PAM PAM Contraindications & Precautions 1 — Questions and Answers
Question 1: Which of the following is an absolute contraindication for all forms of electrical stimulation?
- Chronic low back pain
- Implanted cardiac pacemaker (Correct answer)
- Subacute muscle spasm
- Post-surgical edema
Correct answer: Implanted cardiac pacemaker
An implanted cardiac pacemaker is an absolute contraindication for electrical stimulation because electrical current can interfere with pacemaker function.
Question 2: Over which area should therapeutic ultrasound never be applied in pediatric patients?
- Quadriceps muscle belly
- Lumbar paraspinals
- Epiphyseal growth plates (Correct answer)
- Gastrocnemius muscle
Correct answer: Epiphyseal growth plates
Ultrasound over active epiphyseal growth plates in children is contraindicated because it may disrupt normal bone development.
Question 3: Why are heat modalities contraindicated in acute inflammation?
- Heat causes excessive muscle relaxation
- Heat increases circulation and metabolism, worsening swelling and pain (Correct answer)
- Heat reduces nerve conduction
- Heat causes vasoconstriction
Correct answer: Heat increases circulation and metabolism, worsening swelling and pain
Heat increases circulation and cellular metabolic activity, which can exacerbate acute inflammation by adding to existing swelling and pain.
Question 4: Cold modalities are contraindicated in patients with which condition?
- Chronic muscle spasm
- Raynaud's disease (Correct answer)
- Acute ankle sprain
- Post-exercise muscle soreness
Correct answer: Raynaud's disease
Raynaud's disease involves vasospastic attacks triggered by cold exposure, making cold modalities dangerous for these patients.
Question 5: Over which anatomical area is TENS (transcutaneous electrical nerve stimulation) absolutely contraindicated?
- Lumbar paraspinals
- Carotid sinus (Correct answer)
- Quadriceps
- Forearm flexors
Correct answer: Carotid sinus
Applying TENS over the carotid sinus can trigger cardiac arrhythmias and a dangerous reflex drop in blood pressure.
Question 6: Which situation represents a precaution rather than an absolute contraindication for ultrasound therapy?
- Active malignancy in the treatment area
- Implanted pacemaker
- Pregnancy over the gravid uterus (Correct answer)
- Acute thrombophlebitis
Correct answer: Pregnancy over the gravid uterus
Ultrasound over the pregnant abdomen is generally avoided as a site-specific precaution; the other options listed are absolute contraindications.
PAM PAM Contraindications & Precautions 1
Which of the following is an absolute contraindication for all forms of electrical stimulation?