MSK
Which of the following special tests assesses for Achilles Tendinopathy?
a) Anterior Drawer Test
b) Arc Sign
c) Talar Tilt Test
d) Squeeze Test
b) Arc Sign
Which of the following is a risk factor for developing atherosclerosis?
A) Increased LDL cholesterol
B) Decreased blood pressure
C) Female gender
D) Sedentary lifestyle
A) Increased LDL cholesterol
Explanation of the correct answer:
Explanation of incorrect answers:
Which of the following is a modifiable risk factor for stroke?
a) Family history
b) Genetics
c) Hypertension
d) Black race
c) Hypertension
Which of the following drug strategies can be used in the treatment of Parkinson's Disease, either alone or in conjunction with L-DOPA therapy?
A) Dopamine antagonists, which block dopamine receptors, and therefore decrease dopamine levels.
B) COMT inhibitors, which break down L-DOPA in peripheral tissues.
C) MAO-B inhibitors, which prolong dopamine effects in the brain
D) Drugs that increase the effects of excitatory amino acids by blocking the NMDA receptor, such as Amantadine
Correct Answer: C) MAO-B inhibitors, which prolong dopamine effects in the brain
Explanation of why the other options are incorrect:
A is incorrect because dopamine antagonists would worsen Parkinson's symptoms.
B is incorrect because COMT inhibitors prevent the breakdown of L-DOPA5.
D is incorrect because Amantadine blocks, and therefore decreases the effects of excitatory amino acid
Which of the following is a safety consideration for exercise for a patient with Diabetic Peripheral Neuropathy?
a) Exercising when blood sugar is above 240 mg/dL
b) Ensuring proper shoe wear
c) Exercising with a blood sugar below 100mg/dL without a snack
d) Avoiding all weight-bearing exercise
b) Ensuring proper shoe wear
Which of the following best describes the purpose and a positive result of the Thompson Test?
a) To assess for ankle sprains; a positive test is indicated by pain at the lateral malleolus.
b) To assess for Achilles tendon rupture; a positive test is indicated by a lack of plantar flexion when the calf muscle is squeezed.
c) To assess for plantar fasciitis; a positive test is indicated by pain along the plantar fascia.
d) To assess for syndesmotic injury; a positive test is indicated by pain near the ankle with compression
b) To assess for Achilles tendon rupture; a positive test is indicated by a lack of plantar flexion when the calf muscle is squeezed.
Which of the following is a characteristic of Atrial Fibrillation (A-fib)?
A) A regular R-R interval
B) A "chaotic" atrial arrhythmia with multiple foci
C) A "sawtooth" appearance
D) A consistent P wave before each QRS complex
B) A "chaotic" atrial arrhythmia with multiple foci
Explanation of the correct answer:
Atrial fibrillation is described as a "chaotic" atrial arrhythmia with multiple foci.
If the R-R interval is regularly irregular, then it is assumed to be A-fib unless diagnosed otherwise.
Explanation of incorrect answers:
A regular R-R interval is not characteristic of A-fib, which is described as "chaotic".
A "sawtooth" appearance is characteristic of atrial flutter.
A consistent P wave before each QRS complex is a characteristic of normal sinus rhythm, not A-fib
What is the most common type of primary headache?
a) Migraine
b) Tension-type headache
c) Cluster headache
d) Cervicogenic headache
b) Tension-type headache
Which of the following statements is TRUE regarding the use of levodopa (L-DOPA) in the treatment of Parkinson's disease?
A) L-DOPA directly stimulates dopamine receptors in the brain.
B) L-DOPA is effective because it can directly cross the blood-brain barrier (BBB) and be converted to dopamine
C) Oral administration of dopamine is very effective because it is converted into L-DOPA in the bloodstream.
D) L-DOPA is ineffective in treating Parkinson's because it cannot cross the BBB
B) L-DOPA is effective because it can directly cross the blood-brain barrier (BBB) and be converted to dopamine
Which of the following is a typical clinical finding associated with Charcot-Marie-Tooth disease (CMT)?
a) Distal limb muscle wasting and weakness, with skeletal deformities and abnormal DTRs
b) Proximal muscle weakness with normal reflexes.
c) Rapidly progressing muscle weakness with UMN signs
d) Loss of sensation in the upper extremities
a) Distal limb muscle wasting and weakness, with skeletal deformities and abnormal DTRs
What is the primary purpose of the Navicular Drop Test?
a) To assess the mobility of the cuboid joint
b) To assess for tibial nerve entrapment
c) To assess the girth of the ankle joint
d) To assess navicular movement in resting position compared to subtalar neutral as a potential cause of foot pain and flat footedness
d) To assess navicular movement in resting position compared to subtalar neutral as a potential cause of foot pain and flat footedness
Which of the following is an expected benefit of physical therapy for a patient with pulmonary dysfunction?
A) Decreased work of breathing
B) Increased oxygen utilization
C) Decreased expiratory power
D) Reduced muscle strength
A) Decreased work of breathing
Explanation of the correct answer:
Physical therapy can help to decrease the work of breathing for patients with pulmonary dysfunction. Other benefits include improved respiratory muscle strength, decreased oxygen utilization, improved walking distance, decreased overall rate of perceived exertion (RPE), increased expiratory power/force, and improved airway clearance.
Explanation of incorrect answers:
Physical therapy aims to decrease oxygen utilization and requirements, not increase it.
Physical therapy is expected to increase expiratory power/force, not decrease it.
Physical therapy aims to improve muscle strength, not reduce it
What is the primary focus of treatment for Multiple Sclerosis (MS)?
a) Surgical removal of plaques
b) Pharmacologic immune modulators to slow demyelination
c) Physical therapy to improve muscle strength
d) Nutritional interventions to prevent exacerbation
b) Pharmacologic immune modulators to slow demyelination
Which of the following mechanisms describes how alkylating agents affect DNA in cancer cells?
A) They insert themselves into the DNA double helix, causing breaks in the DNA chain.
B) They inhibit topoisomerases, causing breaks in the DNA chain.
C) They form strong cross-links within or between DNA strands, preventing replication.
D) They act as "bogus" ingredients that impair DNA synthesis.
Correct Answer: C) They form strong cross-links within or between DNA strands, preventing replication.
Explanation of why the other options are incorrect:
A is incorrect because it describes the mechanism of antitumor antibiotics.
B is incorrect because it describes the mechanism of topoisomerase inhibitors
D is incorrect because it describes the mechanism of antimetabolites
Which of the following is a potential cause of "slap foot" during gait?
a) Tight plantar flexors
b) Weak dorsiflexors
c) Shortened contralateral limb
d) Spastic toe flexors
b) Weak dorsiflexors
Rationale:
Slap foot occurs during the loading response, initial contact, of the gait cycle, when the foot makes contact with the ground too quickly. The dorsiflexors are responsible for controlling the lowering of the foot to the ground. When the dorsiflexors are weak, they cannot eccentrically contract and control the descent of the foot, causing it to "slap" the ground. The other options are incorrect, as they are not directly related to the dorsiflexor muscle group
Which of the following is a reason for using orthotics?
a) To fix biomechanical faults
b) To improve blood circulation
c) To control excessive foot/ankle motion
d) To increase muscle strength
c) To control excessive foot/ankle motion
Which of the following medication categories is used to decrease myocardial oxygen demand by decreasing heart rate, blood pressure, and myocardial contractility?
A) Beta Blockers
B) Antiarrhythmics
C) Nitrates
D) Cardiac Glycosides
A) Beta Blockers
Explanation of the correct answer:
Explanation of incorrect answers:
Which of the following is a common early symptom of Guillain-Barre Syndrome (GBS)?
a) Ascending, symmetrical distal motor weakness
b) Loss of vision
c) Severe headaches
d) Cognitive decline
a) Ascending, symmetrical distal motor weakness
Which of the following statements is TRUE regarding targeted cancer therapies?
A) Targeted therapies, like monoclonal antibodies, bind to a specific antigen on tumor cells and do not impact healthy cells
B) Targeted therapies, such as tyrosine kinase inhibitors, are designed to activate cell division in cancer cells, leading to cell death
C) Conventional anticancer drugs are more effective than targeted therapies because they target both healthy and cancerous cells
D) Monoclonal antibodies (MABs) are only used to directly destroy cancer cells
Correct Answer: A) Targeted therapies, like monoclonal antibodies, bind to a specific antigen on tumor cells and do not impact healthy cells
Explanation of why the other options are incorrect:
B is incorrect because tyrosine kinase inhibitors block activation of cell division.
C is incorrect because conventional anticancer drugs often cause severe side effects because they do not discriminate between healthy tissues and cancerous cells
D is incorrect because MABs can also block signaling pathways that cause mitosis or initiate apoptosis
Which cranial nerves are involved in ocular eye movement?
a) CN V, VII, VIII
b) CN I, II, III
c) CN III, IV, VI
d) CN IX, X, XII
c) CN III, IV, VI
A patient is supine with their knee flexed to 90 degrees and the examiner is sitting on the patient's foot to stabilize the leg. The examiner applies an anterior force to the proximal tibia. The examiner notes a greater anterior tibial displacement on the affected side compared to the uninvolved side. Which of the following is the MOST LIKELY interpretation of this finding?
a) A positive test for posterior cruciate ligament (PCL) injury.
b) A positive test for a medial collateral ligament (MCL) injury.
c) A positive test for a lateral collateral ligament (LCL) injury.
d) A positive test for an anterior cruciate ligament (ACL) injury.
d) A positive test for an anterior cruciate ligament (ACL) injury.
The scenario described is the procedure for the Anterior Drawer Test. The Anterior Drawer Test is used to assess the integrity of the anterior cruciate ligament (ACL). A positive Anterior Drawer Test is indicated by greater anterior tibial displacement on the affected side compared to the uninvolved side, suggesting an ACL injury. A Posterior Drawer Test is performed with the patient in a similar position, but assesses the posterior cruciate ligament (PCL) by applying a posterior force to the proximal tibia.
Valgus and Varus Stress Tests are used to assess the integrity of the medial collateral ligament (MCL) and lateral collateral ligament (LCL) respectively, and are not performed with an anterior force to the tibia
Which of the following diagnostic tests uses a radioactive tracer to create pictures of the heart?
A) Transthoracic Echocardiogram
B) Cardiac CT Scan
C) Cardiac Positron Emission Tomography (PET)
D) Holter Cardiac Monitor
C) Cardiac Positron Emission Tomography (PET)
Explanation of the correct answer:
A Cardiac Positron Emission Tomography (PET) scan is a noninvasive nuclear imaging test that uses radioactive tracers to produce pictures of the heart.
Explanation of incorrect answers:
A Transthoracic Echocardiogram is a non-invasive procedure using an ultrasound machine and gel.
A Cardiac CT scan is a noninvasive imaging procedure that utilizes a series of x-rays to take detailed pictures of the heart and its blood vessels.
A Holter Cardiac Monitor is a small, wearable device that keeps track of a patient’s heart rate and rhythm
Which of the following statements is true regarding the impact of exercise on the immune system?
a) Strenuous exercise enhances the immune system by increasing the activity of lymphocytes and NK cells.
b) Moderate exercise suppresses the activity of neutrophils and macrophages.
c) Strenuous exercise can suppress lymphocyte and NK cell activity, potentially increasing susceptibility to viruses and bacteria.
d) Moderate exercise decreases the number of white blood cells (WBCs).
c) Strenuous exercise can suppress lymphocyte and NK cell activity, potentially increasing susceptibility to viruses and bacteria.
The sources state that strenuous or long-duration exercise (80% of VO2 max) impairs the immune system, suppressing lymphocytes and NK cell activity and leaving the host susceptible to viruses and bacteria
The sources indicate that moderate exercise enhances the immune system, stimulating activity of neutrophils and macrophages1. Moderate exercise also enhances the number and function of NK cells and increases WBC count
Therefore, options a, b, and d are not accurate based on the provided information.
Which of the following is NOT considered a disease-modifying antirheumatic drug (DMARD) used in the treatment of rheumatoid arthritis (RA)?
A) Methotrexate (Rheumatrex)
B) Aspirin
C) Etanercept (Enbrel)
D) Leflunomide (Arava)
Correct Answer: B) Aspirin
Explanation of why the other options are incorrect:
A is incorrect because methotrexate is a traditional DMARD
C is incorrect because etanercept is a newer "biologic" DMARD, specifically a tumor necrosis factor inhibitor
D is incorrect because leflunomide is a traditional DMARD
Explanation of why the correct answer is correct:
Aspirin and other NSAIDs can help reduce the pain and inflammation associated with RA, but they do not alter the progression of the disease, and are therefore not considered DMARD
A patient presents with ipsilateral spasticity and paralysis, as well as contralateral loss of pain and temperature sensation a few levels below the lesion. Which of the following clinical syndromes is MOST likely?
a) Anterior Cord Syndrome
b) Central Cord Syndrome
c) Brown-Sequard Syndrome
d) Posterior Cord Syndrome
c) Brown-Sequard Syndrome