Vestibular
Your patient has posterior canal BPPV, what 2 maneuvers can you use to treat this patient?
Epley Maneuver/ Canalith Repositioning Procedure and Liberatory/ Semont maneuver (1)
Before seeing your next patient, you note they are not on any medications. Prior to starting exercise, your patient’s resting HR is 87 bpm; you put the patient on the Nustep at level 4. After 10 mins the patient is sweating profusely, so you check the patient’s HR and note that it’s 89 bpm. Should this patient continue exercising?
No, the patient’s HR should increase with increasing intensity unless they are on a beta blocker (3)
A patient scores a 2 / 5 MMT for hip abduction; what position should you place the patient in to strengthen the glut med?
Supine with a towel or pillow case under the foot and have the patient slide the foot out to the side and back (8)
While working with a stroke survivor, you notice that their UE is more affected than their LE, which artery is most likely affected?
Middle Cerebral Artery (MCA) (13)
Your diabetic patient initiates their treatment session on the NuStep; after 10 mins the patient complains of increased hunger, sweating, shakiness, weakness, and headache. What are these symptoms indicative of?
Hypoglycemia (18)
You want to perform the Dix Hallpike Test for a patient you suspect has BPPV; how should you position the patient?
45 degrees rotated towards the tested ear and 20 degrees extended.
The down ear is the ear that is being tested for the posterior canal. (1)
A patient complains of lightheadedness when standing up after a supine exercise. The patient’s blood pressure in supine is 123/75 and their blood pressure in standing is 100/77. What may the patient be experiencing?
Orthostatic hypotension
Defined by a decrease in systolic blood pressure of 20 mmHg or a decrease in diastolic blood pressure of 10 mmHg (4)
A patient is performing a 5 times Sit To Stand test and is using his arms to push up; what should you correct the patient on?
Cross arms over chest (9)
What is one treatment that can be used to help correct a shoulder subluxation in stroke patients?
Neuromuscular Electrical Stimulation, stretching, tapping, sling/orthosis, UE weight bearing exercises (14)
A patient with a L2-L3 posterolateral herniated disc would have weakness with what movement?
Knee extension (19)
How does posterior canal BPPV nystagmus differ from lateral canal BPPV?
Posterior Canal is up beating and torsional whereas Lateral Canal is horizontal (1)
A patient’s patellar reflex is graded +4; this indicates that the patient has what type of reflex?
More than normal (enhanced)
Could also include a clonus (5)
What score out of 56 is considered a fall risk in the general population on the Berg Balance Scale?
<45 points (10)
If your patient has a Left Cerebellar Stroke which side of the body would be affected?
Left Side (15)
A patient complains of right big toe numbness and tingling, which dermatome is affected?
L4 (19)
What are central pathology characteristics of nystagmus?
Changes direction with gaze, purely vertical, does not change with fixation (2)
During the first treatment session with a diabetic patient, the patient tells you their last blood glucose level was 220 mg/dL. Is it contraindicated to exercise this patient?
No, it’s contraindicated if blood glucose is > 250 mg/dL with ketones or >300 mg/dL without ketones (6)
During the compensatory stepping correction section of the miniBESTest, a patient took 3 steps to recover balance. What score would be given?
1 (11)
Your stroke patient is having a difficult time grasping the meaning of spoken words and sentences; however, their ease of producing speech is not affected. Which type of aphasia is your patient presenting with?
Wernicke’s /Fluent/Receptive Aphasia (16)
A patient with an upper motor neuron lesion would present with what type of reflexes?
Increased/ enhanced/ hyperreflexia (7)
A patient is experiencing vestibular issues, which part of the cerebellum is affected?
Flocculonodular Lobe/Vestibulocerebellum and Vermis (2)
When checking PROM, a patient’s quad demonstrates an increase in muscle tone throughout most of knee flexion and extension, but can still easily be moved. What grade would this be on the Modified Ashworth Scale?
2
Defined as more marked increase in muscle tone through most of ROM, but the affected part is easily moved (7)
There is strong evidence for what outcome measure to measure walking distance in those with chronic progressive conditions?
6 Minute Walk Test (12)
During a chart review, you see that your new patient has Pusher Syndrome, will they push towards their paretic or non-paretic side?
Their paretic side (17)
What is the seat width of an adult standard wheelchair?
18 inches (20)