Quiz
USA - Differential Diagnosis - Units 1-4 and 6-8
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Perguntas do quiz (56)
1In the context of screening for referral, primary purpose of a diagnosis is:
- ATo obtain reimbursement
- BTo guide the plan of care and intervention strategies
- CTo practice within the scope of physical therapy
- DTo meet the established standards for accreditation
2Direct access is the only reason physical therapists must screen for systemic disease.
- AVerdadeiro
- BFalso
3A patient/client gives you a written prescription from a physician, chiropractor, or dentist. The first screening question to ask is:
- AWhat did the physician (dentist, chiropractor) say is the problem?
- BDid the physician (dentist, chiropractor) examine you?
- CWhen do you go back to see the doctor (dentist, chiropractor)?
- DHow many times per week did the doctor (dentist, chiropractor) suggest you come to therapy?
4Screening for medical disease takes place:
- AOnly during the first interview
- BJust before the client returns to the physician for his/her next appointment
- CThroughout the episode of care
- DNone of these
5Physical therapists are qualified to make a human movement system diagnosis regarding primary neuromusculoskeletal conditions, but we must do so in accordance with:
- AThe Guide to Physical Therapist Practice
- BThe State Practice Act
- CThe screening process
- DThe SOAP method
6Medical referral for a problem outside the scope of the physical therapy practice occurs when:
- ANo apparent movement dysfunction exists
- BNo causative factors can be identified
- CFindings are not consistent with neuromuscular or musculoskeletal dysfunction
- DClient presents with suspicious red-flag symptoms
- EAny one of these
- FNone of these
7Physical therapy evaluation and intervention may be part of the physician’s differential diagnosis.
- AVerdadeiro
- BFalso
8What is the effect of NSAIDs (e.g., Naprosyn, Motrin, Anaprox, ibuprofen) on blood pressure?
- ANo effect
- BIncreases blood pressure
- CDecreases blood pressure
9Most of the information needed to determine the cause of symptoms is contained in the:
- ASubjective examination
- BFamily/Personal History Form
- CObjective information
- DAll of these
- ESubjective Examination and Objective Information
10A risk factor for NSAID-related gastropathy is the use of:
- AAntibiotics
- BAntidepressants
- CAntihypertensives
- DAntihistamines
11After interviewing a new client, you summarize what she has told you by saying, “You told me you are here because of right neck and shoulder pain that began 5 years ago as a result of a car accident. You also have a ‘pins and needles’ sensation in your third and fourth fingers but no other symptoms at this time. You have noticed a considerable decrease in your grip strength, and you would like to be able to pick up a pot of coffee without fear of spilling it.”
This is an example of:- AAn open-ended question
- BA funnel technique
- CA paraphrasing technique
- DNone of these
12Screening for alcohol use would be appropriate when the client reports a history of accidents.
- AVerdadeiro
- BFalso
13What is the significance of sweats?
- AA sign of systemic disease
- BSide effect of chemotherapy or other medications
- CPoor ventilation while sleeping
- DAll of these
- ENone of these
14Spontaneous uterine bleeding after 12 consecutive months without menstrual bleeding requires medical referral.
- AVerdadeiro
- BFalso
15Which of the following are red flags to consider when screening for systemic or viscerogenic causes of neuromuscular and musculoskeletal signs and symptoms:
- AFever, (night) sweats, dizziness
- BSymptoms are out of proportion to the injury
- CInsidious onset
- DNo position is comfortable
- EAll of these
16You should assess clients who are receiving NSAIDs for which physiologic effect associated with increased risk of hypertension?
- ADecreased heart rate
- BIncreased diuresis
- CSlowed peristalsis
- DWater retention
17Instruct clients with a history of hypertension and arthritis to:
- ALimit physical activity and exercise
- BAvoid over-the-counter medications
- CInform their primary care provider of both conditions
- DDrink plenty of fluids to avoid edema
18Alcohol screening tools should be:
- AUsed with every client sometime during the episode of care
- BBrief, easy to administer, and nonthreatening
- CDeferred when the client has been drinking or has the smell of alcohol on the breath
- DConducted with one other family member present as a witness
19What is the best follow-up question for someone who tells you that the pain is constant?
- ACan you use one finger to point to the pain location?
- BDo you have that pain right now?
- CDoes the pain wake you up at night after you have fallen asleep?
- DIs there anything that makes the pain better or worse?
20A 52-year-old woman with shoulder pain tells you that she has pain at night that awakens her. After asking a series of follow-up questions, you are able to determine that she had trouble falling asleep because her pain increases when she goes to bed. Once she falls asleep, she wakes up as soon as she rolls onto that side. What is the most likely explanation for this pain behavior?
- AMinimal distractions heighten a person’s awareness of musculoskeletal discomfort.
- BThis is a systemic pattern that is associated with a neoplasm.
- CIt is impossible to tell.
- DThis represents a chronic clinical presentation of a musculoskeletal problem.
21Referred pain patterns associated with impairment of the spleen can produce musculoskeletal symptoms in:
- AThe left shoulder
- BThe right shoulder
- CThe mid-back or upper back, scapular, and right shoulder areas
- DThe thorax, scapulae, right shoulder, or left shoulder
22Associated signs and symptoms are a major red flag for pain of a systemic or visceral origin compared to musculoskeletal pain.
- AVerdadeiro
- BFalso
23Words used to describe neurogenic pain often include:
- AThrobbing, pounding, beating
- BCrushing, shooting, pricking
- CAching, heavy, sore
- DAgonizing, piercing, unbearable
24Pain (especially intense bone pain) that is disproportionately relieved by aspirin can be a symptom of:
- ANeoplasm
- BAssault or trauma
- CDrug dependence
- DFracture
25Joint pain can be a reactive, delayed, or allergic response to:
- AMedications
- BChemicals
- CInfections
- DArtificial sweeteners
- EAll of these
26Bone pain associated with neoplasm is characterized by:
- AIncreases with weight bearing
- BNegative heel strike
- CRelieved by Tums or other antacid in women
- DGoes away after eating
27Pain of a viscerogenic nature is not relieved by a change in position.
- AVerdadeiro
- BFalso
28Referred pain from the viscera can occur alone but is usually preceded by visceral pain when an organ is involved.
- AVerdadeiro
- BFalso
29A 48-year old man presented with low back pain of unknown cause. He works as a carpenter and says he is very active, has work-related mishaps (accidents and falls), and engages in repetitive motions of all kinds using his arms, back, and legs. The pain is intense when he has it, but it seems to come and go. He is not sure if eating makes the pain better or worse. He has lost his appetite because of the pain. After conducting an examination including a screening exam, the clinical presentation does not match the expected pattern for a musculoskeletal or neuromuscular problem. You refer him to a physician for medical testing. You find out later he had pancreatitis.
What is the most likely explanation for this pain pattern?- AToxic waste products from the pancreas are released into the intestines causing irritation of the retroperitoneal space.
- BRupture of the pancreas causes internal bleeding and referred pain called Kehr’s sign.
- CThe pancreas and low back structures are formed from the same embryologic tissue in the mesoderm.
- DObstruction, irritation, or inflammation of the body of the pancreas distends the pancreas, thus applying pressure on the central respiratory diaphragm.
30When assessing the abdomen, what sequence of physical assessment is best?
1.) [blank_start]Inspection[blank_end]
2.) [blank_start]Auscultation[blank_end]
3.) [blank_start]Percussion[blank_end]
4.) [blank_start]Palpation[blank_end]- AInspection
- BAuscultation
- CPercussion
- DPalpation
31A line drawn down the middle of a lesion with two different halves suggests:
- AA malignant lesion
- BA benign lesion
- CA normal presentation
- DA skin reaction to medications
32Pulse strength graded as 1 means:
- AEasily palpable, normal
- BPresent occasionally
- CPulse diminished, barely palpable
- DWithin normal limits
33During auscultation of an adult client with rheumatoid arthritis, the heart rate gets stronger as she breathes in and decreases as she breathes out.
This sign is:- ACharacteristic of lung disease
- BTypical in coronary artery disease
- CA normal finding
- DCommon in anyone with pain
34Body temperature should be taken as part of vital sign assessment:
- AA.) Only for clients who have not been seen by a physician
- BB.) For any client who has musculoskeletal pain of unknown origin
- CC.) For any client reporting the presence of constitutional symptoms, especially fever or sweats
- DB.) and C.)
- EAll of the above
35A 23-year-old female presents with new onset of skin rash and joint pain followed 2 weeks later by GI symptoms of abdominal pain, nausea, and diarrhea. She has a previous history of Crohn’s disease, but this condition has been stable for several years.
She does not think her current symptoms are related to her Crohn’s disease.
What kind of screening assessment is needed in this case?- AVital signs only.
- BVital signs and abdominal auscultation.
- CVital signs, neurologic screening examination, and abdominal auscultation.
- DNo further assessment is needed; there are enough red flags to advise this client to seek medical attention.
36Pursed-lip breathing in the sitting position while leaning forward on the arms relieves symptoms of dyspnea for the client with:
- AOrthopnea
- BEmphysema
- CCHF
- DOrthopnea and CHF
37Palpitations lasting for hours or occurring in association with pain, shortness of breath, fainting, or severe lightheadedness require medical evaluation.
- AVerdadeiro
- BFalso
38Peripheral vascular diseases include:
- AArterial and occlusive diseases
- BArterial and venous disorders
- CAcute and chronic arterial diseases
- DAll of these
- ENone of these
39Which statement is the most accurate?
- AArterial disease is characterized by intermittent claudication, pain relieved by elevating the extremity, and history of smoking.
- BArterial disease is characterized by loss of hair on the lower extremities and throbbing pain in the calf muscles that goes away by using heat and elevation.
- CArterial disease is characterized by painful throbbing of the feet at night that goes away by dangling the feet over the bed.
- DArterial disease is characterized by loss of hair on the toes, intermittent claudication, and redness or warmth of the legs that is accompanied by a burning sensation.
40What are the primary signs and symptoms of CHF?
- AFatigue
- BDyspnea
- CEdema
- DNocturia
- EVaricose Veins
- FTinnitus
- GHeadache
- HNight Sweats
41When would you advise a client in physical therapy to take his/her nitroglycerin?
- A45 minutes before exercise
- BWhen symptoms of chest pain do not subside with 10 to 15 minutes of rest
- CAs soon as chest pain begins
- DNone of the above
- EAny of the above
42Neurologic symptoms such as muscle weakness or muscle atrophy may be the first indication of:
- ACystic fibrosis
- BBronchiectasis
- CNeoplasm
- DDeep vein thrombosis
43Back pain with radiating numbness and tingling down the leg past the knee does not occur as a result of:
- APostoperative thrombus
- BBronchogenic carcinoma
- CPott’s disease
- DTrigger points
44Pain associated with pleuropulmonary disorders can radiate to the:
- AAnterior Neck
- BUpper Trapezius Muscle
- CIpsilateral Shoulder
- DThoracic Spine
45The presence of a persistent dry cough (no sputum or phlegm produced) has no clinical significance to the therapist.
- AVerdadeiro
- BFalso
46Dyspnea associated with emphysema is the result of:
- AA.) Destruction of the alveoli
- BB.) Reduced elasticity of the lungs
- CC.) Increased effort to exhale trapped air
- DA.) and B.)
- EAll of the above
47The presence of pain and anxiety in a client can often lead to hyperventilation. When a client hyperventilates, the arterial concentration of carbon dioxide will do which of the following?
- AIncrease
- BDecrease
- CRemain unchanged
- DVary depending on potassium concentration
48Common symptoms of RESPIRATORY ACIDOSIS would be most closely represented by which of the following descriptions?
- APresence of numbness and tingling in face, hands, and feet
- BPresence of dizziness and lightheadedness
- CHyperventilation with changes in level of consciousness
- DOnset of sleepiness, confusion, and decreased ventilation
49Bleeding in the gastrointestinal (GI) tract can be manifested as:
- ADysphagia
- BMelena
- CPsoas abscess
- DTenderness over McBurney’s point
50What is the significance of Kehr’s sign?
- AGas, air, or blood in the abdominal cavity
- BInfection of the peritoneum (peritonitis, appendicitis)
- CEsophageal cancer
- DThoracic disk herniation masquerading as chest or anterior neck pain
51What areas of the body can GI disorders refer pain to?
- ASternum
- BShoulder
- CScapula
- DAnterior Neck
- EMid-Back
- FLower Back
- GHip
- HPelvis
- ISacrum
52A 56-year-old client was referred to PT for pelvic floor rehab. His primary symptoms are obstructed defecation and puborectalis muscle spasm. He wakes nightly with left flank pain. The pattern is low thoracic, laterally, but superior to iliac crest. Sometimes he has buttock pain on the same side. He doesn’t have any daytime pain but is up for several hours at night. Advil and light activity do not help much. The pain is relieved or decreased with passing gas. He has very tight hamstrings and rectus femoris.
Change in symptoms with gas or defecation is possible with:- AThoracic disk disease
- BObturator nerve compression
- CSmall intestine disease
- DLarge intestine and colon dysfunction
53Which of the following are common medications, taken by clients seen in a physical therapy practice, that are likely to induce GI bleeding.
- ACorticosteroids
- BAntibiotics and antiinflammatories
- CStatins
- DNone of these
54Which of the following are clues to the possible involvement of the GI system?
- AAbdominal pain alternating with TMJ pain within a 2-week period
- BAbdominal pain at the same level as back pain, occurring either simultaneously or alternately
- CShoulder pain alleviated by a bowel movement
- DAll of these
55A 65-year-old client is taking OxyContin for a “sore shoulder.” She also reports aching pain of the sacrum that radiates.
The sacral pain can be caused by:- APsoas abscess caused by vertebral osteomyelitis
- BGI bleeding causing hemorrhoids and rectal fissures
- CCrohn’s disease manifested as sacroiliitis
- DPressure on sacral nerves from stored fecal content in the constipated client taking narcotics
56Body temperature should be taken as part of vital sign assessment:
- Aa. For every client evaluated
- Bb. For any client who has musculoskeletal pain of unknown origin
- Cc. For any client reporting the presence of constitutional symptoms, especially fever or night sweats
- Dd. b and c
Informações
- Descrição
- All Questions and Answers taken directly from the textbook publisher's website: http://www.differentialdiagnosisforpt.com/
- Autor
- Ben Williams
- Idioma
- English
- Visualizações
- 160
- Etiquetas
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