neuro exam
Which of the following diagnosis has sensory deficits as one of the primary
impairments?
a. Polio
b. Steriod induced myopathy
c. Becker's Muscular Dystrophy
d. ALS
e. Charco-Marie Tooth Disease - Answer E
You observe that your patient tends to lose his balance posterior when he is lightly
bumped or nudged backwards, no loss of balance observed when nudged forward.
Therefore, during your examination you assess his ankle strength and ankle ROM.
Findings: ankle strength 5/5, ankle ROM bilaterally df= 0-12° pf =0-35°. The most likely
impairment that is causing the loss of balance backwards is
a. inability to use a hip strategy
b. lack of ROM of ankle plantar flexors
c. delayed timing of muscle activation
d. muscle weakness - Answer C
All of the following are true of post polio syndrome (PPS) EXCEPT:
a. patients present with new onset of muscle weakness after being stable for at least 15
years
b. must have evidence of prior episode of muscle denervation
c. PPS is a diagnosis of exclusion (no other explanations)
d. patients usually do not have pain - Answer
Curare, a toxin, blocks the acetylcholine receptors on muscle tissue. This would result
in:
a. contraction of the muscle fiber
b. inability of the muscle to respond to motor nerve stimulus
c. increased stimulation of the muscle fiber
d. excessive contractions and convulsions - Answer B
Lack of acetylcholinesterase in the synaptic cleft would result in:
a. excessive, continuous stimulation of the muscle fiber
b. relaxation of the muscle fiber
c. decrease acetylcholine production by the motor neuron
d. inability of the motor neuron to stimulate the muscle fiber - Answer A
What is the name of the primary neurotransmitter at the neuromuscular junction?
a. glutamate
b. acetycholine
c. gaba
d. dopamine - Answer B
, When an action potential reaches the presynaptic terminal of the motor neuron:
a. acetylcholinesterease is released into the synaptic cleft
b. acetylcholine is released into the synaptic cleft
c. calcium is released inside of the muscle fiber
d. physical contact between the motor neuron and the muscle fiber occurs - Answer B
You received a PT referral for a 46 year old female diagnosed with ALS. She presents
with the following:
• severe foot drop ( 2-/5 right, 1/5 left)
• stumbles on smooth surfaces
• fallen twice in the past month
• normal cognition and sensation
• currently ambulates "independently" without assistive devices
• spasticity bilateral LEs grade one on Modified Ashworth scale
The focus of your intervention will be
a. instruct in a high intensity strengthening program for LEs especially distal muscles
b. assess for an ambulation device and AFOs
c. provide hospice care
d. BOTOX referral for spasticity control - Answer B
Which of the following is true with regard to pharmacological management of ALS?
a. There are currently no medications available for the treatment of ALS
b. Drugs such as Copaxone, which are commonly used in the treatment of multiple
sclerosis, are also effective in slowing the progression of ALS.
c. The glutamate inhibitor Riluzole is approved for the treatment of ALS and may extend
survival by several months.
d. Anticonvulsant medication such as Dilantin are often prescribed because of risk of
seizures increases as the disease progresses. - Answer C
Though the exact mechanism for the cause of ALS is not known what has been
identified in patients with ALS is
a. decreased acetylcholine receptor density
b. elevated levels of glutamate in cerebral spinal fluid
c. elevated levels of acetycholine in cerebral spinal fluid
d. lack of dystrophin in muscle structure - Answer B
Amyotrophic lateral sclerosis is characterized by :
a. lower motor neuron signs and symptoms
b. both upper and lower motor neuron signs and symptoms
c. upper motor neuron signs and symptoms
d. peripheral nerve injury signs and symptoms - Answer B
All of the diagnoses below are considered autoimmune diseases EXCEPT:
a. Charco-Marie Tooth disease
Which of the following diagnosis has sensory deficits as one of the primary
impairments?
a. Polio
b. Steriod induced myopathy
c. Becker's Muscular Dystrophy
d. ALS
e. Charco-Marie Tooth Disease - Answer E
You observe that your patient tends to lose his balance posterior when he is lightly
bumped or nudged backwards, no loss of balance observed when nudged forward.
Therefore, during your examination you assess his ankle strength and ankle ROM.
Findings: ankle strength 5/5, ankle ROM bilaterally df= 0-12° pf =0-35°. The most likely
impairment that is causing the loss of balance backwards is
a. inability to use a hip strategy
b. lack of ROM of ankle plantar flexors
c. delayed timing of muscle activation
d. muscle weakness - Answer C
All of the following are true of post polio syndrome (PPS) EXCEPT:
a. patients present with new onset of muscle weakness after being stable for at least 15
years
b. must have evidence of prior episode of muscle denervation
c. PPS is a diagnosis of exclusion (no other explanations)
d. patients usually do not have pain - Answer
Curare, a toxin, blocks the acetylcholine receptors on muscle tissue. This would result
in:
a. contraction of the muscle fiber
b. inability of the muscle to respond to motor nerve stimulus
c. increased stimulation of the muscle fiber
d. excessive contractions and convulsions - Answer B
Lack of acetylcholinesterase in the synaptic cleft would result in:
a. excessive, continuous stimulation of the muscle fiber
b. relaxation of the muscle fiber
c. decrease acetylcholine production by the motor neuron
d. inability of the motor neuron to stimulate the muscle fiber - Answer A
What is the name of the primary neurotransmitter at the neuromuscular junction?
a. glutamate
b. acetycholine
c. gaba
d. dopamine - Answer B
, When an action potential reaches the presynaptic terminal of the motor neuron:
a. acetylcholinesterease is released into the synaptic cleft
b. acetylcholine is released into the synaptic cleft
c. calcium is released inside of the muscle fiber
d. physical contact between the motor neuron and the muscle fiber occurs - Answer B
You received a PT referral for a 46 year old female diagnosed with ALS. She presents
with the following:
• severe foot drop ( 2-/5 right, 1/5 left)
• stumbles on smooth surfaces
• fallen twice in the past month
• normal cognition and sensation
• currently ambulates "independently" without assistive devices
• spasticity bilateral LEs grade one on Modified Ashworth scale
The focus of your intervention will be
a. instruct in a high intensity strengthening program for LEs especially distal muscles
b. assess for an ambulation device and AFOs
c. provide hospice care
d. BOTOX referral for spasticity control - Answer B
Which of the following is true with regard to pharmacological management of ALS?
a. There are currently no medications available for the treatment of ALS
b. Drugs such as Copaxone, which are commonly used in the treatment of multiple
sclerosis, are also effective in slowing the progression of ALS.
c. The glutamate inhibitor Riluzole is approved for the treatment of ALS and may extend
survival by several months.
d. Anticonvulsant medication such as Dilantin are often prescribed because of risk of
seizures increases as the disease progresses. - Answer C
Though the exact mechanism for the cause of ALS is not known what has been
identified in patients with ALS is
a. decreased acetylcholine receptor density
b. elevated levels of glutamate in cerebral spinal fluid
c. elevated levels of acetycholine in cerebral spinal fluid
d. lack of dystrophin in muscle structure - Answer B
Amyotrophic lateral sclerosis is characterized by :
a. lower motor neuron signs and symptoms
b. both upper and lower motor neuron signs and symptoms
c. upper motor neuron signs and symptoms
d. peripheral nerve injury signs and symptoms - Answer B
All of the diagnoses below are considered autoimmune diseases EXCEPT:
a. Charco-Marie Tooth disease
