NCS Advantage Test Review Exam
Questions with Verified Answers
Nocera et al.'s 2013 article proposes a cut-off of 11.5 seconds for determining falls
risk among individuals with Parkinson's disease.
A 36-year-old female with a history of multiple sclerosis reports new onset of diplopia
when reading the newspaper. In what area of the brain is demyelination most likely?
- ANSWER-Medial longitudinal fasciculus
Intranuclear Opthalmoplegia - ANSWER-A lesion of the medial longitudinal
fasciculus produces slowed or absent adduction of the ipsilateral eye upon
contralateral gaze. This is usually associated with involuntary jerky eye movements
(nystagmus) of the abducting eye, a syndrome called internuclear ophthalmoplegia
Internuclear ophthalmoparesis (INO), also commonly referred to as internuclear
ophthalmoplegia, is a specific gaze abnormality characterized by impaired horizontal
eye movements with weak and slow adduction of the affected eye, and abduction
nystagmus of the contralateral eye.
Symptoms of INO may vary in severity. Symptoms range from, horizontal diplopia,
difficulty in tracking high-speed objects, or dizziness on lateral gaze. Horizontal
diplopia is caused by the limitation of adduction in the ipsilateral eye.
INO= Intranuclear Opthalmoparesis
What increases the risk of developing post-polio syndrome? - ANSWER-A very fast
recovery from the initial infection increases risk for developing post-polio syndrome
How to appropriately monitor ICPs? - ANSWER-In order to appropriately measure
intracranial pressure and allow some drainage of CSF, the monitor needs to be
positioned at the level of the external auditory meatus. Therefore, the head of the
bed must be elevated to at least 30 degrees.
The head of bed must be elevated to at least 30 degrees
Which precaution is true for patients with intracranial pressure monitors? -
ANSWER-The head of bed must be elevated to at least 30 degrees
TOPAMAX - ANSWER-TOPAMAX= SEIZURE MEDICATION
It can also be used to prevent migraines and treat bipolar disorder
What is a likert scale? - ANSWER-For example, consider a scale where 1 = strongly
agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree. In this scale, 4
,is more negative than 3, 2, or 1. However, it cannot be inferred that a response of 4
is twice as negative as a response of 2.
A 38-year-old male is six months status-post middle cerebral artery stroke. During an
outpatient physical therapy evaluation, he scored 96 on the Stroke Impact Scale.
Based on this information alone, how severe do you expect his limitations to be? -
ANSWER-Very minimal limitations
Stroke Impact Scale - ANSWER-The Stroke Impact Scale is a Likert scale assessing
an individual's health status following a stroke. The score ranges from 0-100 with
higher numbers representing greater recovery/less impairment.
The stroke impact scale is a self report questionnaire that reports health related QOL
and disability after stroke
It's rated 0-100 with higher scores being better
8 domains
Strength
Hand function
ADL/IADL
Mobility
Communication
Emotion
Memory and thinking
Participation and role/function
Each item is rated on a 5 point likert scale depending on how much difficulty a
person has with each item
Likert data is what kind of data? - ANSWER-Ordinal data
They go in order but there is not equal intervals or spaces between each anchor on
the likert scale
Cerebral perfusion pressure (CPP) is the difference between mean arterial pressure
and intracranial pressure. Pressures less than what values cause ischemia? -
ANSWER-40-50 mmHg
Pressures less than 40-50 mmHg cause ischemia in the brain.
HD Pathophysiology- - ANSWER-Extra repeats of cytosine-adenine-guanine triplets,
or CAG, produce an abnormal form of huntingtin protein which causes severe loss of
neurons in the brain.
Loss of striatal medium spiny neurons I believe
Superior canal dehiscence is characterized by what? - ANSWER-Superior canal
dehiscence is characterized by vertigo and oscillopsia evoked by loud noises.
A forefoot initial contact increases the energy demand of gait by interfering with
which rocker? - ANSWER-All 3 rockers - the heel, ankle and forefoot rocker
Rockers in Gait- - ANSWER-Gait is made up of 3 rockers
, First the heel rocker from initial contact at heel strike until foot flat (eccentric control
of anterior tib)
Then the ankle rocker where the tibia gets anterior translation over the talus
Then the 3rd rocker is the forefoot rocker when the plantar flexors supply power for
push off and the ankle plantarflexes over a fixed forefoot which ends in toe off
All of these rockers would be disturbed by a forefoot initial contact
What stage(s) of the Expanded Disability Status Scale is (are) characterized by
independent ambulation? - ANSWER-Stages 0-4.5
According to the EDSS, individuals scoring higher than 4.5 demonstrate various
degrees of dependence with ambulation
Axonal sprouting- where does this occur? what is the rate it occurs at? - ANSWER-
Axonal sprouting occurs at a rate of approximately 1mm/day in the PNS. Damage in
the CNS is irreversible.
When is body temperature been shown to be the lowest? - ANSWER-Body
temperature is lowest in the morning
So PT for people with MS might be better in the AM
What type of PT can be good for MS and avoiding the Uthoff Phenomenon? -
ANSWER-Aquatic therapy has been shown to reduce effects of overheating
A patient presents to the emergency department after a motorcycle accident. He
opens his eyes in response to voice, is uttering inappropriate words, and
demonstrates a flexion/withdrawal response to painful stimuli. What is the severity of
his traumatic brain injury? - ANSWER-Moderate
His Glasgow Coma Scale score is 10 (eyes 3, verbal 3, motor 4), which is indicative
of a traumatic brain injury with moderate severity.
What are the items on the GCS? How is each item scored? - ANSWER-Eye
opening- scored 1-4
Verbal response- scored 1-5
Motor response- scored 1-6
So a 3 is the lowest score and that would be no response on anything- no eye
opening, no verbal response even if nonsensical, no motor response even if reflexive
or abnormal flexion/extension. 3 is NOTHING
All sensory information passes through the thalamus prior to reaching its target on
the cerebral cortex, except __________. - ANSWER-Smell
Information gathered by the olfactory receptors travels via the lateral olfactory tract
directly to the primary olfactory cortex. Information is passed through the thalamus
later in the pathway to reach other areas of the brain unlike other sensory
information which passes through the thalamus before reaching the cortex.
Questions with Verified Answers
Nocera et al.'s 2013 article proposes a cut-off of 11.5 seconds for determining falls
risk among individuals with Parkinson's disease.
A 36-year-old female with a history of multiple sclerosis reports new onset of diplopia
when reading the newspaper. In what area of the brain is demyelination most likely?
- ANSWER-Medial longitudinal fasciculus
Intranuclear Opthalmoplegia - ANSWER-A lesion of the medial longitudinal
fasciculus produces slowed or absent adduction of the ipsilateral eye upon
contralateral gaze. This is usually associated with involuntary jerky eye movements
(nystagmus) of the abducting eye, a syndrome called internuclear ophthalmoplegia
Internuclear ophthalmoparesis (INO), also commonly referred to as internuclear
ophthalmoplegia, is a specific gaze abnormality characterized by impaired horizontal
eye movements with weak and slow adduction of the affected eye, and abduction
nystagmus of the contralateral eye.
Symptoms of INO may vary in severity. Symptoms range from, horizontal diplopia,
difficulty in tracking high-speed objects, or dizziness on lateral gaze. Horizontal
diplopia is caused by the limitation of adduction in the ipsilateral eye.
INO= Intranuclear Opthalmoparesis
What increases the risk of developing post-polio syndrome? - ANSWER-A very fast
recovery from the initial infection increases risk for developing post-polio syndrome
How to appropriately monitor ICPs? - ANSWER-In order to appropriately measure
intracranial pressure and allow some drainage of CSF, the monitor needs to be
positioned at the level of the external auditory meatus. Therefore, the head of the
bed must be elevated to at least 30 degrees.
The head of bed must be elevated to at least 30 degrees
Which precaution is true for patients with intracranial pressure monitors? -
ANSWER-The head of bed must be elevated to at least 30 degrees
TOPAMAX - ANSWER-TOPAMAX= SEIZURE MEDICATION
It can also be used to prevent migraines and treat bipolar disorder
What is a likert scale? - ANSWER-For example, consider a scale where 1 = strongly
agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree. In this scale, 4
,is more negative than 3, 2, or 1. However, it cannot be inferred that a response of 4
is twice as negative as a response of 2.
A 38-year-old male is six months status-post middle cerebral artery stroke. During an
outpatient physical therapy evaluation, he scored 96 on the Stroke Impact Scale.
Based on this information alone, how severe do you expect his limitations to be? -
ANSWER-Very minimal limitations
Stroke Impact Scale - ANSWER-The Stroke Impact Scale is a Likert scale assessing
an individual's health status following a stroke. The score ranges from 0-100 with
higher numbers representing greater recovery/less impairment.
The stroke impact scale is a self report questionnaire that reports health related QOL
and disability after stroke
It's rated 0-100 with higher scores being better
8 domains
Strength
Hand function
ADL/IADL
Mobility
Communication
Emotion
Memory and thinking
Participation and role/function
Each item is rated on a 5 point likert scale depending on how much difficulty a
person has with each item
Likert data is what kind of data? - ANSWER-Ordinal data
They go in order but there is not equal intervals or spaces between each anchor on
the likert scale
Cerebral perfusion pressure (CPP) is the difference between mean arterial pressure
and intracranial pressure. Pressures less than what values cause ischemia? -
ANSWER-40-50 mmHg
Pressures less than 40-50 mmHg cause ischemia in the brain.
HD Pathophysiology- - ANSWER-Extra repeats of cytosine-adenine-guanine triplets,
or CAG, produce an abnormal form of huntingtin protein which causes severe loss of
neurons in the brain.
Loss of striatal medium spiny neurons I believe
Superior canal dehiscence is characterized by what? - ANSWER-Superior canal
dehiscence is characterized by vertigo and oscillopsia evoked by loud noises.
A forefoot initial contact increases the energy demand of gait by interfering with
which rocker? - ANSWER-All 3 rockers - the heel, ankle and forefoot rocker
Rockers in Gait- - ANSWER-Gait is made up of 3 rockers
, First the heel rocker from initial contact at heel strike until foot flat (eccentric control
of anterior tib)
Then the ankle rocker where the tibia gets anterior translation over the talus
Then the 3rd rocker is the forefoot rocker when the plantar flexors supply power for
push off and the ankle plantarflexes over a fixed forefoot which ends in toe off
All of these rockers would be disturbed by a forefoot initial contact
What stage(s) of the Expanded Disability Status Scale is (are) characterized by
independent ambulation? - ANSWER-Stages 0-4.5
According to the EDSS, individuals scoring higher than 4.5 demonstrate various
degrees of dependence with ambulation
Axonal sprouting- where does this occur? what is the rate it occurs at? - ANSWER-
Axonal sprouting occurs at a rate of approximately 1mm/day in the PNS. Damage in
the CNS is irreversible.
When is body temperature been shown to be the lowest? - ANSWER-Body
temperature is lowest in the morning
So PT for people with MS might be better in the AM
What type of PT can be good for MS and avoiding the Uthoff Phenomenon? -
ANSWER-Aquatic therapy has been shown to reduce effects of overheating
A patient presents to the emergency department after a motorcycle accident. He
opens his eyes in response to voice, is uttering inappropriate words, and
demonstrates a flexion/withdrawal response to painful stimuli. What is the severity of
his traumatic brain injury? - ANSWER-Moderate
His Glasgow Coma Scale score is 10 (eyes 3, verbal 3, motor 4), which is indicative
of a traumatic brain injury with moderate severity.
What are the items on the GCS? How is each item scored? - ANSWER-Eye
opening- scored 1-4
Verbal response- scored 1-5
Motor response- scored 1-6
So a 3 is the lowest score and that would be no response on anything- no eye
opening, no verbal response even if nonsensical, no motor response even if reflexive
or abnormal flexion/extension. 3 is NOTHING
All sensory information passes through the thalamus prior to reaching its target on
the cerebral cortex, except __________. - ANSWER-Smell
Information gathered by the olfactory receptors travels via the lateral olfactory tract
directly to the primary olfactory cortex. Information is passed through the thalamus
later in the pathway to reach other areas of the brain unlike other sensory
information which passes through the thalamus before reaching the cortex.
