Chapter 2
Diseases and Conditions
Questions
1. Which of the following is an example of an organ-specific autoimmune disorder?
2. A PTA begins intervention for a patient diagnosed with liver cancer. Which of the following choices is a normal complication of liver cancer and would NOT require the PTA to contact the referring physician or the supervising physical therapist?
3. Which of the following is associated with strenuous exercise?
4. Which of the following is NOT considered a major cause of upper gastrointestinal bleeding?
5. Which of the following could cause decreased pressure of the lower esophageal sphincter, predisposing an individual to gastroesophageal reflux disease?
6. Which of the following medications will stop acid production in the stomach?
7. Presence of a peptic ulcer will radiate pain to what part of the body?
8. Which of the following conditions is considered a chronic inflammatory disorder of the mucosa and submucosa of the colon in a continuous manner?
9. What type of hernia occurs when a sac formed from the peritoneum and intestines pushes outward through the abdominal wall?
10. Which of the following symptoms are most likely to raise suspicion of liver disease?
a. Fever, melena, urinary frequency
b. Left shoulder pain, pallor, coffee-ground emesis
c. Jaundice, ascites, asterixis
11. Cheyne-Stokes respiration is common with which of the following?
12. All of the following can be described as a type of chronic obstructive pulmonary disease EXCEPT which?
13. Which of the following is NOT a sign or symptom of pulmonary edema?
14. Hyperventilation is least likely to occur in which of the following scenarios?
15. What system of the body is most affected by deconditioning?
16. What is the primary impairment for a patient with limited functional activities related to deconditioning?
17. Which of the following would be the first to decline after a period of bed rest for a healthy 45-year-old man?
18. The inspiratory-to-expiratory ratio you would expect to see in the patient with chronic obstructive pulmonary disease is which of the following?
19. The thoracic index (anteroposterior-to-lateral thoracic diameter ratio) in an individual with severe pulmonary emphysema would likely be which of the following?
20. Which of the following breath sounds is always considered abnormal no matter where it is heard on the thorax using auscultation?
21. Which of the following is TRUE about systolic heart failure?
a. It is most prevalent in males.
b. It is difficult to diagnose.
c. It may have ischemic or nonischemic causes.
22. What is the hallmark symptom of heart failure?
23. In which stage of lymphedema is there no measurable increase in limb volume?
24. Which stage of lymphedema is characterized by hyperkeratosis?
25. What are the two most common chronic obstructive pulmonary disease conditions?
a. Respiratory failure and asthma
b. Emphysema and chronic bronchitis
c. Chronic bronchitis and respiratory failure
26. If the left ventricle does NOT contract appropriately as in congestive heart failure, where will an abnormal amount of blood collect?
27. Which of the following is considered an invasive procedure for the cardiovascular system?
28. Which of the following is indicative of left heart failure?
29. A patient asks the PTA to explain the function of his medication verapamil (a calcium antagonist). Which of the following points should be conveyed in the explanation?
a. Verapamil causes decreased contractility of the heart and vasodilation of the coronary arteries.
b. Verapamil causes decreased contractility of the heart and vasoconstriction of the coronary arteries.
c. Verapamil causes increased contractility of the heart and vasodilation of the coronary arteries.
d. Verapamil causes increased contractility of the heart and vasoconstriction of the coronary arteries.
30. Which of the following statements is NOT a common physiologic change of aging?
31. A patient whose resting and exercise-induced heart rates are less than they were before is most likely starting therapy with which of the following?
32. A patient inhales a beta agonist to relieve her asthma. You may notice which of the following after its use?
33. Statin drugs lower cholesterol by which of the following?
a. Preventing cholesterol absorption
b. Binding to cholesterol in the intestines
c. Inhibiting HMG-CoA reductase
34. A patient is being treated with an antiarrhythmic drug. The drug might cause all of the following adverse reactions EXCEPT which?
35. An asthmatic patient is to be exercised in a rather cool environment. It is recommended that he should use the inhaler at what frequency?
a. About 1 hour before the exercise
b. About 20 minutes before exercise
c. Just at the beginning of exercise
36. A patient using a beta blocker is exercised and might experience all of the following EXCEPT which?
37. A beta blocker reduces blood pressure by all of the following actions EXCEPT which?
a. A reduction in cardiac output
b. A reduction in central sympathetic outflow
c. Inhibition of renin release
38. A patient on calcium channel blocker therapy might complain during therapy sessions about all of the following EXCEPT which?
39. Your patient is a 48-year-old man who reports to physical therapy with complaints of left shoulder and neck pain. Symptoms began insidiously 3 weeks ago and have been increasing in frequency and duration since that time. He notices the symptoms with lifting heavy objects and shoveling dirt for a garden that he is building. Walking fast elicits symptoms. Symptoms abate after several minutes of rest. He is in relatively good health with the exception of high blood pressure and shortness of breath. What system is most likely affected?
40. Your patient is a 38-year-old man who is a patient that you have been treating for left shoulder pain. He was in a motor vehicle crash since you last treated him 2 days ago. He was the driver and was rear-ended. He hit his left side on the door handle and has been having sharp pain in his ribs. Radiographs the day of the accident revealed fractured ribs (ribs 6 and 7 on the left). He has been having difficulty breathing and has been very short of breath. Sharp pain is noted on the left with breathing and coughing. He has also noticed some blood in his sputum. What is system is mostly likely the source of the patient’s symptoms?
41. Aspirin and clopidogrel (Plavix) fall into which class of antithrombics?
42. Which of the following drugs should patients with angina always carry in case of an anginal attack?
43. Some of the classes of drugs used to treat angina include which of the following?
44. Beta blockers that are useful in the treatment of hypertension are characterized by which of the following?
a. Work by competitively inhibiting beta receptors, thereby decreasing heart rate
b. Are always selective for beta-1 receptors
c. Do not cause bronchoconstriction in patients with asthma
d. Should not be combined with any other type of antihypertensive medication
45. Which of the following medications should be used to treat an acute asthma attack?
a. Oral steroid such as prednisone
b. Long-acting beta agonist such as salmeterol
c. Inhaled steroid such as fluticasone
46. Primary lymphedema occurs in which of the following patients?
a. Older, who have had surgery
b. Younger, who have had surgery
c. Younger, who have not had surgery
47. A patient using diuretics might experience during strenuous exercise all of the following EXCEPT which?
48. A PTA is working with a patient who has chronic obstructive pulmonary disease. If the patient’s level of oxygen being carried by arterial blood is measured, a PaO2 finding of what is considered normal?
49. The most serious complication of lower extremity thrombophlebitis is which of the following?
50. At a team meeting, the respiratory therapist informs the rest of the team that the patient, just admitted to the subacute floor, experienced breathing difficulty in the acute care department. The respiratory therapist describes the breathing problem as a pause before exhaling after a full inspiration. Which of the following is the therapist describing?
51. A PTA is performing chest physiotherapy on a patient who is coughing up a significant amount of sputum. The PTA later describes the quality of the sputum in his notes as mucoid. This description tells other personnel which of the following?
52. A PTA is sent to provide passive range of motion to a patient in the intensive care unit. The chart reveals that the patient is suffering from pulmonary edema. The charge nurse informs the PTA that the patient is coughing up thin white sputum with a pink tint. Which of the following terms best describes this sputum?
53. Which of the following conditions is a generalized connective tissue disorder of unknown origin cause characterized by thickening and fibrosis of the skin?
54. Where on the body are herpes simplex virus type 1 skin lesions most likely to appear?
55. Which of the following populations is considered at low risk for cellulitis?
a. Patients diagnosed with diabetes
b. Patients older than 80 years
c. Patients with pressure ulcers
56. What is the most commonly recognized skin manifestation of systemic lupus erythematosus?
57. A full-thickness burn has what feature?
58. Which of the following areas is the most common location for a diabetic ulcer?
59. Which of the following is indicative of an arterial ulcer?
a. Edema in the involved lower extremity, superficial wound with red wound base
b. Wound over the lateral malleolus with minimum exudate and a dry wound bed
c. Nonpainful wound with a craterlike center with an elevated rim
60. Which of the following areas would NOT be a concern for possible skin breakdown for a patient with spina bifida?
61. Infection may not be obvious in patients with arterial compromise because of which of the following?
62. Which of the following statements about venous ulcers is TRUE?
a. The ulcer tends to be deep and dry.
b. The ulcer tends to be shallow and wet.
c. The ulcer has a punched-out appearance.
63. Kyphoscoliosis primarily affects what part of the spine?
64. Which of the following spinal cord disorders describes external protrusion only of the meninges?
65. Why does osteomyelitis in the adult population lead to pathologic fracture?
a. The epiphyseal growth plate is usually involved.
b. The periosteum is loosely attached to bone and moves away easily.
c. Osteomyelitis is rare in adults.
d. Infection disrupts and weakens the cortex inside the bone without pain.
66. How does back pain associated with osteomyelitis react with patient activity?
a. Back pain would diminish with activity.
b. Back pain would not be present in a radicular distribution.
c. Back pain would be intermittent only.
d. Back pain would commonly be accompanied by spinal tenderness.
67. Which of the following is indicative of mechanical loosening of a prosthetic joint?
a. A wound over the surgical incision with drainage
c. Pain with motion or weight bearing through the joint
68. Which of the following is a malignant tumor of the bone marrow?
69. Which of the following bones is least likely to develop osteosarcoma?
70. What type of benign soft tissue tumor is usually seen in the popliteal area?
71. What is the most common osteoporosis-related fracture?
72. What are the two primary causes of osteomalacia?
a. Diabetes mellitus and increased renal phosphorus loss
b. Insufficient intestinal calcium absorption and diabetes mellitus
c. Excessive corticosteroid use and increased renal phosphorus losses
d. Insufficient intestinal calcium absorption and increased renal phosphorus losses
73. What is the most common presenting symptom in Paget’s disease?
74. What type of fracture most commonly occurs in distance runners?
75. What is the most common site of osteochondritis dissecans?
76. What age group is most likely to suffer from Osgood-Schlatter syndrome?
77. Definitive osteophyte formation occurs at what grade of osteoarthritis?
78. Which of the following signs/symptoms is indicative of osteoarthritis?
a. Its onset may be sudden over several weeks or months.
b. Inflammation, redness, and warmth are always present.
c. Osteoarthritis usually begins on one side of the body.
d. Systemic presentation with fatigue, weight loss, and fever is characteristic of osteoarthritis.
79. Which of the following is indicative of swan-neck deformity?
a. Hyperflexion of the proximal interphalangeal joint and flexion of the distal interphalangeal joint
b. Flexion of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint
c. Hyperextension of the proximal interphalangeal joint and extension of the distal interphalangeal joint
d. Hyperextension of the proximal interphalangeal joint and partial flexion of the distal interphalangeal joint
80. Which of the following is FALSE regarding heterotopic ossification (HO)?
a. HO usually appears 4 to 12 weeks after the injury.
b. Usually the first sign of HO is loss of range of motion around a joint.
c. HO is not associated with traumatic brain injury.
d. There is erythema, swelling, and pain with movement of the affected joint.
81. At what age would a person be considered to have peak bone mass?
82. Which of the following clients would have the greatest risk for developing osteoporosis?
a. An Asian man who weighs 175 pounds
b. An African American woman who weighs 150 pounds
c. A Caucasian woman who weighs 120 pounds
83. What is the most common manifestation of osteoporosis?
84. Which of the following is TRUE regarding age-related muscle strength?
a. Loss is generally uniform for most muscle groups
b. Upper extremity strength declines faster than lower extremity strength
c. Strength potential is at its greatest between 18 and 30 years of age
d. Changes in strength are not generally associated with less use
85. The patient history helps in selection of interventions for patients with connective tissue dysfunctions. Which of the following is NOT true?
a. Many of these pathologies are chronic and systemic; thus, lifestyle adaptations need to be developed.
b. Selection of interventions should not be previous experiences and outcomes.
c. The behavior of symptoms may vary based on activity level, medications, and compensatory mechanisms.
d. It identifies patient education opportunities to help them become self-managers.
86. Which of the following is NOT a joint manifestation of rheumatoid arthritis?
87. Which of the following diseases could be categorized as an autoimmune disease that results from the body producing antibodies directed against its own tissue?
88. What is the clinical presentation of a boutonniere deformity?
a. Flexion at the proximal interphalangeal (PIP) joint and hyperextension at the distal interphalangeal (DIP) joint
b. Extension at the PIP joint and flexion at the DIP joint
c. Flexion at the PIP joint and flexion at the DIP joint
d. Extension at the PIP joint and extension at the DIP joint
89. Which of the following conditions is most likely to involve weakness in the proximal musculature?
90. Gout is caused by high blood levels of which of the following?
91. What is the first effect of osteoarthritis on a healthy joint?
a. Subchondral bone will be eroded.
b. Fragments of cartilage fall into the joint.
c. Inflammatory mediators damage healthy cartilage.
92. Which of the following is NOT a risk factor for development of osteoarthritis?
93. Sequestrated intervertebral disk herniation is characterized by which of the following?
a. Bulging of the outer annular fibers because of migration of nuclear material through annular tears, although outer annular fibers remain intact
b. Vertical extrusion of nuclear material through the vertebral end plate into the substance of the vertebral body
c. Nuclear material travels from its central location posterolaterally into the annular fibers
d. Nuclear material, extruded through a rupture of annular fibers, forms a free fragment within the spinal canal
94. A fracture that runs at approximately a 30-degree angle to the long axis of the bone is called which of the following?
95. Which of the following type of fracture is typically seen only in children?
96. All of the following are associated with delayed or nonunion of fractures EXCEPT which?
97. Which of the following fractures is least likely to heal quickly and without complication?
a. Hip fractures in a 6-month-old
b. Clavicle fracture in a 17-year-old
c. Tibial fracture in a 35-year-old
98. Which of the following patients is most likely to receive a lower extremity stress fracture?
99. How does extended immobilization affect a healing ligament?
a. Causes a loss of tensile strength
b. Increases the amount of collagen in the ligament
c. Increases collagen fiber bundle diameter
100. Which of the following statements is TRUE regarding aging and skeletal muscle?
a. The size of type II fibers decreases with age.
b. There will be a smaller percentage of type I fiber mass.
c. There will be an increase in the number of muscle fibers.
d. There will be a decrease in fatty tissues within the muscle.
101. Which of the following groups of people are most likely to see a damaged patellar tendon?
102. In children with osteogenesis imperfecta, fractures heal in what time frame?
103. Osteochondritis dissecans occurs most commonly in which of the following?
104. Which joint is most frequently involved in pauciarticular juvenile rheumatoid arthritis?
105. What is the most common onset type of juvenile rheumatoid arthritis?
106. Considering an injury to the medial collateral ligament of the knee, when does the inflammatory phase of healing begin?
107. A patient who just had received a steroid injection into one of the joints is seen by you. What should you do?
108. A patient with osteoporosis might be treated with all of the following drugs EXCEPT which?
109. A patient has been told to use Advil for rheumatoid arthritis. You notice that the patient uses acetaminophen because a friend uses it and it is cheaper. What can you can tell the patient about acetaminophen?
a. It can be used because it is the same as Advil.
b. It is different from Advil but has the same therapeutic action.
c. It is actually more effective than Advil.
110. Skeletal muscle relaxants have what characteristic?
a. May interfere with walking in patients who use their spasticity to control balance
b. Paralyze selectively certain muscle groups
c. Should be stopped quickly after long-term use when problems have been resolved
111. A 27-year-old woman is referred to a physical therapy clinic with a diagnosis of torticollis. The right sternocleidomastoid is involved. What is the most likely position of the patient’s cervical spine?
a. Right lateral cervical flexion and left cervical rotation
b. Right cervical rotation and right lateral cervical flexion
c. Left cervical rotation and left lateral cervical flexion
d. Left lateral cervical flexion and right cervical rotation
113. Where does temporomandibular anterior disk displacement without reduction occur?
a. Between the disk and the lower joint compartment
b. Between the disk and the ementia articularis
c. Between the disk and the lateral pterygoid muscle
114. What is the normal temporomandibular joint arthrokinematics for lateral movements?
115. What is the normal temporomandibular joint arthrokinematics for protrusion?
a. Bilateral anterior translation
b. Bilateral posterior translation
c. Ipsilateral rotation with contralateral translation
116. What is the normal temporomandibular joint arthrokinematics for wide opening?
b. Combination of rotations occur in the first 26 mm, then anterior translation
c. Combination of anterior translations occur in the first 26 mm, then anterior rotation
117. A patient is suffering from chronic back pain as a result of a recent automobile accident. He is currently taking an opioid medication for relief of this pain. Which of the following medications is an opioid?
118. An athlete has been complaining of muscle spasms. Her physician decided to treat her with a medication called cyclobenzaprine, which is a muscle relaxant. She is unfamiliar with this medication and asks if you can tell her anything about it. Which of the following is a correct statement?
a. There are no such medications as muscle relaxants.
b. Muscle relaxants are the same thing as antiinflammatory medications.
c. Drowsiness, blurred vision, and dry mouth are some of the side effects of muscle relaxants.
119. All nonsteroidal antiinflammatory drugs inhibit which of the following in some manner or another?
120. Which nonsteroidal antiinflammatory drug (NSAID) has been used because of its lower incidence of gastrointestinal complications?
121. A patient taking opioid pain medications might experience all of the following EXCEPT which?
122. Whiplash injury from a rear-end collision would tear which of the following ligaments?
123. What is the most common site of fracture in osteoporosis?
124. Which of the following conditions is descriptive of osteoarthritis?
a. It provokes giant cell pigmented villonodular synovitis.
b. It is associated with decreased type II collagen, cytokines, and chondrolysis.
c. Ankylosis and follicular inflammation are predominant.
d. It is associated with increased cartilage matrix synthesis and deposition.
125. Which of the following is a defining symptom of fibromyalgia?
126. In the geriatric population, which condition usually occurs after which defect is present?
a. Spondylolisthesis; spondylolysis
b. Spondylolysis; spondylolisthesis
c. Spondyloschisis; spondylolysis
127. A patient is referred to physical therapy with a diagnosis of arthritis. What type of arthritis would the PTA expect if the patient presented with the following signs and symptoms: (1) bilateral wrists and knees involved, (2) pain at rest and with motion, (3) prolonged morning stiffness, and (4) crepitus?
128. The signs and symptoms of juvenile rheumatoid arthritis include all of the following EXCEPT which?
129. Osgood-Schlatter disease is primarily which of the following?
130. Which orthopedic complication is NOT probable in a child with tetraplegic spinal cord injury?
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