Pediatrics
A child begins demonstrating independent sitting, midline play, and push‑up in prone. Based on your developmental milestone chart, this child is MOST likely around:
A. 3 months B. 6 months C. 9 months D. 12 months
Which primitive reflex is described as: “Head turn → jaw side extends, skull side flexes,” with an onset at 0–2 months and integration at 4–6 months?
A. Moro B. ATNR C. STNR D. TLR
B — 6 months
Which heart sound is described in your notes as a ventricular gallop, occurring after S2, and often associated with heart failure (though normal in athletes)?
A. S1 B. S2 C. S3 D. S4
C — S3
According to your stress‑strain curve, what occurs at the yield point of tissue loading?
A. Tissue returns fully to original length
B. Tissue begins permanent deformation
C. Tissue fails completely
D. Tissue demonstrates increased elasticity
B — Tissue begins permanent deformation
A patient presents with contralateral loss of pain and temperature sensation and ipsilateral loss of motor function, proprioception, and vibration below the lesion. Based on your notes, which syndrome BEST explains this presentation?
A. Wallenberg’s syndrome B. Brown‑Sequard syndrome C. Locked‑In syndrome D. Horner’s syndrome
B — Brown‑Sequard syndrome
which type of validity asks: “Did the intervention cause the outcome?”
A. Internal validity
B. External validity
C. Construct validity
D. Content validity
A — Internal validity
A 5‑month‑old infant demonstrates strong extensor tone when placed in supine, and strong flexor tone when placed in prone. Which reflex is still present and not yet integrated?
A. Landau B. TLR C. STNR D. Palmar grasp
B — TLR
According to your ECG notes, ST elevation most commonly indicates:
A. Myocardial ischemia
B. Myocardial infarction
C. Ventricular hypertrophy
D. Atrial fibrillation
B — myocardial infarction
A PT is analyzing shoulder arthrokinematics. At 90° abduction, which glenohumeral ligament is taut and what translation does it primarily resist?
A. Superior GH ligament — inferior translation
B. Middle GH ligament — anterior translation
C. Inferior GH ligament — anterior translation and IR/ER
D. Coracohumeral ligament — external rotation
C — Inferior GH ligament — resists anterior translation and IR/ER at 90° abduction
During sensory testing, a patient can feel light touch but cannot localize it, and demonstrates impaired stereognosis and graphesthesia. Which tract and cortical region are MOST likely involved?
A. Spinothalamic tract + thalamus
B. DCML tract + parietal lobe (somatosensory cortex)
C. Corticospinal tract + frontal lobe (motor cortex)
D. Spinocerebellar tract + cerebellum
B — DCML tract + parietal lobe
A PT is evaluating a new balance assessment tool. The test consistently produces the same results when repeated by different clinicians. Which reliability measure BEST describes this property?
A. Test‑retest reliability B. Intra‑rater reliability C. Inter‑rater reliability D. Cronbach’s alpha
C — Inter‑rater reliability
A child demonstrates difficulty transitioning from quadruped to sitting, with clear UE flexion and LE extension when the neck is flexed, and the opposite pattern when the neck is extended. Which reflex is most likely retained, and what functional skill is most affected?
A. ATNR — rolling
B. STNR — crawling C.
Moro — protective reactions
D. Landau — standing balance
B — STNR
A PT is reviewing an ECG strip and notes:
No P waves
Chaotic, irregular rhythm
Ventricular rate >100 bpm at rest
which interpretation is MOST accurate?
A. Controlled atrial flutter
B. Uncontrolled atrial fibrillation
C. Premature ventricular contractions
D. Junctional rhythm
B — uncontrolled atrial fibrillation
During gait analysis, a patient demonstrates limited dorsiflexion and compensates with early heel rise and excessive inversion. which muscle imbalance or structural issue BEST explains this pattern?
A. Weak tibialis posterior with valgus alignment
B. Overactive tibialis anterior with varus alignment
C. Weak dorsiflexors with plantarflexor contracture
D. Overactive peroneals with lateral instability
C — Weak dorsiflexors with plantarflexor contracture
A patient presents with:
Ipsilateral limb ataxia
Dysarthria and dysphagia
Vertigo and pathologic nystagmus
Ipsilateral Horner’s syndrome
Contralateral loss of pain and temperature sensation from the body
Based on your notes, which brainstem lesion BEST explains this presentation?
A. Acoustic neuroma affecting CN VIII
B. Wallenberg’s syndrome (lateral medulla stroke, PICA involvement)
C. Locked‑In syndrome (large pontine lesion)
D. Midbrain lesion affecting CN III and IV
B — Wallenberg’s syndrome (lateral medulla stroke, PICA involvement)
A PT is interpreting results from a diagnostic test for fall risk.
Sensitivity = 0.92
Specificity = 0.40 Based on your notes, which conclusion is MOST appropriate?
A. The test is good at ruling IN fall risk but poor at ruling OUT
B. The test is good at ruling OUT fall risk but poor at ruling IN
C. The test has equal ability to rule IN and OUT fall risk
D. The test is not useful because sensitivity and specificity must both exceed 0.80
B — Good at ruling OUT fall risk (high sensitivity, low specificity)
During assessment, a PT observes that an 8‑month‑old does not demonstrate sideways protective reactions, has poor sitting balance, and still shows strong palmar grasp reflex activity. Based on your pediatric development notes, which combination best explains the child’s presentation?
A. Delayed integration of palmar grasp + absence of sideways protective reactions
B. Retained ATNR + delayed Landau
C. Retained STNR + delayed forward protective reaction
D. Delayed plantar grasp + delayed equilibrium reactions
A — delayed palmar grasp + absent sideways protective reactions
A patient’s vitals during exercise show:
Flat HR response despite increasing workload
Drop in systolic BP with exertion
BNP above normal values
Based on your CV pump dysfunction criteria, which conclusion is MOST appropriate?
A. The patient is demonstrating normal aerobic conditioning
B. The patient is demonstrating signs of CV pump dysfunction
C. The patient is demonstrating signs of dehydration
D. The patient is demonstrating signs of pulmonary restriction
B — CV pump dysfunction
A PT observes that a patient demonstrates limited side bending in the cervical spine with dizziness during testing. Based on your cervical spine notes, which structure is MOST responsible for limiting side bending to protect vascular supply?
A. Atlantoaxial joint
B. Uncovertebral joints
C. Alar ligament
D. Transverse ligament
B — Uncovertebral joints
A patient demonstrates expressive aphasia with intact comprehension, difficulty producing speech, and right‑sided weakness. Based on your cerebral lesion notes, which cortical region and tract are MOST likely involved?
A. Wernicke’s area + spinothalamic tract
B. Broca’s area + corticospinal tract
C. Occipital lobe + DCML tract
D. Parietal lobe + spinocerebellar tract
B — Broca’s area + corticospinal tract
A PT is interpreting results from a study comparing two independent groups with skewed data. Which statistical test is MOST appropriate?
A. Independent t‑test B. Mann‑Whitney U test C. Paired t‑test D. ANOVA
B — Mann‑Whitney U test
A 7‑month‑old infant is referred to PT for delayed motor milestones. Findings include:
No independent sitting
No weight‑bearing in supported standing
Persistent palmar grasp
Strong extensor tone in supine
Difficulty bringing hands to midline
Poor midline orientation
No protective reactions Based ONLY on your pediatric notes, which reflex profile and developmental concerns best match this presentation?
A. Retained TLR + delayed sitting and midline control
B. Retained ATNR + delayed protective reactions
C. Retained STNR + delayed weight‑bearing
D. Retained Moro + delayed grasp development
A — retained TLR + delayed sitting/midline control
A 72‑year‑old patient in cardiac rehab presents with:
SpO₂ = 91% at rest
BP = 168/92 mmHg
BNP = 420 pg/mL
S3 heart sound
Bilateral pitting edema (3+)
Shortness of breath when supine
Based ONLY on your cardiopulmonary notes, which interpretation BEST fits this presentation?
A. The patient is demonstrating signs of heart failure with elevated cardiac workload
B. The patient is demonstrating normal aging changes
C. The patient is demonstrating isolated pulmonary dysfunction
D. The patient is demonstrating dehydration and hypotension
A — heart failure with elevated cardiac workload
A 45‑year‑old recreational runner presents with:
Knee pain during terminal extension
Positive valgus stress test
History of repeated medial knee injuries
MRI shows C‑shaped meniscus tear
Functional limitation in stair descent and pivoting
Based ONLY on your musculoskeletal notes, which combination of structures is MOST likely compromised, and what is the primary biomechanical consequence?
A. LCL + lateral meniscus — loss of varus stability
B. ACL + medial meniscus — loss of anterior stability
C. MCL + medial meniscus — loss of valgus stability and shock absorption
D. PCL + lateral meniscus — loss of posterior stability
C — MCL + medial meniscus — valgus instability and reduced shock absorption
A 68‑year‑old patient presents after a stroke with:
Impulsivity and poor spatial awareness
Left‑sided neglect
Difficulty with emotional regulation
Preserved speech production and comprehension
MRI shows infarct in the right hemisphere involving parietal and frontal lobes
Based ONLY on your cerebral hemisphere notes, which interpretation BEST fits this presentation?
A. Left hemisphere lesion — cautious behavior, speech deficits
B. Right hemisphere lesion — impulsivity, spatial neglect, emotional perception deficits
C. Left hemisphere lesion — math/science deficits, sequential processing issues
D. Right hemisphere lesion — expressive aphasia and cautious behavior
B — Right hemisphere lesion — impulsivity, spatial neglect, emotional perception deficits
A 70‑year‑old patient in outpatient rehab demonstrates improved gait speed after 6 weeks of training.
Baseline 10‑Meter Walk Test = 0.6 m/s
Follow‑up 10‑Meter Walk Test = 0.7 m/s Your notes list the MCID for gait speed as 0.05–0.1 m/s. Which interpretation BEST fits this patient’s outcome?
A. The change exceeds MDC but not MCID, so it is statistically real but not clinically meaningful
B. The change meets MCID, so it is both statistically real and clinically meaningful
C. The change is below MDC, so it may be due to measurement error
D. The change is clinically meaningful but not statistically significant
B — Meets MCID (0.1 m/s change is clinically meaningful)