Parkinsons
A 65-year-old patient presents with a unilateral resting tremor and mild rigidity but reports no difficulty with balance or functional activities. According to the Hoehn \& Yahr (H\&Y) staging, which stage best describes this patient's current disease severity?
A.Stage 3
B.Stage 2
C.Stage 1
D.Stage 4
C- stage 1
bonus: what does it bean to be H/Y stage 3
A therapist is treating a patient with Unilateral Vestibular Hypofunction (UVH). The primary goal is to improve the gain of the Vestibulo-Ocular Reflex (VOR). Which mechanism of recovery is being utilized during VOR x1 exercises?
A.Adaptation
B.Habituation
C.Spontaneous Recovery
D.Substitution
A.Adaptation
bonus: show us a VOR exam
physical therapist is evaluating a patient with suspected femoroacetabular impingement (FAI). Which special test, if positive, would most likely reproduce anterior groin pain through a combination of hip flexion, adduction, and internal rotation?
A.Scour Test
B.Thomas Test
C.FABER Test
D.FADIR Test
D.FADIR Test
bonus: what test is most sensitive for intra-articular
Neuro: A therapist notes that a patient who recently suffered a stroke is experiencing dizziness, seems to have difficulty talking with doctor, and has abnormal findings on the convergence test. Which area of the brain was likely involved in the stroke?
A.Left Sided Hemisphere
B.Cerebellum
C.Brainstem
D.Right Sided Hemisphere
C.Brainstem
what are the 4 ds of brainstem lesions?
Other: A patient with Left-Sided Heart Failure is most likely to present with which set of symptoms during a physical therapy session?
A.Isolated orthostatic hypotension without respiratory changes
B.Normal oxygenation and clear auscultation
C.Peripheral edema, weight gain, and jugular venous distension (JVD)
D.Dyspnea on exertion (DOE), orthopnea, and pulmonary crackles
D.Dyspnea on exertion (DOE), orthopnea, and pulmonary crackles
bonus: how would tis fact modify your tx
Parkinsons: Which medication class is primarily used to reduce dopamine metabolism by inhibiting the COMT enzyme, thereby extending the effectiveness of Levodopa?
A.MAO Inhibitors (e.g., Selegiline)
B.COMT Inhibitors (e.g., Comtan)
C.Dopamine Agonists (e.g., Ropinirole)
D.Anticholinergics
B.COMT Inhibitors (e.g., Comtan)
bonus: what pathway is overactive in parkinsons?
A patient presents with oscillopsia, significant imbalance, and a positive head thrust test bilaterally. The patient's history includes a recent course of ototoxic IV antibiotics. What is the most appropriate management strategy?
A.High-dose VOR x2 exercises exclusively
B.Habituation exercises for motion sensitivity
C.Canalith Repositioning Maneuvers
D.Substitution strategies using visual and somatosensory cues
D.Substitution strategies using visual and somatosensory cues
bonus: what is oscillopsia
Which clinical finding would provide the highest diagnostic accuracy (specifically high specificity) for a PCL injury during a knee evaluation?
A.Valgus Stress Test at 30∘
B.Lachman's Test
C.Anterior Drawer Test
D.Posterior Sag Sign
D.Posterior Sag Sign
bonus: what other tests can you do for PCL
Neuro: Which spinal tract is responsible for transmitting information regarding light touch, proprioception, and vibration, and where does it decussate (cross) in the nervous system?
A.Spinothalamic Tract; decussates in the spinal cord
B.DCML Tract; decussates in the lower medulla
C.Corticospinal Tract; decussates in the spinal cord
D.DCML Tract; decussates in the spinal cord
B.DCML Tract; decussates in the lower medulla
bonus: what tracts give info on the LE
Other: A therapist is monitoring a patient's vitals and notes a drop in blood pressure when moving from supine to standing. What is the minimum criteria for a diagnosis of Orthostatic Hypotension?
A.Drop of >10 mmHg Systolic or >5 mmHg Diastolic
B.Increase of >20 bpm in Heart Rate alone
C.Drop of >20 mmHg Systolic or >10 mmHg Diastolic
D.Drop in systolic pressure below 90 mmHg regardless of starting point
C.Drop of >20 mmHg Systolic or >10 mmHg Diastolic
bonus: what are some pt populations you may see OH in?
Parkinsons: A patient diagnosed with Parkinson's disease 2 years ago exhibits a rapid onset of dementia and frequent backward falls during the initial examination. Which 'Parkinson's Plus' disorder should the therapist most likely suspect?
A.Corticobasal Degeneration (CBD)
B.Progressive Supranuclear Palsy
C.Lewy Body Dementia (LBD)
D.Multiple System Atrophy (MSA)
B.Progressive Supranuclear Palsy
bonus: define one of the other Parkinons + disorders
Which of the following findings is most characteristic of a Central Vestibular Disorder rather than a peripheral one?
A.Vertical or non-fatiguing nystagmus
B.Hearing loss and tinnitus
C.Positive Head Thrust Test to one side
D.Severe vertigo that is suppressed by visual fixation
A.Vertical or non-fatiguing nystagmus
bonus: what UVH would you see Hearing loss and tinnitus
According to the source material, what is the 'pass' criterion for the Hamstring 90/90 muscle length test?
A.Knee flexion to at least 70∘
B.Extension within 20∘ of full extension
C.Ability to touch toes in a standing position
D.Full knee extension to 0∘
B.Extension within 20∘ of full extension
bonus: what is the other muscle length test we have learned and can you show it
Neuro: During a cranial nerve screen, a therapist asks a patient to stick out their tongue. The tongue deviates significantly to the right side. Which cranial nerve is most likely impaired?
A.CN X: Vagus
B.CN XII: Hypoglossal
C.CN IX: Glossopharyngeal
D.CN VII: Facial
B.CN XII: Hypoglossal
bonus (what sd is the lesion on?)
Other: Which lab value is a specific marker for the severity of Heart Failure, with values over 400 indicating a significant issue?
A.Serum Bilirubin
B.Serum Albumin
C.Creatinine
D.B-type Natriuretic Peptide (BNP)
D.B-type Natriuretic Peptide (BNP)
bonus: show us how you would get a pt out of bed who just had a CABG
Parkinsons: The cardinal sign of bradykinesia is a requirement for a clinical diagnosis of Parkinson's. Which of the following must also be present along with bradykinesia to confirm the diagnosis?
A.At least one of: Tremor, Rigidity, or Postural Instability
B.Visual hallucinations and cognitive decline
C.At least two of: Tremor, Rigidity, or Postural Instability
D.Positive DaT scan alone
A.At least one of: Tremor, Rigidity, or Postural Instability
bonus: what is the program we did in class that targets the cardinal symptoms of parkinsons, show us one?
When performing the mCTSIB (Modified Clinical Test for Sensory Integration and Balance), which condition specifically tests the patient's ability to rely solely on vestibular input?
A.Condition 3: Compliant surface with eyes open
B.Condition 1: Firm surface with eyes open
C.Condition 4: Compliant surface with eyes closed
D.Condition 2: Firm surface with eyes closed
C.Condition 4: Compliant surface with eyes closed
bonus: what type of tx would focus on working on the visual and somatosensory systems to compensate for a faulty vestibular system?
A patient reports constant morning stiffness that improves with activity but worsens with rest. There are also signs of systemic warmth and swelling. Which origin of pain is most consistent with these key characteristics?
A.Inflammatory B.Mechanical C.Visceral D.Neuropathic
A.Inflammatory
bonus: what is an example of an Inflammatory disease that could cause these symptoms
Neuro: A patient is unable to understand spoken language, though they can produce speech fluently. However, the speech produced is nonsensical (word salad). Which specific type of aphasia and brain region is involved?
A.Dysarthria; Brainstem
B.Ideational Apraxia; Posterior Parietal Cortex
C.Expressive Aphasia; Left Frontal Lobe
D.Receptive Aphasia; Left Temporal Lobe
D.Receptive Aphasia; Left Temporal Lobe
(which on would you rather have?)
Other: In the context of Heart Failure classification, what is the primary difference between AHA/ACC Stages and NYHA Classes?
A.NYHA classes are only used for Right-Sided Failure; AHA stages are for Left-Sided Failure
B.NYHA Class IV is the starting point for all patients; AHA Stage A is the terminal stage
C.AHA/ACC measures only symptoms; NYHA measures structural heart disease
D.AHA/ACC measures disease progression (irreversible); NYHA measures symptom-based limitation (variable)
D.AHA/ACC measures disease progression (irreversible); NYHA measures symptom-based limitation (variable)
bonus: what would it mean if your pt was AHA stage C, NYHA level 2
Parkinsons: During the late stages of Parkinson's Disease, which dopamine pathway is primarily affected, leading to symptoms like impaired emotion, perception, and reward?
A.Nigrostriatal
B.Mesolimbic
C.Mesocortical
D.Tubero-infundibular
B.Mesolimbic
bonus: whats kind of symptoms are usually seen first in early stage Parkinsons
What is the recommended minimum dosage of gaze stabilization exercises for a patient with a chronic unilateral vestibular hypofunction (UVH)?
A.≥12 minutes per day
B.30 seconds, 3 times per week
C.60 minutes per day in a single session
D.≥20 minutes per day
D.≥20 minutes per day
bonus: what it the recommended time for acute?
Musculoskeletal: When performing a Passive Lumbar Extension Test, which finding would constitute a positive result according to the clinical exam guidelines provided?
A.Radicular tingling down to the foot
B.Pain or a feeling of heaviness in the low back
C.Increased range of motion in the L5-S1 segment
D.Pain that subsides when the legs are lifted
B.Pain or a feeling of heaviness in the low back
whats the other test you can do to look at movement coordination impairments
Neuro: Which principle of neuroplasticity suggests that when you practice activities that matter to you (such as brushing your teeth or talking with friends), your brain makes new connections more easily?
A.Transference Matters
B.Intensity Matters
C.Salience Matters
D.Specificity Matters
C.Salience Matters
bonus (how would you practice walking with salience in a pt with parkinsons who likes baseball)
Other: A patient who has been on bedrest for 48 hours exhibits a 15 bpm increase in Heart Rate during a simple transfer. Based on the cardiovascular diagnosis guidelines, how should this patient be categorized?
A.HFrEF (Systolic Heart Failure)
B.Deconditioned
C.Hypertensive Crisis
D.Normal aerobic response
B.Deconditioned
bonus: what is a normal response to exercise?