Medicine & Physical Therapy Notes to Pass with Confidence
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1. A physical therapist assistant notes that a two-year-old child exhibits mus-
cle pseudohypertrophy in the lower extremities. The child has been reluctant
to ambulate recently and exhibits difficulty rising from the floor. Which medical
condition is MOST consistent with the described clinical presentation?
1. Cerebral palsy
2. Duchenne muscular dystrophy
3. Charcot-Marie-Tooth disease
4. Limb-girdle muscular dystrophy: 2. Duchenne muscular dystrophy
Patients with Duchenne muscular dystrophy (DMD) typically present with symptoms
between the ages of 2 and 5. Gastrocnemius pseudohypertrophy is common with
early symptoms including clumsiness, toe walking, frequent falls, difficult rising
from the floor, and a reluctance to walk or run at appropriate developmental ages.
The pseudohypertrophy is caused by muscle tissue being replaced with fat and
connective tissue.
2. A patient recently diagnosed with anemia asks the physical therapist as-
sistant what effect this condition will have on their ability to participate in an
exercise program. Which of the following responses is the MOST appropriate
for the assistant to give to the patient?
1. You may feel as though your muscles are weak
2. You may experience frequent nausea
3. Your aerobic capacity may be reduced
4. You may have a tendency to become fatigued: 4. You may have a tendency to
become fatigued
Anemia is a common cause of fatigue. Fatigue often results since there are an
inadequate number of red blood cells available to transport oxygen to the tissues
of the body.
3. A physical therapist assistant treats a patient diagnosed with Guillain-Barre
syndrome in an acute care hospital. Based on the condition's typical clinical
presentation, what should the assistant anticipate that the patient will demon-
strate?
1. Cognitive dysfunction
,2. Hyperflexia
3. Incoordination
4. Normal sensation: 3. Incoordination
Patients diagnosed with Guillain-Barre syndrome will typically present with muscle
weakness, clumsiness, and dyskinesia
4. A patient receives surgical discharge instructions that include the use of
an incentive spirometer and lower extremity compression stockings. Which
,of the following surgical procedures would be MOST likely to necessitate the
use of this type of medical equipment?
1. Achilles tendon repair
2. Lateral ankle ligament reconstruction
3. Knee meniscectomy
4. Total knee arthroplasty: 4. Total knee arthroplasty
The destruction of articular cartilage secondary to osteoarthritis is the most common
indication for total knee arthroplasty (TKA). Due to the magnitude of the surgery, the
use of compression stockings and incentive spirometry are typically included in the
post-operative management of patients post TKA
5. A patient who has cerebral palsy exhibits slow, involuntary, continuous
writhing movements of the upper and lower extremities. Which of the following
motor impairments is MOST representative of this type of motor disturbance?
1. Spasticity
2. Ataxia
3. Hypotonia
4. Athetosis: 4. Athetosis
Athetosis refers to involuntary movements characterized as slow, irregular, and
twisting. Peripheral movements occur without central stability. This type of motor
disturbance makes it extremely difficult to maintain a static body position.
6. A patient diagnosed with fibromyalgia syndrome reports difficulty with
managing flare-ups of their symptoms. Which of the following interventions
should the physical therapist assistant MOST emphasize in order to address
the patient's complaint?
1. Lumbar stabilization exercises
2. Aerobic exercise
3. Instruction in pacing activities
4. General flexibility training: 3. Instruction in pacing activities
Instruction in pacing activities, so as not to push too hard or too little, is a key
component of the management of FMS in an attempt to avoid fluctuations or
flare-ups of symptoms. Individuals with FMA often cycle their activity around their
pain on "good" and "bad" days, with typically lower tolerance for activities and
exercise. Learning to pace activities throughout the day is an important strategy
to break up the vicious cycle of pain leading to decreased activity, which leads to
deconditioning and more pain.
7. A physical therapist assistant administers the Thomas test to a patient
rehabilitating from a lower extremity injury. Which of the following findings
would represent the MOST significant shortening of the right iliopsoas?
1. In supine with the left hip flexed to the chest, the right hip exhibits 5 degrees
, of flexion
2. In supine with the left hip flexed to the chest, the right hip exhibits 15
degrees of flexion
3. In supine with the right hip flexed to the chest, the left hip exhibits 5 degrees
of flexion
4. In supine with right hip flexed to the chest, the left hip exhibits 15 degrees
of flexion.: 2. In supine with the left hip flexed to the chest, the right hip exhibits 15
degrees of flexion.
Special tests may be utilized to determine if a patient has muscle tightness or
pathology. The Thomas test is a special test commonly used to assess the length of
the hip flexors.
To assess the right iliopsoas, the patient would lie supine and flex the left hip to the
chest. The described testing procedure demonstrates more significant shortening of
the right iliopsoas than option 1.
8. A physical therapist assistant works with a patient rehabilitating from a
lumbar laminectomy. During the session the patient suddenly becomes light-
headed and faint. The patient hypothesizes that this is likely a diabetic reaction
since the morning was so hurried and there was not time to have breakfast.
What is the MOST appropriate assistant reaction?
1. Provide the patient with a glass of juice or candy
2. Place the patient in a supine position and monitor the patient's vital signs
3. Attempt to administer an insulin shot
4. Call a code: 1. Provide the patient with a glass of juice or candy
An overdose of insulin, late or skipped meals or overexertion with exercise can cause
a hypoglycemic reaction. Signs and symptoms of hypoglycemic reactions include
weakness, headache, irritability, and lack of muscular coordination.
When he physical therapist assistant recognizes a hypoglycemic reaction, they
should immediately provide the patient with carbohydrates
9. A physical therapist assistant performs a manual muscle test on a patient's
shoulder lateral rotators. Which muscle would be involved in this specific
test?
1. Pectoralis major
2. Teres major
3. Latissimus dorsi
4. Teres minor: 4. Teres minor
The primary muscles being assessed while testing the shoulder lateral rotators
include the teres minor, infraspinatus, and posterior deltoid. The test is performed
with the patient supine and resistance is applied to the forearm in the direction of
medially rotating the humerus. The test can alternately be performed with patient in