Canadian Chiropractic Examining Board | Conseil canadien des examens chiropratique

1. A chiropractor is taking the history of his 21-year-old male patient who was involved in a roll over motor vehicle accident three years ago. He suffered from a number of injuries as a result of the accident including a laceration to the front of the right ear that damaged one of his jaw muscles, damage to the middle ear and a fractured cribriform plate in the head. Since the injury he has had difficulty smelling and tasting food, hearing out of his right ear and chewing tough food. He also gets recurrent sinus congestion and post-nasal drip that causes him to have coughing fits. Which of the following historical factors provided is most likely due to the fracture he suffered in the accident?

2. A 60-year-old man is experiencing chronic low back pain, and his lumbar radiographs reveal moderate degenerative changes of the L5-S1 facet joints. The chiropractor makes the assumption that the facet joints are likely a source of pain for which the nociception may be arising from the plexus of nerve fibers that innervate the joints. From which neurological structure do these nociceptors originate from?

3. A 29-year-old male bodybuilder is experiencing numbness and tingling on the inside half of his forearm. On sensory testing, he has impaired sensation of the medial half of his forearm to the wrist. Which of the following cords of the brachial plexus does the nerve involved originate from?

4. A chiropractor suspects that a 24-year-old female soccer player strained her biceps femoris tendon during a game yesterday. The chiropractor is palpating the posterior aspect of the tendon, and in doing so compressed a nerve that provoked tingling in the patient’s big toe. Which of the following nerves did the chiropractor compress?

5. A lumbar spine MRI scan confirms the presence of an L4/L5 intervertebral disc herniation in a 35-year-old female patient with chronic back and leg pain. By which of the following mechanisms has the intrinsic load bearing function of this structure been lost?

6. A 54-year-old female has difficulty abducting her right leg due to trochanteric bursitis. In which plane of movement is she limited?

7. The mother of a 3-month-old male is complaining of her child’s runny nose and sore throat. Upon an examination his pharynx appears red and his tonsils are swollen. It is suspected that he has a bacterial infection that is causing his symptoms. Which of the following antibodies passed through the placenta and will be largely responsible for his immune response to the infection?

8. A 19-year-old male comes into the clinic feeling extremely unwell. He reports that he has had seizures, headaches and a stiff neck. The lab results show that he has been exposed to the eggs of Taenia solium. How would he have contracted this infection?

9. This morning, a 69-year-old woman experienced an attack of vertigo when she went from a lying to sitting position. The attack lasted about a minute and resolved on its own. She was fine for the rest of the morning until she looked up to see inside a top cupboard. When she did this, she had another attack of vertigo that settled after about one minute. She denies any hearing loss, tinnitus, fullness in her ear or previous attacks. Which of the following is the most likely etiology for her complaints?

10. A 50-year-old female awoke with a stiff neck and came into the chiropractic office for assessment. During the history, she is observed to have an arm tremor. During the examination, she exhibited spastic paralysis of her right arm. Which of the following neurological systems in the brain is most likely affected?

11. A 14-year-old rugby player comes into the office two weeks after he dislocated his right shoulder during a rugby game. The shoulder self-relocated upon examination by the athletic trainer at the game; however, he was unable to continue playing. He was sent to the hospital as a precaution where he was assessed and discharged with medications, an arm sling, and instructions to go for rehabilitation. Upon chiropractic examination, the chiropractor finds that there is atrophy in the deltoid, weakness with elbow extension and shoulder external rotation. What peripheral nerve was damaged as a result of the shoulder injury?

12. A 38-year-old woman suffers from recurrent bilateral hand stiffness and swelling as a result of rheumatoid arthritis. Her chiropractor recommended modifying her diet to include foods that are high in omega 3 fatty acids. Which of the following should she add to her diet?

13. A 44-year-old female is at the chiropractic office for an assessment related to some chronic mild left lower back pain. During the history she remarks that she has a mild pain in the pit of her stomach and in the upper right part of her belly. The pain spreads to her right upper back and shoulder blade area. Sometimes the pain is severe and it may be steady or it may come and go. It also may get worse when she eats. Her medical doctor has been sending her for various organ function tests to determine the cause of her problems. What organ should the medical doctor assess?

14. A 66-year-old woman is suffering constant fatigue accompanied by constant achiness localized to the left sacral region. Lumbar and pelvic radiographs revealed numerous lytic punched out lesions in the sacrum and left ilium. A biopsy was obtained that showed the normal marrow cells largely replaced by neoplastic plasma cells. Blood and urine tests were also obtained from the patient. Which of the following results was observed on the additional tests?

15. A 40-year-old man injured his low back three days ago. Initially his medical doctor prescribed 25 mg per dose of an analgesic medication. At this level the patient did not have any benefit. He returned to his medical doctor who changed his medication but kept the same dose. With this new drug the patient was able to obtain some relief. Which of the following describes why the second drug was better for the patient?

16. A 70-year-old woman has been feeling a lot of aches and pains throughout her back. Along with these aches and pains, she has been feeling nauseous, gets confused easily, and feels tired and weak. A trip and fall resulted in a compression fracture at T9 due to marked osteoporosis. To help improve her symptoms the medical doctor prescribed calcitonin. What effect does this drug have on this patient?

17. A chiropractor observes that the lower leg and foot of a 50-year-old male patient is swollen. The chiropractor confirms that pitting edema is present in the patient’s lower leg and foot. Further examinations raise the suspicion that the patient has developed a deep vein thrombosis. Which of the following is a physiological step that caused the development of the vascular condition?

18. A 47-year-old female is lying in the fetal position on the treatment table when the chiropractor walks in the room for an assessment. On the pain diagram the patient has circled her whole body as hurting, with sharp achy pains in her low back, and shooting pains into her legs and up her back. She explains that she has had chronic low back pain since her car accident five years ago. It is daily pain that never goes away. She related that she has had a number of tests that show nothing is wrong with her back and her doctor said he cannot do anything else other that keep her on pain killers. She has a hard time moving around because of the back pain, and often lies in bed. As she is explaining this to the chiropractor she starts to cry and is wondering how to cope with the problem. Which of the following strategies may be beneficial for her condition?

19. A 23-year-old female comes into the office for her monthly adjustment. She comments to her chiropractor that she has joined a gym and the trainer is going to determine if the fat composition of her body is excessive. Which of the following techniques will most accurately determine this information?

20. An exercise physiologist is studying the effects of distance cycling on aerobic capacity. She recruits 60 subjects for her study and divides them into three groups: Group A has had no distance training, Group B cycles 48 km per week, and Group C cycles 96 km per week. She then compares the results of all three groups basing her conclusions on how much cycling was done. What type of study design is this research study?