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Which of following tracts do the majority of fibers do not cross
during their pathway?

a. dorsal column medial lemniscus d. spinocerebellar

b. corticospinal
c. spinal-thalamic
d. spinocerebellar
Fromet's paper sign is used to identify ______.

a. ulnar neuritis
d. ulnar paralysis
b. median neuritis
c. median paralysis
d. ulnar paralysis
Mark is a 45 year-old who presents with complaints of right hand
weakness. He states he was playing handball and since this
he has been having problems flexing his fingers. When muscle
testing his hand for strength, you note that he cannot hold his
fingers in flexion against gravity but has full active range of motion
in his fingers. According to the Oxford grading scale, what muscle
grade would he be given? b. 2/5

a. 1/5
b. 2/5
c. 3/5
d. 4/5
e. 5/5
Brudzinski's sign would indicate ______.

a. sciatic radiculopathy
c. meningitis/meningeal irritation
b. Sciatic neuralgia
c. meningitis/meningeal irritation
d. lower motor neuron lesion
Giant Betz cells originate in the:

a. anterior horn cell

c. motor cortex
b. dorsal root ganglion
c. motor cortex
d. cerebellum
Demyelization of the peripheral nervous system is seen with
_____.

a. myasthenia gravis b. Gullian Barre

b. Gullian Barre
c. multiple sclerosis
d. amyotrophic lateral sclerosis
In the early stages of Syringolmyleia the patient will present with
________.

a. loss of pain and temperature a. loss of pain and temperature

b. loss of light touch and proprioception
c. rapid loss of muscle mass
d. lower lumbar to sacral pain
Micrographia is seen with ________.

a. Multiple sclerosis
c. Parkinson's disease
b. Myasthenia Gravis
c. Parkinson's disease
d. Amyotrophic lateral sclerosis

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Sensory ataxia can be due to _______.

a. tabes dorsalis
a. tabes dorsalis
b. amyotrophic lateral sclerosis
c. myasthenia gravis
d. all of the above
Normal range of motion of ankle plantar-flexion is ______ degrees

a. 10
d. 50
b. 25
c. 40
d. 50
Although myofascial pain and fibromyalgia have some overlapping
features, fibromyalgia is considered to be a regional pain pattern
and not a widespread pain problem as seen with myofascial pain.
b. False
a. True
b. False
Which nerve innervate the peronei muscles?

a. deep peroneal
b. superficial peroneal
b. superficial peroneal
c. superior gluteal
d. inferior gluteal
The lateral malleolus is a feature of which of the following bones?

a. Femur
c. Fibula
b. Tibia
c. Fibula
d. Calcaneous
Consolidation of the lung will reveal ____________ during the
physical exam.

a. decreased tactile fremitus c. dullness with percussion over the thorax

b. absence of vocal resonance
c. dullness with percussion over the thorax
d. vesicular sounds heard over the lung field
The adult pulse pressure should range from:

a. 10 to 20
c. 30 to 40
b. 20 to 25
c. 30 to 40
d. 60 to 70
Compression of the median nerve in the carpal tunnel will affect
which muscle?

a. adductor pollicus d. flexor pollicis brevis

b. second palmar interosseous
c. pronator teres
d. flexor pollicis brevis
Which of the following tests would not test positive for a patient
with a sacroiliac sprain?
a. Fabere
a. Fabere
(Patrick)
b. Laguerre
c. Lewin-Gaenslen
d. Hibb
Rheumatoid arthritis can be a cause of carpal tunnel syndrome.

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a. True
a. True
b. False
A patient has weakness in the pronator teres muscle. What other
muscle do you need to test?

a. brachioradialis d. abductor pollicus brevi

b. supinator
c. anconeus
d. abductor pollicus brevi
A patient with a wide base and staggering gait would be demon-
strating signs of ____ ataxia.

a. vestibular d. cerebellar
b. sensory
c. proprioceptive
d. cerebellar
Horner's syndrome can develop with which of the following con-
ditions?

a. multiple sclerosis b. syringomyelia

b. syringomyelia
c. myasthenia gravis
d. amyotrophic lateral sclerosis
Passive neck flexion producing sciatic pain is known as
__________ sign.

a. L'Hermitte d. Linder
b. Kerning
c. Brudzinski
d. Linder
You perform Weber's test on a patient with right hearing loss and
he hears it louder in his right ear. This finding is indicative of
________.
c. conductive deafness in the right ear
a. sensorineural deafness in the right ear
b. sensorineural deafness in the left ear
c. conductive deafness in the right ear
d. conductive deafness in the left ear
A patient who slaps their feet on the ground when they walk
(slappage gait) is seen with _________ ataxia.

a. motor c. sensory
b. vestibular
c. sensory
d. auditory
Varicosities in the subcutaneous veins of the medial thigh were
observed ..

a. Femoral Greater saphenous

b. Greater saphenous
c. Lesser saphenous
d. Popliteal
A 45 year old male presents with a cough, hemoptysis, night
sweats..

a. Emphysema Oat cells carcinoma

b. Bronchitis
c. Oat cell carcinoma
d. Pulmonary emboli

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Related symptoms do not identify red flags and rarely tie back to..
False
a. True
b. False
Which of the following would NOT cause alkaline phosphatase to

a. Hepatitis
Pernicious anemia
b. Pagets disease
c. Blastic metastasis
d. Pernicious anemia
Shingles is associated with which of the following microbial
agents?

a. Cytomegalo virus Varicella Virus

b. Staph aures
c. Varicella virus
d. Ebstein barr virus
A 60 year old non febrile female presents with severe acute pain
in the superior lateral aspects of her
left shoulder. There is no history of trauma or previous similar
symptoms. Active shoulder range of motion is painful. Palpation of
the intertubercular groove produces moderate tenderness, which
is increased with active resisted shoulder flexion. What is the
a. bicipital tendinitis
diagnosis? ..

a. bicipital tendinitis
b. Rotator cuff tear
c. Shoulder dislocation
d. Subacromial bursitis
A 37-year-old male presents with right calf pain that is worse with
walking. He denies previous episodes or trauma. Pain worsens
when walking. Exam reveals mild swelling in the affected calf,
flushing on the skin and dorsiflexion of the foot increases the calf
pain. What is the diagnosis?
Deep vein thrombosis
a. Cellulitis
b. Deep vein thrombosis
c. Venous insufficiency
d. Rupture of achilles tendon
A 56 year old female presents complaining of epigastric pressure
with right shoulder and scapular of 12 hours duration... Sensation
as if he has to burb, of which she is unable to. She has been taking
antacids without any relief. What is the most like...
d. Cholecystitis
a. Peptic ulcer
b. GERD
c. Angina
d. Cholecystitis
A 42-year-old male with right sided lower back and leg pain. He
presents with a left antalgic lean (lean to the left). This is ....

a. Medial, right d. Lateral right

b. Lateral, left,
c. Medial, left
d. Lateral right
A 35 year old male patient presents with knee pain, right sided
leg pain on the lateral aspect of the leg, dorsum of the foot
and.... He denies any low back pain. Examination findings include:
hypoesthesis
between 1st and 2nd digits of the foot; resisted... reflexes of the
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lower extremity are WNL. The SLR, kemp and trendelenburg are
negative. Which of the following is the ....

a. L5 radiculopathy L5 radiculopathy
b. Peroneal neuropathy
c. L5 disc herniation
d. Tibial neuropathy
The team doctor tells a football player that he has "pulled a
hamstring" muscle. This results from tearing of the origin of a
hamstring
Ischial tuberosity
a. Sacrum
b. Iliac tubercle
c. Obturator membrane
d. Ischial tuberosity
Schamroths sign is associated with ____.

a. Appendicitis
COPD
b. COPD
c. Angina pectoralis
d. Cholecystitis
t would be appropriate to perform Valsavla test on patient when
they have all of the following complaints EXCEPT ____

a. Knee pain Knee pain

b. Neck pain
c. Tingling in the foot
d. Lower back pain
Ape hand is associated with a lesion to the nerve.

a. Ulnar
Median
b. Radial
c. Axillary
d. Median
Which of the following nutrients is most needed for DNA synthe-
sis?

a. Vitamin B6 Vitamin B12

b. Vitamin B12
c. Vitamin c
d. Vitamin k
In a case of suspected myocardial infarction, which of the following
lab values would be the most specific indicator of this

a. Ck-mb(cpk-mb) Troponin t
b. Troponin t
c. LDH
d. Myoglobin
During a case history, if your patient is telling you that their
condition began 3 weeks ago what portion of your case history
wo..
History of present illness
a. A history of presents illness
b. Pat medical history
c. Social history
d. None of the above

A patient presents to your office after an ice skating injury. Which

component of the case history would BEST describe how the
tissue...
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a. Quality of the compliant

b. Time since the injury Mechanism of injury
c. Aggravating factors
d. Mechanism of injury
Trendelenburg testing evaluates for functioning of the ___ nerve?

a. Superior gluteal
Superior gluteal
b. Inferior gluteal
c. Tibial
d. Femoral
Which of the following is considered a significant red flag sign that
is seen with cauda equina syndrome?

a. Pain in the L5 dermatome Urinary retention

b. Constipation
c. Weakness of hip abductors
d. Urinary retention
In a patient with multiple sclerosis, which of the following is least
likely to occur?

a. Nystagmus Deep tendon hypo refelxia

b. Deep tendon hyporeflexia
c. Positive babinksi sign
d. Spastic paralysis
A construction worker, who wears a heavy work belt all day on the
job, notices of tingling sensation of
the anterolateral...
Meraligia paresthestica
a. Meraglia paresthestica
b. L4 disc herniation
c. Cauda equina syndrome
d. Lumbar facet
Barrel chest presentation is seen with:

a. Acute bronchitis
Emphysema
b. Pneumonia
c. Lung cancer
d. Empysema
Which of the following would not be considered a component of a
functional goal in patient record?

a. Actor Diagnosis
b. Behavior
c. Condition
d. Diagnosis
A 25 year old male presents with foot pain and tingling on the
inside and bottom of his foot, without the presence of low back ..

a. L4 nerve root Tibial nerve

b. Tibial nerve
c. Common peroneal nerve
d. Deep personal nerve
The first heart sound is created by the closure of the ___valves.

a. Pulmonic and aortic

Mitral and tricuspid
b. Mitral and tricuspid
c. Tricuspid and pulmonic
d. Tricuspid and aortic

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A 68-year-old male patient presents with severe neck pain, an
altered gait, unsteadiness on his feet and he seems to slaps....
Gets up to go to the bathroom or when his eyes are shut. He
denies pain or any other symptoms. What is most likely diagnosis?
Parkinson's
a. Parkinsons
b. Cervical myelopathy
c. Amyotrophic lateral sclerosis
d. Muscular dystrophy
In the acronym HIPPARONI, what does the R stand ROM
In a patient with an infection, you would expect to find a ____ and
___ lymph node.

a. Moveable and tender Moveable and tender

b. Fixed and tender
c. Moveable and non tender
d. Fixed and non tender
While performing allis sign you notice that the height of the right
leg is lower than the left. There is no translation AP what is the
most likely indication of this finding?
a. Right anatomical short leg
a. Right anatomical short leg
b. Left anatomical short leg
c. Left hip dislocation
d. All of the above
A lesion in the corticospinal tract would result dysfunction of the
___

a. Upper motor neuron pathway UPN pathway

b. Lower motor neuron pathway
c. Basal ganglia
d. Cerebellum
The closed packed position of a joint is the joint position that
results in ...

a. Minimal tautness of the major ligaments Maximal stability of the joint

b. Minimal surface congruity
c. Maximal joint volume
d. Maximal stability of the joint
What will occur if the right lateral spinothalamic track is severed?

a. Pain impulses from the left side of the body will be blocked
Pain impulses from the left side of the body will be blocked
b. Muscles on the left side of the body will be paralyzed
c. Pain impulses from the right side of the body will be blocked
d. Muscles on the right side of the body will be paralyzed
Optic neuritis is associated with

a. Amyotrophic lateral sclerosis

Multiple sclerosis
b. Multiple sclerosis
c. Myasthenia gravis
d. Parkinsons
A patients left pupil does not respond to direct light reflex, through
indirect light reflex (on the right) causes the left pupil to con..

a. CN III on the right CN II on the left

b. CN II on the right
c. CN III on the left
d. CN II on the left

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While squeezing the gastrocnemius muscle, the foot moves into
slight plantar flexion. This is considered to be a(an)___

a. Normal finding Normal finding

b. Positive for a deep vein thrombosis
c. Upper motor neuron lesion sign
d. Sign of a torn achilles tendon
A 42 year old male patient presents with sudden excruciating
chest pain. He denies dyspnea or a cough and tells you he has
been ...
Pulmonary embolism
a. Vascular claudication
b. Angina pectoris
c. Myocardial infarction
d. Pulmonary embolism
A positive Nafzinger test would most likely indicate a___

a. Muscular strain
Nerve root encroachment
b. Ligamentous sprain
c. Nerve root encroachment
d. Spinous process fractures
Kidney stones are most commonly caused by excessive intake of
____.

a. Potassium Calcium
b. Calcium
c. Fat
d. Magnesium
The ___ ankle rules are utilized to help determine the need for
___.

a. Ottawa, MRI, Ottaway, x-ray

b. Toronto, xray
c. Ottaway, xray
d. Three rivers, MRI
Cervical distraction increases your patients localized neck pain
and foraminal compression does not alter the symptoms ...

a. Disc herniation Muscle strain

b. Radiculopathy
c. Thoracic outlet syndrome
d. Muscle strain
A microcytic, hypochromic anemia is seen with___.

a. Pernicious anemia
Iron deficiency anemia
b. A severe B12 deficiency
c. Iron deficiency anemia
d. Sickle cell anemia
Those activities and tasks beyond basic self care that are
necessary for living independently. These activities include
comm...managing medication. This describes what part of the
history
Extended activities of daily living
a. Extended activities of daily living
b. Pace of the illness
c. Review of systems
d. Occupational history

A patient has problem flexing the proximal interphalangeal (PIP)

joint of their index finger. You place the metacarpo-phalang.. Place
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the MCP joint in a few degrees of flexion and attempts to move
PIP
joint into flexion. The proximal PIP joint then flexion...
Tight intrinsic muscle- if flexion of PIP is achieved
a. Tight intrinsic muscles - if flexion of PIP is achieved
b. Tight retinacular ligament
c. Joint capsule contracture - if flexion cannot be achieved
d. None of the above
Compression of the ulnar nerve in the tunnel of Guyon will most
likely affects which muscles?

a. Adductor pollicus Adductor pollicis

b. Second lumbricale
c. Pronator teres
d. Flexor pollicis brevis
An intention tremor would most likely indicate a lesion in the ___.

a. Dorsal column medial lemniscus pathway

Cerebellum
b. Spinal thalamic pathway
c. Corticospinal tract
d. Cerebellum
The afferent branch of the corneal reflex is cranial nerve___.

a. II
V
b. III
c. V
d. VII
Inability to internally rotate the shoulder could indicate a tear in the
__muscles.

a. Subscapularis Subscapularis
b. Teres minor
c. Pectoralis minor
d. Rhomboid major
Intermittent claudicatoin is due to which of following conditions?

a. Spinal stenosis
Atherosclerosis
b. Disc herniation
c. Atherosclerosis
d. Trigger points
Which of the following tests would help identify sciatic neuropathy
due to piriformis syndrome?

A. Bragard Bonnet
B. Bonnet
C. Turyn
D. Sicard
The cubital tunnel is formed by the ___ and can entrap the ____
nerve.
A. flexor carpi ulnaris tendon, ulnar
Flexor carpi ulnaris, ulnar
B. supinator muscle, radial
C. pronator teres, ulnar
D. tunnel of Guyon, median

A 28-year-old male presents with a long-standing history of lower

back pain and posterior thigh pain to his knee, which does not
pass the knee joint. The pain is described as dull and achy pain.
Scleratagenous
Palpation of the lumbar facet joint is very tender. Kemp's test
reproduces his pain. Reflexes are +2 and muscle strength is +5.
His pain is likely due to what cause?
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A. neuropathic
B. scleratagenous
C. myotagenous
D. dermatagenous
Stanley is an 80 year-old male who complains of right arm and
hand pain without any evidence of trauma. He notes that the pain
is most noted in his first 2 digits. Foraminal compression test is
positive for reproduction of his symptoms. What is the most likely
etiology of his complaints?
Facet arthosis
A. muscle strain
B. disc herniation
C. facet arthrosis
D. ligamentous sprain
Which of the following statements is correct in reference to Tho-
racic outlet syndrome?

A. lateral arm paresthesia is present Posture affects the symptoms

B. posture affects the symptoms
C. subjective numbness is present
D. is not related to trauma
Foot drop is most likely related to a(n)_____.
A. deep peroneal neuropathy
B. S1 radiculopathy Deep peroneal neuropathy
C. L5 disc herniation
D. superficial peroneal neuropathy
A patient with a diminished patellar reflex due to a peripheral
neuropathy would be expected to have a weakness with the _____
muscle?
Quadriceps
A. tibialis anterior
B. extensor digitorum longus
C. soleus
D. quadriceps
A patient presents with complaints of right hand weakness with the
inability to grab a ball and he has no issues with fine manipulation
tasks. Which of the following nerves would be involved?
A. Median Ulnar
B. Ulnar
C. Radial
D. Axillary
Which of the following tracts do the majority of fibers do not cross
during their pathway?

A. Dorsal columns Spinocerebellar

B. Corticospinal
C. Spinal thalamic
D. Spinocerebellar
The healthy patient should minimally be able to identify ___
degrees of joint movement at the DIP joint of the finger while
performing joint position sense.
1
A. 1
B. 2
C. 4
D. 6

Indication of the presence of apraxia is part of the ______ evalu-

ation.
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A. Mental status
B. Coordination Mental status
C. Motor
D. Sensory
Which of the following symptoms is predominant in a ventral nerve
root lesion?

A. Decrease pain and temp Flaccid muscle

B. Hyper-reflexia
C. Apallesthesia
D. Flaccid muscle
Myasthenia gravis is considered to be an

A. Lower motor neuron lesion

Lower motor neuron lesion
B. Cerebellar lesion
C. Dorsal column lesion
D. Upper motor neuron lesion
The cerebellum is responsible for ______.

A. Gross motor activity

Fine motor control
B. Fine motor control
C. Regulating muscle tone
D. Joint position sense
Which of the following statements is correct in reference to my-
ofascial pain?

A. patients report generalized (whole body) pain Patients have the presence of trigger points
B. patients have the presence of trigger points
C. myofascial pain is extremely rare
D. myofascial pain is predominantly seen in women
A 72-year-old female presents with nausea vomiting and pain
in the left lower quadrant. Physical exam reveals that the blood
pressure 142/92 mmHg Pulse 72 b/m and Temperature 99.0 °F.
What is the most likely diagnosis?
diverticulitis
A. diverticulitis
B. appendicitis
C. ruptured appendix
D. GERD
A 22 year old male who was recently in a motor vehicle collision.
He notes that the pain is bilateral in nature and located at the
level of the 5-7th ribs close to the sternum. What is the most likely
etiology of his condition?
Costochondritis
A. Tietze's syndrome
B. costochondritis
C. rib fracture
D. angina
Your patient is a 29-year-old male who presents to your office
with complaints of right- sided lower back and leg pain. During the
physical examination you notice he is leaning to the right side with
slight torso flexion as well. These findings make you suspect he
has a
___________ lumbar disc herniation. Right medial

right medial
left medial
right lateral
left lateral
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Upon performing the ankle dorsiflexion test, if the patient cannot
dorsiflex the ankle in either an extended or flexed position of the
knee this would indicate contracture of the___ muscle.
Soleus
soleus
gastrocnemius
tibilalis anterior
peroneus
A 75-year-old male who presents with tiredness and pallor that
is aggravated with exertion would be suggestive of which of the
following:
Iron deficiency anemia
iron deficiency anemia
multiple sclerosis
amyotrophic lateral sclerosis
muscular dystrophy
Tactile fremitus will be increased with which of the following con-
ditions?

lobar obstruction Consolidation

atelectasis
consolidation
asthma
A 48 year old male presents with recent onset of a cough and
shortness of breath. Respiratory excursion is reduced only on the
right. Which of the following diagnoses is most consistent with this
finding?
Pneumonia
bronchitis
emphysema
pneumonia
ALS
Your patient states during the interview that she has not been
tolerating temperature changes very well. Which body system
from the following is most likely the cause?
Endocrine
musculoskeletal
endocrine
cardiovascular
genitourinary
During a case history, if your patient is telling you that their
condition began 3 weeks ago what portion of your case history
would that fulfill?
History of present illness
history of present illness
past medical history
social history
none of the above
The corneal reflex integrates in the _____.

pons
Pons
midbrain
medulla
occipital cortex
A 19 year-old female presents with neck pain, nausea and vomit-
ing of 2 hours duration. She is febrile, and passive range of motion
of the neck produces pain into both arms. The diagnosis is _?
Meningitis
spinal stenosis
facet syndrome
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meningitis
cervical spine sprain
The Alvarado scale is utilized to help assess ______.

appendicitis
Appendicitis
pancreatitis
mental status
ligamentous instability

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