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MS/TBI Flashcards

1
Q

What is the description of a Rancho Los Amigos level of IV?
a. Localized response to stimuli
b. Confused with inappropriate behavior
c. Confused but appropriate behavior
d. Confused and agitated behavior

A

d. Confused and agitated behavior

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2
Q

What is the most common location of heterotopic ossification (HO) after traumatic brain injury (TBI)?
a. Shoulder
b. Knee
c. Hip
d. Elbow

A

a. Shoulder

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3
Q

Plasticity in response to one training experience can enhance the acquisition of similar behaviors
a. Specificity
b. Use it and improve it
c. Transference
d. Interference
e. None of these

A

c. Transference

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4
Q

Traumatic brain injuries (TBI) in elderly patients are most frequently due to:
a. Falls
b. Motor vehicle accidents
c. Alcohol (ETOH) abuse
d. Assault

A

a. Falls

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5
Q

This is NOT a feature of multiple sclerosis:
a. Clear mentation
b. Muscle weakness
c. Optic neuritis
d. Diplopia
e. Prominent fatigue

A

a. Clear mentation

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6
Q

The exacerbating-remitting pattern of multiple
sclerosis is characterized by:

a. A steady worsening of symptoms over time
b. Spasticity, fatigue and bladder dysfunction
c. Periods of impairment followed by partial
remission of symptoms
d. Periods of impairment followed by full or
partial remission of symptoms.
e. Evidence can be shown from the onset of
their symptoms

A

d. Periods of impairment followed by full or
partial remission of symptoms.

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7
Q

Exert their effects by inhibiting leukocyte proliferation, modulating cytokine production, and inhibiting T-cell migration across BBB, preventing disability in MS patients: (Young 486)

a. Natalizumab
b. Cyclophosphamide
c. Methotrexate
d. Interferon Beta
e. Glatiramer Acetate

A

d. Interferon Beta

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8
Q

In decerebrate posturing, there is:

a. Flexion of the upper and lower extremities
b. Extension of the upper and flexion of the
lower extremities
c. Flexion of the upper and extension of the
lower extremities
d. Extension of the upper and lower extremities

A

d. Extension of the upper and lower extremities

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9
Q

Of the following disorders of consciousness, which would have the best prognosis?
a. Coma
b. Vegetative state
c. Minimally conscious state
d. None of the above

A

c. Minimally conscious state

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10
Q

Uncal herniation would cause compression of:
a. Cranial nerve (CN) III
b. CN I
c. CN VII
d. CN X

A

a. Cranial nerve (CN) III

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11
Q

A traumatic brain injury (TBI) patient that is confused and inappropriate would be considered a Ranchos level:
a. IV
b. V
c. VI
d. None of the above

A

b. V

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12
Q

Which of the following tests is most useful for
evaluation of memory loss?
a. Mini Mental Status Examination (MMSE)
b. Galveston Orientation and Amnesia Test
(GOAT)
c. Ranchos Los Amigos Scale
d. Glasgow Coma Scale (GCS)

A

b. Galveston Orientation and Amnesia Test
(GOAT)

Memory loss –> amnesia

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13
Q

A clinical feature of normal pressure hydrocephalus (NPH) is:
a. Memory impairment
b. Urinary incontinence
c. Ataxic gait
d. All of the above

A

d. All of the above

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14
Q

According to the Glasgow Coma Scale (GCS), a
severe brain injury would be:
a. 13 to 15
b. 0 to 2
c. 8 to 12
d. 3 to 7

A

d. 3 to 7

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15
Q

What part of the central nervous system (CNS) is affected in multiple sclerosis (MS)?
a. Dendritic receptors
b. Axon
c. Terminal branches
d. Myelin sheath

A

d. Myelin sheath

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16
Q

Coup-contrecoup injuries in traumatic brain injuries (TBI) are typically concentrated in:
a. Frontal and parietal lobes
b. Frontal and temporal lobes
c. Occipital and parietal lobes
d. Subcortical structures

A

b. Frontal and temporal lobes

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17
Q

Severity of brain injury is most reliably indicated by:
a. Presence of seizure
b. Presence of vomiting
c. Chronic neck pain
d. Length of coma and amnesia

A

d. Length of coma and amnesia

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18
Q

Which is the best study for locating white matter plaque in multiple sclerosis or vascular infarcts?
a. Computed tomography (CT)
b. Electroencephalogram (EEG)
c. Magnetic resonance imaging (MRI)
d. Lumbar puncture (LP)

A

c. Magnetic resonance imaging (MRI)

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19
Q

Which of the following is true about Glasgow Coma Scale (GCS) in traumatic brain injury (TBI)?
a. A GCS of 2 is a severe injury
b. A GCS of 8 is a moderate injury
c. A GCS of 10 is a moderate injury
d. A GCS of 12 is a mild injury

A

c. A GCS of 10 is a moderate injury

Severe: 3-8
Moderate: 9-12
Mild: 13-15

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20
Q

Which are the most commonly injured areas of the brain after a traumatic brain injury (TBI)?
a. Occipital and frontal
b. Frontal and temporal
c. Parietal and frontal
d. Occipital and temporal

A

b. Frontal and temporal

Kasi si counter-coup injury rawr

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21
Q

Which of the following is not true about diffuse axonal injury (DAI)?
a. Primarily occurs at the grey matter
b. Only seen in traumatic brain injury (TBI)
c. Responsible for loss of conscience (LOC)
d. Occurs from acceleration-deceleration and
rotational forces
e. None of the above

A

a. Primarily occurs at the grey matter

White matter dapat

22
Q

A 28-year-old woman after motor vehicle accident sustained a traumatic brain injury (TBI). The impact of injury was to the right side of her head, and she now has visual changes consistent with an oculomotor cranial nerve (CN) dysfunction. What would the ocular
exam demonstrate?
a. Dilation of the ipsilateral pupil
b. Constriction of the ipsilateral pupil
c. Dilation of the contralateral pupil
d. Constriction of the contralateral pupil

A

a. Dilation of the ipsilateral pupil

23
Q

The TBI patient is in a heightened state of activity. Behavior is bizarre and nonpurposeful. Unable to cooperate directly with treatment efforts. Confabulation may present. Verbalizations are incoherent and inappropriate. This is the RLA level of:
a. Generalized response
b. Confused-inappropriate
c. Confused-agitated
d. Confused-appropriate

A

c. Confused-agitated

24
Q

Severe TBI presents with which of the following characteristics?
a. Initial GCS 13 to 15
b. No focal neurological deficit
c. Negative CT and/or MRI
d. Loss of consciousness, if any, 30 min or more

A

d. Loss of consciousness, if any, 30 min or more

25
Q

Most distinguishing feature of TBI?
a. Diffuse axonal injury
b. Contusions
c. Hypoxic-ischemic injury
d. Increased intracranial pressure

A

a. Diffuse axonal injury

26
Q

A physical therapist is working with a patient
recovering from traumatic brain injury (Rancho Los Amigos Levels of Cognitive Functioning Scale level VII). The best test to determine if this patient demonstrates progression to open skills is to have the
patient walk in which environment?
a. In the hallway
b. Across the busy hospital lobby
c. In the patient’s room
d. In the patient’s home

A

b. Across the busy hospital lobby

27
Q

In traumatic brain injury, diffuse axonal injury is responsible for the initial loss of consciousness. The most commonly affected area is the:
a. Corpus callosum
b. Periventricular region
c. Brainstem
d. Thalamus
e. Cerebellar tracts

A

a. Corpus callosum

28
Q

The Rancho Los Amigos “confused-appropriate” level of cognitive functioning is described as
a. The patient follows commands inconsistently
b. The patient has some goal directed behavior under direction
c. The patient’s behavior is appropriate but
somewhat robotic
d. The patient is confused and amnestic

A

b. The patient has some goal directed behavior under direction

29
Q

A 25-year-old male patient suffered from TBI. The patient reacts to stimuli in non-specific / stereotypic limited response. What RLA level of cognitive functioning does the patient have?
a. I
b. II
c. III
d. IV

A

b. II

30
Q

A patient had brain injury for the past two weeks PT evaluation shows that he can open his eyes upon command, localized pain and utter inapproriate words. The severity of this injury is:
a. Mild
b. Severe
c. A and B
d. Moderate
e. Normal

A

d. Moderate

31
Q

A physical therapist reviews the medical record of a patient recently admitted to an inpatient rehabilitation hospital. The patient sustained a traumatic head injury in a motor vehicle accident five weeks ago. The medical record indicates that the patient is often
disoriented and can frequently become agitated with little provocation. The MOST appropriate location for the therapist to make initial contact with the patient is:
a. in the patient’s room
b. in the physical therapy gym
c. in a private treatment room
d. in the physical therapy waiting room

A

a. in the patient’s room

32
Q

This is characteristic of mild traumatic brain injury.
a. Post traumatic amnesia of 24 minutes
b. none of these
c. Loss of consciousness of 30 hours
d. initial Glasgow Coma Scale of 10-13

A

a. Post traumatic amnesia of 24 minutes

33
Q

Using the Glasgow Coma Scale, what is the score of the patient with spontaneous eye opening, withdraws from painful stimulus and offers uncomprehensive sound?
a. 10
b. 8
c. 7
d. 9

A

a. 10

34
Q

A Glasgow Outcome Scale of 7 would indicate:
a. automatic appropriate
b. lower good recovery
c. purposeful appropriate
d. death
e. none of these

A

b. lower good recovery

35
Q

Brain herniation at foramen magnum, a progression of uncal herniation. This causes neck pain, stiffness, flaccidity, coma and alteration of pulse , RR and BP:
a. Uncal
b. Tonsillar
c. Central
d. Central and Tonsillar

A

b. Tonsillar

36
Q

Normal ICP
a. <20 mmHg
b. >20 mmHg
c. 4-15 mm Hg
d. 3 mm HG

A

c. 4-15 mm Hg

37
Q

Charcots triad Except
a. Scanning Speech
b. Resting tremor
c. Intention tremor
d. Nystagmus

A

b. Resting tremor

38
Q

Malignant MS
a. Disease in which the patient remains fully
functional in all neurological systems 15
years after onset
b. Rapid severe progression with relapses over
period of time
c. Marburg dse
d. AOTA

A

c. Marburg dse

39
Q

This is NOT a common impairment in Multiple
Sclerosis:
a. Ataxia
b. Fatigue
c. spasticity
d. deafness

A

d. deafness

40
Q

The most common cranial nerve involved in multiple sclerosis is:
a. CN II
b. CN I
c. CN X
d. CN VI

A

a. CN II

41
Q

The most common clinical course/pattern of multiple sclerosis is:
a. Relapsing-remitting with incomplete
remission
b. Benign
c. Relapsing-remitting with complete remission
d. Primary progressive

A

a. Relapsing-remitting with incomplete
remission

42
Q

The following are factors considered in poor
prognosis of multiple sclerosis, except:
a. Age of onset is less than 40 y/o
b. Multiple system involvement at onset
c. Cerebellar involvement
d. None of these

A

a. Age of onset is less than 40 y/o

43
Q

The Disability Scale used in assessing patients with Multiple Sclerosis:
a. Kurtzke
b. Karnoffsky
c. Rancho Los Amigos
d. FIM

A

a. Kurtzke

44
Q

All are not signs of better prognosis in a patient with MS, except: (Young 479)
a. male
b. >35 years old
c. Polysymptomatic
d. Initial sensory signs of optic neuritis
e. Rapid disease progression

A

d. Initial sensory signs of optic neuritis

45
Q

Characterized by progression of disability from onset, without plateaus or remissions or with occasional plateaus and temporary minor improvements. Patient does not experience acute attacks: (roth 379)
a. Relapsing-Remitting MS
b. Primary Progressive
c. Secondary Progressive
d. Progressive Relapsing
e. Marburg

A

b. Primary Progressive

46
Q

Hypersensitivity to minor stimuli
a. Dysesthetic limb
b. Hyperpathia
c. Lhermitte’s sign
d. AOTA

A

b. Hyperpathia

47
Q

Most important diagnostic tool in TBI
a. CT SCAN
b. NCM
c. MRI
d. Plaques

A

a. CT SCAN

48
Q

Least common type of MS?
a. RRMS
b. PPMS
c. SPMS
d. PRMS

A

d. PRMS

49
Q

Failure to drive specific brain functions can lead to functional degradation
a. Use it or lose it
b. Use it and improve it
c. Transference
d. Interference
e. None of these

A

a. Use it or lose it

50
Q

What is the Glasgow Coma Scale (GCS) for someone
who withdraws from pain, is confused, and opens
eyes to pain?
a. 6
b. 8
c. 10
d. 12

A

c. 10

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