1 The one time cyclical gradual and pregressive pain pattern occurs in an orthopedic situation is

A: tendon Pain

B: NMS pain

C: Discogenic pain

D: none of the above

2 The difference between a NMS pattern of pain and symptoms and a visceral pattern is

A: NM symptoms gets worse over time and Visceral improves overtime

B: NM symptoms improves overtime and visceral improves aswell

C: NM symptoms improves overtime and visceral gets worse overtime

D: NM symptoms gets worse overtime and visceral as well .

3 Psychophysiologic disorders (also known as psychosomatic disorders) are any conditions in which the
physical symptoms may be

A: caused by psychological problem

B: caused by neurogenic problems

C: caused by visceral problem

D: caused by somatic problems

4 Three are the key psychologic components that have important significance in the pain response of
many people EXCEPT

A: anxiety

B: behavior

C: depression

D: panic disorder

5 The signs and symptoms of depression are

A: apetite loss

B: headaches

C: Thoughts of death and sucide

D: all of the above

6 The clinical sign and symptoms of panic disorder are all EXCEPT

A: sweats or chills

B: fear of dying

C: sence of hopelessness

D: extreme fear of losing control

7 the symptoms of ______ can mimic those of the other medical conditions such as repiratory or heart
problem

A: depression

B: discogenic problem

C: anxiety

D: none of the above

8 _____ explains the influence of the nervous system on the immune and inflammatory responses and
the how the immune system communicates with the neuroendocrine system

A: PNF

B: PNI (psycho-neuro-immunology)

c: PNU

d: NIH

9 Screening tool for emotional overlay include all EXCEPT

a: McGill pain questionnaire

b: Symptoms magnifications and Pain control

Symptom magnification and illness behaviour

c: Waddells non organic signs

d: None of the above

10 Anxiety is more apparent in acute pain episodes whereas depression occurs in

A: acute
B: subacute

C: chronic

D: acute on chronic

11 Cancer pain wakes the client up from

A: long sleep

B: night sleep

C: sound sleep

D: all of the above

1. Pain and sensory disturbances associated with central changes maybe present with:
a. Acute pain
b. Sub-acute pain
c. Chronic pain
d. Sub-chronic pain

2 From a ________ perspective, we look at the possible sources of pain and types of pain.
a. Screening
b. Treatment
c. Diagnosis
d. None of the above

3 Pain associated with deep somatic lesions follows patterns

that relate to the _________ development of the musculoskeletal
system.
a. Neurological
b. Musculoskeletal
c. Embryological
d. None of the above

4 Visceral sources of pain include the _____ organs and the heart muscle.
a. Internal
b. External
c. Multiple
d. None of the above

5 Neuropathic pain can occur as a result of injury or destruction to the _______nerves, pathways in the
spinal cord, or neurons located in the brain.
a. Central
b. Peripheral
c. Spinal
 d. None of the above

6.Medications used to treat neuropathic pain include _______, anticonvulsants, antispasmodics,

adrenergics, and anesthetics.
a. Anti-depressants
b. Anti- hypertensive
c. Panadol
d. Opiates

7.Referred pain is defined as the pain felt in an area far from the site of the lesion but supplied by the
_____ or adjacent neural segments.
a. Opposite
b. Same
c. Different
d. None of the above

8.From a medical screening perspective there are____ sources of most physiologic pain.
a. Three
b. Two
c. Four
d. Five

1. Infections from the mouth can quickly spread throughout the body increasing the risk of …………
in critically ill patients except;
a) osteomyelitis,
b) pneumonia,
c) septicemia
d) osteoarthritis.

2. Jugular venous distention is a sign of ……….

a) increased venous return
b) right sided heart failure.
c) Pulmonary HTN
d) Cervical pathologies

3. American Diabetes Association recommends screening for anyone with diabetes who is -…..
years old or older.
a) 40
b) 50
c) 60
d) 70

4. In Rubor on Dependency test, the leg Is elevated to …. Degress.

a) 30 degree
 b) 35 degree
c) 45 degree
d) 50 degree

5. Following are the scales of DVT assessment;

a) Autar DVT Risk Assessment scale
b) Wells clinical decision rule
c) Ankle brachial index
d) Both A and B

6. Normal anteroposterior vs transverse diameter of the chest is;

a) 1:2
b) 2:1
c) 1:3
d) 3:1

7. Dullness over the lungs during percussion may indicate ……….

a) pneumonia
b) tumor
c) Consolidation
d) All of the above

8. Following are not the normal heart sounds except

a) Lubb-dubb
b) Ventricular gallop
c) Pericardial friction rub
d) Herat murmers
9. Screening for early detection of Breast cancer is suggested by;
a) American Medical association
b) CBE The Guide
c) JNC 7 Classification
d) Mamography

10. Blueish discoloration around the umbilicus is;

a) Cullen’s sign
b) Homans’s sign
c) Grey turner’s sign (around the peri-umbelical region)
d) None of the above

11. About the auscultation in abdominal quadrants;

a) Should be done before palpation
b) Should be done after palpation
 c) Should be done before palpation and percussion
d) Should be done after palpation and percussion

12. Test for rebound tenderness is also known as;

a) Pinch-an-inch test
b) Blumberg’s sign
c) Both A & B
d) None of the above

13. In which conditions. The liver of a patient is more readily palpable?

a) COPD
b) Ascites
c) Peritonitis
d) Intestinal obstruction

14. Murphy’s percussion test is done for

a) Pancreas
b) Uterus
c) Gall bladder
d) Kidneys & bladder

15. ………….. Helps to identify problems that impair lung ventilation.

a) Inspection
b) Percussion
c) Palpation
d) auscultation
1. The system that can not usually refer pain to chest or breast:
A: upper GIT
B: Pulmonary
C: renal
D: Cardiovascular
2. Cancer can present as primary chest pain with or without accompanying pain/symptoms:
A: neck
B: shoulder
C: upper back
D: All of the above
3. Chest pain can be evaluated using which way:
A: Cardiac versus noncardiac
B: systemic versus neuromusculoskeletal
C: both a and b
D: none of the above
4. Risk for cardiac diseases decrease with:
 A: advancing age
B: exercise
C: tobacco use
D: family history of hypertension
5. Constitutional symptoms regarding GIT include:
A: nausea
B: fever
C: chills
D: night sweats
6. s/s of MI in women exclude:
a: dyspnea
b: symptoms aggravated by antacids
c: indigestion or heartburn
d: sleep disturbance
7. following are the three p’s used by doctors except:
a: pain on palpation
b: pain with change in position
c: pain at rest
d:pleuritic pain
8. Irritation of an intercostal nerve from rib metastasis produces burning pain that is:
A: unilateral
B: segmental
C: bilateral
D: both a and b
1. Pulmonary chest pain includes all causes except:
a) Obstruction
b) Dilation
c) restriction
d) disposition
e) distention
2. chest pain that worses with deep breathig,coughing and relived by changing position is most
likely:

a ) epigastric in origin

b) pulmonary

c) MSK pain

d) none of above

3. Clinical signs and symptoms of GI causes of chest pain includes all except:
a) Nausea & Vomiting
 b) Dark urine, blood in stool
c) Indigestion, pain while swallowing food.
d) Pain on deep breathing

4) pain that is in lower substernal area and is squeezing and gripping in nature like heartburn is due to:

a) gallbladder
b) GERD
c) pancreatic
d) none of above

5) clinical signs and symptoms of breast cancer includes all except:

a) difficult breathing
b) weight loss
c) axillary mass
d) arm swelling

6) factors associated with breast cancer includes all except:

a) genetic family history
b) age
c) psychological status
d) exposure to estrogen

7) Breast pathology causing chest and breast pain includes which one of following condition:
a) mastitis
b) titeiz syndrome
c) both a and b
d) none

8) GI causes of chest pain have following symptoms except:

a) difficult swalloing
b) heartburn
c) food related discomfort
d) none of above

9) Pleuro pulmonary causes of chest pain includes following pathologies:

a) asthma
b) pneumonia
c) pneumothorax
d) all of above
 10) past medical history of alcoholism, cirrhosis of liver and peptic ulcer shows which system
involvement:

a) pulmonary

b) GI

c) respiratory

d) all of above

1. Orientation refers to the client’s ability to answer correctly questions about

a) Time, place, and person
b) Things, place, and person
c) Time and place only
d) None of the above
2. The pulse reveals important information about the client’s___________
a) Heart rate
b) Heart rhythm
c) Both a&b
d) None of them
3. A resting pulse rate normal range is:
a) 40-60 bpm
b) 60-100 bpm
c) 95%-100%
d) 120-130 bpm
4. Amir come to your clinic during physical examination you palpate his radial artery to assess his
pulse its seems bounding, too strong to obliterate rate, what is its grade
a) 0 (absent, not palpable)
b) 1+ (diminished pulse, barely palpable)
c) 2+ (normal, easily palpable)
d) 3+ (increased strength, full pulse)
e) 4+ (bounding, to strong to obliterate)
5. The rise and fall of the chest equals_____________
a) 1 cycle
b) 2 cycles
c) 4 cycles
d) 6 cycles
6. The normal SaO2 range at rest and during exercise is______________
a) 80% to 85%
b) 90% to 95%
c) 95% to 100%
 d) None of them
7. To measure B.P the cuff bladder should encircle at least
a) 40% of the arm
b) 60% of the arm
c) 80% of the arm
100% of the arm
1. Joint pain manifesting as a local response to an infection is called ______arthritis.
a. Infectious
b. Septic
c. Bacterial
d. All of the above

2. ________________ is/are the most common cause of infectious arthritis.

a. Staphylococcus aureus
b. Streptococci
c. Gonococci
d. All of the above

3. Infective arthritis commonly affects the following joints except

a. Shoulder
b. Knee
c. Ankle
d. hip
e. Elbow
f. wrist

4. The pain that spreads or fans out from the originating point of pain is referred to as
a. radicular pain
b. radiating pain
c. referred pain
d. none of the above

5. ________ is the pain is caused by nerve root compression.

a. radicular pain
b. radiating pain
c. referred pain
d. none of the above
6. ________ Pain results from activation of nociceptive free nerve endings of the nervous system
in somatic or visceral tissue.
 a. Radicular pain
b. Radiating pain
c. Referred pain
d. None of the above

7. Pain arising from the GI tract tends to ______ with peristaltic activity.
a. Increase
b. Decrease
c. Remains same
d. First increase than decrease

8. Pain related to ischemia of the skin and subcutaneous tissues is characterized by the client
as______
a. Burning and boring
b. Dull and boring
c. Deep and aching
d. None of the above

9. There is ______ relationship between the degree of circulatory insufficiency and muscle work.
a. Direct
b. Indirect
c. No
d. none of the above

10. The most convenient point of the division of acute and chronic pain according to International
Association for the Study of Pain is
a. 3 months
b. 6 months
c. 1 month
d. None of the above

1) When a men has prostate cancer and women has reproductive cancer or breast cancer, this is a red
flag because these cancers may be associated with metastases to the ___________

a) Lumber spine

b) Hip

c) Shoulder joint
d) Cervical spine

2) Following are the red flag histories associated with the lower extremity

a) Previous history of renal or urologic disease

b) Pelvic inflammatory disease (PID)

c) History of AIDS

d) all of the above

3) Pain perceived on the outer (lateral) side of the hip is usually not caused by an intra-articular
problem, but more likely results from a ____________ except
a) trigger point
b) bursitis
c) SI, or back problem.
d) degenerative changes

4) systemic causes of the buttock pain are the following except

a) fracture of sacrum or ilium

b) ischemia

c) both a and b

d) trigger points

5) SI joint dysfunction can cause groin pain and, with referred pain to the hip, may be accompanied by
an ipsilateral decrease in hip joint
a) internal rotation of 05 degrees

b) internal rotation of 15 degrees

c) internal rotation of 25 degrees

d) internal rotation of 35 degrees

6) localized hip pain can caused due to __________

a) bursitis

b) femoral hernia

c) meralgia paresthetica

d) all of the above

7) which of the statement is true regarding vascular claudication?

a) Pain is usually bilateral with decreased or absent pulses

b) pain is unilateral with increased pulses

c) Pain, aching, and numbness of feet with normal pulses

d) Crawling, creeping sensation in legs with decreased pulses

8) Hip pain referred from the upper lumbar vertebrae can radiate into the ________
a) anterior aspect of the thigh
b) posterior aspect of the thigh
c) lateralaspect of the thigh
d) both a and c

9) Empty end feel of the hip joint can be an indicator of potentially serious disease such as _______
a) infection

b) femoral hernia

c) neoplasm

d) both a and c

10) if a patient come to you with painless, progressive enlargements of lymph nodes or lymph nodes
that are aberrant or suspicious for any reason, especially if present in more than one area in the groin or
in the presence of a past medical history of cancer. Which statement is correct?
a) need for medical referral.
b) ignore the problem
c) start the treatment
d) none of the above

11) The most common causes of leg cramps are the following ______
a) neuropathy
b) medications
c) metabolic disturbances
d) all of the above

12) The most common musculoskeletal cause of groin pain is strain of the
a) adductor longus.
b) adductor magnus
c) hip flexors
d) hip extensors

13) if a patient come to you with anterior or anterolateral thigh pain which of the nerve is compressed?
a) sural nerve
b) tibial nerve
c) lateral femoral cutaneous nerve
d) common peroneal nerve

14) Fulcrum test is used for diagnosis of _________

a) femoral shaft stress injury
b) tibial stress fracture

c) humeral fracture

d) both a and b

15) Pain on weight bearing is a _____________ symptom for stress reaction or fracture in any individual.
a) yellow flag
b) red flag
c) non serious
d) serious

16) clinical signs and symptoms of stress fracture includes _________

a) Compensatory gluteus medius gait
b) Positive Patrick's or Faber's test
c) positive SLR
d) both a and b

17) Risk factors which are associated with sciatic -like symptoms are the following except
a) endometriosis
b) diabetes mellitus
c) crohn’s disease
d) HIV-AIDS
18) Hodgkin's disease arises in the lymph glands, most commonly on _____________
a) single side of the neck or groin
b) bilateral sides of the neck and groin
c) single side of axilla
d bilateral sides of axilla

19) Testing the cremasteric reflex may help the therapist identify neurologic impairment in any male
with suspicious. All of the following include except.
a) ankle pain
b) pelvic
c) groin (including testicular)
d) anterior thigh pain.

20) The absence of a cremasteric reflex is an indication of disruption at which level ________
a) T12-L1 level
b) T12-L5 level
c) T8-L1 level
d) T8-L5 level

21) If a patient come to you with pain which begins posteriorly in the costovertebral angle but may
radiate anteriorly to the upper thigh and groin.which type of pain is this?
a) bone tumor pain
b) Ureteral pain
c) oncologic pain
d) systemic pain

22) Murphy's percussion is performed by the therapist test to rule out _________ involvement.
a) reproductive
b) spine
c) cardiac
d) kidney

23) Which conditions affecting the entire peritoneal cavity and may cause hip or groin pain in the young,
healthy adult.?
a) pelvic inflammatory disease
b) spine tumor
c) appendicitis
d) both a and c

24) Any infectious or inflammatory process affecting the ___________region can lead to psoas abscess
and irritation of the psoas muscle.
a) abdominal
b) pelvic
c) spine
d) both a and b

25) In reactive arthritis, joint symptoms occur _______________ after an infection, usually GI
(gastrointestinal) or GU (genitourinary).
a) 1 to 4 weeks
b) 1 to 5 weeks
c) 1 to 6 weeks
d) 1 to 7 weeks

26) which of the following statement is true regarding abdominal aortic aneurysm?
a) Pain not relieved by change in position
b) Pain described as "tearing" or "ripping"
c) cold, pulseless lower extremities
d) all of the above

27) Risk factors such as chronic use and abuse of alcohol, systemic lupus erythematosus, diabetes
mellitus and kidney disease are common in ____________condition.
a) abdominal aortic aneurysm
b) Avascular Osteonecrosis
c) cancer
d) osteoporosis

28) The therapist can carry out the screening test/tests for liver impairment including the following:
a) Palmar erythema
b) Scan for angiomas
c) Assessment of nail beds for change in color
d) all of the above

29) Cyriax's "Sign of the Buttock" can help differentiate between _________and ________ disease.
a) hip and lumber spine
b) hip and knee
c) hip and ankle
d) hip and Sacroiliac joint

30) Vascular diseases that may cause referred hip pain include:
a. Coronary artery disease
b. Intermittent claudication
c. Aortic aneurysm
d. All of the above

31) The screening model used to help identify viscerogenic or systemic origins of hip, groin, and
lower extremity pain and symptoms is made up of:
a. Past medical history, risk factors, clinical presentation, and associated signs and symptoms
b. Risk factors, risk reduction, and primary prevention
c. Enteric disease, systemic disease, neuromusculoskeletal dysfunction
d. Physical therapy diagnosis, review of systems, physician referral

32) Screening for cancer may be necessary in anyone with hip pain who:
a. Is younger than 20 or older than 50
b. Has a past medical history of diabetes mellitus
c. Reports fever and chills
d. Has a total hip arthroplasty (THA)

33) Recurrenceof _______________ cancer is possible with referred pain to the hip and/or groin area.
a) endometrial
b) prostate
c)colorectal
d) none of the above

34) Spinal cord tumors (primary or metastasized) present as dull, aching discomfort or sharp pain in the
___________ area in a beltlike distribution, with pain extending to the groin or legs.
a) thoracolumbar
b) cervicothoracic
c) sacroiliaic
d) lumbosacral

35) If a patient come to you with hemorrhage within the psoas muscle, either spontaneous or associated
with anticoagulation
therapy for hemophilia, can cause a painful compression syndrome of the nerve. Which nerve is
involved?
a) common peroneal nerve
b)femoral nerve
c) tibial nerve
d) sural nerve.
1. A patient comes to you with low back pain and he/she takes the treatment of low back pain but
the symptoms persists for more than 30 days. What is the best option?
a. Ignore the patients symptoms
b. Continue the treatment
c. Go for imaging
d. Refer the patient
2. A 50 year old man complain of leg weakness and spasticity resulting from tumor, infection,
degenerative changes in the spine and from cord compression at the level of ________
a. Above the thoracic spine
b. Below the thoracic spine
c. Above the lumbar spine
d. Below the lumbar spine
3. A 55 year old patient comes to you with low back pain and when patient walk for few steps pain
starts in the whole leg. What is the best possible cause?
a. Disk herniation
 b. Spinal stenosis
c. Myelopathy
d. Cauda equine
4. A patient comes to you with low back pain which is constant and not improved with rest. What
do you think about that patient?
a. It may be due to systemic disease
b. Patient having radiculopathy
c. Patient may have some sort of psychological issue
d. Both a and c
5. A patient come to the clinic and complains of low back pain which is above the knee. What is the
source of pain?
a. Sacroiliac joint pathology
b. Hip joint pathology
c. Systemic cause
d. Disk herniation
6. If a patient complains of tearing or ripping like pain, it may be due to ________
a. Disk herniation
b. Malignancy
c. Referred pain from visceral organ
d. Aortic dissection
7. A patient name Ali having low back pain and the pain improves when he eat something. What
thing comes in your mind?
a. Gall bladder disease
b. Peptic ulcer disease
c. Pancreatitis
d. Disk herniation
8. Following are the red flags of low back pain except:
a. Structural deformity
b. Systemic steroids
c. presence of catastrophic thinking
d. Systemic illness
9. Piriformis syndrome is also called __________
a. Wallet sciatica
b. Fat wallet syndrome
c. Somatic syndrome
d. Both a and b
10. A patient comes to you with shooting and shock like pain in the back and on subjective
examination patient also told that the pain worsens with coughing or sneezing. What is the best
answer?
a. Patient may have systemic disease
b. Spondylolisthesis
c. Disk herniation
 d. Inflammation of the spine
11. A patient complaint of spreading or shooting or radiating pain towards leg during exercise, it
means the patient having ________ pain.
a. Peripheralize
b. Centralize
c. Systemic
d. Both a and b
12. A 35 year old man is complaining that when he wakes up he feels stiffness in the back with
persisting limitation of motion and patient also having skin rashes, colitis and urethral discharge.
What is the most likely underlying diagnosis?
a. Spondylolisthesis
b. It may be due to poor sleep
c. Ankylosing spondylitis
d. Systemic disease
13. _______ is the primary diagnostic tool when cauda equina or malignancy is suspected.
a. CT scan
b. MRI
c. X-ray
d. Bone scan
14. A patient having low back pain and imaging shows the slippage of L5 vertebra on S1 vertebra
with loss of lumber lordosis. This type of condition is more common in _________
a. Athletes
b. Old age
c. Women age above 40
d. Both a and c
15. A patient comes to your clinic with complain of radicular pain, it may be due to _________
a. Inflammation of the dura
b. Inflammation of the nerve root
c. Inflammation of the bone
d. None of the above
16. A patient came to you with complain of shortness of breath over the period of hours to days.
Which type of dyspnea is this?
a. Acute
b. Sub-acute
c. Chronic
d. Severe
17. A patient came to the hospital having clinical episodes of acute dyspnea, cough and wheezing
and shows the sign of pulsus paradoxus. What is your underlying diagnosis?
a. Bronchitis
b. Pericarditis
c. Asthma
d. Bronchiectasis
18. A person came to the hospital and shows signs of pulsus alernans, central cyanosis and basal
crepitus. What do you think?
a. Patient may have acute right heart failure
b. Patient may have chronic right heart failure
c. Patient may have acute left heart failure
d. Patient may have chronic left heart failure
19. A 35 year old man came to your clinic having severe dyspnea, cyanosis, fast repiratory rate and
pulmonary edema of non cardiac cause. What is your diagnosis?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Hyperventilation syndrome
d. Acute respiratory distress syndrome
20. What are the possible risk factors for pulmonary embolism except
a. Hypocougulable states
b. Previous history of DVT
c. Smoking
d. Birth control pills
21. Which is not the possible cause of spontaneous pneumothorax?
a. Emphysema
b. Alpha 2 antitrypsin deficiency
c. Alpha 1 antitrypsin deficiency
d. Interstitial lung disease
22. If the patient chest X-ray shows the hyperlucency and lack of lung markings at the periphery of
the lung and appearance of fine line that represents the retraction of the visceral from the
parietal pleura, mediastinal shifting. What is you underlying diagnosis?
a. Pneumothorax
b. Pulmonary embolism
c. Pericarditis
d. Emphysema
23. When you see a lady and her respiration is rapid and deep to washout CO2 as a compensatory
mechanism. Which possible etiology is not concern for that patient?
a. Renal faliure
b. Diabetic ketoacidosis
c. Cardiac failure
d. Salicylate poisoning
24. When you see the patient chest X-ray and you find the Upper lobe diversion and Kerley’s B lines.
What thing comes in you mind?
a. Acute pulmonary edema
b. chronic pulmonary edema
c. emphysema
d. pulmonary embolism
1. Anterior thigh pain is commonly disk related, resulting from_____________
a. L3-L4 disk
b. L4-L5 disk
c. L5-S1 disk
d. None of them
2. Regarding back and thigh pain, a positive reverse straight leg raise (SLR) test, and depressed
knee reflex are described more often in clients with disk herniation at the ______________
a. L3-L4 level
b. L4-L5 level
c. L5-S1 levels
d. All of the above
3. To differentiate between bursitis and nerve root distribution which statement is true?
a. “Jump” sign is seen with nerve root irritation
b. Bursitis exhibit a positive “jump” sign
c. Both a and b
d. None of them
4. The sciatic nerve is innervated by
a. L4, L5,
b. L4, L5, S1,
c. L4, L5, S1, S2,
d. L4, L5, S1, S2, and sometimes S3