review of neurologic and geriatric material PT 764
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| with aging cells generally become more/less able to adapt to stressors | less
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| with aging tissues become stiffer due to changes in collagen and elastin. What are the changes in each of these? | collagen becomes stiffer and has more cross linking elastin becomes stiffer and more like collagen
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| which test can be administered to the UE (ARM) to determine if an UMN lesion is likely present? | Hoffman's
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| You are doing passive range of motion with your patient. Which of these can you test for? synergy or changes in tone? | changes in tone
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| you are having your patient do active range of motion. Which of these can you test for? synergy or change in tone? | synergy
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| to test non-equilibrium coordination which test would you choose? finger to nose or tandem stance? | finger to nose
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| to test equilibrium coordination which test would you choose? finger to nose or tandem stance? | tandem stance
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| which of the following should be evaluated first? hearing or strength? | hearing
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| When asked to sit up straight your patient extends his thoracic spine and leans back. You check range of motion and strength and they are both adequate. this leads you to suspect that the reason this patient is unable to sit up straight is most likely ___ | lack of motor control. You could also say coordination deficits or not knowing what position they are in.
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| Your patient walks independently but tends to drag their foot due to foot drop from paralysis of the dorsiflexors. You elect to use an ace wrap to place the foot into dorsiflexion for gait. Because of this you are prepared for what change in their gait? | Their knee may buckle due to now landing with a more dorsiflexed foot which will require more control around the knee.
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| Your patient is 3 days s/p CVA and requires moderate assist to walk with a cane. If you were to administer the Tinetti they would have a _____________ effect | floor
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| your patient is s/p CVA and able to walk independently on level surfaces, transfer independently and do all ADL's. The patient wishes to return to sports. If you administer the Berg there is likely to be a _________ effect | ceiling
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| you set up treadmill training for your post cVA patient. the patient presently walks at .4 m/s so you set the treadmill speed at: | .5 or .6 m/s
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| your patient does not weight bear on their Left leg. To improve this during transfers you FIRST have him 1. reach to the left while standing 2. stand with right foot on egg carton | 2. stand with right foot on egg carton progress to reaching activity once force to learn the motor task
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| Your patient had a CVA and you dont want them getting up so you put on a seat belt. The patient cannot remove the seat belt. The seat belt is a ____________ | restraint
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| Your patient had a CVA 2 days ago and has posttraumatic delirium and has fallen getting up so you put on a seat belt. The patient cannot remove the seat belt. The seat belt is a ____________ | restraint and enabler as it is for the patient's safety and likely to be very temporary
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| Mrs. D can walk with supervision on her alzheimer unit and tends to get up and wander. The best device for her would be: 1. a table top 2. a seat belt 3. a chair alarm | 3. chair alarm as it is least restrictive
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| with aging what are normal age related changes of the mouth related to appetite and eating? | decreased saliva, fewer taste buds
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| You and your grandma each have a giant piece of pumpkin pie. What is different about how your pancreases respond to this? | grandmas pancreas is slower to respond to the sudden increase in blood glucose
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| patient s/p (L) CVA keeps weight too far posterior when going sit to stand. You set up the task using a bedside table. Where do you place the table? 1. to his right 2. out in front so he has to reach for it 3. in front and elevated so he has to reach up | 2. out in front so he has to reach for it if set elevated he will reach up and this pushes a person "back" you want to get a forward lean with nose over toes.
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| s/p (L) CVA patient has been working on sit to stand and gets equal weight bearing when the task forces it. the next step would be to have him 1. stand with egg carton under (L) foot 2. reach to right while standing | 2. reach to right while standing is the correct progression. the egg carton "forces" the weight shift and is where you start if he wont weight shift.
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| an ashworth score of 0 means: | normal tone
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| an ashworth score of 3 means | hypertonicity - moderate to severe
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| in the patient s/p CVA you note scapular winging. this is most likely due to weakness of the | serratus anterior
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| the patient s/p cva shrugs when elevating the arm. This indicates over use of what muscle? | levator scapuli
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| in patients with CVA the scapula typically rotates _________ when elevating the arm | downward
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| in patients s/p CVA shoulder elevation leads to impingement and painful sequelae because of: | poor scapular kinematics - downward rotation and elevation rather than upward rotation and movement around the thorax
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| Mr X has a rash and his doctor gives him steroids. It turns out the rash is from the antibiotic he was taking. This is an example of: | polypharmacy
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| In the elderly aspirin produces a greater/lesser response due to changes in plasma protein | greater
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| Your patient started a lipid soluble drug a month ago. Today they started having dizziness. Knowing that the drug is lipid soluble makes it more/less likely to cause a delayed onset of side effects? | more
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| in normal aging overall intelligence declines true/false | false
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| older learners will do better when new material is presented in a way that 1. encourages them to problem solve through new connections 2. relates it to previously learned material | 2. relates it to previously learned material
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| alzheimers is the most common form of dementia. What is the most common form of TREATABLE dementia? | Depression
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| your patient underwent a hip replacement a week ago. Her daughter is concerned because her mother is confused since the surgery. What do you tell her is most likely causing the confusion? | delirium (could be post-anesthetic or due to the trauma and stress of the surgery)
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| your patient's family describe a step-wise progression of his dementia and he exhibits a shuffling gait with mild dementia. You suspect his dementia is from: | vascular dementia
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| your patient has dementia and hallucinations. this leads you to suspect | dementia with lewy bodies
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| your patient has dementia with good short term memory and significant changes in personality that came on early. You suspect what type of dementia? | Frontotemporal dementia
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| The mini mental status exam is used to: 1. diagnose alzheimers 2. screen for dementia | 2. screen for dementia
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| Your patient has alzheimers. you are teaching him to use a rollator walker. do you use random or blocked practice? | blocked
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| your alzheimers patient that needs to learn to use a rollator should be taught every day or 3 times a week? | every day
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| Can physical therapy be beneficial in the third stage of alzheimers? | yes - primarily to teach caregivers how to lift and stretch.
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