cceb chiro tutor practice questions

A 27 year-old electrician presents to your clinic with a primary complaint of right-sided shoulder pain. Upon physical examination, it is noticed that the patient is unable to abduct or externally rotate the affected shoulder. Which nerve is likely being impacted in this patient?

Dorsal scapular nerve

Suprascapular

Superior subscapular nerve

Axillary nerve

B - the muscles in question are supraspinatus and infraspinatus

A 76-year-old female patient comes in with a complaint of low back pain and pain down into her left leg. Additionally, she has had an MRI examination done in her lumbar spine to assess for stenosis. The report reveals IVF narrowing of the left L4-5 IVF. What part of her lower extremity will have decreased sensation?

Medial portion of the leg (L4)

Lateral portion of the leg (L5)

Web of the big toe (L5)

Plantar aspect of the foot (S1)

A - IVF narrowing of L4-5 impacts the L4 nerve root

3. A young hockey player comes in to your office after being checked into the boards. A severe amount of force was transmitted in towards his skull as evidenced by the extensive damage on his helmet. A head CT was performed and revealed rupture of the middle meningeal artery. Based on the history and MRI findings, what bone was likely fractured?

Occipital bone

Temporal bone

Frontal bone

Sphenoid bone

B - the better answer to this question would be pterion, as that is where the middle meningeal artery travels through

4. A patient presents to the chiropractor's office with a complaint of neck stiffness. Observation reveals the patient's head is in a right laterally flexed position with rotation to the left. Which muscle is involved?

Right anterior scalene

Left SCM

Left middle scalene

Right SCM

D - SCM does ipsilateral lateral flexion and contralateral rotation

A 21-year-old athletic female patient comes in with a chief complaint of mid-back pain, which is especially noted when she is doing push-ups. During the physical exam you have her do a push-up and you notice that her scapulae are winging. Which muscle should be targeted and strengthened?

Lev scap

Teres major

Subscapularis

Serratus anterior

D - because she has a winging scapula, her serratus anterior is not functioning properly. This can be from a long thoracic nerve palsy or a weakness in the muscle

6. One of your regular patients presents to your clinic for a maintenance visit. She mentions that her GP has her taking an iron supplement to combat her anemia. What should she take with it to encourage its absorption?

Vitamin C

Calcium

Magnesium

Vitamin D

A - vitamin C is known to help with the absorption of iron. Coffee decreases its absorption

A father brings his 8-year-old daughter to her check-up at a chiropractor's office. He was told that his daughter had some recent blood work done and it revealed that her calcium levels were a bit lower than usual. He inquires about what foods she should be eating to increase those levels. What would be the best option?

Ground almonds

Spinach

Canned sardines

Ground chick peas

C - canned sardines (or any canned fish at that) has bones in it and therefore, calcium levels will be higher than the other foods

A 45-year-old female has been consistently treated for approximately 3 months from chronic neck pain with radiculopathy. Her symptoms are primarily experienced on the right side of her neck and into her lateral forearm and thumb. An X-ray report showed IVF narrowing impacting the nerve root that is causing her radiculopathy. What is the diagnosis?

C4 radiculopathy due to C4-5 IVF narrowing

C5 radiculopathy due to C4-5 IVF narrowing

C6 radiculopathy due to C5-6 IVF narrowing

C7 radiculopathy due to C6-7 IVF narrowing

C - in this case, the C6 nerve root is being impacted. Due to the IVF narrowing, it must be C5-6 IVF narrowing

A slightly overweight male patient presents to the chiropractor with numbness and tingling along the anterior and lateral thigh. The doctor palpated just medial to the ASIS, which reproduced these same symptoms. What structure is likely involved and what is being impacted?

Pectineus compressing obturator nerve

Rec fem compressing femoral nerve

Sartorius compressing lateral femoral cutaneous nerve

Vastus medialis compression saphenous nerve

C - lateral femoral cutaneous nerve inner ages the anterolateral thigh and sartorius is a known entrapment site for this nerve

A patient reports having an irritating pain at the back of their shoulder. The doctor palpates a muscle, which attaches from the middle 1/3 border of the scapula to the head of the humerus. How should the doctor test this muscle?

Internal rotation

Abduction

Adduction

External rotation

D - the muscle in question is teres minor and therefore, the primary action is external rotation

A 14-year-old female soccer player experienced a fall during her game last night. She presents to the clinic with a painful right foot and ankle, which has noted swelling seen on the lateral aspect. Physical examination reveals pain with passive inversion of the ankle and tenderness along the superolateral ankle. Based on the information above, what is the structured that is most likely damaged.

CFL

Deltoid ligament

PTFL

ATFL

D - this is an inversion ankle sprain and therefore, the most common ligament injured is that ATFL

A 27-year-old electrician was working on the job site when his foot got stuck in a pothole, which caused him to fall. He immediately felt pain along the medial aspect of his ankle and was experiencing pain with walking when he presented to your clinic. What is the most likely injured structure?

Talus

ATFL

Deltoid ligament

Achille's tendon

C - this is an eversion ankle sprain and therefore, the injured ligament is the deltoid ligament

Osteophyte development at which spinal level would result in an inability to retract the shoulder?

C3

C4

C5

C6

C - the dorsal scapular nerve is primarily supplied by the C5 nerve root

A 12-year-old girl presents to the office with a stiff neck and vomiting. Based on the most likely diagnosis, what is the most common causative pathogen?

Streptococcus pneumoniae

Neisseria meningitidis

Staphyococcal aureus

Epstein-Barr virus

A - this patient has meningitis and in this particular age group, streptococcus pneuomoniae is the most common pathological agent

A patient of yours presents for her regular maintenance adjustment following a visit with her MD, where she recently had some blood work done. Her doctor recommended she increase her omega 3 intake and she is wondering what food would be best to do so?

Flax seeds

Cabbage

Spinach

Milk

A - flax seeds have a high level of omega 3's in them. Another example would be fish

What is the dominant motion that occurs at the level of C0/C1?

Lateral flexion

Flexion and extension

Rotation

None of the above

B - based on the anatomy of the joints at the level of C0-C1, flexion and extension is primarily happening

The vertebral artery can be broken up into 4 distinct parts. Where does the 90 degree bend occur?

Between the levels of C6-C2

As it branches off the subclavian artery

At the level of C1-C2

After it pierces the dura to become basilar artery

C - the vertebral artery bends at the levels of C1-C2 after it travels vertically up through the transverse foramen from C6-C2

A 74-year-old female patient presents to a chiropractic office for an initial assessment. The chiropractor is following evidence-based guidelines. What research is this form of practice based on?

Observational studies

Case report

Cohort study

Meta-analysis

D - meta-analyses are the result of synthesizing multiple randomized control trials

When assessing for relative risk for a stroke, what might be a key finding?

Diet high in polyunsaturated fats

Uncontrolled hypertension

Sedentary job

Cervical manipulation

B - hypertension is the "silent killer" and is associated with stroke. However, this is usually associated with high cholesterol, overweight/obesity, and inactivity

The concept that someone is required to take a higher dose of medication to achieve the same benefit is referred to as?

Hypersensitization

Desensitization

Rebound effect

Drug dependence

B - with long-term medication use, some patients have been known to experience desensitization and therefore, need to take a higher dose. This may result in harsher effects on the liver and kidneys

A patient presenting with low back pain and central abdominal tenderness would be expected to have what condition?

Non-specific mechanical low back pain

Appendicitis

Peritonitis

Abdominal aortic artery dissection

D - these are tell-tale signs with AAA dissection. This is a challenging condition because the signs and symptoms are non-specific and not necessarily obvious

A commonly tight muscle that can be palpated traversely from the sciatic notch to the greater trochanter is?

Piriformis

Gluteus maximus

Gluteus medius

Gluteus minimus

A - origin and insertion of piriformis (have a general idea of the origin and insertions of common muscles)

A patient experiences a stroke and has difficulty moving their left shoulder into external rotation. What spinal tract is implicated in this case?

Left dorsal spinocerebellar tract

Right lateral spinothalamic tract

Right lateral corticospinal tract

Left lateral corticospinal tract

C - the lateral corticospinal tract crosses at the pyramids (in the brain stem) and supplies muscles on the contralateral side. Know your ascending and descending pathways

24. A doctor is performing a physical examination on a patient's hip complaint. He notices weakness when the patient performs resisted hip adduction. What nerve is implicated?

Superior gluteal nerve

Inferior gluteal nerve

Sciatic nerve

Obturator nerve

D - the adductors are innervated by obturator nerve, which has an anterior and posterior division

A male cyclist falls and sustains a concussion. As a result, he experiences post-concussive disorder, which is categorized as an excessive release of glutamate from the brain, which increases calcium ions entering into the cells. What principle is occurring to make this happen?

Passive diffusion

Active transport

Osmosis

Exocytosis

A - following brain trauma (like a concussion), there is usually a disruption in the ion balance, which causes things to go haywire. Therefore, as glutamate is released it causes calcium to enter into the cells passively.

If a patient wishes to improve their overall cholesterol levels, what is the best type of fat to avoid?

Saturated fat

Monounsaturated fat

Polyunsaturated fat

Hydrogenated fat

D - hydrogenated fats and trans fats are known for their tendency to increase cholesterol levels, particularly LDL cholesterol

A marathon cyclist sustained a hamstring injury. The doctor palpated the injured muscle that originated from the linea aspera of the femur and inserted onto the head of the fibula. What muscle was injured?

Semitendinosis

Short head of biceps femoris

Semimembranosis

Long head of biceps femoris

B - these are the origin and insertion of the short head of biceps. This muscle also has a different innervation from the other hamstring muscles, which is common fibular nerve

Following a traumatic brain injury at the pterion of a patient's skull, an MRI is ordered, which reveals a lens-shaped high signal intensity over the parietal and temporal lobes. What artery is injured in this case?

Anterior cerebral artery

Middle meningeal artery

Middle cerebral artery

Pericallosal artery

B - middle meningeal artery travels through the pterion. This is similar to question 3

Which of the following is considered a closed chain exercise?

Biceps curl

Hamstring curl

Push-up

Triceps extension

C - closed chain exercises are performed where the hand or foot is fixed in space and cannot move. Open chain allows the extremities to move freely without being locked in position

The stomach is the first location where proteins are digested. What enzyme is responsible for this and what secretes it?

Hydrochloric acid, chief cells

Pepsin, chief cells

Hydrochloric acid, parietal cells

Pepsin, parietal cells

B - pepsin is released from the chief cells and hydrochloric acid is released from the parietal cells

A patient sustained damage to the pyramidal tract following a traumatic brain injury, what fibres run through this area?

Motor fibres

Proprioceptive fibres

Vibration and fine touch fibres

Temperature fibres

A - the pyramidal tracts are where the anterior and lateral corticospinal tracts travel, which are motor fibers

Lab work in a patient that shows increased levels of Bence Jones proteins would be indicative of:

Lytic metastasis

Small lung cell carcinoma

Multiple myeloma

Prostate carcinoma

C - Bence Jones proteins are seen in a patient's urine sample in multiple myeloma

If a patient presents with a foot drop when walking, what nerve root is likely responsible?

L2

L3

L4

L5

D - L5 nerve root supplies the ankle dorsiflexors and therefore, foot drop would occur in L5 radiculopathy

A patient is experiencing rapid fluctuations in their blood pressure and heart rate, which is suspected to be due to a neurological tumour. Where would you expect to find it?

Pons

Midbrain

Medulla oblongata

Post-central gyrus

C - medulla oblongata is the primary centre for blood pressure and heart rate control

A natural way to help a patient who is experiencing degenerative joint disease would be to supplement with?

Chondroitin sulfate

Vitamin D

Calcium

Co-Enzyme Q-10

A - chondroitin sulphate in controversial, but there has some research showing that it helps maintain the existing cartilage

Rib fracture is a possible risk of thoracic manipulation. In an osteoporotic patient, what part of the rib is this most likely to occur?

Neck

Non-articulating tubercle

At the articulation with the sternum

Angle of the rib

D - angle of the rib is where force is transmitted during trauma and due to the angulation at this area, there is a fracture risk associated with it

A 14-year-old female has a scoliosis and her iliac crest if 25% ossified. How much longer until it is fully ossified?

1 year

2 years

3 years

4 years

B - iliac crest fully ossifies by 16 years of age

What might you expect to find in a patient who has an upper motor neuron lesion?

Flaccid paralysis

Hyporeflexia

Loss of sensory

Clonus

D - clonus is the pulsating/fasciculating of the feet when they are forced into dorsiflexion and held there. This with hyperreflexia and Hoffman's/Babinski's are other tell-tale signs of upper motor neuron lesions

A young child has Legg-Calve-Perthes disease. What is the pathophysiology behind this disease?

Avascular necrosis of the femoral head

Infection in the hip joint

Acute fracture of the hip

Vitamin D deficiency

A - LCP is an idiopathic avascular necrosis of the femoral head that occurs in children. Late stage of the disease (if not treated) may result in deformity and collapse of the bone, which may require surgical replacement earlier in life

Pott's disease is a rare spinal infection that occurs due to what pathogen?

Staph aureus

Neisseria meningitidis

Mycobacterium tuberculosis

Epstein-Barr virus

C - Pott's disease is non-pyogenic spondylodiscitis or spinal infection that comes from TB. Pyogenic spondylodiscitis is from staph aureus, which is more common

During a fight or flight response, epinephrine is released. Which of the following occurs as a result of high levels of epinephrine?

Decrease glycogenolysis

Increase glyconeogenesis

Decrease stroke volume

Vasodilation to lower extremity muscles

D - epinephrine is a hormone that results in vasodilation of the appendicular/peripheral muscles, increase heart rate and stroke volume, and increase respiratory rate

Following a stroke, a patient was shown to have experienced damage in the outer portion of the parietal lobe. What artery is likely implicated in this patient?

Anterior cerebral artery

Middle cerebral artery

Posterior cerebral artery

Temporal artery

B - middle cerebral artery supplies most of the outer portion of the frontal and parietal lobes; posterior cerebral artery supplies the occipital lobe; anterior cerebral artery supplies the medial portion of the frontal and parietal lobe

A 65-year-old patient presents with persistent headaches without any aura or light sensitivity. What is the cause?

Chronically contracted neck musculature

Infection by serious bacteria

Onset of a migraine headache

Haemorrhage of a cerebral artery

A - this is more of a situation where cervicogenic headache is being described and therefore, chronically contracted neck musculature would be to blame (particularly the suboccipitals)

In lumbar flexion, what structure limits flexion?

Facet joint

Intervertebral discs

Anterior longitudinal ligament

Ligamentum flavum

D - ligamentum flavum limits excessive flexion while anterior longitudinal ligament limits extension

Those struggling with Parkinson's have destruction of what structure?

Post-central gyrus

Substantia nigra

Thalamus

Medial geniculate body

B - substantia nigra is in the midbrain and is responsible for releasing dopamine, which regulates movement. In Parkinson's, there is no dopamine (or very low levels of it), which causes a resting tremor.

What neurotransmitter is depleted in Parkinson's?

Serotonin

Epinephrine

Acetylcholine

Dopamine

D - same explanation as question 45

A patient experiences numbness and weakness on the outside of their shoulder. What cord from the brachial plexus feeds into the affected nerve?

Posterior cord

Anterior cord

Medial cord

Lateral cord

A - the nerve in question here is the axillary nerve, which supplies the deltoids and the cutaneous innervation to the outside of the shoulder, which comes from the posterior cord

What artery is known to wrap around the medial malleolus?

Fibular artery

Anterior tibial artery

Posterior tibial artery

Lateral plantar artery

C - the posterior tibial artery runs under the medial malleolus while the anterior tibial artery runs on the dorsum of the foot (becoming the dorsal pedal artery)

A BMI of a female who is thought to be underweight would be?

<18

18-25

25-30

30-35

A - this one is straight forward, know your different ranges and meanings for BMI

When assessing the eyes, if a patient's eye position is down and in, what nerve is not functioning properly?

Superior oblique

Inferior oblique

Lateral rectus

Medial rectus

B - the function of the inferior oblique is to elevate and abduct (laterally move) the eye. Therefore, when it is not functioning, the remaining muscles over-power and move the eye into a down and in position

In the cubital fossa, what structure lies lateral to the biceps tendon?

Radial nerve

Median nerve

Radial artery

Ulnar artery

A - radial nerve runs lateral to the biceps tendon where it divides into the superficial and deep radial nerve

In the popliteal fossa, what structure is located most anteriorly?

Popliteal artery

Popliteal vein

Tibial nerve

Common fibular nerve

A - popliteal artery is the most anterior structure, which means that it is the most deep structure. This is because arterial supply is always the deepest and most protected

A patient is experiencing numbness in their lower legs and feet. It is revealed that they are also an alcoholic and indulge in an unhealthy diet. What vitamin should they increase in their diet?

Vitamin C

Vitamin B6

Vitamin B12

Vitamin E

C - vitamin B12 (AKA cobalamin) is an essential vitamin that functions to keep the body's nerve and blood cells healthy as well as being a component DNA. A lack may result in polyneuropathies and megaloblastic anemia

Following a major fall, a young female patient experiences a compression fracture at T7. Sympathetic innervation to what organ would be affected?

Liver

Large colon

Ovary

Sigmoid colon

A - at the level of T7, we would be impacting our greater splanchnic nerve (which is the T5-9 spinal levels). Organ supply (for sympathetic innervation) would be lower esophagus, stomach, liver, pancreas, and duodenum

If a 65-year-old diabetic male patient presents with bilateral numbness in his toes, what do you suspect they are suffering from?

Central stenosis

Lumbar radiculopathy

Diabetic neuropathy

Peripheral nerve entrapment of sciatic nerve

C - diabetic neuropathy is the answer because history indicates he is a diabetic male and he has a bilateral sensory loss. Other complications of poorly-managed diabetes would be diabetic retinopathy

If a patient's blood levels reveal high levels of asparate aminotransferase, which organ is likely affected?

Kidney

Liver

Prostate

Spleen

B - this particular enzyme is usually elevated with severe liver damage

In a patient with megaloblastic anemia, what vitamin should be increased to resolve this condition?

Vitamin B1

Vitamin B2

Vitamin B7

Vitamin B12

D - vitamin B12 for the same reasons as question 53

In a 2-month-old infant, where will the the first secondary curvature form?

Cervical

Lumbar

Thoracic

Sacral

A - cervical because babies start to lift their head so that they can see where they are going while they crawl

In a spontaneous dissection of the vertebral artery, what layer is affected?

Tunica intima

Tunica media

Tunica externa

Internal elastic membrane

A - tunica intima is the lining of the artery where cholesterol-rich calcific plaques can build up and eventually dislodge, block, or damage the lining, which may lead to spontaneous dissection of different arteries

If a child is suspected to have meningitis, what test would be performed to confirm the diagnosis?

Upper and lower limb neurological examination

Lumbar puncture

Blood testing

Cranial nerve exam

B - lumbar puncture in a patient with meningitis would reveal a cloudy and purulent appearance, an elevated WBC count, a low glucose level (if bacterial infection), and elevated protein levels

If someone is trying to reduce inflammation in their body, what herbal supplement might they use?

Ginseng

Saw palmetto

Curcumin

Coenzyme Q-10

C - Curcumin is what is typically found in turmeric and has been used for a very long time as a way to naturally reduce inflammation in the body. Research on this is still up for debate, however.

Pain and tingling in the arms and fingers may indicate damage to what neurological structure?

Schwann cells

Glial cells

Astrocytes

Oligodendrocytes

D - oligodendrocytes are the myelin-producing cells of the central nervous system, which are the cells implicated in multiple sclerosis. Schwann cells produce myelin in the peripheral nervous system

A person is instructed to keep their neck neutral and slightly tilt their head into flexion. What muscle is responsible for this movement?

Longus colli

Anterior scalenes

Middle scalenes

Sternocleidomastoid

A - by keeping the neck neutral, this person is performing a chin tuck exercise, which is used to strengthen the deep neck flexors, which in this case is the longus colli.

A young male patient is known to use NSAIDs for his chronic pain. He now has severe abdominal pain and rigidity. What is the cause?

Liver failure

Ulcer

Kidney stones

Appendicitis

B - chronic use of NSAIDs is known the destroy the stomach lining and therefore, ulcers may form

During an allergic reaction, histamine is released. What type of cell is responsible?

Macrophage

Neutrophil

Monocyte

Mast cells

D - mast cells reduce histamine, which is responsible for increasing permeability of the capillaries to WBC's (allowing them to engage pathogens)

What is the function of the quadratus lumborum?

Steadies the hip in the stance phase of gait

Flexes the lumbar spine

Fixes the 12th rib for expiration

Flexes the hip

C - fixing of the 12th rib occurs during forced expiration, while it helps the diaphragm during inhalation

When glucose is absorbed in the small intestine, what process is being used in this situation?

Passive diffusion

Active transport

Osmosis

Facilitated diffusion

B - glucose absorption takes place by SGLT1 transport, which uses ATP to function, therefore, an active transport

A male in his 50's has a swollen big toe. The breakdown of which macronutrient is responsible?

Carbohydrates

Fats

Proteins

Triglycerides

C - this patient is suffering from gout in this place, which occurs when proteins are broken down (particularly purine synthesis), which creates high levels of uric acid

A hip is seen to have decreased internal rotation, flexion, and adduction. What structure is responsible for this?

Iliofemoral ligament

Iliopectineal bursa

Ischiofemoral ligament

Articular capsule

C - ischiofemoral ligament limits internal rotation, flexion, and adduction. So, in this case, this ligament is too taut and therefore, limiting these actions even more

The primary stabilizer of the lumbopelvic region is the?

Psoas

Iliocostalis lumborum

Multifidus

Quadratus lumborum

C - based on Dr. Stu McGill's research, the major stabilizer of the lumbopelvic region is the multifidus. Working in close conjunction with this muscle is the transverse abdominis

A person has erythema migrans. What organism is involved

Epstein-Barr virus

Borrelia burgdorferi

Shigella

Trichomoniasis

B - Borrelia burgdorferi is the bacterial species in Lyme disease. It impacts many organs of the body, but especially attacks the nervous system, muscles, joints, and the heart

You are palpating the femoral triangle. You palpate the iliacus muscle and then you palpate the femoral artery. What direction did you move to find the artery?

Medial

Lateral

Inferior

Superior

A - as was mentioned above, arterial supply will always be deeper and more protected, so in this case, it is located medial to the iliacus muscle, closer to the groin.

In a patient with adhesive capsulitis, what disease predisposes them to this condition?

Hyperparathyroidism

Hyperthyroidism

Diabetes

Gout

C - people with uncontrolled diabetes may be predisposed to adhesive capsulitis. The reason and mechanism for this is known, however.

An 18-year-old male regularly smokes cannabis over a 2 week period to deal with his back pain. What side effect is least likely to develop?

Confusion

Anxiety

Lung infection

Increased appetite

C - although a controversial issue and evidence is definitely lacking, there has been no link with smoking marijuana and increased risk for lung infection

What muscle assists in extension of the thumb?

Abductor pollicis brevis

Opponens pollicis

Adductor pollicis

Abductor pollicis longus

D - in conjunction with abduction, the APL also provides extension

A young male athlete had injured his wrist 6 weeks back and he is still not improving in his symptoms. What is causing this?

Localized bone tissue inflammation

Muscle strain

Ligament sprain

Dislocation

A - localized bone tissue inflammation typically occurs in a long standing bony injury following a trauma. This is typically a precursor to avascular necrosis

n a patient with neurofibromatosis, what do their skin lesions consist of?

Cartilage

Muscle

Nerve

Bone

C - neurofibromatosis is a genetic neurological disorder that causes nerve-based tumours, called neurofibromas, to grow all along the body's nerves or underneath the skin

What vitamin has a close relation to cholesterol?

Vitamin A

Vitamin D

Vitamin C

Vitamin B12

B - vitamin D and cholesterol go hand-in-hand because vitamin D is absorbed through the skin from UV rays, which in-turn activates cholesterol. Some research has shown that increasing vitamin D reduces LDL cholesterol (the bad cholesterol)

In a patient with an idiopathic scoliosis, what is the most likely curvature that they will have?

Left-sided C-shaped

Right-sided C-shaped

Left-sided S-shaped

Right-sided S-shaped

B - the most common one is a right-sided C-shaped thoracolumbar scoliosis. A left-sided scoliosis usually indicates a serious pathology

In a 70-year-old female patient, how much calcium would you recommend she take daily?

800mg/day

1000mg/day

1200mg/day

1400mg/day

C - these are challenging questions and have begun showing up in the more recent exams. Have a general idea of specifics of each vitamin or micronutrient that people need.

In hemochromatosis, what disease is part of the triad?

Diabetes

Kidney failure

Splenic calcification

Eye pigmentation

A - clinical triad is liver cirrhosis, diabetes, and bronze pigmentation of the skin

Alkaptonuria is associated with the accumulation of what amino acid?

Leucine

Tryptophan

Methionine

Phenylalanine

D - alkaptonuria is a recessive genetic deficiency resulting in the incomplete oxidation of tyrosine and phenylalanine, which causes increased levels of homogentisic acid

During Trendelenburg's test, what muscle is being tested?

Quadriceps

Psoas

Gluteus medius

Pectineus

C - if the hip sags while the patient is standing on one leg, then this indicates a weakness in the gluteus medius, superior gluteal nerve palsy, or hip OA

In Trendelenburg's test, what nerve is being assessed?

Inferior gluteal nerve

Superior gluteal nerve

Sciatic nerve

Obturator nerve

B - same as explanation above

In the lumbar plexus, what does the nerve at T12 supply?

Iliohypogastric nerve

Lateral femoral cutaneous nerve of the thigh

Genitofemoral

Obturator nerve

A - iliohypogastric nerve comes from the T12-L1 spinal levels that provides sensory to the skin over the lateral gluteal region and above the pubis as well as motor to the internal and transverse abdominal muscles

The muscle that attaches from the supraspinous fossa to the greater tubercle is innervated by?

Upper subscapular nerve

Axillary nerve

Suprascapular nerve

Medial pectoral nerve

C - the muscle being described is the supraspinatus, which is innervated by suprascapular nerve

A patient is unable to externally rotate their arm against resistance. What nerve is likely damaged?

Upper subscapular nerve

Axillary nerve

Suprascapular nerve

Medial pectoral nerve

C - the muscle in question is infraspinatus, which is innervated by suprascapular nerve

The muscle that attaches from the spinous processes of T2-T6 to the medial border of the scapula is?

Levator scapula

Rhomboid major

Upper trapezius

Longissimus

B - they love rhomboid questions - this is a common theme over the years

The innervation of the muscle that attaches from the spinous processes of T2-T6 to the medial border of the scapula is?

Dorsal scapular nerve

Long thoracic nerve

Spinal accessory nerve

Suprascapular nerve

A - same as above

What type of virus is hepatitis A?

Double stranded DNA

Single stranded DNA

Double stranded RNA

Single stranded RNA

D - hepatitis A is single-stranded RNA and hepatitis B is double stranded DNA

What type of virus is hepatitis B?

Double stranded DNA

Single stranded DNA

Double stranded RNA

Single stranded RNA

A - same as above

Which muscle does not attach to the greater tubercle of the humerus?

Supraspinatus

Teres major

Teres minor

Infraspinatus

B - these questions are common where they want to know which muscle does NOT attach or which nerve does NOT innervate a certain level

What would be a finding seen in zinc deficiency?

Unexplained weight gain

Hyperactivity

White spots on the nail beds

Constipation

C - zinc deficiency is characterized by growth retardation, decrease appetite, impaired immune function, hair loss, diarrhea, delayed sexual maturation, and white spots on the nail beds

What is the capsular pattern in the hip?

Loss of adduction and internal rotation

Loss of abduction and internal rotation

Loss of adduction and external rotation

Loss of abduction and external rotation

B - capsular pattern indicates what would be the painful loss of range of motion conducive to capsular contracture and osteoarthritis

What is the capsular pattern in the shoulder?

Loss of adduction and internal rotation

Loss of abduction and internal rotation

Loss of adduction and external rotation

Loss of abduction and external rotation

D - same as above

The ectoderm creates what type of tissue?

Muscles

Digestive organs

Lung tissue

Nerves

D - ectoderm gives rise to the nervous system and the epidermal skin cells

What is it called when there is a lack of fusion of the duct between the pulmonary trunk and the aorta?

Patent foramen ovale

Tetralogy of Fallot

Patent ductus arteriosus

Hypoplastic left ventricle syndrome

C - in patent ductus arteriosus, this results in a portion of oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta, which may result in increased work of breathing and failure to gain weight (especially noticed in the first year of life)

What is the infectious pathogen in Syphillis?

Neisseria gonorrhoea

Treponema pallidum

Chlamydia trachomatis

Staphylococcal aureus

B - know the most common infectious pathogens to diseases throughout the body

What do high levels of neutrophils indicate?

Viral infection

Fungal infection

Worm infection

Bacterial infection

D - neutrophils phagocytose bacteria and therefore, neutrophilia (high levels of neutrophils) would be indicative of body fighting off infection

High levels of eosinophils indicate what?

Viral infection

Fungal infection

Parasitic infection

Bacterial infection

C - same explanation as above, but for parasitic infections.