Mixed Deck — All NCS Topics Flashcards

What are the signs of increased intracranial pressure?

Answer: Headache, vomiting, altered consciousness, papilledema, and Cushing's triad (hypertension, bradycardia, irregular breathing)

Rising ICP requires urgent intervention to prevent brain herniation.

Which characteristic distinguishes peripheral vestibular nystagmus from central vestibular nystagmus?

Answer: It is direction-fixed and suppressed by visual fixation

Peripheral vestibular nystagmus is direction-fixed (fast phase does not change direction with gaze) and is suppressed by visual fixation, distinguishing it from central causes.

What is multiple sclerosis?

Answer: An autoimmune disease where the immune system attacks myelin in the CNS, causing varied neurological symptoms

MS damages the myelin sheath around nerve fibers, disrupting signal transmission and causing diverse symptoms.

Which neurotransmitter imbalance is primarily implicated in the pathophysiology of schizophrenia?

Answer: Excessive dopamine

The dopamine hypothesis of schizophrenia posits that the positive symptoms of the disorder, such as hallucinations and delusions, are primarily associated with excessive dopamine activity in certain brain regions. Antipsychotic medications, the cornerstone of treatment, primarily work by blocking dopamine D2 receptors. While other neurotransmitters are involved, dopamine dysregulation remains a central focus in understanding and treating schizophrenia.

Ketamine's analgesic mechanism in chronic pain states primarily involves:

Answer: NMDA receptor antagonism reducing central sensitization

Ketamine blocks NMDA receptors, interrupting the glutamate-driven central sensitization and wind-up that perpetuate chronic pain states.

A patient with refractory chronic migraine is being considered for occipital nerve stimulation (ONS). What is the theoretical basis for its analgesic effect?

Answer: Direct stimulation of the trigeminal nucleus caudalis via convergent pathways

ONS modulates the trigeminocervical complex where occipital afferents converge with trigeminal pain signals, reducing migraine pain through neuromodulation.

For a patient with a traumatic brain injury (TBI), which outcome measure is most appropriate for assessing cognitive and executive function?

Answer: Mini-Mental State Examination (MMSE)

The Mini-Mental State Examination (MMSE) is a widely used and validated screening tool for assessing global cognitive function, which is often impaired in traumatic brain injury (TBI). It evaluates various cognitive domains including orientation, attention, memory, language, and visuospatial skills. While not exhaustive for all executive functions, it provides a quick and standardized measure of overall cognitive status relevant to TBI recovery and monitoring.

What is the difference between nociceptive and neuropathic pain?

Answer: Nociceptive pain results from tissue damage; neuropathic pain results from nerve damage

Nociceptive pain has a clear tissue injury source, while neuropathic pain arises from nervous system dysfunction.

What are the cranial nerves?

Answer: Twelve pairs of nerves emerging directly from the brain, each with specific sensory or motor functions

The 12 cranial nerve pairs control functions from smell and vision to facial expression and swallowing.

What is the difference between complete and incomplete spinal cord injury?

Answer: Complete means total loss of function below the injury; incomplete means some function is preserved

Complete injuries have no motor or sensory function below the level; incomplete injuries retain some function.

A patient with cervical radiculopathy has severe neuropathic pain unresponsive to conservative therapy. Which interventional option directly targets the pain generator?

Answer: Cervical epidural steroid injection

Cervical epidural steroid injection delivers anti-inflammatory medication directly to the affected nerve root, addressing the inflammatory pain generator.

Which principle of neuroplasticity BEST supports incorporating task-specific training in high repetitions during stroke rehabilitation?

Answer: Specificity principle combined with repetition-dependent plasticity

The specificity principle ensures training gains transfer to the practiced task, while repetition-dependent plasticity demonstrates that synaptic strengthening and cortical map reorganization require large numbers of repetitions.

In complex regional pain syndrome (CRPS), which finding differentiates Type I from Type II?

Answer: Documented nerve injury in Type II

CRPS Type II (formerly causalgia) is distinguished by a confirmed peripheral nerve injury, whereas Type I occurs without identifiable nerve damage.

When measuring spasticity in a patient with multiple sclerosis, which scale quantifies resistance to passive movement across a velocity spectrum?

Answer: Tardieu Scale

The Tardieu Scale assesses spasticity at both slow and fast velocities, capturing the velocity-dependent nature of spastic resistance that the Modified Ashworth Scale cannot distinguish.

What is aphasia?

Answer: A language disorder caused by brain damage affecting the ability to speak, understand, read, or write

Aphasia affects language processing, not intelligence. Types include Broca's (expressive), Wernicke's (receptive), and global.

A patient with C6 ASIA B SCI is being educated on skin integrity. What is the MINIMUM recommended frequency for pressure relief when seated in a wheelchair?

Answer: Every 15–30 minutes

Current SCI clinical guidelines recommend weight shifts or pressure relief maneuvers every 15–30 minutes while seated to prevent ischemic tissue damage.

A 68-year-old patient with Guillain-Barré syndrome is in the plateau phase with 2/5 proximal lower extremity strength. Which therapy intensity is MOST appropriate?

Answer: Low-to-moderate intensity activity with fatigue monitoring

During the GBS plateau phase, low-to-moderate intensity exercise with careful fatigue monitoring prevents deconditioning without risking exercise-induced exacerbation or overwork weakness.

What type of nystagmus is characteristic of posterior canal BPPV when performing the Dix-Hallpike test?

Answer: Upbeat-torsional nystagmus beating toward the affected ear

Posterior canal BPPV produces upbeat-torsional nystagmus beating toward the affected (lowermost) ear due to ampullofugal deflection of the cupula by displaced canaliths.

A 55-year-old develops post-herpetic neuralgia. Which topical agent is FDA-approved as first-line for localized neuropathic pain?

Answer: Lidocaine 5% patch

The lidocaine 5% patch is FDA-approved for post-herpetic neuralgia and provides targeted sodium channel blockade with minimal systemic absorption.

Which gait parameter is MOST sensitive to detecting early balance impairment in patients with Parkinson's disease?

Answer: Step width variability

Increased step width variability reflects anticipatory postural control deficits and is among the earliest and most sensitive gait markers for balance impairment in Parkinson's disease.