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MOH Physiotherapy Licensure Exam (Jordan) study materials
MOH Physiotherapy Licensure Exam (Jordan) study resources

MOH Physiotherapy Licensure Exam (Jordan) practice questions

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Question 1Anatomy, Physiology, and Biomechanics

A patient sustains a fracture through the surgical neck of the humerus. Which nerve is most at risk because it runs in close relation to this region?

  1. Radial nerve
  2. Median nerve
  3. Musculocutaneous nerve
  4. Axillary nerve Correct answer.

Explanation

The axillary nerve winds around the surgical neck of the humerus together with the posterior circumflex humeral vessels, so fractures at this site commonly injure it. Clinically this produces deltoid weakness and sensory loss over the lateral shoulder. The other nerves listed travel at other levels of the limb.

Question 2Anatomy, Physiology, and Biomechanics

Which muscle is the primary flexor of the hip during the initial swing phase of normal gait?

  1. Adductor magnus
  2. Iliopsoas Correct answer.
  3. Gluteus maximus
  4. Biceps femoris

Explanation

Iliopsoas is the strongest hip flexor and initiates limb advancement during swing. Gluteus maximus extends the hip, adductor magnus adducts, and biceps femoris flexes the knee. Recognizing the prime mover guides strengthening in gait rehabilitation.

Question 3Anatomy, Physiology, and Biomechanics

Which type of synovial joint permits movement in only one plane, such as the elbow?

  1. Hinge joint Correct answer.
  2. Saddle joint
  3. Pivot joint
  4. Ball-and-socket joint

Explanation

A hinge (uniaxial) joint allows flexion and extension in one plane, as at the humeroulnar articulation. Ball-and-socket joints are triaxial, saddle joints are biaxial, and pivot joints allow rotation. Joint classification determines the range and type of motion a therapist can expect.

Question 4Anatomy, Physiology, and Biomechanics

During normal quiet inspiration, which muscle is the principal driver of thoracic volume expansion?

  1. Rectus abdominis
  2. External intercostals
  3. Diaphragm Correct answer.
  4. Sternocleidomastoid

Explanation

The diaphragm provides roughly 70-80% of the tidal volume during quiet breathing by descending and increasing vertical thoracic dimensions. The external intercostals assist but are not the principal muscle, and the others are accessory or expiratory muscles. This underpins breathing exercise prescription.

Question 5Anatomy, Physiology, and Biomechanics

Which structure forms the medial boundary of the anatomical snuffbox?

  1. Extensor pollicis brevis tendon
  2. Extensor pollicis longus tendon Correct answer.
  3. Abductor pollicis longus tendon
  4. Flexor carpi radialis tendon

Explanation

The anatomical snuffbox is bounded medially by the extensor pollicis longus tendon and laterally by the extensor pollicis brevis and abductor pollicis longus tendons. Tenderness here after a fall suggests scaphoid fracture. Knowing the borders improves clinical examination of the wrist.

Question 6Anatomy, Physiology, and Biomechanics

Which type of muscle contraction produces tension while the muscle lengthens?

  1. Isometric
  2. Eccentric Correct answer.
  3. Isokinetic
  4. Concentric

Explanation

An eccentric contraction occurs when external resistance exceeds the force generated, so the muscle lengthens while developing tension. Isometric contractions hold length constant, concentric contractions shorten the muscle, and isokinetic refers to constant angular velocity. Eccentric loading is central to tendon rehabilitation.

Question 7Anatomy, Physiology, and Biomechanics

Which ligament prevents anterior translation of the tibia on the femur?

  1. Anterior cruciate ligament Correct answer.
  2. Posterior cruciate ligament
  3. Lateral collateral ligament
  4. Medial collateral ligament

Explanation

The anterior cruciate ligament resists anterior tibial translation and limits tibial internal rotation. The posterior cruciate ligament resists posterior translation, while the collateral ligaments control varus and valgus stress. This distinction guides the anterior drawer test interpretation.

Question 8Anatomy, Physiology, and Biomechanics

Which nerve root level is most commonly assessed by the biceps brachii reflex?

  1. T1
  2. C7
  3. C5 Correct answer.
  4. C8

Explanation

The biceps reflex is mediated mainly by the C5 root through the musculocutaneous nerve. The triceps reflex assesses C7, while C8 and T1 contribute to intrinsic hand muscles. Accurate root mapping supports neurological screening in cervical radiculopathy.

Question 9Anatomy, Physiology, and Biomechanics

A patient with a complete lesion of the radial nerve at the mid-shaft of the humerus is expected to show which pattern of weakness?

  1. Weakness of elbow flexion and forearm supination
  2. Weakness of thumb opposition and thenar bulk
  3. Weakness of wrist extension and finger extension Correct answer.
  4. Weakness of shoulder abduction and external rotation

Explanation

The radial nerve supplies the wrist extensors and finger extensors, so mid-shaft injury produces wrist drop and grip impairment. Elbow flexion and supination are musculocutaneous functions, thenar muscles are median nerve, and shoulder abduction is axillary. This pattern localizes the lesion.

Question 10Anatomy, Physiology, and Biomechanics

When a patient rises from a chair, which biomechanical event occurs at the hip and knee?

  1. Hip flexion with knee extension
  2. Hip extension with knee flexion
  3. Hip and knee flexion
  4. Hip and knee extension Correct answer.

Explanation

Sit-to-stand requires concentric hip and knee extension to lift the center of mass over the feet. The trunk leans forward first to shift momentum, but the joint motion producing rise is extension at both joints. Understanding this guides task-specific training.

Question 11Anatomy, Physiology, and Biomechanics

Which structure is the primary stabilizer preventing anterior displacement of the humeral head during elevation?

  1. Long head of biceps tendon
  2. Inferior glenohumeral ligament Correct answer.
  3. Glenoid labrum
  4. Coracoacromial ligament

Explanation

The inferior glenohumeral ligament complex, especially its anterior band, is the main restraint against anterior humeral head translation with the arm abducted and externally rotated. The labrum deepens the socket, the coracoacromial ligament forms an arch, and the biceps tendon contributes little to anterior stability.

Question 12Anatomy, Physiology, and Biomechanics

A patient reports numbness over the palmar surface of the thumb, index, and middle fingers with nocturnal worsening. Which nerve is most likely compressed?

  1. Median nerve Correct answer.
  2. Axillary nerve
  3. Ulnar nerve
  4. Radial nerve

Explanation

The median nerve supplies sensation to the palmar thumb, index, middle, and radial half of the ring finger, and compression at the carpal tunnel causes nocturnal symptoms. The ulnar nerve affects the little finger and ulnar ring finger, while the radial and axillary nerves supply the dorsum and shoulder. This pattern is classic for carpal tunnel syndrome.

Question 13Anatomy, Physiology, and Biomechanics

During a squat exercise, the knee flexes while the foot remains flat on the floor. Which type of joint motion occurs at the ankle?

  1. Dorsiflexion Correct answer.
  2. Eversion
  3. Inversion
  4. Plantarflexion

Explanation

As the knee flexes in a squat with the foot flat, the tibia moves forward over the fixed foot, requiring closed-chain dorsiflexion at the talocrural joint. Plantarflexion would raise the heel, and eversion or inversion are frontal-plane motions not primarily responsible for this sagittal movement. This informs ankle mobility assessment in squat mechanics.

Question 14Anatomy, Physiology, and Biomechanics

Which muscle group acts as the primary dynamic stabilizer limiting anterior tibial translation during landing from a jump?

  1. Hamstrings Correct answer.
  2. Quadriceps
  3. Gastrocnemius
  4. Hip flexors

Explanation

The hamstrings co-contract with the quadriceps and generate posterior tibial shear that protects the anterior cruciate ligament during landing. Quadriceps contraction alone increases anterior tibial shear, while gastrocnemius and hip flexors do not directly control tibial translation. This principle supports hamstring strengthening in ACL injury prevention.

Question 15Anatomy, Physiology, and Biomechanics

Which type of collagen predominates in articular cartilage and provides tensile strength?

  1. Type I
  2. Type III
  3. Type IV
  4. Type II Correct answer.

Explanation

Hyaline articular cartilage is composed mainly of type II collagen, which forms a network resisting tensile forces, embedded in proteoglycan-rich ground substance. Type I dominates tendon and bone, type III appears in early repair tissue, and type IV is in basement membranes. This affects healing expectations after cartilage injury.

Question 16Anatomy, Physiology, and Biomechanics

A patient has weakness of ankle dorsiflexion and loss of sensation over the dorsum of the foot after a fibular neck injury. Which nerve is affected?

  1. Obturator nerve
  2. Sural nerve
  3. Common fibular nerve Correct answer.
  4. Tibial nerve

Explanation

The common fibular nerve winds around the fibular neck, where it is vulnerable to compression or trauma, producing foot drop and dorsal foot sensory loss. The tibial nerve supplies plantarflexors, the sural nerve is purely sensory, and the obturator nerve supplies the medial thigh. This localization guides orthotic and strengthening plans.

Question 17Anatomy, Physiology, and Biomechanics

Which lung volume cannot be measured by simple spirometry and requires body plethysmography or gas dilution?

  1. Tidal volume
  2. Expiratory reserve volume
  3. Inspiratory reserve volume
  4. Residual volume Correct answer.

Explanation

Residual volume is the air remaining after maximal expiration and cannot be exhaled, so spirometry cannot measure it directly. Tidal volume and the inspiratory and expiratory reserve volumes are all measurable by spirometry. Residual volume is needed to calculate total lung capacity.

Question 18Anatomy, Physiology, and Biomechanics

Which muscle is the primary external rotator of the shoulder and is commonly strengthened in rotator cuff rehabilitation?

  1. Pectoralis major
  2. Infraspinatus Correct answer.
  3. Subscapularis
  4. Teres major

Explanation

Infraspinatus, with teres minor, is a primary external rotator and a key rotator cuff stabilizer. Subscapularis is an internal rotator, teres major also internally rotates, and pectoralis major is a powerful internal rotator and adductor. Targeted external rotation strengthening addresses common shoulder impingement mechanisms.

Question 19Anatomy, Physiology, and Biomechanics

In a patient with a C6 complete spinal cord injury, which function is most likely preserved?

  1. Elbow extension
  2. Finger abduction
  3. Diaphragmatic breathing Correct answer.
  4. Wrist extension

Explanation

C6 lesions spare the C3-C5 phrenic nerve supply to the diaphragm, so independent breathing is preserved. Elbow extension is C7 (triceps), wrist extension is C6 and may be weak or absent depending on level, and finger abduction is T1. This mapping informs transfer and wheelchair training goals.

Question 20Anatomy, Physiology, and Biomechanics

Which factor most increases the risk of pressure injury over the ischial tuberosities in a seated patient?

  1. Frequent position changes
  2. Elevated room temperature
  3. Increased subcutaneous fat
  4. High interface pressure sustained over time Correct answer.

Explanation

Pressure injury results from sustained interface pressure exceeding capillary closing pressure, combined with shear and time. Increased subcutaneous fat and frequent repositioning are protective, and room temperature is not a primary determinant. This drives pressure-relief scheduling and cushion selection.

Question 21Anatomy, Physiology, and Biomechanics

During normal gait, at what point in the gait cycle does the center of mass reach its highest point?

  1. Double support
  2. Initial contact
  3. Toe-off
  4. Midstance Correct answer.

Explanation

The center of mass rises during single-limb support and peaks at midstance as the body vaults over the stance limb, then descends toward double support. Initial contact and toe-off occur at lower points of the cycle. This vertical oscillation is a key efficiency mechanism in gait analysis.

Question 22Anatomy, Physiology, and Biomechanics

Which structure is most responsible for the screw-home mechanism locking the knee in terminal extension?

  1. Pop muscle
  2. Medial meniscus
  3. Anterior cruciate ligament and meniscus together
  4. Anterior cruciate ligament Correct answer.

Explanation

Terminal knee extension is accompanied by external rotation of the tibia, the screw-home mechanism, which tightens the anterior cruciate ligament and the collateral ligaments to lock the joint. The menisci distribute load, and no single other structure produces the lock. Understanding this helps assess extension range and joint stability.

Question 23Anatomy, Physiology, and Biomechanics

A patient with a lesion of the superior gluteal nerve will most likely demonstrate which gait deviation?

  1. Scissoring from hip adductor spasticity
  2. Circumduction from hip flexion contracture
  3. Trendelenburg sign with pelvic drop on the contralateral side Correct answer.
  4. Steppage gait from foot drop

Explanation

The superior gluteal nerve supplies gluteus medius and minimus, so weakness causes pelvic drop on the unsupported side during stance, the Trendelenburg sign. Foot drop reflects common fibular nerve injury, and circumduction and scissoring reflect other mechanisms. This distinguishes myopathic from neuropathic hip abductor weakness.

Question 24Anatomy, Physiology, and Biomechanics

Which property of skeletal muscle describes the increase in force with increasing velocity of lengthening during active stretch?

  1. Force-velocity relationship in eccentric contraction Correct answer.
  2. Length-tension relationship
  3. Creep
  4. Stress-relaxation

Explanation

During active lengthening, muscle force rises as lengthening velocity increases, up to a limit, which is the eccentric limb of the force-velocity relationship. Length-tension describes force variation with sarcomere length, and stress-relaxation and creep are viscoelastic time-dependent behaviors. This explains why controlled eccentric loading is effective in tendon rehabilitation.

Question 25Anatomy, Physiology, and Biomechanics

Which change in the sarcomere explains the reduced force at very long muscle lengths on the length-tension curve?

  1. Increased ATP hydrolysis rate
  2. Reduced calcium release from the sarcoplasmic reticulum
  3. Decreased overlap between actin and myosin filaments Correct answer.
  4. Excessive actin-myosin crossbridge overlap

Explanation

At long sarcomere lengths, actin and myosin filaments are pulled apart so fewer crossbridges can form, reducing active force. Excessive overlap reduces force at short lengths, and calcium release and ATP hydrolysis are not the primary length-dependent determinants. This underpins optimal positioning in strengthening.

Question 26Anatomy, Physiology, and Biomechanics

A physiotherapy student is reviewing the mechanics of the patellofemoral joint. During open-chain knee extension from 90° to full extension, which statement best describes the patellar motion relative to the femur?

  1. The patella moves proximally along the femoral trochlea. Correct answer.
  2. The patella tilts laterally to increase the Q-angle.
  3. The patella moves distally along the femoral trochlea.
  4. The patella remains stationary while the tibia rotates.

Explanation

During open-chain knee extension, the tibia moves while the femur is fixed; the patella is pulled proximally by the quadriceps as the knee extends. This proximal glide increases the patellofemoral contact area in the trochlear groove. The patella does not move distally or remain stationary in this scenario.

Question 27Anatomy, Physiology, and Biomechanics

A 45-year-old patient reports a deep ache in the buttock that radiates down the posterior thigh after prolonged sitting. Which structure is most likely involved in producing this pain pattern?

  1. The femoral nerve compressed by the iliopsoas muscle
  2. The lateral femoral cutaneous nerve compressed at the inguinal ligament
  3. The obturator nerve compressed by the adductor longus
  4. The sciatic nerve compressed by the piriformis muscle Correct answer.

Explanation

Piriformis syndrome occurs when the piriformis muscle compresses the sciatic nerve, causing buttock pain that radiates down the posterior thigh. The femoral, obturator, and lateral femoral cutaneous nerves have different sensory distributions and are not typically compressed by the piriformis. This pattern is classic for sciatic nerve irritation in the gluteal region.

Question 28Anatomy, Physiology, and Biomechanics

A patient with a complete spinal cord injury at T4 performs a sit-to-stand transfer. Which biomechanical strategy is most likely to be observed compared with an uninjured individual?

  1. Reduced hip and knee extensor torque generation
  2. All of the above are expected compensations Correct answer.
  3. Greater forward trunk lean to shift the center of mass over the feet
  4. Increased use of the upper extremities to generate momentum

Explanation

Individuals with T4 complete spinal cord injury lack voluntary control of the lower extremities and trunk, so they rely on upper extremity momentum, excessive forward trunk lean, and have reduced hip and knee extensor torque during sit-to-stand. Therefore, all listed strategies are expected compensations. This question tests the integration of motor control and biomechanics in a clinical population.

Question 29Anatomy, Physiology, and Biomechanics

During a gait analysis, a patient demonstrates excessive anterior pelvic tilt during terminal stance. Which muscle group is most likely contributing to this deviation?

  1. Hip adductors
  2. Hip flexors
  3. Hip extensors Correct answer.
  4. Hip abductors

Explanation

Excessive anterior pelvic tilt during terminal stance can result from weak hip extensors, which fail to control the forward rotation of the pelvis. The hip flexors, abductors, and adductors do not primarily limit anterior pelvic tilt in this phase. Strengthening the hip extensors is a common intervention for this gait deviation.

Question 30Anatomy, Physiology, and Biomechanics

A patient with a complete lesion of the median nerve at the wrist is evaluated for grip strength. Which biomechanical consequence is most likely to impair power grip?

  1. Loss of wrist extension during grip
  2. Loss of finger flexion at the distal interphalangeal joints
  3. Loss of finger abduction
  4. Loss of thumb opposition and lateral pinch Correct answer.

Explanation

The median nerve innervates the thenar muscles, including the opponens pollicis, which are essential for thumb opposition and lateral pinch. Power grip requires stabilization of the thumb, so loss of opposition impairs grip strength. Finger flexion at the DIP joints is mainly ulnar nerve (via flexor digitorum profundus), wrist extension is radial nerve, and finger abduction is ulnar nerve.

Question 31Pathology and Medical Sciences Relevant to Physiotherapy

A 62-year-old man with chronic obstructive pulmonary disease has a barrel-shaped chest and prolonged expiration. Which pathophysiological change best explains his prolonged expiratory phase?

  1. Fibrotic stiffening of the chest wall
  2. Reduced residual volume with preserved tidal volume
  3. Increased elastic recoil of the lung parenchyma
  4. Loss of alveolar elastic recoil with airway collapse on expiration Correct answer.

Explanation

In COPD, destruction of elastin in alveolar walls reduces elastic recoil, so small airways collapse during expiration and expiratory time lengthens. This produces air trapping, hyperinflation and a barrel chest. Increased recoil and stiff chest wall would shorten, not prolong, expiration.

Question 32Pathology and Medical Sciences Relevant to Physiotherapy

Which finding on arterial blood gas most directly indicates that a patient with an acute asthma attack is developing ventilatory muscle fatigue?

  1. Falling arterial carbon dioxide with rising pH
  2. Stable oxygen saturation with rising bicarbonate
  3. Rising arterial carbon dioxide with a normal or falling pH Correct answer.
  4. Rising arterial oxygen with falling bicarbonate

Explanation

Early asthma produces hyperventilation with low PaCO2; a rising PaCO2 signals that the patient can no longer maintain the work of breathing and is tiring. This is a warning sign of impending respiratory failure. Rising oxygen and stable saturation do not indicate fatigue.

Question 33Pathology and Medical Sciences Relevant to Physiotherapy

A patient with type 2 diabetes mellitus reports burning pain and hypersensitivity in both feet. Which mechanism best explains these symptoms?

  1. Distal symmetrical sensory polyneuropathy from chronic hyperglycaemia Correct answer.
  2. Acute inflammatory demyelination of the facial nerve
  3. Compression of the common peroneal nerve at the fibular head
  4. Ischaemic necrosis of the plantar fascia

Explanation

Chronic hyperglycaemia damages small nerve fibres in a length-dependent pattern, producing symmetrical burning pain and hypersensitivity in the distal lower limbs. This is diabetic peripheral neuropathy. Focal compression or isolated nerve lesions would give a unilateral, territory-specific deficit.

Question 34Pathology and Medical Sciences Relevant to Physiotherapy

Which clinical feature most strongly suggests that a patient's low back pain is due to inflammatory spondyloarthritis rather than mechanical causes?

  1. Pain that improves with rest and worsens with activity
  2. Pain limited to a single episode after heavy lifting
  3. Pain radiating below the knee with a positive straight leg raise
  4. Pain that worsens at night and improves with movement and exercise Correct answer.

Explanation

Inflammatory back pain characteristically occurs at rest and at night and eases with movement, reflecting inflammatory rather than mechanical joint irritation. Mechanical back pain typically worsens with activity and improves with rest. Radicular pain suggests nerve root involvement instead.

Question 35Pathology and Medical Sciences Relevant to Physiotherapy

After a myocardial infarction, a patient develops a new pansystolic murmur and acute pulmonary oedema. Which complication is most likely?

  1. Constrictive pericarditis
  2. Aortic stenosis progression
  3. Left atrial myxoma
  4. Rupture of the interventricular septum Correct answer.

Explanation

Septal rupture after infarction creates a left-to-right shunt producing a harsh pansystolic murmur with sudden pulmonary oedema and cardiogenic shock. It is a mechanical complication requiring urgent surgical repair. Constrictive pericarditis and myxoma do not present acutely in this way.

Question 36Pathology and Medical Sciences Relevant to Physiotherapy

A patient with rheumatoid arthritis has persistent synovitis of the wrist. Which pathological process best explains the joint destruction?

  1. Crystal deposition within the synovial fluid
  2. Fibrous ankylosis without inflammation
  3. Pannus formation eroding cartilage and bone Correct answer.
  4. Avascular necrosis of the synovial membrane

Explanation

Rheumatoid arthritis produces a proliferating inflammatory pannus that erodes articular cartilage and subchondral bone. The process is autoimmune and chronic, leading to deformity. Crystal deposition describes gout, and fibrous ankylosis is a late non-inflammatory outcome.

Question 37Pathology and Medical Sciences Relevant to Physiotherapy

A 70-year-old woman with osteoporosis sustains a fragility fracture of the distal radius. Which factor most directly explains her increased fracture risk?

  1. Increased muscle mass with reduced joint stiffness
  2. Reduced bone mineral density with deterioration of trabecular architecture Correct answer.
  3. Increased collagen cross-linking in cortical bone
  4. Enhanced periosteal apposition with ageing

Explanation

Osteoporosis reduces bone mineral density and disrupts trabecular microarchitecture, lowering bone strength so low-energy trauma causes fracture. Fragility fractures at the wrist, hip and vertebrae are typical. Increased muscle mass and enhanced periosteal apposition would increase, not reduce, strength.

Question 38Pathology and Medical Sciences Relevant to Physiotherapy

A patient with a complete spinal cord injury at T4 develops sudden severe headache, sweating and hypertension during a bladder catheter change. Which mechanism explains this response?

  1. Uninhibited sympathetic outflow below the lesion with intact baroreflex above it Correct answer.
  2. Loss of vagal parasympathetic tone to the heart
  3. Adrenal insufficiency with compensatory tachycardia
  4. Direct cerebral vasodilation from hypercapnia

Explanation

Autonomic dysreflexia occurs with lesions above T6: noxious stimuli below the lesion trigger massive sympathetic discharge that cannot be modulated, while intact baroreceptors above cause bradycardia and flushing. The result is severe hypertension and headache. Adrenal insufficiency would cause hypotension.

Question 39Pathology and Medical Sciences Relevant to Physiotherapy

Which change in lung mechanics is expected in a patient with advanced pulmonary fibrosis?

  1. Reduced lung compliance with decreased total lung capacity Correct answer.
  2. Increased lung compliance with increased residual volume
  3. Normal compliance with air trapping
  4. Increased chest wall compliance with hyperinflation

Explanation

Fibrosis stiffens the lung interstitium, reducing compliance and restricting expansion, so total lung capacity and vital capacity fall. This is a restrictive pattern with a high work of breathing. Increased compliance with air trapping describes emphysema instead.

Question 40Pathology and Medical Sciences Relevant to Physiotherapy

A patient with chronic heart failure has bilateral ankle oedema, raised jugular venous pressure and basal crackles. Which pathophysiological sequence best explains these findings?

  1. Increased capillary oncotic pressure from hyperalbuminaemia
  2. Excessive renal potassium loss causing hypovolaemia
  3. Reduced cardiac output leading to neurohormonal activation and sodium and water retention Correct answer.
  4. Primary lymphatic obstruction with normal cardiac function

Explanation

Falling cardiac output activates the renin-angiotensin-aldosterone and sympathetic systems, causing sodium and water retention and raised filling pressures. The resulting congestion produces oedema, raised venous pressure and pulmonary crackles. Hypovolaemia and hyperalbuminaemia would not cause congestion.

Question 41Pathology and Medical Sciences Relevant to Physiotherapy

Which laboratory marker is most specific for acute myocardial infarction when measured 6 to 12 hours after symptom onset?

  1. C-reactive protein
  2. Troponin I Correct answer.
  3. Creatine kinase total
  4. Lactate dehydrogenase

Explanation

Cardiac troponin I is highly specific to myocardium and rises within hours of infarction, remaining elevated for days. Total creatine kinase is also found in skeletal muscle, so it is less specific. CRP and LDH are non-specific markers of inflammation and tissue damage.

Question 42Pathology and Medical Sciences Relevant to Physiotherapy

A patient with Parkinson's disease presents with festinating gait and difficulty initiating movement. Which pathological change best explains these features?

  1. Loss of dopaminergic neurons in the substantia nigra pars compacta Correct answer.
  2. Degeneration of anterior horn cells
  3. Loss of cerebellar Purkinje cells
  4. Demyelination of peripheral motor axons

Explanation

Parkinson's disease results from degeneration of dopaminergic neurons in the substantia nigra pars compacta, reducing striatal dopamine and disrupting basal ganglia motor control. This produces bradykinesia, rigidity and festinating gait. Anterior horn cell loss causes motor neuron disease.

Question 43Pathology and Medical Sciences Relevant to Physiotherapy

Two days after a stroke, a patient has flaccid hemiplegia with reduced reflexes on the affected side. Which explanation is most accurate?

  1. The lesion has spared the corticospinal tract
  2. Spinal shock with transient flaccidity precedes the development of spasticity Correct answer.
  3. Peripheral nerve injury has occurred simultaneously
  4. Spasticity always appears immediately after stroke

Explanation

After an upper motor neuron lesion, an initial period of flaccidity and reduced reflexes is followed by spasticity and hyperreflexia as the corticospinal tract loses descending inhibition. This transient flaccid phase is sometimes called spinal shock. Immediate spasticity is not the usual pattern.

Question 44Pathology and Medical Sciences Relevant to Physiotherapy

A patient with multiple sclerosis reports transient visual blurring with pain on eye movement. Which underlying process is most likely?

  1. Optic nerve demyelination with inflammation Correct answer.
  2. Acute glaucoma
  3. Vitreous haemorrhage
  4. Retinal detachment

Explanation

Optic neuritis is a common early feature of multiple sclerosis, caused by inflammatory demyelination of the optic nerve, producing painful visual loss that often improves. Demyelination slows conduction and may cause reduced colour vision. Glaucoma and retinal detachment produce different clinical pictures.

Question 45Pathology and Medical Sciences Relevant to Physiotherapy

Which feature distinguishes a complete rupture of the Achilles tendon from a partial tear on clinical examination?

  1. Presence of a palpable gap with a positive Thompson test Correct answer.
  2. Localized tenderness only at the insertion
  3. Mild swelling without weakness
  4. Pain on active plantarflexion with intact strength

Explanation

A complete Achilles rupture produces a palpable gap and a positive Thompson test, in which squeezing the calf fails to produce plantarflexion. Partial tears may retain some plantarflexion strength and lack a clear gap. Localized tenderness alone is non-specific.

Question 46Pathology and Medical Sciences Relevant to Physiotherapy

A patient with chronic kidney disease has muscle weakness and generalized fatigue. Which electrolyte disturbance most commonly contributes to this presentation?

  1. Hypochloraemia with metabolic alkalosis
  2. Hypercalcaemia with metabolic alkalosis
  3. Hypernatraemia with respiratory alkalosis
  4. Hyperkalaemia with metabolic acidosis Correct answer.

Explanation

Chronic kidney disease impairs potassium excretion and acid excretion, producing hyperkalaemia and metabolic acidosis, both of which contribute to weakness and fatigue. Reduced renal function also affects calcium and phosphate balance, but hyperkalaemia and acidosis are the classic contributors.

Question 47Pathology and Medical Sciences Relevant to Physiotherapy

A patient with a deep partial-thickness burn over the anterior thigh has intact sensation and blanches on pressure. Which statement about this wound is most accurate?

  1. It is full thickness because blanching is present
  2. It will heal without scarring because the dermis is intact
  3. It requires immediate escharotomy because the fascia is exposed
  4. It involves the epidermis and part of the dermis with preserved dermal appendages Correct answer.

Explanation

Deep partial-thickness burns damage the epidermis and part of the dermis while sparing deeper dermal appendages, allowing re-epithelialization but with scarring risk. Intact sensation and blanching indicate viable dermis. Full-thickness burns are insensate and do not blanch.

Question 48Pathology and Medical Sciences Relevant to Physiotherapy

Which pathophysiological mechanism best explains exercise-induced bronchoconstriction in a patient with asthma?

  1. Progressive alveolar destruction from elastase deficiency
  2. Reduced chest wall compliance during exertion
  3. Airway cooling and drying causing osmotic and thermal changes that trigger mast cell mediator release Correct answer.
  4. Permanent fibrotic narrowing of the bronchial wall

Explanation

Hyperventilation during exercise cools and dries the airway, causing osmotic and thermal changes that activate mast cells and release bronchoconstrictor mediators. This produces transient airflow limitation after exercise. Alveolar destruction and fibrosis are structural, chronic changes unrelated to acute exercise-induced narrowing.

Question 49Pathology and Medical Sciences Relevant to Physiotherapy

A patient with type 1 diabetes develops hypoglycaemia after exercise. Which physiological factor most contributes to this risk?

  1. Increased hepatic glucose output that exceeds muscle uptake
  2. Reduced muscle glucose uptake during exercise
  3. Impaired counter-regulatory glucagon response during and after exercise Correct answer.
  4. Excessive insulin secretion from residual beta cells

Explanation

In type 1 diabetes, the glucagon and adrenaline responses to falling glucose are often impaired, while exercise increases insulin-independent muscle glucose uptake. Together these predispose to hypoglycaemia during and after exercise. Residual beta cell function and reduced muscle uptake would not increase risk.

Question 50Pathology and Medical Sciences Relevant to Physiotherapy

A patient with chronic obstructive pulmonary disease has a resting oxygen saturation of 88 percent and a history of cor pulmonale. Which pathophysiological change explains the development of right heart failure?

  1. Left ventricular infarction causing backward failure
  2. Mitral stenosis reducing left atrial emptying
  3. Systemic hypertension increasing left ventricular afterload
  4. Chronic hypoxaemia causing pulmonary vasoconstriction and increased right ventricular afterload Correct answer.

Explanation

Chronic hypoxaemia and acidosis cause hypoxic pulmonary vasoconstriction and remodelling of pulmonary vessels, raising pulmonary artery pressure. The right ventricle must then work against a higher afterload, leading to cor pulmonale. Left-sided lesions cause different patterns of failure.