Lec 08: Rehabilitation of Stroke

Question 1

T/F: There is usually extension synergy in the upper extremities after stroke.

Answer 1

F

UE - flexion
LE - extension

Question 2

This vessel is the most commonly involved in stokes.

A. middle cerebral artery
B. basilar artery
C. vertebral artery
D. anterior cerebral artery
E. posterior cerebral artery

Answer 2

A. MCA

Question 3

Enumerate three primary goals of rehabilitation in stroke.

Answer 3

prevent complications
minimize impairment
maximize function

Question 4

ID: This still ‘off label’ use drug has shown potential to promote neuroplasticity in the cerebral cortex for memory and learning.

Answer 4

dopamine

Meanwhile, SSRIs regulate memory, mood, sleep, and activate cortical motor areas.

Question 5

ID: This is the inability to identify objects in the hand.

Answer 5

astereognosia

Question 6

The following sign/s is/are strongly predictive of of aspiration post-stroke

A. severe dysphagia
B. abnormal pharyngeal sensation
C. abnormal gag reflex
D. A & B only
E. AOTA

Answer 6

D.

Abnormal gag reflex is a poorly reliable predictor of aspiration.

Question 7

This is the best management for upper limb complex regional pain syndrome (UE-CRPS).

A. tramadol and gabapentin
B. desensitization
C. early mobilization
D. stellate ganglion block
E. transcutaneous electrical nerve stimulation

Answer 7

C. early mobilization

Question 8

The following are included in the Braden scale for risk of pressure ulcers EXCEPT

A. sensory perception
B. moisture
C. nutrition
D. blood pressure
E. NOTA

Answer 8

D. blood pressure

Risk factors include:

sensory perception
moisture
activity
mobility
nutrition
friction and shear

Question 9

ID: What is the main sign/symptom of deep vein thrombosis?

Answer 9

leg swelling

Question 10

In 95% of stroke survivors, the best neurologic level is typically achieved after how many weeks?

A. 6 weeks
B. 9 weeks
C. 11 weeks
D. 15 weeks
E. NOTA

Answer 10

C. 11 weeks

This however may vary depending on the severity of the stoke.

Question 11

The affected limb in stoke should be mobilized or used for how long in one day?

A. 50% of waking hours
B. 60% of waking hours
C. 70% of waking hours
D. 80% of waking hours
E. 90% of waking hours

Answer 11

E. 90% of waking hours

Question 12

ID: This is a treadmill location training with assistance of a robot-drive gait orthosis.

Answer 12

Lokomat

Question 13

Urinary incontinence has higher incidence in patients with

A. increased age
B. increased stroke severity
C. presence of diabetes
D. A & B only
E. AOTA

Answer 13

E. AOTA

Question 14

ID: This antidepressant also improves motor strength and can help in motor recovery.

Answer 14

fluoxetine

Question 15

Enumerate the two scales used for neurologic and cognitive status assessment.

Answer 15

NIHSS (NIH Stroke Scale)

GCS (Glasgow Coma Scale)

Question 16

True of neuroplasticity EXCEPT

A. allows structural reorganization
B. restitution of partially damaged pathways
C. reduction of representational brain maps
D. modification of neuronal network
E. NOTA

Answer 16

C.

Representational brain maps are EXPANDED due to recruitment of latent neurons.

Question 17

This functional assessment score measures functional independence in personal care and mobility.

A. barthel index score
B. modified rankin score
C. glasgow outcome score
D. inchiong functional score
E. NOTA

Answer 17

A. barthel index score

Question 18

This is the gold standard in determining whether other stroke scales have good construct validity

A. barthel index score
B. modified rankin score
C. glasgow outcome score
D. inchiong functional score
E. NOTA

Answer 18

C. glasgow outcome score

Question 19

Early mobilization can prevent the following EXCEPT

A. deep vein thrombosis
B. skin breakdown
C. constipation
D. pneumonia
E. NOTA

Answer 19

E. NOTA

Question 20

ID: This must be integrated in the management of all stroke patients.

Answer 20

rehabilitation program

Question 21

When should the rehabilitation program start in stroke patients?

A. as soon as medical / surgical intervention is completed
B. as soon as the patient is medically stable
C. as soon as two weeks after the intervention
D. as soon as the patient regain basic reflexes
E. NOTA

Answer 21

B. medically stable

Question 22

This is the most common complication of stroke.

A. deep vein thrombosis
B. motor impairment
C. communication impairment
D. sensory deficits
E. cognitive deficits

Answer 22

B. motor impairment

Question 23

ID: Communication impairment usually presents as

Answer 23

slurring of speech

Question 24

ID: This is the most basic test for dysphagia screening.

Answer 24

simple bedside swallowing evaluation (GUSS)

Question 25

The patient is at risk for ulcer in the braden scale in less that

A. 14
B. 15
C. 16
D. 17
E. depends on the type of lesion

Answer 25

C. 16