PAM PAM Contraindications & Precautions 2 — Questions and Answers
Question 1: Why is electrical stimulation contraindicated directly over malignant tissue?
- It causes excessive localized pain
- It may increase cellular metabolism and potentially accelerate tumor growth or spread (Correct answer)
- It causes immediate skin burns
- It leads to muscle atrophy
Correct answer: It may increase cellular metabolism and potentially accelerate tumor growth or spread
Electrical stimulation can increase local circulation and cellular metabolic activity near malignant tissue, potentially facilitating tumor growth or metastasis.
Question 2: Hot pack application is contraindicated when a patient has which of the following?
- Chronic low back pain
- Intact skin over the treatment area
- Impaired sensation in the treatment area (Correct answer)
- Mild post-exercise muscle soreness
Correct answer: Impaired sensation in the treatment area
Impaired sensation prevents the patient from detecting dangerously elevated heat levels, significantly increasing burn risk.
Question 3: Ultrasound is contraindicated when applied over which of the following surgical sites?
- Healed soft tissue repair
- Spinal cord after laminectomy (Correct answer)
- Post-ACL reconstruction at 6 months
- Repaired Achilles tendon at 12 weeks
Correct answer: Spinal cord after laminectomy
After laminectomy, the bony arch protecting the spinal cord is removed, making direct ultrasound application dangerous to exposed neural tissue.
Question 4: Which patient condition warrants special precaution when applying any heat modality?
- Controlled hypertension without complications
- History of mild asthma
- Peripheral arterial disease (Correct answer)
- Type I diabetes without neuropathy
Correct answer: Peripheral arterial disease
Peripheral arterial disease impairs the body's ability to dissipate heat through normal vascular responses, increasing the risk of thermal tissue damage.
Question 5: Cryotherapy is contraindicated in patients with cryoglobulinemia because:
- Cold decreases their blood pressure too rapidly
- Cold-sensitive proteins in their blood can precipitate upon cooling, causing vascular occlusion (Correct answer)
- Cold causes excessive pain in their joints
- Cold reduces their immune response
Correct answer: Cold-sensitive proteins in their blood can precipitate upon cooling, causing vascular occlusion
Cryoglobulinemia involves cold-sensitive proteins that precipitate at low temperatures, potentially causing dangerous vascular complications.
Question 6: Why are metal implants in the treatment area an absolute contraindication for shortwave diathermy?
- Metal blocks the electromagnetic waves entirely
- Metal concentrates diathermy energy and can cause severe internal burns (Correct answer)
- Metal disrupts the therapeutic frequency
- Metal causes skin irritation from the field
Correct answer: Metal concentrates diathermy energy and can cause severe internal burns
Metal implants absorb and concentrate electromagnetic energy from diathermy, leading to dangerous focal heating and internal burns.
PAM PAM Contraindications & Precautions 2
Why is electrical stimulation contraindicated directly over malignant tissue?