CSEP CEP LATEST COMPREHENSIVE EXAM ALL
QUESTIONS AND ANSWERS SURE A+
✔✔What are some factors contributing to fracture risk? - ✔✔Chronic disease
(osteoporosis, arthritis, diabetes), history of smoking/drinking, low BMI, corticosteroid
use, age, gender
✔✔What is FRAX? - ✔✔Fracture risk assessment tool
10-year probability of hip fracture and 10-year probability of major osteoporotic fracture
Takes into account: age, gender, previous fractures, BMD, other risk factors
✔✔What is the CAROC? - ✔✔Canadian Association of Radiologists and Osteoporosis
Canada risk assessment
10 year absolute fracture risk
✔✔What are the categories used in the CAROC? - ✔✔Low <10% risk, lifestyle
measures sufficient for those without additional risk factors for rapid BMD loss
Moderate 10%-20% risk, treatment should be individualized and may include
pharmacologic therapy/lifestyle measures with monitoring
High >20% risk, >50 years who have had a fragility fracture of hip/vertebra and those
who have had more than 1 fragility fracture
✔✔Neer's Test - ✔✔Impingement test
Arm is medially rotated and fully elevated in scaption (30 degrees from frontal plane)
,- pain indicates a positive test
✔✔Hawkins-Kennedy Test - ✔✔Impingement test
Arm is flexed to 90 degrees forearm is then medially rotated
- pain indicates a positive test
✔✔Empty Can Test - ✔✔Tests supraspinatus for impingement
Arms are brought into flexion and scaption, and then medially rotated (emptying a can),
patient must resistance adduction
- weakness or pain indicated a positive test
✔✔Drop arm sign - ✔✔Tests supraspinatus and infraspinatus for rotator cuff tears
Arms are brought into 90 degree abduction and externally rotated, patient must hold
position without support
- inability to hold position indicates a positive test
✔✔Tinnel's sign - ✔✔Median nerve compression in carpal tunnel syndrome
Tap over the carpal tunnel
- tingling in the thumb or index finger indicates a positive test
✔✔Phalen's Test - ✔✔Carpal tunnel test
Flex patient's wrists and push them together for 1 min
- tingling in the thumb or index finer indicates a positive test
✔✔Patrick's Test - ✔✔Hip or SI joint affection, tightness of adductors or iliopsoas
Patient lies supine with test leg foot on opposite leg knee, knee of test leg is lowered to
table while stabilizing pelvis
- test leg's knee remains above opposite leg indicates a positive test, negative test
would show test leg knee falling to table or parallel
✔✔Thomas Test - ✔✔Rectus femoris, sartorius or TFL tightness
Patient lies supine on table, test knee is pulled into flexion as much as possible
(modified version involves patient's opposite knee hanging off bed)
- opposite leg lifting off bed indicates a positive test and iliopsoas tightness; lateral
rotation of opposite leg also indicates tightness in glutes/TFL
✔✔What are the steps of MI? - ✔✔Engaging
Focusing
Evoking
Planning
✔✔What are OARS? - ✔✔Open ended question
Affirmation
Reflection
Summary
,✔✔What are some tools that can be used in MI? - ✔✔Evocative questions
Importance ruler
Querying extremes
Looking back/forward
Exploring goals and dreams
✔✔Valgus Stress Test - ✔✔MCL laxity
Apply a valgus pressure to the outside of the knee while holding lower leg still
- excessive laxity indicates MCL is most likely torn
✔✔Varus Stress Test - ✔✔LCL laxity
Apply a varus pressure to the inside of the knee while holding the lower leg still
- excessive laxity indicates LCL is most likely torn
✔✔Anterior Drawer Test (Knee) - ✔✔ACL laxity
Patient in supine with knee flexed, tibia is pulled anteriorly
- excessive movement indicates laxity and possible tears
✔✔Posterior Drawer Test (Knee) - ✔✔PCL laxity
Patient in supine with knee flexed, tibia is pushed posteriorly
- excessive movement indicates laxity and possible tears
✔✔Lachman's Test - ✔✔ACL injury
Patient in supine with affected knee extended, stabilize femur and hold knee slightly
flexed at 30 degrees, tibia is moved anteriorly
- excessive laxity and soft end feel indicate ACL injury
✔✔McMurray Test - ✔✔Meniscus
Patient in supine with knee completely flexed, tibia is medially rotated and scoured
(lateral meniscus)/laterally rotated and scoured (medial meniscus) and then knee is
extended
- snapping or clicking with pain indicates a meniscus injury
✔✔Anterior Drawer Test (Ankle) - ✔✔Anterior talofibular and tibiotalar ligaments
Patient in supine with foot relaxed, stabilize tibia/fibula and flex foot into slight plantar
flexion, pull foot anteriorly
- laxity and significant translation indicate ligament insufficiencies
✔✔Talar Tilt Test - ✔✔Deltoid/calcaneofibular ligaments
Patient sits with feet relaxed and dangling, ankles are inverted (CFL) and everted
(deltoid ligament)
- pain and excessive laxity indicate ankle sprain and ligament insufficiencies
, ✔✔Thompson Test - ✔✔Achilles' tendon; patient lies prone with leg relaxed, squeeze
the calf muscles
- no plantar flexion indicates a torn Achilles
✔✔What is LTAD? - ✔✔Long Term Athlete Development
Active Start, FUNdamentals, Learn to Train, Train to Train, Train to Compete, Train to
Win, Active for Life
✔✔What are the WHO physical activity recommendations? - ✔✔Children: 60min/day
moderate/vigorous physical activity, resistance exercise 3x week
Adults: 150min/week moderate/vigorous physical activity, resistance exercise 2x week
Older adults: 150min/week moderate/vigorous physical activity, resistance exercise 2x
week and balance activity to prevent falls
✔✔What is the importance of a warm-up? - ✔✔Increases blood flow and O2 delivery to
muscles that will be working
Vasodilates blood vessels to ensure adequate blood flow to muscles
Increases contraction rate and rate of force development of muscles
Decreases muscle and joint resistance
Helps prevent injury
✔✔Importance of a cool down? - ✔✔Regulate blood flow post exercise to prevent
pooling in muscles
Prevent DOMS
Reduce buildup of lactic acid/metabolic by-products Actively slows down BP/HR
Recovery of respiratory variables
✔✔What are some signs/symptoms of over training? - ✔✔Physical - decreased
performance, increased perceived effort during exercise, excessive fatigue, loss of
appetite, chronic injury, excessive weight loss
Emotional - agitation, depression, low motivation
Physiological - abnormal HR or BP, low HR variability
✔✔What are some benefits associated with exercise training in youth? - ✔✔Increased
load and stress from RE provide added stimulus to neural proliferation occurring
Increased motor activation and gains in strength compared to adults undergoing initial
RE
Improved perceived competence, improved academic performance and self-
efficacy/self-esteem
Decreased rates of fracture, MSK injuries associated with sport specific practice and
competition
Increased bone mineral density leading to a higher bone strength index
✔✔What are some risks associated with exercise training in youth? - ✔✔Epiphyseal
plate injury and fractures in young athletes
QUESTIONS AND ANSWERS SURE A+
✔✔What are some factors contributing to fracture risk? - ✔✔Chronic disease
(osteoporosis, arthritis, diabetes), history of smoking/drinking, low BMI, corticosteroid
use, age, gender
✔✔What is FRAX? - ✔✔Fracture risk assessment tool
10-year probability of hip fracture and 10-year probability of major osteoporotic fracture
Takes into account: age, gender, previous fractures, BMD, other risk factors
✔✔What is the CAROC? - ✔✔Canadian Association of Radiologists and Osteoporosis
Canada risk assessment
10 year absolute fracture risk
✔✔What are the categories used in the CAROC? - ✔✔Low <10% risk, lifestyle
measures sufficient for those without additional risk factors for rapid BMD loss
Moderate 10%-20% risk, treatment should be individualized and may include
pharmacologic therapy/lifestyle measures with monitoring
High >20% risk, >50 years who have had a fragility fracture of hip/vertebra and those
who have had more than 1 fragility fracture
✔✔Neer's Test - ✔✔Impingement test
Arm is medially rotated and fully elevated in scaption (30 degrees from frontal plane)
,- pain indicates a positive test
✔✔Hawkins-Kennedy Test - ✔✔Impingement test
Arm is flexed to 90 degrees forearm is then medially rotated
- pain indicates a positive test
✔✔Empty Can Test - ✔✔Tests supraspinatus for impingement
Arms are brought into flexion and scaption, and then medially rotated (emptying a can),
patient must resistance adduction
- weakness or pain indicated a positive test
✔✔Drop arm sign - ✔✔Tests supraspinatus and infraspinatus for rotator cuff tears
Arms are brought into 90 degree abduction and externally rotated, patient must hold
position without support
- inability to hold position indicates a positive test
✔✔Tinnel's sign - ✔✔Median nerve compression in carpal tunnel syndrome
Tap over the carpal tunnel
- tingling in the thumb or index finger indicates a positive test
✔✔Phalen's Test - ✔✔Carpal tunnel test
Flex patient's wrists and push them together for 1 min
- tingling in the thumb or index finer indicates a positive test
✔✔Patrick's Test - ✔✔Hip or SI joint affection, tightness of adductors or iliopsoas
Patient lies supine with test leg foot on opposite leg knee, knee of test leg is lowered to
table while stabilizing pelvis
- test leg's knee remains above opposite leg indicates a positive test, negative test
would show test leg knee falling to table or parallel
✔✔Thomas Test - ✔✔Rectus femoris, sartorius or TFL tightness
Patient lies supine on table, test knee is pulled into flexion as much as possible
(modified version involves patient's opposite knee hanging off bed)
- opposite leg lifting off bed indicates a positive test and iliopsoas tightness; lateral
rotation of opposite leg also indicates tightness in glutes/TFL
✔✔What are the steps of MI? - ✔✔Engaging
Focusing
Evoking
Planning
✔✔What are OARS? - ✔✔Open ended question
Affirmation
Reflection
Summary
,✔✔What are some tools that can be used in MI? - ✔✔Evocative questions
Importance ruler
Querying extremes
Looking back/forward
Exploring goals and dreams
✔✔Valgus Stress Test - ✔✔MCL laxity
Apply a valgus pressure to the outside of the knee while holding lower leg still
- excessive laxity indicates MCL is most likely torn
✔✔Varus Stress Test - ✔✔LCL laxity
Apply a varus pressure to the inside of the knee while holding the lower leg still
- excessive laxity indicates LCL is most likely torn
✔✔Anterior Drawer Test (Knee) - ✔✔ACL laxity
Patient in supine with knee flexed, tibia is pulled anteriorly
- excessive movement indicates laxity and possible tears
✔✔Posterior Drawer Test (Knee) - ✔✔PCL laxity
Patient in supine with knee flexed, tibia is pushed posteriorly
- excessive movement indicates laxity and possible tears
✔✔Lachman's Test - ✔✔ACL injury
Patient in supine with affected knee extended, stabilize femur and hold knee slightly
flexed at 30 degrees, tibia is moved anteriorly
- excessive laxity and soft end feel indicate ACL injury
✔✔McMurray Test - ✔✔Meniscus
Patient in supine with knee completely flexed, tibia is medially rotated and scoured
(lateral meniscus)/laterally rotated and scoured (medial meniscus) and then knee is
extended
- snapping or clicking with pain indicates a meniscus injury
✔✔Anterior Drawer Test (Ankle) - ✔✔Anterior talofibular and tibiotalar ligaments
Patient in supine with foot relaxed, stabilize tibia/fibula and flex foot into slight plantar
flexion, pull foot anteriorly
- laxity and significant translation indicate ligament insufficiencies
✔✔Talar Tilt Test - ✔✔Deltoid/calcaneofibular ligaments
Patient sits with feet relaxed and dangling, ankles are inverted (CFL) and everted
(deltoid ligament)
- pain and excessive laxity indicate ankle sprain and ligament insufficiencies
, ✔✔Thompson Test - ✔✔Achilles' tendon; patient lies prone with leg relaxed, squeeze
the calf muscles
- no plantar flexion indicates a torn Achilles
✔✔What is LTAD? - ✔✔Long Term Athlete Development
Active Start, FUNdamentals, Learn to Train, Train to Train, Train to Compete, Train to
Win, Active for Life
✔✔What are the WHO physical activity recommendations? - ✔✔Children: 60min/day
moderate/vigorous physical activity, resistance exercise 3x week
Adults: 150min/week moderate/vigorous physical activity, resistance exercise 2x week
Older adults: 150min/week moderate/vigorous physical activity, resistance exercise 2x
week and balance activity to prevent falls
✔✔What is the importance of a warm-up? - ✔✔Increases blood flow and O2 delivery to
muscles that will be working
Vasodilates blood vessels to ensure adequate blood flow to muscles
Increases contraction rate and rate of force development of muscles
Decreases muscle and joint resistance
Helps prevent injury
✔✔Importance of a cool down? - ✔✔Regulate blood flow post exercise to prevent
pooling in muscles
Prevent DOMS
Reduce buildup of lactic acid/metabolic by-products Actively slows down BP/HR
Recovery of respiratory variables
✔✔What are some signs/symptoms of over training? - ✔✔Physical - decreased
performance, increased perceived effort during exercise, excessive fatigue, loss of
appetite, chronic injury, excessive weight loss
Emotional - agitation, depression, low motivation
Physiological - abnormal HR or BP, low HR variability
✔✔What are some benefits associated with exercise training in youth? - ✔✔Increased
load and stress from RE provide added stimulus to neural proliferation occurring
Increased motor activation and gains in strength compared to adults undergoing initial
RE
Improved perceived competence, improved academic performance and self-
efficacy/self-esteem
Decreased rates of fracture, MSK injuries associated with sport specific practice and
competition
Increased bone mineral density leading to a higher bone strength index
✔✔What are some risks associated with exercise training in youth? - ✔✔Epiphyseal
plate injury and fractures in young athletes
