INSTITUT UNVIVERSITAIRE DE LA COTE

First Semester Examinations

2022/2023 Academic year

Department: Applied Option : PHYSIOTHERAPY Level: 200

Sciences Time : 8 :00—11 :00am
Course code/ Title: BPT401/ PHYSIOTHERAPY IN GENERAL Credit value : 4
MEDICINE AND GENERAL SURGERY
Duration : 3 hours Date : /01/2023 Venue : Examination Hall
Course Instructor Dr ASOBO – KHAN N.

SECTION 1 ; MCQs (20MARKS)

1. A patient has fallen off a bicycle and fractured the head of the proximal fibula. A cast
was placed on the patient’s lower extremity. Which of the following is the most
probable result of the fall?
A. Peroneal nerve injury
B. Tibial nerve injury
C. Sciatic nerve injury
D. Femoral nerve injury

2. A physical therapist is caring for a patient who has experienced burns to the right
lower extremity. According to the Rule of Nines which of the following percents most
accurately describes the severity of the injury?
A. 36%
B. 27%
C. 18%
D. 9%

3. The family of your 70yrs old stroke patient has inquired about the common causes of a
stroke. Which of the following risk factors should the physiotherapist include in the
response?
A. Hypertension, diabetes and heart disease.
B. Hypertension, alcohol abuse, poor hygiene.
C. Diabetes, overweight and varicose veins.
D. Low socio-economic status, alcohol abuse and hypertension.

4. A patient has experienced a severe third degree burn to the trunk in the last 36 hours.
Which phase of burn management is the patient in?
A. Shock phase
B. Emergent phase
C. Healing phase
D. Wound proliferation phase
5. A physical therapist is working in a pediatric clinic and a mother brings in her 13
months old child who has Down Syndrome. The mother reports, “My child’s muscles
feel weak and he isn’t moving well. My friend check his reflexes and she said they are
diminished.” Which of the following actions should the physical therapist take first?
A. Contact the physician immediately
B. Have the patient go to X-ray for a c-spine work-up.
C. Start an IV on the patient
D. Position the child’s neck in a neutral position then contact the physician.

6. A physical therapist working in a pediatric clinic and observes the following

situations. Which of the following may indicate a delayed child to the physical
therapist?
A. A 12-month old that does not “cruise”.
B. A 8-month old that can sit upright unsupported.
C. A 6-month old that is rolling prone to supine.
D. A 3-month old that does not roll supine to prone.

7. A new born baby exhibits a reflex that includes: hand opening, abducted and extended
extremities following a jarring motion. Which of the following correctly identifies the
reflex?
A. Casemiro reflex
B. Startle reflex
C. Grasping reflex
D. Moro reflex

8. A patient has suffered a left CVA and has developed severe hemiparesis resulting in a
loss of mobility. The physical therapist notices on assessment that an area over the
patient’s left elbow appears as non-blanchable erythema and the skin is intact. The
physical therapist should score the patient as having which of the following?
A. Stage I pressure ulcer
B. Stage II pressure ulcer
C. Stage III pressure ulcer
D. Stage IV pressure ulcer

9. 42. A 55year-old female asks a physical therapist the following, “Which

mineral/vitamin is the most important to prevent progression of osteoporosis. The
physical therapist should state:
A. Potassium
B. Magnesium
C. Calcium
D. Vitamin B12

10. Little Rawlings has been followed for cerebral palsy since age 3yrs and is brought to
your PT center having a petit mal seizure in the clinic on the floor. Which of the
following criteria has the highest priority in this situation?
A. Provide a safe environment free of obstructions in the immediate area
B. Call an ambulance service.
 C. Contact the patient’s physician
D. Prevent excessive movement of the extremities

11. A physical therapist assesses a 83 year-old female’s venous ulcer for the second time
that is located near the right medial malleolus. The wound is exhibiting purulent
drainage and the patient has limited mobility in her home. Which of the options is the
best course of action?
A. Encourage warm water soaks to the right foot.
B. Notify the case manager of the purulent drainage.
C. Determine the patient’s pulse in the right ankle.
D. Recommend increased activity to reduce the purulent drainage

12. Daniella complains that the bilateral hip pains she complained about on the first day
post op of her caesarean section aren’t going away. Which of the following
medications may be necessary?
A. Nystatin
B. Acetone
C. Albendazole
D. Acetaminophen

13. A 93-year-old female with a history of Senile dementia gets admitted to an

Alzheimer’s unit. The patient has exhibited signs of increased confusion and limited
stability with gait. Moreover, the patient is refusing to use a wheel chair. Which of the
following is the most appropriate course of action for the physical therapist?
A. Recommend the patient remain in her room at all times.
B. Recommend family members bring pictures to the patient’s room.
C. Recommend a speech therapy consult to the doctor.
D. Recommend the patient attempt to walk pushing the wheel chair for safety.

14. A physical therapist working on an ICU unit, notices a patient is experiencing

Shortness of breath, calf pain, and warmth over the posterior calf. All of these may
indicate which of the following medical conditions?
A. Patient may have a deep veinous thrombosis.
B. Patient may be exhibiting signs of dermatitis.
C. Patient may be in the late phases of CHF.
D. Patient may be experiencing anxiety after surgery.

15. . A physical therapist is working in an outpatient orthopedic clinic. During the

patient’s history the patient reports, “I tore 3 of my 4 Rotator cuff muscles in the past.”
Which of the following muscles cannot be considered as possibly being torn?
A. Teres minor
B. Teres major
C. Supraspinatus
D. Infraspinatus
16. A physical therapist at an outpatient clinic is returning phone calls that have been
made to the clinic. Which of the following calls should have the highest priority for
medical intervention?
A. A home health patient reports, “I am starting to have breakdown of my heels.”
B. A patient that received an upper extremity cast yesterday reports, “I can’t feel my
fingers in my right hand today.”
C. A young female reports, ”I think I sprained my ankle about 2 weeks ago.”
D. A middle-aged patient reports, ”My knee is still hurting from the fall of 3 weeks
ago.”

17. A physical therapist is performing a screening on a patient that has been casted
recently on the left lower extremity. Which of the following statements should the
physical therapist be most concerned about?
A. The patient reports, “I didn’t keep my extremity elevated like the doctor asked me
to.”
B. The patient reports, “I have been having pain in my left calf.”
C. The patient reports, “My left leg has really been itching.”
D. The patient reports, “The arthritis in my wrists is flaring up, when I put weight on
my crutches.”

18. A physical therapist is instructing a person who had a left CVA and right lower
extremity hemiparesis to use a quad cane. Which of the following is the most
appropriate gait sequence?
A. Place the cane in the patient’s left upper extremity, encourage cane, then right
lower extremity, then left upper extremity gait sequence.
B. Place the cane in the patient’s left upper extremity, encourage cane, then left lower
extremity, then right upper extremity gait sequence.
C. Place the cane in the patient’s right upper extremity, encourage cane, then right
lower extremity, then left upper extremity gait sequence.
D. Place the cane in the patient’s right upper extremity, encourage cane, then left
lower extremity, then right upper extremity gait sequence

19. The nurse is giving an overview of cerebral palsy (CP) to a group of new nurses.
Which statement should the nurse include in the teaching?
A. "CP is a progressive disease that is inherited."
B. "CP is identified during the prenatal period."
C. "Not all patients with CP have an intellectual disability."
D. "The pathogenesis of CP is the same in most cases.

20. Which conditions in your opinion most frequently shorten the life of adults with
cerebral palsy (CP)?
A. Respiratory disorders and seizures
B. Incontinence and skin breakdown
C. Muscle atrophy and brain tumors
D. Arthritis and contractures
Bonus. The nurse is obtaining a health history from the parents of a child with cerebral palsy
(CP).Which question should the nurse use to determine whether the child's brain insult
happened after birth?
A. "Were there any accidents before age 3?"
B. "Was the mother older than 40 years when the child was born?"
C. "Was the child born prematurely?"
D. "Was the child born subsequent to the fourth child?

SECTION 2: STRUCTURAL QUESTIONS (20marks)

1. As a Physiotherapist, the words and phrases you choose to use can send a very
powerful message to your patient.
Using the example of a patient with chronic non-specific neck pain, answer the
following:
a) Give two examples of statements that may be unhelpful for your patient, providing a
brief justification for each statement. (2marks)
b) Give two examples of statements that may be helpful for your patient, providing a
brief justification for each statement. (2 marks)

2. State 2 of the most common types of gait anomalies found in cerebral palsy patients.
(2marks)
3. What are the possible complications of decubitus in patients who have undergone
abdominal surgery? (4marks)
4. State 4 general goals set during the management of geriatric patients. (2marks)
5. What are the 3 phases of burn injuries? (3marks)
6. Why is skin assessment very important in the management of burns? (2marks)
7. What are the main goals of post stroke rehabilitation? (3marks )

SECTION 3: SHORT ESSAY QUESTIONS (20marks)

Question 1 (10 marks)
A patient has recently been admitted to a nursing home for care post stroke (he experienced
the stroke 10 days ago). You have been asked to undertake a mobility assessment of your
patient. On examination you detect weakness in the right upper and lower limbs, and he
appears somewhat confused.
1. List possible reasons for the confusion (3 marks)
2. What steps would you take to help differentiate between these possible reasons?
(2marks).
3. Why is it important to differentiate between these possible reasons? (5 marks)

Question 2 (10marks)
A 45-year-old male patient presents to you for assessment and management of an acute
sprained ankle, while out jogging. While assessing him, he advises you that he was diagnosed
with type 2 diabetes two years ago. You observe that he is a big man, and decide to
undertake some assessment to determine whether or not his weight is healthy.
1. List two measurement strategies that you might employ to assist your assessment of
whether or not he has a healthy weight. (2 marks)

Your assessment reveals that he is overweight. You feel that this is relevant, given his
diagnosis of diabetes.
2. In what way is it relevant? (2 marks)

In further discussion, he tells you that he is aware that he has been overweight for
some time, and feels that this is because he doesn’t do much exercise. He also tells
you that he recently decided start running in order to help the problem.
3. What ‘stage of change’ do you think that he has reached in terms of altering his
physical activity behaviour? (1 mark)

You consider treating the ankle with heat.

4. In what way does type 2 diabetes represent a precaution when applying heat? (1
mark)

The patient asks your opinion regarding the value of continuing the jogging
programme he has started (once the ankle problem has settled down).

5. How would you respond (considering both risks and benefits)? (4 marks)

SECTION 4: LONG ESSAY QUESTIONS (10marks)

QUESTION 1 (10marks)
Briefly discuss the role of the Physiotherapist in the management of cerebral palsy.
 Marking guide
Section 1; MCQ = 20marks
1. A
2. C
3. A
4. B
5. D
6. A
7. D
8. A
9. C
10.A
11.B
12.D
13.D
14.A
15.B
16.B
17.B
18.A
19.C
20.A
BONUS. A

SECTION 2: STRUCTURAL QUESTION = 20MARKS

1. Each of these question raises the subject of bias of communication in
Health care practise and the psychological & sometimes medico-legal
ramifications that specific statements could have.

2. Crouch gait
Jump-knee gait
Stiff-knee gait
Scissoring gait

3. Hemorragic complications
Infectious complications
Thrombotic complications
Pressure ulcers
Aspiration pneumonitis

4. To achieve functional independence

To relieve pain
To improve/maintain range of motion
To improve/ maintain strength of movement
To improve cardiovascular endurance
To improve or maintain ambulatory status

5. Emergent phase
Acute phase
Rehabilitative phase

6. To determine the size and depth of burn injury for better management and
ample timely identification of potential sites of difficult, poor scarring.
7. The main goal is to optimise functional autonomy and overall level of
independence.
Ameliorate quality of life to the best possible degree.

SECTION 3 : SHORT ESSAY QUESTIONS = 20MARKS

QUESTION 1
1. Delirium (especially from pre-existing condition)
Substance use
Prolonged hypoxia/hypoxemia linked to the cerebrovascular accident.
Punctual aggravation of current state.
2. A comprehensive clinical evaluation (history taking)

3. Depending on the incriminated etiologies; timely therapeutic intervention

and sometimes emergency medical care could be indicated with a
potential need for all immediate physical therapy to be
suspended/postponed.
QUESTION 2
1. Body mass Index
Waist circumference

2. Obesity is a major risk factor for diabetes (type 2)

3. Action (there are 5 stages of change in physical activity, self-efficacy and

decisional balance.)

4. Susceptibility to bruising.
Susceptibility to skin infection.
Relatively constrained wound healing/ scarring
5. Non-specific response.

SECTION 4 : LONG ESSAY QUESTIONS = 10MARKS

QUESTION 1
The role of PT in cerebral palsy management revolves around the following;
 Rehabilitation of physical impairments (Conservative Treatment).
- Second line of treatment.
- main intervention for spasticity and dystonia
- maximize functional control of the body
- increase motor function
- improve posture of cerebral palsy patients

 Give advice regarding walking aids and equipment with the help of
occupational therapist.
- Improve the patient’s co-ordination and body balance.
- To allow children to go to school.
- Perform daily activities.
- To enhance the ability of self-care.
 Teaching parents physical therapy that has to be carried out at home on
daily basis.
- To maintain effectiveness of Botulinum Toxin A injection .
- Encourage normal postures and movement (legs, arms,head control).