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Patho 1350 Midterm Exam Review

Total questions: 25

Worksheet time: 13mins

Name
Class
Date
1.

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?

a)

Demyelination of corticospinal tracts

b)

Degeneration of dopamine-producing neurons in the substantia nigra

c)

Autoimmune destruction of acetylcholine receptors

d)

Degeneration of motor neurons in the anterior horn

2.

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?

a)

Ulnar nerve at Guyon's tunnel

b)

Subclavian artery and brachial plexus

c)

Median nerve at the carpal tunnel

d)

Radial nerve at the spiral groove

3.

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?

a)

Easy strengthening and stretching exercises only to maintain ROM and strength

b)

Provide energy conservation techniques and new assistive devices for balance deficits to prevent falls

c)

Keep instructions simple, clear and concise and use simple exercises

d)

Giving multiple-step commands for each task to progress cognition

4.

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?

a)

Guillain-Barré Syndrome

b)

ALS

c)

Huntington's Disease

d)

Multiple Sclerosis

5.

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?

a)

R Middle cerebral artery

b)

Left middle cerebral artery

c)

Basilar artery in the cerebellum

d)

Subclavian artery on the left

6.

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?

a)

ALS

b)

Alzheimer's

c)

Parkinson's Disease

d)

Huntington's Disease

7.

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?

a)

Brown-sequard syndrome

b)

Autonomic Dysreflexia

c)

Spinal Shock

d)

Lower Motor Neuron primary injury

8.

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?

a)

Orthostatic hypotension and falls

b)

Seizure activity due to cortical hyperexcitability

c)

Respiratory failure from diaphragm paralysis

d)

Visual field deficits from optic nerve damage

9.

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?

a)

Postural hypotension

b)

Autonomic dysreflexia

c)

Spinal shock

d)

Neurogenic shock

10.

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?

a)

Autoimmune destruction of oligodendrocytes in the CNS

b)

Genetic mutation leading to abnormal dopamine metabolism

c)

Autoimmune demyelination of the peripheral nerves

d)

Degeneration of anterior horn motor neurons

11.

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?

a)

Avoid overfatigue and allow frequent rest periods

b)

Use maximal resistance to accelerate remyelination

c)

Focus on isolated strengthening before functional mobility

d)

Begin running and plyometric activity early to restore motor control

12.

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?

a)

Autoimmune destruction of peripheral myelin

b)

Autoimmune demyelination within the central nervous system

c)

Genetic degeneration of basal ganglia dopamine neurons

d)

Chronic inflammation of motor endplates

13.

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?

a)

Provide therapy in a warm environment to relax muscles and schedule treatments in the mornings

b)

Schedule short sessions in a cool environment with frequent rest breaks and schedule treatments in the morning

c)

Encourage endurance training to improve heat tolerance and schedule treatments in the afternoon

d)

Use hot packs before gait training to reduce spasticity and schedule treatments in the morning

14.

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?

a)

GBS affects the CNS; MS affects the PNS

b)

GBS affects the PNS; MS affects the CNS

c)

Both affect the CNS but MS is autoimmune

d)

Both affect the PNS but GBS progresses slower

15.

What treatment is MOST appropriate for a patient with fibromyalgia?

a)

Stretching and short bouts of aerobics

b)

Progressive strengthening

c)

Functional training that elicits fatigue for endurance training

d)

Daily aerobic exercises

16.

What type of seizure is a patient who exhibits a temporary loss of consciousness with staring MOST likely having?

a)

Absence

b)

Myoclonic

c)

Atonic

d)

Tonic

17.

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?

a)

Deltoid ligament

b)

Anterior talofibular ligament (ATFL)

c)

Posterior talofibular ligament

d)

Calcaneonavicular (spring) ligament

18.

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?

a)

Patellar tendon avulsion at the tibial tuberosity due to repetitive traction forces

b)

Inflammation of the infrapatellar fat pad

c)

Degeneration of the meniscus from overuse

d)

Stress fracture of the distal femur

19.

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?

a)

Degeneration of intervertebral discs

b)

Fracture or defect in the pars interarticularis

c)

Compression fracture of the vertebral body

d)

Facet joint dislocation

20.

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?

a)

Receptive aphasia (Wernicke’s)

b)

Expressive aphasia (Broca’s)

c)

Global aphasia

d)

Conduction aphasia

21.

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?

a)

Ulnar nerve under the Guyon’s canal

b)

Median nerve beneath the flexor retinaculum

c)

Radial nerve at the lateral epicondyle

d)

Brachial plexus between scalene muscles

22.

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?

a)

Postural training emphasizing scapular retraction and thoracic extension in a seated position

b)

Weight-bearing strengthening exercises for the lower extremities

c)

Spinal flexion and trunk rotation exercises during abdominal strengthening

d)

Balance training and fall prevention activities in standing

23.

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?

a)

Pain with resisted wrist flexion and ulnar deviation

b)

Pain with thumb flexion and pronation of the forearm

c)

Pain with ulnar deviation while the thumb is flexed across the palm

d)

Pain with radial deviation and finger extension

24.

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?

a)

Permanent loss of blood flow resulting in cerebral infarction

b)

Temporary interruption of cerebral blood flow without permanent tissue damage

c)

Hemorrhage from rupture of a small intracerebral vessel

d)

Progressive demyelination of upper motor neurons in the cortex

25.

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?

a)

Wrist extensors, primarily the extensor carpi radialis brevis

b)

Wrist flexors and pronators, such as the flexor carpi radialis and pronator teres

c)

Supinators and brachioradialis

d)

Triceps brachii and anconeus