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Quiz on Physical Medicine and Rehabilitation
1. Which of following is a risk factor for the development of heterotopic ossification in SCI?
(1) Female Gender
(2) Level of lesion
(4) Neuropathic pain
2. Which respiratory muscles are expected to still be functional in a patient with complete C7 tetraplegia?
(1) Accessory muscles
(2) Accessory muscles and diaphragm
(3) Accessory muscles, diaphragm and intercoastal muscles
(4) Accessory muscles, diaphragm and intercoastal muscles and abdominal muscles
3. A typical meteabolic change seen after Spinal Cord Injury (SCI) is
(1) Decreased testosterone
(2) An increased HDL
(3) Gain in muscle mass
(4) An increased rate of hypoglcemia
4. Regarding tendon transfer: tendon to be transferred should have all except
(1) Muscle to be transfer must have good strength or better as it loses grade power after transfer
(2) Range of excursion similar to one it is reinforcing
(3) Adequate nerve and blood supply
(4) Transferred to antagonist muscle
5. Which clinical finding is not indicative of a ruptured Achilles tendon?
(1) Negative Thompson test
(2) Absent Achilles reflex
(3) Lack of toe off during gait cycle
(4) A palpable defect in musculotendinous unit
6. Which of the following is not present in metabolic syndrome?
(1) Fasting glucose greater than 110 mg%
(2) Triglycerides greater than 150 mg%
(3) HDL cholesterol less than 50 mg%
(4) Waist circumference less than 80 cm
7. What is the most common cause of sudden cardiac arrest in a athletes?
(1) Coronary artery anomaly
(2) Ventricular fibrillation
(3) HCM (Hypertrophic cardiomyopathy)
(4) Commotio cardis
8. Which finding correlates with a high risk for ischemic ulceration?
(1) Ankle brachial Index (ABI) of 0.40
(2) Transcutaneous oxygen (TcPo2) of 50 mm hg
(3) Serum albumin 3.2 gm/dl
(4) Stenotic lesion of superficial femoral artery
9. In negative pressure wound therapy for wound healing how much pressure is applied?
(1) 100 mm Hg below ambient
(2) 50mm Hg below ambient
(3) 125 mm Hg below ambient
(4) 75 mm Hg below ambient
10. General principle of childhood amputation surgery are all except
(1) preserve length
(2) perform transosseous rather than disarticulation
(3) preserve growth plate
(4) stabilize proximal portion of limb
11. Which of following is true regarding below knee amputation in ischemic limb?
(1) Tourniquet is used
(2) Equal anterior and posterior flap
(3) Long posterior flap and short anterior flap
(4) Tension myodesis is done
12. Competitive female athletes are at high risk of stress fracture if she has the female athlete triad of
(1) Amenorrhoea, anorex!a, osteoporosis
(2) Amenortrhoea, hypertension, osteoarthritis
(3) Bulimia, diabetes mellitus, osteoporosis
(4) Anorexia, short stature, hypothyroidism
13. Which is not released in Steindler procedure done for cavus deformity?
(1) Flexor digitorum brevis
(2) Adductor hallucis brevis
(3) Abductor digiti quinti muscle
(4) Peroneus brevis
14. What is the most important factor to consider while injecting myofascial trigger points?
(1) Type of medication injected
(2) Accurate location of trigger point
(3) Frequency of injections
(4) Size of needle
15. Which nerve innervates the L4-L5 facet joint in lumber spine?
(1) L2 and L3 medial branches
(2) L3 and L4 medial branches
(3) L4 and L5 medial branches
(4) LS dorsal ramus
16. For neurogenic detrusor over activity cystoscopic guided injection of Botulinum toxin type A in bladder wall approved dose is
(1) 200 units distributed in 30 sites
(2) 300 units distributed in 30 sites
(3) 400 units distributed in 30 sites
(4) 200 units distributed in 10 sites
17. Which is true for Botulinum toxin in comparison to phenol blockade?
(1) Botulinum toxin injection is relatively easy to administration
(2) Botulinum toxin injection is associated with higher incidence of dysesthetic pain
(3) Botulinum injection produces neurolysis
(4) Effect of Botulinum injection is observed within 24 hrs.
18. Which of the following steroids has shortest serum half-life?
(3) Methylprednisolone acetate
19. Anterior cerebral artery lesion will result in all except
(1) Contralateral hemiplegia
(2) Contralateral hemianaesthesia
(3) Ipsilateral upper limb sensory loss
(4) Head or eye turning toward lesion
20. Which is true regarding glossopharyngeal breathing (GPB)?
(1) It is a form of voluntary breathing
(2) Air is pumped into the lungs by the patient using the tongue as a piston
(3) It increase vocal volume and flow of speech
(4) All of the above
21. In obstructive pulmonary disorder the FEVI and the ratio of FEVI/FVC are
(1) Both FEV1 and FEVI/FVC ratio decreased
(2) FEVI decrease and FEVI/FVC ratio increase
(3) FEVI increase and FEVI/FVC ratio decrease
(4) Both FEV! and FEVI/FVC ratio increase
22. Which of the following clinical manifestations or signs seen in Parkinsonism disease?
(4) All of the above
23. What is true regarding the Morton’s neuroma?
(1) Is caused by irritation of one of the inter-digital nerve
(2) Most common location is between 2nd and 3rd meta-tarsal head
(3) Pain is relief with high heel shoes
(4) All of the above
24. What is the most appropriate prescription for a patient with progressive communication deficits due to flaccid dysarthria secondary to amyotrophic lateral sclerosis?
(1) Computer based augmentative communication system
(2) Articulation training
(3) Adaptive speech strategies such as slow speaking rate
(4) Speech exercise emphasising optimum performance
25. A child with Duchenne muscular dystrophy, which muscle group has is earliest and most significant weak at the time of presentation?
(1) Proximal muscles of upper extremity
(2) Proximal muscles of lower extremity
(3) Distal muscles of upper extremity
(4) Distal muscles of lower extremity
26. Which is not a correct statement regarding Guillain Barre syndrome?
(1) It is also known as acute inflammatory demyelinating polyneuropathy
(2) Hyporeflexia or areflexia early in disease
(3) Progressive and symmetrical weakness of limbs
(4) Autonomic dysreflexia
27. What is the first line treatment of choice for the pain in the patient with acute spinal pain due to bony metastasis?
28. Benediction hand is seen in
(1) Proximal ulnar nerve injury
(2) Distal ulnar nerve injury
(3) Proximal radial nerve injury
(4) Distal radial nerve injury
29. Which of the following clinical condition is not a contraindication for the exercise during the cardiac rehabilitation programme
(1) Stable angina
(2) Uncontrolled arrhythmias
(3) Resting systolic blood pressure is greater than 200 mm Hg
(4) Resting diastolic blood pressure is greater than 110 mm Hg
30. Regarding fascioscapulohumeral dystrophy which statement is incorrect?
(1) Autosomal recessive
(2) Majority of patients has asymptomatic high frequency sensory neural hearing loss
(3) Most of the patients demonstrated asymmetrical weakness by the age of 20 years
(4) Facial weakness and lateral winging scapula seen
31. A patient presented in the OPD with the examination finding of involuntary, slow, writhing and snake like movements at his wrist, fingers and ankle; this clinical condition is known as
32. A traumatic brain injury patient is admitted in ICU and on examination exhibits random, fragmented and non-purposeful response to complex or unstructured stimuli and is non-agitated; define his Ranchos level of cognitive functioning scale
33. Locked in syndrome can be due to infarct of
(1) Basilar artery affecting pons
(2) Anterior cerebral artery affecting at frontal lobe
(3) Middle cerebral artery affecting parietal lobe
(4) Posterior cerebral artery affecting occipital lobe
34. Identify the symptom not present in normal pressure hydrocephalus.
(2) Ataxic gait
(3) Urinary incontinence
(4) Hearing loss
35. What is the reversible cause cancer related fatigue?
(4) All of the above
36. Which is most common subtype of multiple sclerosis?
(1) Relapsing remitting
(2) Primary progressive
(3) Secondary progressive
(4) Progressive relapsing
37. Parkinsonism is due to lesion in
(1) Corpus luteum
(2) Corpus striatum
(3) Corpus callosum
(4) Substantia gclatinosa
38. All are true regarding post-radiation brachial plexopathy except
(1) MRT is helpful in diagnosis
(2) presence of myokymia on needle EMG
(3) most of the patients present with painful and muscle weakness around shoulder and or proximal arm
(4) commonly seen in patients with breast cancer or lung cancer receiving fraction of greater than 2.2 Gy and cumulative 44 Gy dose of radiation
39. Regarding cardiac rehabilitation phase which is correct?
(1) Started during acute care hospitalisation
(2) ECG monitoring is not done
(3) It is based on parameters determined by exercise stress test
(4) Only ROM and early mobilisation exercises are done during this phase
40. Which rapidly progressive hereditary LMN disorder occurs in infancy and causes death by age of around two (2) years?
(1) Spinal muscular atrophy (SMA)
(2) Duchenne muscular dystrophy
(3) Progressive muscular atrophy
(4) Primary lateral sclerosis
41. In men the energy cost of sexual activity typically doesn’t exceed by how many metabolic equivalents?
42. While managing a patient of lymphedema with complete or complex decongestive therapy (CDT), use of compression garments racilitated the following except
(1) improve lymphatic drainage and reduce accumulated protein
(2) decreased the venous return
(3) properly shape and reduce the size of limb
(4) maintain skin integrity
43. In three zone model of lung (West’s zone of lung), which zone has maximum perfusion in upright position?
(1) Zone 1
(2) Zone 2
(3) Zone 3
(4) All zones has equal perfusion
44. Which is gold standard for prenatal diagnosis of myelomeningocele?
(2) Serum AFP
(3) Chromosomal assay
45. Which is the incorrect statement for the Arnold Chiari II malformation?
(1) Is characterised variable displacement of cerebellar tissue Into spinal canal
(2) Accompanied by cranial displacement of lower brainstem and forth ventricle
(3) It is one of the leading cause of death in infants with MMC
(4) Patient may present with apnoea, cyanosis bradycardia