Sample review questions with explanations from our Part 1 Chiropractic Board Review.

Part 1 Chiropractic Board Review: Chemistry (sample review questions) 1. Which enzyme catalyzes 2-phosphoglyceric acid into phosphoenolpyruvic acid in glycolysis? a. pyruvate kinase b. enolase c. hexokinase d. triose phosphate isomerase The correct answer is enolase. Phosphoenolpyruvic acid becomes pyruvic acid by the use of the enzyme, pyruvate kinase, in step 10 of glycolysis. Dihydroxyacetone phosphate becomes glyceraldehyde 3-phosphate by use of the enzyme, triose phosphate isomerase. Glycolysis is a series of reactions or steps that breaks down glucose into 2 pyruvate molecules. Glucose is a six carbon molecule, and pyruvate is a 3 carbon molecule. 2. In tryptophan degradation, which enzyme is utilized to convert N-formylkynurenine into kynurenine? a. phenylalanine hydroxylase b. kynureninase c. formamidase d. tryptophan-2,3-dioxygenase The correct answer is formamidase. Phenylalanine hydroxylase is used in phenylalanine degradation to change phenylalanine into tyrosine. In the breaking down of tryptophan or tryptophan degradation, 3-hydroxykynurenine is changed to 3-hydroxyanthranilate and alanine by the help of the enzyme, kynureninase. In tryptophan degradation, tryptophan is changed to N-formylkynurenine by the use of the enzyme, tryptophan-2,3-dioxygenase.

Part 1 Chiropractic Board Review: Pathology (sample review questions) 3. Short statue, neck webbing, and coarctation of the aorta are signs associated with which of the following genetic disorders? a. Klinefelter syndrome b. Turner syndrome c. alkaptonuria d. Ehlers-Danlos syndrome The correct answer is Turner syndrome. Other signs or symptoms of Turner syndrome include wide chest, amenorrhea, infertilty, and excessively low hairline on the back of the neck. Turner syndrome occurs only in females. Alkaptonuria is a genetic disorder where there is too much buildup of homogentistic acid. The excessive amounts of homogentistic acid causes recently excreted urine to appear black over time upon exposure to air. There is a genetic defect in the HGD gene in alkaptonuria. With alkaptonuria, there is a buildup of homogentistic acid in the body because of the absence of the enzyme homogentistic oxidase. Homogentistic oxidase changes homogentistic acid to methylacetoacetic acid. Tyrosine is not broken down properly in patients with alkaptonuria. Alkaptonuria can result in osteoarthritis. Dermatosparaxis, arthrochalasia, kyphoscoliosis, vascular hypermobility, and classical are 5 types of Ehlers-Danlos syndromes. The classical type of Ehler-Danlos syndrome consists of skin that bruises easy, hyperextensibility of the skin, and hypermobility of the joints. 4. Signs or symptoms include pain, swelling, increased alkaline phosphatase, and Codman's triangle. A malignant bone tumor is present either in the arm or leg in the metaphyseal region of a 19-year-old male. Which condition does this describe? a. multiple myeloma b. Ewing's sarcoma c. osteosarcoma d. chondrosarcoma The correct answer is osteosarcoma. Multiple myeloma, Ewing's sarcoma, osteosarcoma, and chondrosarcoma are all malignant bone tumors. The most common site for osteosarcoma is around the knee. Most patients with osteosarcoma are between 10 and 30 years of age. However, this condition is also observed in elderly patients. Osteosarcoma usually affects the metaphyseal location in bone in the arms and legs. Radiologic signs of osteosarcoma are Codman's Triangle and cumulus cloud appearance. Punched out lesions in bone, Bence-Jones protein, osteopenia, and anemia are observed with mulitple myeloma. Ewing's sarcoma occurs in males between the ages of 10-26 years of age. It occurs most commonly in bones of the femur and tibia. Signs or symptoms are fever, increased ESR, and increase in white blood cells. Radiologic signs include onion skin appearance. Chondrosarcoma occurs usually in males between 40 and 60 years of age. Popcorn matrix calcification, endosteal scalloping, and pain are signs of chondrosarcoma. Chondrosarcoma commonly occurs in the femur, humerus, and pelvis.

Part 1 Chiropractic Board Review: Physiology (sample review questions) 5. Which of the following neuroglia form myelin in the CNS? a. microglia b. oligodendrocytes c. astrocytes d. ependymal cells The correct answer is oligodendrocytes. The CNS is made of the spinal cord and brain. Oligodendrocytes, astrocytes, ependyma, and microglia are all neuroglia of the CNS or cells of the CNS. Microglia are macrophages that can destroy bacteria in the brain. Ependymal cells create a lining around the ventricles of the brain and also the spinal cord. It also helps with CSF circulation. The blood-brain barrier is formed by astrocytes. 6. Which is a sensory tract or pathway that carries nerve impulses for proprioception that is subconscious to the cerebellum? a. anterior spinothalamic tract b. medial lemnicus pathway c. posterior spinocerebellar tract d. lateral corticospinal tract The correct answer is posterior spinocerebellar tract. The anterior spinothalamic tract carries sensations such as itch, pressure, and touch. It is a sensory tract. The medial lemnicus pathway transmits sensation to the cerebrum. It is responsible for two-point discrimination, light touch, weight discrimination, and proprioception that is conscious. The fasciculus gracilis and fasciculus cuneatus are part of the medial lemniscus pathway.

Part 1 Chiropractic Board Review: Spinal Anatomy (sample review questions) 7. Which of the following is not innervated by cranial nerve 10? a. arytenoid b. cricothyroid c. stylohyoid d. thyroarytenoid The correct answer is stylohyoid. The arytenoid, cricothyroid, and thyroarytenoid are all intrinsic muscles of the larynx and are all innervated by the vagus nerve or cranial nerve 10. The posterior cricoarytenoid and lateral cricoarytenoid are also intrinsic muscles of the larynx thar are innervated by cranial nerve 10. The stylohyoid is innervated by cranial nerve 7. The stylohyoid is responsible for hyoid bone elevation. 8. All of the following are part of the levator ani except: a. puborectalis b. iliococcygeus c. coccygeus d. pubococcygeus The correct answer is coccygeus. The pelvic floor is composed of the levator ani and the coccygeus. Muscles of the pelvic floor are responsible for the ability to defecate, cough, lift objects, and forced expiration. The muscles of the pelvic floor are also important for a person's ability to have control when to defecate and urinate. If the pelvic floor is weak, urination, defecation, lifting objects, and even walking can be painful.

Part 1 Chiropractic Board Review: General Anatomy (sample review questions) 9. Which of the following is innervated by the tibial nerve and has an insertion of the medial condyle and lateral condyle of the femur? a. tibialis anterior b. soleus c. gastrocnemius d. peroneus tertius The correct answer is gastrocnemius. The gastrocnemius has an insertion of the Achilles tendon. Leg flexion and plantarflexion of the foot are actions of the gastrocnemius. The soleus has a nerve supply of the tibial nerve. Plantarflexion is the action of the soleus. It has an origin of the tibia and the fibula head. It also has an insertion of the Achilles tendon. The peroneus tertius is innervated by the deep peroneal nerve. The 5th metatarsal is the insertion for the peroneus tertius. The peroneus tertius has an origin of interosseus membrane and lower fibula. Peroneus longus has an insertion of the first cuneiform and first metatarsal. 10. The medial plantar nerve innervates which of the following foot muscles? a. medial lumbrical b. extensor digitorum brevis c. plantar interossei d. soleus The correct answer is the medial lumbrical. There are four foot lumbricals. The three lateral lumbricals are innervated by the lateral plantar nerve, and the one medial lumbrical is innervated by the medial plantar nerve which is located on the 2nd toe. The lumbricals have actions of flexion of the metatarsophalangeal joints and extension of the interphalangeal joints. The insertion of the foot lumbricals is extensor digitorum longus tendons, and the origin is the flexor digitorum longus tendons. The extensor digitorum brevis has a nerve supply of the deep peroneal nerve. It has an origin of the calcaneus. The action of the flexor digitorum brevis is extension of the big toe, 2nd toe, 3rd toe, and 4th toe. The plantar interossei is innervated by the lateral plantar nerve. Actions of the plantar interossei include adduction of the 5th toe, 4th toe, 3rd toe, and proximal plalangeal flexion. The soleus is innervated by the tibial nerve and responsible for foot flexion.

Part 1 Chiropractic Board Review: Microbiology (sample review questions) 11. Trypanosoma cruzi is a protozoan parasite that causes which of the following? a. toxoplasmosis b. Chagas disease c. Malaria d. African Sleeping Sickness The correct answer is Chagas disease. Transmission of Chagas disease occurs by a reduvid bug bite that is infected with Trypanosoma cruzi. Chagas disease occurs more often in South America. Kissing bugs called triatomids transmit this disease from animals to humans. The site of infection can cause a chagoma which is an erythematous nodule. The heart also can get enlarged in Chagas disease. P.Falciparum usually causes the most serious type of malaria. Signs or symptoms include pulmonary edema, renal failure, extreme anemia, and death. Toxoplasmosis can cause abscesses in the brain. Tsetse fly bite is the mode of transmission for African sleeping sickness. African sleeping sickness can cause headache, fever, and cachexia. 12. Ingestion of undercooked pork is the mode of transmission for which of the following? a. Hookworm disease b. Trichinellosis c. Lymphatic filariasis d. Schistosomiasis The correct answer is Trichinellosis. Trichinellosis is caused by Trichinella spiralis. Signs or symptoms of trichinellosis are constipation, nausea, vomiting, and pain in the intestines. Hookworm disease is caused by Ancylostoma duodenale or Necator americanus which are hookworms. Walking barefoot on the soil is a risk factor in getting Hookworm disease. The filariform larvae from an Ancylostoma duodenale or Necator americanus can go into the bottom of the soles of the feet when one walks on soil. Lymphatic filariasis has a mode of transmission of the a mosquito bite. Wuchereria bancrofti causes lymphatic filariasis. Elephantiasis is the classic sign of lymphatic filariasis. Schistosomiasis has a mode of transmission of cercariae from the blood fluke Schistosoma mansoni going into the skin of a human being.