NCS ADVANTAGE TEST REVIEW
QUESTIONS AND ANSWERS
TUG cut off scores
Elderly patients
PD - Correct Answers -For elderly patients, a time of greater than 13.5 seconds is
indicative of a high risk of falls.
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? -
Correct Answers -Medial longitudinal fasciculus
Intranuclear Opthalmoplegia - Correct Answers -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? - Correct Answers -A very
fast recovery from the initial infection increases risk for developing post-polio syndrome
How to appropriately monitor ICPs? - Correct Answers -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? - Correct
Answers -The head of bed must be elevated to at least 30 degrees
TOPAMAX - Correct Answers -TOPAMAX= SEIZURE MEDICATION
It can also be used to prevent migraines and treat bipolar disorder
What is a likert scale? - Correct Answers -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? - Correct
Answers -Very minimal limitations
Stroke Impact Scale - Correct Answers -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? - Correct Answers -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? - Correct
Answers -40-50 mmHg
Pressures less than 40-50 mmHg cause ischemia in the brain.
, HD Pathophysiology- - Correct Answers -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? - Correct Answers -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? - Correct Answers -All 3 rockers - the heel, ankle and forefoot rocker
Rockers in Gait- - Correct Answers -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? - Correct Answers -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? - Correct
Answers -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? - Correct Answers -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? - Correct
Answers -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? - Correct Answers -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.
QUESTIONS AND ANSWERS
TUG cut off scores
Elderly patients
PD - Correct Answers -For elderly patients, a time of greater than 13.5 seconds is
indicative of a high risk of falls.
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? -
Correct Answers -Medial longitudinal fasciculus
Intranuclear Opthalmoplegia - Correct Answers -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? - Correct Answers -A very
fast recovery from the initial infection increases risk for developing post-polio syndrome
How to appropriately monitor ICPs? - Correct Answers -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? - Correct
Answers -The head of bed must be elevated to at least 30 degrees
TOPAMAX - Correct Answers -TOPAMAX= SEIZURE MEDICATION
It can also be used to prevent migraines and treat bipolar disorder
What is a likert scale? - Correct Answers -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? - Correct
Answers -Very minimal limitations
Stroke Impact Scale - Correct Answers -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? - Correct Answers -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? - Correct
Answers -40-50 mmHg
Pressures less than 40-50 mmHg cause ischemia in the brain.
, HD Pathophysiology- - Correct Answers -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? - Correct Answers -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? - Correct Answers -All 3 rockers - the heel, ankle and forefoot rocker
Rockers in Gait- - Correct Answers -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? - Correct Answers -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? - Correct
Answers -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? - Correct Answers -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? - Correct
Answers -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? - Correct Answers -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.
