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NBCE part 2/3


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"
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
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)
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
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
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
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
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
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
Created by: tsim
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