ADULT 2 A+ COMPILED ACTUAL SCRIPT 2026
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ ALS UMN involvement.
Answer: results in weakness, spasticity, hyperreflexia
typically eye mvmt, bowel/bladder control, and sensation not
affected
◉ ALS LMN involvement.
Answer: results in weakness/muscle atrophy of extremities, cervical
extensor weakness, fasciculations, muscle cramps, loss of reflexes
typically eye mvmt, bowel/bladder control, and sensation not
affected
◉ etiology of ALS.
Answer: o 6,000 people in USA are Dx annually (15 people/day)
o Approx. 20,000 Americans have this at any given time
o 60% of people are male
o 93% of people are white
,o Military veterans, particularly those deployed during the golf war,
are 2x as likely to develop this
◉ Dx of ALS.
Answer: o No special test is available to est. the Dx, and cause is
unknown
o Initial symptoms vary widely, and Dx is a careful, multistep system
of exclusion
o A comprehensive Dx workup includes, most, if not all, of the
following procedures:
Electrodiagnostic tests including EMG and nerve conduction
velocity (NCV)
Blood and urine studies including high resolution serum protein
electrophoresis, thyroid, and parathyroid hormone levels and 24 hr
urine collection for heavy metals
Spinal tap
X-rays, including MRI
Myelogram of cervical spine
Mm and/or nerve biopsy
Thorough neurological exam
◉ types of ALS.
Answer: o Sporadic- most common in US
90-95% of all cases
,o Familia- small number of cases in US
5-10% of all cases
o Guamaniam
High incidence was observed in the 50's
◉ Mean survival of individuals with ALS.
Answer: 3-5 y. many lives 5, 10, or more years
◉ Stage I of ALS.
Answer: ambulatory, no problems with ADL, mild weakness
◉ stage II of ALS.
Answer: ambulatory, moderate weakness in certain muscles
◉ Stage III of ALS.
Answer: ambulatory, severe weakness in certain muscles
◉ Stage IV of ALS.
Answer: w/c confined, almost independent, severe weakness in legs
◉ Stage V of ALS.
, Answer: w/c confined, dependent; pronounced weakness in legs,
severe weakness in arms
◉ Stage VI of ALS.
Answer: bedridden, no ADL, max A required
◉ Assessments specific to ALS.
Answer: ALS functional rating scale
Purdue pegboard or other timed UE function test and standard ROM
and MMT
Multidimensional fatigue inventory
◉ goal setting for early stages of ALS.
Answer: Optimize strength and ROM using home exercise programs
Maintain function in ADL/IADL through use of AT, home
modification
Decrease pain and fatigue through use of splints/orthotics
Employ joint protection, pain management, energy conservation,
and work simplification techniques
◉ goal setting for later stages of ALS.
Answer: Focus on enabling the CG to assist pt safely and effectively
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ ALS UMN involvement.
Answer: results in weakness, spasticity, hyperreflexia
typically eye mvmt, bowel/bladder control, and sensation not
affected
◉ ALS LMN involvement.
Answer: results in weakness/muscle atrophy of extremities, cervical
extensor weakness, fasciculations, muscle cramps, loss of reflexes
typically eye mvmt, bowel/bladder control, and sensation not
affected
◉ etiology of ALS.
Answer: o 6,000 people in USA are Dx annually (15 people/day)
o Approx. 20,000 Americans have this at any given time
o 60% of people are male
o 93% of people are white
,o Military veterans, particularly those deployed during the golf war,
are 2x as likely to develop this
◉ Dx of ALS.
Answer: o No special test is available to est. the Dx, and cause is
unknown
o Initial symptoms vary widely, and Dx is a careful, multistep system
of exclusion
o A comprehensive Dx workup includes, most, if not all, of the
following procedures:
Electrodiagnostic tests including EMG and nerve conduction
velocity (NCV)
Blood and urine studies including high resolution serum protein
electrophoresis, thyroid, and parathyroid hormone levels and 24 hr
urine collection for heavy metals
Spinal tap
X-rays, including MRI
Myelogram of cervical spine
Mm and/or nerve biopsy
Thorough neurological exam
◉ types of ALS.
Answer: o Sporadic- most common in US
90-95% of all cases
,o Familia- small number of cases in US
5-10% of all cases
o Guamaniam
High incidence was observed in the 50's
◉ Mean survival of individuals with ALS.
Answer: 3-5 y. many lives 5, 10, or more years
◉ Stage I of ALS.
Answer: ambulatory, no problems with ADL, mild weakness
◉ stage II of ALS.
Answer: ambulatory, moderate weakness in certain muscles
◉ Stage III of ALS.
Answer: ambulatory, severe weakness in certain muscles
◉ Stage IV of ALS.
Answer: w/c confined, almost independent, severe weakness in legs
◉ Stage V of ALS.
, Answer: w/c confined, dependent; pronounced weakness in legs,
severe weakness in arms
◉ Stage VI of ALS.
Answer: bedridden, no ADL, max A required
◉ Assessments specific to ALS.
Answer: ALS functional rating scale
Purdue pegboard or other timed UE function test and standard ROM
and MMT
Multidimensional fatigue inventory
◉ goal setting for early stages of ALS.
Answer: Optimize strength and ROM using home exercise programs
Maintain function in ADL/IADL through use of AT, home
modification
Decrease pain and fatigue through use of splints/orthotics
Employ joint protection, pain management, energy conservation,
and work simplification techniques
◉ goal setting for later stages of ALS.
Answer: Focus on enabling the CG to assist pt safely and effectively
