Deck 17: Amyotrophic Lateral Sclerosis

Question 1

Which approach needs to be considered when determining the appropriate amount and type of exercise in a patient with amyotrophic lateral sclerosis whose functional status has declined?

A)Encouraging the patient to rest and exercise less so energy can be conserved
B)Providing a program that includes exercises with heavy eccentric loading
C)Developing a program that focuses more on the weaker muscles versus the stronger ones
D)Providing the patient with an exercise program at moderate to low intensities

Answer 1

D

Question 2

A patient who was recently diagnosed with amyotrophic lateral sclerosis presents with clonus and weakness in the right dorsiflexors (3/5)and hip flexors (4-/5).The patient also reports a few choking episodes when eating.Which is the MOST appropriate category for this patient according to the El Escorial Criteria?

A)Clinically probable
B)Clinically definite
C)Clinically possible
D)Clinically probable with laboratory support

Answer 2

A

Question 3

A patient with amyotrophic lateral sclerosis is unable to elevate the eyebrows.Which cranial nerve (CN)is MOST likely involved?

A)CN V
B)CN VII
C)CN IX
D)CN X

Answer 3

B

Question 4

A patient reports difficulty with holding eating utensils and writing but denies difficulty when using the left hand.Upon physical examination,fasciculations and a positive Babinski sign are noted in the right upper extremity.Which of the following is the MOST likely diagnosis?

A)Acute poliomyelitis
B)Charcot-Marie-Tooth disease
C)Guillain-Barré syndrome
D)Amyotrophic lateral sclerosis

Question 5

A 56-year-old patient with amyotrophic lateral sclerosis reports mild to moderate right shoulder pain that has been getting worse over the past 3 weeks.The strength of the shoulder musculature is 4/5.Which of the following is the MOST appropriate intervention at this point in time?

A)Performing heavy eccentric exercises to maintain stabilization
B)Providing the patient with a sling to allow his shoulder to rest
C)Managing pain and advancing to moderate resistance exercises
D)Using modalities for pain relief