SAER Quizes Flashcards by Timothy Zielicke

What is the most common level of occult spine fracture after trauma that is missed by plain radiographs?

C7/T1

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Type of neuropathy caused by:

alcohol

axons (hate alcoholics); sensory first (drunks don’t feel), then motor (SAM Adams brewery)

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Type of neuropathy caused by:

Diabetes

diabetes DAMS all 4. sensori-motor axonal demyelinating.

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Type of neuropathy caused by:

lead

motor, UE weakness

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Type of neuropathy caused by:

B12

sensory axonal

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Type of neuropathy caused by:

CMT/HSMN-1

motor, uniform demyelination, autosomal dominant

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Type of neuropathy caused by:

GBS/CIDP

motor demyelinating

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Type of neuropathy caused by:

HSMN-2

axonal, autosomal dominant

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Type of neuropathy caused by:

cisplatin

sensory axonal

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Type of neuropathy caused by:

vasculitis

axonal

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inheritance pattern of myotonic dystrophy?

autosomal dominant disease

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location of myotonic dystrophy gene

chromosome 19

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common pathology seen in myotonic dystrophy?

cataracts, testicular atrophy, heart disease, dementia, and baldness in addition to muscular dystrophy.

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Which of the following is a rare extra-articular manifestation of rheumatoid arthritis?

glomerular disease

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Spinal instrumentation in neuromuscular scoliosis is indicated when?

primary curve exceeds 25° and forced vital capacity (FVC) is greater than 35% of normal.

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characteristics of vincristine neuropathy

sensorimotor axonal polyneuropathy that primarily affects the most distal aspects of the nerve
Nerve conduction studies reveal small amplitude/absent motor and sensory responses.

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slow writhing movement of the limbs or other body parts. It is important to differentiate athetosis from spasticity, because athetosis does not respond to antispasticity treatment.

Athetosis

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brief, irregular contractions, which affect individual muscles as random events that seem to flow from one muscle to the other.

chorea

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rapid, shock-like or lightning-like jerks.

Myoclonus

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syndrome of sustained muscle contraction that frequently causes twisting and repetitive movements or abnormal postures.

Dystonia

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A 10-year-old boy suffered a blunt injury to his arm with resultant wrist drop. Electrophysiologic studies done on the day of injury show normal nerve conduction studies in the nerves in the affected limb except for the radial nerve. The radial nerve responses are normal distally but with stimulation proximal to the site of injury responses are absent. Which finding is most consistent with a good prognosis for recovery?

Normal radial motor response with stimulation distal to the injury on day 5.

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Which treatment or medication is effective in treating both the skin and joint disease in persons with psoriatic arthritis?

Methotrexate (Rheumatrex, Trexall).

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Which feature would more likely be seen in recurrent neoplasm than radiation plexopathy as the cause of the LSP?

Deep aching pain locally presenting within 3 months of treatment.

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A 47-year-old man complains of generalized weakness and dysarthria that worsens throughout the day. He has dysphagia primarily with dinner and his wife reports that “he looks sleepy.” On examination, ptosis is prominent along with proximal muscle weakness. The most likely diagnosis is

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What is concerning for cervical cord involvement rather than just a stinger?

Bilateral symptoms

highest risk factors for late post-traumatic seizures were found to be?

bilateral parietal contusion

blastic lesions come most commonly from what cancer

prostate

Under the prospective payment system for inpatient rehabilitation facilities, which item is used in assigning a patient to a case-mix group?

FIM motor score

Which description best localizes the extensor indicis proprius muscle (with the forearm fully pronated) for needle electrode examination?

Two fingerbreadths proximal to the ulnar styloid and just radial to the ulna.

Blink reflex studies can be useful in diagnosing which condition?

Midpontine lesion.

works by binding to B-lymphocyte CD20 surface antigens (monoclonal antibody) and thereby depleting the B cell population

Rituximab

TNF alpha antagonist

Etanercept

inhibits interleukin-1 type receptors.

Anakinra

Which pulmonary parameter is most commonly followed in a patient with amyotrophic lateral sclerosis (ALS)?

Double limb stance is what percent of the entire gait cycle?

To allow pronation of the foot, which 2 joints must have their axis of rotation in parallel?

Talonavicular and calcaneocuboid.

Moro and asymmetric tonic neck reflexes (ATNR) usually are integrated by approximately?

6 months

The plantar grasp reflex is integrated by?

12 to 14 months (after walking has begun)

Protective extension in sitting is seen anteriorly at? lateral at? posterior at?

5 to 7 months 6 to 8 months 7 to 8 months.

The most common benign brain tumor in adults is?

meningioma

Etidronate disodium (Didronel) is used in the management of heterotopic ossification to

prevent ossification.

In patients with a traumatic brain injury, which factor suggests a poor prognosis for emergence from unresponsiveness?

Factors associated with poor prognosis include decerebrate posturing and flaccid muscle tone.

class of antibiotics is contraindicated in patients with myasthenia and other neuromuscular junction disorders.?

aminoglycoside

Kugelberg Welander syndrome (also known as spinal muscular atrophy type 3) onset?

during childhood

Which is more sensitive to trauma, brain or spinal cord?

spinal cord

severe disability is unlikely when length of coma is less than ______ and when post-traumatic amnesia was less than ______?

2 weeks | 2 months

early diagnostic feature of Parkinson disease

Assymetric tremor

distal muscle receiving innervation from the C5 root

brachioradialis

Which electrodiagnostic finding is most consistent with neurogenic thoracic outlet syndrome?

- Abnormal median sensory responses Neurogenic thoracic outlet syndrome involves the lower trunk of the brachial plexus; hence, sensory and motor loss develops in the C8–T1 distribution. Thumb abduction is often affected. Sensory changes are usually in the distribution of the ulnar and medial antebrachial cutaneous nerves.

selective cox-2 NSAIDs------>non selective NSAIDs

celecoxib, meloxicam, Nabumetone, Indomethacin

In the determination of muscle strength, absolute muscle strength is most related to?

the physiologic cross-sectional area of the muscle.

what are the four common socket-related problems that expose the distal tibia to elevated forces that may lead to breakdown?

(1) a socket that is too large, (2) a socket that is too broad in the anteroposterior plane ("bell clapper" effect), (3) excessive dorsiflexion of the prosthetic foot, and (4) excessive anterior tilt of the socket on the pylon.

conversion of electromagnetic energy into thermal energy when the oscillation of high frequency electrical and magnetic fields produces molecular movement and heat.

Short wave diathermy

Preterm infants who develop cerebral palsy as the result of an intraventricular hemorrhage (IVH) most commonly have which of the following types of cerebral palsy?

spastic diplegic

What CP is associated with hyperbilirubinemia and kernicterus with changes noted in the basal ganglia on magnetic resonance imaging?

Athetoid CP

CP most commonly seen with severe hypoxic ischemic encephalopathy (HIE)?

Spastic tetraplegia

Following lung transplantation, which medication causes delirium, including visual hallucinations?

tacrolimus

Which treatment for spasticity is contraindicated with intravenous ciprofloxacin (Cipro)?

tizanidine

Sural sparing is seen in ______? Early in the course of the disease, motor nerve conduction studies are abnormal and sensory nerve conduction studies remain normal. Within 1-2 weeks, sensory abnormalities are observed in the median and ulnar nerves however the sural sensory may remain normal. This finding is referred to as “sural sparing” and is thought to be diagnostic.

acute inflammatory demyelinating polyneuropathy (AIDP) or Guillain- Barré syndrome.

_____ results in motor nerve conduction abnormalities with segmental demyelination and conduction block.

Multifocal motor neuropathy

For individuals with AIS C injuries, ___ % become community ambulators. Individuals with AIS A, B and D injuries become community ambulators at a rate of ____, _____, &____ %, respectively.

75 | 3, 50 and 95

Your 67-year-old patient with ankylosing spondylitis comes for an urgent appointment after falling 3 weeks ago. He complains of a headache at the back of his head, along with progressive weakness, and numbness in his hands and feet. You suspect?

atlantoaxial subluxation

Inclusion body myositis (IBM) is a ____ myopathy that tends to affect ______________. Clinical manifestations can include _____ Muscle enzyme levels ________ There is a _____ predominance. There generally (is/is no) significant improvement with corticosteroids?

``` slowly progressive middle-aged and older individuals. distal as well as proximal asymmetrical weakness. may be mildly elevated. 3:1 male no ```

- -By 18 months a child should have a _____word vocabulary using single words at a time. - By 24 months this should have increased to at least ___ words and they should be putting __ words together. - By age 3 a child should be able to state ___and recognize ____.

10 to 25 50, 2 his or her full name, count to 3, basic colors.

What is the most likely cause of a hemorrhagic stroke in a 14-year-old child?

Hemophilia

The circle of Willis is comprised which complex of arteries?

Anterior communicating, posterior communicating, posterior cerebral, anterior cerebral

The negative features of the UMNS are characterized by? Positive features of the UMNS are?

a reduction in motor activity. Fatigability, muscle weakness and loss of dexterity. increased muscle stretch reflexes, clonus, positive Babinski, spasticity, extensor or flexor spasms, dyssynergic patterns of cocontraction and other associated reactions, and dyssynergic and stereotypical spastic dystonias.

``` Modified Ashworth Scale is scored as follows: 1- 1+ 2 3 4 ```

0: no increase in muscle tone; 1: catch and release at end range of motion; 1+: catch, followed by minimal resistance throughout the remainder (less than half) of the range of motion; 2: more marked increase in tone, through most of the range of motion, but joint easily moved; 3: considerable increase in muscle tone, passive movement is difficult; 4: affected part is rigid in flexion or extension.

Carotid cavernous fistula

look up syndrome

In a person with a transfemoral amputation, an abnormal prosthetic gait with lateral trunk bending toward the involved side in midstance most commonly occurs with hip

abductor weakness. why???

Considering safety and comfort, what is the preferred location for needle electrode insertion when studying the diaphragm?

C. The eighth or ninth interspace, at the anterior axillary line

The treatment program for a 43-year-old patient during the first week following an impacted humeral neck fracture should include

immobilization

When treating a patient with a traumatic brain injury (TBI) for detrusor hyperreflexia using anticholinergic agents, what is a possible adverse effect?

Worsening of delirium

Which factor differentiates myotonic discharge from complex repetitive discharges (CRDs)?

Amplitude and frequency of potentials

Which finding correlates with a high risk of ischemic ulceration?

A. Ankle/brachial ratio of 0.40

Which anticonvulsant medication is most likely to cause bone marrow suppression?

Carbamazepine

Which corticosteroid has the longest duration of anti-inflammatory activity?

Betamethasone

Which fibers transmit poorly localized, dull, visceral pain to the spinal cord?

Unmyelinated C

In nondisabled subjects walking at self-selected normal speeds, the normal distribution of time spent in double support is approximately?

20%