Patho2 Final

A patient complains of fatigue and a weight gain of 8 pounds in the past 2 days. You observe jugular venous distention, dependent edema in his legs and pitting edema. From this clinical presentation, which of the following statements is correct?
a. this clinical presentation is consistent with right sided heart failure
b. this clinical presentation is consistent with left sided heart failure
c. this clinical presentation is consistent with myocardial infarction
d. this clinical presentation is consistent with COPD

a. this clinical presentation is consistent with right sided heart failure

A patient reports he is experiencing severe substernal chest discomfort with indigestion-like symptoms, which have lasted more than 30 minutes and is not relieved by change in position or after taking his nitroglycerin medication. He begins to perspire heavily and becomes pale and short of breath. From your knowledge of pathology which of the following is correct and is the most appropriate course of action?
a. You suggest the patient wait a few hours longer since these signs and symptoms are consistent with severe GERD
b. You are not overly concerned since he has presented this way previously and eventually all symptoms subsided.
c. You recognize the symptoms to be consistent with stable ischemic angina and suggest he take additional nitroglyercin medication.
d.You call 911 because you have concerns he is experiencing a myocardial infarction

d.You call 911 because you have concerns he is experiencing a myocardial infarction

Infant mortality is defined as:
a. death of a child less than 1 year old
b. death of an infant less than 28 days old
c. death of an infant less than 1 month old
d. death of a child less than 2 years old

a. death of a child less than 1 year old

In order to diagnose fetal alcohol syndrome, all of the following 3 clinical manifestations are required:
a. Documentation of lead intake, metabolic signs, CNS abnormalities
b. Documentation of three facial abnormalities, growth deficits, CNS abnormalities
c. Documentation of three facial abnormalities, congenital deficits, CNS abnormalities
d. Documentation of three facial abnormalities, neonatal hemorrhage, CNS abnormalities

b. Documentation of three facial abnormalities, growth deficits, CNS abnormalities

A two year old child with Down syndrome is being treated by a physical therapist. The child has moderate developmental delay and exhibits hypo tonicity. The MOST appropriate physical therapy treatment should include:
a. Pushing a toy cart while standing
b. Locomotor training using body weight support
c. Rolling and somersault activities
d. Postural training of postural extensors in sitting

a. Pushing a toy cart while standing

At birth an infant presents with facial dysmorphic features, lymphedema of the hands and feet, low set hears and hairline, webbed neck and loose skin folds at the neck. Which of the following statements is most likely to be correct?
a. The infant will likely have intellectual disability
b. The infant will likely be male
c. The infant is showing clinical features consistent with Turner Syndrome
d. The infant is showing clinical features consistent with Down Syndrome

c. The infant is showing clinical features consistent with Turner Syndrome

It is considered lead toxicity if the lead levels are more than:
a. 9 ug/dL
b. 10 kg/dL
c. 11 ug/dL
d. 12 pg/dL

double check this one

The following is a condition resulting from repeated pressure to the same area:
a. Cranio-synostosis
b. Deformational Plagiocephaly
c. Sudden Infant Death Syndrome
d. Deformational Polycephaly

b. Deformational Plagiocephaly

What is the name of the genetic condition when there is failure of chromosome pair to separate during cell division resulting in one more chromosome?
a. Non-dysjunction Down Syndrome
b. Angelman Syndrome
c. Translocation Down
d. Turner Syndrome

a. Non-dysjunction Down Syndrome

Which of the following is a correct statement about babies born with orofacial clefts?
a. Cleft palate is more common than cleft lip
b. Cleft lip defect occurs during the Git to 9th week of gestation
c. Cleft palate defect occurs during the 4th to 7th week of gestation
d. Cleft lip is more common than cleft palate

d. Cleft lip is more common than cleft palate

Which of the following is the leading cause of infant mortality in the US?
a. Trisomy 13
b. Sudden Infant Death Syndrome
c. Congenital Malformations of the heart and/or brain
d. Preterm birth

d. Preterm birth

Which of the following is true:
a. Achondroplasia results from mutation on growth factor receptor 4, which is located on chromosome 3.
b. Achondroplasia results from mutation on growth factor receptor. 3, which is located on chromosome 4.
c. Achondroplasia results from mutation on UBEA, which is located on chromosome 4.
d. Achondroplasia results from mutation on UBEA, which is located on chromosome 3.

b. Achondroplasia results from mutation on growth factor receptor. 3, which is located on chromosome 4.

Which of the following is true:
a. Angelman Syndrome results from mutation on UBE3A, which is located on chromosome 15.
b. Angelman Syndrome results from mutation on UBE3A, which is located on chromosome 4.
c. Angelman Syndrome results from deletion of chromosome 16.
d. Angelman Syndrome results from deletion of chromosome 4.

a. Angelman Syndrome results from mutation on UBE3A, which is located on chromosome 15.

Which of the following represents the most accurate explanation regarding Down 's syndrome?
a. Down syndrome is a genetically inherited disorder that is caused when both parents are carriers of a mutated gene.
b. Down syndrome is a genetically inherited disorder that may be caused when only one parent is a carrier of a mutated gene.
c. The risk for Down syndrome increases when the mother is older than age 35 and the egg is fertilized by multiple sperm.
d. The risk for Down syndrome increases when the mother is older than age 35 and chromosomes in her eggs fail to separate properly during cell division.

d. The risk for Down syndrome increases when the mother is older than age 35 and chromosomes in her eggs fail to separate properly during cell division.

Which of the following statements pertaining to the most.common congenital limb deficiency is correct?
a. The ratio of boys to girls who are affected is a 2:1 ratio
b. It is usually right sided
c. It is classified as trans radial
d. It is bilateral in more than 50% of the cases

c. It is classified as trans radial

Which of the following statements regarding the various forms of deformational plagiocephaly is correct?
a. An increase in the incidence is relad to prone sleep position
b. It is a result of premature fusion of the cranial sutures
c. Babies born post term (at 40 weeks gestation) are at greater risk
d. It is associated with restricted prone play time

d. It is associated with restricted prone play time

Which of the following will you find in a patient who has myocardial infarction?
a. Presenting symptoms may be non specific in women
b. A Q and ST wave infarct are characteristic in a subendocardial MI
c. Angina relieved by rest
d. Atherosclerosis is rarely a contributing cause for an MI

a. Presenting symptoms may be non specific in women

A 10 year old presents with sensory and motor function below level of lesion and more than 50% of key muscles have grade <3. According to ASIA classification, you will classify your patient as having a lesion of:
a. Level D
b. Level C
c. Level B
d. Level A

b. Level C

A child with cerebral palsy who presents with more involvement in the lower extremities than upper extremities would be classified as having:
a. Diplegia
b. Hemiplegia
c. Quadriplegia
d. Tetraplegia

a. Diplegia

Children with spastic diplegic cerebral palsy typically exhibit which of the following:
a. Normal patterns of movement
b. Decreased muscle tone in the extremities
c. Scissoring gait
d. Underlying increased muscle tone in trunk

c. Scissoring gait

In traumatic brain injury, which of the following statements is correct about herniation syndromes?
a. Cerebral edema can lead to displacement of the brain
b. The brain may shift beyond it's usual midline orientation
c. Herniation syndromes may cause hydrocephalus
d. All of the above

d. All of the above

Spinal muscular atrophy is an autosomal recessive disorder resulting from:
a. Loss of sensory neurons along the entire length of spinal cord
b. Loss of posterior horn cells along the entire length of spinal cord
c. Loss of alpha motor neurons along the entire length of spinal cord
d. Loss of alpha motor neurons along the cervical section of spinal cord

c. Loss of alpha motor neurons along the entire length of spinal cord

Vertebral arches, meninges and spinal cord are involved in this defect:
a. Spina Bifida Occulta
b. Spina Bifida Meningocele
c. Spina Bifida Myelomeningocele
d. Cerebral Palsy

c. Spina Bifida Myelomeningocele

What is the most likely classification of the spinal cord injury (SCI) for a child who has some motor and sensory function preserved below level of lesion?
a. Level A Complete
b.Level A incomplete
c. Level B, C, or D incomplete

c. Level B, C, or D incomplete

Which of the following statements is correct regarding the mechanism of pediatric TBI?
a. Focal lesions are typically present at the site of the impact and absence of skull fracture dies not exclude brain injury.
b. Skull fractures are always present with significant brain injury
c. Most injuries are translational injuries when the head hits a moving object
d. Young infants have more restriction of motion in neck which may result in less displacement of skull and brain

a. Focal lesions are typically present at the site of the impact and absence of skull fracture dies not exclude brain injury.

Which of the following statements is true about the risk factors for cerebral palsy?
a. Maternal infection poses a risk primarily because the inflammatory response exposes the fetus to cytokines which are damaging to the developing fetal brain
b.Babies of normal birth weight are at relatively low risk for cerebral palsy and therefore few children with CP are born at term with a normal birth weight
c. Multiple births are at greater risk only if they are of normal weight.
d.When the mother's blood type is Rh+ and the fetus' blood type is Rh+, the mother's body may begin to produce antibodies that attack fetal cells.

a. Maternal infection poses a risk primarily because the inflammatory response exposes the fetus to cytokines which are damaging to the developing fetal brain

You are treating a 13-year-old, cervical level spinal cord injury patient in your clinic. During therapy, your patient complaints about pounding headache, anxiety and vision changes. A sudden increase in blood pressure is also noted. The change in your patient's status can be explained due to:
a. Presence of blood clots
b. Autonomic Dysreflexia
c. Muscular Atrophy
d. Pneumonia

b. Autonomic Dysreflexia

Please determine if the following statement is true or false:
Concussion is a type of brain injury caused by blow to the head or violent shaking with temporary cognitive.

True

Decerebrate or Decorticate Posture?
This posture results from damage to upper brain stem, in which the arms are adducted and extended, wrists pronated, fingers flexed and legs are extended with plantarflexion of feet.

Decerebrate Posture

Decerebrate or Decorticate Posture?
This posture results from damage to corticospinal tracts, in which arms are adducted and flexed, with wrists and fingers flexed on chest, legs are extended internally rotated with plantarflexion of feet.

Decorticate Posture

True or False?
Heterotrophic ossification is a complication seen in patients with traumatic brain injury.

True

A 12 year old has a structural right thoracic idiopathic scoliosis. The clinical features you would expect to find include a high:
a. right shoulder, a prominent right scapula and a left hip that protrudes
b. left shoulder, a prominent left scapula and a right hip that protrudes
c. right shoulder, a prominent left scapula and a right hip that protrudes
d. left shoulder, a prominent right scapula and a left hip that protrudes

a. right shoulder, a prominent right scapula and a left hip that protrudes

A 13 year old boy of African American descent who is OVERWEIGHT presents with the following signs and symptoms on his right side that appeared suddenly: pain in groin, medial thigh and knee; inability to bear weight on leg; limited ability to walk, limps on the right side, reduced hip ROM (abduction, internal roation and flexion). He has had a recent growth spurt. Which of the following is the most likely pediatric musculoskeletal disorders for the child to have?
a. Osgood Schlatter's Disease
b. Slipped capital femoral epiphysis
c. Developmental dysplasia of the hip
d. Legg-Calve Perthes Disease

b. Slipped capital femoral epiphysis

A 6 year old boy presents with the following signs and symptoms: limps on the left side, non-specific pain in his left knee, reduced hip internal rotation and adduction ROM, spasms in his left iliopsoas. Which of the following is the most likely pediatric musculoskeletal disorders for the child to have?
a. Slipped capital femoral epiphysis.
b. Osgood Schlatter's Disease
c. Legg-Calve Perthes Disease
d. Developmental dysplasia of the hip

c. Legg-Calve Perthes Disease

Early involvement of cardiac vascular system is seen in which type of muscular dystrophy?
a. Congenital Muscular Dystrophy
b. Emery- Dreifuss Muscular Dystrophy
c. Limb Girdle Dystrophy
d. Fascioscapulohumeral Dystrophy

b. Emery- Dreifuss Muscular Dystrophy

True or False: Frog posture and Jack Knife posture are commonly seen in a pathological condition called Osgood Schlatter's Disease.

False

True or False: In congenital muscular torticollis, head is tilted to affected side and rotation of the head is to affected side as well.

False

True or False: Ortolani's test is done to diagnose Leg Calve Perthe's disease.

False

True or False: Osgood Schlatter disease results from overuse of knee joint.

True

True or False: Unilateral shortening of sternocleidomastoid muscle results in muscular torticollis.

True

Which of the following is the most frequently occurring type of scoliosis?
a. Myopathic.
b. Neuropathic
c. Osteopathic
d. Idiopathic

d. Idiopathic

Which of the following statements is correct about the most common form of muscular dystrophy?
a. It affects primarily the face, scapulae and upper extremities.
b. It is an X-linked recessive disorder affecting boys in early childhood.
c. It can be manifested in increasing severity of impairments in succeeding generations
d. It is an autosomal dominant form of MD and can affect boys and girls equally in later childhood

b. It is an X-linked recessive disorder affecting boys in early childhood.

Which of the following types of juvenile idiopathic arthritis (JIA) affects 10-11% of children, begins at any age, affects both males and females, and may not appear for several weeks, months, or years after the initial onset? Hallmark sign is spiking fever:
a. Systemic onset JIA
b. Oligoarticular JIA
c. Polyarticular JIA RF+
d. Polyarticular JIA

a. Systemic onset JIA

Gowers Sign is seen in which pathological condition?
a. Duchenne's Muscular Dystrophy
b. Osteogenesis Imperfecta
c. Idiopathic Juvenile Arthritis
d. Leg Calve Perthes Disease

a. Duchenne's Muscular Dystrophy

What sign is this?
Infant placed in a supine position with the hip flexed to 90°. From an adducted position, the hip is gently abducted while lifting or pushing the femoral trochanter anteriorly.

Ortolani’s Sign

What sign is this?
The infant is placed in a supine position with the hip flexed to 90° and in neutral rotation. The examiner adducts the hip while applying a posterior force on the knee to cause the head of the femur to dislocate posteriorly from the acetabulum.

Barlow’s Sign

Avulsion of patellar tendon is associated with: 

Osgood-Schlatter Disease

Inability to make Type 1 Collagen is associated with:

Osteogenesis Imperfecta

Mutation of dystrophin gene on chromosome X is associated with:

Duchenne’s Muscular Dystrophy

A hiatal hernia is a condition in which the
a. duodenum is perforated
b. colon bulges outside the peritoneum
c. stomach extends upward into the chest
d. esophagus becomes distended by inflammation

c. stomach extends upward into the chest

True or False: Colonoscopy is a kind of lower endoscopy GI testing method.

True

Gastritis can be caused by which of the following
a. excessive hot beverage consumption
b. bacterial infection with Helicobacter pylori
c. history of scleroderma
d. pregnancy

b. bacterial infection with Helicobacter pylori

True or false: Hepatic encephalopathy develops when ammonia is excreted in urine.

False

True or False: Pigment stones are the most common type of gallstones.

False

Diverticulitis is a condition that develops due to:
a. iron malabsorption in the intestines
b. gallstones stuck in the bile duct
c. autoimmune stimulation of the hepatic tract
d. trapped fecal matter

d. trapped fecal matter

A 45 year old male patient is being evaluated by a physical therapist. Which of the following guidelines below is correct for in treating a patient with hiatal hernia?
a. Valsalva maneuver should be avoided
b. Exercise in flat supine position
c. Can lift heavy weights
d. Bending over activities recommended

a. Valsalva maneuver should be avoided

A patient reports head, neck and chest pain that is aggravated by eating large meals and performing the Valsalva maneuver. Which of the following gastrointestinal conditions is MOST likely causing the symptoms?
a. Gastroesophageal reflux disease
b. Peritonitis
c. Inflammatory bowel disease
d. Diverticular disease

a. Gastroesophageal reflux disease

All of the following are guidelines in treating GERD except:
a. Any intervention requiring a supine position should be scheduled before meals and avoided just after eating
b. Encourage the patient to sleep on left side for nocturnal reflex
c. Modification of position towards a more upright posture may be required if symptoms persist during therapy.
d. Encourage the patient to sleep on right side for nocturnal reflex

d. Encourage the patient to sleep on right side for nocturnal reflex

A 30 year old patient presents with right lower abdominal pain, bloody stools and diarrhea. The patient also complains about failure to gain weight. Which condition below is MOSTLY related to the symptoms described?
a. Crohn's disease
b. Appendicitis
c. Diverticulitis
d. Inflammatory Bowel Disease

a. Crohn's disease

The main pathology in the condition "acute pancreatitis" is best described as:
a. ulceration of the lower Gl tract
b. autoimmune stimulation due to inherited disease
c. hypertriglyceridemia in the blood stream
d. inappropriate activation of digestive enzymes

d. inappropriate activation of digestive enzymes

The main pathology in the condition "Jaundice" is best described as:
a. ability of bilirubin to get excreted in intestine
b. ability of bilirubin to get excreted in urine
c. inability of bilirubin to build up in blood
d. inability of bilirubin to get excreted in intestine C

d. inability of bilirubin to get excreted in intestine C

The gradual destruction of liver tissue in chronic liver disease includes:
a. deposition of fat > connective tissue formation > scar tissue formation
b. deposition of fat > scar tissue formation > connective tissue formation
c. deposition of connective tissue formation > scar tissue formation > deposition of fat
d. scar tissue formation > connective tissue formation > deposition of fat

b. deposition of fat > scar tissue formation > connective tissue formation

Which of the following is NOT a risk factor for developing colon rectal cancer?
a. Diabetes
b. Older than 60 years
c. Have family history of colon cancer
d. Smoking

a. Diabetes

A 50 year old male is admitted to the ICU with a diagnosis of hepatic encephalopathy. Which clinical manifestation is most common in this condition?
a. decreased tendon reflex
b. hypotension
c. increase urine output
d. altered level of consciousness

d. altered level of consciousness

A 54 year old male patient with a history of cirrhosis and alcoholism is admitted to the hospital with severe dyspnea resulting in ascites. The PT must be aware that the ascites is most likely the result of increased:
a. Production of serum albumin
b. Pressure in the portal vein
c. Interstitial osmotic pressure
d. Secretion of bile salts

b. Pressure in the portal vein

Which of the following findings will strongly indicate the possibility of cirrhosis?
a. Hypotension
b. Hepatomegaly
c. Dry skin
d. Peripheral Edema

d. Peripheral Edema

A consequence of "wear and tear" on joints, affecting bone, soft tissue and synovium of large weight bearing joints is
a. osteoarthritis
b. psoriatic arthritis
c. juvenile arthritis
d. rheumatoid arthritis

a. osteoarthritis

Cartilage, synovium and intervertebral disks are hard to repair because they are
a. dehydrated, hydrophobic structures
b. made up of lymph tissue and leukocytes
c. made up of elastic cartilage which is hard to regenerate
d. primarily avascular and alymphatic

d. primarily avascular and alymphatic

Osteophytes refer to
a. formation of new bone at bone margins
b. bony spicules in fracture injury
c. vitamin D deficiency
d. bony development in soft tissue

a. formation of new bone at bone margins

A person who trips and in the process of falling forward sticks out his/her wrists to break the fall would most likely suffer from which type of fracture.
a. Maisonneuve
b. Torus
c. Colle's
d. Nightstick

c. Colle's

Ankylosing spondylitis is most frequently seen affecting (select one or more)
a. the axial skeleton
b. teenaged girls
c. large peripheral joints
d. people who are HLA-B27+

a. the axial skeleton
c. large peripheral joints
d. people who are HLA-B27+

A stretching or tearing of the musculotendinous unit is best characterized as a
a. contusion
b. strain
c. sprain
d. subluxation
e. fracture

b. strain

Contracture of the DIPs and PIPs is osteoarthritis is referred to as
a. Herberden's and Bouchard's nodes, respectively
b. Smith syndrome and Jones kyphosis, respectively
c. Swan neck and Boutonniere deformities, respectively
d. Lhermitte's and Babinski's signs, respectively

a. Herberden's and Bouchard's nodes, respectively

The first phase of healing is characterized by which of the following
a. angiogenesis
b. cytokine signaling
c. hematoma formation
d. granulation tissue
e. remodeling

c. hematoma formation

A runner who presents with deep, throbbing pain in left gastrocnemius and paresthesia in the left foot would most likely be suffering from
a. stress fractures
b. excess lactic acid build-up
c. mysofascial compartment syndrome
d. osteoarthritis

c. mysofascial compartment syndrome

Which one of the following is an incomplete fracture in which bone is bent, and occurs most commonly in children
a. Greenstick fracture
b. Butterfly fracture
C. Torus fracture
d. Epiphyseal fracture

a. Greenstick fracture

What kind of Fracture? Fracture at base of fifth metatarsal bone:

Jone’s Fracture

What kind of Fracture? Fracture in which the bone segment is wedge-shaped.

Butterfly Fracture

What kind of Fracture? Fracture of ulna alone (usually midshaft).

Nightstick Fracture

What kind of Fracture? Oblique fracture of lateral malleolus and transverse fracture of medial malleolus.

Pott’s Fracture

What kind of Fracture? Fracture of the middle third and distal third of radius with dislocation of radio-ulnar joint of wrist.

Galeazzi’s Fracture

What condition is this? The condition is age related and results from reduction in muscle mass and/or function as we well affects the capacity of muscle to regenerate.

Sarcopenia

What condition is this? The condition results in rapid breakdown of skeletal muscle tissue due to mechanical, physical or chemical traumatic injury; resulting in creatine phosphokinase enzyme release.

Rhabdomyolysis

What condition is this? The condition is caused by overuse or muscles and is marked by the presence of trigger points within muscle bands.

Myofascial Pain Syndrome

The following pathological condition is caused by anterior displacement of vertebra in relationship to the vertebra below:
a. Spinal Stenosis
b. Spondylosis
c. Spondylolysisitis
d. Spondylolisthesis

d. Spondylolisthesis

You are evaluating a 50 year old male patient with GOUT, whose primary concern is intense joint night pain at the big toe. What will you suggest to NOT be included in this patient's diet?
a. Bread
b. Eggs
c. Red Meat
d. Nuts

c. Red Meat