DPT Patient Evaluation & Diagnosis 2 — Questions and Answers
Question 1: A patient reports pain that worsens with lumbar extension and improves with flexion. Which diagnosis is MOST consistent with this pattern?
- Lumbar disc herniation
- Lumbar spinal stenosis (Correct answer)
- Sacroiliac joint dysfunction
- Piriformis syndrome
Correct answer: Lumbar spinal stenosis
Lumbar spinal stenosis classically worsens with extension (narrowing the canal) and improves with flexion (widening it).
Question 2: During the Thomas Test, the contralateral leg rises off the table while the tested hip is held in maximal flexion. This finding indicates tightness of the:
- Hamstrings
- Tensor fasciae latae
- Hip flexors (iliopsoas) (Correct answer)
- Gluteus medius
Correct answer: Hip flexors (iliopsoas)
A positive Thomas Test with the contralateral leg rising indicates iliopsoas tightness, as the hip cannot fully extend against gravity.
Question 3: A 70-year-old presents with sudden onset of severe unilateral facial droop, arm weakness, and slurred speech. The PT's FIRST action should be:
- Perform a full neurological screen
- Call 911 immediately (Correct answer)
- Document findings and notify the referring physician
- Conduct the Cincinnati Stroke Scale
Correct answer: Call 911 immediately
These signs are a medical emergency consistent with stroke; the PT must activate emergency services immediately before any further assessment.
Question 4: Which special test assesses for thoracic outlet syndrome by reproducing symptoms when the arm is abducted to 90° and externally rotated with repeated fist clenching?
- Adson's test
- Roos test (EAST) (Correct answer)
- Allen test
- Spurling's test
Correct answer: Roos test (EAST)
The Roos test (Elevated Arm Stress Test) reproduces symptoms of thoracic outlet syndrome through sustained arm elevation and repetitive grip.
Question 5: On the ICF model, a patient's inability to return to work as a carpenter due to shoulder pain best represents which component?
- Body function and structure
- Activity limitation
- Participation restriction (Correct answer)
- Environmental factor
Correct answer: Participation restriction
Inability to fulfill a life role (occupation) is classified as a participation restriction in the ICF framework.
Question 6: During ankle assessment, the squeeze test (compressing tibia and fibula at mid-shaft) reproduces pain at the distal syndesmosis. This is MOST indicative of:
- Lateral ankle sprain
- Medial ankle sprain
- High ankle (syndesmotic) sprain (Correct answer)
- Achilles tendon rupture
Correct answer: High ankle (syndesmotic) sprain
The squeeze test stresses the interosseous membrane and syndesmosis; pain at the distal joint indicates syndesmotic injury.
Question 7: A patient scores 18/56 on the Lower Extremity Functional Scale (LEFS) at initial evaluation. This score indicates:
- Minimal functional limitation
- Moderate functional limitation
- Severe functional limitation (Correct answer)
- No functional limitation
Correct answer: Severe functional limitation
The LEFS maximum is 80 points; a score of 18 represents approximately 22% of maximum function, indicating severe limitation.
DPT Patient Evaluation & Diagnosis 2
A patient reports pain that worsens with lumbar extension and improves with flexion.
Which diagnosis is MOST consistent with this pattern?