INDONESIAN COLLEGE OF PHYSICAL MEDICINE AND REHABILITATION NATIONAL BOARD EXAMINATION JULY 4 ,2018INDONESIAN COLLEGE OF PHYSICAL MEDICINE AND REHABILITATION NATIONAL BOARD EXAMINATION KEY DATE : JULY 04, 2018 Henini fi Putra naan, Nutone 9a ehafdaton Commtsson >| >| o| >| >| wo mm a} @ >| Of | 0) Of of Of > >| O} OD mo] mm >| mmm >| mo} >] Of m| >| o >| Of Of >| | mm a} >| oj oO] Oo] o | | mmo} oo} @| | 9} mm > ml > Of Of MO} of > ol | > >| o} ml >| o| ml a of o| mo of mol a of | >] 9] | Of Ol of m m| >| 0) of ww) Oo} >| mm > Of of mo >| ml of >| >| m ml >| mo mm} o} >| mm mm >} >| of m of of mm Of} >| m >| >| >| mw] >NATIONAL BOARD EXAMINATION PHYSICAL MEDICINE AND REHABILITATION JULY 4, 2018 CHOOSE THE MOST APPROPIATE ANSWER 1, Female, 38 y.o with knee pain, from physical examination founds swolen at left knee, warm palpable and pain at anterior knee with VAS 6-7, what will you do as a physiatrist? A. Do PRICE and HARM. B. Send to radiologist for x-ray C. Give modalities treatment (heat) D. Give some resistance exe and TENS E. Do PRICE and give some analgesic 2. The clinical symptoms of degenerative joint disease of the shoulder are below, EXCEPT..... A. Pain may be nocturnal and relieved by rest B. Tenderness on palpation on the anterior and posterior aspects of the shoulder C. Limitation and pain on active and passive range of motion which affecting their ADLs D. Manual muscle testing (MMT) may or may not be affected depending on the severity of the disease E. Pain more commonly occurred in external rotation of the shoulder, but may also be seen in adduction motion 3. The level of transhumeral amputation which preferred for optimum prosthetic restoration is.. A. long arm residual limb (7-10 om from the distal humeral condyle) B, short arm residual limb (one-third of bone length), C. very long arm residual limb D. very short arm residual limb E. medium arm residual limb 4. What is common ‘‘red flags” that identify the 10-20% of cases less likely to improve well? A. Obesity B. Osteoporosis, C. High education D. Diabetes Mellitus E, Presence of significant emotionalS.Brain plasticity represents the capability of the damaged brain to repair itself. Plasticity does NOT influenced by.......... A. complexity of stimulation B, location of the lesion C. repetition of tasks D. environment E, motivation 6,Group of motor speech disorders characterized by slow, weak, imprecise, or uncoordinated movements of speech musculature is called ... A. apraxia B. aphasia C. stuttering D, dysarthria E. dysphonia 7.A glove and stocking pattern of sensory disturbance usually develops with disease in. A. peripheral nerve B. the spinal cord C. the brainstem D. the thalamus E. the cortex 8. In TBI subjects, the FIM ( Functional Independence Measure) is INADEQUATE in which of the following area, that is ... A. neuropsychological B. spaincter control C. locomotion D, mobility E. self care 9, In stroke patients, there are various function problems such as in below, EXCEPT. A. neglect of the hemiplegic side B. missing automatic reactions C. have selective movement D. lack of balance E. sensory deficit10. Infantile form of spinal muscular atrophy, is generally ........ ‘A. have underlying pathology of degeneration of posterior horn cells in the spinal cord B. have high amplitude, long duration potential on EMG examination C. 30% of cases have normal. nerve conduction velocity D. transmited by autosomal dominant gene E. hyperreflexia of physiological reflex 11.-The indicator for good prognosis for ambulation in Cerebral Palsy children is A. children with spastic diparesis B, dependent sitting occurs by age 2 C. the absence of postural reactions at age 2 years . ability to crawi on hands and knees by 1.5 ~2.5 years E. persistence of three or more primitive reflexes at 18 - 20 months 12. A 12 years old child has spina bifida. The L2 and L3 neurological level are spared, The motor strength below L3 is fair. Which rehabilitation program is not suitable for this patient? A. Bladder management B. Bowel management C. Gait training D. KAFO. E. AFO 13.. A 10 years old boy complaint frequent falls. He used to walk independently but recently showed waddling gait. He is able to whistle. He has no problem studying at school. His electrodiagnostic evaluation showed normal SNAP, low amplitude CMAP, fibrillation and PSW in spontaneous activity, MUAPs low amplitude and area, and full screen fill in maximal contraction. What is the diagnosis of this patient? Fascioscapulohumeral Dystrophy Becker Musculad Atrophy Spinal Muscular Atrophy Gullian Barre Syndrome Poliomyositis, mooED14. A 5 years old girl with Cerebral Palsy diplegic. Her gait showed tightness on hip flexor and hamstring, quadriceps weakness, and excessive ankle dorsoflexion. What kind of gait she has? Trendelenburg gait Stiffed knee gait Scissoring gait Crouch gait Jump gait mouOpD> 15. A 14 year-old boy presents with a 3 months history of knee pain. The pain is most marked in the area of the tibial tubercles bilaterally and it increases with activity, Physical examination is unremarkable. What is the likely diagnosis? A. Osgood-Schlatter disease B. Patelofemoral arthritis C. Rheumatoid arthritis D. Patellar tendinitis E. Jumpers knee 16.Which schematic diagram illustrating idealised shapes of spirograms on spirometry examination that suggest found in patient with Obstructive lung disease?17. The indication for long term oxygen therapy in patient with COPD if, A.PH> 7.45 B. PaO2 < 60 mmHg C. PaO? < $5 mmHg D. PaCO2 > 45 mmHg E, PaCO2 > 50 mmHg 18. What is the expected outcome of effective exercise training in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD)? A. Improved radiologic status of the Iung fields B. Slowed loss of forced expiratory volume C. Reduced need for supplemental oxygen D. Make lung anatomy became normal E, Reduced dyspnea 19, A patient with restrictive lung disease and mild scoliosis from Duchenne muscular dystrophy (DMD) develops nocturnal hypoventilation, What is the initial treatment? A. Breathing control B. Incentive spirometry every four hours C. Nocturnal supplement allow-flow oxygen D. Tracheostomy and nocturnal mechanical ventilation with positive pressure E, Nocturnal noninvasive positive airway pressure and short periods of daytime hyperinsufflation 20. Which finding correlates with a high risk of ischemic ulceration? A. Serum albumin 3.2 gm/ dl B, Ankle Brachial Index of 0.40 C. Hemoglobin less than 12 g/ dl. D. Stenotic lesion of the superficial femoral artery E, Transcutaneous oxygen ( TePO2 ) of 50 mmHg 21, Adding consecutive quantities of air into lungs exercise is called... A. air stacking exercise B. effective coughing exercise C. controlled breathing exercise D. segmental breathing exercise E. diaphragmatic breathing exercise22. Which cardiorespiratory outcome would you expect from an elderly person participating in an aerobie program? A. Improvement in VO2max B. No change in stroke volume C.No reduction in systemic vascular resistance D. No change in tolerance during activities of daily living E. A decrease in VO2max but an increase in walking speed 23, The most appropriate exercise training for elderly patiens with peripheral artery dissease is walking with intensity, progression from 50% of peak excersise intermittent walking to near minimal claudication pain. isotonic strengthening exercise of lower extremity swimming one hour bicycling 30 minutes moUOmD> 24, The most risk factor for falls in the elderly is ..... ‘A. poor balance B. hip deformity C. knee weakness D. ankle weakness E. use antidepressants 25. An elderly woman is being discharged from the acute rehabilitation unit after a stroke that resulted in right hemiparesis. When ordered by a physician and medically justified, which service is covered under medicare? A. Front-wheeled walker B, Spasticity medications C. Observation activity daily living D. Dressing assistance in the morning E. Transportation for medical appointments26.Diziness and unsteadiness are frequent symptoms with aging. It is may cause by the following factors, EXCEPT... A. increased the threshold of cutaneous sense B, decreased the threshold of joint position sense C. decreased the ability of CNS to perform sensory motor integration D. decreased the ability of musculoskeletal system to performed sensory motor . increased the threshold of for detecting movement in the metatarsophalangeal joint integration 27, What is the most common diagnosii in young female gymnasts with chronic back pain? ‘A Spondylitis B. Spondylosis C. Spondylolysis D. Spondylolysthesis E, Retrospondylolisthesis 28, What is the advantage of using closed kinetic chain exercises during the early stages of an anterior cruciate ligament (ACL) rehabilitation program? A. Improved targeting of the vastus medialis B. Limited knee extensor synergy activity C. Decreased shear forces across the joint D. Decrease oedema of the joint E, Improved terminal stretch 29. A 23 yo soccer player athlete presents knee pain after injury 2 days ago. The injury is impact to the front of the tibia with the knee flexed. Physical examination shows a positive “sag sign”. Which structure is injured? ‘A. Medial collateral ligament B. Anterior cruciate ligament C. Posterior cruciate ligament D. Medial meniscus E. Politeal muscle30. One of the criteria for return to sport for patient with Anterior Cruciate Ligament after reconstruction is. ‘A. quadriceps bilateral comparison (90% or greater) B. acceleration rate at 90% of quadriceps peak toque C. quadriceps torque body weight ratio (75% or greater) D. functional hop test (80% or greater of contralateral side) E, hamstrings quadriceps (>60 % for males, >70 % for females) 31. Medical rehabilitation program of ankle sprain rehabilitative phase in 6 weeks post-injury is... A. Aquatic exercise B. Motor relearning C. Strengthening exercise D. Aerobic exercise using static bieyele E, Balance exercise using balance board 32.Nerve conduction is slow for the patient with. ‘A. myopathy B, upper motor neuron lesion C. axonal sensory neuropathy D. primary axonal degeneration E. demyelinated peripheral nerve 33. The structure below is NOT a members of the motor unit. A. Skeletal muscle B. Motor and plate C, Neuromuscular junction D. Neuron of the anterior horn of spinal cord E, Neuron of the dorsal horn of the spinal cord34. The strong, protective, connective tissue surrounding bundles or fascicles of myelinated and unmyelinated nerve fibers is A. endoneurium B. perineurium C. epineurium D. cell body E. axon 35. Which muscle fibers transmit poorly localized, dull, visceral pain to the spinal cord? A. Unmyelinated C B. Myelinated beta C. Myelinated A-delta D. Myelinated A-alpha E, Unmyelinated gamma 36, Conduction velocity is... A. the number of nerve fibers activated B. the maximum voltage difference between two points C. the time between the initiation of the electrical stimulus and the beginning of saltatory conduction D. the speed an impulse travels along a nerve and primarily dependent on the integrity of the myelin sheath. E, the chemical transmission of the signal across the neuromuscular junction to initiate a single fiber action potential 37. The structure that was a sense of change in the skeletal muscle tension is... A. Troponin B. Tropomyosin C. Muscle spindle D. Golgi tendon organ E, Myotendineal junctionA male of 29 years old with post op right total hip replacement due to hip OA, on day 2 during rehabilitation program he complain of sudden painful of the right hip and can not move his right hip. X ray photo shows a dislocation. The revised of hip arthroplasty was done. The day one after the second surgery, he complain of pain until he can not move and follow rehabilitation program. From x ray foto it was found that he suffered a dislocation. The third surgery was done and day 1 afier the third surgery, he was sent back to Rehabilitation Department. (Question number 38 (&39) 38. What is the correct exercise to be done? A. Avoid knee ROM exercise B. Lying down for 4-6 weeks C. Proper positioning exercise D. Gradually sitting up position E, Walking exercise with NWB using bilateral crutches 39.The orthopedics ask for a brace, what kind of brace you would like to give ? A. HKAFO with ischial bearing to reduce weight bearing B, Hip and knee orthoses to avoid hip and knee motion C. A hemispica brace to avoid hip motion D. KAFO to help in walking activity E. Unloader knee orthoses 40, A 50 year-old man with type 2 DM presents for evaluation of a swollen ankle. An examination demonstrates diminish pinprink sensation in a stocking pattern, abscent ankle jerks, and a warm, erythematous right ankle with a mild effusion, What is the most likely diagnosis relating to the right ankle? A. Charcot joi B. Gout arthritis C. Septic arthritis D. Avascular necrosis E, Rheumatoid arthritis41.A 30 year-old man presents with low back, knee and ankle pain of two months’ duration. He also has had burning on urination. Physical examination reveals a rash over the palms and soles, Sacroilitis is present on radiolographs. The clinical diagnosis is. A, gonococeal arthritis B. psoriatic arthropathy C. ankylosing spondylitis D. generalized osteoarthritis E. reactive arthritis ( Reiter disease ) 42. What is the most common cause of lumbar stenosis? A. Spondylosis B. Disc herniation C. Sondylolisthesis D, Degenerative disk disease E. Vertebral compression fractures 43. The following statement is the sign of calcaneovalgus foot, A. Excessive dorsiflexion at the ankle with eversion of the foot B. Adduction of the forefoot, with the heel in normal position C. Usually associated contracture of toe extensors D. Equines or plantar flexion at the ankle E, Usually seen in muscle dystrophia 44, “Waddling” gait may cause by ....... A. contralateral gluteus medius weakness B. ipsilateral gluteus medius weakness C. bilateral glutous medius weakness D. adductor muscle contracture E. hip pain45. Knee flexion mechanism involve rotation of tibia upon femur. It’s mechanism is..... ‘A. active due to muscle contraction B. active due to muscle relaxation C. passive due to cruciate ligament tightness and loose D. passive due to collateral ligament tightness and loose E. passive due to anatomical configuration of the articular surface 46, Extending the wrist from full flexion automatically flexes the DIP joint about 20 degrees, the PIP joint about $- degrees , and the MCP joint about 35 degrees is called... A. tenodesis B. movement of wrist C. opposition of the thumb D. screw home mechanism E, extensor hood mechanism 47. The reason why supraspinatus most vulnerable to excessive wear is....... A. creates mechanical advantage for 1:10 B. deltoid muscle do not shares the demand for supraspinatus C. has an internal moment arm for shoulder abduction about lem D. high forces generated in short periode could cause a tear to muscle tendon E, assist deltoid during abduction and provides dynamic and static stability to glenohumeral joint 48, The following statement is the reason why cervical vertebra very prone to injury. ‘A Cervical vertebra connected to the head that have a bigger size and heavier weight compare with cervical vertebra B. The area of the corpus on cervical vertebra is smallest compare to the cther vertebra C. Cervical vertebra have specific movement that we call “YES and NO motion” D. The joint on the cervical vertebra have 3 degree freedom of motion E, Cervical vertebra is the end of “open kinematic chain”49.A first time stroke patient after two months of onset show good recovery. The patients begin to activate muscles selectively outside the flexor and extensor synergies were characteristic for Brunnstrom stages of motor recovery in stage... FUOU> onoee 50. A 21 years old female, unmarried, paraplegia was referred as inpatient rehabilitation ward due to TS burst fracture, Stabilization with PPSW was done and now was medically stable. Physical examination ; vital signs and general health status were within normal limits. What should you examine when you have to determine whether the patient has a complete or an incompiete lesion? ‘A. Anal sensation and voluntary anal sphineter contraction B, Anocutaneal and bulbocavernous reflexes C. Myotome and dermatome D. Physiological reflexes E, Pathological reflexes 51. You are evaluating a patient with hand problem. During evaluation, the patient shows a positive Froment’s sign, Which nerve is injured? A. Ulnar B. Radial C. Median D. Ulnar and radial E, Ulnar and median 52. Which type of aphasia is characterized by nonfluency, an intact ability to repeat, and intact comprehension? A. Broca B. Anomic C. Wermicke D. Transcortical motor F, Transcartical sensory53. The temperature and pain sense loss usually develops with disease in ... A. posterior columns of spinal cord B. posterior horn of spinal cord C. anterior hom of ‘spinal cord D. lateral horn of spinal cord E, cerebellum 54. The following statements is the therapeutic application of cryotherapy, A. an acute of musculoskeletal diseases B. chronic polyarthritis C. joint contracture D. sports injuries E. spasticity 55, Massage exerts its therapeutic effects through all of the following mechanism, EXCEPT... ‘A. Decreased perspiration and secretion of cebaceous glands B, Cuitaneus stimulation of the autonomic nervous system C. Mobilization of edema within soft tissue D, Improved soft tissue blood flow E. Release of endogenous opiates 56. One of the condition below are NOT the contraindication on using traction, Vertebrobasilar atherosclerosis disease Ligamentous instability Metastatic bone disease Radicular pain Osteoporosis moOw> 57. The general contraindications of electrotherapy include the following, EXCEPT. A. stimulation over carotid sinus B. stimulation across the heart C. thrombophiebitis D. dermal wounds E, malignancy58. Which statement is NOT TRUE regarding ultrasound diathermy? A. Should not be used in laminectomized spine B. Must be moved constantly to avoid endothelial damage C. Must be used with caution in the presence of metal implants D. Should not used in the presence of methylmethacrylate cement E. Phonophoresis uses direct current to drive medications through the skin 59. The following condition is contraindication for lumbar traction. There is... A. ischias syndrome B. lumbar disc hemiation C. postural low back pain D. restrictive lung disease E, paralumbal muscle spasm 60. A boy with CP spastic quadriplegic with scissoring position of lower extremities. From evaluation showed difficulty to fastly move the hip into abduction with hip on extension position. The fast movement can occur smoothly with hip on flexion position. Which muscle was injected for this program with the Botulinum Toxin A type.? A. Iliopsoas muscle B. Rectus femoris muscle C. Adductor longus muscle D. Medial hamstring muscle E, Adductor magnus muscle 61. A toddler still unable to sit independently. She had history of jaundice and showed slow writhing involuntary movements. She was diagnosed as Cerebral Palsy. What kind of CP this child has? Athetoid type Chorea type Spastic type Mixed type Ataxic type moopD>62.This reflex is best elicited by a sudden dropping of the baby’s head in relation to its trunk. A. Vertical Suspension B. Extetnsor thrust C. Righting Reflex D. Landau Reflex E. Moro Reflex 63.Spina bifida is considered a primary failure of neurulation and the spinal cord defect associated with the anatomic level of the lesion and neurologic level of functional involvement. A boy suffered from spina bifida L4-L5 segment, the preserved muscle function is....... iliopsoas muscles hamstring muscles Quadriceps muscles foot intrinsie muscles gluteus maximus muscle moOp> Children two years of age have stereotypic and ritualistic behavior with impairment in social interaction, comunication and imaginative play. (Question number 64.& 65) 64., The diagnose is .... Fragile x synd:ome Mental retardation Down syndrome ‘ADHD Autism moOOm> 65. That above case have also clinical features such A. flat feet B, inattention C. cognitive inpairment D. executive dysfunction E. a lack of eyes contact and dificulty playing with others66, During ambulation using a transfemoral prosthesis, a patient raises his entire body (vaults) with plantar flexion of the sound foot during the swing phase of the prosthetic extremity. To decrease the vaulting, what should you do ? A. Lengthen the prosthesis B. Add a knee extension aid C. Tighten the socket suspension D, Set the knee joint to assist flexion E, Set the prosthetic foot in a few more degrees of plantar flexion 67. A patient with osteoarthritis presents with pain in the carpometacarpal joint of the thumb. ‘What is the most appropriate splint? A Ring B. Thumb spica C. Resting hand D. Spring coil flexion assist E. Spring coil extension assist 68. The proper length for a cane should be measured with the elbow in which position? A. Full extension B. 20 degrees of flexion C. 45 degrees of flexion D. 60 degrees of flexion E. 90 degrees of flexion 69. Jn an amputee with a PTB prosthesis and a SACH foot, inordinately delayed knee flexion at heel strike may due to. A. poor hip extension B. anterior socket tilt C. too soft a heel cushion D. excessive dorsiflexion of the foot E, discomfort over the anterior the tibia70. A plastic ankle-foot orthosis with a rigid ankle is indicated in patients with. A. weak or absent dorsiflexors without severe weakness of the plantar flexors B. weak or absent dorsiflexors and plantar flexors CC. weak or absent knee extensors D. absent to moderate spasticity E. plantar flexion contractures 71, Which of the following components of a KAFO would stabilize the knee, while applying force to pressure tolerant tissue in the best way? A. A knee cap strap B. A single suprapatellar strap C. A single patellar tendon strap D. Combined suprapatellar and patellar tendon straps E. A lower thigh band closure in combination with a calf band closure 72.Following surgery a patient is asked to perform bottle blowing exercises to maintain pulmonary function. Which of the following is the most common side effect of the bottle blowing exercise ? AV Block atrial fibrillation rupture of the trachea pulmonary embolism premature ventricular beats mOOW> 73. A 56 yo female suffered from obesity (BMI 29) and hypertension (BP 135/85). What the best exercise regimen for this woman? A. Continue walking exercise while blood pressure exceeds 220/100, because the exercise will decreased the blood pressure B. Arm curl with dumbbell for biceps strengthening, with intensity 80% of IRM, 8 repetitions, 3 bouts/session, 2-3x/week Leg extension exercise with quadriceps bench, with intensity 80% of 1 RM, 8 repetitions, 3 bouts/session, 2-3x/week. Fast walking exercise, with intensity 40-70% of heart rate reserve, 30-60 minutes/day, 3-Sx/Aveek Static cycle exercise, with intensity 40-70% of heart rate reserve, 30-60 minutes/day, 3-Sx/week 99 m74.The following is causes of restrictive pulmonary disease, EXCEPT A. Guillian Barre Syndrome B. Chronic bronchitis C. Myasthenia gravis D. Pleural effusion E, Obesity, 78, Patient ‘s cardiac disease results in slight limitation on physical activity .They are comfortable at rest. Ordinary physical activity results in fatique ,palpation,dyspnea.or angina pain. Patient can perform to completion any activity requiring > 5 METs,but cannot perform to completion of activities requiring > 7 METs. Sexual intercourse to completion without interruption, walk at 4 mph on level ground .The Cardiac Functional Classification is, NYHA Class I NYHA Class IL NYHA Class IIT NYHA Class IV NYHA Class V rooDD 76. Man, 70 years old, came to emergency ward with short of breath since two days before. He was heavy smoker for 20 years and has been stopped 10 years ago because of short of breath and recurrently hospitalized 2 years recently, History of past illness: no diabetic, no heart disease ‘After acute state was overcome, he was referred to pulmonary ward and consulted to rehabilitation department, What the proper program for this patient ? A. Gradual mobilization B. Breathing control and relaxation C. Relaxation technique, gradual mobilization D. Breathing control and removal technique secretion E. Breathing control, pursed lip breathing, when the short breath relieve progress to diaphragmatic breathing, removal technique secretion if needed, gradual mobilization77. Woman, 24 years old consulted from surgery ward with post ASD closure day two after extubation. The hemodynamic was stable. In this condition, the prescription of rehabilitation program is .. A. Deep breathing, secretion removal by effective coughing B, Deep breathing, effective coughing, strengthening exercise C. Gradual sitting with support if tolerable by the patient progress to active sitting, strengthening exercise, effective coughing, active range of motion, ankle pumping D. Gradual sitting with support if tolerable by the patient progress to active sitting, breathing exercise, effective coughing, active range of motion, ankle pumping E. Gradual sitting with support if tolerable by the patient progress to active sitting, strengthening exercise, breathing exercise, effective coughing, active range of motion, ankle pumping 18, The conservative treatment of scoliosis is bracing and specific exercise. The following are the factors that influence the result in brace treatment, EXCEPT...... ‘A. compliance to treatment B. dosage of wearing C. quality of bracing D. the Risser sign E, family history 79. The following statement is NOT TRUE regarding strengthening exercise. A. Circuit weight training are carried out in a specific sequence using a variety of exercise, could include 8 to 10 RMs, with a 30-second to 1-minute rest period between each bout B. Brief repetitive isometric exercise (BRIME) regimen uses 5 to 10 brief but maximum isometric contractions performed against resistance 5 days per week C. The rule of tens by Davies uses 10 sets of 10 repetitions of 10 second contractions every 10 degrees in the range of motion D. Isokinetic strengthening exercise is a dynamic exercise performed with variety angular Joint velocity E, Regressive resistive exercise is the reverse of the DeLorme technique80. Which of the following statement is TRUE regarding endurance exercise? A. Anaerobic endurance exercise are performed to deplete the creatine system B. A rating of 12 to 13 on the 20-point scale corresponds to about 85% of maximum HR C. Aerobic endurance training uses small groups of muscles to increase the 02 consumption D. Aerobic training for longer durations and at lower intensities for 4 toS days per week may be prescribed to maximize the weight-controlling effect E, When the MET equivalent is used for exercise prescription, it is advisable to begin exercise with an initial target range of 70 to 80% of the maximal MET level 81. Brief, explosive maneuvers that consist of an eccentric muscle contraction followed immediately by a concentric contraction is called.. A. ballistic exercise B. plyometric exercise C. propioception exercise D. passive stretching exercise E, neuromuscular fascilitation exercise 82, Muscle hypertrophy occurs at how many weeks of resistance training? A. 4-5 weeks B. 5-6 weeks C. 6-7 weeks D. 7-8 weeks E. 8-9 weeks 83. The following statement is TRUE regarding clinical (bedside) swallowing studie (CSS) A. Patient must have an intact cough reflex B.Itis capable of detecting “silent” aspiration C. Itis reliable as videofluoroscopic swallowing studies D. This test is the gold standar in determining the safety of oral feeding E. To reduced the risk of aspiration, the patient must upright for at least 5 minutes after the CSS 84, Gait in the elderly is characterized by. A. decreased velocity B. longer stride length C. broader base of support D. increased single limb support E, not associated with falls and the fear of falling85, Sarcopenia in elderly may also affect respiratory muscle strength, that would lead to... ‘A. decreased residual volume and functional capacity B. decreased lung compliance and thoracic wall mobility C. increased residual volume and functional residual capacity D. increased lung compliance and decreased thoracic wall mobility E, preserveed lung compliance and decreased thoracic wall mobility 86. After Alzeimer disease, the most frequent dementia in the elderly is secondary Weessessssteescesee A. drug toxicity B. multiple infarcts C. metabolic causes D, subdural hematoma E, occult hydrocephalus 87. A 75-year-old sedentary man with a history of hypertension, type I diabetes mellitus, and mild sensory neuropathy who is currently a nonsmoker wishes to begin an exercise program, ‘What would be the safest initial modality’? A. Walking with no competition B. Treadmill walking at 1 5mph on level surface C. Stair stopper for 15 minutes without resistance D. Lifting 1- to 3-pound weights overhead while seated E, Machine-based quadriceps extensions at 80% maximum weight 88, What is the most common cause of knee pain in runners? A. Baker cyst B. Discoid meniscus C. Hamstring tendinitis D. Iliotibial friction syndrome E, Patellofremoral pain syndrome 89. A 17 year-old football palyers sustained a noncontact knee injury while planting his leg to make a cut. He heard a pop and elt his knee buckle. What is the most sensitive clinical test to establish the diagnosis? A. Thomas B. Lachman C. McMurray D, Anterior drawer E. Posterior drawer90.The following statement is TRUE about plyometric exercise. It is have no risk to injury Functional type of exercise The principle is slow stretching Is useful to many neurologic impairment Exercise using this principle including balance training moapD> 91, Ruptur of the profundus tendon (flexor digitorum) which most commonly due to trauma as seen inathlete (foot ball,wrestling) is said A Rennet’s fracture B. Rolando’s fracture C, Boxer’s Fracture D. Mallet Finger E. Jersey Finger 92. Acommon term for patella tendinopathy is .... A. Cho-Pat strap B. Jumper’s knee C, Patella Tendon Rupture D. Osgood ~Schlater Disease E. Sinding ~ Larsen ~ Johansson Disease. 93.According to the standart of the American Spinal Injury Association , what is the key area for testing pin-prick sensation to determine the sensory level after T4 spinal cord injury ? Umbilicus Acromiom Nipple tine Apex of axilla Lateral aspect of the elbow myOD> 94. The following statement about Rheumatoid Arthritis is TRUE. Female : male ration = 1 : 3 ‘Affects the synovial membrane of multiple joints The joints mostly affected are shoulders and. hips ‘The cause of * piano- key sign” is the ulnar head “ floats up” anteriorly in the wrist Atlanto-axial subluxation is best detected on x-ray when a lateral view of the neck in extension mouOw>95. The following test is the special test for tear of supraspinatus tendon. ‘A. Hawkins impingement test B. Neer impingement test C. Apley’s scratch test D. Yergasson test E, Drop arm test 96. Which nerve is most commonly injured with traumatic anterior shoulder dislocations? A. Radial B. Axillary C. Long thoracic D. Thoracodorsalis E. Musculocutaneous A 56 year-old right handed secretary presents to the emergency room with the sudden onset of inability to speak and right hand clumsiness. Her symptoms began abruptly in the morning while returning from the bathroom. Physical examination found the the patient is alert, BP 150/90 mmHg; P 110/min; the rhythm is irregular. She is able to follow simple commands and appears to comprehend conversational speech, but her response are effortful and limited to simple one word answers. She is unable to read aloud and can only write her name with difficulty. The laboratory studies reveal a normal haematocrit, normal electrolytes and glucose. Her electrocardiogram shows atrial fibrillation with a ventricular rate 90 to 120/min, A head computed tomography (CT scan) obtained that evening is unremarkable. Within 2 days, her speech has become more fluent, although she continues to have subtle word-finding difficulties. (Questions umber 97 & 98 ) 97. What would you characterize the patient’s difficulty in communication? A. Anon-fluent motor aphasia B.A fluent sensory aphasia C. Conduction aphasia D. Global aphasia E, Apraxia verbal98, Why is her CT scan normal? A. The infarction is too small B. The infarction can only be seen in Brain MRI C. Because it is Transient Ischemic Attack (TIA) D. The cause of speech problem is not in the brain E. The time interval from symptom onset to the CT scan is relatively short (less than 24 hours) 99. Exercise programs for patients with Parkinson’s disease have been shown to A. reduce the frequency of falling B. reduce tremor more than bradykinesia C. have no effect on activities of daily living D. produce a short-term improvement in ambulation ability E. improve motor function primarily in more severely involved patients 100. A 45 yo man presents with a several month history of weakness in his lower and upper extremities. On examination, in addition to weakness in multiple muscles groups, he demonstrates atrophy, hyperreflexia, spasticity of the legs, and bilateral babinski sign. Fasciculation in multiple muscles are also noted. His sensation to pain, temperature, and joint position sense appear intact. What is his most likely diagnosis ? ‘A. Amyotrophic lateral sceloris ( ALS ) B. Anterior spinal artery syndrome CC. Brown Sequard syndrome D, Vitamin B 12 deficiency E. Central cord syndromeANSWER IF NUMBERS 1,2,3 ARE CORRECT B: IF NUMBERS 1 AND 3 ARE CORRECT C:IF NUMBERS 2 AND 4 ARE CORRECT D:IF ONLY NUMBER 4 IS CORRECT E: IF ALL NUMBERS ARE CORRECT 101. “Scottie dog” appearance can be shown in what position(s) vertebral x-ray plane ? Antero posterior Postero anterior Lateral Oblique Bees 102, Besides rotator cuff disease, what is another differential diagnostic possibility must be considered in evaluating shoulder pain’? Suprascapular nerve entrapment Cervical facet syndrome Cervical radiculitis Shoulder instability Bene 103. What are the most common types of bursitis around the hip? Ischial (tailor’s or weaver’s bottom) Tliopsoas (iliopectineal) Greater trochanteric Supragluteal 104. The following statement(s) is/are the major criteria in determining amputation level in the dysvascular limb. 1. Palpable pulses at the next more-proximal joint have clinical significance only when present, and their presence is a very positive indication of the likelihood of healing at any given level 2. The degree of loss sensory is significance in the diabetic patient whose ischemic Process is frequently accompanied by peripheral neuropathy ‘Skin temperature is a representative measure of collateral circulation 4, Dependent rubor indicates marginal viability of the skin105. The following symptom(s) is/ are the most common in cauda equina syndrome, there is/are. 1. burning ache in legs 2. bladder dysfunction 3. flaccids paraplegia in legs 4. anesthesia in lower extremities and perineum 106. Vertebrobasilar system involvement may present with any combination of the following sign and symptoms such as........ abnormalities of motor function often bilaterally ipsilateral cranial nerve function symptom of vertigo cognitive deficits 107. Tricyclic antidepressant are useful for patients having chronic low back pain migraine headache tension headache neuropathic pain 108. Which type of aphasia have fluent caharacteristics? Broca’s Anomic Global Conduction Rene 109.The high risk factor(s) of neural tube defect (NTD) is/are the following. ‘Mother who taking valproic acid Taking antiretroviral medication Failure of neurulation Matemal diabetes110. The characteristic of Trisomy 21 is/are increases distance between Ist and 2nd finger clinodactyly of Sth finger Mongoloid slant of eyes polydactyly 111. The characteristic of clubfoot is/are... ‘Metatarsal 1 is more in plantar flexion Inversion of hindfoot Hindfoot equines Midfoot varus 112. Indication for six minutes walk test is/are... Functional status assessment of peripheral vascular disease Pretreatment and posttreatment comparisons Predictor of mortality and morbidity Pulmonary rehabilitation evaluation 113, The effets of pursed lip breathing is/are Bene increase respiratory rate decrease respiratory rate decrease tidal volume increase tidal volume 114., Patient with congestive heart failure who is participated in cardiac rehabilitation program will improve which parameter(s)? Rene Diastolic Ventricular filling Systolic Ejection Fraction Oxygen saturation VO2max 115:The following is/are the rehabilitation treatment of vertigo and dizziness in the elderly, ‘Modification of life style and home environment Correct the intemal representation of posture Improve ankle, hip and neck mobility Sedative drugs116. Implementation of Comprehensive Geriatric Assessment (CGA) include Identification of patient resource and strenghts Evaluation in patients multiple problems ‘Multidisciplinary evaluation Coordinated care plan Bene 117, Elderly patient with hypoglycemia may experiencing ... tachycardia diaphoresis lightheadedness visual disturbances ene 118. Which of the following is/are the component of the management of postmastectomy lymphedema? Manual lymphatic drainage External compression Surgical management Loop diuretics aeNe 119. Stress testing to assess balance for athlete is/are... 1. Sergeant Jump 2. Ruler Drop Test 3. Edgren Side Step Test 4. SEBT (Star Excursion Balance Test) A 24 yo baseball player suffored from right shoulder pain after technical drill training session, 2 weeks ago. The pain became worsen especially when he made upper head throwing movements, usually ‘occurred after 50 repetitions. He also felt fatigue more easily. The pain was on the anterolateral rright shoulder, no crepitation (Question no.120,121&122). 120.From the history, whet the possible anatomical structure/s could be injured? Bursa Cartilage Tendon Ligament121. If Neer, Hawkins and Lift Off test positive in this case, what specific structure(s) will be involved? AYRE Supraspinates tendon Infraspinates tendon Subscapular tendon Teres minor tendon 122. From shoulder USG, the one of findings was a partial thickness tear of supraspinates tendon. What is the most proper modality should be given? Electrostimulation Ultrasound Diathermy Short Wave Diathermy Low Level LASER Theraphy 123,.Which of the following is/are NOT typical characteristic of motor unit action potential observed during electromyography of patients with myopathy ? Short duration Long duration Low amplitude High amplitude 124. The following is/are the typical characteristics of motor unit action potential observed during electromyography of patients with motor neuron disease. sen reduced motor unit reeraitment high amplitude Jong duration low amplitude 125. The step of examination in rehabilitation management for the child with Muscular ‘Dystrophy include. Pere history with family concen asistive and adaptive device aerobic capacity and endurance community and school/play integration126. A 6 year-old girl with spastic quadriparesis needs a new wheelchair prescription. Patient factors that influence the prescription include of the following(s). Presence of lower limb spasticity Degree of trunk control present Patient's weight and height Presence of Moto reflex Rune 127. The following statement(s) is / are regarding idiopathic scoliosis 1, Genetic factor is a sex-linked trait with incomplete penetrance and variable expressivity 2, Assex-linked tait can be transmitted by a father, to either a son and daughter 3. The curves have strong tendency to progress rapidly during the adolescent growth spurt 4, Juvenile idiopathic scoliosis occurs between ages 2 and 8 128, Tenodesis action is... 1, extending the wrist from full flexion automatically flexes the DIP joint about 20 degrees, the PIP joint about 50 degrees, and the MCP joint about 35 degrees 2. position of the wrist significantly alters the length and subsequent passive tension in extrinsic flexors muscles 3. polyarticular muscle stretching across one joint generates a passive movement at other joints 4, having an important role in tetraplegic patient 129. Steppage gait may caused by severely weak dorsiflexors palantarflexor spasticity equinus deformity weak quadriceps 130, Which of the following are suggested order of muscle tests on sidelying ? 1. Hip adductor 2. Gluteus medius 3. Gluteus minimus 4, Gluteus maximus131. You are in the duty of one patient with diagnosis SCI C5 AIS A. The nurse call you to inform that your patient feels very ill and cold sweating, the blood pressure was 170/100 mm#ig, HR 60/min, respiration 22/min, temperature 37.5°C. Your analysis is the patient suspected having ...... Urinary infection Bladder distention Autonomic dysreflexia Blood hypertension ReNe 132, The physical medicine and rehabilitation programs for people with leprosy is/are. Oil massage Aative exercise Soaking the feet in the water Protection of the hand and feet 133. According to ICF (International Classification of Functioning, Disability and Health) in stroke patient, the following is (are) include in the loss of body functions and structures dimension, Shoulder hand syndrome Cognitive impairment Visuospasial neglect Difficulty in ADL AeNS 134, Laser therapy has been proven effective in the treatment of ..... osteomalacia joint contracture theumatoid arthritis myofascial syndrome seN= 135. The following is/are the contraindication of short wave diathermy. Urinary bladder stimulators Moist wound dressing Electrophrenic pacers Contact lenses136.The effectiveness of cervical traction is dependent on many factors, including the amount of force applied. Other factors include... angle of pull position of the patient position of the cervical spine constant or intermitten traction Rene 137. A deficiency of pulmonary surfactant would .... decrease the change in intrapleural pressure required to achieve a given tidal volume increase functional residual capacity (FRC) decrease surface tension in the alveoli decrease lung compliance aeRe 138. What would you recommend to your patient with insensate feet? Walking barefoot Vitamin C in large doses Use of hiking boots for long walks Restriction of duration of walking time 139. Which of the equipment(s) we needed for 6 minute walking test? Area which is needed for walk minimal 30 meter Emergency equipment Finger oximetry Stop watch 140-The prehensive function of a myoelectric hand simulates which grip pattern(s)? 1, Power 2. Lateral 3. Spherical 4. Three-jaw chuck 141. The following is/are adverse effect of spinal bracing. Excessive spinal motion above and below brace Dysphagia and difficulty chewing Axial muscle wasting Posture erect142, Which of the statement(s) is/are the correct statement about splinting? 1. Early implementation of splints will influence on collagen orientation of developing fibers in wound healing process 2. The indications are soft tissue or skin graft protection, anti deformity, positioning and tissue lengthening 3. Splinting is essential to prevent and treat joint contractures and deformities 4, An optimal splint wearing schedule should not be monitored and modified 143. The clinical feature(s) of myofascial pain include the following statement(s), 1. Continuous, dull, deep aching pain 2. Pain relief by inactivating trigger area 3. Pressure on bands in muscles reproduces pain 4, Local muscle twitch produced by trigger point stimulation 144. The red flag sign(s) in the low back pain patients include 1, Decrease of body weight sifgnificantly 2. Pain profound at night time 3. age more than 50 y.o 4. Fever 145 Joint protection techniques in patients with osteoarthritis include the following principle(s). Use appropriate assistive devices Avoid activities that hurt affected joints Avoid staying in one position for too long Use largest and strongest joint and muscles Bene 146. In the later disease of rheumatoid arthritis, the specific articular manifestation include . button-hole deformity of fingers swan-neck deformity of fingers Z deformity of the thumb finger drop Bene147. The popular program for progressive resistance exercise are... Oxford de Lorme DAPRE method Karvonen method 148, Which equipment(s) can be provided in ROM exercise when we want to reducing the effect of friction and gravity of the moving limb? Suspension Shoulder wheel Overhead pulley Skate and powder board 149. Which adaptive equipment(s) can be provided when deficit in upper extremity have limitation to control efficiency and safety of function ? ‘Swivel fork and spoons Plate quards or specialized dishes. Weighed or large handled cups and utensils Velcro or zipper closures instead of buttons may improve dressing 150. About Frenkel’s exercises for ataxic conditions, how to apply this excercise? Design primarily for coordination They are not intended for strengthening Commands should bwe given in an even, slow, monotonous voice Ability of patients to interpret deep muscle and joint sensibility with eye closed Bene