CCEP Clinical Decision Making 3

Question 1

A 60-year-old diabetic patient presents with bilateral burning foot pain worse at night and loss of protective sensation. What is the most appropriate clinical decision?

Accepted Answer

Comprehensive diabetic foot examination with monofilament testing and neurological referral

Answer

Diabetic peripheral neuropathy requires thorough assessment including monofilament testing for protective sensation and potential neurological or endocrinology referral to prevent ulceration.

Question 2

When using the Ottawa Ankle Rules, which finding indicates the need for radiographic imaging?

Accepted Answer

Point tenderness at the posterior edge of the lateral malleolus

Answer

Ottawa Ankle Rules mandate X-rays if there is bony tenderness at the posterior 6 cm or tip of the lateral or medial malleolus.

Question 3

A pitcher presents with medial elbow pain during the late cocking and acceleration phases of throwing. Valgus stress testing at 30° flexion reveals laxity. Which structure is most likely injured?

Accepted Answer

Ulnar collateral ligament (anterior band)

Answer

The anterior band of the UCL is the primary stabilizer against valgus stress at the elbow and is commonly injured in overhead throwing athletes.

Question 4

Which pattern of hip joint restriction is most consistent with early osteoarthritis of the hip using the capsular pattern?

Accepted Answer

Greatest loss of internal rotation, then flexion, then abduction

Answer

The capsular pattern of the hip joint involves greatest restriction of internal rotation, followed by flexion and abduction, indicating intra-articular pathology.

Question 5

A CCEP practitioner identifies joint hypomobility at the first MTP joint with limitation of dorsiflexion. This clinical pattern is consistent with which condition?

Accepted Answer

Hallux rigidus

Answer

Hallux rigidus is characterized by loss of dorsiflexion at the first MTP joint due to degenerative changes, causing pain and stiffness during push-off.

(CCEP) Certified Chiropractic Extremity Practitioner Practice Test

(CCEP) Certified Chiropractic Extremity Practitioner Practice Test

CCEP Clinical Decision Making 3