WorksheetsPatho 1350 Midterm Exam Review
Total questions: 25
Worksheet time: 13mins
Scenario:
A 70-year-old patient demonstrates a stooped posture, shuffling gait, and resting tremor that decreases with voluntary movement.
Question:
What is the PRIMARY neuropathological change responsible for these symptoms?
Demyelination of corticospinal tracts
Degeneration of dopamine-producing neurons in the substantia nigra
Autoimmune destruction of acetylcholine receptors
Degeneration of motor neurons in the anterior horn
Scenario:
A 32-year-old female hair stylist reports intermittent numbness, tingling, and weakness in her right arm, especially when reaching overhead. Adson’s test is positive.
Question:
Which structure is MOST commonly compressed in this condition?
Ulnar nerve at Guyon's tunnel
Subclavian artery and brachial plexus
Median nerve at the carpal tunnel
Radial nerve at the spiral groove
Scenario:
A 78-year-old patient with Alzheimer's has progressive short-term memory loss, disorientation, and difficulty performing familiar tasks. Which of the following would be the BEST for this patient?
Easy strengthening and stretching exercises only to maintain ROM and strength
Provide energy conservation techniques and new assistive devices for balance deficits to prevent falls
Keep instructions simple, clear and concise and use simple exercises
Giving multiple-step commands for each task to progress cognition
Question:
A patient demonstrates constant progressive weakness, hyperreflexia, and spasticity without sensory loss, eventually affecting respiratory muscles. Which diagnosis is MOST consistent with these findings?
Guillain-Barré Syndrome
ALS
Huntington's Disease
Multiple Sclerosis
Scenario:
A 70-year-old male experiences sudden weakness on the left side and loss of coordination. He demonstrates impulsivity, poor judgment, and difficulty recognizing safety hazards.
Question:
Which cerebral artery and hemisphere are MOST likely affected?
R Middle cerebral artery
Left middle cerebral artery
Basilar artery in the cerebellum
Subclavian artery on the left
Scenario:
A 41-year-old female with a family history of movement disorders develops rapid, jerky involuntary movements and emotional outbursts. MRI reveals atrophy of the caudate nucleus. What is the most likely diagnosis?
ALS
Alzheimer's
Parkinson's Disease
Huntington's Disease
Scenario:
A patient with a complete spinal cord injury at T12 presents with flaccid paralysis, absent reflexes and absent sensation immediately following trauma. Several weeks later, tone increases and reflexes return.
Question:
Which term BEST describes the period of initial flaccidity following injury?
Brown-sequard syndrome
Autonomic Dysreflexia
Spinal Shock
Lower Motor Neuron primary injury
Scenario:
A 74-year-old patient in stage 4 Parkinson’s disease demonstrates marked rigidity, difficulty turning, and frequent freezing episodes.
Question:
Which secondary complication should the PTA monitor MOST closely?
Orthostatic hypotension and falls
Seizure activity due to cortical hyperexcitability
Respiratory failure from diaphragm paralysis
Visual field deficits from optic nerve damage
Scenario:
A patient with a T4 complete spinal cord injury suddenly reports severe headache, sweating, and goosebumps above the level of injury during catheterization.
Question:
Which of the following is likely causing this emergency?
Postural hypotension
Autonomic dysreflexia
Spinal shock
Neurogenic shock
Scenario:
A 42-year-old male reports progressive weakness in both legs that began 5 days ago following a respiratory infection. The weakness has now spread to his arms, and he reports tingling in his hands and feet.
Question:
Which of the following best describes the underlying pathophysiology of Guillain-Barré Syndrome?
Autoimmune destruction of oligodendrocytes in the CNS
Genetic mutation leading to abnormal dopamine metabolism
Autoimmune demyelination of the peripheral nerves
Degeneration of anterior horn motor neurons
Scenario:
A patient recovering from GBS is beginning to regain motor function in the lower extremities. The PTA plans an exercise session focused on mobility and strengthening.
Question:
Which of the following exercise guidelines is MOST appropriate during the recovery phase?
Avoid overfatigue and allow frequent rest periods
Use maximal resistance to accelerate remyelination
Focus on isolated strengthening before functional mobility
Begin running and plyometric activity early to restore motor control
Scenario:
A 32-year-old female reports intermittent episodes of blurred vision, fatigue, and limb weakness. MRI reveals plaques in the white matter of the brain and spinal cord.
Question:
Which pathophysiological process best explains these findings?
Autoimmune destruction of peripheral myelin
Autoimmune demyelination within the central nervous system
Genetic degeneration of basal ganglia dopamine neurons
Chronic inflammation of motor endplates
Scenario:
A patient with MS demonstrates poor heat tolerance, fatigue, and decreased balance during therapy.
Question:
Which intervention is MOST appropriate to prevent symptom worsening during treatment?
Provide therapy in a warm environment to relax muscles and schedule treatments in the mornings
Schedule short sessions in a cool environment with frequent rest breaks and schedule treatments in the morning
Encourage endurance training to improve heat tolerance and schedule treatments in the afternoon
Use hot packs before gait training to reduce spasticity and schedule treatments in the morning
Scenario:
A PTA reviews two patients: one diagnosed with Guillain-Barré Syndrome and another with Multiple Sclerosis.
Question:
Which key clinical distinction differentiates GBS from MS?
GBS affects the CNS; MS affects the PNS
GBS affects the PNS; MS affects the CNS
Both affect the CNS but MS is autoimmune
Both affect the PNS but GBS progresses slower
What treatment is MOST appropriate for a patient with fibromyalgia?
Stretching and short bouts of aerobics
Progressive strengthening
Functional training that elicits fatigue for endurance training
Daily aerobic exercises
What type of seizure is a patient who exhibits a temporary loss of consciousness with staring MOST likely having?
Absence
Myoclonic
Atonic
Tonic
Scenario:
A 22-year-old basketball player reports rolling his ankle inward after landing from a rebound. There is immediate swelling and tenderness over the lateral ankle.
Question:
Which ligament is MOST commonly injured with this mechanism?
Deltoid ligament
Anterior talofibular ligament (ATFL)
Posterior talofibular ligament
Calcaneonavicular (spring) ligament
Scenario:
A 14-year-old soccer player reports anterior knee pain that worsens with jumping and running. The PTA observes tenderness and swelling over the tibial tuberosity.
Question:
Which best describes the underlying pathology?
Patellar tendon avulsion at the tibial tuberosity due to repetitive traction forces
Inflammation of the infrapatellar fat pad
Degeneration of the meniscus from overuse
Stress fracture of the distal femur
Scenario:
A 45-year-old gymnast reports low back pain that worsens with lumbar extension. X-rays show an anterior slippage of the L5 vertebra on S1.
Question:
Which structural defect most commonly causes this condition?
Degeneration of intervertebral discs
Fracture or defect in the pars interarticularis
Compression fracture of the vertebral body
Facet joint dislocation
Scenario:
A patient following a left middle cerebral artery stroke demonstrates good comprehension but significant difficulty producing speech.
Question:
Which type of aphasia does this presentation indicate?
Receptive aphasia (Wernicke’s)
Expressive aphasia (Broca’s)
Global aphasia
Conduction aphasia
Scenario:
A 40-year-old office worker reports numbness and tingling in the thumb, index, and middle fingers, especially at night.
Question:
Which structure is compressed in this condition?
Ulnar nerve under the Guyon’s canal
Median nerve beneath the flexor retinaculum
Radial nerve at the lateral epicondyle
Brachial plexus between scalene muscles
Scenario:
A 72-year-old woman with a history of osteoporosis is being seen in outpatient physical therapy for postural re-education and strengthening. She reports occasional thoracic back pain and demonstrates a kyphotic posture.
Question:
Which of the following interventions is CONTRAINDICATED for this patient?
Postural training emphasizing scapular retraction and thoracic extension in a seated position
Weight-bearing strengthening exercises for the lower extremities
Spinal flexion and trunk rotation exercises during abdominal strengthening
Balance training and fall prevention activities in standing
Scenario:
A 34-year-old new mother reports pain along the radial side of her wrist that worsens when lifting her baby or wringing out a towel. On examination, there is tenderness over the first dorsal compartment of the wrist.
Question:
Which of the following clinical findings is MOST characteristic of this condition?
Pain with resisted wrist flexion and ulnar deviation
Pain with thumb flexion and pronation of the forearm
Pain with ulnar deviation while the thumb is flexed across the palm
Pain with radial deviation and finger extension
Scenario:
A 66-year-old male with a history of hypertension and diabetes reports experiencing sudden right-sided weakness and slurred speech that resolved within 15 minutes. Upon arrival to the clinic the next day, his neurological exam is normal.
Question:
Which of the following BEST describes the underlying pathophysiology of this event?
Permanent loss of blood flow resulting in cerebral infarction
Temporary interruption of cerebral blood flow without permanent tissue damage
Hemorrhage from rupture of a small intracerebral vessel
Progressive demyelination of upper motor neurons in the cortex
Scenario:
A 45-year-old carpenter reports pain along the inside of his right elbow that worsens when gripping tools or performing wrist flexion against resistance. On examination, there is tenderness just distal to the medial epicondyle.
Question:
Which muscle group is MOST likely involved in this condition?
Wrist extensors, primarily the extensor carpi radialis brevis
Wrist flexors and pronators, such as the flexor carpi radialis and pronator teres
Supinators and brachioradialis
Triceps brachii and anconeus
