OCS - Medbridge practice exam 2 | 75 Questions with Answers 2023, Exams of Company Secretarial Practice

Download OCS - Medbridge practice exam 2 | 75 Questions with Answers 2023 and more Exams Company Secretarial Practice in PDF only on Docsity! OCS - Medbridge practice exam 2 | 75 Questions with Answers 2023 Sutlive CPR for Dx of Hip OA in individuals with unilateral hip pain - ✓✓✓(1) self- reported squatting as an aggravating factor (2) active hip flexion causing lateral hip pain (3) scour test with adduction causing lateral hip or groin pain (4) active hip extension causing pain (5) passive internal rotation of less than or equal to 25° Renal pain referral - ✓✓✓- pelvis, low back, AND SHOULDER per wiki: "Kehr's sign is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. Kehr's sign in the left shoulder is considered a classic symptom of a ruptured spleen.[1] May result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ruptured ectopic pregnancy." ankylosing spondylitis risk factor - ✓✓✓- Crohn's disease and IBS are high Hill-Sachs lesion - ✓✓✓- A Hill-Sachs lesion is a compression fracture or depression defect on the posterior humerus that can occur when the humeral head impacts the inferior rim of the glenoid during a shoulder dislocation. Intervention to reduce impact of bone mineral density loss - ✓✓✓There is moderate evidence to suggest that high intensity aerobic exercise may be the most appropriate intervention to either reduce the loss or reverse the loss of bone mineral density. (Dutton 2008) Which of the following is most helpful in the diagnosis of cauda equina due to its high sensitivity? - ✓✓✓Urinary dysfunction is common in those who have cauda equina, but urinary retention is more common than urinary incontinence and has a 90% sensitivity. (Small 2005) Non-msk generator for lower abdomen, middle lumbar spine, and buttock region sx? - ✓✓✓Individuals who have involvement of the large intestine will exhibit most of their symptoms in the buttock, middle lumbar spine and the lower abdomen, with the symptoms located in the region of T11-L1. (Goodman and Snyder 2013) Lower GI pathology - ✓✓✓Yes: - bloody diarrhea - central lbp - fecal incontinence - melena No: - Upper thigh pain is more closely related to reproductive or urinary tract pathologies than lower GI pathologies. (Goodman and Snyder 2013) What is the MCID for the Oswestry Disability Index for patients with chronic low back pain? - ✓✓✓Ten points or 20% is the MCID reported in the literature for patients with chronic low back pain. (Davidson 2002) S1 nerve root - ✓✓✓Individuals with nerve root involvement of S1 will often have difficulty with plantarflexion and great toe movement, as well as an inability to walk on their toes. In this case, the patient's atrophy of the gastroc/soleus also pointed to an S1 issue. (Cleland and Koppenhaver 2011) A physical therapist is performing an examination/evaluation on a patient with low back pain that radiates to the posterior thigh. During the active range of motion assessment, the patient has a replication of symptoms during lumbar flexion. What should the physical therapist's next step be? - ✓✓✓repeated motion assessment is an appropriate next step for an individual who exhibits symptoms with range of motion. (Magee 2014) Which special test is most helpful in determining if lumbar mechanical traction is an appropriate intervention? - ✓✓✓Crossed straight leg raise test Reason: Fritz et al discussed a subgroup of patients who were most likely to benefit from mechanical lumbar traction. In this subgroup were patients who had a positive crossed straight leg raise test, so utilizing this test is suitable in determining if traction is appropriate. (Fritz 2007) Which clinical findings support lumbar mechanical traction is an appropriate intervention? - ✓✓✓peripheralization in both directions (ls flexion and extension) and neurological findings mechanical lumbar traction: what parameters are most appropriate? - ✓✓✓40-60% of body weight for a maximum of 12 minutes Reason: These were the exact parameters prescribed by Fritz et al in their study on the traction subgroup of the treatment based classification. (Fritz 2007) What therapeutic exercise would be most beneficial after using mechanical traction in a prone position? - ✓✓✓Prone press-ups Reason: A study by Fritz et al determined that prone lying for at least two minutes, followed by prone press-ups before weight bearing, was most beneficial for complementing the prone traction. (Fritz 2007) Femoral nerve innervation - ✓✓✓The pectineus, along with the quadriceps, iliacus, sartorius and articularis genus, is innervated by the femoral nerve. (Cleland and Koppenhaver 2011) PS: obturator nerve innervates gracilis and obturator externus, and Transverse abdominis is nnervated by the iliohypogastric and ilioinguinal nerves. activity is most likely to be limited in the long term after a posterior cruciate ligament injury - ✓✓✓Reason: In those who had posterior cruciate ligament tears, high speed running was the activity most affected in the long term as reported by Logerstedt et al in the APTA's clinical practice guidelines on knee ligament sprains. (Logerstedt 2 2010) ruling in a posterior cruciate ligament tear - ✓✓✓Reason: The posterior drawer test has a specificity of 99% as discussed by Logerstedt et al in the clinical practice guidelines for ligament sprains from the orthopaedic section of the APTA. However, the posterior sag sign has a specificity of 100%. What is the percentage of individuals who have a rotator cuff lesion, but are asymptomatic? - ✓✓✓67% Reason: Two thirds of individuals with small rotator cuff tears are asymptomatic per Fermont et al. (Fermont 2014) If a patient had which of the following, what would be helpful in ruling in adhesive capsulitis? - ✓✓✓(x)History of shoulder dislocation (x)Patient's age is 72 years Reproduction of symptoms with (o) end range glenohumeral motions Reason: With passive range of motion, patients with adhesive capsulitis regularly show end range limitations and reproduction of symptoms, depending on which stage they are in of the pathology (Kelley 2013). (x)Weakness of the supraspinatus, infraspinatus, and biceps brachii combination of tests would be most appropriate in determining if a SLAP lesion is present? - ✓✓✓Active compression test and Jobe relocation test Reason: Powell et al found that a combination of the active compression test and the Jobe relocation test or a second combination of the Jobe relocation test and the anterior apprehension maneuver was most helpful in ruling in a SLAP lesion. (Powell 2008) What intervention is often deferred in patients who are highly irritable? - ✓✓✓euromuscular re-education exercises Reason: Neuromuscular re-education is often only incorporated in those who exhibit moderate and low irritability, as those who are highly irritable may have significant difficulty with the types of interventions used for neuromuscular re-education. It is better to wait until a patient is less irritable before integrating this into the plan of care (Kelley 2013). pain as 5/10 on average throughout the day...what level of irritability does this patient fall into? - ✓✓✓Moderate irritability Reason: This patient's pain of 5/10 falls into the average level of moderate pain (4-6/10) as discussed by Kelley et al, so this patient would be moderately irritable. (Kelley 2009 and Kelley 2013) In the pathogenesis of knee OA, which of the following occurs last? - ✓✓✓Development of osteophytes Reason: As discussed by Hackenbroch, sclerosis, subchondral cysts and osteophyte development occurs right before misalignment or loss of congruency in the joint, which is the last step in progressive osteoarthritis. (Hackenbroch 2002) irreversible matrix degradation > synovitis > cartilage loss > development of osteophytes Poor prognosticating factor after knee arthroscopy - ✓✓✓Spahn et al studied the factors that led to poor outcomes after arthroscopy for medial compartment osteoarthritis of the knee, and if an individual had a history of knee osteoarthritis for greater than 24 months, they were more likely to have poorer outcomes. (Spahn 2006) Knee OA prevalence - ✓✓✓African American women have knee osteoarthritis more often than white women. (Anderson 1998) Modalities for knee pain - ✓✓✓moderate evidence that: - acupuncture, TENS and low level laser therapy will reduce pain from evidence provided in a systematic review by Jamtvedt et al. (Jamtvedt 2007) (CPR) for pt with knee pain and evidence of OA with favorable short-term response to hip mobilizations - ✓✓✓(1) hip or groin pain or paresthesia (2) anterior thigh pain (3) passive knee flexion less than 122 degrees (4) passive hip medial (internal) rotation less than 17 degrees (5) knee pain with hip distraction Hip mobilizations used: caudal glide, AP glide, PA glide, PA glide with flexion, abduction, and lateral rotation When found on imaging is associated with pain and stiffness - ✓✓✓(o) large joint effusion - osteophyte associated with pain but not stiffness - subchondral cyst not associated with clinical sx - sublux of meniscus not associated with clinical sx Outcome measure closely associated with the NDI - ✓✓✓SF-36 (physical and mental components) How can patient still be positive for the upper limb tension test even though they have no reproduction of symptoms - ✓✓✓A patient does not necessarily need to exhibit a reproduction of symptoms. Instead, tension that creates a side to side difference of greater than 10 degrees of elbow extension or wrist extension is also considered a positive finding. (Childs 2008) Supervised PT vs HEP for knee OA (Deyle) - ✓✓✓- after one month, those in the supervised physical therapy group had a greater improvement in WOMAC scores - patients in a supervised physical therapy group and patients in a home exercise program group had equal maintenance of improvements - those who received supervised physical therapy were less likely to be taking medication at one year after intervention Cleland CPR for use of thoracic spine manipulation for neck pain - ✓✓✓▪ Symptoms <30 d ▪ No symptoms distal to the shoulder ▪ Looking up does not aggravate symptoms ▪ FABQPA score <12 ▪ Diminished upper thoracic spine kyphosis ▪ Cervical extension ROM <30° Tongue on roof of mouth deactivates - ✓✓✓Activation of the platysma and the hyoid muscles will be decreased if the patient places their tongue on the roof of their mouth. (Childs 2008 and Netter 2014) neck pain with radiating pain should be treated with - ✓✓✓- Mechanical Intermittent Traction Reason: For patients with chronic neck pain and radiating pain, clinicians should provide mechanical intermittent traction combined with other interventions based on the 2017 Neck Pain CPG. - PS on the 2008 neck pain clinical practice guidelines, upper quarter and nerve mobilization procedures have moderate evidence; however this has been updated in the 2017 guidelines and are no longer recommended for patients with neck pain with radiating pain. neck pain with radiating pain, would not expect? - ✓✓✓Neck pain that radiates during cervical flexion Reason: It is highly unlikely to see neck pain that radiates during cervical flexion. Instead, it would typically radiate during cervical extension, side bending and rotation (Childs 2008). which TFCC ligament should be taught in supination? - ✓✓✓palmar radiolunar ligament (dorsal should be taut in pronation) Long thoracic nerve injury - ✓✓✓cardinal sign is winging of the scapula/serratus weakness Spinal accessory n injury - ✓✓✓- trapezius and SCM are very weak - may present with; depressed shoulder girdle, scapular winging during shoulder abduction, decreased shoulder flexion and abduction ROM - commonly seen with blunt trauma injuries Accessory/secondary muscles for radial deviation - ✓✓✓APL, EPL, EPB