Physical Medicine and Rehabilitation MCQ

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MCQ on Physical Medicine and Rehabilitation

1. According to ACR criteria, diagnosis of fibromyalgia, pain must be inducible by palpation at least at how many points?
(1) 9
(2) 11
(3) 7
(4) 5

2. Speed test is done to diagnose the following
(1) Bicipital tendinitis
(2) Shoulder impingement
(3) Shoulder stability
(4) Supraspinatus tear

3. Cozen’s test is specific for
(1) Lateral epicondylitis
(2) Medial epicondylitis
(3) Elbow stability
(4) Radial and ulnar collateral ligament defect

4. Which is not true regarding adhesive capsulitis of shoulder joint?
(1) Normal Radiograph
(2) Painful restricted shoulder movements
(3) Most frequently seen in age group between 40 to 60 years
(4) More common seen in men than women

5. Which is or are red flag sign or signs for low back pain?
(1) Use of systemic steroid
(2) Difficulty in micturition
(3) History of cancer
(4) All of the above

6. Methadone hydrochloride works as
(1) NMDA receptor antagonist
(2) GABA agonist
(3) Release calcium from sarcoplasmic reticulum
(4) Acetylcholine receptor blocker

7. What property of NSAIDS is most likely to cause an acute adverse event when used to treat a patient with severe quadriceps contusion?
(1) Anti-inflammatory
(2) Analgesic
(3) Anti-pyretic
(4) Anti-platelet

8. What is mechanism of action of capsaicin?
(1) Increases substance P
(2) Blocks mu opiod receptors
(3) Increases calcitonin gene related peptide
(4) Activating vanilloid receptor

9. In low back pain which structure is not innervated and cannot transmit pain?
(1) Vertebrae
(2) Nucleus pulposus
(3) Anterior longitudinal ligament
(4) External part of annulus

10. Which structure would be torn in a high grade superior labrum anterior posterior (SLAP) tear?
(1) Supraspinatus tendon
(2) Long head biceps tendon
(3) Subscapularis tendon
(4) Coracoarcromial ligament

11. Gabapentin work by blocking which of the following ion channels?
(1) Sodium
(2) Calcium
(3) Potassium
(4) Magnesium

12. Winging of scapula is caused by injury of pathology of
(1) Long thoracic nerve
(2) Spinal accessory nerve
(3) Dorsal scapular nerve
(4) All of the above

13. Most common level affected in Degenerative Spondylolisthesis is
(1) L2-L3
(2) L3-L4
(3) L4-L5
(4) L5-SI

14. Lumber spine is not involved in which disease?
(1) Ankylosing spondylitis
(2) Rhumatod artherities
(3) Osteoartherities
(4) All of the above

15. Identify the common cause of osteoporosis.
(1) Postmenopausal
(2) Sedentary lifestyle
(3) Smoking
(4) All of the above

16. Following burn injury transparent face mask device is used to
(1) Cover the disfigurement
(2) Prevent facial scarring and deformity
(3) Increase eyelid eversion
(4) Prevent infection

17. Burns with blistering, moist, blanches with pressure and having pain is
(1) 1st degree burn
(2) 2nd degree burn
(3) 3rd degree burn
(4) 4th degree burn

18. In a patient with 3rd degree burn which position would minimise contracture formation
(1) Hip external rotation
(2) Elbow extended and pronated
(3) Shoulder abducted 90 degree and internal rotation
(4) Knee in full extension

19. Modified Vancouver Scar Scale for measurement of hypertrophic burn scar scores in all domains except
(1) Pliability
(2) Height
(3) Vascularity
(4) Surface area

20. All are true regarding Psoriatic arthritis except
(1) Polyarthritis pattern most common
(2) Onycholysis
(3) Pencil in cup appearance on x-ray
(4) Lengthening of digits

21. Joint not involved in Rheumatoid arthritis according to ACR 2010 classification
(1) Knee
(2) Ankle
(3) Metatarsophalangeal
(4) Tarsometatarsal

22. A 55 year old woman with history of esophageal stricture due to long standing GERD and vasomotor symptoms due to menopause. A recent DEXA showed T score of -2.5 in lumbar spine and -2.6 in left hip. Which drug is most appropriate for her?
(1) Denosumab 60 mg subcutancous every 6 months
(2) Ibandronate 150 mg orally once a month
(3) Alendronate 35 mg orally weekly
(4) Prednisolone 10 mg once daily

23. All are true regarding teriparatide in osteoporosis management except
(1) Self-administered subcutaneous Injection 20 microgram daily
(2) Bone antiresorptive action
(3) Causes nausea, leg cramps, headache as side effects
(4) It is contraindicated in patients with cancer history

24. Which of the following lesion can lead to tethered cord syndrome?
(1) Diastematomyelia
(2) Meningomyelocele
(3) Tight filum terminale
(4) All of the above

25. Jefferson fracture is a burst fracture of which vertebrae?
(1) C1
(2) C2
(3) C3
(4) C4

26. A young female patient with D4 complete spinal cord injury is unable to experience the following :
(1) Pregnancy
(2) Physcogenic Veginal lubrication
(3) Sexual arousal
(4) Orgasm

27. Which of the anticonvulsant medication is most likely to cause bone marrow suppression?
(1) Carbamazepine
(2) Valproic acid
(3) Gabapentine
(4) Lomatrigene

28. In MRI of cervical spine, which tissue is dark on a TI weighted image and bright on T2 weighted image?
(1) Spinal cord
(2) Facet joint
(3) Interspinal ligament
(4) Nucleous pulposus

29. In complete upper motor neurone (UMN) injury which mode of penile erection is more effective?
(1) Phychogenic
(2) Reflexogenic
(3) Both
(4) None

30. What is normal maximum flow rate during the voiding phase of urodynamic study?
(1) 15 to 20 ml/sec
(2) <10 m/sec
(3) 20 to 30 ml/sec
(4) > 30 m/sec

31. Which is not a correct statement regarding heterotrophic ossification (HO) following spinal cord injury (SCI)?
(1) Serum alkaline phosphatage level is low
(2) Hip joint is most common site
(3) Triple phage bone scan is gold standard for diagnosis
(4) Ossification is extra articular and always found below the level of SCI

32. Which is not true about phrenic nerve stimulation (PNS)?
(1) It is useful for the patients with cervical spine injury above C3 level
(2) PNS usually not done until 12 months post injury
(3) Absent or significant compromised phrenic nerve function is contraindicate for PNS
(4) None of the above

33. Which investigation is preferred to diagnose the nerve root avulsion in a patient of spinal cord injury with non-titanium shoulder plate?
(1) MRI scan
(2) MRI myelography
(3) CT Scan
(4) CT myelography

34. Which type of odontoid fracture is associated with greater risk of non-union?
(1) Type I
(2) Type II
(3) Type Il
(4) Both (1) and (3)

35. A SCI individual at which neurological level has potential to be independent in transfers on level surfaces, upper body dressing and manual wheelchair propulsion on even terrain (except curbs)
(1) C4
(2) C5
(3) C6
(4) C7

36. Which of the following drugs is a surfactant laxative agent that is used for constipation?
(1) Docusate sodium
(2) Lactulose
(3) Castor oil
(4) Sorbitol

37. Moving the wheelchair axle anteriorly has an advantage of
(1) Stability is increased
(2) Maneuverability is increased
(3) Both stability and maneuverability are increased
(4) Maneuverability is decreased

38. Which is true regarding zone of partial preservation in SCI assessment?
(1) Motor ZPPs are defined and should be documented in all cases including patients with incomplete injuries with absent voluntary anal contraction (VAC).
(2) The sensory ZPP on a given side is defined in the absence of sensory function in S4-5 (LT, PP) on this side as long as DAP is not present.
(3) In cases with present DAP, sensory ZPPs on both sides are not defined and should be noted as “not applicable (NA)”
(4) All of the above

39. In a person with chronic spinal cord injury (SCI) at 2 year post injury the most common location for a pressure ulcer Is
(1) Trochanter
(2) Ischtum
(3) Elbow
(4) Sacrum

40. Which of the following statement is true regarding spinal cord injury without radiographic abnormality (SCIWORA)?
(1) A young children have a high predisposition for SCIWORA due to ligamentous flexibility and skeletal mobility immature spine
(2) One of the major criteria for SCIWORA is the presence of a negative magnetic resonance imaging (MRI) study
(3) Lumbar region of spinal cord more prone
(4) The adolescent population is most susceptible to SCIWORA through sports injuries especially in football

41. Assuming all the below patients have normal urinary tract anatomy; choose the best suitable patient for intermittent catheterization (IC) among patients with spinal cord injury (SCI) in your inpatient rehabilitation unit.
(1) 70 year old female with central cord syndrome and rheumatoid arthritis
(2) 18 year old male with T5 complete paraplegia and autonomic dysreflexia
(3) 35 year old male with 19 incomplete paraplegia and hypercalcemia
(4) 23 year old female with TIO complete paraplegia and spontaneous bladder contractions

42. In the population with spinal cord injury (SCI) a posttraumatic syringomyelia Is
(1) most commonly presented as pain in the clinical setting
(2) pain is mostly neuropathic in nature
(3) often associated with dissociated sensory loss
(4) All of the above

43. A spinal cord injury patient with grade 3 spasticity having spasm frequency of 5 in one hour; please define the grade of spasm according to Penn spasm frequency score.
(1) 1
(2) 2
(3) 3
(4) 4

44. An example of utilizing the gastrocolic reflex in the management of neurogenic bowel would be
(1) Timed defecation within half hour after meals
(2) Prescribing senna 1 to 4 tablets orally daily at noon
(3) Digitally stimulating inside rectum
(4) Abdominal massage

45. A presentation for a high back power wheelchair with tilt and recline headrest, modified joystick and upper extremity support is best suited for a tetraplegia patient with the neurological level of
(1) C8
(2) CS
(3) C7
(4) T2