Quiz 2 - Questions 2

Question 1

What is a hallmark feature of Duchenne Muscular Dystrophy (DMD) during the early ambulatory stage (ages 5-8)?
A) Scoliosis
B) Gower’s sign
C) Dependent transfers
D) Severe respiratory infections

Answer 1

Correct Answer: B) Gower’s sign
Rationale:
- Correct (B): Gower’s sign reflects proximal muscle weakness, typical during the early ambulatory stage.
- Incorrect (A): Scoliosis develops in later stages.
- Incorrect (C): Dependent transfers occur in the late non-ambulatory stage.
- Incorrect (D): Respiratory infections are common in advanced stages.

Question 2

Which stage of Spinal Muscular Atrophy (SMA) is characterized by onset >18 months and independent walking?
A) Type 1
B) Type 2
C) Type 3
D) Type 4

Answer 2

Correct Answer: C) Type 3
Rationale:
- Correct (C): Type 3 SMA (Kugelberg-Welander disease) presents with proximal weakness and independent walking.
- Incorrect (A): Type 1 involves <6 months onset and rapid progression.
- Incorrect (B): Type 2 has onset between 6-18 months and primarily affects the lower extremities.
- Incorrect (D): Type 4 has adult onset with no reduced lifespan.

Question 3

Which Gross Motor Function Classification System (GMFCS) level describes a child who can walk independently but has limitations with running and jumping?
A) Level I
B) Level II
C) Level III
D) Level IV

Answer 3

Correct Answer: A) Level I
Rationale:
- Correct (A): Level I children walk independently with minimal functional limitations.
- Incorrect (B): Level II includes independent walking but with notable limitations.
- Incorrect (C): Level III requires mobility aids for ambulation.
- Incorrect (D): Level IV involves significant reliance on wheeled mobility.

Question 4

What is the primary hallmark of Charcot-Marie-Tooth (CMT) disease?
A) Muscle hypertrophy
B) Distal muscle wasting
C) Proximal weakness
D) Joint laxity

Answer 4

Correct Answer: B) Distal muscle wasting
Rationale:
- Correct (B): Distal muscle wasting, particularly in the legs and arms, is a hallmark of CMT.
- Incorrect (A): Hypertrophy does not occur; weakness predominates.
- Incorrect (C): Proximal weakness is typical in other neuromuscular disorders like DMD.
- Incorrect (D): Joint laxity is not characteristic of CMT.

• CMT: Slowly progressive neuropathy affecting peripheral nerves

Question 5

What respiratory condition is characterized by airless alveoli, inelastic lungs, and a respiratory rate >60 bpm?
A) Bronchopulmonary Dysplasia (BPD)
B) Respiratory Distress Syndrome (RDS)
C) Atelectasis
D) Cystic Fibrosis

Answer 5

Correct Answer: B) Respiratory Distress Syndrome (RDS)
Rationale:
- Correct (B): RDS presents with these hallmark features in neonates.
- Incorrect (A): BPD involves chronic lung scarring and oxygen dependence.
- Incorrect (C): Atelectasis is lung collapse, not specific to alveolar immaturity.
- Incorrect (D): Cystic Fibrosis involves thick mucus and lung infections.

Question 6

Which type of SMA is prenatal in onset and typically not viable at birth?
A) Type 1
B) Type 2
C) Type 0
D) Type 3

Answer 6

Correct Answer: C) Type 0
Rationale:
- Correct (C): Type 0 presents prenatally with severe impairments and is usually incompatible with life.
- Incorrect (A): Type 1 has postnatal onset (<6 months).
- Incorrect (B): Type 2 occurs later (6-18 months).
- Incorrect (D): Type 3 begins after 18 months.

Question 7

What is the purpose of standing programs for children with neuromuscular disorders?
A) Promote joint stability
B) Prevent contractures and improve bone health
C) Increase muscle hypertrophy
D) Reduce spasticity

Answer 7

Correct Answer: B) Prevent contractures and improve bone health
Rationale:
- Correct (B): Standing programs maintain joint integrity and promote skeletal health.
- Incorrect (A): Joint stability is a secondary outcome, not the primary goal.
- Incorrect (C): Muscle hypertrophy is not achieved through passive standing.
- Incorrect (D): Spasticity reduction is a potential, but indirect, benefit.

Question 8

What is the appropriate PT intervention for early non-ambulatory Duchenne Muscular Dystrophy?
A) High resistance training
B) Stretching to prevent contractures
C) Submaximal exercise
D) Eccentric exercise

Answer 8

Correct Answer: C) Submaximal exercise
Rationale:
- Correct (C): Submaximal exercise avoids muscle breakdown and overexertion.
- Incorrect (A): High resistance training is contraindicated.
- Incorrect (B): Stretching is helpful but does not address overall functional conditioning.
- Incorrect (D): Eccentric exercise increases muscle damage in DMD.

Question 9

Which PT outcome measure is specifically designed for functional mobility across environments?
A) GMFM
B) PEDI-CAT
C) Functional Mobility Scale
D) BOT-2

Answer 9

Correct Answer: B) PEDI-CAT
Rationale:
- Correct (B): PEDI-CAT assesses functional mobility and daily activity performance.
- Incorrect (A): GMFM focuses on gross motor skills.
- Incorrect (C): Functional Mobility Scale evaluates walking in specific distances.
- Incorrect (D): BOT-2 targets fine and gross motor coordination.

Question 10

Which pulmonary condition in children is associated with scarring of lung tissue and dependence on supplemental oxygen?
A) RDS
B) Bronchopulmonary Dysplasia (BPD)
C) Atelectasis
D) Cystic Fibrosis

Answer 10

Correct Answer: B) Bronchopulmonary Dysplasia (BPD)
Rationale:
- Correct (B): BPD involves chronic scarring and long-term oxygen use.
- Incorrect (A): RDS is acute and related to surfactant deficiency.
- Incorrect (C): Atelectasis refers to localized lung collapse.
- Incorrect (D): Cystic Fibrosis involves thick mucus production and recurrent infections.

Question 11

Which physical feature is commonly associated with Duchenne Muscular Dystrophy (DMD) due to muscle replacement by fat and fibrosis?
A) Pseudohypertrophy of calves
B) Muscle atrophy
C) Joint laxity
D) Kyphosis

Answer 11

Correct Answer: A) Pseudohypertrophy of calves
Rationale:
- Correct (A): The calves appear enlarged, but this is due to fat and fibrosis, not true muscle hypertrophy.
- Incorrect (B): Muscle atrophy occurs but is not visually prominent in early stages.
- Incorrect (C): Joint laxity is not characteristic of DMD.
- Incorrect (D): Kyphosis may develop but is not a defining feature.

Question 12

What is a typical gait abnormality observed in children with Duchenne Muscular Dystrophy?
A) Scissoring gait
B) Waddling gait
C) Spastic gait
D) Steppage gait

Answer 12

Correct Answer: B) Waddling gait
Rationale:
- Correct (B): Waddling gait is due to proximal muscle weakness affecting hip stability.
- Incorrect (A): Scissoring gait is seen in spastic CP, not DMD.
- Incorrect (C): Spastic gait is unrelated to DMD.
- Incorrect (D): Steppage gait is seen in peripheral neuropathies, not DMD.

Question 13

Which SMA type is associated with infantile onset and rapid progression leading to respiratory failure?
A) Type 0
B) Type 1
C) Type 2
D) Type 3

Answer 13

Correct Answer: B) Type 1
Rationale:

• Correct (B): Type 1 SMA (Werdnig-Hoffmann disease) presents with severe weakness and respiratory failure.
• Incorrect (A): Type 0 occurs prenatally and is typically incompatible with life.
• Incorrect (C): Type 2 has a slower progression and affects lower extremities more than upper.
• Incorrect (D): Type 3 is later onset with less severe progression.

Question 14

What is the primary focus of bracing in SMA management?
A) Prevent scoliosis
B) Improve posture and function
C) Increase muscle hypertrophy
D) Correct gait abnormalities

Answer 14

Correct Answer: B) Improve posture and function
Rationale:
- Correct (B): Bracing helps maintain posture and functional capabilities in SMA patients.
- Incorrect (A): While scoliosis management is important, it is not the primary goal.
- Incorrect (C): Bracing does not increase muscle size.
- Incorrect (D): Bracing is not typically used to correct gait abnormalities in SMA.

Question 15

Which GMFCS level describes children who are transported in a wheelchair but can operate a power wheelchair independently?
A) Level II
B) Level III
C) Level IV
D) Level V

Answer 15

Correct Answer: C) Level IV
Rationale:
- Correct (C): Level IV children rely on wheeled mobility but can control a power wheelchair.
- Incorrect (A): Level II describes walking with limitations but no need for wheelchairs.
- Incorrect (B): Level III involves hand-held mobility devices for ambulation.
- Incorrect (D): Level V includes total dependence for mobility.

Question 16

What is the hallmark respiratory sign of Cystic Fibrosis (CF)?
A) Wheezing
B) Thick, viscous mucus
C) Intercostal retractions
D) Cyanosis

Answer 16

Correct Answer: B) Thick, viscous mucus
Rationale:
- Correct (B): Thick mucus leads to airway obstruction and frequent infections in CF.
- Incorrect (A): Wheezing is nonspecific and occurs in other conditions.
- Incorrect (C): Intercostal retractions are typical in acute respiratory distress, not CF.
- Incorrect (D): Cyanosis is a late-stage symptom of severe respiratory compromise.

Question 17

What PT intervention is contraindicated for children with Duchenne Muscular Dystrophy?
A) Cycling
B) Swimming
C) High resistance training
D) Submaximal exercise

Answer 17

Correct Answer: C) High resistance training
Rationale:
- Correct (C): High resistance training increases muscle damage and accelerates weakness.
- Incorrect (A): Cycling is recommended for overall conditioning.
- Incorrect (B): Swimming is a preferred low-impact activity.
- Incorrect (D): Submaximal exercise is safe and beneficial.

Question 18

Which respiratory condition involves chronic scarring of lung tissue due to mechanical ventilation?
A) RDS
B) Bronchopulmonary Dysplasia (BPD)
C) Atelectasis
D) Asthma

Answer 18

Correct Answer: B) Bronchopulmonary Dysplasia (BPD)
Rationale:
- Correct (B): BPD results from prolonged mechanical ventilation causing lung tissue scarring.
- Incorrect (A): RDS is an acute condition in neonates.
- Incorrect (C): Atelectasis involves lung collapse, not chronic scarring.
- Incorrect (D): Asthma involves airway inflammation, not scarring.

Question 19

What is the primary purpose of the GMFM-66 test?
A) Measure functional mobility in daily activities
B) Assess gross motor function in children with CP
C) Evaluate sensory processing abilities
D) Test fine motor coordination

Answer 19

Correct Answer: B) Assess gross motor function in children with CP
Rationale:
- Correct (B): GMFM-66 is specifically designed to measure gross motor function in children with CP.
- Incorrect (A): Functional mobility is better assessed with PEDI-CAT.
- Incorrect (C): Sensory processing is not evaluated by GMFM-66.
- Incorrect (D): Fine motor skills are not the focus of this test.

Question 20

Which type of SMA typically has no reduction in lifespan and presents in adulthood?
A) Type 1
B) Type 2
C) Type 3
D) Type 4

Answer 20

Correct Answer: D) Type 4
Rationale:
- Correct (D): Type 4 SMA presents in adulthood with mild symptoms and no reduced lifespan.
- Incorrect (A): Type 1 has severe early onset and rapid progression.
- Incorrect (B): Type 2 involves intermediate severity and reduced functional abilities.
- Incorrect (C): Type 3 has later onset but can still impact lifespan in severe cases.

Question 21

What is the primary cause of respiratory failure in the later stages of Duchenne Muscular Dystrophy (DMD)?
A) Bronchial obstruction
B) Weakness of respiratory muscles
C) Pulmonary fibrosis
D) Chronic infections

Answer 21

Correct Answer: B) Weakness of respiratory muscles
Rationale:
- Correct (B): Respiratory failure in DMD results from progressive weakness of the diaphragm and intercostal muscles.
- Incorrect (A): Bronchial obstruction is not specific to DMD.
- Incorrect (C): Pulmonary fibrosis is unrelated to muscular dystrophy.
- Incorrect (D): Infections are a complication but not the primary cause of respiratory failure.

Question 22

Which test is most appropriate for evaluating functional mobility in children with CP?
A) GMFM-66
B) Functional Mobility Scale
C) BOT-2
D) PEDI-CAT

Answer 22

Correct Answer: B) Functional Mobility Scale
Rationale:
- Correct (B): The Functional Mobility Scale evaluates walking ability over specified distances.
- Incorrect (A): GMFM-66 focuses on gross motor skills.
- Incorrect (C): BOT-2 assesses fine and gross motor coordination, not mobility.
- Incorrect (D): PEDI-CAT evaluates daily activity performance, not specific distances.

Question 23

What is the primary physical therapy goal in managing Charcot-Marie-Tooth (CMT) disease?
A) Prevent scoliosis
B) Improve strength and functional activities
C) Reduce spasticity
D) Enhance pulmonary function

Answer 23

Correct Answer: B) Improve strength and functional activities
Rationale:
- Correct (B): PT aims to enhance strength and maintain independence in CMT patients.
- Incorrect (A): Scoliosis is not a primary concern in CMT.
- Incorrect (C): Spasticity is not typical in CMT.
- Incorrect (D): Pulmonary issues are not characteristic of CMT.

Question 24

Which hallmark sign distinguishes Respiratory Distress Syndrome (RDS) in neonates?
A) Productive cough
B) Grunting on expiration
C) Thick mucus secretions
D) Cyanosis

Answer 24

Correct Answer: B) Grunting on expiration
Rationale:
- Correct (B): Grunting is a compensatory mechanism to maintain alveolar pressure.
- Incorrect (A): Productive cough is not seen in RDS.
- Incorrect (C): Thick mucus is associated with conditions like CF.
- Incorrect (D): Cyanosis occurs but is a late-stage sign.

Question 25

Which type of SMA affects lower extremities more than upper extremities and typically has onset between 6-18 months?
A) Type 0
B) Type 2
C) Type 3
D) Type 4

Answer 25

Correct Answer: B) Type 2
Rationale:
- Correct (B): Type 2 SMA presents with weakness primarily in the lower extremities.
- Incorrect (A): Type 0 is prenatal and severe.
- Incorrect (C): Type 3 affects both extremities but allows for independent walking.
- Incorrect (D): Type 4 is adult onset with mild symptoms.

Question 26

What is the main benefit of a standing frame for children with neuromuscular disorders?
A) Prevent scoliosis
B) Facilitate upright posture and bone health
C) Strengthen lower extremity muscles
D) Improve aerobic capacity

Answer 26

Correct Answer: B) Facilitate upright posture and bone health
Rationale:
- Correct (B): Standing frames promote skeletal integrity and participation.
- Incorrect (A): While scoliosis prevention is secondary, it is not the primary benefit.
- Incorrect (C): Strengthening is not achieved passively.
- Incorrect (D): Aerobic capacity is improved through active exercises.

Question 27

Which GMFCS level describes children who require total physical assistance for mobility?
A) Level III
B) Level IV
C) Level V
D) Level II

Answer 27

Correct Answer: C) Level V
Rationale:
- Correct (C): Level V indicates complete dependence for mobility and transfers.
- Incorrect (A): Level III involves mobility aids for walking.
- Incorrect (B): Level IV includes power wheelchair operation.
- Incorrect (D): Level II involves independent walking with some limitations.

Question 28

What hallmark feature is used to identify Duchenne Muscular Dystrophy on clinical examination?
A) Ataxia
B) Gower’s sign
C) Elevated CK levels
D) Spasticity

Answer 28

Correct Answer: C) Elevated CK levels
Rationale:
- Correct (C): Elevated creatine kinase levels indicate muscle breakdown in DMD.
- Incorrect (A): Ataxia is not associated with DMD.
- Incorrect (B): Gower’s sign is common but less definitive than CK levels.
- Incorrect (D): Spasticity is not a characteristic of DMD.

Question 29

Which type of pulmonary therapy is recommended for infants with bronchial obstruction?
A) Incentive spirometry
B) Chest physiotherapy
C) High-intensity aerobic training
D) Breathing exercises

Answer 29

Correct Answer: B) Chest physiotherapy
Rationale:
- Correct (B): Chest physiotherapy aids in clearing bronchial obstructions in infants.
- Incorrect (A): Incentive spirometry is not practical for infants.
- Incorrect (C): High-intensity training is contraindicated.
- Incorrect (D): Breathing exercises are more appropriate for older children.

Question 30

What is the primary goal of orthotic management in CMT?
A) Correct foot deformities
B) Improve gait and prevent contractures
C) Strengthen lower limb muscles
D) Facilitate upright posture

Answer 30

Correct Answer: B) Improve gait and prevent contractures
Rationale:
- Correct (B): Orthotics in CMT improve walking mechanics and limit contracture development.
- Incorrect (A): Correction of deformities is secondary.
- Incorrect (C): Orthotics do not directly strengthen muscles.
- Incorrect (D): Facilitating posture is not the primary goal in CMT.

Question 31

Which characteristic is most associated with Type 4 SMA?
A) Prenatal onset with poor viability
B) Early onset with severe respiratory failure
C) Adult onset with no lifespan reduction
D) Juvenile onset with proximal muscle weakness

Answer 31

Correct Answer: C) Adult onset with no lifespan reduction
Rationale:
- Correct (C): Type 4 SMA presents in adulthood and has mild symptoms with no impact on lifespan.
- Incorrect (A): This describes Type 0 SMA.
- Incorrect (B): This describes Type 1 SMA.
- Incorrect (D): This describes Type 3 SMA.

Question 32

What is the primary early symptom of Duchenne Muscular Dystrophy observed in children?
A) Respiratory distress
B) Delayed walking milestones
C) Gower’s sign
D) Scoliosis

Answer 32

Correct Answer: B) Delayed walking milestones
Rationale:
- Correct (B): Children with DMD often exhibit delayed walking, with milestones like walking typically achieved after 18 months.
- Incorrect (A): Respiratory distress appears in later stages.
- Incorrect (C): Gower’s sign is more evident in the early ambulatory stage.
- Incorrect (D): Scoliosis is a late-stage complication.

Question 33

Which type of Cerebral Palsy (CP) is characterized by uncontrolled, involuntary movements?
A) Spastic CP
B) Dyskinetic CP
C) Ataxic CP
D) Hypotonic CP

Answer 33

Correct Answer: B) Dyskinetic CP
Rationale:
- Correct (B): Dyskinetic CP involves athetosis or dystonia, leading to involuntary movements.
- Incorrect (A): Spastic CP involves velocity-dependent resistance.
- Incorrect (C): Ataxic CP involves coordination and balance issues.
- Incorrect (D): Hypotonic CP is associated with low muscle tone.

Question 34

What is the primary hallmark feature of BPD (Bronchopulmonary Dysplasia) in neonates?
A) Intercostal retractions
B) Chronic scarring of lung tissue
C) Dependence on supplemental oxygen
D) Thick, viscous mucus

Answer 34

Correct Answer: C) Dependence on supplemental oxygen
Rationale:
- Correct (C): BPD is identified by oxygen dependency beyond the neonatal period.
- Incorrect (A): Intercostal retractions are more typical of RDS.
- Incorrect (B): Scarring occurs but is not the primary clinical hallmark.
- Incorrect (D): Thick mucus is a feature of CF, not BPD.

Question 35

Which intervention is contraindicated for children with SMA?

• A) Active assisted stretching
• B) Use of a stander
• C) Vibration plate therapy
• D) Eccentric exercises for cervical muscles

Answer 35

Correct Answer: D) Eccentric exercises for cervical muscles

Rationale:

• Correct (D): Eccentric exercises are contraindicated for weak cervical muscles due to the risk of overexertion.
• Incorrect (A): Active assisted stretching is beneficial.
• Incorrect (B): Standing programs are recommended for posture and bone health.
• Incorrect (C): Vibration therapy can improve strength and function.

Question 36

Which respiratory complication is common in children with Duchenne Muscular Dystrophy?
A) Pulmonary fibrosis
B) Atelectasis
C) Bronchiectasis
D) Asthma

Answer 36

Correct Answer: B) Atelectasis
Rationale:
- Correct (B): Atelectasis results from weakened respiratory muscles and poor lung expansion.
- Incorrect (A): Pulmonary fibrosis is not typical of DMD.
- Incorrect (C): Bronchiectasis is seen in CF, not DMD.
- Incorrect (D): Asthma is unrelated to DMD.

Question 37

Which CMT symptom most significantly impacts mobility?
A) Curled toes
B) Muscle atrophy
C) Foot drop
D) High arches

Answer 37

Correct Answer: C) Foot drop
Rationale:
- Correct (C): Foot drop disrupts gait mechanics, requiring orthotic intervention.
- Incorrect (A): Curled toes are a less impactful symptom.
- Incorrect (B): Muscle atrophy contributes but is not the primary mobility limiter.
- Incorrect (D): High arches are a characteristic feature but do not directly impair mobility.

Question 38

Which CP classification describes children with increased lumbar lordosis and hip internal rotation?
A) Hemiplegia
B) Quadriplegia
C) Diplegia
D) Ataxia

Answer 38

Correct Answer: C) Diplegia
Rationale:
- Correct (C): Diplegia primarily affects the lower extremities with this characteristic posture.
- Incorrect (A): Hemiplegia affects one side of the body.
- Incorrect (B): Quadriplegia involves all four extremities.
- Incorrect (D): Ataxia involves balance and coordination deficits.

Question 39

What is the primary PT goal for children with Type 2 SMA?
A) Develop independent walking
B) Maintain joint mobility and function
C) Improve aerobic capacity
D) Prevent respiratory infections

Answer 39

Correct Answer: B) Maintain joint mobility and function
Rationale:
- Correct (B): PT focuses on preventing contractures and maximizing functional independence.
- Incorrect (A): Independent walking is typically unachievable in Type 2.
- Incorrect (C): Aerobic capacity is a secondary concern.
- Incorrect (D): Preventing respiratory infections is a medical, not PT, goal.

Question 40

Which test is used to assess gross motor skills in children with CP?
A) BOT-2
B) PEDI-CAT
C) GMFM-66
D) Functional Mobility Scale

Answer 40

Correct Answer: C) GMFM-66
Rationale:
- Correct (C): GMFM-66 is specifically designed for assessing gross motor function in children with CP.
- Incorrect (A): BOT-2 assesses fine and gross motor coordination, not solely gross motor skills.
- Incorrect (B): PEDI-CAT measures functional mobility and daily activities.
- Incorrect (D): Functional Mobility Scale assesses walking ability over specific distances.