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Worksheets

Musculoskeletal and Pain

Total questions: 47

Worksheet time: 24mins

Name
Class
Date
1.

A 39 year old baseball pitcher presents to your office with tenderness along medial epicondyle and pain worse with resisted wrist flexion and pronation. Medial epicondylitis is suspected. What phase during the throwing motion of a pitcher is most associated with this diagnosis?

a)

Early cocking phase

b)

Late cocking phase

c)

Acceleration phase

d)

Follow through

e)

Two of the above

2.

A 39 year old tennis player presents to your office with tenderness along lateral epicondyle. Lateral epicondylitis is suspected. What is not an associated risk factor for developing this diagnosis?

a)

A. Improper technique for backhand swings

b)

B. Inappropriate string tension

c)

C. Inappropriate grip size

d)

D. All the above are associated risk factors

3.

A football player was struck directly from the front during the Championship Final. During your assessment, you noticed that his clavicle is displaced posteriorly through his trapezius. Which Rockwood classification is this:

a)

III

b)

IV

c)

V

d)

VI

4.

After a total shoulder arthroplasty, what precautions should be abided by during the first 6 weeks

a)

a. No external rotation over 30 degrees

b)

b. Isotonics cannot begin until 4 weeks after

c)

c. Light weights cannot begin until 5 weeks after

d)

d. Avoid abduction and extension > 0 degrees

5.

Which of the following is a non-particulate steroid

a)

a. Betamethasone

b)

b. Dexamethasone

c)

c. Triamcinolone

d)

d. Methylprednisolone

6.

Your patient had a long thoracic nerve injury. Identify the correct pair of the affected muscle and clinical finding.

a)

A - Serratus anterior - Lateral winging of scapula;

b)

B - Serratus anterior - Medial winging of scapula;

c)

C - Trapezius - Lateral winging of scapula;

d)

D - Trapezius - Medial winging of scapula

7.

In adhesive capsulitis, how long does the painful stage and stiffening phase each last?

a)

A - 3 months

b)

B - 6 months

c)

C- 8 months

d)

D- 12 months

8.

Which of the following NSAIDs is the most selective for COX-2?

a)

Ibuprofen

b)

Naproxen

c)

Ketorolac

d)

Meloxicam

9.

What is the correct sequence of anesthetics' duration of action (longest duration to shortest)?

a)

A - ropi > bupi > lido

b)

B - bupi > ropi > lido

c)

C - bupi > lido > ropi

d)

D - lido > ropi > bupi

10.

A tennis player presents to you with pain in the medial side of his elbow that is worse with resisted flexion movements of his wrist. Cozen’s and mill’s tests are positive. How should he change his racket to decrease his symptoms and prevent future recurrence?

a)

a. Increase grip size, increase string tension

b)

b. Increase grip size, decrease string tension

c)

c. Decrease grip size, increase string tension

d)

d. Decrease grip size, decrease string tension

11.

A 24 year old female was playing soccer and fell on her outstretched hand. She subsequently noticed that she couldn’t bend her right elbow and has pain in the right shoulder and wrist. She was found to have a posterior dislocation of the right elbow on XR. After reduction, how long does the elbow need to be splinted?

a)

2 days

b)

5 days

c)

7 days

d)

10 days

12.

Which of the following structures is matched correctly with its corresponding spinal column?

a)

A) Ligamentum Flavum - Posterior Column

b)

B) Anterior Longitudinal Ligament - Middle Column

c)

C) Posterior Longitudinal Ligament - Posterior Column

d)

D) Posterior 2/3rds of Vertebral Body - Posterior Colum

13.

Which of the following is FALSE regarding disc herniations?

a)

A) A herniated nucleus pulposus refers to an injury where the nucleus pulposus migrates through the annual fibers

b)

B) The most common location for disc herniations is at the L4-L5, L5-S1, and C5-C6 levels

c)

C) A bulging disc describe a herniation that includes an annual defect

d)

D) An extruded disc describes a herniation where nuclear material extends to the PLL

14.

Which of the following is TRUE regarding return to work in injured workers with low back pain?

a)

A) Off from work for 6 months = 85% return to workreturning to work, regardless of the duration of time off

b)

B) Off from work for 1 year = 50% return to work

c)

C) Off from work for 2 years = < 5% return to work

d)

D) All patients have an equal chance of

15.

1. 21 year old soccer player attempts a long kick and feels a pain in his posterior thigh. Which is correct regarding hamstring injury pathomechanics and location?

a)

a. Most likely during eccentric contraction and in the lateral hamstring

b)

b. Most likely during concentric contraction and in the lateral hamstring

c)

c. Most likely during eccentric contraction and in the medial hamstring

d)

d. Most likely during eccentric contraction and in the medial hamstring

16.

2. An 18 year old F marathon runner presents to clinic with groin pain during running and while attending to her ADLs. XR is negative but MRI shows a stress fracture on the superior aspect of the femoral neck. What is treatment?

a)

a. Weight bearing as tolerated and start PT

b)

b. Partial weight bearing for 4-6 weeks and then PT

c)

c. Bed rest for 4-6 weeks

d)

d. Immediate non weight bearing and surgical evaluation with orthopedics.

17.

What points are used to measure for a true leg length discrepancy?

a)

A) AIIS to lateral malleolus

b)

B) AIIS to medial malleolus

c)

C) ASIS to lateral malleolus

d)

D) ASIS to medial malleolus

18.

Which of the following hip precautions are true for a patient who recently underwent an ANTERIOR APPROACH THA that does/do not apply to a posterior approach THA?

a)

A) Avoid hip extension

b)

B) Avoid external rotation

c)

C) Avoid extreme internal rotation

d)

D) Avoid hip flexion greater than 90 degrees

e)

E) Both A & B

19.

A 19 yo male sustains a right shoulder dislocation after taking a fall while snowboarding in Park City, Utah. In advising this patient on the rate of recurrence, you would be correct in saying:

a)

25%

b)

50%

c)

75%

d)

90%

20.

What percentage of humeral head articulates with the glenoid fossa?

a)

10%

b)

20%

c)

30%

d)

40%

21.

53 yo female suffering from right shoulder impingement syndrome presents to your clinic for subacromial bursa steroid injection. You want to select a nonparticulate steroid preparation, so you administer:

a)

Triamcinolone

b)

Dexamethasone

c)

Betamethasone

d)

Methylprednisolone

22.

Which of the following thumb flexors does not receive innervation from the median nerve?

a)

FPB

b)

FPL

c)

Opponens pollicis

d)

Adductor pollicis

23.

"Jersey finger" involves loss of which of the following instructions?

a)

DIP flexion

b)

DIP extension

c)

PIP flexion

d)

PIP extension

24.

Which of the following is NOT included within Waddell's signs?

a)

Simulation

b)

Distraction

c)

Tenderness

d)

Malingering

25.

A 10 year old wheelchair bound boy with DMD presents for follow-up, on reviewing spine imaging, you find a Cobb angle of 37 degrees. How do you counsel his caretakers?

a)

A. Observe at the moment

b)

B. He would most benefit from surgery at this time

c)

C. He needs spinal bracing at this time

d)

D. Traction with 50 lbs will fix the deformity

26.

Which of these Modic change MRI pairings is correct?

a)

A. Type 1. T1: bright, T2: bright

b)

B. Type 1. T1: dark, T2: dark

c)

C. Type 2: T1: bright, T2: bright

d)

D. Type 2: T1 dark, T2: dark

27.

Which of the following non-opiate medications is paired correctly with their mechanism of action?

a)

A. Meloxicam - Cox-2 inhibitor

b)

B. Gabapentin - GABA B inhibitor

c)

C. Oxcarbazepine - Voltage-gated potassium channels inhibitor

d)

D. Valproic Acid - GABA inhibitor

28.

Which of the following is true regarding performing the Apley grind?

a)

A. Position in supine, apply translational force to the tibia relative to the femur

b)

B. Position in prone, apply rotational and compressive force to the tibia relative to the femur

c)

C. Position in prone, apply translational force to the tibia relative to the femur

d)

D. Position in sitting, apply rotational and compressive force to the tibia relative to the femur

29.

Which of the following would NOT be a useful component of a treatment plan for PFPS in a biker?

a)

A. Patellar taping

b)

B. Lowering the saddle position to increase knee flexion

c)

C. Raising the saddle position to decrease knee flexion

d)

D. VMO strengthening

30.

Which nerve innervate Abductor Hallucis and why it is important to know?

a)

A. Deep perineal nerve

b)

B. Superficial peroneal nerve

c)

C. Medial plantar nerve (branch of the tibial nerve)

d)

D. I don’t know

31.

Too many toes sign is an indication of which tendon injury?

a)

Tibialis posterior tendon rupture.

b)

Tibialis anterior tendon rupture

c)

Achilles tendon rupture

d)

Peroneus longus tendon rupture

32.

What is the most commonly injured ligament of the knee?

a)

LCL

b)

ACL

c)

MCL

d)

PCL

33.

What is the unhappy/O'Donoghue triad of the knee?

a)

A. LCL tear, PCL tear, lateral meniscal tear

b)

B. MCL tear, ACL tear, medial meniscal tear

c)

C. MCL tear, ACL tear, patellar fracture

d)

D. LCL tear, ACL tear, lateral meniscal tear

34.

What is the mechanism of action of Gabapentin?

a)

A. Interacts with a2d subunit of L-type calcium channels

b)

B. Interacts with b4 subunit of voltage gated sodium channels

c)

C. Interacts with mu opioid receptor

d)

D. Interacts with GABA receptors

35.

What is the injection target area in stellate ganglion blocks, also known as “Chassaignac tubercle”?

a)

A. Tubercle of the C5 vertebral body

b)

B. Tubercle of the C6 vertebral body

c)

C. Tubercle of the C7 vertebral body

d)

D. Tubercle of the T1 vertebral body

36.

The pes anserine bursa is located between the gracilis, sartorius, and (___________) tendons as well as the (___________) ligament.

a)

A) Semimembranosis, lateral

b)

B) Semitendinosis, lateral

c)

C) Semimembranosis, medial

d)

D) Semitendinosis, medial

37.

All of these INCREASE the Q angle except:

a)

A) Internal femoral torsion

b)

B) Lateral insertion of infrapatellar tendon

c)

C) Genu Valgum

d)

D) Genu Varum

38.

A positive response for a diagnostic medial branch block procedure is when there is

a)

A. >80% pain relief postprocedure

b)

B. >50% pain relief postprocedure

c)

C. >75% pain relief postprocedure

d)

D. >60% pain relief postprocedure

39.

Which of these is a nonparticulate steroid you may want to use for an epidural steroid injection?

a)

A. triamcinolone

b)

B. methylprednisolone

c)

C. betamethasone

d)

D. dexamethasone

40.

Bracing should be performed for scoliosis for a Cobb angle of

a)

A. <20 degrees

b)

B. >40 degrees

c)

C. 20 to 40 degrees

d)

D. >35 degrees

41.

Reproduction of anterior thigh pain in the prone position with knee flexion and hip extension is a positive

a)

A. Bowstring test

b)

B. Seated slump test

c)

C. Femoral nerve stretch test

d)

D. Yeomans test

42.

Which of the following puts a patient at higher risk of developing plantar fasciitis?

a)

pes planus

b)

pes cavus

c)

Neither

d)

Both

43.

What is a neuroma and where does a Mormons neuroma develop in the foot?

a)

a cyst forming around a nerve; between 2 and 3 intermetatarsal space

b)

a fibrosis of the deep peroneal nerve; between the 3 and 4 intermetatarsal space 

c)

a fibrosis of the perineurium of the interdigital nerves; 2 and 3 intermetatarsal space

d)

a fibrosis of the perineural fibers; the 3 and 4 interdigital nerves

44.

Claw toe definition

a)

MTP extension, PIP extension, flexion of DIP

b)

PIP and DIP are extended, MTP extended

c)

MTP flexed, PIP and DIP are extended

d)

MTP extension, flexion of PIP and DIP. 

45.

What is the most common location of a scaphoid fracture?

a)

Waist

b)

Tubercle

c)

Distal Pole

d)

Proximal Pole

46.

Which of the following is not associated with scapholunate dissociation?

a)

Terry Thomas Sign

b)

David Letterman Sign

c)

Michael Strahan Sign

d)

Val Kilmer Sign

47.

Which is the most common headache type?

a)

Migraine Headache

b)

Tension Headache

c)

Cluster Headache

d)

Secondary Headaches