Myelin Your Own Business
A Turn for the Worse
Mind the Gap
Shaking Things Up
Testing the Limits
100

This is the most common disease course of MS at onset, characterized by clear relapses followed by periods of recovery.

What is Relapsing-Remitting MS (RRMS)?

100

If a patient complains of brief spinning episodes specifically when rolling over in bed, they most likely have this condition.

What is Benign Paroxysmal Positional Vertigo (BPPV)?

100

The Glasgow Coma Scale (GCS) measures TBI severity by evaluating motor responses, verbal responses, and this type of response.

What is eye opening?

100

The four cardinal signs of Parkinson disease spell out this four-letter acronym.

What is TRAP (Tremor, Rigidity, Akinesia/bradykinesia, Postural instability)?  

100

This positional test is the standard assessment used to diagnose posterior and anterior canal BPPV.

What is the Dix-Hallpike test?

200

Medical management of MS has three main goals: manage symptoms, treat active relapses with steroids, and use Disease-Modifying Therapies (DMTs) to do this.

What is prevent relapses?

200

This reflex moves the eyes equal and opposite to head motion to keep an image stable on the retina.

What is the vestibulo-ocular reflex (VOR)?

200

The two most common joint contractures you must prevent in early TBI management are ankle plantarflexion and flexion of this joint.  

What is the elbow?

200

The classic Parkinson's tremor typically diminishes with effort and increases under these two conditions.

What are stress and fatigue?

200

A patient's Dynamic Visual Acuity (DVA) test is considered abnormal if they lose this many lines or more on the chart while you move their head.  

What is 3 lines (or ≥ 3 lines)?

300

Because MS patients experience heat intolerance, you should keep the clinic cool to prevent this temporary worsening of symptoms during exercise.  

What is weakness (or fatigue)?

300

You should use this repositioning maneuver to treat a patient who has right posterior canalithiasis BPPV.

What is the Epley maneuver?

300

If a TBI patient at Rancho Level IV is highly agitated and lacks short-term memory, your treatment sessions should focus on this type of learning, rather than cognitive learning.

What is motor learning?

300

According to the Hoehn & Yahr staging scale, a patient reaches Stage 5 when they are confined to a bed or this mobility device unless aided.  

What is a wheelchair?

300

During a vestibular exam, nystagmus that changes direction based on where the patient looks points to dysfunction in this nervous system.  

What is the central nervous system?

400

This common impairment in MS can be quantified using the free, 20-item FSMC.  

What is fatigue?

400

If a patient experiences dizziness when standing up first thing in the morning, you should check their heart rate and blood pressure to rule out this non-vestibular condition.

What is orthostatic hypotension?

400

 In the ICU, nausea, vomiting, papilledema, and drowsiness in a TBI patient are red flags for this dangerous condition.

What is increased intracranial pressure (or intracranial hypertension)?

400

To help a Parkinson's patient who frequently freezes in doorways, the clinical practice guideline strongly recommends this intervention, which can involve rhythmic auditory sounds or visual lines.

What is external cueing?

400

If you observe a catch-up saccade when performing a head thrust to the right, it indicates hypofunction on this side.

What is the right side?

500

If an MS patient trips frequently because their foot drops when they get tired, utilizing this specific electrical intervention can improve their gait quality and reduce falls.

What is Functional Electrical Stimulation (FES)?

500

You must stop vestibular habituation exercises for the day if the patient's dizziness increases and does not settle within this specific amount of time.  

What is 5 minutes?

500

When examining a patient with a concussion, you should evaluate and treat this region of the spine first if the patient has high neck pain irritability.  

What is the cervical (and thoracic) spine?

500

Out of the cardinal signs of Parkinson's disease, this specific sign correlates best with the severity of dopamine loss in the basal ganglia.  

What is bradykinesia (or akinesia)?

500

If a BPPV patient has nystagmus lasting longer than 60 seconds during a positional test, it indicates this condition.

What is cupulolithiasis?