ALS GB CIDP PPS

Postpolio syndrome is diagnosed based on which of the following criteria?

• There is a new onset of problems within 10 years of original infection

• There is onset of weakness in previously unaffected muscles years after the original infection

• Blood tests show low levels of creatine kinase

• Muscle biopsy indicates long-term denervation with no signs of reinnervation

Answer explanation

the timeline is not necessarily limited to 10 years,

Creatine Kinase test is most often used to diagnose and monitor muscular injuries and diseases. These diseases include:

Muscular dystrophy and

Rhabdomyolis,

The test can be used to help diagnose a heart attack, though not very often. CK testing used to be a common test for heart attacks. But another test, called troponin, has been found to be better at detecting heart damage.

Tinel’s sign is when you:

• Put the nerve on a stretch and the distal limb goes numb

• Tap over the nerve and there is tingling in its distribution

• Compress the nerve and there is tingling in its distribution

• Tap over the nerve and the limb forcefully flexes

Answer explanation

he Hoffman-Tinel sign, now more commonly known as the Tinel sign, was defined in 1915 by Paul Hoffmann and Jules Tinel as the "pins and needle feeling" elicited by tapping on a nerve proximally, with resulting paresthesia experienced in the corresponding distal cutaneous distribution of an injured peripheral nerve.

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) attacks what part of the peripheral nerve?

• Basement membranes surrounding Schwann cells

• Schwann cells

• Nodes of Ranvier

• Myelin sheath

Answer explanation

Schwann cells (SCs) are a type of glial cell that surrounds neurons, keeping them alive and sometimes covering them with a myelin sheath, and are the major glial cell type in the peripheral nervous system. They play essential roles in the development, maintenance, function, and regeneration of peripheral nerves.

and

nodes of Ranvier allow the generation of a fast electrical impulse along the axon. This rapid rate of conduction is called saltatory conduction.

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

•  Dysphagia

•  Fatigue

• Sensory deficits

• Weakness/paralysis of spinal muscles

A therapy client who is using the stationary bike as part of his therapy completes 20 minutes of pedaling and his heart rate is elevated to 110 bpm. After 5 minutes of rest his heart rate is still 110 bpm. This response indicates:

• A possible myocardial infarction (MI)

• Enhanced parasympathetic activation

• Possible cardiac autonomic neuropathy

• Orthostatic hypotension

The most appropriate initial exercise progression for a patient recovering from GBS with limb muscle strength ranging between P+ (2+) to F− (3−/5) strength is:

• Functional based exercise → light progressive resistive exercise → active range of motion

• Passive range of motion→ active range of motion gravity-eliminated → active range of motion against gravity

• Active range of motion against gravity → light progressive resistive exercise → functional-based exercise

• Active range of motion gravity-eliminated → active range of motion against gravity → light progressive resistive exercise

Answer explanation

2+ moves through partial range against and full range with gravity eliminated

3- can do a gradual release from test position (eccentric)

A client with postpolio syndrome comes to therapy with foot drop. She wishes to regain walking without the use of an AFO or with the least intrusive AFO possible. On testing the tibialis anterior is graded 1/5 or trace strength. A recommended therapy would be to:

• Prescribe resistance strengthening for the tibialis anterior

• Prescribe a rigid AFO and discourage active dorsiflexion

• Implement strengthening of the extensor hallicus longus and extensor digitorum longus muscles to perform dorsiflexion

• Use a maximal exercise protocol working muscles to failure

Answer explanation

TA is not working and will not work..so need to overstrengthen muscles that maybe are not primary movers ...they can then innervate mor.

Which form of neuropathy affects motor and sensory and leaves autonomic nerves intact?

• Chronic inflammatory demyelinating polyradiculopathy

• Diabetic peripheral neuropathy

• Guillain–Barré

• Multifocal motor neuropathy

Answer explanation

Chronic inflammatory demyelinating polyradiculopathy is the correct answer. CIDP is caused by an abnormal immune response. CIDP occurs when the immune system attacks the myelin cover of the nerves. thought to be an autoimmune disease.

Diabetic peripheral neuropathy encompasses sensory, motor, and autonomic neuropathy.

Guillain–Barré= sensory and motor and may impact autonomic

Multifocal motor neuropathy = MOTOR