PM&R SAE Set Full (2021) Exam 1 Questions AND Correct Answers
"<div style="""">What is the most common level of occult spine fracture after
trauma that is missed by plain radiographs?</div><div
style=""""> </div><div style="""">A. C7/T1 </div><div
style="""">B. T5/T6 </div><div style="""">C. T12/L1 </div><div
style="""">D. L4/L5 </div>" - ✔✔"2006,
Q5<div><br></div><div>A. <div style=""display: inline
!important;"">Occult cervical fractures are most often seen at the C1 and C7
levels. By adding computed </div>tomography (CT) scanning to the
evaluation of trauma patients, a significant number of occult cervical fractures
can be diagnosed. Of spinal fractures, 5% to 30% are multiple and may appear at
noncontiguous levels. Thus, radiographic evaluation of the entire spinal axis is
necessary whenever injury at 1 region of the spine is detected. </div>"
"<div>A 40-year-old construction worker presents with the gradual onset of
aching pain in the forearm and hand. He reports numbness of the thumb and
index fingers and drops objects at work. On exam, weakness is present in thumb
opposition, wrist flexion, and finger flexion. Reflexes at the biceps and triceps
are intact. The most likely diagnosis is:</div><div><br></div><div>(a) C7
radiculopathy.</div><div>(b) upper trunk plexopathy (Erb's
palsy).</div><div>(c) median neuropathy at the elbow (pronator
syndrome).</div><div>(d) carpal tunnel syndrome.</div>" -
✔✔C.<div><br></div><div><div>The pattern of weakness and numbness is
consistent with a median neuropathy in the forearm. Pronator syndrome is an
entrapment of the median nerve as it passes through the pronator teres muscle.
Depending on severity, neurologic deficits may include weakness in wrist flexion
(flexor carpi radialis), finger flexion (flexor pollicis longus, flexor digitorum
superficialis, flexor digitorum profundus digit 2/3), intrinsic hand muscles
(abductor pollicis brevis, opponens pollicis), and sensory abnormalities in a
median nerve distribution. Reflexes are normal.</div></div> industrial
,"<div>A 45-year-old breast cancer patient complains of diminished exertional
tolerance. She completed</div><div>adjuvant chemotherapy 1 year ago. Chest
x-ray reveals evidence of congestive heart failure. Which</div><div>agents
could have caused this patient's symptoms?</div><div><br></div><div>(a)
Cyclophosphamide (Cytoxan) and methotrexate (Rheumatrix)</div><div>(b)
Docetaxel (Taxotere) and bleomycin (Blenoxane)</div><div>(c) Cisplatinum
(Platinal AQ) and 5-fluorouracil (5-FU)</div><div>(d) Doxorubicin (Adriamycin)
and herceptin (Trastuzumab)</div>" - ✔✔<div>(d) Doxorubicin (Adriamycin)
and herceptin (Trastizumab) are increasingly common
antineoplastics</div><div>used in primary breast cancer treatment. Both are
associated with cardiac toxicity. Patients who</div><div>receive either agent
have a multigated angiogram (MUGA) scan prior to the initiation
of</div><div>chemotherapy to establish baseline cardiac function. Signs or
symptoms suggestive of cardiac</div><div>failure indicate the need for a repeat
MUGA scan and referral to a cardiologist.</div>
"<div>A 48-year-old is admitted to your rehabilitation facility 3 weeks after
sustaining a spinal cord</div><div>injury. The motor and sensory examination is
as follows:</div><div>
R Motor
L Motor</div><div>Deltoid
5
5</div><div>Biceps
5
5</div><div>Wrist extensor
5
5</div><div>Triceps
3
&nb - ✔✔<div>Answer: A</div><div>Commentary: Based on the ASIA
classification system this patient would be classified as C7,</div><div>given the
normal sensation in that myotome and a muscle grade of 3/5 at C7 with the
level above</div><div>being 5/5. The trace activity in finger flexors and
intrinsics are within 3 segments of the level of</div><div>injury and cannot be
,used to suggest the patient is motor incomplete (ASIA C). The patient
is</div><div>classified as ASIA B because of the retained sacral sensation.</div>
"<div>According to the American Medical Association Code of Ethics Opinion,
which statement is</div><div>TRUE?</div><div><br></div><div>(a) Individual
gifts of minimal value from pharmaceutical representatives to physicians
are</div><div>permissible so long as the gifts are related to the physician's
work.</div><div>(b) It is acceptable for physicians to request free
pharmaceuticals for personal use or use by</div><div>family
members.</div><div>(c) Subsidies to underwrite the costs of continuing medical
education are permissible when</div><div>provided directly from the
pharmaceutical company to the physician.</div><div>(d) Faculty presenting at
conferences cannot accept honoraria and reimbursement for
travel,</div><div>lodging, and meal expenses.</div>" - ✔✔"<div>Answer:
A</div><div>Commentary: According to the AMA Code of Ethics Opinion,
individual gifts of minimal value</div><div>from pharmaceutical
representatives to physicians are permissible, so long as the gifts are
related</div><div>to the physician's work. It is not acceptable for physicians to
request free pharmaceuticals for</div><div>personal use or use by family
members. Subsidies to underwrite the costs of continuing
medical</div><div>education are permissible when they are accepted by the
conference's sponsor and are not</div><div>provided directly to the physician.
It is acceptable for faculty at conferences to accept
reasonable</div><div>honoraria and reimbursement for travel, lodging, and
meal expenses.</div>"
"<div>An 80-year-old man with peripheral neuropathy and multiple medical
conditions fell at home and</div><div>was found several hours later. He was
admitted to the hospital for a sacral insufficiency fracture</div><div>and failure
to thrive. During your initial consultation, you notice a skin ulcer in which the
entire</div><div>thickness of the skin is involved without involvement of the
underlying fascia. According to the</div><div>National Pressure Ulcer Advisory
Panel, the patient's ulcer is classified as stage</div><div><br></div><div>(a)
, 1</div><div>(b) 2</div><div>(c) 3</div><div>(d) 4</div>" - ✔✔<div>(c) Stage 1:
Nonblanchable erythema of intact skin not resolved within 30 minutes;
epidermis intact.</div><div>Stage 2: Partial-thickness skin loss involving the
epidermis, possibly into dermis. Stage 3: Full-</div><div>thickness skin loss
involving damage or necrosis of subcutaneous tissue that may extend down
to,</div><div>but not through, underlying fascia. Stage 4: Full-thickness skin
loss with extensive destruction,</div><div>tissue necrosis, or damage to
muscle, bone, or supporting structures (eg, tendon or joint capsule).</div>
"<div>For optimal sensitivity, cardiac stress testing conducted 4 to 8 weeks
following myocardial infarction</div><div>must proceed to what percentage of
a patient's age-adjusted maximal heart rate?</div><div><br></div><div>(a)
60%</div><div>(b) 75%</div><div>(c) 85%</div><div>(d) 90%</div>" -
✔✔<div>(c) For both functional and diagnostic testing, patients must proceed to
85% of their age-adjusted</div><div>maximal heart rate. Otherwise half of the
abnormalities will be missed. Patients on beta blockers</div><div>should be
tested to a work load that would incur oxygen consumption of 80% of maximal
oxygen</div><div>consuption (V02.max).</div>
"<div>In instances where a researcher has financial investments in a company
and is researching the</div><div><br></div><div>effectiveness of one of the
company's products, the researcher is obligated to</div><div>(a) terminate the
investigation if the investigational agent is found to be not
effective.</div><div>(b) disclose this involvement in writing to subjects that are
being enrolled in the study.</div><div>(c) end financial involvement in the
company before the results of the research are revealed to</div><div>the
public.</div><div>(d) disclose this involvement to the investigator's medical
center, to funding organizations, and to</div><div>journals publishing the
results.</div>" - ✔✔"<div>(d) Conflicts of interest in biomedical research are
becoming more apparent as private companies</div><div>increasingly develop
relationships with academic research scientists. Avoidance of real
or</div><div>perceived conflicts of interest in clinical research is necessary if
the medical community is to ensure</div><div>objectivity and maintain
"<div style="""">What is the most common level of occult spine fracture after
trauma that is missed by plain radiographs?</div><div
style=""""> </div><div style="""">A. C7/T1 </div><div
style="""">B. T5/T6 </div><div style="""">C. T12/L1 </div><div
style="""">D. L4/L5 </div>" - ✔✔"2006,
Q5<div><br></div><div>A. <div style=""display: inline
!important;"">Occult cervical fractures are most often seen at the C1 and C7
levels. By adding computed </div>tomography (CT) scanning to the
evaluation of trauma patients, a significant number of occult cervical fractures
can be diagnosed. Of spinal fractures, 5% to 30% are multiple and may appear at
noncontiguous levels. Thus, radiographic evaluation of the entire spinal axis is
necessary whenever injury at 1 region of the spine is detected. </div>"
"<div>A 40-year-old construction worker presents with the gradual onset of
aching pain in the forearm and hand. He reports numbness of the thumb and
index fingers and drops objects at work. On exam, weakness is present in thumb
opposition, wrist flexion, and finger flexion. Reflexes at the biceps and triceps
are intact. The most likely diagnosis is:</div><div><br></div><div>(a) C7
radiculopathy.</div><div>(b) upper trunk plexopathy (Erb's
palsy).</div><div>(c) median neuropathy at the elbow (pronator
syndrome).</div><div>(d) carpal tunnel syndrome.</div>" -
✔✔C.<div><br></div><div><div>The pattern of weakness and numbness is
consistent with a median neuropathy in the forearm. Pronator syndrome is an
entrapment of the median nerve as it passes through the pronator teres muscle.
Depending on severity, neurologic deficits may include weakness in wrist flexion
(flexor carpi radialis), finger flexion (flexor pollicis longus, flexor digitorum
superficialis, flexor digitorum profundus digit 2/3), intrinsic hand muscles
(abductor pollicis brevis, opponens pollicis), and sensory abnormalities in a
median nerve distribution. Reflexes are normal.</div></div> industrial
,"<div>A 45-year-old breast cancer patient complains of diminished exertional
tolerance. She completed</div><div>adjuvant chemotherapy 1 year ago. Chest
x-ray reveals evidence of congestive heart failure. Which</div><div>agents
could have caused this patient's symptoms?</div><div><br></div><div>(a)
Cyclophosphamide (Cytoxan) and methotrexate (Rheumatrix)</div><div>(b)
Docetaxel (Taxotere) and bleomycin (Blenoxane)</div><div>(c) Cisplatinum
(Platinal AQ) and 5-fluorouracil (5-FU)</div><div>(d) Doxorubicin (Adriamycin)
and herceptin (Trastuzumab)</div>" - ✔✔<div>(d) Doxorubicin (Adriamycin)
and herceptin (Trastizumab) are increasingly common
antineoplastics</div><div>used in primary breast cancer treatment. Both are
associated with cardiac toxicity. Patients who</div><div>receive either agent
have a multigated angiogram (MUGA) scan prior to the initiation
of</div><div>chemotherapy to establish baseline cardiac function. Signs or
symptoms suggestive of cardiac</div><div>failure indicate the need for a repeat
MUGA scan and referral to a cardiologist.</div>
"<div>A 48-year-old is admitted to your rehabilitation facility 3 weeks after
sustaining a spinal cord</div><div>injury. The motor and sensory examination is
as follows:</div><div>
R Motor
L Motor</div><div>Deltoid
5
5</div><div>Biceps
5
5</div><div>Wrist extensor
5
5</div><div>Triceps
3
&nb - ✔✔<div>Answer: A</div><div>Commentary: Based on the ASIA
classification system this patient would be classified as C7,</div><div>given the
normal sensation in that myotome and a muscle grade of 3/5 at C7 with the
level above</div><div>being 5/5. The trace activity in finger flexors and
intrinsics are within 3 segments of the level of</div><div>injury and cannot be
,used to suggest the patient is motor incomplete (ASIA C). The patient
is</div><div>classified as ASIA B because of the retained sacral sensation.</div>
"<div>According to the American Medical Association Code of Ethics Opinion,
which statement is</div><div>TRUE?</div><div><br></div><div>(a) Individual
gifts of minimal value from pharmaceutical representatives to physicians
are</div><div>permissible so long as the gifts are related to the physician's
work.</div><div>(b) It is acceptable for physicians to request free
pharmaceuticals for personal use or use by</div><div>family
members.</div><div>(c) Subsidies to underwrite the costs of continuing medical
education are permissible when</div><div>provided directly from the
pharmaceutical company to the physician.</div><div>(d) Faculty presenting at
conferences cannot accept honoraria and reimbursement for
travel,</div><div>lodging, and meal expenses.</div>" - ✔✔"<div>Answer:
A</div><div>Commentary: According to the AMA Code of Ethics Opinion,
individual gifts of minimal value</div><div>from pharmaceutical
representatives to physicians are permissible, so long as the gifts are
related</div><div>to the physician's work. It is not acceptable for physicians to
request free pharmaceuticals for</div><div>personal use or use by family
members. Subsidies to underwrite the costs of continuing
medical</div><div>education are permissible when they are accepted by the
conference's sponsor and are not</div><div>provided directly to the physician.
It is acceptable for faculty at conferences to accept
reasonable</div><div>honoraria and reimbursement for travel, lodging, and
meal expenses.</div>"
"<div>An 80-year-old man with peripheral neuropathy and multiple medical
conditions fell at home and</div><div>was found several hours later. He was
admitted to the hospital for a sacral insufficiency fracture</div><div>and failure
to thrive. During your initial consultation, you notice a skin ulcer in which the
entire</div><div>thickness of the skin is involved without involvement of the
underlying fascia. According to the</div><div>National Pressure Ulcer Advisory
Panel, the patient's ulcer is classified as stage</div><div><br></div><div>(a)
, 1</div><div>(b) 2</div><div>(c) 3</div><div>(d) 4</div>" - ✔✔<div>(c) Stage 1:
Nonblanchable erythema of intact skin not resolved within 30 minutes;
epidermis intact.</div><div>Stage 2: Partial-thickness skin loss involving the
epidermis, possibly into dermis. Stage 3: Full-</div><div>thickness skin loss
involving damage or necrosis of subcutaneous tissue that may extend down
to,</div><div>but not through, underlying fascia. Stage 4: Full-thickness skin
loss with extensive destruction,</div><div>tissue necrosis, or damage to
muscle, bone, or supporting structures (eg, tendon or joint capsule).</div>
"<div>For optimal sensitivity, cardiac stress testing conducted 4 to 8 weeks
following myocardial infarction</div><div>must proceed to what percentage of
a patient's age-adjusted maximal heart rate?</div><div><br></div><div>(a)
60%</div><div>(b) 75%</div><div>(c) 85%</div><div>(d) 90%</div>" -
✔✔<div>(c) For both functional and diagnostic testing, patients must proceed to
85% of their age-adjusted</div><div>maximal heart rate. Otherwise half of the
abnormalities will be missed. Patients on beta blockers</div><div>should be
tested to a work load that would incur oxygen consumption of 80% of maximal
oxygen</div><div>consuption (V02.max).</div>
"<div>In instances where a researcher has financial investments in a company
and is researching the</div><div><br></div><div>effectiveness of one of the
company's products, the researcher is obligated to</div><div>(a) terminate the
investigation if the investigational agent is found to be not
effective.</div><div>(b) disclose this involvement in writing to subjects that are
being enrolled in the study.</div><div>(c) end financial involvement in the
company before the results of the research are revealed to</div><div>the
public.</div><div>(d) disclose this involvement to the investigator's medical
center, to funding organizations, and to</div><div>journals publishing the
results.</div>" - ✔✔"<div>(d) Conflicts of interest in biomedical research are
becoming more apparent as private companies</div><div>increasingly develop
relationships with academic research scientists. Avoidance of real
or</div><div>perceived conflicts of interest in clinical research is necessary if
the medical community is to ensure</div><div>objectivity and maintain
