ACO Continuing Education Issue Self Test

back to June 10 Issue

CE Self Test: JACO - June, 2010

Written by: James Demetrious, DC, FACO

The Academy of Chiropractic Orthopedics is developing another means to obtain Fellow Re-
Certification credit. The following CE Self Test is for your academic and educational
enjoyment. In the future, we hope to provide this format for credit and to enhance our journal
and your learning experience.

Instructions: Read the journal and select the best answer for each of the following questions. The
test answers are provided at the end of this section.

1. When considering renal cell carcinoma, at the time of presentation, how many patients have metastatic deposits?
   1. 20 to 25%
   2. 25 to 30%
   3. 30 to 35%
   4. 35 to 40%
2. In the case of renal cell carcinoma bone metastases, lesions often appear as follows?
   1. Large expansile blastic lesions on radiography, most commonly affecting the axial skeleton.
   2. Large expansile blastic lesions on radiography, most commonly affecting the appendicular skeleton.
   3. Large expansile lytic lesions on radiography, most commonly affecting the axial skeleton.
   4. Large expansile lytic lesions on radiography, most commonly affecting the axial skeleton.
3. Kanodia et al. report the following:
   1. It was reported that chiropractic had the highest perceived benefit of the six most frequently used CAM modalities (including chiropractic, massage, herbal therapies, relaxation techniques, Yoga and Acupuncture).
   2. The American College of Physicians and American Pain Society has previously recommended that medical physicians refer acute, sub-acute and chronic lower back pain patients for manipulation.
   3. In the current article, the authors published in the Journal of the American Board of Family Medicine that chiropractic is a highly utilized modality of care that receives the highest perceived benefit.
   4. All of the above.
4. In the American Academy of Orthopaedic Surgeons Clinical Practice Guideline on Diagnosis of Carpal Tunnel Syndrome the following is recommended:
   1. The physician may obtain electro-diagnostic tests to differentiate among diagnoses.
   2. The physician may obtain electro-diagnostic tests in the absence of thenar atrophy and/or persistent numbness.
   3. The physician should not obtain electro-diagnostic tests if clinical and/or provocative tests are positive and surgical management is being considered.
   4. The physician should routinely evaluate patients suspected of having carpal tunnel syndrome with new technology, such as magnetic resonance imaging (MRI), computerized axial tomography (CAT) and pressure specified sensorimotor devices (PSSD) in the wrist and hand.
5. When assessing degenerative rotator cuff tears, Kim et al. did not measure:
   1. The width of the tear.
   2. The length of the tear.
   3. The distance from the biceps tendon to the anterior margin of the tear.
   4. The distance from the inferior aspect of the acromium to the posterior margin of the tear.
6. Clohisy et al. report the following:
   1. Acetabular inclination can also be assessed using the Wiberg angle.
   2. The acetabular depth can be measured for the assessment of coxa profunda and/or protrusio acetabuli.
   3. The center-edge angle of Tonnis can also be assessed, particularly useful for evaluating developmental dysplasia of the hip, as can the position of the hip center.
   4. The evaluation of acetabular version is not useful for the evaluation of femoroacetabular impingement syndrome.
7. When assessing avulsions of the proximal hamstring, the authors’ Wood et al. report the following is true:
   1. CT is the most accurate imaging modality for diagnosing hamstring injuries and will differentiate strains from tears.
   2. MRI (using surface coil) is the most accurate imaging modality for diagnosing hamstring injuries and will differentiate strains from tears.
   3. Type-1 injuries represent avulsions at the musculotendinous junction.
   4. Type-2 injuries represent osseous avulsions.
8. From the study written by Woods et al., the following is True:
   1. Proximal hamstring origin avulsions respond well to non-operative treatment.
   2. For the majority of hamstring muscle injuries the authors recommend early surgical repair.
   3. A delay in surgical repair renders the repair more technically challenging, and may increase the likelihood of sciatic nerve involvement.
   4. A delay in surgical repair decreases the need for postoperative bracing, and reduces postoperative outcome in terms of hamstring strength and endurance.
9. The diagnosis of shoulder conditions by physical examination methods must be a blend of history, physical examination, and imaging to improve the diagnostic accuracy.
   1. True
   2. False
10. In the examination of the shoulder, Jia et al. report:
    1. Speed’s Test is sensitive and specific for biceps tendon lesions.
    2. Palpation is not challenging as the supraspinatus and the subscapularis tendon insertions are in close proximity to the biceps tendon.
    3. The Lift-off test that reproduces anterior shoulder is not diagnostic.
    4. Diagnosis is challenging as the majority of the time, other shoulder injuries simultaneously coexist such as rotator cuff tears or other intra-articular abnormalities.

Record your answers here by circling the appropriate letter:

1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b
10. a b c d

Evaluation

Did the material presented in this activity meet the educational objectives?

5 = Excellent; 4 = Very good; 3 = Good; 2 = Fair; 1 = Poor
(Circle your response.)

Please rate the contents of this issue using the following scale:
5 = Excellent; 4 = Very good; 3 = Good; 2 = Fair; 1 = Poor

(Circle your response.)
Correct Answers: b,c,d,a,d,b,b,c,a,d