist extension b. forearm supination C. thumb abduction d. lateral rotation or the shoulder
C.
69. The following conditions can cause pressure ulcers to develop in SCI patients, EXCEPT: a. voluntary motor paralysis b. sensory impairment c. autonomic dysfunction d. bladder incontinence
C.
71. At what phase of the gait cycle would a PT expect to notice an everted posture of the calcaneus a. terminal stance (heel off) to pre swing (toe off) b. from midstance through heel off (toe off) C. from initial contact: (heel strike) through loading response (foot-flat) d. initial swing (acceleration) through midswing
C.
86. A patient with a left CVA demonstrates right hemiparesis and strong and dominant hemiplegia synergies in the lower extremity. The BEST strategy to break up these synergies is: a. supine, PNF D2F with knee flexing and D2F with knee extending b. foot tapping in a sitting position C. bridging, pelvic elevation d. supine-lying hip extension with adduction
C.
92. A major reason cervical traction is done intermittently is: a. machine will not overheat b. to increase blood flow to that area C. greater poundage can be tolerated d. all of these
C.
84. A PT measures a patient for a wheelchair. Which measurement technique is used to determine armrest height in a wheelchair? a. femur to radial head distance b. seat to anterior superior iliac spine C. seat to olecranon distance d. elbow to acromion distance
C. From floor to armrest: 30 inches From floor to push handles: 36
99. This is a test for thoracic outlet syndrome where patient is positioned in sitting or supine. The therapist moves the patient's arm overhead in the frontal plane while monitoring the patient's radial pulse. A positive test is indicated by an absent or diminished radial pulse and may be indicative of compression in the costoclavicular space. a. Roos b. Allen C. Adson maneuver d. Wright test
D.
35. While performing ROM, your patient with dermatomyositis complains daily about pain. For BEST long term positive result, the PT's strategy should be: a. discontinue exercise and use only positioning splint b. do ROM to the maximum limits possible C. continue to stretch slightly past the point of pain d. stop exercise as soon as patient complains of pain
D. A. discontinue exercise and use only positioning splint: hindi daw functional in the long run ang splinting for dermatomyositis Polymyalgia rheumatica (PMR): multiple muscle pain and stiffness common in women, > 50 yrs old; inflammatory genetic disorder Manifestations: -Locations of pain and stiffness: proximal muscles *Cervical *Shoulder *Hip -Low grade fever -Fatigue [kasi magiging sedentary man sila] -Wt loss d/t loss of appetite [kasi masakit kung kumilos] -EMG is typically normal, muscles are not inflamed. Pagmamaga ng joint (origin) yung nagcacause ng pain sa muscle (referred pain) Management of PMR: [IS] -Immunosuppressive agents, systemic corticosteroids Mnemonic for polymyalgia rheumatica (PMR): [SECRET] -Stiffness -Elderly -Caucasians -Rheumatism: also presents with arthritis in the synovial jts (synovitis), differential diagnosis is RA starts at small jts and symmetrical involvement, while PMR starts at proximal muscles and large jts, and is not symmetrical from early symptoms -Increased ESR (40-100 mm/hr) [mas marami dapat erythrocyte ng mga babae kasi nagmemens sila] M: <15 mm/hr F: <25 mm/hr Sa exam kung ano yung lowest choice, siya ang sagot *ESR, hallmark for inflammation, and PMR is an inflammation type of arthritis *Temporal arteritis/giant cell arteritis (GCA) [TAGCA]: highly associated with PMR; inflammation of the medium-sized arterial walls of the arteries located in the temple area of the head *H/A *Scalp pain *Blurring of vision, could lead to blindness Scleroderma: thickening or hardening of skin, which involves the skin, jt, heart, lungs, blood vessels, and GIT [isipin mo dito nag-originate yung myth nila kay Medusa] CREST syndrome: Calcinosis: increased calcium deposit on skin Raynaud's phenomenon Esophageal dysfunction Sclerodactyly: thickening and tightening of skin and fingers Telangiectasia: red marks or spots on face d/t dilation of capillaries *Management: systemic corticosteroids, and immunosuppressive agents Dermatomyositis (DM): skin lesions with dermatitis Management: Systemic corticosteroids and immunosuppressive agents Polymyositis (PM): skin lesions with weakness and atrophy of proximal muscles (shoulder and pelvic girdle); muscle is replaced with fats and can be seen via MRI Management: Systemic corticosteroids and immunosuppressive agents
87. PT is evaluating a 40-year-old male patient referred by a pulmonary specialist. Pt observes a pattern of breathing with periods of alternate deep breathing and apnea. Patient reports the same occurs at bedtime. This type of breathing or disorder in rate and rhythm is consistent with: a. diaphragmatic b. Biot's C. ataxic d. Cheyne-Stokes
D. Ataxic respiration: complete irregular breathing, irregular pauses, and increasing periods of apnea
44. While talking to a patient about a previous exercise program, the patient mentioned that his PT from another clinic said that he performed negative work. Negative work or a negative muscular contraction is BEST defined as: a. the muscle develops tension and increases in length b. purposeful voluntary motion c. the muscle develops tension and decreases in length d. muscle length remains constant as tension is developed
A. Concentric contraction: positive work Eccentric contraction: negative work
48. A traumatic brain injured patient reports to physical therapy feeling lethargic after being placed on phenobarbital. The primary purpose of the medication is to: a. prevent seizures b. reduce spasticity C. limit arrhythmias d. decrease agitation
A. Side-effects of phenobarbital: Sleepiness Vitamin deficiency Nystagmus Ataxia
72. Postural drainage is prescribed to a patient with cystic fibrosis. If the superior segment of the lower lobes are the target areas, how will PT proceed? a. patient lies prone, head down, 20 inches foot elevation with pillows under the hips b. patient lies supine, head down 20 inches with pillows under the knees C. patient lies supine with 2 pillows under hips, bed flat d. patient lies supine with pillows under the knees, bed flat
A. Anterior apical segment of the upper lobe Just below the clavicle Sitting et leaning backward Behind the pt (stay away from face for safety, so patient will not cough at you) Posterior apical segment of the upper lobe Above the scapula Sitting et leaning forward [mga apical segments ang seated position] Anterior segment of the upper lobe Male, nipples; female, above the breast Supine, bed is flat; pillow is placed behind of the head et popliteal areas for comfort Posterior segment of the L upper lobe L scapula 1/4 turn from prone position on R side; the ONLY reverse T position in all of the postural drainage positions (30-45 degrees elevation); if tilt table is not available, use large pillows with 18-20 inches of elevation [L upper lobe Lang ang only reverse T position; and siya Lang sa upper lobe yung may angulation; kasi yung ibang parts sa upper lobe either nakaupo lang or bed flat] Posterior segment of the R upper lobe R scapula 1/4 turn from prone on L side; bed flat *bed flat lang kasi hindi kumpara sa L upper lobe, maliit ang R upper lobe (divided into three lobes baya ang R lung) R middle lobe Below R nipple 1/4 turn from supine on L side; T position of 15-30 degrees, or large pillows with equivalent of 12-16 inches Lingula Below L nipple 1/4 turn from supine on R side; T-position of 15-30 degrees, or large pillows with equivalent of 12-16 inches [sa middle lobe nagsimula yung meron angulations ang T-position; besides sa L posterior upper lobe] Anterior segment of the lower lobes Anterior lower ribs Supine; T-position of 30-45 degrees, or large pillows of 18-20 inches [yung mga lower lobes; lower ribs] Posterior segment of the lower lobes Posterior lower ribs Prone; T-position of 30-45 degrees, or large pillows of 18-20 inches; placement of pillow is on the abdomen, or ant hips L lateral segment of lower lobe L lateral lower ribs R side lying; T-position of 30-45 degrees, or large pillows of 18-20 inches; placement of pillows are under the head, between arms et legs R lateral segment of the lower lobes R lateral lower ribs L side lying; T-position of 30-45 degrees, or large pillows of 18-20 inches; placement of pillows are under the head, between arms et legs [sa lateral lower ribs, hindi na 1/4 turn from sidelying] Superior segment/apical segment of the lower lobes Below inferior angle of scapula Prone; bed flat; placement of pillows are under abdomen, or ant hip) [apical segment pero lower lobe, madali lang din; pero hindi nakaupo; prone position na lang]
36. Joint stiffness, a common complain of RA and OA patients has these physical components. a. inertia, viscocity, friction, plasticity, elasticity b. elongation, viscocity, friction, plasticity, inertia c. texture, inertia, viscocity, plasticity, elasticity d. friction, elongation, texture, viscocity, elasticity
A. Joint contracture physical components: [VIP si FE] Viscosity Inertia Plasticity Friction Elasticity
4. Which research model contains the characteristics of variable manipulation control and randomization? a. experimental model b. case study C. descriptive model d. historical model
A. True experimental research: true cause and effect relationship [I cause De effect: cause (independent); effect (dependent)] Criteria for true experimental research: -Controlled and experimental group: controlled group yung tipong traditional treatments, tapos experimental group yung gusto mo ipropose na treatment kung more effective ba -Researched manipulated variables: independent, dependent, and intervening variables -Randomization Quasi experimental research: still cause and effect relationship, but one or more criteria is not met from criteria of true experimental research; MC cause d/t lack of randomization *quasi: seemingly or apparently but not really. Non experimental descriptive: (-) cause and effect relationship, describes characteristics, attitude, behavior, beliefs, manifestations, etc. *kunwari yung mga crime statistics, usually binibilang nila aling ethnic group yung maraming crimes nagawa pero hindi nila pinapag-aralan ang bakit Non experimental exploratory: (-) cause and effect relationship, but still tries to explore connections without conducting an actual experiment; ex. Smoking and lung cancer, hindi ka pwede mag-gather ng mga tao tapos ipasigarilyo mo sila para malaman na magkakalung cancer ba talaga sila (this is unethical) *parang gumagawa lang ng hypothesis or theory
89. To prevent the onset of pneumonia for a non-ambulating patient, PT can recommend: a. bedside sitting 2-3 times/day b. chest tapping four times a day C. starting spirometry and wheelchair mobility d. nebulizer twice a day
A. b. chest tapping four times a day: kasi wala pang secretions ang pt C. starting spirometry and wheelchair mobility: spirometry for atelectasis d. nebulizer twice a day: for asthmatic pts
59. Ohm's Law describes the relationship among: a. voltage, resistance and amperage b. amperage, conductance and resistance C. conductance, voltage and resistance d. voltage, conductance and amperage
A. Ohm's law Voltage= IntensityxResistance
94. For each degree in Fahrenheit rise in body temperature, the pulse rate will increase about ____ beats. a. 10 b. 4 C. 6 d. 8
A. 1:10 1 Fahrenheit:10 beats
79. In designing a ramp for patients with wheelchair, for every inch of threshold height, there should be a corresponding inches of ramp length. a. 12 b. 10 C. 15 d. 8
A. 1:12 ratio Ramp Height of handrail from the ramp: Ht to length/rise to run ratio= 1:12 (1/12= 8.3%) [1 ruler = 12 inches; 8% yung percentage kasi intended for wheels yung ramp (parang wheels ang 8)] Width Minimum: 36 inches Ideal: 48 inches Height of handrail from the ramp: 32 inches
83. A short-term goal for a patient with a neurological deficit is as follows: The patient will transfer from tall kneeling to half kneeling with supervision. This activity is an example of: a. controlled mobility b. skill c. mobility d. stability
A. Controlled mobility also includes: wt shifting and rotational trunk control [SR. PNP QWS (cues)] [mobility] 1. Supine/flexor withdrawal: towards T10 vertebra; mobility motor control 2. Roll-over: supine to prone, or side lying to prone; mobility motor control [stability] 3. Pivot prone: prone, then superman position; mobility and stability motor control 4. Neck co-contraction: dito daw nagkakaroon ng head bobbing yung baby; stability motor control (FIRST REAL STABILITY PATTERN) 5. Prone on elbows: stability motor control [controlled mobility] 6. Quadruped: PREPARES child for equilibrium responses; stability and controlled mobility motor control [skill] 7. Standing: skill motor control [between skill and control mobility] 8. Walking: mobility, stability, and skill motor control
66. A patient is evaluated after a stroke. When tested for two-point discrimination on the right hand, the patient cannot tell whether the PT is touching with one or two points. PT suspects that there is impaired function in the: a. spinotectal tract and somatosensory cortex b. dorsal column/lemniscal pathways and somatosensory cortex C. anterior spinothalamic tract and thalamus d. lateral spinothalamic tract and somatosensory cortex
B. 2 major ascending tracts (sensory) of the SC's white matter: -SPINOTHALAMIC TRACT (anterior and lateral spinothalamic tract) -DORSAL COLUMN PATHWAY/MEDIAL LEMNISCUS *Other examples of ascending tracts: Spinocerebellar Spinotectal Spino-olivary Descending tracts (motor) of the SC's white matter: -Pyramidal tracts (voluntary motions; kaya pyramidal kasi nag-originate sa 5th cortical layer known na inner pyramidal layer + yung fiber tracts niya present dscrus cerebri, inverted pyramid ang hitsura) -Exterapyramidal tracts (involuntary motions) Enumerate the pyradmial tracts: [mga pyramidal, mga letter "C" then spinal tract] -CST: originates from BA 4, 6 (motor); BA 3, 1, 2 (sensory) *Lateral CST: 90% of the CST; decussates at the medulla oblongata *Anterior CST: 10% of the CST -Corticobulbar tract: originates at BA 4, 8; primitive name of the brainstem is bulb Enumerate the extrapyramidal tracts and their functions: [RT VR] -Rubrospinal tract: red nucleus of the tegmentum of the midbrain (2nd superior structure of midbrain) --> spinal cord; UE flexion facilitation, if impaired = decerebrate posturing -Tectospinal tract: tectum of the midbrain (3rd superior strx of midbrain) --> spinal cord; head turning reflexes *Corpora quadrigemina: **2 superior colliculi: vision **2 inferior colliculi: hearing -Vestibulospinal tract: vestibular nucleus of the pons --> spinal cord; balance and posture [yung pons nakadikit sa kanya ang cerebellum kaya meron din siya kinalaman sa balance and posture; balance mo na nakatayo lang] -Reticulospinal tract: reticular formation (RAS) of the brainstem (midbrain, pons, medulla oblongata) --> spinal cord; locomotion and posture [posture while walking] Spinothalamic tracts and its components with their functions: -Lateral spinothalamic tract: pain et temp -Anterior spinothalamic tract: light/crude/non-discriminative touch and pressure Functions of the dorsal column pathway/medial lemniscus [PVD: proprioception, vibration, 2pt discrimination] -Proprioception, 2-pt discrimination, vibration sense -Precise localization: Stereognosis: palpatory sense Barognosis Graphesthesia Fine intensity gradation Cell bodies found in the dorsal column pathway/medial lemniscus, and their functions: Fasciculus gracilis: LE proprioception [merong L] Fasciculus cuneatus: UE proprioception [merong letter U] Origin of the corticospinal tract: Area 4 (motor): 30% Area 6 (motor): 30% Areas 3, 1, 2 (sensory): 40% *Frontal lobe: Area 4: precentral sulcus (primary motor area for C/L limbs) Area 6: premotor cortex (secondary motor area (plan, initiation, coordination) of movements for C/L limbs) *Parietal lobe: Areas 3, 1, 2: post central sulcus (primary somatosensory area for C/L limbs) Origin of the corticobulbar tract: Area 4 Area 8: frontal eye field *CBT: responsible for all the motor functions in the CN (kasi origin ng CN is sa brainstem); it's not responsible for CN 1, 2, 8 who are pure sensory in function (nasakto din na hindi located sa brainstem si CN 1 et 2) Lateral CST decussates at the level of: Lower ventral medulla [LVM] oblongata (pyramidal decussation); contralateral manifestations (if the lesion is before the decussation site) (ventral: motor) LSTT decussates at the level of: Spinal cord segmental levels (substancia gelatinosa, lamina 2) [Lamina 2, ascend 2 levels] *Brown Sequard: hemisection of the spinal cord; lesion is after the decussation level= I/L manifestation *Rule: it will ascend 2 segments first ipsilaterally before it decussates contralaterally (ex. pinprick at the R C7 level, it will decussate at the level of the R C5 --> L C5) 1st order neuron: dorsal root ganglion 2nd order neuron: substancia gelatinosa 3rd order neuron: thalamus
46. A PT is preparing a 45-year-old female patient for treatment. The latter asked if she could go to the comfort room. Wondering why patient has not returned to the treatment area after several minutes, PT checked and found patient slumped on the floor face down. The appropriate course of action the PT should take is: a. check level of response, call for help, establish airway and assess breathing b. check level of response, call for help, assess breathing and establish airway C. call for help, check level of response, assess breathing and establish airway d. call for help, check level of response, establish airway and assess breathing
A. check level of response, call for help, establish airway and assess breathing [assess mo breathing kung na-establish mo properly ang airway]
91. If a laser radiation interacts with matter, the effect can be either of the following, EXCEPT: a. conversion b. reflection C. refraction d. absorption
A. conversion is common for diathermy
38. During 180 degrees of abduction in the scapulohumeral rhythm, there is roughly a ratio of movement of the humerus to the scapula. a. 2:1 b. 1:1 C. 1:3 d. 1:2
A. letter D. kung scapula to humerus Scapulohumeral rhythm occurs after: 30 degrees *the GH is responsible during the first 30 degrees of arm abduction, Explain the scapulohumeral rhythm ratio: After 30 degrees of abduction, a ratio of 2:1 occurs, or 1:2 (depende kung ano yung tanungin ng examiner; like GH:ST, or ST:GH) Every 3 degrees: 2 degrees: GH 1 degree: ST Calculate the scapulohumeral rhythm in 180 degrees of arm abduction: 180 degrees; 180 divided by 3 = 60; 2:1 = 120 (GH) : 60 (ST) *Some references are strict they don't include the first 30 degrees made by the GH jt; so minus 180 degrees by the 30 degrees, then solve again for the 2:1 ratio; finally add 30 degrees... Only do this formula if your first calculation did not work in answering the exam [30-60-90; gawing 2:1 ratio] Phase 1 of scapulohumeral rhythm: [30] GH jt: 30 degrees ST jt: setting phase (preparation for scapulohumeral rhythm) SC jt: 0-5 degrees of elevation Phase 2 of scapulohumeral rhythm: 30-90 degrees [60: 40+20] GH jt: 40 degrees ST jt: 20 degrees SC jt: 10-15 degrees of elevation Phase 3 of scapulohumeral rhythm: > 90 degrees [90: 60+30] GH jt: 60 degrees ST jt: 30 degrees SC jt: Posterior rotation
47. The correct sequence in the hierarchy of the criteria of a profession is: a. lifetime commitment, representative organization, specialized education, service to clients, autonomy of judgment b. representative organization, lifetime commitment, service to clients, specialized education, autonomy of judgment c. autonomy of judgment, lifetime commitment, specialized education, representative organization, service to clients d. service to clients, autonomy of judgment, specialized education, representative organization, lifetime commitment
A. lifetime commitment, representative organization, specialized education, service to clients, autonomy of judgment [Commit and Represent your Education to your Clients, and let them Judge you]
32. When comparing the gait cycle of young adults with the gait cycle of the older adults, the TRUE statement is: a. The younger population has a short period of double support b. The younger population has a shorter stride length C. The younger population has a decrease in speed of ambulation d. The younger population has a shorter step length
A. longer ang period of double limb support for geria
76. Criteria that can be used to assess motor learning include all of the following, EXCEPT: a. ability to remember response-produced augmented feedback b. resistance to contextual change C. performance acquisition of a motor task d. retention-recall of a motor task after a period of no practice
A. should be augmented feedback throughout motor learning Criteria for motor learning -resistance to contextual change -performance acquisition of a motor task -retention-recall of a motor task after a period of no practice -providing augmented feedback throughout motor learning
82. The following are Bobath's concepts of muscular weakness, EXCEPT: a. sensory deficit cannot result in weakness b. weakness is due to being relatively overcome by spastic antagonistic muscles C. a muscle may be weak only as a prime mover but "strong" whenever an abnormal mass movement pattern occurs d. soft tissue periarticular contraction can enhance or stimulate weakness
A. should be can result in weakness
78. A medial or lateral whip during gait of an amputee can occur because of the following reasons, EXCEPT: a. inadequate rotation of the knee b. tight socket fit C. improper alignment of toe break d. valgus in the prosthetic knee
A. should be excessive rotation of the knee Swing phase whips: -Medial whip: at heel off, the heel moves medially; Excessive ER of the prosthetic knee -Lateral whip: at heel off, the heel moves laterally; Excessive IR of the prosthetic knee
17. The navicular drop test in weight bearing can be utilized clinically in the examination of: a. integrity of the dorsal talonavicular ligament b. medial longitudinal arch collapse c. tendon injury to the tibialis anterior muscle d. motion across the longitudinal axis of the midtarsal joint
B.
3. A comparison of the effects of exercise in water, on land or combined on the outcome of patients with intraarticular anterior cruciate ligament reconstruction revealed that less joint effusion was noted after 8 weeks in the water group. An appropriate statistical test to compare the girth measurements of the 3 groups is: a. chi square b. analysis of variance c. analysis of covariance d. Pearson's Product Moment
B.
63. A patient with a spinal cord injury finds it difficult to transfer from mat to wheelchair. The patient can't seem to process the idea of how to coordinate this movement. In this situation the MOST effective use of feedback during the early motor learning is to: a. focus on guided movement and proprioceptive inputs b. concentrate on knowledge of results and visual inputs c. give feedback only after a short (5 sec) delay d. concentrate on knowledge of performance and proprioceptive inputs
B.
7. A patient is on immune suppressants following renal transplantation was referred to the clinic for mobility training using crutches. Initial evaluation revealed paresthesia in both lower extremities with peripheral weakness in both hands and feet. PT suspects that patient is MOST LIKELY experiencing a. leukopenia b. peripheral neuropathy c. myopathy d. quadriparesis
B.
93. Heat removed or lost from an object is referred to as: a. rarefaction b. heat abstraction C. warming d. convention
B.
97. A patient has difficulty going down ramps. His knees wobble and are unsteady. The action to take is: a. prolonged icing to reduce hamstring pain b. progressive resistance training for the quadriceps C. stretching thru posterior resting splint for tight plantarflexors d. continuous passive movement machine to keep the range
B.
57. Which ultrasound treatment parameter is recommended for a stage 2 chronic dermal wound? a. 1 MHz at 1.5 watt.cm2 b. 3 MHz at .2-1 wat:/cm2 C. 3 MHz at 1.5 watt/cm d. 1 MHz at .2-1 watt/cm2
B. Frequency: 3 MHz for stage 2 ulcers 1 MHz for stage 3, 4 ulcers Intensity: 0.2-1 W/cm2 Duty cycle: 20% pulsed [parehas sa intensity na .2] Treatment time: 1-2 mins per area, 3 times weekly, Treatment location: around the edges of the wound or directly over the wound with water based occlusive dressing as conducting medium 1: superficial skin loss (epidermis) Clinical manifestations: [WIN] Warm or cool skin Itching pain Nonblanchable erythema: discoloration of the skin that does not turn white when pressed - is one clinically important skin abnormality 2: partial thickness skin loss (epidermis and dermis) Clinical manifestations: [ABC] Abrasion Blister (+) Crater (shallow) 3: full thickness skin loss (epidermis, dermis, hypodermis) Clinical manifestation: (+) Deep crater 4: full thickness skin loss extending to fascia, muscles, and bone Clinical manifestation: (+) Undermining/tunneling/rimming and sinus tracts *stage 3 and 4 are generally recommended for surgery, transparent film for stage 1 and 2
27. This test, also known as Ritchie or Trillart, is the BEST indicator of injury to the anterior cruciate ligament especially the posterolateral band. a. Gravity drawer b. Lachman's C. Slocum d. Godfrey
B. Lachman/Ritchie-Trillet/Ritchie/Trillet'stest: best indicator for ACL Between 0-30 degrees of knee flexion Provide anterior translation for the tibia (+) mushy/soft end-feel; ACL, POL, APOL [terrible triad 2.0] Anterior drawer sign Hip flexed to 45 degrees with knee flexed to 90 degrees Anterior translation of the tibia (+) > 6 mm translation; All structures of the knee, except the PCL Posterior sag sign/gravity drawer test: this test must be done first before the anterior drawer test; because there may already be already sagging at the joint and you only returned the knee to its original position (anterior drawer) Hip flexed to 45 degrees et knee flexed to 90 degrees Observe knees (+) sagging, thumb, step-off sign PCL, ACL, APOL, POL Godfrey's gravity test Both hips et knees flexed to 90 degrees Passively hold the position in place (+) tibia sags back; Posterior instability
50. A 75-year-old frail female is being treated at home for general strengthening and mobility. The patient has a 5 year history of taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin for joint pain and recently added calcium channel. The possible adverse reactions/side effects include: a. weight increase, hyperglycemia, hypotension b. stomach pain, bruising, confusion c. paresthesia, incoordination, bradycardia d. increased sweating, fatigue, chest pain
B. Types of anti-inflammatory drugs: [non steroids and steroids] -NSAIDS -Corticosteroids COX types -COX 1: responsible for the protective lining of the stomach, and thromboxane (responsible for stimulation of the platelet aggregation/clotting) [para siyang plate (platelet) and lining] -COX 2: for pain and inflammation; prostacyclin, responsible for vasodilation, and inhibition of platelet aggregation/clotting in the coronary and carotid arteries *Coronary artery: blood supply of the heart *Carotid arteries: origin of circulation for Circle of Willis Nonselective NSAID vs selective NSAID -Non selective NSAID: inhibits the COX 1 and COX 2 -Selective NSAID/COX 2 NSAID: inhibits the COX2 Examples of nonselective NSAID: [AKIN Mefenamic] Aspirin Ketoprofen Ibuprofen Naproxen Mefenamic acid Common side effects of nonselective NSAID: [BUG] Bleeding Ulceration Gastric upset Examples of selective NSAID/COX 2 NSAID: [COX 2= Cray cray "CRE CRE mga COXIB"] Celecoxib Rofecoxib Etodolac Common side effects of selective NSAID/COX 2 NSAID: [you CRE CRE (celecoxib, rofecoxib, etodolac) kasi willing ka irisk cardiac arrest at CVA] -Cardiac arrests -CVA *kasi nicounter niya yung action ng prostacyclin which is vasodilation in the coronary and carotid arteries, plus inhibit niya yung inhibition ng prostacyclin na antiplatelet, so magkakaroon ng platelet formation Corticosteroids/glucocorticosteroid: stimulates endogenous steroid (cortisol, aldosterone), stimulates the leukocytes and macrophages Examples of corticosteroids/glucocorticosteroid [nagsteteroid mga PCP] -Prednisone -Cortisone -Prednisolone Common side effects of corticosteroids: [OC; yung mga nagsteteroids] -Osteoporosis d/t decrease of breaking down of vitamin D; hence vigorous exercises are avoided with px with this medication -Cataract
5. In comparing the clinical features of cerebral artery thrombosis with cerebral embolism, the former a. presents an abrupt onset with rapidly developing symptoms b. has the most common site of occlusion in the internal carotid artery c. usually includes a sudden loss of consciousness d. includes more generalized disturbance of cerebral function
B. A and C describes: embolism a. presents an abrupt onset with rapidly developing symptoms c. usually includes a sudden loss of consciousness Most common etiology of stroke: Thrombotic stroke/large vessel thrombosis (40% of the cases of stroke). Development or formation of blood clot within the cerebral artery or their branches Major contributory factor of thrombotic stroke/large vessel thrombosis: Atherosclerosis, progressive narrowing of the blood vessel d/t plaque formation with accumulation of lipids, fibrin complex, carbohydrates, and calcium deposits in the arterial walls [fats, carbs, calcium, fibrin] Onset of thrombotic stroke/large vessel thrombosis: Gradual *Thrombotic stroke usually occurs at night Common sites for thrombotic stroke/large vessel thrombosis: [CMV] -Common carotid artery (internal and external carotid artery) -Middle cerebral artery -Vertebral basilar artery Embolic stroke is: travelling bits of matter formed elsewhere; 20% of the cases of stroke Most common source of embolic stroke: Disease of the CVS (MC d/t atrial fibrillation) *Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. [AFib= arrhythmia] Onset of embolic stroke: abrupt
65. Of the following ligaments situated around the ankle joint, the one that is MOST susceptible to strain is the: a. calcaneofibular b. talofibular c. tibiofibular d. talotibial
B. A. CACAFI: 2nd most commonly strained
75. A 29-year-old data encoder complains of numbness and tingling in the right hand, a median nerve involvement. Upon a visit to the jobsite for evaluation, it was revealed that patient was working on a very rigid 10 hour shift with only 15-minute break every 4 hours. A recommendation to the supervisor to ease the symptoms of the patient could be: a. provide the worker a resting splint b. give frequent rest periods of 15 min every hour C. require worker to attend a cumulative trauma disorder d. lessen work schedule to 8 hours
B. A. provide a resting splint: trabaho ng PT hindi administrative for the advisor
37. A 36-year-old fast food delivery crew got involved in a motorcycle accident. He sustained an injury to the posterior cord of the brachial plexus. Which muscle would not be affected by the injury? a. latissimus dorsi b. infraspinatus c. teres major d. subscapularis
B. Posterior cord: -Radial -Axillary -Thoracodorsal (middle subscapular nn) -Subscapular nn (upper, lower)
15. This is a test associated with a pars interarticularis stress fracture or spondylolisthesis. The patient stands on one leg and extends the spine while balancing on the left. The test is repeated with the patient standing on the opposite leg. A positive test is indicated by pain in the back. a. Segmental instability b. Stork standing C. Pheasant d. Quadrant
B. Stork's one-leg standing/lumbar extension test: Stands on one leg followed by trunk extension (+) pain: pars interarticularis pathology, or spondylolisthesis Stands on one leg followed by trunk extension then rotation, if (+) pain: facet jt dysfunction *Extension quadrant test: overpressure is applied in extension while the pt side flexes and rotates to the side of pain. The movement is continued until the limit of range is reached or until symptoms are produced. This position causes maximum narrowing of the intervertebral foramen and stress on the facet jt to the side witch rotation occurs Flamingo test: Stands on one leg then the pt is gonna hop (+) pain: SI jt dysfunction Pheasant's test: Pt is in prone, PT will flex the knee (heel to buttock) of the pt while applying pressure to the lumbar area (+) pain during hyperextension of trunk (during heel to buttock)= unstable spinal segments *parang PKB1
23. The following are guidelines during vestibulo-ocular retraining EXCEPT: a. Use of gravity, varying surface conditions, visual conditions and environmental cues should be included in therapeutic planning b. The center of gravity is allowed to move at each stage of treatment C. Individualize each program based on the patient's specific impairments (rehabilitation versus compensation training) d. Use of practice, feedback and repetition are vital for skill refinement
B. COG must be controlled not allowed to move Vestibulo-ocular retraining guidelines: -Use of gravity, varying surface conditions, visual conditions and environmental cues should be included in therapeutic planning -The center of gravity is not allowed to move at each stage of treatment -Individualize each program based on the patient's specific impairments (rehabilitation versus compensation training) -Use of practice, feedback and repetition are vital for skill refinement CTSIB sensory conditions: 1: Firm surface, eyes open 2: Firm surface, eyes closed 3: Firm surface, visual conflict dome 4: Foam surface, eyes open 5: Foam surface, eyes closed 6: Foam surface, visual conflict dome Conditions and dysfunctions: [VS VS] Visually dependent: dysfunction on 2, 3, 5, 6 Somatosensory dependent: dysfunction on 4, 5, 6 Pts with vestibular loss: dysfunction on 5, 6 because they can't rely on vision or somatosensory Pts with sensory selection: dysfunction on 3-6
49. A post Ml patient is about to begin phase 3 cardiac rehabilitation program. During the initial exercise session, the patient's ECG responses are monitored via radio telemetry. PT noticed three PVCs occurring in a run with no wave. PTS next strategy is: a. have the patient sit down and rest for a few minutes before resuming exercise b. stop the exercise and notify the physician immediately C. continue the exercise session, but monitor closely d. modify the exercise prescription by decreasing the intensity
B. PVC may lead to ventricular fibrillation then eventually to cardiac arrest
67. The following impairments may result in patients with a lesion in the frontal lobe of the brain, EXCEPT: a. perseveration, in attention b. homonymous hemianopsia c. contralateral weakness d. personality changes, antisocial behavior
B. common ito sa (occipital lobe), or parietal lobe, or MCA, or PCA
29. A 75-year-old female was referred to PT for a fall risk assessment. Patient fell twice at home. If patient's timed up and go (TGU) score is 33 seconds, her fall risk is: a. moderate, based on a mildly abnormal score b. low, based on a mildly abnormal abnormal score c. high, based on an abnormal score d. moderate, based on poor sensory adaptation response
C.
33. A licensed physical therapist may append the following initials after his/her name. a. RPT b. LPT C. PTRP d. PTR
C.
19. A 58-year-old female is recovering from a surgical resection of an acoustic neuroma and presents with symptoms of dizziness, vertigo, horizontal nystagmus and postural instability. To manage these problems, the program should include: a. strengthening exercises focusing on spinal extensors b. repetition of movements and positions that provoke dizziness and vertigo C. Hallpike's exercises to improve speed in movement transitions d. prolonged bedrest to allow vestibular recovery to occur
B. habituation Unilateral vestibular hypofunction managements: -Gaze stabilization exercise: to improve VOR; head moves while gaze if fixed -Habituation exercise: place patient in provoking positions and maintain the position for 30 s (3-5 times) Bilateral vestibular hypofunction managements: -Tai Chi -Pool exercises -Balance exercises -Central program for eye movement: using cards, practice patient's horizontal eye movements --> vertical eye movements --> maintain gaze with eyes closed (when they open their eyes, dapat fixated pa rin sa object of focus)
45. The CORRECT technique in stretching the iliotibial band is: a. Patient is positioned in sidelying on the uninvolved side. The uppermost thigh is adducted with the hip in 90 degrees flexion b. Patient is positioned in sidelying on the uninvolved side close to the edge of the table. Externally rotate and extend the involved thigh and allow a gravity assisted stretch. c. All of these d. Patient is positioned in hook lying with the uninvolved leg crossed over the leg to be stretched. The involved leg is adducted with gentle isometric abduction contraction
B. parang Ober's test The correct procedure for self-stretching of the ITB is: Patient is standing with tight extremity in slightly ER and crossed behind the normal leg, keeping both feet on the floor, the patient bends away from the tight side allowing slight knee flexion on his normal knee *PNF D2 extension (bowling stance)
62. Patient is a 16-year-old female student with idiopathic scoliosis. PT plans to apply bipolar or quadripolar electrodes over the overstretched and weakened muscles. He can select the following parameters, EXCEPT: a. duration: gradually increased until patient tolerates 8 hours of stimulation b. pulse rate: 50 pps C. waveform: rectangular monophasic waveform with 220 microseconds output d. stimulus amplitude: 50 to 70 mmA
B. should be 25 pps For weakened overstretched muscles: -duration: gradually increased until patient tolerates 8 hours of stimulation -pulse rate: 25 pps -waveform: rectangular monophasic waveform with 220 microseconds output -stimulus amplitude: 50 to 70 mmA
51. A PT will evaluate the shoulder of a patient with hepatitis B. PT finds no open wound abrasions. Patient has good hygiene. The prescription includes passive range of motion because of adhesive capsulitis. Which of these precautions is absolutely necessary to prevent infection for PT? a. PT should wear gloves b. none of these c. PT should wear a mask d. PT should wear a gown
B. unless merong open wound si pt, A.
14. A patient presents with a vague hip pain that radiates to the lateral knee, a negative FABERES test, negative Grind test and a positive Noble's compression test. A possible cause can be a. irritation of the L5 spinal nerve root b. DJD of the hip c. an iliotibial band friction disorder d. SI joint dysfunction
C.
16. This is associated with a pars interarticularis stress fracture or spondylolisthesis. The patient stands on one leg and extends the spine while balancing on the leg. The test is repeated with the patient standing on the opposite leg. A positive result is indicated by pain in the back. a. Quadrant b. segmental instability c. Stork standing d. pheasant
C.
2. A 65-year-old former banker with mild dementia is included in a national study testing of efficacy of a new drug to increase memory. The patient's family reports that he is perky while taking the medication and memory seem to be better. At the conclusion of the study, it is revealed that the patient was part of the control group. These responses are MOST LIKELY due to: a. Hawthorne's effect b. Sampling bias C. placebo effect d. Pretest treatment interference
C.
21. What is the FIRST step in controlling organizational behavior in a PT Department? a. establish system of measuring performance b. develop system of review C. determine types of jobs and skills needed d. monitor performance and provide feedback
C.
52. A child with cerebral palsy has difficulty releasing food from the hand to the mouth. To assist the hand opening when the food is in the mouth, the caregiver should: a. passively extend the fingers b. slowly stroke the finger flexors in a distal to proximal directions C. slowly stroke the finger extensors in a proximal to distal direction d. apply a quick stretch to the finger flexors
C. Inhibitory techniques Slow stroking Slow rolling Prolonged icing (BEST MANAGEMENT to use for extremely spastic muscle) Maintained stretch (purpose ng mga splints) Light joint compression [hindi mafacilitate ms kung light load lang] Tendinous pressure [opposite sa muscle] Joint approximation [opposite sa osteo, at heavy jt compression] Gentle shaking Neutral warmth Facilitatory techniques Fast brushing Fast icing Quick stretch, applied during diminished muscle response (kunwari DB curls tapos napapagod na muscles mo to apply full ROM, apply quick stretch) Heavy joint compression [mastimulate yung proprioception] Muscle belly pressure [FACILITATE DTR pag muscle belly] Osteo pressure Bone pounding Tapping
10. The following are characteristics of the right hemisphere of the brain EXCEPT: a. process information in a holistic manner b. hand-eye coordination c. produce written and spoken language d. artistic abilities
C. B. hand-eye coordination: music A. process information in a holistic manner: insight L hemisphere: [MALL] Mathematics Analytics Language Logic R hemisphere: [MICA] Memory Insight Creativity Arts and music
28. PT is conducting an exercise class for geriatrics. below, which would be of LEAST benefit Among the exercises the participant? a. active neck extension b. active stretching of the pectoral muscles C. active neck flexion d. active hip extension
C. Common senile posturing: Forward head Thoracic kyphosis Flattened lumbar curve Hip flexion
8. A patient exhibiting symptoms of thalamic pain syndrome, cortical blindness and memory impairment. PT will suspect occlusion in the artery. a. vertebral basilar b. middle cerebral C. posterior cerebral d. anterior cerebral
C. PCA supplies [MID] midbrain, inferomedial temporal lobe and whole occipital lobe, and diencephalon (SHET) PERIPHERAL TERRITORY Memory impairment (lesion at inferomedial temporal lobe) Visual impairments: C/L homonymous hemianopsia (parehas sa MCA) Visual agnosia *Prosopagnosia: inability to identify familiar faces *Dyschromatopsia/color agnosia *Simultanagnosia/Balint syndrome *Alexia without agraphia: can't read, but can write *Dyslexia: difficulty reading CENTRAL TERRITORY C/L hemiplegia C/L hemianesthesia C/L hemiballismus, choreoathetosis, intention tremor [basal ganglia symptoms] Thalamic pain syndrome/central post-stroke pain syndrome/Dejerine Roussy syndrome (Diencephalon lesion) Weber and Benedict syndrome: CN 3 (slight miosis and ptosis), 4 palsy (midbrain lesion) Pontine gaze pattern: pt looks toward the hemiplegic side, away from the lesion
81. The use of hyperbaric oxygen in treating chronic dermal wounds is more useful in: a. wounds from insect bites b. arterial insufficiency ulcers c. venous insufficiency ulcers d. burn wounds
C. and decubitus ulcer
39. When doing range of motion exercises with a patient who suffered a head injury, a PT notes that the patient lacks full elbow extension and classifies the end-feel as hard. The MOST LIKELY cause is: a. anterior capsular tightness b. triceps weaken c. heterotopic ossification d. spasticity of the biceps
C. common among prolonged immobility Heterotopic ossification: Ossification that occurs near a tendon; joint affected is usually below the level of lesion "below the level of lesion" kaya sa CVA/TBI: shoulder; SCI: hip Arrange the heterotopic ossification sites for SCI (from most to least): [my hip, my knee, my shoulder, elbow] hip > knee > shoulder > elbow Most common site for heterotopic ossification in TBI and CVA: Shoulder Pharmacological management for heterotopic ossification: Disodium etidronate Laboratory hallmark for heterotopic ossification: Elevation of alkaline phosphatase Myositis ossifican traumatica: Ossification within the ms after severe trauma Most common site for for myositis ossificans in the body: Quads If UE: brachialis > biceps
24. An 80-year-old patient diagnosed with Alzheimer's type of dementia was referred for balance and coordination training. In preparing a plan of care, it is essential to know that the patient is: a. usually trusted to be responsible for own daily care needs b. usually trusted with transfers with appropriate positioning of the wheelchair C. likely not open to activity training if unfamiliar activities are used d. more likely to remember recent experiences than past ones
C. dapat familiar activities Common interventions for the neurologic changes encountered by the elderly: -Allow increase of increased reaction time: better adherence, and may motivate patient (hindi man sila mabilis makareact sa situations, so bigyan mo lang sila ng appropriate time) -Avoid long sequence of instructions, should be clear, short, and concise instructions -Use familiar activities + repetition, ex. Carpenter, to imitate sawing, perform dumbbell row
100. When utilizing the skinfold measurement procedure to check body composition, the following guidelines are followed, EXCEPT: a. Wait one to two seconds before reading the caliper b. skinfold calipers should be positioned one centimeter away from the examiner's fingers when pinching the side, positioned perpendicular to the skinfold and centered between the base and top of the fold C. Take only one measurement at each site d. Maintain pinching of the site during the reading of the caliper
C. in sir JD we trust
12. A sports PT is tasked to prescreen athletes to identify who are susceptible to heat illness. Which of these elements would be MOST useful to the project? a. flexibility b. height C. percent body fat d. weight
C. kasi fats man ang good for insulating heat Layer of skin which contains fats and loose connective tissue: Subcutaneous tissue/hypodermis -Functions: [SCSI "sexy"] Support Cushion Storage of energy Insulation *pero yung mga excessive ang fats, sila din yung may heat intolerance
70. The range of motion requirements for normal gait include the following , EXCEPT: a. knee flexion: 0 - 60 degrees b. ankle dorsiflexion: 0 - 10 degrees C. hip extension: 0 - 30 degrees d. hip flexion: 0 - 30 degrees
C. should be 0-10 degrees hip flexion: 0 - 30 degrees ankle dorsiflexion: 0 - 10 degrees into 20 degrees PF knee flexion: 0 - 60 degrees hip extension: 0 - 10 degrees
98. The silver fork deformity results from an unreduced or inadequately reduced: a. fracture of the lower ulna b. fracture of one or more carpals c. fracture of the first metacarpal d. Colle's fracture
D.
58. Electrical stimulation of spastic muscles has been proven to effectively reduce spasticity. The following are parameters to apply EXCEPT: a. waveform: symmetrical or asymmetrical biphasic pulses with 200-500 microseconds duration b. stimulus: amplitude adjusted to maximum tolerable contraction C. duty cycle: 1:2 d. pulse rate: greater than 60 pps biphasic pulses to produce tetanic muscle contraction
C. should be 1:1 ES to reduce spasticity -waveform: symmetrical or asymmetrical biphasic pulses with 200-500 microseconds duration -stimulus: amplitude adjusted to maximum tolerable contraction -duty cycle: 1:1 -pulse rate: greater than 60 [parang biceps ang "6"] pps biphasic pulses to produce tetanic muscle contraction
85. A PT is part of a health team that will examine applicants for flight attendants of an airline company. His task was to examine the posture of applicants. Which of these descriptions would NOT match a good posture? a. chest is slightly up and forward b. front of pelvis and thighs are in a straight line C. shoulder blades pulled back and separated about 2 inches from each other d. arms hang relaxed at the sides with palms of hand facing toward the body
C. should be 4 inches or 10 cm from each other
1. A PT wants to compare frequencies of carpal tunnel syndrome occurring in different groups of workers restaurant waiters and call center agents. The MOST suitable statistical tool for analysis data is: a. t-test b. normal distribution curve C. chi square test d. simple one-way ANOVA
C. this is used to compare frequencies Parametric tests: interval, ratio (I/R) (quantitative) Non-parametric tests: nominal (N) and ordinal (O) (qualitative) [McWilson's Corny Cheesy Man Traded Coke 2 Receive Cheezy Kisses Ama; dependent muna bago maging independent] 2 variables Dependent related N: McNemar's test O: Wilcoxon Signed Rank test I/R: Correlated T-test Independent unrelated N: Chi square O: Mann Whitney I/R: T-test 3 variables Dependent related N: Cochran Q test O: 2-way ANOVA I/R: Repeated T-test Independent unrelated N: Chi-square O: Kruskay Wallis I/R: ANOVA, Multiple ANOVA, or ANCOVA [AMA]
25. ___ is issued to a PT who passes the board examination, after approval of his ratings and payment of required fees. a. Diploma from the Board Examiners b. Certificate of Recognition for passing the Board Examinations C. Certificate of Completion d. Certificate of Registration
D.
54. A 3-year-old child with spastic cerebral palsy and at a 6-month-old gross developmental level is referred to the clinic. The plan of care would include: a. visually tracking a black and white object held 9 inches from his/her face b. reaching for a black and white object while in the supine position C. reaching for a multi colored object while in an unsupported standing position d. reaching for a multi-colored object while in an unsupported, guarded sitting position
D.
90. In pool therapy, the depth of the water may significantly affect the percentage of weightbearing on a limb. At 60 inches deep, the percentage of weight bearing in relation to the patient's body weight is: a. 21 - 27 b. 20 - 35 C. 13 - 20 d. 5 - 12
D.
95. A PT checks the water temperature of the hot pack machine after several patients report the heat being very strong. Which of the following temperatures would be acceptable? a. 83 degrees Celsius (181 degrees F) b. 64 degrees Celsius (147 degrees F) C. 94 degrees Celsius (201 degrees F) d. 71 degrees Celsius (160 degrees F)
D.
96. For each degree in Fahrenheit use in body temperature, pulse rate will increase about a. 14 b. 4. C. 6 d. 10
D.
26. This inner ear disease that affects balance has the following symptoms: intense vertigo, occasionally unilateral deafness, buzzing or ringing in the ear. a. otitis media, chronic b. bulging disc C4-C5 C. otitis externa d. Meniere's disease
D. Classic manifestation of Meniere's disease: [Meniere's VTS] Vertigo = vestibular Tinnitus = cochlear Sense of fullness in the ears *Tinnitus: sound in the head with no external source. For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.
53. A 2-year-old child with Down Syndrome and moderate developmental delay is treated in as early intervention program. Daily training activities that can be considered include: a. rolling activities, initiating movement with stretch and tracking resistance b. stimulation to postural extensors in sitting using rhythmic stabilization C. locomotor training using body weight support d. holding and weight shifting in sitting and standing using tactile and verbal cueing
D. Down syndrome (Trisomy 21) manifestations: Flat occiput Plica palpebro nasalis (up slanted epicanthal fold) Flat nasal bridge Small eyes, nose, ears Overweight Mental retardation Simian crease Hypotonia Lax ligaments Susceptible for AA subluxation Common rehab interventions for down syndrome patients: [PMA] Promote oromotor function Minimize gross motor delay Avoid hyperextension of elbows and knees
31. A 60-year-old golfer was referred to PT for a sacroiliac joint pain. In your evaluation, you plan to include a Gillet's test. Which of these methods describe how test is carried out? a. Patient in supine with correct trunk alignment, pelvis and lower limbs. You stand at edge of table by patient's feet palpating medial malleolus to assess asymmetry. Have patient come to long sitting position and assess the leg length. b. Place thumb of your hand under PSIS of limb to be tested and place your other thumb on center sacrum at same level as thumb under PSIS. Ask patient to extend hip of limb being tested. c. Patient is sidelying at edge of bed while holding bottom leg in maximal hip and knee flexion (knee to chest). Standing behind patient passively extend hip of uppermost limb. d. Patient is standing. Place thumb of your hand under PSIS of limb to be tested and place your other thumb on center of sacrum at same level as thumb under PSIS. Ask patient to flex hip and knee of limb tested like bringing knee to chest
D. Gillet's sacral fixation/posterior I/L rotation test: Standing, while PT is behind placing the two thumbs at each PSIS (at the level of S2), then instruct the pt bring one leg to chest Normal: the sacrum should rotate posteriorly (+) PSIS moves up/rotates anteriorly, or moves minimally Piedallus test: Pt is seated at a hard flat surface while the PT palpates the PSIS, ask the pt to bend forward [isipin mo dahil pinapakain mo siya ng pie] Normal: both PSIS are equal (it's normal for some pts to have unequal PSIS) and moves together (+) if the affected PSIS moves higher compared to the other PSIS, even if the pt has asymmetrical PSIS Pheasant's test: Pt is in prone, PT will flex the knee (heel to buttock) of the pt while applying pressure to the lumbar area (+) pain during hyperextension of trunk (during heel to buttock)= unstable spinal segments *parang PKB1 Yeoman's test: Pt is in prone position, PT will flex the knee to 90 degrees, then extend the hip (+) pain *parang PKB2 Gaenslen's test: Pt in sidelying position, lower leg is on the end of the bed side. PT passively hyperextends upper leg while the lower leg is hugged by the patient (knee to chest) Hand placement: one hand on the extended leg while the other hand stabilizes the hip (+) pain : SI pathology *parang slump test 3
30. A 60-year-old male complains of pain in the left hip region. The symptoms appear to be consistent with hip osteoarthritis. The test to perform to assist in making this diagnosis would be: a. Thomas b. Posterior impingement C. Craig's d. Scouring
D. Knee osteoarthritis manifestations: Morning stiffness < 30 minutes Persistent knee pain Restricted movement Reduced function Crepitus Bony enlargement Hip osteoarthritis manifestations: Morning stiffness < 60 minutes Pain present in: [F>Ab>IR] -Hip IR -Hip flexion < 115 degrees *Age: > 50 yrs old Hand osteoarthritis manifestations: -Presence of Heberden's nodes (can be familial) -Joint space narrowing in any finger joint *Age > 40 yrs old
61. In electrotherapy, the frequencies generated by high voltage units are usually no greater than 100 to 140 Hz while that produced by low voltage units are HZ. a. 500 - 1,000 b. 2,000 - 3,000 C. 3,000 - 4,000 d. 1,000 - 2,000
D. Medium frequency currents: 3000-6000 Hz High frequency currents: > 10,000 Hz
41. A football player suffered a grade II inversion ankle sprain 2 weeks Ago. The Best intervention in the early subacute phase of rehabilitation would most likely include: a. functional football related drills b. mobilization at the talocrural and subtalar joints C. plyometric based exercise d. closed chain strengthening and proprioceptive exercises
D. B. mobilization at the talocrural and subtalar joints: acute phase [PRICEM: Protection, Rest, Ice Compression, Elevation, Mobility] Chronic phase a. functional football related drills C. plyometric based exercise
6. This is to test brachial plexus injury, brachial plexus neuritis or Meningitis. a. Westphal b. Keri C. Lhermittes d. Bikele
D. C. Lhermitte's hindi niya ma-assess ang brachial plexus neuritis A. Westphal: kung (-) knee jerk sa DTR
68. At what level may a spinal cord injury patient begin to be a functional ambulator? a. T1 - T8 b. T9 - T12 C. L4-L5 d. L1 - L3
D. Functional ambulator: household and community ambulation *Hindi daw maganda walking sa SCI above T12 kasi grabe ang energy expenditure, kaya mas maganda na W/C na lang sila
13. This is a tool to asses and treat balance dysfunction but does not assist to diagnose the cause of balance dysfunction. It consists of eight test conditions used in the battery with each leg measured on two counts, the time spent in each test position and the number of steps that a patient performed. a. Functional Reach b. Berg Balance Scale c. Fugl Meyer Sensory Assessment d. Fregley Graybiel Ataxia Test Battery
D. Geria age classifications: [65, 75, 85] 65-74: young elderly 75-84: old elderly >85: old, old elderly/frail elderly Common assessment tools to assess balance: [TB FT; mahilig mag"throwback" mga tigulang "featuring" themselves] -Tinetti's performance oriented mobility assessment (POMA) -Berg balance scale -Functional reach test -Timed get up and go (TUG) test Tinetti Performance oriented mobility assessment (POMA) Low risk: 25-28 Moderate risk: 19-24 [super dami pa yung mga puma nung 1924] High risk: < 19 Berg balance scale: can be used for elderly, vestibular conditions, and stroke Low risk: 41-56 Moderate risk: 21-40 [ages 21-40 yung mga magaling magbalance] High risk: < 20 Functional reach test: landmark is 3rd MCP High risk: If < 10 inches: high risk [hindi lang makaabot ng 1 ruler na 12 inches] Timed get up and got (TUG) test: Low risk: < 20 s High risk: > 30 s (dependent for ADLs) Normal for healthy individuals: < 10 s Normal for the elderly: < 30 s An elderly and frail adult were referred to therapy for an examination of balance. The pt has a recent hx of falls (2 in the last 6 months). Based on knowledge of balance changes in the elderly and scoring of standardized balance measures, the test data that best indicate increased fall risk are: B. a. Functional reach of 13 inches b. Berg balance of 22 c. Tinetti performance oriented mobility assessment (POMA) score of 25 d. Timed get up and go (TUG) test result of 15 seconds
20. World Health Organization defines this term as abnormalities of anatomical, physiology or psychologic origin within specific organs or systems of the body. a. functional limitation b. handicap C. functional disability d. impairment
D. Nagi's model of disablement [FAP Dis] Active Pathology: The intrinsic pathology or disorder Physical Impairment: Anatomical, physiological, mental, or emotional abnormality or loss Functional Limitation: Limitation of performance at the level of the whole organism or person Disability: Limitation in performance of socially defined roles and tasks within a sociocultural and physical environment International Classification of Impairments, Disabilities, and Handicaps Model [DID with Hand] Disease: Biochemical, physiologic, and anatomical abnormalities of the human organism (EQUIVALENT TO ACTIVE PATHOLOGY) Impairment: Loss or abnormality at the tissue, organ, or body system level (EQUIVALENT TO PHYSICAL IMPAIRMENT) Disability: Inability to perform a task or participate in activity considered normal for a human being (EQUIVALENT TO FUNCTIONAL LIMITATION) Handicap: Disadvantage for a given individual, resulting from an impairment or a disability that limits or prevents the fulfillment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual (EQUIVALENT TO DISABILITY)
73. A patient who sustained burns on 25 percent of his body was admitted! If patient has hypovolemia, the laboratory value MOST affected is: a. oxygen saturation ratio b. hemoglobin C. prothrombin time d. hematocrit
D. "pt has hypovolemia"
11. A PT employee of a rehabilitation center of a hospital evaluates a patient showing several signs and symptoms of anemia. Which of these questions would be the MOST useful to gather additional information in relation to anemia? a. Does it hurt to take a deep breath? b. Are you susceptible to bruising? C. Do you frequently experience dizziness, headaches or blurred vision? d. Do you experience heart palpations or shortness of breath at rest or with mild exertion?
D. SOB dahil kulang Hgb, kulang oxygen supply a. Does it hurt to take a deep breath? respiratory system impairment b. Are you susceptible to bruising? polycythemia, thrombocytopenia, hemophilia C. Do you frequently experience dizziness, headaches or blurred vision? polycythemia
22. Which statement of Speed's test is FALSE? a. The test may also be performed by forward flexing the patient's arm to 90 degrees and Chen asking the patient to resist an eccentric movement into extension b. A positive test elicits increased tenderness in the bicipital groove and is indicative of bicipital tenderness C. The examiner resists the shoulder forward flexion by the patient while the patient's forearm is first supinated, then pronated, and the elbow is completely extended d. It is less effective than Yergason's test because the tendon moves over the bone during the test
D. Speed's test is more effective because the tendon moves over the bone during the test Common special tests for biceps: -Speed's biceps/straight arm test Sitting or standing PT will resist forward shoulder flexion of the pt with elbow extension et forearm supinated vs pronated (+) bicipital groove pain, occurs during supination > pronation; bicipital tendinitis, or paratenonitis (+) pain in the shoulder jt line, occurs during pronation > supination; SLAP lesion (similar sa O'Brian test) Yergason's test Sitting; elbow flexed to 90 degrees with forearm pronation PT will resist forearm supination and shoulder ER while palpating the bicipital groove of pt (+) pop, or tendon slides out (painless); transverse humeral ligament lesion (+) pain on bicipital groove; bicipital tendinitis/paratenonitis Ludington's test [parang "L" yung maform ng elbows] Sitting; with hands clasped behind the head Pt will alternately contract, relax biceps while PT will palpate the long head of the biceps (+) no palpable biceps contraction of the tendon Rupture to the distal biceps Heuter's sign [Neuter, if (+) = normal] Sitting, elbow flexed to 90 degrees with forearm pronated PT will resist elbow flexion (-) supination Rupture to biceps brachii [parang yergason's]
88. The plumb line is a tool that consists of a weight suspended at the end of a string to determine vertically. Ideal positioning of selected body parts in relation to the plumb line is described below, EXCEPT: a. midway through the tip of the shoulder b. through the external auditory meatus C. through the axis of the odontoid process d. slightly anterior to the coronal suture
D. should be slightly posterior
9. Your patient with Parkinson's disease was prescribed levodopa. The side effects of the drug are the following EXCEPT: a. arrhythmias b. gastrointestinal distress C. orthostatic hypotension d. impaired visual accommodation
D. should be visual hallucination Levodopa side effects: [HAGO] Hallucination Arrythmias GI distress Orthostatic hypotension 4 pharmacological managements for PD: [MAD Dopamine] [anti-excitatory] -Monoamine oxidase (MAO) B inhibitors: enhance the levels of dopamine -Anticholinergic drugs: for tremor and dystonia (mas mataas kasi levels ng Ach kaysa sa dopamine sa PD) [prodopamine] -Dopamine agonists: stimulate postsynaptic dopamine receptors; for rigidity, bradykinesia, and motor fluctuations (apomorphine test) -Dopamine replacement therapy Drugs used for dopamine replacement therapy: [LCS] -Levodopa: ALTERNATIVE kung hindi available ang sinemet -Carbidopa -Sinemet (levodopa + carbidopa): GOLD STANDARD therapy for PD Dopamine agonistic medications: [BRP ni Dops] Bromocriptine: least common [promo] Ropinirole Pramipexole [promise] Anticholinergic drugs for PD: Benztropine mesylate Trihexyphenidyl *PD: increased Ach, decreased dopamine Monoamine oxidase (MAO) B inhibitors medications: [SeleRa giline] Selegiline Rasagiline
18. A 75-year-old patient was referred to the clinic. What technique is usually included in the PT program? a. ankle weights b. lengthening stride C. walking aids d. hip group strengthening
D. strong hip muscle groups could make the elderly more functional long term
56. A patient with vascular problem develops an infected skin ulcer on the left heel. The modality that would NOT be applied for this patient is: a. low intensity direct current b. ultraviolet radiation c. high voltage galvanic stimulation d. hot moist pack
D. this will increase rate of infection
