CHAPTER No. 01
1. In the context of screening for referral, primary purpose of a diagnosis is:
a. To obtain reimbursement
b. To guide the plan of care and intervention strategies
c. To practice within the scope of physical therapy
d. To meet the established standards for accreditation
2. Direct access is the only reason physical therapists must screen for systemic disease.
3. A patient/client gives you a written prescription from a physician, chiropractor, or dentist. The frst screening question to ask is:
a. What did the physician (dentist, chiropractor) say is the problem?
b. Did the physician (dentist, chiropractor) examine you?
c. When do you go back to see the doctor (dentist, chiropractor)?
d. How many times per week did the doctor (dentist, chiropractor) suggest you come to therapy?
4. Screening for medical disease takes place:
a. Only during the frst interview
b. Just before the client returns to the physician for his/her next appointment
c. Throughout the episode of care
d. None of the above
5. Physical therapists are qualifed to make a human movement system diagnosis regarding primary neuromusculoskeletal conditions, but we must do so in accordance with:
a. The Guide to Physical Therapist Practiceb. The State Practice Act
c. The screening process
d. The SOAP method
6. Medical referral for a problem outside the scope of the physical therapy practice occurs when:
a. No apparent movement dysfunction exists
b. No causative factors can be identifed
c. Findings are not consistent with neuromuscular or musculoskeletal dysfunction
d. Client presents with suspicious red-ﬂag symptoms
e. Any of the above
f. None of the above
7. Physical therapy evaluation and intervention may be part of the
physician’s differential diagnosis.
8. What is the difference between a yellow- and a red-ﬂag symptom?
A yellow flag is a cautionary or warning symptom that signals, “Slow down, and think about the need for screening.” A red flag symptom requires immediate attention, either to pursue further screening questions or tests, or to make an appropriate referral. The presence of a single yellow or red flag is not usually cause for immediate medical attention. Each cautionary or warning flag must be viewed in the context of the whole person, given his or her age, gender, past medical history, and current clinical presentation.
9. What are the major decision-making tools used in the screening process?
Past medical history, risk factor assessment, clinical presentation (including pain types and pain patterns), associated signs and symptoms, review of systems. Each client can be framed by these five components. Any suspicious finding or response in any of these areas warrants a closer look.
10. See if you can quickly name 6 to 10 red ﬂags that suggest the need for further screening
Check your list against Box 1-2; see also Appendix A-2.