Topics that may be assessed.docx

**Topics that may be assessed:** \ **1. Migraine** \ **2. Cervicogenic headache** \ **3. VBI** \ **4. Neck pain assessment and management** \ **5. Thoracic pain assessment and management** \ **6. Acute/Chronic/Non-specific LBP assessment and management** \ **7. Radiculopathy assessment and managemen...

**Topics that may be assessed:** \ **1. Migraine** \ **2. Cervicogenic headache** \ **3. VBI** \ **4. Neck pain assessment and management** \ **5. Thoracic pain assessment and management** \ **6. Acute/Chronic/Non-specific LBP assessment and management** \ **7. Radiculopathy assessment and management** \ **8. Neurodynamic assessments of upper limb and lower limb nerves** \ **9. Red flags** \ **10. Spinal stenosis** **Example questions** 1. When seeing patient\'s with lower back pain, patients are often triaged into three subgroups: non-specific lower back pain, specific pathology and serious pathology. Please describe the signs and features of each subgroup. 2. **Case:** Margaret, a 68-year-old woman, presents with a 2-week history of low back pain that she describes as a deep, constant ache. The pain is worse at night and does not improve with rest. Additionally, Margaret has experienced weight loss of 5 kg over the past month but she is not on a diet, and has a low-grade fever. Her medical history includes osteoporosis and hypertension, but she has no history of trauma. What is the most appropriate next step in managing Margaret\'s condition? 3. Which red flag(s) are presented in Margaret\'s case? 4. Which of the following is a sign of a potential serious underlying condition in a patient with low back pain? 5. What is a typical feature of spinal stenosis? 6. Match the motor neurological exam with the appropriate nerve root. Hip flexion Knee extension Dorsiflexion Plantarflexion Toe extension Knee flexion 7. What is the role of passive treatments like ultrasound and electrical stimulation in managing low back pain, according to guidelines? 8. Mario, a 45-year-old man, has been experiencing chronic low back pain for over 6 months, with pain radiating to his right buttock. He is highly stressed due to work and avoids physical activity because he believes it will worsen his condition. He expresses fear of getting worse and lower expectations (\"I\'ll never get better\", \"I tried a chiropractor once and it didn\'t help me at all\"). He has no significant past medical history but exhibits high levels of anxiety and fear-avoidance behaviour. Which of the following is the most appropriate exercise strategy for Mario, given his chronic low back pain and fear-avoidance behaviour? 9. What is the primary goal of pain education in managing Mario\'s chronic low back pain? 10. What is the most appropriate initial (first line) treatment for acute low back pain? 11. What is the purpose of the StartBack questionnaire in the assessment of low back pain? 12. Mei, 42 years old\ Complaint: Recurrent low back pain\ History: Mei has been experiencing recurrent episodes of low back pain with radiating leg pain for the past year. Her pain typically worsens with prolonged sitting and improves with walking, lying flat, or during extension of the spine. \ Medical History: No significant medical history. What McKenzie classification is most likely appropriate for Mei? 13. Which of the following statements best describes the concept of pain centralisation in the context of McKenzie Therapy? 14. If Mei has a positive response to repeated extension exercises in the first session, what would be the initial recommended exercise approach according to the McKenzie method? 15. Which of the following is a key goal of the treatment plan for Mei under the McKenzie approach? 16. What are the 4 grades of neck pain severity (and its characteristics)? 17. The atlanto-axial (C1/2) joint has what amount of rotation ROM? 18. Which muscles are primarily responsible for neck flexion? 19. Sarah, a 38-year-old woman, has been suffering from neck pain for the last 3 months. Recently, the pain has started radiating down her right arm, accompanied by weakness in her grip strength and occasional numbness in her thumb and index finger. She reports that the pain worsens with activities such as lifting or extending her neck and is slightly relieved by rest. Sarah has not experienced any significant trauma, and her medical history is otherwise unremarkable. On physical examination, you notice decreased deep tendon reflexes in the right biceps, weakness in elbow flexion, and a sensory deficit in the C6 dermatome. Based on Sarah\'s symptoms and physical examination findings, which cervical nerve root is most likely affected? 20. Given Sarah's diagnosis of radiculopathy (Grade III), design a treatment plan for Sarah. 21. Which of the following is a common clinical feature of vertebrobasilar insufficiency (VBI)? 22. Thomas, a 55-year-old man, reports episodes of dizziness, unsteadiness, and occasionally blurred vision over the past 2 months. These symptoms are most pronounced when he turns his head to the right, particularly when looking over his shoulder while reversing his car. He also experiences some mild neck pain but denies any significant trauma. He reports no recent infections or systemic illnesses. There are no symptoms of limb weakness or sensory loss, but he does occasionally feel nauseated during these episodes. Thomas has a history of hypertension and is a smoker. Which of the following physical examination tests is most appropriate to assess Thomas for VBI? 23. During the test, which of the following findings would be most concerning and suggestive of VBI? 24. After performing the test and finding positive results, what would be the most appropriate next step in managing Thomas's condition? 25. Maria, a 35-year-old South American woman, has been experiencing mid-thoracic pain for the past 4 months. She describes the pain as a constant dull ache that worsens with prolonged sitting and when she reaches overhead. The pain occasionally radiates to her left shoulder but does not extend below the level of the scapula. Maria works at a desk job and spends most of her day sitting. She reports no recent trauma, fever, or systemic symptoms. On physical examination, she has tenderness over the mid-thoracic paraspinal muscles and restricted thoracic extension and rotation due to pain. Which assessment would be most appropriate to determine if Maria's thoracic pain has a mechanical (or contractile) relantionship? 26. Which of the following manual therapy techniques and grade would be most appropriate for addressing Maria's possible restricted thoracic movements? 27. In the context of Mulligan's manual therapy, what is the primary goal of applying a SNAG to the thoracic spine? 28. Which exercise would be most beneficial for addressing Maria's postural issues related to prolonged sitting at work?