Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

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How is a hyperactive DTR response classified?

  1. DTR Grade 1

  2. DTR Grade 2

  3. DTR Grade 3

  4. DTR Grade 4

The correct answer is: DTR Grade 3

A hyperactive deep tendon reflex (DTR) response is classified as DTR Grade 3 or Grade 4, as these grades indicate an exaggerated response to stimuli, which is typically associated with upper motor neuron lesions or heightened neuromuscular excitability. DTR Grade 3 denotes a brisk response that is still within normal limits but is enhanced compared to a typical reflex. This can suggest a mild degree of hyperactivity. In contrast, DTR Grade 4 is characterized by a very brisk reflex response and can be accompanied by clonus, which indicates a significantly heightened level of neural excitability associated with more severe neurological conditions. Understanding the grading system of deep tendon reflexes is important for assessing neurological function. In a clinical context, finding a patient with a hyperactive reflex assists healthcare providers in narrowing down potential central nervous system issues or conditions affecting the nervous system as a whole.

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