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PM&R > Misc > Flashcards

Misc Flashcards

1
Q

Spasticity is a ______ disorder characterized by an abnormal, _______-dependent increase in tonic stretch reflexes

A

motor;

velocity

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2
Q

Where does baclofen act? Main SE? Symps of withdrawal?

A

GABA agonist at GABA-B receptors;
can cause sedation/drowsiness, lowers seizure threshold;
can get seizures, hallucinations, rebound spasticity, “itchy, bitchy, twitchy”

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3
Q

Two agents used as chemoneurolysis?

A

Phenol and ethyl alcohol;

phenol will require higher concentrations for chemical denervation and neurolysis

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4
Q

Peak effect and duration overall for botox?

A

4-6 weeks;

Can last 2-6 months

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5
Q

What does SPLATT stand for and treat?

A

Split Anterior Tibial Tendon Transfer;

Treats equinovarus deformity of the foot due to spasticity of tib ant

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6
Q

Classic symps of Parkinson’s?

A 
TRAP:
Tremor (resting)
Rigidity (cogwheel)
Akinesia (bradykinesia)
Postural instability (tendency to fall to side or backward)
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7
Q

Some surgical treatments for Parkinson’s?

A
  1. Destructive (includes thalamotomy and pallidotomy)

2. DBS (preferred): thalamic reduces tremor on contralateral side, while pallidal controls all the cardinal symptoms

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8
Q

Why SLP eval for Parkinson’s?

A

Evaluate for oropharyngeal dysphagia

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9
Q

For progressive supranuclear palsy, what is a hallmark sign and earliest symptom?

A

Supranuclear ophthalmoparesis;

gait and balance impairment

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10
Q

What is multiple system atrophy characterized by?

A

Combo of parkinsonism, cerebellar dysfunction, autonomic failure (CAP)

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11
Q

Inaccurate measurements of wheelchairs are major contributing factor to

A

increased deformity;
pressure injury development;
patient discomfort

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12
Q

How wide should seat width be for wheelchair?

A

Approx 1 inch wider than hip width; avoid pressure injury at greater trochanter of hips

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13
Q

Why is seat height in foot drive, or hemi-plegic height WC, lower?

A

Allows unaffected leg to propel the chair

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14
Q

What is the most commonly prescribed armrest for WC?

A

Removable desk length armrest

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15
Q

Benefits of tilt and space compared to recliner?

A

Patient remains in same position, but orientation in space changes; shear forces are minimized, and pressure re-distributed from seating surface to back support;
get pain relief, can remain seated during weight shifts, can mobilize secretions, smaller turning radius

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16
Q

How much should the WC system tilt to redistribute sufficient pressure for weight shift?

A

Ideally at least 45 degrees

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17
Q

For adjustable axle, what happens with moving it forward?

A

Allows for more efficient wheelchair propulsion; also can do wheelies

  1. Less rolling resistance
  2. Less energy to propel
  3. Smaller the turning radius
  4. Less stable the chair
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18
Q

What happens with moving axle posteriorly?

A
  1. Increased rolling resistance
  2. More energy required for propulsion
  3. Greater turning radius
  4. Stable chair
  5. Need more extension at GH joint
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19
Q

Better tire for carpeting, pneumatic or solid rubber tires?

A

Pneumatic (carpeting increases rolling resistance by factor of 4; the tires provide cushioning for outdoor use)

20
Q

Advantages for camber?

A
  1. Maximize lateral stability of the WC
  2. Low degrees of camber make WC easier to propel
  3. Protects hands of user
21
Q

What does a smaller caster mean for WC?

A

Smaller turning radius, does poorly on outdoor surfaces and carpets as it can get stuck

22
Q

Moving caster placement more posterior

A
  1. decreases turning radius
  2. increases maneuverability
  3. decreases stability
23
Q

How are footrests measured? How far off the floor should they be?

A

Distance from heel to under surface of thigh at popliteal fossa;
should have 2 inches of clearance from the floor

24
Q

What is the most common cause of osteomalacia?

A

Vitamin D deficiency

25
Q

What is the female athlete triad?

A

Disordered eating, menstrual disorders, low BMD

26
Q

Gold standard for bone mineral density measurement testing?

A

DEXA

27
Q

Calcitonin acts through what mechanism?

A

Inhibits osteoclastic activity;

can decrease pain in acute compression fx

28
Q

Burns are number ___ cause of accidental death for those under age of 2; What about for ages 4 and 19 or less, respectively?

A

1;
2;
3

29
Q

Inflammatory mediators released upon thermal injury

A
  1. Histamine
  2. Prostaglandins
  3. Thromboxane
  4. Catecholamines
30
Q

Rule of nines for burns

A 
Head = 9% BSA;
Each UE = 9%;
Each LE = 18%;
Anterior trunk = 18%;
Posterior trunk = 18%;
Perineum = 1% BSA
31
Q

Consequences of burn injury if epidermis compromised?

A
  1. Decreased protection
  2. Increased water loss
  3. Microorganism growth
  4. Entry of noxious agents
  5. Repeated sunburn
32
Q

Splint positioning for elbow burns? Dorsal hand burns?

A

Elbow extended and forearm supinated;
Wrist in 15-20 degrees extension, MCP in 60-70 degrees flexion, PIP and DIP in full extension; thumb in slight IP flexion and palmar abduction

33
Q

Should splinting be prescribed for exposed tendons and joints?

A

Yes

34
Q

Most common site of HO in adults after burns?

A

Elbows, followed by shoulder

35
Q

Management for MRSA furunculitis in burn patient?

A

I&D, may need abx

36
Q

How long should compression garments be worn on burn sites and at what pressures?

A

23 hr/day at least, need at least 25 mmHg

37
Q

Difference between comparative and non-comparative justice?

A

Comparative: allocation of resources based on needs or wants;
non-comparative: favors equal share over individual needs

38
Q

For MS, preg _______ relapses but then ________ after delivery; any changes in long-term prognosis?

A

decreases; increases;

no

39
Q

Four types of MS; which is most common, and what is worst prognosis?

A

Primary progressive, relapsing-remitting, secondary progressive, clinically isolated syndrome;
RRMS most common;
primary progressive worst prognosis

40
Q

Better prognosis for MS?

A 
Monosymptomatic;
sudden, good recovery with long remission;
sensory optic neuritis;
longer, more complete remissions;
female
41
Q

Most prevalent symps of MS?

A
  1. Bladder and bowel dysfunction
  2. Fatigue (central)
  3. Pain
42
Q

Clinical findings for MS?

A

Lesions scattered in time and space based on clinical findings, or clinical finding with MRI finding

43
Q

Fatigue in MS worsens with increased

A

temperature, stress, and activity (TSA)

44
Q

Medication of choice for central spasticity in MS?

A

Baclofen

45
Q

What are the neurogenic bladder types in MS? Most common?

A

Failure to store, failure to empty, combination bladder;

failure to store

46
Q

IQ of MS patients is usually

A

intact, especially early on; processing speed often delayed

PM&R (12 decks)

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