PRELIMS: Reviewer [2] Flashcards
A patient demonstrates difficulty maintaining balance on an unstable surface during the CTSIB. Which muscle group is most likely to compensate during forward sway?
A) Gastrocnemius
B) Quadriceps
C) Abdominals
D) Hip flexors
Hip flexors
Which finding during motor function testing would most strongly suggest a lesion in the anterior horn cells?
a. Intention tremor and dysmetria
b. Muscle fasciculations and atrophy
c. Hyperreflexia and clonus
d. Spasticity and rigidity
b. Muscle fasciculations and atrophy
A patient with diabetic neuropathy exhibits significant instability in the CTSIB condition 4 (eyes open on a foam surface). What does this indicate about their balance strategy?
a.Over-reliance on somatosensory inputs
b.Poor proprioceptive feedback
c.Dependence on visual inputs
d.Impaired vestibular function
b.Poor proprioceptive feedback
Which assessment finding would most likely indicate impaired anticipatory postural control?
a. Difficulty maintaining balance on an unstable surface
b. Excessive sway during quiet standing
c. Instability when catching a weighted ball
d. Reduced reach distance in the Functional Reach Test
d. Reduced reach distance in the Functional Reach Test
Which system is primarily responsible for detecting the body’s position and motion in relation to the support surface?
a.Visual system
b.Motor system
c.Vestibular system
d.Somatosensory system
d.Somatosensory system
During the Sensory Organization Test (SOT), what does a low equilibrium score in conditions 5 and 6 indicate?
a. Visual dependency
b. Cognitive impairment
c. Vestibular dysfunction
d. Somatosensory dependency
c. Vestibular dysfunction
During a sensory examination, a patient is unable to perceive light touch on the dorsum of the hand but reports exaggerated pain when the same area is lightly pricked. This presentation is most consistent with:
a. Hyperesthesia
b. Hypoesthesia
c. Allodynia
d. Paresthesia
Allodynia
Which subtype of Guillain-Barré Syndrome is characterized by the triad of ataxia, areflexia, and ophthalmoplegia?
Miller Fisher syndrome
What type of cancer is most commonly associated with Lambert-Eaton Myasthenic Syndrome?
a. Colon cancer
b. Prostate cancer
c. Breast cancer
d. Small cell lung cancer
d. Small cell lung cancer
During motor function assessment, what would a positive Babinski sign indicate?
a. Basal ganglia impairment
b. Upper motor neuron lesion
c. Cerebellar dysfunction
d. Lower motor neuron lesion
b. Upper motor neuron lesion
In the context of coordination assessment, what does dyssynergia refer to?
a. Inability to perform movements as a single, coordinated action
b. Smooth, fluid movement patterns
c. Tremors during rest
d. Hypertonic muscle activity
a. Inability to perform movements as a single, coordinated action
Which clinical sign is least likely to be present in a patient with basal ganglia dysfunction?
a. Rigidity
b. Resting tremor
c. Bradykinesia
d. Dysmetria
d. Dysmetria
Which of the following is most indicative of cerebellar dysfunction during a motor examination?
a. Hypotonia
b. Dysmetria
c. Resting tremor
d. Spasticity
b. Dysmetria
Which subtype of Guillain-Barré Syndrome is most likely to be diagnosed in a patient with severe sensory involvement and rapid progression to quadriparesis?
a. Acute inflammatory demyelinating polyneuropathy (AIDP)
b. Acute motor axonal neuropathy (AMAN)
c. Acute motor-sensory axonal neuropathy (AMSAN)
d. Miller Fisher syndrome
Acute motor-sensory axonal neuropathy (AMSAN)
Which of the following is NOT a characteristic finding in Guillain-Barré Syndrome?
a. Progressive symmetrical weakness
b. Hyperreflexia
c. Hyporeflexia or areflexia
d. Sensory abnormalities may or may not be present
b. Hyperreflexia
What does affective lability in a patient suggest during a mental status examination?
a. Rapid and unpredictable changes in mood and emotions
b. Difficulty in interpreting sensory stimuli
c. A tendency to maintain a flat affect
d. Consistent emotional responses to external stimuli
a. Rapid and unpredictable changes in mood and emotions
What is the primary pathophysiological mechanism in Myasthenia Gravis?
Antibody-mediated destruction of acetylcholine receptors at the neuromuscular junction
Which of the following conditions is most likely associated with left-side hemispatial neglect?
a. Lesion in the right parietal lobe
b. Damage to the right frontal cortex
c. Damage to the left temporal lobe
d. Lesion in the left angular gyrus
a. Lesion in the right parietal lobe
In the context of the Clinical Test of Sensory Interaction and Balance (CTSIB), what instability would you expect in a visually dependent patient?
a. Instability only on firm surfaces
b. Instability in conditions with altered somatosensory input
c. Instability in conditions with removed or altered visual input
d. Instability when both visual and vestibular inputs are intact
d. Instability when both visual and vestibular inputs are intact
Which of the following is considered a major factor contributing to the development of Post-Polio Syndrome?
a. High levels of stress during the initial polio infection
b. Aging and increased metabolic demands on motor units
c. Genetic predisposition
d. Consistent physical activity
b. Aging and increased metabolic demands on motor units
Which of the following is a key diagnostic criterion for Post-Polio Syndrome?
a. Muscle biopsy showing active inflammation
b. Rapid onset of muscle weakness
c. Progressive new muscle weakness after years of stability
d. Elevated creatine kinase levels
c. Progressive new muscle weakness after years of stability
What is the primary purpose of using a tuning fork in the assessment of sensory function?
a. To determine the level of tactile discrimination
b. To test auditory acuity
c. To evaluate vibratory sensation
d. To assess proprioceptive function
c. To evaluate vibratory sensation
What does a positive Romberg test indicate about the integrity of the sensory systems involved in balance?
a. Visual system impairment
b. Somatosensory hyperactivity
c. Proprioceptive deficits
d. Vestibular system dysfunction
c. Proprioceptive deficits
During sensory testing, a patient consistently fails to recognize that their hand is being touched when the other hand is touched simultaneously. This phenomenon is known as:
Extinction
What is the hallmark feature of Myasthenia Gravis on repetitive nerve stimulation (RNS) testing?
a. Decremental decrease in amplitude with repeated stimulation
b. Irregular amplitude response with stimulation
c. No change in amplitude with stimulation
d. Incremental increase in amplitude with stimulation
a. Decremental decrease in amplitude with repeated stimulation
Which thymic abnormality is frequently associated with Myasthenia Gravis?
a. Thymic aplasia
b. Thymic carcinoma
c. Thymoma or thymic hyperplasia
d. Thymic cyst
c. Thymoma or thymic hyperplasia
Which of the following is a characteristic feature of dystonia observed during motor function assessment?
a. Sudden, jerky movements
b. Sustained muscle contractions
c. Rhythmic, oscillatory movements
d. Involuntary, twisting movements
b. Sustained muscle contractions
Which feature distinguishes Post-Polio Syndrome from amyotrophic lateral sclerosis (ALS)?
a. Muscle atrophy
b. Respiratory involvement
c. Progressive muscle weakness
d. Presence of upper motor neuron signs in ALS
d. Presence of upper motor neuron signs in ALS
Which of the following is a hallmark clinical feature of ALS?
a. Spasticity and muscle atrophy
b. Fluctuating muscle strength
c. Persistent headaches
d. Widespread sensory loss
a. Spasticity and muscle atrophy
Which coordination test would best assess a patient’s ability to perform sequential finger movements rapidly?
a. Finger tapping test
b. Heel-to-shin test
c. Finger-to-nose test
d. Tandem gait test
a. Finger tapping test
Post-Polio Syndrome is thought to result from the progressive deterioration of which cells?
a. Oligodendrocytes
b. Schwann cells
c. Anterior horn cells
d. Upper motor neurons
c. Anterior horn cells
What is the primary difference between intention tremor and resting tremor in terms of their association with specific neurological structures?
a. Both tremors are associated with cerebellar dysfunction
b. Intention tremor is associated with cerebellar lesions, while resting tremor is linked to basal ganglia pathology
c.Intention tremor occurs at rest, while resting tremor appears during movement
d. Resting tremor is associated with spinal cord lesions, while intention tremor is linked to cortical dysfunction
b. Intention tremor is associated with cerebellar lesions, while resting tremor is linked to basal ganglia pathology
A patient with ideomotor apraxia is most likely to demonstrate which of the following behaviors?
a. Inability to imitate a sequence of gestures on command but can perform them automatically
b. Inability to recognize familiar faces despite normal vision
c. Inability to recall recent events but retains remote memories
d. Inability to imitate a sequence of gestures on command but can perform them automatically
Difficulty understanding spoken language despite intact hearing
Inability to imitate a sequence of gestures on command but can perform them automatically
What is the most likely effect of a lesion in the cerebellar hemispheres on fine motor coordination?
a. Loss of proprioception in the contralateral limbs
b. Hypertonia in the affected limbs
c. Impaired coordination of ipsilateral limb movements
d. Dysphagia and speech difficulties
c. Impaired coordination of ipsilateral limb movements
Which of the following is a typical early clinical manifestation of ALS?
a. Visual disturbances
b. Hyperreflexia with spasticity
c. Symmetrical sensory loss
d. Asymmetric limb weakness and muscle atrophy
d. Asymmetric limb weakness and muscle atrophy
What does the presence of hyperreflexia and spasticity indicate in ALS?
a. Sensory nerve involvement
b. Peripheral nerve involvement
c. Upper motor neuron degeneration
d. Lower motor neuron damage
c. Upper motor neuron degeneration
Which assessment would be most appropriate for detecting subtle signs of neglect syndrome in a patient?
a. The Galveston Orientation and Amnesia Test
b. The Glasgow Coma Scale
c. The line bisection test
d. The Mini-Mental State Examination
c. The line bisection test
During an assessment using the Functional Reach Test, what does a reduced reach distance indicate about a patient’s balance?
a. Improved dynamic balance
b. Decreased limits of stability
c. Good anticipatory postural control
d. Enhanced proprioceptive function
b. Decreased limits of stability