Elsevier: Goodman & Snyder: Differential Diagnosis for Physical Therapists Screening for Referral|| Chapter 12 (Answer Key)

Elsevier: Goodman & Snyder: Differential Diagnosis for Physical Therapists Screening for Referral|| Chapter 12 (Answer Key)

1. Fibromyalgia syndrome is a:

a. Musculoskeletal disorder
b. Psychosomatic disorder
c. Neurosomatic disorder
d. Noninflammatory rheumatic disorder

2. Which of the following best describes the pattern of rheumatic joint disease?

a. Pain and stiffness in the morning gradually improves with gentle activity and movement during the day.
b. Pain and stiffness accelerate during the day and are worse in the evening.
c. Night pain is frequently associated with advanced structural damage seen on x-ray.
d. Pain is brought on by activity and resolves predictably with rest.

3. Match the following skin lesions with the associated underlying disorder:

a. Raised, scaly patches
b. Flat or slightly raised malar on the face
c. Petechiae
d. Tightening of the skin
e. Kaposi’s sarcoma
f. Erythema migrans
g. Hives
h. Subcutaneous nodules
______ Psoriatic arthritis
______ Systemic lupus
______ HIV infection
______ Scleroderma
______ Rheumatoid arthritis
______ Allergic reaction
______ Lyme disease
______ Thrombocytopenia

(a) Psoriatic arthritis

(b)Systemic lupus erythematosus (subcutaneous nodules may also occur with SLE)

(e) HIV infection

(d) Scleroderma

(H) Rheumatoid arthritis

(G) Allergic reaction (see Table 12-1)

(F) Lyme disease

(c )Thrombocytopenia

 4. A new client has come to you with a primary report of new onset of knee pain and swelling. Name three clues that this client might give from his medical history that should alert youto the possibility of immunologic disease.

Many red flag clues must be considered. The therapist may observe or hear reports of any one or combination of the following:

• Previous history of allergies, especially if the client has received medications over the past 6 weeks (even if the client is no longer taking the medications)

•  Recent history or presence of burning or urinary frequency (urethritis)

• Recent history or presence of conjunctivitis or eye crusting, redness, burning, or tearing that lasts only a few days

• Recent report or presence of skin rash, especially combined with a report of exposure to ticks

•  Positive family history for arthritis, spondyloarthropathy, psoriasis

•  Recent report of dry mouth or sore throat

•  Recent history of operative procedure

• Other extra-articular signs or symptoms, such as diarrhea, constitutional symptoms, or other symptoms already mentioned

•  Enlarged lymph nodes

5. A positive Schober’s test is a sign of:

a. Reiter’s syndrome
b. Infectious arthritis
c. Ankylosing spondylitis
d. a or b
e. a or c

6. What is Lhermitte’s sign, and what does it signify?

An electric shock sensation down the spine and radiating to the extremities when the neck is flexed; this is a fairly common sign in multiple sclerosis but may also accompany disc protrusion against the spinal cord.

7. Proximal muscle weakness may be a sign of:

a. Paraneoplastic syndrome
b. Neurologic disorder
c. Myasthenia gravis
d. Scleroderma
e. b, c, and d
f. All of the above

8. Which of the following skin assessment fndings in the HIVinfected client occurs with Kaposi’s sarcoma?

a. Darkening of the nail beds
b. Purple-red blotches or bumps on the trunk and head
c. Cyanosis of the lips and mucous membranes
d. Painful blistered lesions of the face and neck

9. The most common cause of change in mental status of the HIV-infected client is related to:

a. Meningitis
b. Alzheimer’s disease
c. Space-occupying lesions
d. AIDS dementia complex

10. Symptoms of anaphylaxis that would necessitate immediate medical treatment or referral are:

a. Hives and itching
b. Vocal hoarseness, sneezing, and chest tightness
c. Periorbital edema
d. Nausea and abdominal cramping


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