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NBCE part 2/3
Chiropractic
| Question | Answer |
|---|---|
| Child with Legg Calve Perthes disease Should be braced with the thigh and hip in: | Internal Rotation and Abduction |
| 26 YO male presents with Hx of trauma PROM is hypermobile in the Upper Cx's Davis serious taken to R/O damage to all following ligaments except: | Intertransverse |
| ID test where SLR of unaffected limb produces sciatic pain in the opposite limb | FAJERSZTAIN'S |
| Female 7th month pregnant gets a physical. When raising head from supine Midline Abdominal Mass noted Most likely to be: | Diastasis Recti |
| Destruction of a pedicle which is visible on AP Lx Xray usually associated with: | Osteolytic METS |
| Pes Anserine Bursae Swelling and tenderness Palpated at what area: | Medial to tibial tuberosity |
| INC ESR (erythrocyte sedimentation rate) | Multiple Myeloma |
| Radiolucent expansile lesion Distal femur or Proximal tibia may progress to the articular surface | Giant Cell Tumor |
| On a case of traumatic injury LX XRAY reveals Bulging of psoas muscle Usual finding of: | Hemorrhage |
| Advantage of MRI over CT scan is that | MRI does not use ionizing radiation |
| Adjustment of S2 nerve root Is most beneficial in Tx in what condition | Constipation |
| Schilling shift to Left INC of Alkaline phosphatase & serum bilirubin GREAT INC of SGOT suggests: | Acute Hepatitis |
| Myofascial Pain Syndrome is characterized by all EXCEPT | altered medial occlusion position |
| NOT associated with Adrenal Insufficiency | Weight Gain |
| Male with tender lemon shaped mass 3 CM in diameter Mid belly of biceps Proximal to antecubital fossa Pain started suddenly 2 days ago when bowling Probable DX: | Proximal bicep tendon rupture |
| Spasmodic flank pain radiates to groin with mild hematuria Suggests: | Ureteral Stone |
| Pain for few seconds Disappears w/ no correlation to tissue mvt Shooting, burning, lightening feeling | Neuralgia |
| 24 YO male Acute T-L pain while sledding Treated for Crohn's disease w/ steroids 4yrs Dx: | Vertebral Fracture |
| Best position for someone who has Sciatica/ L5 discopathy | Supine with rolled towel under knees |
| Flat foot Gait with no forceful Toe-Off Motor deficit @ What Cord Level? | S1 |
| Normal articular cartilage fails under cyclic loading Due to tissue __________ | Fatigue |
| Pes planus Which is LEAST likely to aid the condition? | Lateral heel lift |
| Spinal NR responsible for Scapular retraction | C5 |
| With mechanical irritation of spinal NR's due to inflammation Posterior joints in the spine initially causes __________ changes | Reflex |
| Best Tx for patient who was punched in the face and aspirated a tooth | refer to the ER |
| 46 YO Female Muscle weakness and Fatigue with exertion Mask face, dysphagia, pharyngitis Diplopia & LID LAG | Myasthenia Gravis |
| Tx NR compression most likely causes: | Severe Pain in sloping pattern Which follows the intercostals spaces |
| Least useful for a patient who has a palpable/visible abdominal pulsations... | EKG |
| Major peripheral nerve tested by: Thumb ABDuction, opposition and compression | MEDIAN |
| 36 YO woman: Dyspnea and Right side pain Woke up with a cold. Afebrile Blood chem's are unremarkable Tachypea Antalgic lean to the right: | Spontaneous pneumothorax |
| Kid was thrown playing karate and fell on his back. Findings: Weak head roation and flexion Normal ROM | Strain of SCM |
| Best XRAY view for: 7th Cervical vertebra | Swimmer's Lateral |
| Test to differentiate: SI Lesion from a LS Lesion | Goldhwaits |
| Serum Enzyme elevated FIRST after a myocardial Infarction | CPK-MB |
| Maintenance of normal juxtaposition of upper cervical complex is dependent on: | Ligamentous integrity |
| After getting up from laying prone patient has lBP on flexion and extension | Articular capsulitis |
| Pronator reflex test What is the nerve level? | C8 |
| PT modalityhas distinct chemical effect | Ultraviolet |
| Lx dis herniation What is contraindicated | Static Traction |
| What is the PAUSE b/w: QRS and next wave form | ST segment |
| Type of Force you do not want to do with a patient with Spondylolisthesis | Extension |
| 60 YO Male w/ LBP INC alkaline phosphatase and CRP | Pagets |
| Management of acute tendinitis (tennis elbow) DOES NOT include: | immobilize the elbow |
| 20 YO Male Congested sinuses + common cold What is a contraindicated therapy? | Interferential Currency |
| Enlargement Left supraclavicular. Primary area of this condition... | Upper abdomen |
| Test to differentiate b/w: collateral ligament injury or meniscus | Appley's compression/decompression |
| 28 degree scoliosis which increased another 5 degrees since last PE 6 months ago. What is the MGT? | Orthopedic consultation |
| Lease effective Tx for Cx TP injury | Cervical traction |
| Facets in upper Tx region most clearly resemble _______ : ________ (which is why motion is limited in this direction) | Cervical: Coronal |
| In Thoracic Spine- SP move to the _______ similar to the _______ Spine | Convexity Cervicals |
| Modality most indicated for Acute shoulder pain: | ICE |
| Mild sprain to ankle during soccer; Earliest heat Tx should be started- | 48 hours |
| Young soccer player turns ankle 2 days ago. What's recommended | Cold in acute phase Hot in chronic phase |
| Carpal Tunnel Syndrome contraindication | Wrist Flexion |
| Maxillary sinus problem Modality contraindication: | Interferential |
| Prolapse Disc. What do you NOT do: | Static Traction |
| Woman Headache: Vise like, around base of skull, during midday. In last 6 months the headace: unilateral, lasts 2-12 hours, vomitting, visuals | Common Migraine |
| Woman Headache Went to MD (gave her antihistamine and aspirin) She also takes Vitamin C What might cause fatigue? | Anti-histamine |
| Least likey to cause joint mice | Osteitis Condensens ilii |
| Standard of care for Milwaukee bracing | Scoliosis approaches 30 degrees and is progressive |
| 19 YO, well defined kidney shaped mobile nodule, TENDER, 1cm in diameter. Does not transilluminate | Fibroadema |
| Male w/ periorbital HA Started 11 AM and lasted about 2 hours. Recently just moved here and skips breakfast: | Hypoglycemic HA |
| Middle age female: Pain and milde infection of the leg. Red Marks from right medial malleous to popliteal fossa | Lymphangitis |
| Inabilty to sleep Instability Tremors | Hyperthyroid |
| Turning head, atlas rotates _____ | 25 degrees |
| Racer has sharp pain from hip to knee. Now feels clicking when walking. | ITB injury |
| Female with pain in right arm/shoulder Xray shows reabsorption of distal right clavicle. Increase: serum calcium, alkaline phosphataste, ESR Decrease: Serum phosphorus | Hyperparathyroidism |
| Constipation is associated with... | Appendicitis |
| Pain down arm, hand and LITTLE finger. Pain INC with Abduction and external rotation of arm. XRAY shows Bilat enlarged ribs at C7 TOS is due to: | Coracoid process |
| Sudden onset of acute leg pain from knee down to the heel. No pain in back and ROM is normal. (+) Laseque, normal well leg, (-) Valsalva | Psuedosciatica |
| Patient walks 100 yds w/ Claudication but ignores pain. He cont. and pain disappears... | Oxygen debt |
| 68 YO patient walks for a 100 yds and feels leg pain. Pain disappears with rest: | Vascular compression |
| 49 YO male walks 3 miles and has acute leg pain. This has been going on for 2 years! | DJD in his knees. |
| Crackles in posteriolateral aspect Fever of 102 Bilat depression of diaphragm (Typical resp infection) | Lobar Pneumonia |
| BP during inspiration is 120/80, BP during expiration is 132/90 Supine and standing low its 120/80 What is the significance? | Pulsus Paradoxus |
| 18 month old child has respiraiton rate of 30, temp 100, pulse rate 110 Findings are.... | Normal! |
| Basketball player jumped and felt a click and pain in the knee McMurray's and Slocums test were positive | Medial Meniscus |
| Areas of spine for adjustment with Diaphragm problems | C3-5 |
| Accentuated QRS complex and an inverted T wave at leads II, III, aVF, and V6 | Chronic MI |
| DJD at C5-6 which have ostephytes, sclerosis, no Hx of trauma This is called: | discogenic spondylosis |
| 25 YO male DX with AK What is best thing to do? | |
| Dangerous sign and should be referred out! | Loss of bladder control |
| 35 YO male Leaned over sink and now has: Lx rigidity and BILAT LBP What is likely? | Functional muscle spasm Scoliosis of Lumbars |
| What is effect of chronic decreased blood supply on the skin? | White and brittle |
| Constipation Adjust where? | S2 |
| Abnormality commonly seen with spondylolisthesis | Spina Bifida |
| Pain increase after eating 2 hours | duodenal ulcer |
| What muscles involve: pullups, back strokes, breast stroke, wall weight cable pulls and the stretchs. | Latissimuss Dorsi |
| INC of angle b/w a line from top of S. base to true horizontal | Hyperlordosis |
| Enlargement of single supraclavicular lymph node may suggest: | Malignancy |
| 37 YO Male w/ Hx: weight loss, chronic sore throat, night sweats | Ask about his lifestyle |
| 50 degree Scoliosis | immediate referral if have lung problems |
| Cx manipulations contraindicated in | "drop attacks" |
| 13 YO female fever, pain in ankle, knee, shoulder Had throat infexn 2 wks ago Systolic murmur on mitral area INC ESR and CRP | ASO-titre |
| Peripheral nerve tested by opposition | Median |
| Cyanosis localized to neck, head and upper limbs is characteristic of | Sup Vena Cava obstruction |
| Intermittent SHARP SHOOTING pain with paresthesia suggests... | Neuralgia |
| Obese 14 YO male Pain on walking with legs turned out w/ external rotation. DX... | SCFE |
| 50 YO Female HA VISUAL PROBLEMS, RED, PAINFUL EYES Nausea and vomitting and very exhausted Palp. of eye closed shows a smooth surface that is FIRM AND WOULD NOT INDENT w/ pressure. If left untreated, future consequence would be... | Blindness |
| 12 YO child with neck pain and HA. Hematoma on QL, but denies pain or trauma. What do you do? | Immediately report possible child abuse |
| Acute thrombobronchitis How long does couugh last? | 1-3 weeks |
| Differentiate congenital and pathologic clubbin of the fingers | Press on fingers and feel for bogginess under the nail bed |
| Clubbing of the digits, arthritis, periostitis, hypertrophic arthropathy suggests: | Bronchogenic carcinoma |
| Not typical of testicular masses | most are benign |
| Curdy exudate on tongue and inside mouth, easily removed with scraping with a -tip. | Candidiasis |
| Eye pain increased with movement of the eye. Reduced vision. Optic disc is ELEVATED AND BLURRED edges DX... | Papillitis |
| "Scary" RETROSTERNAL pain during during and for ten minutes climbing stairs. Rule out- | Cholecystitis (what stays: MI, angina pectoris, peptic ulcer) |
| 34 YO Female with Diarrhea. Stool is large, light gray, foul, grasy. This is due to: | Malabsorption |
| 14 YO boy "pinching" sensation in right INGUINAL area. Sausage like mass on abdomen. mosly likely worse complication: | Ischemic necrosis |
| 4 YO child with right arm in a sling. He holds humerus FLEXED AGAINST HIS BODY with forearm pronated. He said his dad was swinging him by his arms just prior. DX... | Dislocated radial head |
| Skin variation will be seen in white people with Addison's disease? | Brown |
| does NOT occur in area b/w P-wave and QRS complex? | Ventricular contraction |
| 42 YO male wakes at 2 AM with: chills, shivers, and pain in BIG TOE. Bed sheet irritate pain a little. What does he have? | Gout. |
| Shoulder pain and atropghy of infra & supraspinatus muscles. PROM has no pain This is... | Rotator cuff tear |
| Poorest prognosis and a Red Flag indicator of possible metastatic bone cancer? | "Worse at night" |
| 30 YO multiparous lady Nausea, vomiting, RLQ pain 2 DAYS OF VAGINAL BLEEDING. HAS NOT HAD HER MENSTRUAL PERIOD IN 2 WEEKS. Hx of PID and has used and IUD. ENGORGED BREASTS AND HYPERCHROMIC AREOLA. Soft cyanotic Cervix. leukocytosis SHIFT TO LEFT. HC | TUBAL PREGNANCY |
| Dx procedure most appropriate to find etiology of symptoms: | abdominal ultrasonography |
| Pain, SUDDEN ANEMIA, INC. RETICULOCYTES, PERIUMBILICAL CYANOSIS and a swelling in retouterine pourch. DX: | Ruptured ectopic pregnancy |
| 18 YO male with vague pain, swelling and JOINT LOCKING OF THE KNEE. Presents his leg in EXTERNAL ROTATION. No history of trauma. Probably due to: | Lateral meniscus tear |
| Dx test utilized Crohn's disease and ulcerative colitis w/o using symptoms: | Sigmoidoscopy and Air contrast Barium |
| BLACK LESION, on skin with rough surface, rough edge contour, irregular border and raised uneven surface: | Melanoma |
| INC heart rate of 100 bpm with normal rhythm | sinus tachycardiac |
| 24 YO female just came home from vacay from NE and thinks she has Lymes disease. What is not Sx of this diz: | Enteric Fever |
| Supine hand flext to chest with SHOCK LIKE sensations down spine and feet. Car accident stiff neck and dec rom. Came in a few weeks later and pain aggragavted on neck flexion. | MS |
| WHEEZING RESPIRATION. DIFFUSE SIBILANT RALES. Chiro Mgt of patient abolished the wheezing respiration, but rales were still there! | Fluid in the bronchial tree |
| 57 YO Male SMOKER with WELLING ON RIGHT CALF. He was able to fully flex forward with no pain: | DVT |
| 46 YO male with LEG PARALYSIS which began as foot to leg to hip paralysis. He got VACCINATION FOR FLU two wks ago. What is the Dx? | Guillain Barre syndrome |
| Male with multiple bruises and hematomas. He reports that it takes only MINOR TRAUMA TO CAUSE THIS. What do you expect to find: | decreased platelets. |
| 24 year ld male with knee pain on Xray exam. Erosion on opposing surfaces of the tibia and femur's joint suraces. What Hx finding would indicate possible etiology: | Recent arthroscopic surgery |
| Small round, MOBILE, TENDER nodule in breast | Cyst |
| Not indicative of breast carcinoma | mobile tender mass |
| Sudden onset of Diplopia is indicative of: | Vascular disease |
| What is characterized by pain lasting 1-2 hours | Ulcer |
| Woman complains of discomfort, not pain. Legs feel rubberty and like she is falling down. Legas feel bandaged up. | Psychogenic disorder |
| Large, curcumscribed SILVER/SCALY patches over back and buttocks | Psoriasis |
| 65 YO Male Cold feet, bilat leg pain of insidious onset, While riding bike And immediately relieved by rest | Vascular claudication |
| 32 YO male complains of COLIICKY ABDOMINAL CRAMPING 3 wks ago was treated for ANXIETY Most likely cause... | Peristatic dysfunction |
| What is initial indication of bacterial pneumonia? | Fever |
| Stressors may caus subluxation | Chemical, mechanica. and mental |
| Fat guy, 54 YO, BP 160/95, 205 lbs and 5'7". Substernal 1 hour attacks relieved by NITROGLYCERINE. Episodes are caused by anxiety and exertion. 1.Whats useful to eval? 2.Procedure to perform? DX? | 1. CPK 2. electrocardiogram 3. MI |
| Xray: LUCENT OVAL SHAPED NIDUS distal TIBA. 8 YO boy with NOCTURNAL PAIN. RADIOLUCENT NIDUS w/ irregular wide sclerotic margins: | Osteoid Osteoma |
| Xray AP Lx and tomogram 16 YO female gymnast w/ LO=BP | Congenital absence of pars w/ stres hypertrophy of opposite pedicle. |
| Nerve best for Abduction of fingers against resistance | Ulnar |
| Atrophy/Weakness of small intrinsic muscles of hand. Lesion of what NR level? | T1 |
| Type of pain indicative of Causalgia? | BURNING |
| Pupillary reflex do to examin which CN? | II & III |
| Quads are paralyzed, what mm would be used instead for leg extension? | Sartorious |
| LBP radiating down postero-lateral leg. Dec. sensation w/ numbness on dorsum of foot, but with normal sensation on sole. what disc? | L4-L5 |
| Parkinson's disease will likely present with what physical finding? | Stopped posture Festination Gait Pill rolling Tremor Cogwheel rigidity |
| 30 FEMALE w/ Leg weakness + fasciculations | MS |
| Tumor occurs in patients older than 40+ | Multiple Myeloma |
| M/C age for idiopathic infantile scoliosis to begin | 2-4 |
| Tube angulation for an A-P oblique of the SI joint the affected side should be | Perpendicular to the film |
| PENDUCLATED lesion attached by a STALK to the metaphysis of long bone best describes: | Osteochondroma |
| Contraindication of MRI | Pacemaker |
| Radiographic study definitive of hyperparathyroidism | Hand series |
| Osteochondritis dessicans most commonly found in the .... | Medial femoral condyle (lateral portion) |
| Facet imbrication best seein on which view: | Lateral lumbar |
| "Hot spot" on bone scan suggests | INC blood and bone activity |
| 25 YO male stepped off curb and had pain at L4/L5 level. Xray shows decreased density @ L1 Trabeculated VERTICAL STRIATION | Hemangioma |
| Ulnar deviation XRAY visualizes which structure best? | Scaphoid (or navicular bone of the wrist) |
| Most appropriate question to ask when patient inquires about a lung ailment: | Do you have shortness of breath? |
| Calf pain after walking several hours. This information should be written as: | Chief Complaint |
| Insurance company approves care for a patient. Patient has beenseen for 2 months. Pas two weeks care has INC dramatically. What would the insurance company request for the doctor? | Patient progress notes |
| Young male comes in w/ LBP when he tried to lift a heavy box. What question do you NEED to as? | Where is the location of the pain? |
| During case history, MUSCULOSKELETAL PAIN What is most important question to ask? | Was there recent trauma? |
| 20 YO MALE, SLIGHT JANDICE, SLIGHT INC UNCONJUGATED BILIRUBIN. ASYMPTOMATIC and all other lab findings are normal: | Gilberts disease |
| Most diagnostic of EYE W/ HELIOTROP coloration: | Polymyositis |
| Condition needs to be referred: | Stye |
| Which following is NOT found on the eyelid | Pinguecula (the following are: xanthelasma, syte, chalazion) |
| RED BULGING DISC W/fuzzy, indistinct margins and red TRORTUOUS ARTERIES would suggest: | Papilledema |
| 18 YO M w/ painful bent reection which curves upwards due to THICKENING AND FIBROUS ADHESIONS of the fascia of anterior or DORSAL SURAFACE OF THE PENIS: | Peyronie's disease |
| Primary cause of EGOPHONY, BRONCHOPHONY, AND PECTOILOQUY: | Lobar pnemonia |
| Vascular obstruction of an extremity. What will you see? | Difference of BP b/w limbs |
| High risk for heart attack: | INC cholesterol levels |
| M/C Sx presenting with serous otitis media: | Hearing loss |
| Preggo in 3rd trimester w/ carpal tunnel syndrome. Which would you believe is the cause? | Edema due to fluid retention |
| Male with "GRAPE-LIKE" or "SAC OF WORMS" mass attached to balls. Does NOT transilluminate: | Varicocele |
| 45 YO Female w/ left side headaces of 2 wks lasting 1-2 HOURS W/ LACRIMATION OF LEFT EYE AND RHINITIS. Best Dx: | CLUSTER |
| 70 YO male with LBP. What studies should be performed? | Protein electrophoresis Bone marrow biopsy |
| PE finding expect to see in patient with CHRONIC UREMIA: | Yellowish skin |
| Woman with breast cancer. Most likely location it can be palpated: | Upper lateral quadrant |
| 19 YO with MOVEABLE TENDER mass of boob. With transillumination of mass was TRANSLUCENT. DX? | Cyst |
| 29 YO woman with Right adnexal mass 9 cm tender to touch. Pain only on right side with NO FEVER CBC is w/in NORMAL limits | Uterine Fibroid |
| ACUTE ONSET OF WHEEZING AND DYSPNEA. Most likely DDX. | Asthma + Pulmonary embolism |
| Most appropriate for initial eval of 28 YO FEMALE W/ LOWER UTI | Urine Nitrate |
| 36 YO Male Hard time urinating Palpable LARGE, HARD, PAINLESS, LUMPY PROSTATE. What is the condition? | Malignant prostatic carcinoma |
| NOT associated with iritis | DJD |
| 25 YO female with chest pain in T4-T5 STERNAL AREA esp when taking deep breath or coughing. Pain INC with A-P pressure. Exam and Labs are all normal. | Tietze's |
| Hx of angina pectoris w/ residual back pain with a "bout of angina" lasts hours and is not relieved when siting. What condition must be ruled out? | Myocardial Infarction |
| 60 YO male w/ 6 month Hx of angina. Pain is sharp stabbing pain in the Tx while CLENCHING FIST over sternum. pain is NOT relieved with rest. | Myocardial Infarction |
| TAN W/ abd discomfort, diarrhea and nausea. Chronic FATIGUE. BLUE BLACK SPOTS IN ORAL MUCOSA. BP IS 80/50 light headed from stand to seated position | Adrenocortical deficiency |
| YOUNG ADULT W/ SUDDEN ONSET CHEST PAIN + VIOLEN COUGHING. PAIN IS AT A SPECIFIC AREA IN THE CHEST. | Pneumothorax |
| 80 YO Female came in after falling. Legs were in External Rotation and shorter(no exray or lab work given) | Intra-articular femoral fracture |
| Where does COG run exactly through | Entire body |
| Weakness of which muscle causes WADDLING GAIT? | Gluteus medius |
| Strengthening VMO helps condromalacia patella by... | Reducing Q- Angle |
| Weakness of Abductor Pollices. What other mm must be checked that could cause weakness to this muscle? | Pronator Teres |
| 2 MONTH female asaymmetrical skin folds on an and post HIP. What ortho test to do? | Ortolani's |
| A series of tests to evaluate VBI. | George's test |
| Which joint has an internal menisucs | TMJ |
| Injury to medial meniscus is usually accompanied by injury to the ... | Medial meniscus |
| What joint is MUSCLE INTEGRITY considered most important? | Gleno-humeral |
| What do high school football players need to INC to reduced knee injuries LATE IN THE GAME? | Endurance |
| Primary elevator of scapulae | Traps |
| Primary external rotator of the shoulder | Infrapinatus |
| Burns bench test tells... | Malingering |
| Neurovascual compression by scalenus anticus will give postiive test | Adsons |
| Exercise to promote a normal lordosis in a patient with HYPOLORDOTIC spine? | Hamstring stretches |
| M/C seen in a patient with TOS | Bruit heard Superior to the clavicle |
| Doc trying to achieve WHAT? with patient lying pronce and alternately lifting each leg: | INC lordosis |
| Diet rec. of a person with DJD of weith bearing joint: | Ca and Mg Supplements |
| Element helps liver promote glucose tolerance factor | Chromium |
| 2nd trimester of preggo taking 44g of protein/d. What is the rec. daily amt for non preggo's? | stay same utnil last trimester, then inc by 30g/d |
| Restriction of terminal ileum may result in deficiency of what? | B12 |
| Man w/ muscle weakness in hands/arms. Confessed to alcholism and exam shows tortuous radial artery and slightly enlarged heart. no lab finding. What B vitamin is recommend? | Thiamine |
| MACROcytic / Normochromic anemia = ________ | Pernicious anemia |
| Conditions with Normal ESR | Angina pectoris (NOT- MI, PID, MM) |
| INC HLA-B27 | AS |
| Serum chem elevated w/ ongoing inflammation? | ESR |
| Hyperflexion/extension injury 5 DAYS AGO, tx w/ ice and rest. What is next IMMEDIATE TX? | adjust fixations, avoid stretching and strenthenting |
| What part of the spine do you NOT contact the TP | Lumbar |
| Adjustment occurs in what area of motion | Paraphysiological |
| Modality best for migraine headache: | Cold pack |
| 62 YO male shoveling snow, BP 170/90. Best advice to give him... | Pust snow in small amounts rather than lifting it |
| Cast on a recent fracture presents with LBP. During PE he has decreased sensation on the dorsum of his foot: | Refer back to the doctor that gavce him the cast |
| Best advice to a patient who suffers from angina pecotris: | STOP SMOKING |
| What do you do when you get a patient under 18 years of age? | parental signature |
| ACA journal definition of using modalities in chirorpactic | allow body to return to a more normal state of health |
| Lateral epicondylitis TX | fricion rub and pulsed ultrasound |
| Best Tx for person with chronic costoclavicular syndrome | exercises to strengthen the trap |
| Contraindicates use of flextion distraction traction in the lumbar spine? | Grade 3 sprain |
| Condition best helped with manipulation of the knee: | popliteal tenosynovitis |
| Proper care of Tx for lordotic NR irritation and facet imbrication | Strengthen and stretch the lumbar muscles |
| 7 YO male wi/ chest pain and productive cough. Chest films reveal 2.5 cm opacity on the right with AIR BRONCHOGRAM SIGN. PE reveals dull sound on percussion: | Pneumonia |
| Black and white on Xray called: | Film contrast |
| Man has no fluid arm motion. Arm stays at his side when walking. RESTING TREMORS AND MASK LIKE FACE. | Extrapyramidal |
| Lateral cervial film of patient with hyperflextion/ hyperextention injury reveals a retropharyngeal interval of 29 mm. This suggests a: | hematoma |
| Supplement recommend for patient who had a parathyroid gland removal: | Calcium |
| Taping volar carpal ligament in disto of MEDIAN NERVE to reproduce pain is known as: | Tinel's sign |
| Primary PROTRACTOR of scapula is innervated by what roots? | C5-C7 |
| 37 YO female with arthralgia, tender swollen hand joints and a mild RASH ON THE MALAR ASPECT OF THE FACE. CBC was normal. UA shows +2 Proteinuria ESR was 35mm/hr | SLE |
| Time perioud for Milwaukee brace | 23 hours/ day |
| Normal WBC count | 5-10K |
| Dec. hematorcrit best seeen in what conditions: | pregnancy |
| Normal lab findings: | Dupuytrens Contracture (NOT: marie strumpell disease, reiters or dermatomyositis) |
| Sound occuring during expiration when air is forced through contricted bronchiole: | Wheezing |
| Use of small focal spot: | INC resolution |
| 22 YO patient w/ SHORT BREATH. m/c cause: | Anxiety |
| Sputum smelling like ROTTEN EGGS | Lung abscess |
| What is found in rheumatic fever? | Chorea |
| ATH inury to knee. Best way to visualize: | MRI |
| mineral given 1:1 ration with calcium to prevent hypcalcemia: | Phosphorus |
| 25 YO female 7 m onths pregnant w/ signs of weakness, pallor, sore toungue and intermittent diarrhea. She has Macrocytic anemia. What dietary advice would you give: | Animal proteins and green vegetables. |
| Groups cause the most common food allergies: | milk, eggs, wheat and corn |
| 64 YO male with paroxysmal nocturnal dyspnea 2-3 years. PE show temp of 98.8 90 bpm and bp 179/105. CRACKLES WERE HEARD AT BOTH LUNG BASES. 2/4 rumbling apical diastolic murmur with opening snap. 1. What is Cause 2. Do next? 3. Dx | 1.Pulmonary edema 2. AP, LAT Tx films 3. Mitral stenosis |
| 50 YO patient complain of INC DIFFICULTY DRIVING AT NIGHT. Papular lesions on the posterior aspects of his upper arm. What deficiency below would apply? | Vitamin A |
| Produces elevated serum calcium | hypervitaminosis D |
| Why parents should avoid giving kids aspirin with viral infections | Reyes |
| Physiological effect of heat would make heat a poor choice in Tx patient with acute injury and tissue edema: | local histamine release |
| Hearing loss. Webers test lateralizes to right ear. What does this suggest? | Otosclerosis in right ear |
| Dull achy pain originating above GREATHER TROCHANTER AND EXTENDS DOWN THE LATERAL THIGH to the knee and anterio-lateral leg. Walking up and down stairs aggravates it. Plumbline shows pelvis is shifted away from the side of pain. What therapy is best: | Transverse friction massage to ITB |
| What age is scoliosis mos pregressive | 12-15 |
| CIRCUMFERENTIAL tear w/in disc in early degeneration may due to what motion | Rotation |
| Athlete presents w/ knee pain on active knee extension. Unable to fully extend knee and there is NO ROTATION on femur on tibia. | Medial menisucus |
| Doc says "what brings you in here today"... he is trying to elicit | Chief complaint |
| Morning Stivfness in joints which improved as day went on. + HBLA-27 | AS |
| Should lesion with slight hollowness over joint with tight firm stringy deltoid | Anterior inferior humeral dislocation |
| Leg length showed a 1" difference, but measurement from ASI S to medial malleolus was equal: | Pelvic obiquity |
| Muscle action best used to test L4 | Inversion |
| What you need to know in case of ankle sprain for INITIAL TX | grade of serverity |
| Bronchospasms result from a reflex subluxation of the ____ vertebrae | T3-4 |
| Most important finding to suggest successful resolution prior to releasing an athlete back to play football after a pinch stretch NEURAPRAXIA of the brachial plexus | Inc strength of extremity |
| 60 YO w/ generalized weakness, light head, rapid pulse and diarrhea. Tingling on fingertips, difficulty knitting and pickup up coins. CBC shows MCV of 10 fl, DEC leukocytes, platelets and erythrocytes and sed rate is decreased. What should be done next | Serum B12 Assay |
| What sequelae of an acute whiplash injury contraindicates use of CONTINUOUS cervical traction? | Muscle spasm |
| 63 YO female with pain in multiple joints. Chronic eye irritation and DRY MOUTH AND EYES. Sometimes when touches cold stuff, she will get blacnching of the skin. 2 yrs ago DX w/ Raynauds syndrome. based on this Hx, which syndrome is most likey? | Sjogren's |
| Man long hx of diffuce/ achy pain bilat on the back and down his knee. PALPATION OF L4-5 FACET very tender. Laseques test produces leg pain. Spinus percussion tender at L4-5 and L5-S1 interspaces. His pain is likely: | Sclerotogenous |
| M/C reason for using IFC on LBP patient | relief of pain |
| 50 YO male dull achy pain. Auscultation reveals SYSTOLIC BRUIT OVER ABDOMINAL AORTA. Diffuse spondylosis of Lx spoine on xray. All ortho and neuro are negative. | Aortic Aneursm |
| 67 YO male SMOKER faints a lot. Each time before fainting he gets muscles weakness in the arm. And afterwards he feels irritable and has to urinate on himself. What do you do? | EEG |
| Male with HIGH CHOLESTEROL. He tried a new modified diet but no change in his blood. He has TRANSIETN, PRICKLY HOT SENSATION OF THE SKIN of his arms, legs and face. What is this from? | Excess intake of dietary niacin |
| 40 YO male w/ knee pain. KNEE LOCKS up when sits in theater too long. Why? | Chondromalacia patella |
| Initial Tx for adhesive capulitis? | Prone cirumduction exercises |
| Male patients comoplains of whiplash. He was in an auto accident 2 days ago. DRIED UP BLOOD IN HIS RIGHT EAR leans to his left and POSITIVE ROMBERGS TEST w/ eyes closed. Neck and low back pain w/ mm spasms and sublux at C1,2 and L5. Best MGT: | make plans to immediately take patient to the emergency room |
| Most sensitive way of detecting early eschemic necrosis of the femoral capital epiphysis? | radionuclide bone scan |
| Dull Tx pain. 2 days earlier, patient had flu like Sx's, vomit, clammy skin and racking pulse along w/ deep chest pain and a "pressure" sensation | MI |
| Left handed carpenter w/ ant. humerus pain radiates down lateral arm. INC pain on movt and unable to work. 1. What movt is most painful? 2. How is this pain dff. from visceral problem? 3. What is DX? | 1. ABDuction 2. Pain worse w/ movt 3. Bursitis |
| If u find calcium pyrophosphate crystals what do u expect? | Chondrocalcinosis |
| 28 YO male w/ POLYURIA AND POLYDYPSIA for last 3 wks. Lost 10 lbs w/o trying... | Diabetes |
| SOLITARY pulmonary parenchymal OPACITY in chest XRAY: | Infiltrate |
| Contraindication of grade 2 spondylolisthesis | Extenstion |
| Grade 1 spondylolisthesis, which type of exercises would be good: | Abdominal |
| Ortho test for testing weak gluteus medius | Trandelenburg |
| 30 female w/ dull LBP. Secretary whose PAIN HURTS AT THE END OF THE WORKING DAY. lab, ortho tests are normal. What do you recommend? | Change her postural habits |
| Method used to measure central canal stenosis | Eisentein's |
| Malingering test in LOWER LIMB PARALYSIS: | HOOVERS |
| Idiopathic scoliosis MC in what age? | 10-15 |
| Vitamin excess produces FLUSHING AND TINGLING OF THE SKIN: | Niacin |
| MC method used to grade a spondylolisthesis? | Meyerdings |
| Nerve lesion giving RIGHT lateral deviation of tongue: | RIGHT hypoglossal |
| CLAW HAND | ULNAR (DR. CU MA) |
| Lesion w/ NIDUS | OO (osteoid osteoma) |
| elbow pain after FOOSH. XRAY shows (+) POSTERIOR FAT PAD SIGN. Elbow is intact. Whaqt would be initial mgt? | Immobilize elbow and refer to orthopedist |
| When together w/ anemia this would indicate presence of MM | Uremia |
| Differentiate iritis from conjunctivitis | turn lip upward to seed extent of redness |
| Supplement helps to INC immune system | ZINC |
| Substernal pain, CPK AND LDH IS NORMAL. INC SGOT AND ALK PHOSPHATASE. | Acute cholecystitis |
| Angle of Cx traction will most influence C0-C2 complex | 5-10 degrees |
| Sx dominant in VENTRAL NR Lesion: | flaccidity of muscle supplied by nerve |
| Child on MACROBIOTIC DIET w/ swollen tender "mushy" gums. What supplement should u give him? | Vitamin C |
| Polycythemia Vera will show INC in what? | hematorcit |
| "my back hurts" corresponds to the | Cheif Complaint |
| Schmorls and Junghans concept of joint physiology, contiguous spinal compnents are referred to as | Vertebral motor unit |
| best method for pericardial effusion: | echocardiogram |
| Dx procedure contraindicated for patient with foreign metallic object in the eye: | MRI |
| Enlarged supraclavicular lymph node on left. What area would u look for the pathology: | upper abdomen |
| Diz process MC etio of pathologic spondylolysis: | METS carcinoma |
| 60 YO male w/ early satiety, ingestion and weight loss. PE shows VIRCHOWS NODE in left supraclavicular area and a POZ guiac for occuilt blood: | Stomach cancer |
| R SI and little toe pain for 3 months. There is NO achilles and Quad DTR ON R + WEAKNESS ON R hamstring and glut max. BACK PAIN gone BUT STILL HAS LEG PAIN. Wakes every 4 AM w/ leg pain. ANAL SPHINCTER FLACCID, mm fasciculations. + DEJERINE. | Free fragment from L5-S1 disk necessitating CAT scan, MRI and neuro consultation |
| Most important recommendation to patient w/ LBP of POSTURAL origin | Maintain lordosis when sitting and bending forward |
| Sequela will cause mm cramping due to excess salt loss | Crohn's |
| Advantage of using intensify screens | DEC exposure time |
| Lesion w/ hives | wheal |
| cells that reproduce least when exposed to radiation | lymphocytes |
| Cx spine PAIN RADIATION to R arm, forearm, hand and fingers. Numbness in hight hand and weak grip strength. Past Hx: 2 MILD WHIPLASHES. Adson neg. What exam should be most focused? | DTR'S |
| 45 YO male w/ Tx PAIN RADIATING INTO R GROIN. Position change and movt appear to have no effect. DX: | Kidney stone |
| Normal ADI in adult | 1-3 mm |
| UC sublux cause face and head pain... HOW? | Spinal nucleus of trigeminal nn is affected by noxious afferent stimuli of C1-3 |
| Myxedema shows what Sx's | Intolerance |
| Most accurate procudre for adjusting base posterior? | Line of correction is S-I |
| What syndrome would chiro manipulation offer POOREST prognosis? | Canal Stenosis |
| You will NOT find INC ESR w/: | OA |
| retrosternal pain and DYSPHAGIA. M/C cause: | Esophagitis |
| 31 YO female w/ hand tremors and speech w/ SLOW ENUNCIATION AND HISITNACY at start of words. | Scanning speech |
| 32 YO male w/ left L-Sx pain. Pain INC w/ bending and rotation. A-P radiograph shows problem. | Facet tropism |
| Man gets dizzy and gets HA after exercising vigorously. father died of a stroke: | Berry aneurysm |
| Mosts useful in finding out effect of iron replacement therapy in IDA | Iron binding protein |
| what level is the most significant anomaly appear? | C1-C2 |
| When adusting Cx spine, use caution cuz of what anomaly that has a relationship to the vertebral artery: | Posterior ponticulous |
| You have to take lateral Cx xray to check integrity of the transverse ligament for what patient? | Downs Syndrome |
| Young 6month preggo lady with CRACKING AT CORNERS OF HER LIPS and an oily dermatitis of her face. What factor is missing in her diet. | Riboflavin |
| Modality gives you short and long term analgesia, DEEP THERMALeffect, DEC fibrosis and INC absorption with a powerful MICROMASSAGE? | Ultrasound |
| M/C definite Sx with MM | Bone Pain |
| 30 YO male just started working out, RIDING STATIONARY BIKE FOR LAST 3 DAYS. Compolains of post thigh pain. Lasegues test produes pain at 40 degrees, but ankle flexion does not. What do you suspect? | Hamstring Strain |
| Atrophy of intrinsic muscles of palmar surface on left hand. "CLAW LIKE" appearance | ULNAR neuropathy |
| CRACKED LIPS, sparse coarse hair, dry rough skin. HA and weakness. ACNE condition. Nutritional cause of his Sx's: | Hypervitaminosis A |
| NEURITIC PAIN indicates what pathophysiological process | INC impulse transmission on SOMATIC AFFERENT FIBERS |
| Whiplash Sx's. Best initial Tx: | Cryotherapy and neck brace for 2 days |
| Nausea/vomit/fever and RUQ colicky pain. PE shows ICTERUS of the eye and P w/ inspiration to the point where she couldn't breath. 1.WHAT SIGN IS SHOW WITH DEEP PALPATION OF THE RUQ? 2. Lab? 3. DX? 4. Due to VISERO-SOMATIC REFLEX, pain be referred | 1. Murphys 2. Bilirubin 3. Acute Cholethiasis 4. Right Scapula |
| LBP, sciatica, marked STIFFNESS W/ TRUNK MOVT. | AS |
| 14 YO child presents 2 days after having been KICKED IN THE SHIN playin soccer. SKIN IS TAUGHT AND SHINY. | Anterior Compartment syndrome |
| HA changing intensities. 6 months ago she had "common headaches" START BACK OF NECK AND HEAD then TURNED INTO CONSTRICTING BAND OF PAIN OVER HER HEAD AND AFFECT HER EYES. Presently HA are worse with light sensitivity and vomit. HA 6 months ago and L8R: | 6 months ago= Muscle contraction HA Past 6 months- Migraine HA |
| HA w: INC ESR | Temporal arteritis |
| Posture w/ MOST amt of pressure on L3-4 disc/ | Sitting bending forward |
| 24 YO woman w/ whiplash NOT w/in 10 day but also says she is NOT preggo. How do you manage case? | light cervical manipulation and Xray at end of the 10 day rule |
| OA DIPS | Heberden's nodes |
| 55 YO may w/ dysphagia and tissue calcification OPLL | DISH |
| MC age for "pulled elbow syndrome | 2-4 |
| Cubital tunnel syndrome... Tell patient to avoid: | Elbow flexion |
| Pronator Teres syndrome adjunctive therapy includes putting elbow in _____ and forearm in ______ | flexion; supination |
| Tarsal tunnel syndrome should avoid: | Jogging |
| Constricted, unreactive and unequal pupils which did not react to painful stimulus | Horner's Syndrome |
| Type of Fx most unstable | Oblique |
| Lowest possible loss of bone density needed to detect osteoporosis? | 30% |
| To prevent upper incisors being superimposed over DENS on APOM? | move central ray 5 degrees caudal |
| Imaging method best to view AAA | US |
| Right middle lobe syndrome ass. w/: | chronic pneumonia |
| Best way to view mediastinal mass | CT |
| Radiologic objective of supinating forearm on AP XRAY: | so radius and ulna do not superimpose |
| Adult ADI | 1-3 mm |
| 14x36 cassette, the film distance to be used consistenly is: | 60-72" |
| Which cell LEAST likely be affected by radiation? | Neuron |
| Doc extends and rotates patient head for 15-40s and patient gets dizzy and nauseated. What is this test? | Maigne's |
| Problem that produces NEG Patricks | Chronic SI strain |
| Mechanism for an INC in the INTRATHECAL pressure: | Valsalva |
| INC TSH levels seen w/ .... | HYPOthyroidism |
| Condition cryotherapy is contraindicated? | Shock |
| Tx carpal tunnel w/ US under water what is correct Tx? | 1.5-2.0 cubic cm |
| Modalities used for bactericidal effects/ | cold quartz UV |
| When using US and HHV in combo what must you make sure to do? | Put dispersal pad on patient |
| Desired effect of Infrared Tx/ | pleasent tingling sensation in the extremeties |
| UV irradiation tx is MOST effective in what condition? | Psoriasis |
| Webers test, COMPLETE OCCLUSION OF RIGHT EXTERNAL AUDITORY MEATIUS? | Webers lateralizes to the right |
| Episodes of dizziness and also w/ CHANGE OF POSITION from lying to sit or standing: | BPV |
| Exam produces a FLOW OF ENDOLYMPH w/ convection into the semicircular canal | Cold Caloric irrigationtest |
| Tinnitus and vertigo where is the problem? | Inner Ear |
| GREATEST PAIN UPON INITIAL ONSET | Dissecting aneurysm |
| 60 YO patient w/ Hx of Rhumatic Fever and bouts of strep throat as a child. M/C sequela: | Mitral Valve disease |
| 35 YO male Unilateral HA INC by ETOH Lacrimation and rhinorrhea | Cluster |
| Finding commonly seen with cirrhosis of liver | Spider angioma |
| surgeon general say this substance most serious illness and death in country | Tobacco |
| Indicative of C6 NR compression | diminished brachoradialis reflex |
| Test AC joint play in what direction? | A-P glide |
| transporting unconscious AT takes 4 people to carrhim | one to stabilize neck and keep it from moving |
| Ass w/ psoriasis | SCALES |
| DEC pigmentation of skin | Vitiligo |
| Red Fiery lesions on upper ext's and trunk. Lesions are 1.5cm w/ SPIDER EXTENSIONS | LIVER CIRRHOSIS |
| 1 CM raised PEARLY GRAY nodule on cheek showing occasional telangiectasis | Basal Cell Carcinoma |
| Enlarged left supraclavicular lymph node. | MRI |
| Least indicative of child abuse? | angry interface b/w adult and child |
| Lethal condition | hematogenous osteomyelitis |
| 2 kinds of Bracing for L-Sx region to limit flexion | 1. Chair Back Brace 2. Knights |
| POST Partum woman, what would you do to strengthen PELVIC muscles? | KEGAL |
| Swollen red mass at 5th COSTOCHONDRAL jxn w/ no trauma. | Tietze's |
| Muscle movt or contrxn observable with a person almost alseep | Mycoclonus |
| Dorsifexion of big toe causing INC in sciatic pain down loeg is what sign? | Sicard's |
| Muscle responsible for maintaining a leveled pelvis when stending on one foot? | ABDuctors |
| Technique emphasizing adjusting on the convexity of a scoliotic curve | Gonstead |
| Hypotension, intolerance to cold and a moon face. What system is involved? | Endocrine |
| Greatest risk factor for coronary heart disease/ | INC triglycerides |
| 60 YO female w/: - Resting tremors - Slow movements - Cogwheel Ridgidity on passive rom What is DX? | Paralysis agitans AKA PARKINSONS |
| COLICKY ABD pain after eating FATTY/FRIED food. Pain will be referred to what area? | Right Scapular tip |
| Patient being treated for mild goiter. What foods would you have them AVOID? | Broccoli, cabbage and soybeans |
| Nutritional Supplement for THYROID problem? | Tyrosine and Iodine |
| 30 YO boxer in a fight 3 days ago. Mid Tx and right shoulder pain. Least likely? | stomach disorder |
| Syncome on exertion. What is most useful in R/O idiopathic hypertonic sub aortic stenosis? | Echocardiogram |
| 60 to male w/ chest and mid Tx pain, cyanosis of lips and oral mucosa and clubbing of fingers. Bilat hypertrophy of SCM. What system is involved/ | Respiratory |
| 30 YO computer programmer complain of aches and tingling in heands and arms after typing and holding up arms above shoulder level. Pain is produced by holding her arm in abduction and external rotation. What is the site of neurological compression? | Beneath pec minor muscle |
| M/c cause of left ventricular hypertrophy | systemic HTN |
| Contraindicated for 3rd trimester of pregnancy? | standing for long periods of time |
| In lateral flexion of spine, motion would be in the _____ and around the ______ axis. | Frontal; Horizontal |
| Post- lateral L4-5 disc protrusion using flexion distraction pressure is applied to what structure? | L4 spinous |
| Vertical innominate angle is INC due to the INC of muscle strength of what mm group? | Quads |
| Designation of spatial orientation of one vertebra in relation to the adjacent segments is known as: | static listing |
| EXTENSTION INJURY of a rear end collision will strain what? | Scalenes and SCM |
| 4 YO boy, sore throat and fever. Swollen lymph nodes and tip of spleen is palpable. Monospot is negative. What other test should be done/ | Heterophile |
| disc protursion affecting extensor hallucis longus results in what? | Inability to walk on heels |
| Spontaneous MUSCLE SPASMS w/ WRY NECK deformity | Sposmodic Torticollis |
| Sx w/ ventral nerve root lesion | Flaccid paralysis of muscles |
| Absence of lifght reflex found with: | Structural brain lesion |
| 65 YO male w/ flu like Sx's and constant headache been on for 6 wks. Loss of vision in left eye for 15 s. Pain on jaw during chewing. What is Dx? | Temporal arteritis |
| Knee injury. Clicking during extension From flexed position with foot in EXT. ROT. What is sight of injury? | Medial Meniscus. |
| 83 YO woman severe LLQ pain, LBP nausea and vomitting. Abdomien is distended but compressible with bowels sounds. KUB shows prox. dilation of colon (asc, des, and trans). What is most approporiate MGT? | Colonoscopy |
| LBP . What warrants an oblique xray of SI joint/ | LBP of insidious onset with DEC lung excursion of a young male. |
| Finding would be Dx for INFLAMMATION? | INC ESR |
| HIGHEST INC IN WBC COUNT | CHRONBIC MYELOGENOUS LEUKEMIA |
| DEC URINE SPECIFIC GRAVITY | VIRAL |
| 12 YO male w/ hematuria and INC RBC CASTS. What should be the testing? | ASO Titre |
| 50 YO female w/ gen. osteopenia. Blood work indicates normocytic anemia and INC ESR. 1.What is the next test? 2. TOTAL SERUM PROTEIN found in? | 1. Serum Immunoelectrophoresis 2. MM |
| 45 YO male w/ Hx of MITRAL STENOSIS. Now has a temp of 104. HEMORRHAGES OF SKIN AND RETINA. WHAT TEST SHOULD BE TAKEN? | ASO TITRE |
| Flank pain. paces floor TRYING TO FIND A COMFORTABLE POSITION to relieve pain. Pain is sharp/stabbing in waves or paroxysms. 1. Initial DX? 2. Lab test? 3. Lab findings? 4. incidental findings? | 1. Nephrolithiasis 2. UA 3. pH-7, few RBC's and WBC and trace casts 4. urgency and pain w/ urination |
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