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Vestibular Rehabilitation and Concussion Exam Part 1

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Vestibular Rehabilitation and Concussion Exam Part 1
You'll need to correctly answer at least 45 of the 58 questions below (at least 76%) to progress to the next unit.
Question #1: Therapy objectives will be best met when the status of the patient’s vision, vestibular and somatosensory function is determined prior to therapy.
Question #2: Use of adaptation, habituation and substitution therapies cannot be used in combination with the same patient.
Question #3: Treatment of BPPV should always precede VRT or balance therapy.
Question #4: Bilateral BPPV is most often seen in patients post head-trauma.
Question #5: The Berg Balance and Tinnetti Get up and Go Tests were developed to assess vestibular function.
Question #6: Tests of dynamic visual acuity correlate with complaints of oscillopsia.
Question #7: The CTSIB Test does not provide meaningful information about vestibular function.
Question #8: The purpose of the VCR is to provide information to the neck muscles from the gravity sensors in the inner ear.
Question #9: The VOR is a reflex mechanism that is frequency specific with a normal gain of 2:1
Question #10: All otologic disorders cause both hearing and vestibular loss.
Question #11: 30-40% of children with sensorineural hearing loss have been reported to also have vestibular dysfunction.
Question #12: The otoconia are found only in the semicircular canals.
Question #13: The vestibular system is the first sensory system to develop.
Question #14: Cortical injuries can occur from acceleration or deceleration of the brain within the skull.
Question #15: Concussions always result in macroscopic damage to the brain, visible with CT or MRI.
Question #16: In order to be defined as a concussion injury the person MUST lose consciousness during the event.
Question #17: A common ear condition which causes dizziness secondary to head trauma is Benign Paroxysmal Positioning Vertigo (BPPV).
Question #18: Vestibular Rehabilitation Therapy (VRT) has shown to rarely be beneficial in the treatment of concussion symptoms.
Question #19: Oscillopsia cannot occur secondary to concussion.
Question #20: Tests of dynamic visual acuity (DVA) are an excellent tool in the evaluation of BPPV.
Question #21: BPPV is rarely seen in both ears in patients post head trauma.
Question #22: The latest evidence as put forth by the International concussion experts suggest baseline neurocognitive testing does not correlate to concussion management outcomes.
Question #23: More sport-related concussions per exposure occur in practices versus games.
Question #24: The signs and symptoms that an athlete presents with 24-48 hours following a concussion will not change 1-2 weeks later.
Question #25: A suspected concussion on a sports field warrants immediate removal from play, a thorough assessment, and physician clearance with a diagnosed concussion.
Question #26: Recent studies show that for each successive day in delay to initiative of aerobic exercise post-concussion, there is a less favorable trajectory to recovery.
Question #27: Initial physician clearance following a concussion refers to starting an exertional phased rehabilitation process.
Question #28: The ability to identify a single physiological window of recovery through well-designed algorithms is what allows for improved concussion outcomes.
Question #29: Evidence in children ages 10-13 post-concussion reveal returning to the classroom timelines align with returning to sport.
Question #30: The strongest predictor of concussion recovery is the severity of one’s symptoms on day one of the injury.
Question #31: Poor sleep is associated with greater symptom severity, especially in pediatric aged sustained concussions.
Question #32: Which of the following is the most common neurological disorder causing vertigo?
Question #33: BPPV patients typically complain of symptoms when…
Question #34: BPPV of the posterior canal (BPPV-PC) produces which type of nystagmus?
Question #35: Vertebral Artery Screening, when positive, may produce which symptom?
Question #36: Which of the following repositioning treatments does NOT treat BPPV-PC?
Question #37: An uncompensated vestibular dysfunction may manifest with which of the following symptoms?
Question #38: Which of the following therapy protocols would be best for a patient whose symptoms are provoked with movement requiring desensitization?
Question #39: Gaze stabilization protocols are best used for patients who present with…
Question #40: Outcome measures may include…
Question #41: Which of the following is NOT a repositioning treatment for BPPV-HC?
Question #42: The Stroop Color and Word test:
Question #43: Balance dysfunction as it relates to concussion:
Question #44: A collision between the brain and the skull that occurs on the side of the impact is called a
Question #45: Clinical diagnosis of a Concussion Injury may be based upon
Question #46: The pathological degenerative brain finding that may be found upon autopsy of a person who sustained multiple concussions in life (e.g. NFL football player) is referred to as:
Question #47: A neurological exam involves a series of questions and simple commands in order to
Question #48: The balance center or vestibular system is located within the
Question #49: Otoconia from the utricle are most likely to fall into the
Question #50: Labyrinthine concussion post head trauma may result in
Question #51: The direction of blunt force trauma may
Question #52: Surgical repair is best for which of the following
Question #53: BPPV-PC will cause which type of nystagmus pattern
Question #54: Which VRT treatment outcomes may affect return to play (RTP) readiness
Question #55: Meta-analysis has shown that the most at risk athletes are
Question #56: Prior to your evaluation for a post-concussive fall in your 72 year old patient, you wish to perform the Buffalo Concussion Treadmill Test (BCTT). Which of the following are not a termination criteria for this test?
Question #57: 40. Your 72 year old, mostly-sedentary patient just finished their Buffalo Concussion Treadmill Test and you have determined their symptom-limited threshold HR to be 107 BPM. Which of the following is the most appropriate target HR for exercise at the first two (2) week mark and then their progressed HR for week three (3)?
Question #58: Your patient presents to the emergency department with a sinus infection and an insidious onset of minutes-long, infrequent positionally-provoked “world-spinning” vertigo, nausea, and imbalance. Immediate assessment reveals positive head thrust to the left, direction-fixed nystagmus, and negative test of skew. Based on the above, what is the most appropriate diagnosis and next step?