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End of Chapter Review Questions

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USA - Differential Diagnosis - Units 9-14

Pregunta 1 de 57

1

Referred pain patterns associated with hepatic and biliary pathologic conditions produce musculoskeletal symptoms in the:

Selecciona una de las siguientes respuestas posibles:

  • Left shoulder

  • Right shoulder

  • Mid-back or upper back, scapular, and right shoulder areas

  • Thorax, scapulae, right or left shoulder

Explicación

Pregunta 2 de 57

1

Clients with significant elevations in serum bilirubin levels caused by biliary obstruction will have which of the following associated signs?

Selecciona una de las siguientes respuestas posibles:

  • a. Dark urine, clay-colored stools, jaundice

  • b. Yellow-tinged sclera

  • c. Decreased serum ammonia levels

  • d. a and b only

Explicación

Pregunta 3 de 57

1

Preventing falls and trauma to soft tissues would be of utmost importance in the client with liver failure. Which of the following laboratory parameters would give you the most information about potential tissue injury?

Selecciona una de las siguientes respuestas posibles:

  • Decrease in serum albumin levels

  • Elevated liver enzyme levels

  • Prolonged coagulation times

  • Elevated serum bilirubin levels

Explicación

Pregunta 4 de 57

1

Decreased level of consciousness, impaired function of peripheral nerves, and asterixis (flapping tremor) would probably indicate an increase in the level of:

Selecciona una de las siguientes respuestas posibles:

  • AST (aspartate aminotransferase)

  • Alkaline phosphatase

  • Serum bilirubin

  • Serum ammonia

Explicación

Pregunta 5 de 57

1

An inpatient who has had a total hip replacement with a significant history of alcohol use/abuse has a positive test for asterixis. This may signify:

Selecciona una de las siguientes respuestas posibles:

  • Renal failure

  • Hepatic encephalopathy

  • Diabetes

  • Gallstones obstructing the common bile duct

Explicación

Pregunta 6 de 57

1

A decrease in serum albumin is common with a pathologic condition of the liver because albumin is produced in the liver. The reduction in serum albumin results in some easily identifiable signs.

Which of the following signs might alert the therapist to the condition of decreased albumin?

Selecciona una de las siguientes respuestas posibles:

  • Increased blood pressure

  • Peripheral edema and ascites

  • Decreased level of consciousness

  • Exertional dyspnea

Explicación

Pregunta 7 de 57

1

Percussion of the costovertebral angle that results in the reproduction of symptoms:

Selecciona una de las siguientes respuestas posibles:

  • Signifies radiculitis

  • Signifies pseudorenal pain

  • Has no significance

  • Requires medical referral

Explicación

Pregunta 8 de 57

1

Renal pain is aggravated by:

Selecciona una de las siguientes respuestas posibles:

  • Spinal movement

  • Palpatory pressure over the costovertebral angle

  • Lying on the involved side

  • All of these

  • None of these

Explicación

Pregunta 9 de 57

1

Important functions of the kidney include all the following EXCEPT:

Selecciona una de las siguientes respuestas posibles:

  • Formation and excretion of urine

  • Acid-base and electrolyte balance

  • Stimulation of red blood cell production

  • Production of glucose

Explicación

Pregunta 10 de 57

1

Match the Definition to the Term:
Difficult or painful sexual intercourse in women ::
Painful or difficult urination ::
Blood in the urine ::
A sudden, compelling desire to urinate ::

Arrastra y suelta para completar el texto.

    Dyspareunia
    Dysuria
    Hematuria
    Urgency

Explicación

Pregunta 11 de 57

1

What are the most common musculoskeletal symptoms associated with endocrine disorders?

Selecciona una o más de las siguientes respuestas posibles:

  • Proximal Muscle Weakness

  • Myalgia

  • Carpal Tunnel Syndrome

  • PeriArthritis

  • Adhesive Capsulitis

  • Hematuria

  • Pursed Lip Breathing

  • Malaise

Explicación

Pregunta 12 de 57

1

What systemic conditions can cause carpal tunnel syndrome?

Selecciona una o más de las siguientes respuestas posibles:

  • Endocrine Disorders

  • Infectious Diseases

  • Collagen Disorders

  • Cancer

  • Liver Disease

  • CHF

  • Diabetes

Explicación

Pregunta 13 de 57

1

Disorders of the endocrine glands can be caused by:

Selecciona una de las siguientes respuestas posibles:

  • a. Dysfunction of the gland

  • b. External stimulus

  • c. Excess or insufficiency of hormonal secretions

  • a and b

  • b and c

  • All the above

Explicación

Pregunta 14 de 57

1

3 Most common symptoms of Diabetes Mellitus

Selecciona una o más de las siguientes respuestas posibles:

  • Polydipsia

  • Polyuria

  • Polyphagia

  • Weight Gain

  • SOB

  • Polyketosis

Explicación

Pregunta 15 de 57

1

The major differentiating factor between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) is the absence of ketosis in HHS.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 16 de 57

1

it is safe to administer a source of sugar to a lethargic or unconscious person with diabetes.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 17 de 57

1

It is NOT safe to administer a source of sugar to a lethargic or unconscious person with diabetes?

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 18 de 57

1

Clients with diabetes insipidus (DI) would most likely come to the therapist with which of the following clinical symptoms?

Selecciona una de las siguientes respuestas posibles:

  • Severe dehydration, polydipsia

  • Headache, confusion, lethargy

  • Weight gain

  • Decreased urine output

Explicación

Pregunta 19 de 57

1

Clients who are taking corticosteroid medications should be monitored for the onset of Cushing’s syndrome. You will need to monitor your client for which of the following problems?

Selecciona una de las siguientes respuestas posibles:

  • a. Low blood pressure, hypoglycemia

  • b. Decreased bone density, muscle wasting

  • c. Slow wound healing

  • b and c

Explicación

Pregunta 20 de 57

1

Signs and symptoms of Cushing’s syndrome in an adult taking oral steroids may include:

Selecciona una de las siguientes respuestas posibles:

  • Increased thirst, decreased urination, and decreased appetite

  • Low white blood cell count and reduced platelet count

  • High blood pressure, tachycardia, and palpitations

  • Hypertension, slow wound healing, easy bruising

Explicación

Pregunta 21 de 57

1

Parathyroid hormone (PTH) secretion is particularly important in the metabolism of bone. The client with an oversecreting parathyroid gland would most likely have:

Selecciona una de las siguientes respuestas posibles:

  • Increased blood pressure

  • Pathologic fractures

  • Decreased blood pressure

  • Increased thirst and urination

Explicación

Pregunta 22 de 57

1

Which glycosylated hemoglobin (A1C) values are within the recommended range?

Selecciona una o más de las siguientes respuestas posibles:

  • 4%

  • 5%

  • 6%

  • 7%

  • 8%

  • 9%

  • 10%

  • 11%

  • 12%

Explicación

Pregunta 23 de 57

1

A 38-year-old man comes to the clinic for low back pain. He has a new diagnosis of Graves’ disease.
When asked if there are any other symptoms of any kind, he replies “increased appetite and excessive sweating.”

When you perform a neurologic screening examination, what might be present that would be associated with the Graves’ disease?

Selecciona una de las siguientes respuestas posibles:

  • Hyporeflexia but no change in strength

  • Hyporeflexia with decreased muscle strength

  • Hyperreflexia with no change in strength

  • Hyperreflexia with decreased muscle strength

Explicación

Pregunta 24 de 57

1

All of the following are common signs or symptoms of insulin resistance except:

Selecciona una de las siguientes respuestas posibles:

  • Acanthosis nigricans

  • Drowsiness after meals

  • Fatigue

  • Oliguria

Explicación

Pregunta 25 de 57

1

Fibromyalgia syndrome is a:

Selecciona una de las siguientes respuestas posibles:

  • Musculoskeletal disorder

  • Psychosomatic disorder

  • Neurosomatic disorder

  • Noninflammatory rheumatic disorder

Explicación

Pregunta 26 de 57

1

Which of the following describes the pattern of rheumatic joint disease?

Selecciona una de las siguientes respuestas posibles:

  • Pain and stiffness in the morning gradually improves with gentle activity and movement during the day.

  • Pain and stiffness accelerate during the day and are worse in the evening.

  • Night pain is frequently associated with advanced structural damage seen on x-ray.

  • Pain is brought on by activity and resolves predictably with rest.

Explicación

Pregunta 27 de 57

1

Which of the following symptoms are more indicative of osteoarthritis than rheumatoid arthritis?

Selecciona una o más de las siguientes respuestas posibles:

  • Pain and stiffness in the morning gradually improves with gentle activity and movement during the day.

  • Pain and stiffness accelerate during the day and are worse in the evening.

  • Night pain is frequently associated with advanced structural damage seen on x-ray.

  • Pain is brought on by activity and resolves predictably with rest.

Explicación

Pregunta 28 de 57

1

A positive Schober’s test is a sign of:

Selecciona una o más de las siguientes respuestas posibles:

  • Reiter’s syndrome

  • Infectious arthritis

  • Ankylosing spondylitis

Explicación

Pregunta 29 de 57

1

Proximal muscle weakness may be a sign of:

Selecciona una o más de las siguientes respuestas posibles:

  • Paraneoplastic syndrome

  • Neurologic disorder

  • Myasthenia gravis

  • Scleroderma

Explicación

Pregunta 30 de 57

1

Which of the following skin assessment findings in the HIV-infected client occurs with Kaposi’s sarcoma?

Selecciona una de las siguientes respuestas posibles:

  • Darkening of the nail beds

  • Purple-red blotches or bumps on the trunk and head

  • Cyanosis of the lips and mucous membranes

  • Painful blistered lesions of the face and neck

Explicación

Pregunta 31 de 57

1

The most common cause of change in mental status of the HIV-infected client is related to:

Selecciona una de las siguientes respuestas posibles:

  • Meningitis

  • Alzheimer’s disease

  • Space-occupying lesions

  • AIDS dementia complex

Explicación

Pregunta 32 de 57

1

Symptoms of anaphylaxis that would necessitate immediate medical treatment or referral are:

Selecciona una de las siguientes respuestas posibles:

  • Hives and itching

  • Vocal hoarseness, sneezing, and chest tightness

  • Periorbital edema

  • Nausea and abdominal cramping

Explicación

Pregunta 33 de 57

1

In a physical therapy practice, clients are most likely to present with signs and symptoms of metastases to:

Selecciona una de las siguientes respuestas posibles:

  • Skeletal system, hepatic system, pulmonary system, central nervous system

  • Cardiovascular system, peripheral vascular system, enteric system

  • Hematologic and lymphatic systems

  • None of thse

Explicación

Pregunta 34 de 57

1

In any individual, any neurologic sign may be the presentation of a silent lung tumor.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 35 de 57

1

Complete the CAUTIONS Mnemonic for Early Warning Signs for Cancer

C -
A -
U -
T - Thickening or lump in the breast or elsewhere
I -
O -
N -
S -

Arrastra y suelta para completar el texto.

    Changes in bowel or bladder habits
    A sore that does not heal within 6-weeks
    Unusual bleeding or discharge
    Indigestion or difficulty in swallowing
    Obvious change in a wart or mole
    Nagging cough or hoarsenss
    Supplemental signs and symptoms

Explicación

Pregunta 36 de 57

1

Whenever a therapist observes, palpates, or receives a client report of a lump or nodule, what three questions must be asked?

Selecciona una o más de las siguientes respuestas posibles:

  • How long have you had this area of skin discoloration/mole/spot/lump?

  • Has it changed over the past 6 weeks to 6 months?

  • Has your physician examined this area?

  • Have you noticed this skin discoloration/mole/spot/lump?

  • When did this skin discoloration/mole/spot/lump first appear?

  • Do you have any other skin discoloration/moles/spots/lumps on your body?

Explicación

Pregunta 37 de 57

1

When tumors produce signs and symptoms at a site distant from the tumor or its metastasized sites, these “remote effects” of malignancy are called:

Selecciona una de las siguientes respuestas posibles:

  • Bone metastases

  • Vitiligo

  • Paraneoplastic syndrome

  • Ichthyosis

Explicación

Pregunta 38 de 57

1

A client who has recently completed chemotherapy requires immediate medical referral if he has which of the following symptoms?

Selecciona una de las siguientes respuestas posibles:

  • Decreased appetite

  • Increased urinary output

  • Mild fatigue but moderate dyspnea with exercise

  • Fever, chills, sweating

Explicación

Pregunta 39 de 57

1

A suspicious skin lesion requiring medical evaluation has:

Selecciona una de las siguientes respuestas posibles:

  • Round, symmetric borders

  • Notched edges

  • Matching halves when a line is drawn down the middle

  • A single color of brown or tan

Explicación

Pregunta 40 de 57

1

What is the significance of Beau’s lines in a client treated with chemotherapy for leukemia?

Selecciona una de las siguientes respuestas posibles:

  • Impaired nail formation from death of cells

  • Temporary longitudinal groove or ridge through the nail

  • Increased production of the nail by the matrix as a sign of healing

  • A sign of local trauma

Explicación

Pregunta 41 de 57

1

A 16-year-old boy was hurt in a soccer game. He presents with exquisite right ankle pain on weight bearing but reports no pain at night. Upon further questioning, you find he is taking Ibuprofen at night before bed, which may be masking his pain.

What other screening examination procedures are warranted?

Selecciona una o más de las siguientes respuestas posibles:

  • Perform a heel strike test.

  • Review response to treatment.

  • Assess for signs of fracture (edema, exquisite tenderness to palpation, warmth over the painful site).

Explicación

Pregunta 42 de 57

1

When is it advised to take a work or military history?

Selecciona una de las siguientes respuestas posibles:

  • Anyone with head and/or neck pain who uses a cell phone more than 8 hours/day

  • Anyone over age 50

  • Anyone presenting with joint pain of unknown cause accompanied by multiple other signs and symptoms

  • This is outside the scope of a physical therapist’s practice

Explicación

Pregunta 43 de 57

1

A 70-year-old man came to outpatient physical therapy with a complaint of pain and weakness of his fingers and morning stiffness lasting about an hour. He presented with bilateral swelling of the metacarpophalangeal (MCP) joints of the index and ring fingers. He saw his family doctor 4 weeks ago and was given diclofenac, which has not changed his symptoms. Now he wants to try physical therapy. Since he last saw his physician, he has developed additional joint pain in the left knee and right shoulder.

How can you tell if this is cancer, polyarthritis, or a paraneoplastic disorder?

Selecciona una de las siguientes respuestas posibles:

  • Ask about a previous history of cancer and recent onset of skin rash.

  • You can’t. This requires a medical evaluation.

  • Look for signs of digital clubbing, cellulitis, or proximal muscle weakness.

  • Assess vital signs.

Explicación

Pregunta 44 de 57

1

A 49-year-old man was treated by you for bilateral synovitis of the proximal interphalangeal (PIP) joints in the second, third, and fourth fingers. His symptoms went away with treatment, and he was discharged. Six weeks later, he returned with the same symptoms. There was obvious soft tissue swelling with morning stiffness worse than before. He also reports problems with his bowels but isn’t able to tell you exactly what’s wrong. There are no other changes in his health. He is not taking any medications or over-the-counter drugs and does not want to see a doctor.

Are there enough red flags to warrant medical evaluation before resumption of physical therapy intervention?

Selecciona una de las siguientes respuestas posibles:

  • Yes; age, bilateral symptoms, progression of symptoms, report of GI distress

  • No; treatment was effective before—it’s likely that he has done something to exacerbate his symptoms and needs further education about joint protection.

Explicación

Pregunta 45 de 57

1

A client with a past medical history of kidney transplantation (10 years ago) has been referred to you for a diagnosis of rheumatoid arthritis. His medications include tacrolimus, methotrexate, Fosamax, and Wellbutrin. During the examination, you notice a painless lump under the skin in the right upper anterior chest. There is a loss of hair over the area. What other symptoms should you look for as red flag signs and symptoms in a client with this history?

Selecciona una de las siguientes respuestas posibles:

  • Fever, muscle weakness, weight loss

  • Change in deep tendon reflexes, bone pain

  • Productive cough, pain on inspiration

  • Nose bleeds or other signs of excessive bleeding

Explicación

Pregunta 46 de 57

1

A 55-year-old man with a left shoulder impingement also has palpable axillary lymph nodes on both sides. They are firm but movable, about the size of an almond. What steps should you take?

Selecciona una de las siguientes respuestas posibles:

  • Examine other areas where lymph nodes can be palpated.

  • Ask about history of cancer, allergies, or infections.

  • Document your findings and contact the physician with your concerns.

  • All of these

Explicación

Pregunta 47 de 57

1

The most common sites of referred pain from systemic diseases are:

Selecciona una de las siguientes respuestas posibles:

  • Neck and back

  • Shoulder and back

  • Chest and back

  • None of these

Explicación

Pregunta 48 de 57

1

To screen for back pain caused by systemic disease:

Selecciona una de las siguientes respuestas posibles:

  • Perform special tests (e.g., Murphy’s percussion, Bicycle test)

  • Correlate client history with clinical presentation and ask about associated signs and symptoms

  • Perform a Review of Systems

  • All of the above

Explicación

Pregunta 49 de 57

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, 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 50 de 57

1

Pain associated with pleuropulmonary disorders can radiate to:

Selecciona una de las siguientes respuestas posibles:

  • a. Anterior neck

  • b. Upper trapezius muscle

  • c. Ipsilateral shoulder

  • d. Thoracic spine

  • A. and C.

  • B. and C.

  • B., C., and D.

  • A., B., C., and D.

Explicación

Pregunta 51 de 57

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 of time

  • 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 52 de 57

1

Percussion of the costovertebral angle resulting in the reproduction of symptoms signifies:

Selecciona una de las siguientes respuestas posibles:

  • Radiculitis

  • Pseudorenal pain

  • Has no significance

  • Medical referral is advised

Explicación

Pregunta 53 de 57

1

A 53-year-old woman comes to physical therapy with a report of leg pain that begins in her buttocks and goes all the way down to her toes.

If this pain is of a vascular origin she will most likely describe it as:

Selecciona una de las siguientes respuestas posibles:

  • Sore, hurting

  • Hot or burning

  • Shooting or stabbing

  • Throbbing, “tired”

Explicación

Pregunta 54 de 57

1

Twenty-five percent of the people with GI disease, such as Crohn’s disease (regional enteritis), irritable bowel syndrome, or bowel obstruction, have concomitant back or joint pain.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 55 de 57

1

Skin pain over T9 to T12 can occur with kidney disease as a result of multisegmental innervation. Visceral and cutaneous sensory fibers enter the spinal cord close to each other and converge on the same neurons. When visceral pain fibers are stimulated, cutaneous fibers are stimulated, too. Thus visceral pain can be perceived as skin pain.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 56 de 57

1

Autosplinting is the preferred mechanism of pain relief for back pain caused by kidney stones.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 57 de 57

1

Back pain from pancreatic disease occurs when the body of the pancreas is enlarged, inflamed, obstructed, or otherwise impinging on the diaphragm.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación