After examining a 25-year-old individual with a body mass index of 31, the physical
therapist designed an exercise training program. Which of the following is the BEST
initial exercise prescription for this individual?
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40% to <60% HRR, five days per week for 30-45 minutes
A body mass index of 31 can be defined as obese. As per the ACSM
guidelines, the initial exercise training for obese individuals should be
moderate (40% to <60% of heart rate reserve/ HRR). Eventual progression
to more vigorous exercise intensity (i.e. ≥ 60% HRR) may result in further
health/fitness benefits. Frequency should be ≥ 5 days to maximize caloric
expenditure and duration should be a minimum of 30 minutes per day
progressing to 60 min per day of moderate intensity, aerobic activity. 15 to
20 minutes is not a long enough duration and 3 days per week is not a high
enough frequency for obese individuals.
,A patient presents with limited mouth opening of 25 mm due to pain. There is no
complain of clicking sound or mouth deviation when he opens his mouth. The patient
is unable to completely close his mouth with teeth clenched together. What is the
MOST likely diagnosis based on the patient symptoms?
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Synovitis
Hypomobility (Option A) has decreased mouth opening but no pain. Disc
displacement with reduction (Option B) has clicking sound. Synovitis
(Option C) and Capsulitis (Option D) both have decreased opening but
there is no deviation in Synovitis, making option C correct.
An EMG was recorded in a 28-year-old female soccer player. After establishing a
baseline EMG activity of the quadriceps during a squatting activity, the patient
performs 3 sets of 10 repetitions. During the last set, the patient shows quadriceps
fatigue and data shows a gradual increase in EMG signal. What is the MOST likely
contributor to this increase in EMG signal?
Give this one a try later!
Increase in fatigue
Force production remains the same throughout, as the weight has not
changed. Increase in fatigue is associated with an increase in EMG signal,
as more neural activity is required to maintain the same level of force
production.
A 20-year-old male athlete presents to a PT clinic 5 days status post allograft ACL
reconstruction. The patient is independent in ambulation with crutches. He has 53
degrees of active knee flexion and 67 degrees of passive knee flexion. He lacks 10
,degrees of active knee extension and 5 degrees passively. What is the MOST
significant deficit on which PT should focus treatment?
Give this one a try later!
Lack of passive knee extension
After ACL reconstruction, the main goal of the therapist is the prevention of
extension lag. So, passive extension must be achieved first (by the end of
the first 1 to 2 weeks). Once passive knee extension is achieved active knee
extension can be achieved to prevent the Lag.
On examination, a 30-year-old female patient complains of pain during extension and
rotation of the cervical spine. During the examination, the PT notes a positive Bacody's
sign. This is MOST consistent with a diagnosis of:
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Cervical radiculopathy
Bakody's sign, also known as shoulder abduction test is used to test for
radicular symptoms, especially those involving the C4 or C5 nerve roots. A
decrease in or relief of symptoms indicates a cervical extradural
compression problem, such as a herniated disc, epidural vein compression,
or nerve root compression. Abduction of the arm decreases the length of
the neurological pathway and decreases the pressure on the lower nerve
roots.
All of the following are signs and symptoms of a later manifestation of cystic fibrosis
EXCEPT?
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, Meconium Ileus
Meconium Ileus is an early manifestation of cystic fibrosis as it seen in
infants. Anorexia, clubbing and Diarrhea are late manifestations.
A geriatric patient recently developed CHF. The patient has symptoms of nausea,
vomiting, and gastrointestinal irritability. The patient also presents with mental
confusion and frustration. Based on these symptoms, what clinical condition does the
therapist suspect?
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Digoxin toxicity
A patient with a tracheostomy tube has been hospitalized for two days. During
physical therapy the patient suddenly exhibits dyspnea, cyanosis of lips, and cramping
of the right calf muscle. What should the therapist suspect based on the symptoms?
Give this one a try later!
Respiratory Distress
Dyspnea, shortness of breath, or cramping in the calf muscles are common
signs of respiratory distress. Mucus plugging, tube displacement, disruption
or disconnection of oxygen can cause respiratory distress in a
tracheostomy patient.
A 40-year-old male was admitted to an acute rehabilitation unit with neurological
impairments, including altered mental status, dysarthria, and motor weakness. During
therapist designed an exercise training program. Which of the following is the BEST
initial exercise prescription for this individual?
Give this one a try later!
40% to <60% HRR, five days per week for 30-45 minutes
A body mass index of 31 can be defined as obese. As per the ACSM
guidelines, the initial exercise training for obese individuals should be
moderate (40% to <60% of heart rate reserve/ HRR). Eventual progression
to more vigorous exercise intensity (i.e. ≥ 60% HRR) may result in further
health/fitness benefits. Frequency should be ≥ 5 days to maximize caloric
expenditure and duration should be a minimum of 30 minutes per day
progressing to 60 min per day of moderate intensity, aerobic activity. 15 to
20 minutes is not a long enough duration and 3 days per week is not a high
enough frequency for obese individuals.
,A patient presents with limited mouth opening of 25 mm due to pain. There is no
complain of clicking sound or mouth deviation when he opens his mouth. The patient
is unable to completely close his mouth with teeth clenched together. What is the
MOST likely diagnosis based on the patient symptoms?
Give this one a try later!
Synovitis
Hypomobility (Option A) has decreased mouth opening but no pain. Disc
displacement with reduction (Option B) has clicking sound. Synovitis
(Option C) and Capsulitis (Option D) both have decreased opening but
there is no deviation in Synovitis, making option C correct.
An EMG was recorded in a 28-year-old female soccer player. After establishing a
baseline EMG activity of the quadriceps during a squatting activity, the patient
performs 3 sets of 10 repetitions. During the last set, the patient shows quadriceps
fatigue and data shows a gradual increase in EMG signal. What is the MOST likely
contributor to this increase in EMG signal?
Give this one a try later!
Increase in fatigue
Force production remains the same throughout, as the weight has not
changed. Increase in fatigue is associated with an increase in EMG signal,
as more neural activity is required to maintain the same level of force
production.
A 20-year-old male athlete presents to a PT clinic 5 days status post allograft ACL
reconstruction. The patient is independent in ambulation with crutches. He has 53
degrees of active knee flexion and 67 degrees of passive knee flexion. He lacks 10
,degrees of active knee extension and 5 degrees passively. What is the MOST
significant deficit on which PT should focus treatment?
Give this one a try later!
Lack of passive knee extension
After ACL reconstruction, the main goal of the therapist is the prevention of
extension lag. So, passive extension must be achieved first (by the end of
the first 1 to 2 weeks). Once passive knee extension is achieved active knee
extension can be achieved to prevent the Lag.
On examination, a 30-year-old female patient complains of pain during extension and
rotation of the cervical spine. During the examination, the PT notes a positive Bacody's
sign. This is MOST consistent with a diagnosis of:
Give this one a try later!
Cervical radiculopathy
Bakody's sign, also known as shoulder abduction test is used to test for
radicular symptoms, especially those involving the C4 or C5 nerve roots. A
decrease in or relief of symptoms indicates a cervical extradural
compression problem, such as a herniated disc, epidural vein compression,
or nerve root compression. Abduction of the arm decreases the length of
the neurological pathway and decreases the pressure on the lower nerve
roots.
All of the following are signs and symptoms of a later manifestation of cystic fibrosis
EXCEPT?
Give this one a try later!
, Meconium Ileus
Meconium Ileus is an early manifestation of cystic fibrosis as it seen in
infants. Anorexia, clubbing and Diarrhea are late manifestations.
A geriatric patient recently developed CHF. The patient has symptoms of nausea,
vomiting, and gastrointestinal irritability. The patient also presents with mental
confusion and frustration. Based on these symptoms, what clinical condition does the
therapist suspect?
Give this one a try later!
Digoxin toxicity
A patient with a tracheostomy tube has been hospitalized for two days. During
physical therapy the patient suddenly exhibits dyspnea, cyanosis of lips, and cramping
of the right calf muscle. What should the therapist suspect based on the symptoms?
Give this one a try later!
Respiratory Distress
Dyspnea, shortness of breath, or cramping in the calf muscles are common
signs of respiratory distress. Mucus plugging, tube displacement, disruption
or disconnection of oxygen can cause respiratory distress in a
tracheostomy patient.
A 40-year-old male was admitted to an acute rehabilitation unit with neurological
impairments, including altered mental status, dysarthria, and motor weakness. During
