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Arousal is mediated by the:

reticular activating system

A 20 y/o suffers a severe closed head injury in a motor vehicle accident. He remains in a vegatative state 1 month after the accident. Which of the following is the most likely dx?

Brain stem

A 16 y/o male took a recreational drugthat altered his level of arousal. PE revelaed an absent babinski sign, equal and reactive pupils, and roving eye movements. Which of the following is the most likely dx?

Metabolically induced coma

The breathing patteren that reflects respirations based primarily on CO2


A 45 y/o female presents to the ER c/o vomiting. A CT scan of the brain reveals a mass in the:

Medulla Oblongata

A teenage boy sustains a severe closed head injury following an ATV accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. Which of the following describes his condition?


Dilated and fixed pupils can be cx by:

brain stem hypoxia

For legal purposes, brain death is defined as:

Cessation of brain function

A 10 y/o female was brought to the ER following a sudden onset of convulsions. The physicians think that she experienced an explosive, disorderly discharge of cerebral neurons referred to as:


A 30 y/o female had a seizure that started with her fingers and progressively spread up her arm and then extended to her leg. This condition is known as:

Focal motor seizure

A 20 y/o male was at the supermarket when he fell to the ground. Bystanders reported that he lost consciousness and his body tensed up then relaxed, then tensed and relaxed, several times. He most likely was experiencing a:

Tonic-clonic seizure

A peculiar sensation that immediately precedes a seizure is called a:


Neural networks basic to cognitive function include:

Memory and language networks

The cognitive disorder that results in the loss of memory of events that occurred before a head injury is:

retrograde amnesia

A 65 y/o male is recently suffered a cerebral vascular accident. He is now unable to recognize and identify objects by touch because of injury to the sensory cortex. The condition is a form of:


An alcoholic checked into a rehab center. He experiences delirium, inability to concentrate, and is easily distracted. From which of the following is he most likely suffering?

Acute confusional state

Dementia is manifested by:

loss of recent and remote memory

A decrease in cerebral perfusion pressure us r/t which of the following changes?

Increase in ICP

A compensatory alteration in the diameter of cerebral blood vessels in response to increased ICP is called:


Cerebral edema is an accumulation of fluid in the:

brain tissue

Vasogenic edema is clinically important because:

the BBB is disrupted

A 51 y/o male is admitted to the neuro critical care unit with a severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. This condition is known as:

decerebrate posturing

A 20 y/o male is admitted to the neuro critical care unit with a severe closed head injury. When am intraventricular catheter is inserted, the ICP is recorded at 24 mm Hg. This reading is:

higher than normal

A 15 y/o female is admitted ICU with a severe closed head injury. This dx puts her at risk for:

cerebral edema

A 70 y/o female is being closely monitored in the neuro critical care unit for a severe closed head injury. After 48 hours, her condition begins to deteriorate. Her pupils are small and sluggish, pulse pressure is widening, and she is bradycardic. These clinical findings are evidence of what stage of intracranial HTN?

Stage 3

An infant is dx with non-communicating hydrocephalus. An immediate concern for this pt

Interstitial edema

Hydrocephalus in adults is most common cx by:

defective CSF reabsorption

A 16 y/o male fell off the bed of a pickup truck and hit his forehead on the road. He now has resistance to passive movement that varies proportionally with the force applied. He is most likely suffering from:


Paralysis of the lower extremities is called:


A disorder that cxs excessive movement is:


Spinal shock is characterized by:

cessation of spinal cord function below the lesion

A 40 y/o male c/o abnormal movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begins in the face and arms and eventually affect the entire body. The most likely dx is:

Huntington's Dz

The most severe brain injury cx by rotational acceleration is most likely to be located:

more peripheral to the brain stem

The most common type of traumatic brain injury is:


A 15 y/o male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had momentary confusion and retrograde amnesia after 5 to 10 minutes. His injury could be categorized as:

Grade II

The main source of bleeding in extradural (epidural) hematomas is:


A 69 y/o male with a hx of alcohol abuse presents presents to the ER after a month long episode of headaches and confusion. Based on his alcoholism, a likely cx of his neurologic sxs is:

chronic subdural hematoma

A 15 y/o male was struck by a motor vehicle and suffered a traumatic brain injury. Paramedics found him unconscious at the scene of the accident. During the ambulance ride, he regained consciousness and was able to maintain a conversation with the medical staff. Upon arrival to the hospital, he was alert and orientated. PE reveals confusion and impaired responsiveness. What is the probable nature of his brain injury based on this hx?

Extradural (epidural) hematoma

Mild concussion is characterized by:

retrograde amnesia

A 39 y/o male suffers a severe brain injury when he falls off a building while working. CT scan reveals that he has a basilar skull fractures. One major concern for this pt is:

meningeal infection

A 65 y/o female loses her balance while walking in the woods

Blunted affect

lO-year-old male was climbing on a house and fell. He suffered a severe brain injury. His Glasglow Coma Scale was 5 initially and 7 after 1 day. He remained unconscious for 2 weeks, then was confused and suffered from anterograde amnesia. Which of the following is he most likely experiencing?

Moderate diffuse brain injury

An initial clinical manifestation associated with acute spinal cord injury is:

loss of voluntary control below the injury

The transient nature of spinal shock is directly related to which of the following mechanisms?

Accumulation of edema within the spinal cord

A I7-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. A spinal cord injury is suspected. The two regions most likely to be
damaged are the:

cervical and lumbar regions

A 33-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because:

diaphragm function may be impaired

A 15-year-old male is brought to the emergency department for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that:

His sympathetic nervous system has been damaged and thermal control disturbed

Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia. She is likely experiencing:

Autonomic dysrreflexia

20-year-old female suffered from spinal cord injury that resulted from a motor vehicle accident. She had spinal shock lasting 15 days and is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. This condition may accompany:

a distended bladder or rectum

A 50-year-old male presents with low back pain.
He denies trauma and says he just woke up and it was hurting. An MRI reveals that the vertebra at L5 slid forward relative to those above and below it. This condition is called:


A 30-year-old white male recently suffered a cerebrovascular accident. Which of the following is the most likely factor that contributed to his stroke?


One risk factor for thrombotic stroke is:


Of the following groups, who are at highest risk for a cerebrovascular accident?

Blacks over 65 years of age

A 72-year-old male demonstrates left-sided weakness of upper and lower extremities. The symptoms disappear in 24 hours. He most likely experienced a(n):


A major contributing process in cerebrovascular accidents (CVA) is the development of atheromatous plaques in cerebral circulation. These most commonly form:

in cerebral arteries

A 75-year-old male experienced a lacunar stroke. This type of stroke is most often associated with:


A 25-year-old male died from a gunshot wound to the heart. Upon autopsy, abnormalities in the media of the arterial wall and degenerative changes were detected. Which of the following most likely accompanied this finding?

Saccular aneurysm

A 48-year-old female presents at the emergency department complaining of an acute severe headache, nausea, photophobia, and nuchal rigidity. These signs and symptoms are probably caused by:

subarachnoid hemorrhage

A cause of hydrocephalus in subarachnoid hemorrhage is:

scarring of meninges and impairment of CSF resorption

A 65-year-old male suffers a subarachnoid hemorrhage secondary to uncontrolled hypertension. He appears drowsy and confused with pronounced focal neurologic deficits. This condition is a grade:


A 25-year-old female presents to her physician complaining of fever, headache, nuchal rigidity, and decreased consciousness. She was previously treated for sinusitis. Which of the following is the most likely diagnosis?

Bacterial Meningitis

Most causes of encephalitis are:


A 15-month-old child from Pennsylvania was brought to the ER for fever, seizure activity, cranial palsies, and paralysis. Which of the following is the most likely cause?

Eastern equine encephalitis

A 23-year-old female begins having problems with tiredness, weakness, and visual changes. Her diagnosis is multiple sclerosis (MS). The pathogenic model of multiple sclerosis includes:

demyelination of nerve fibers in the CNS

The cause of multiple sclerosis (MS) seems to be an interaction between:

autoimmunity and genetic susceptibility

Classic amyotrophic lateral sclerosis (ALS) presents with:

muscle weakness and atrophy

Myasthenia gravis results from:

autoimmune injury at the neuromuscular junction

Patients with myasthenia gravis often have tumors or pathologic changes in the:


The most common primary CNS tumors in adults are:


A 45-year-old male presents with seizures. An MRI reveals a meningioma most likely originating from the:

dura mater and arachnoid membrane

The first reflex of infancy to disappear is:

Moro reflex

A 10-month-old infant presents for a well-baby visit. Which of the following reflexes should be present at this age?


During infancy, what is the fastest growing part of the body?


________defects of neural tube closure are most common.


An example of an anterior midline defect of neural tube closure is:


A newborn child has a hernial protrusion of a saclike cyst through a defect in the posterior arch of a vertebra. This condition is referred to as:


A newborn child is diagnosed with a vertebral arch defect and meningocele. This condition would most likely result in:

spina bifida

A 19-month-old boy developed a premature closure of one or more of the cranial sutures. The most likely diagnosis is:


True microcephaly can be caused by:

an autosomal recessive gene

An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would you expect to see?

Enlarged ventricles

The most common type of cerebral palsy is:


A child is diagnosed with cerebral palsy, characterized by extreme difficulty in fine motor coordination and purposeful movement. Which of the following types of cerebral palsy is he experiencing?


Which of the following diseases is screened for in all newborns?

Phenylketonuria (PKU)

Parents of a 3-month-old infant bring him to the emergency room after he has had a seizure. He has muscle rigidity, and the parents report they are of Jewish ancestry. For what genetic disease should this infant be screened?

Tay-Sachs Dz

A child is brought to the emergency room. Initial examination documents the following clinical manifestations: tissue ischemia, anemia, and an apparent decrease in normal growth rate. Which of the following poisons would most likely be the cause?


To prevent Reye syndrome in infants, which of the following instructions should be given to parents?

Tx fevers with acetaminophen not, Asa

A child presents to his physician with disorientation, delirium, aggressiveness, and stupor. His parents report that he was recently ill with an upper respiratory infection, which they treated with aspirin. Which of the following is the most likely diagnosis?

Reye syndrome

Viral meningitis:

often occurs with measles, mumps, or herpes

A 3-year-old African-American child was diagnosed with sickle cell disease. She is now suffering from meningitis. The most likely cause of the meningitis is:

streptococcus pneumoniae

The majority of children with AIDS were exposed to HIV:

in the uterus

The most common site of HI V infection in children is:

the CNS

A 10-year-old male presents with visual disturbances. CT scan reveals a tumor that is located near the optic chiasm. Which ofthe following is the most likely tumor type?


A lO-year-old female develops pneumonia following a urinary tract infection. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. This condition is referred to as:


A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations that can be characterized by:

a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing. This condition is referred to as:


Paroxysmal nocturnal dyspnea generally occurs with:

left ventricular failure

A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide levels. Which of the following is the most likely cause?


A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. This condition is referred to as:


A 28-year-old male complains to his physician that he has had a cold for a week and is coughing up bloody secretions. This condition is referred to as:


Reduced oxygenation of arterial blood is called:


A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. This condition is caused by:

decreased inspired oxygen

A low ventilation-perfusion ratio results in:


The condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion is called:

alveolar dead space

A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would be expected?

Low PaCO2

The most common cause of pulmonary edema is:

Left HF

A 47-year-old male is diagnosed with pulmonary edema. Which of the following would be expected with this condition?

Pink, frothy sputum

A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. This condition could cause:

pneumonitis and pneumonia

A 26-year-old female recently underwent surgery and is now experiencing dyspnea, cough, fever, and leukocytosis. Tests reveal that she has a collapsed lung caused by removal of air from obstructed alveoli. This condition is called:

absorption atelectasis

A 45-year-old male undergoes lung transplantation. He now suffers from airway occlusion secondary to fibrosis. The most likely diagnosis is:

bronchiolitis obliterans

A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. The most likely diagnosis is:

tension pneumothorax

A 60-year-old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. A diagnosis of pleural effusion is made and a watery fluid is drained. This fluid is referred to as:


A 57-year-old male presents with cough, sputum production, dyspnea, and decreased lung volume. He is diagnosed with pneumoconiosis. His illness is probably caused by:

inhalation of silica, asbestos, mica

A 42-year-old female presents with dyspnea, rapid, shallow breathing, inspiratory crackles, decreased lung compliance and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis?


A 60-year-old female with emphysema is having difficulty expiring a given volume of air. She is most likely experiencing __ pulmonary disease.


Asthma is thought to be caused by:

interactions between genetic and environmental factors

Asthma is classified by:

clinical severity

Airway hyperresponsiveness in asthma is related to:

exposure to an allergen cx mast cell degranulation

Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:

mucus secretion, bronchoconstriction, and airway edema

A 22-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. This condition is most likely caused by:

thick mucus from hypertrophied glands

A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is most likely to cause this condition?

Cigarette Smoke

A 25-year-old male presents with chronic bronchitis of 5 months' duration. Which of the following is the most significant concern in this patient?

Recurrent pulmonary infections

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. His airways are obstructed because of:

loss of elastic recoil

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. Changes in his lungs are caused by:

alpha-1-antitrypsin defieincy

Individuals with a recent diagnosis of emphysema most often present with:


A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior-posterior chest diameter because of:

air trapping

Pneumonia is caused by:

viral or bacterial infections

Nosocomial pneumonia is generally acquired:

during hospitalization

A 30-year-old male prison inmate contracted tuberculosis during an outbreak. The organism that caused this condition is a:


A 30-year-old male prison inmate contracted tuberculosis during an outbreak. He can transmit this disease through:

airborne droplets

A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. This condition is the result of occlusion of a portion of the pulmonary vascular bed by an embolus of:

blood clot

Which of the following patients is at highest risk for developing a pulmonary embolus?

72 y/o male who is recovering from hip- replacement surgery in the hospital

Which of the following shows a correct sequence of events in pulmonary embolism?

Hypoxemia inhibits the production of surfactant, cx alveolar collapse

An 80-year-old female is in the hospital for bone fracture. While there she develops a large, nonlethal pulmonary embolus. Which of the following is a direct result of the obstruction to blood flow?

Pulmonary HTN

A massive pulmonary embolism will most likely lead to:

shock and death

A 50-year-old male is diagnosed with pulmonary embolism. Which of the following symptoms most likely occurred before treatment?

chest pain and SOB

A 60-year-old male undergoes surgery for a bone fracture. Which ofthe following measures would be most effective for preventing pulmonary emboli in this patient?

Prevent DVT formation

Pulmonary hypertension is defined as a rise in pulmonary artery pressure of __ mm Hg above normal.

5 to 10

Secondary pulmonary hypertension is usually caused by:

chronic pulmonary dz

A 50-year-old male with a 30-year history of smoking was diagnosed with lung cancer. He was previously exposed to air pollution, asbestos, and radiation at his job. Which of the following most likely had the greatest impact on development of his cancer?

Cigarette Smoke

A 60-year-old male with a 40-year history of smoking presents with chest pain, cough, sputum production, and pneumonia. Tests reveal widespread metastatic cancer. Which of following is the most likely type of cancer?

Non-small cell carcinoma

A 1-year-old female is diagnosed with croup. The most likely cause of this disease is:

viral infection

A 1-year-old female is diagnosed with croup. Which of the following symptoms is most likely present?

respiratory stridor and braking cough

Respiratory distress and hypoxemia in laryngotracheobronchitis are caused by:

mucosal edema and laryngeal secretions

A 10-year-old male was diagnosed with obstructive sleep apnea. Which of the following treatments would most likely be tried first?


A newborn has respiratory distress syndrome. Which of the following is the most important predisposing factor for this condition?

Premature birth

A newborn has respiratory distress syndrome. He develops atelectasis because of:

lack of surfactant

Cardiovascular alterations seen in respiratory distress syndrome include:

opening of fetal shunt pathways

A newborn has respiratory distress syndrome. This condition appeared:

within minutes of birth

During a respiratory assessment of an infant with respiratory distress syndrome, a sinking in the supraclavicular and intercostal areas of the thorax was noted with inspiration. This observation is called:


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