Question 1

Which of the following is true with regard to pharmacological management of ALS?

Accepted Answer

A) Drugs such as Copaxone,which are commonly used in the treatment of multiple sclerosis,are also effective in slowing the progression of ALS. 
B) The glutamate inhibitor Riluzole (Rilutek)is approved for the treatment of ALS and may extend survival by several months. 
C) Anticonvulsant medications such as Dilantin are often prescribed because risk of seizures increase as the disease progresses. 
D) There are currently no medications available for the treatment of ALS. 
A) Drugs such as Copaxone,which are commonly used in the treatment of multiple sclerosis,are also effective in slowing the progression of ALS. 
B) The glutamate inhibitor Riluzole (Rilutek)is approved for the treatment of ALS and may extend survival by several months. 
C) Anticonvulsant medications such as Dilantin are often prescribed because risk of seizures increase as the disease progresses. 
D) There are currently no medications available for the treatment of ALS. B

Question 2

The treatment of patients with early-stage ALS should include

Accepted Answer

A) restorative intervention. 
B) preventive intervention. 
C) compensatory intervention. 
D) all of the above. 
A) restorative intervention. 
B) preventive intervention. 
C) compensatory intervention. 
D) all of the above. D

Question 3

Which of the following mobility devices would be most appropriate to purchase for a patient with ALS?

Accepted Answer

A) A manual wheelchair with reclining back 
B) A power wheelchair with tilt-in-space seating 
C) A motorized scooter 
D) A wheeled standing frame 
A) A manual wheelchair with reclining back 
B) A power wheelchair with tilt-in-space seating 
C) A motorized scooter 
D) A wheeled standing frame B

Question 4

Which of the following is NOT true with regard to ALS?

Accepted Answer

A) In the majority of cases the disease is inherited. 
B) Average age at onset is mid to late 50s. 
C) Initial symptoms most often occur in the extremities. 
D) It is a neurodegenerative disease. 
A) In the majority of cases the disease is inherited. 
B) Average age at onset is mid to late 50s. 
C) Initial symptoms most often occur in the extremities. 
D) It is a neurodegenerative disease.

Question 5

Pain in patients with ALS

Accepted Answer

A) is typically a sharp and shooting pain as a result of demyelination. 
B) typically occurs as a secondary or composite impairment as a result of immobility or malalignment. 
C) is one of the first signs/symptoms of the disease. 
D) is uncommon. 
A) is typically a sharp and shooting pain as a result of demyelination. 
B) typically occurs as a secondary or composite impairment as a result of immobility or malalignment. 
C) is one of the first signs/symptoms of the disease. 
D) is uncommon.

Question 6

Which of the following interventions is not appropriate for managing cervical muscle weakness in patients with ALS?

Accepted Answer

A) Cervical collars for provide external support 
B) Reclining or tilt-in-space wheelchair with head support 
C) Environmental/ergonomic changes such as elevating reading material 
D) Halotraction 
A) Cervical collars for provide external support 
B) Reclining or tilt-in-space wheelchair with head support 
C) Environmental/ergonomic changes such as elevating reading material 
D) Halotraction

Question 7

Which of the following impairments is relatively rare in patients with ALS?

Accepted Answer

A) Sensory deficits 
B) Contracture 
C) Weakness/paralysis of the spinal muscles 
D) Dysphagia 
A) Sensory deficits 
B) Contracture 
C) Weakness/paralysis of the spinal muscles 
D) Dysphagia

Question 8

Appropriate physical therapy interventions to manage respiratory muscle weakness in patient with ALS may include

Accepted Answer

A) supine positioning to optimize ventilation. 
B) assisted coughing techniques and breathing exercises. 
C) UE ergometry at 70%-85% target heart rate. 
D) locomotor training using body weight support and a motorized treadmill. 
A) supine positioning to optimize ventilation. 
B) assisted coughing techniques and breathing exercises. 
C) UE ergometry at 70%-85% target heart rate. 
D) locomotor training using body weight support and a motorized treadmill.

Question 9

Which of the following is true with regard to prognosis in patients with ALS?

Accepted Answer

A) Older age at onset is a positive prognostic indicator; people diagnosed after age 55 have better 5-year survival rates. 
B) Patients with familial ALS have a better prognosis that those with sporadic ALS. 
C) Those with limb-onset ALS have a better prognosis than those with bulbar-onset ALS. 
D) Disease-modifying medications,if taken early after diagnosis,can increase life expectancy by 10 years or more. 
A) Older age at onset is a positive prognostic indicator; people diagnosed after age 55 have better 5-year survival rates. 
B) Patients with familial ALS have a better prognosis that those with sporadic ALS. 
C) Those with limb-onset ALS have a better prognosis than those with bulbar-onset ALS. 
D) Disease-modifying medications,if taken early after diagnosis,can increase life expectancy by 10 years or more.

Question 10

In patients with MS,which of the following is true with regard to the management of dysphagia?

Accepted Answer

A) For most patients with ALS,dysphagia is not an issue. 
B) Initially,dysphagia can be managed by dietary modifications,patient education,and swallowing adaptations and strategies. 
C) Most patients with ALS are started early on total parenteral nutrition through a central line to prevent malnutrition. 
D) Even in patients with dysphagia,malnutrition and dehydration are not common. 
A) For most patients with ALS,dysphagia is not an issue. 
B) Initially,dysphagia can be managed by dietary modifications,patient education,and swallowing adaptations and strategies. 
C) Most patients with ALS are started early on total parenteral nutrition through a central line to prevent malnutrition. 
D) Even in patients with dysphagia,malnutrition and dehydration are not common.

Question 11

Which is considered the cardinal sign of ALS?

Accepted Answer

A) Pain 
B) Sensory loss 
C) Ataxia 
D) Muscle weakness 
A) Pain 
B) Sensory loss 
C) Ataxia 
D) Muscle weakness

Question 12

The primary goal of medical intervention in patients with ALS is

Accepted Answer

A) to cure the disease and restore the patient to health. 
B) to prevent progression of the disease and when possible reverse the pathological process. 
C) to achieve the best quality of life for patients through palliative care. 
D) to prepare the patient for inevitable early death. 
A) to cure the disease and restore the patient to health. 
B) to prevent progression of the disease and when possible reverse the pathological process. 
C) to achieve the best quality of life for patients through palliative care. 
D) to prepare the patient for inevitable early death.

Question 13

Pseudobulbar affect,which is commonly seen in individuals with spastic bulbar palsy,refers to

Accepted Answer

A) deficits in speaking and swallowing due to weakness in bulbar muscles. 
B) fluctuating pathological emotional control. 
C) deficits that mimic bulbar weakness. 
D) slowness of speech and decreased articulation. 
A) deficits in speaking and swallowing due to weakness in bulbar muscles. 
B) fluctuating pathological emotional control. 
C) deficits that mimic bulbar weakness. 
D) slowness of speech and decreased articulation.

Question 14

For controlling ankle and knee involvement,the most appropriate LE orthosis for patients with ALS is typically

Accepted Answer

A) a hip-knee-ankle-foot orthosis as patients have both trunk and LE involvement. 
B) a knee-ankle-foot orthosis because of the extreme hyperextension that often occurs with LE weakness. 
C) an ankle-foot orthosis because it allows some control of both the ankle and the knee,but it is still relatively lightweight. 
D) a foot orthosis because excessive pronation often results in significant pain if not addressed. 
A) a hip-knee-ankle-foot orthosis as patients have both trunk and LE involvement. 
B) a knee-ankle-foot orthosis because of the extreme hyperextension that often occurs with LE weakness. 
C) an ankle-foot orthosis because it allows some control of both the ankle and the knee,but it is still relatively lightweight. 
D) a foot orthosis because excessive pronation often results in significant pain if not addressed.

Question 15

Based on research on individuals with neuromuscular disease,exercise in patients with ALS

Accepted Answer

A) is contraindicated,as it may cause overuse weakness. 
B) may improve the strength of muscles with a strength grade less than 3/5. 
C) may improve the strength of muscles with a strength grade of at least 3/5. 
D) should be utilized in any weak muscle regardless of the grade. 
A) is contraindicated,as it may cause overuse weakness. 
B) may improve the strength of muscles with a strength grade less than 3/5. 
C) may improve the strength of muscles with a strength grade of at least 3/5. 
D) should be utilized in any weak muscle regardless of the grade.

Question 16

In patients with ALS,positive pressure noninvasive ventilation

Accepted Answer

A) is recommended once vital capacity falls below 50% of predicted values. 
B) is recommended at diagnosis to prevent vital capacity from decreasing. 
C) is not recommended,as supplemental oxygen is usually all that is needed. 
D) is not recommended,as it cannot stop progression of disease and will extend the patient's survival only by a few months. 
A) is recommended once vital capacity falls below 50% of predicted values. 
B) is recommended at diagnosis to prevent vital capacity from decreasing. 
C) is not recommended,as supplemental oxygen is usually all that is needed. 
D) is not recommended,as it cannot stop progression of disease and will extend the patient's survival only by a few months.

Question 17

Which of the following is true with regard to exercise in patients with ALS?

Accepted Answer

A) When prescribing exercises,therapists must strive to attain a balance between promoting optimal use of intact muscles and preventing overuse fatigue. 
B) Strengthening exercises are most effective in the weakest muscles,as these have the greatest room for improvement. 
C) Exercise should be prescribed at moderate-to-high intensities; otherwise it is not effective for improving strength and endurance. 
D) Exercise is contraindicated,regardless of intensity,because it causes overwork damage. 
A) When prescribing exercises,therapists must strive to attain a balance between promoting optimal use of intact muscles and preventing overuse fatigue. 
B) Strengthening exercises are most effective in the weakest muscles,as these have the greatest room for improvement. 
C) Exercise should be prescribed at moderate-to-high intensities; otherwise it is not effective for improving strength and endurance. 
D) Exercise is contraindicated,regardless of intensity,because it causes overwork damage.

Question 18

A patient with a diagnosis of ALS has sialorrhea.The patient will experience

Accepted Answer

A) excessive sweating. 
B) excessive salivation and drooling. 
C) ocular paralysis. 
D) unexplained limb pain. 
A) excessive sweating. 
B) excessive salivation and drooling. 
C) ocular paralysis. 
D) unexplained limb pain.

Question 19

Amyotrophic lateral sclerosis is characterized by

Accepted Answer

A) upper motor neuron signs and symptoms. 
B) lower motor neuron signs and symptoms. 
C) both upper and lower motor neuron signs and symptoms. 
D) peripheral nerve injury signs and symptoms. 
A) upper motor neuron signs and symptoms. 
B) lower motor neuron signs and symptoms. 
C) both upper and lower motor neuron signs and symptoms. 
D) peripheral nerve injury signs and symptoms.

Exam 20: Amyotrophic Lateral Sclerosis

Which of the following is true with regard to pharmacological management of ALS?

The treatment of patients with early-stage ALS should include

Which of the following mobility devices would be most appropriate to purchase for a patient with ALS?

Which of the following is NOT true with regard to ALS?

Pain in patients with ALS

Which of the following interventions is not appropriate for managing cervical muscle weakness in patients with ALS?

Which of the following impairments is relatively rare in patients with ALS?

Appropriate physical therapy interventions to manage respiratory muscle weakness in patient with ALS may include

Which of the following is true with regard to prognosis in patients with ALS?

In patients with MS,which of the following is true with regard to the management of dysphagia?

Which is considered the cardinal sign of ALS?

The primary goal of medical intervention in patients with ALS is

Pseudobulbar affect,which is commonly seen in individuals with spastic bulbar palsy,refers to

For controlling ankle and knee involvement,the most appropriate LE orthosis for patients with ALS is typically

Based on research on individuals with neuromuscular disease,exercise in patients with ALS

In patients with ALS,positive pressure noninvasive ventilation

Which of the following is true with regard to exercise in patients with ALS?

A patient with a diagnosis of ALS has sialorrhea.The patient will experience

Amyotrophic lateral sclerosis is characterized by

Clinical Decision Making

Influence of Psychosocial Factors on Rehabilitation

Influence of Values on Patient Care: Foundation for Decision Making

Vital Signs

Examination of Sensory Function

Musculoskeletal Examination

Examination of Coordination

Examination of Motor Function: Motor Control and Motor Learning

Electromyography and Nerve Conduction Velocity Tests

Examination of Gait

Examination of Functional Status and Activity Level

Examination of the Environment

Strategies to Improve Motor Function

Locomotor Training

Chronic Pulmonary Dysfunction

Heart Disease

Vascular,lymphatic,and Integumentary Disorders

Stroke

Multiple Sclerosis

Parkinsons Disease

Traumatic Brain Injury

Traumatic Spinal Cord Injury

Vestibular Disorders

Amputation

Arthritis

Burns

Chronic Pain

Cognitive and Perceptual Dysfunction

Neurogenic Disorders of Speech and Language

Orthotics

Prosthetics

The Prescriptive Wheelchair

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