CCEP Patient Management 5

Question 1

Which neurological screen is most important before performing cervicothoracic junction manipulation in a patient with radiating upper extremity symptoms?

Accepted Answer

Upper motor neuron assessment including Hoffman's sign

Answer

Upper motor neuron signs (e.g., Hoffman's sign, hyperreflexia, clonus) suggest cervical myelopathy, which is a contraindication to high-velocity manipulation.

Question 2

A patient with plantar fasciitis fails to improve after 6 weeks of conservative care. The next most appropriate step is to:

Accepted Answer

Re-evaluate biomechanics, modify the plan, and consider co-management or referral

Answer

Lack of progress after 6 weeks warrants re-evaluation of the diagnosis, biomechanical contributing factors, and consideration of co-management or referral.

Question 3

In managing a pediatric patient (age 8) with a suspected Salter-Harris Type II fracture of the distal radius, the chiropractor should:

Accepted Answer

Refer to orthopedics; growth plate injuries require specialist management

Answer

Growth plate (Salter-Harris) fractures in children require orthopedic referral to prevent premature physeal closure and limb length discrepancy.

Question 4

Which special test is used to assess integrity of the ulnar collateral ligament of the elbow?

Accepted Answer

Valgus stress test at 30° elbow flexion

Answer

The valgus stress test at 30° elbow flexion isolates the ulnar collateral ligament by unlocking the olecranon from the fossa and directly stressing the medial stabilizer.

Question 5

A patient's treatment plan requires modifying exercise intensity due to a cardiovascular comorbidity. The chiropractor's best course of action is to:

Accepted Answer

Consult with the patient's cardiologist before modifying the exercise prescription

Answer

Consulting the cardiologist ensures exercise modifications are safe given the patient's cardiovascular status and reflects appropriate interprofessional practice.

(CCEP) Certified Chiropractic Extremity Practitioner Practice Test

(CCEP) Certified Chiropractic Extremity Practitioner Practice Test

CCEP Patient Management 5