Ben Williams
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All Questions and Answers taken directly from the textbook publisher's website: http://www.differentialdiagnosisforpt.com/

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USA - Differential Diagnosis - Units 1-4 and 6-8

Pregunta 1 de 56

1

In the context of screening for referral, primary purpose of a diagnosis is:

Selecciona una de las siguientes respuestas posibles:

  • To obtain reimbursement

  • To guide the plan of care and intervention strategies

  • To practice within the scope of physical therapy

  • To meet the established standards for accreditation

Explicación

Pregunta 2 de 56

1

Direct access is the only reason physical therapists must screen for systemic disease.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 3 de 56

1

A patient/client gives you a written prescription from a physician, chiropractor, or dentist. The first screening question to ask is:

Selecciona una de las siguientes respuestas posibles:

  • What did the physician (dentist, chiropractor) say is the problem?

  • Did the physician (dentist, chiropractor) examine you?

  • When do you go back to see the doctor (dentist, chiropractor)?

  • How many times per week did the doctor (dentist, chiropractor) suggest you come to therapy?

Explicación

Pregunta 4 de 56

1

Screening for medical disease takes place:

Selecciona una de las siguientes respuestas posibles:

  • Only during the first interview

  • Just before the client returns to the physician for his/her next appointment

  • Throughout the episode of care

  • None of these

Explicación

Pregunta 5 de 56

1

Physical therapists are qualified to make a human movement system diagnosis regarding primary neuromusculoskeletal conditions, but we must do so in accordance with:

Selecciona una de las siguientes respuestas posibles:

  • The Guide to Physical Therapist Practice

  • The State Practice Act

  • The screening process

  • The SOAP method

Explicación

Pregunta 6 de 56

1

Medical referral for a problem outside the scope of the physical therapy practice occurs when:

Selecciona una de las siguientes respuestas posibles:

  • No apparent movement dysfunction exists

  • No causative factors can be identified

  • Findings are not consistent with neuromuscular or musculoskeletal dysfunction

  • Client presents with suspicious red-flag symptoms

  • Any one of these

  • None of these

Explicación

Pregunta 7 de 56

1

Physical therapy evaluation and intervention may be part of the physician’s differential diagnosis.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 8 de 56

1

What is the effect of NSAIDs (e.g., Naprosyn, Motrin, Anaprox, ibuprofen) on blood pressure?

Selecciona una de las siguientes respuestas posibles:

  • No effect

  • Increases blood pressure

  • Decreases blood pressure

Explicación

Pregunta 9 de 56

1

Most of the information needed to determine the cause of symptoms is contained in the:

Selecciona una de las siguientes respuestas posibles:

  • Subjective examination

  • Family/Personal History Form

  • Objective information

  • All of these

  • Subjective Examination and Objective Information

Explicación

Pregunta 10 de 56

1

A risk factor for NSAID-related gastropathy is the use of:

Selecciona una de las siguientes respuestas posibles:

  • Antibiotics

  • Antidepressants

  • Antihypertensives

  • Antihistamines

Explicación

Pregunta 11 de 56

1

After 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:

Selecciona una de las siguientes respuestas posibles:

  • An open-ended question

  • A funnel technique

  • A paraphrasing technique

  • None of these

Explicación

Pregunta 12 de 56

1

Screening for alcohol use would be appropriate when the client reports a history of accidents.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 13 de 56

1

What is the significance of sweats?

Selecciona una de las siguientes respuestas posibles:

  • A sign of systemic disease

  • Side effect of chemotherapy or other medications

  • Poor ventilation while sleeping

  • All of these

  • None of these

Explicación

Pregunta 14 de 56

1

Spontaneous uterine bleeding after 12 consecutive months without menstrual bleeding requires medical referral.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 15 de 56

1

Which of the following are red flags to consider when screening for systemic or viscerogenic causes of neuromuscular and musculoskeletal signs and symptoms:

Selecciona una de las siguientes respuestas posibles:

  • Fever, (night) sweats, dizziness

  • Symptoms are out of proportion to the injury

  • Insidious onset

  • No position is comfortable

  • All of these

Explicación

Pregunta 16 de 56

1

You should assess clients who are receiving NSAIDs for which physiologic effect associated with increased risk of hypertension?

Selecciona una de las siguientes respuestas posibles:

  • Decreased heart rate

  • Increased diuresis

  • Slowed peristalsis

  • Water retention

Explicación

Pregunta 17 de 56

1

Instruct clients with a history of hypertension and arthritis to:

Selecciona una de las siguientes respuestas posibles:

  • Limit physical activity and exercise

  • Avoid over-the-counter medications

  • Inform their primary care provider of both conditions

  • Drink plenty of fluids to avoid edema

Explicación

Pregunta 18 de 56

1

Alcohol screening tools should be:

Selecciona una de las siguientes respuestas posibles:

  • Used with every client sometime during the episode of care

  • Brief, easy to administer, and nonthreatening

  • Deferred when the client has been drinking or has the smell of alcohol on the breath

  • Conducted with one other family member present as a witness

Explicación

Pregunta 19 de 56

1

What is the best follow-up question for someone who tells you that the pain is constant?

Selecciona una de las siguientes respuestas posibles:

  • Can you use one finger to point to the pain location?

  • Do you have that pain right now?

  • Does the pain wake you up at night after you have fallen asleep?

  • Is there anything that makes the pain better or worse?

Explicación

Pregunta 20 de 56

1

A 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?

Selecciona una de las siguientes respuestas posibles:

  • Minimal distractions heighten a person’s awareness of musculoskeletal discomfort.

  • This is a systemic pattern that is associated with a neoplasm.

  • It is impossible to tell.

  • This represents a chronic clinical presentation of a musculoskeletal problem.

Explicación

Pregunta 21 de 56

1

Referred pain patterns associated with impairment of the spleen can produce musculoskeletal symptoms in:

Selecciona una de las siguientes respuestas posibles:

  • The left shoulder

  • The right shoulder

  • The mid-back or upper back, scapular, and right shoulder areas

  • The thorax, scapulae, right shoulder, or left shoulder

Explicación

Pregunta 22 de 56

1

Associated signs and symptoms are a major red flag for pain of a systemic or visceral origin compared to musculoskeletal pain.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 23 de 56

1

Words used to describe neurogenic pain often include:

Selecciona una de las siguientes respuestas posibles:

  • Throbbing, pounding, beating

  • Crushing, shooting, pricking

  • Aching, heavy, sore

  • Agonizing, piercing, unbearable

Explicación

Pregunta 24 de 56

1

Pain (especially intense bone pain) that is disproportionately relieved by aspirin can be a symptom of:

Selecciona una de las siguientes respuestas posibles:

  • Neoplasm

  • Assault or trauma

  • Drug dependence

  • Fracture

Explicación

Pregunta 25 de 56

1

Joint pain can be a reactive, delayed, or allergic response to:

Selecciona una de las siguientes respuestas posibles:

  • Medications

  • Chemicals

  • Infections

  • Artificial sweeteners

  • All of these

Explicación

Pregunta 26 de 56

1

Bone pain associated with neoplasm is characterized by:

Selecciona una de las siguientes respuestas posibles:

  • Increases with weight bearing

  • Negative heel strike

  • Relieved by Tums or other antacid in women

  • Goes away after eating

Explicación

Pregunta 27 de 56

1

Pain of a viscerogenic nature is not relieved by a change in position.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 28 de 56

1

Referred pain from the viscera can occur alone but is usually preceded by visceral pain when an organ is involved.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 29 de 56

1

A 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?

Selecciona una de las siguientes respuestas posibles:

  • Toxic waste products from the pancreas are released into the intestines causing irritation of the retroperitoneal space.

  • Rupture of the pancreas causes internal bleeding and referred pain called Kehr’s sign.

  • The pancreas and low back structures are formed from the same embryologic tissue in the mesoderm.

  • Obstruction, irritation, or inflammation of the body of the pancreas distends the pancreas, thus applying pressure on the central respiratory diaphragm.

Explicación

Pregunta 30 de 56

1

When assessing the abdomen, what sequence of physical assessment is best?

1.)
2.)
3.)
4.)

Arrastra y suelta para completar el texto.

    Inspection
    Auscultation
    Percussion
    Palpation

Explicación

Pregunta 31 de 56

1

A line drawn down the middle of a lesion with two different halves suggests:

Selecciona una de las siguientes respuestas posibles:

  • A malignant lesion

  • A benign lesion

  • A normal presentation

  • A skin reaction to medications

Explicación

Pregunta 32 de 56

1

Pulse strength graded as 1 means:

Selecciona una de las siguientes respuestas posibles:

  • Easily palpable, normal

  • Present occasionally

  • Pulse diminished, barely palpable

  • Within normal limits

Explicación

Pregunta 33 de 56

1

During 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:

Selecciona una de las siguientes respuestas posibles:

  • Characteristic of lung disease

  • Typical in coronary artery disease

  • A normal finding

  • Common in anyone with pain

Explicación

Pregunta 34 de 56

1

Body temperature should be taken as part of vital sign assessment:

Selecciona una de las siguientes respuestas posibles:

  • A.) Only for clients who have not been seen by a physician

  • B.) For any client who has musculoskeletal pain of unknown origin

  • C.) For any client reporting the presence of constitutional symptoms, especially fever or sweats

  • B.) and C.)

  • All of the above

Explicación

Pregunta 35 de 56

1

A 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?

Selecciona una de las siguientes respuestas posibles:

  • Vital signs only.

  • Vital signs and abdominal auscultation.

  • Vital signs, neurologic screening examination, and abdominal auscultation.

  • No further assessment is needed; there are enough red flags to advise this client to seek medical attention.

Explicación

Pregunta 36 de 56

1

Pursed-lip breathing in the sitting position while leaning forward on the arms relieves symptoms of dyspnea for the client with:

Selecciona una de las siguientes respuestas posibles:

  • Orthopnea

  • Emphysema

  • CHF

  • Orthopnea and CHF

Explicación

Pregunta 37 de 56

1

Palpitations lasting for hours or occurring in association with pain, shortness of breath, fainting, or severe lightheadedness require medical evaluation.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 38 de 56

1

Peripheral vascular diseases include:

Selecciona una de las siguientes respuestas posibles:

  • Arterial and occlusive diseases

  • Arterial and venous disorders

  • Acute and chronic arterial diseases

  • All of these

  • None of these

Explicación

Pregunta 39 de 56

1

Which statement is the most accurate?

Selecciona una de las siguientes respuestas posibles:

  • Arterial disease is characterized by intermittent claudication, pain relieved by elevating the extremity, and history of smoking.

  • Arterial 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.

  • Arterial disease is characterized by painful throbbing of the feet at night that goes away by dangling the feet over the bed.

  • Arterial 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.

Explicación

Pregunta 40 de 56

1

What are the primary signs and symptoms of CHF?

Selecciona una o más de las siguientes respuestas posibles:

  • Fatigue

  • Dyspnea

  • Edema

  • Nocturia

  • Varicose Veins

  • Tinnitus

  • Headache

  • Night Sweats

Explicación

Pregunta 41 de 56

1

When would you advise a client in physical therapy to take his/her nitroglycerin?

Selecciona una de las siguientes respuestas posibles:

  • 45 minutes before exercise

  • When symptoms of chest pain do not subside with 10 to 15 minutes of rest

  • As soon as chest pain begins

  • None of the above

  • Any of the above

Explicación

Pregunta 42 de 56

1

Neurologic symptoms such as muscle weakness or muscle atrophy may be the first indication of:

Selecciona una de las siguientes respuestas posibles:

  • Cystic fibrosis

  • Bronchiectasis

  • Neoplasm

  • Deep vein thrombosis

Explicación

Pregunta 43 de 56

1

Back pain with radiating numbness and tingling down the leg past the knee does not occur as a result of:

Selecciona una de las siguientes respuestas posibles:

  • Postoperative thrombus

  • Bronchogenic carcinoma

  • Pott’s disease

  • Trigger points

Explicación

Pregunta 44 de 56

1

Pain associated with pleuropulmonary disorders can radiate to the:

Selecciona una o más de las siguientes respuestas posibles:

  • Anterior Neck

  • Upper Trapezius Muscle

  • Ipsilateral Shoulder

  • Thoracic Spine

Explicación

Pregunta 45 de 56

1

The presence of a persistent dry cough (no sputum or phlegm produced) has no clinical significance to the therapist.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 46 de 56

1

Dyspnea associated with emphysema is the result of:

Selecciona una de las siguientes respuestas posibles:

  • A.) Destruction of the alveoli

  • B.) Reduced elasticity of the lungs

  • C.) Increased effort to exhale trapped air

  • A.) and B.)

  • All of the above

Explicación

Pregunta 47 de 56

1

The 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?

Selecciona una de las siguientes respuestas posibles:

  • Increase

  • Decrease

  • Remain unchanged

  • Vary depending on potassium concentration

Explicación

Pregunta 48 de 56

1

Common symptoms of RESPIRATORY ACIDOSIS would be most closely represented by which of the following descriptions?

Selecciona una de las siguientes respuestas posibles:

  • Presence of numbness and tingling in face, hands, and feet

  • Presence of dizziness and lightheadedness

  • Hyperventilation with changes in level of consciousness

  • Onset of sleepiness, confusion, and decreased ventilation

Explicación

Pregunta 49 de 56

1

Bleeding in the gastrointestinal (GI) tract can be manifested as:

Selecciona una de las siguientes respuestas posibles:

  • Dysphagia

  • Melena

  • Psoas abscess

  • Tenderness over McBurney’s point

Explicación

Pregunta 50 de 56

1

What is the significance of Kehr’s sign?

Selecciona una de las siguientes respuestas posibles:

  • Gas, air, or blood in the abdominal cavity

  • Infection of the peritoneum (peritonitis, appendicitis)

  • Esophageal cancer

  • Thoracic disk herniation masquerading as chest or anterior neck pain

Explicación

Pregunta 51 de 56

1

What areas of the body can GI disorders refer pain to?

Selecciona una o más de las siguientes respuestas posibles:

  • Sternum

  • Shoulder

  • Scapula

  • Anterior Neck

  • Mid-Back

  • Lower Back

  • Hip

  • Pelvis

  • Sacrum

Explicación

Pregunta 52 de 56

1

A 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:

Selecciona una de las siguientes respuestas posibles:

  • Thoracic disk disease

  • Obturator nerve compression

  • Small intestine disease

  • Large intestine and colon dysfunction

Explicación

Pregunta 53 de 56

1

Which of the following are common medications, taken by clients seen in a physical therapy practice, that are likely to induce GI bleeding.

Selecciona una de las siguientes respuestas posibles:

  • Corticosteroids

  • Antibiotics and antiinflammatories

  • Statins

  • None of these

Explicación

Pregunta 54 de 56

1

Which of the following are clues to the possible involvement of the GI system?

Selecciona una de las siguientes respuestas posibles:

  • Abdominal pain alternating with TMJ pain within a 2-week period

  • Abdominal pain at the same level as back pain, occurring either simultaneously or alternately

  • Shoulder pain alleviated by a bowel movement

  • All of these

Explicación

Pregunta 55 de 56

1

A 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:

Selecciona una de las siguientes respuestas posibles:

  • Psoas abscess caused by vertebral osteomyelitis

  • GI bleeding causing hemorrhoids and rectal fissures

  • Crohn’s disease manifested as sacroiliitis

  • Pressure on sacral nerves from stored fecal content in the constipated client taking narcotics

Explicación

Pregunta 56 de 56

1

Body temperature should be taken as part of vital sign assessment:

Selecciona una de las siguientes respuestas posibles:

  • a. For every client evaluated

  • b. For any client who has musculoskeletal pain of unknown origin

  • c. For any client reporting the presence of constitutional symptoms, especially fever or night sweats

  • d. b and c

Explicación

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