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199 terms

Endocrine exam 3

STUDY
PLAY
Of the following terms and definitions which is NOT correctly associated?
Choose one answer.
a. Memory - recording, retention, retrieval of knowledge
b. Declarative memory - episodic memory (personal history, events, and experiences) c. Nondeclarative memory - procedural motor memory (actions, behaviors, skills, and outcomes)
d. Hypotonia - increased muscle tone (spasticity, gegenhalten, dystonia, and rigidity)
d. Hypotonia - increased muscle tone (spasticity, gegenhalten, dystonia, and rigidity)
You are assessing the mental status of M.N, a patient with Alzheimer disease. The type of memory loss you would expect to see is...
Choose one answer.
a. Episodic
b. Long term
c. Short term
d. Retrograde
a. Episodic
Which is TRUE regarding Alzheimers Disease?
Choose one answer.
a. The brain increases in volume
b. The brain increase in weight
c. Diagnosis is made upon angiogram
d. Diagnosis is made by ruling out other causes of dementia by CT and blood tests
d. Diagnosis is made by ruling out other causes of dementia by CT and blood tests
Genetic tests to screen for early onset Alzheimers Disease incude:
Choose one answer.
a. PSEN1, PSEN2, APP, and apoE4
b. PARK1
c. HD-IT15
d. PGRN
a. PSEN1, PSEN2, APP, and apoE4
Lower motor neuron syndromes originating in the anterior horn cells or the motor nuclei of the cranial nerves are called_________ what?
Choose one answer.
a. Akinesia
b. Distonia
c. Amyotrophy
d. Cogwheel Rigidity
c. Amyotrophy
An __________ immediately precedes the onset of a seizure.
Choose one answer.
a. Aura
b. axonal force
c. Prodroma
d. All the above can occur
a. Aura
Which statement most accurately describes the basic pathophysiological mechanism of a seizure?
Choose one answer.
a. All seizures involve an excess of GABA inhibition
b. Seizures occur when there is disruption in the balance of excitation and inhibition.
c. The occurrence of seizures is most often due to abnormal excitatory transmission enhancement.
d. Are most often as a result of exaggerated membrane potentials and the overpolarization of resting conductance
b. Seizures occur when there is disruption in the balance of excitation and inhibition.
Which genetic based neurological disorder affects chromosome 16 and is characterized by normal development until 6 months to 2 years when progressive brain disease becomes apparent with seizures, mental retardation, blindness, and death?
Choose one answer.
a. Cri du chat syndrome
b. Lech-Nyhan Syndrome
c. Batten disease
d. Early onset Alzheimer disease
c. Batten disease
A patient admitted to the ICU for alcohol related accidental drowning after falling through the ice. His core temp is 32 C, does not respond to noxious stimuli, pupils are fixed and dilated. Which order would be inappropriate at this time?
Choose one answer.
a. CTOH
b. CBC, BMP, Mg, Phos, PT, PTT
c. Neuro checks q 1 hr
d. Brain death testing
d. Brain death testing
Which of the following may induce a seizure?
Choose one answer.
a. Congenital malformations, genetic predisposition, perinatal injury, and postnatal trauma
b. Myoclonic syndromes, infection, brain tumor, vascular disease, fever
c. Drug and /or alcohol abuse
d. Hypoglycemia, fatigue, sleep deprivation, emotional or physical stress, febrile illness
e. All of the above
e. All of the above
_______________ is the complete inability to perform purposeful or skilled motor task acts in the absence of paralysis.
Choose one answer.
a. Dyspraxia
b. Apraxia
c. Paraylsis
d. Hemiplegia
b. Apraxia
Which type of cerebral edema is the most important because it disrupts the blood brain barrier?
Choose one answer.
a. Cytotoxic Edema
b. Interstitial Edema
c. Vasogenic Edema
d. Ischemic Edema
c. Vasogenic Edema
Cerebral Perfusion Pressure (CPP) is calculated by which of the following formulas:
Choose one answer.
a. MAP - ICP
b. MAP / ICP
c. ICP - MAP
d. ICP / MAP
a. MAP - ICP
Which of the following is not the characteristic of brainstem breathing pattern?
Choose one answer.
a. cluster breathing
b. ataxic breathing
c. cheyne-stokes respirations
d. gasping breathing pattern
c. cheyne-stokes respirations
Brief palpable jerks accompanied by tremor represent what type of rigidity in relation to Parkinson Disease?
Choose one answer.
a. Parkinsonian rigidity
b. Cogwheel rigidity
c. Plastic rigidity
b. Cogwheel rigidity
Which is NOT a characteristic of the clonic phase in a grand-mal seizure?
Choose one answer.
a. flexion spasm of whole body interrupted by muscular relaxation
b. strenuous hyperventilation, and excessive salivation with froth of the mouth
c. contorted face, and eyes rolled
d. slow pulse
e. rapid pulse
d. slow pulse
All of the following are manifestations of a supratentorial lesion compressing the diencephalon or brainstem except:
Choose one answer.
a. Initial signs usually of focal cerebral dysfunction
b. Signs of dysfunction progressing rostral to caudal
c. Neurologic signs at any given time pointing to one anatomic area
d. Symmetric motor signs
d. Symmetric motor signs
All of the following describes decerebrate posturing, except:
Choose one answer.
a. Opisthotonos (hyperextension of the vertebral column)
b. Clenching of the teeth
c. Extension, abduction, and hyperpronation of the arms
d. Flexion of the lower extremities
d. Flexion of the lower extremities
Which type of degenerative dementia has a pathophysiology associated with the development of Lewy Bodies?
Choose one answer.
a. Alzheimer Disease
b. Creutzfeldt-Jakob Disease
c. Huntington
d. Parkinson Disease
d. Parkinson Disease
Concerning Dimentia, mental abilities are impaired with a decrease in?
Choose one answer.
a. Orienting
b. Recent memory
c. Remote memory
d. All of the choices
d. All of the choices
There are 4 predominant types of gait disorders consisting of upper motor neuron dysfunction gait, cerebellar gait, basal ganglion gait, and senile gait. Spastic gait (an upper motor neuron dysfunction) is associated with which of the following?
Choose one answer.
a. unilateral injury, manifested by a shuffling gait with the leg extended and stiff, causing a scraping over the floor.
b. bilateral injury and legs are abducted, causing them to touch each other.
c. wide-based gait with the feet apart and often turned outward or inward for stability.
d. pseudoparkinsonian, frontal lobe
a. unilateral injury, manifested by a shuffling gait with the leg extended and stiff, causing a scraping over the floor.
Duchenne muscular dystrophy is more common in?
Choose one answer.
a. men
b. women
c. children
d. twins
a. men
Dysphasia that accompanies a CVA are associated with which artery?
Choose one answer.
a. Anterior Cerebral Artery
b. Middle Cerebral Artery
c. Posterior Inferior Cerebellar Artery
d. Posterior Cerebral Artery
b. Middle Cerebral Artery
Nonfluent; impairment of ability to find words and difficulty in writing is associated with what type of dysphagia?
Choose one answer.
a. Expressive (Broca)
b. Conduction
c. Transcortical motor
d. Anomic
a. Expressive (Broca)
Which of the following are subdivisions of epilepsy?
Choose one answer.
a. primary, secondary, idiopathic
b. aura, prodroma, cortical
c. idiopathic, symptomatic, cryptogenic
d. metabolic disorders, genetic disorders, grand mal
c. idiopathic, symptomatic, cryptogenic
An increase in intracranial pressure (ICP) may result from all of the following except:
Choose one answer.
a. An intracranial tumor
b. An intracranial bleed
c. Edema
d. Excess CSF
e. A decrease in partial pressure of CO2
e. A decrease in partial pressure of CO2
Which of the following correctly describes a manifestation seen in uncal herniation?
Choose one answer.
a. pupils become sluggish before fixing and dilating
b. The pupils do not change
c. Bilateral pupils stay in a pinpoint position
d. The pupils become star-shaped
a. pupils become sluggish before fixing and dilating
A patient suffering from an uncal herniation experiences ________ hemiplegia secondary to contralateral corticospinal tract compression.
Choose one answer.
a. ipsilateral
b. contralateral
c. bilateral
d. no
a. ipsilateral
Which of the following is a relatively rare, hereditary-degenerative disorder diffusly involving the basal ganglia and cerebral cortex?
Choose one answer.
a. Huntington disease
b. Parkinsonism
c. Tardive dyskensia
d. Bell Palsey
a. Huntington disease
Which of the following statements are true about Hydrocephalus?
Choose one answer.
a. Excess fluid built up within the cranial vault, subarachnoid space, or both
b. Caused by interferences in CSF like decreased reabsorption, increased fluid production, and obstruction within the ventricular system
c. Can be acute secondary to head injuries and may contribute to increased ICP (intracranial pressure)
d. All of the above statements are true.
d. All of the above statements are true.
Types of hyperkenesia include all of the following except?
Choose one answer.
a. Wandering
b. Ocular
c. Akathisia
d. Tremor at rest
b. Ocular
The definition of Paraoxysmal Dyskinesias is?
Choose one answer.
a. Involuntary movements that occur as spasms
b. Tendency to wander without regard for environment
c. Protrusions of the tongue
d. Facial grimacing
a. Involuntary movements that occur as spasms
Chorea, Athetosis, and Ballism are all types of ____________ syndrome.
Choose one answer.
a. Hyperkinesia
b. Hypokinesia
c. Hypotonia
d. Hypertonia
a. Hyperkinesia
Which of the following is NOT a type of Hypertonia:
Choose one answer.
a. Spasticity
b. Rigidity
c. Dystonia
d. Gegenhalten or paratonia
e. All are correct
e. All are correct
As intracranial pressure begins to approach arterial pressure, the brain tissues begin to experience hypoxia and hypercapnia and the individuals condition rapidly deteriorates. All of the following are clinical manifestations except
Choose one answer.
a. increasing level of arousal
b. Cheyne-Stokes Respirations
c. widened pulse pressure
d. Bradycardia
a. increasing level of arousal
What is a risk factor for late onset sporadic Alzheimer disease?
Choose one answer.
a. Increased BP and cholesterol
b. ApoE gene
c. Environmental triggers, toxins
d. All of these are risk factors
d. All of these are risk factors
Name the X-linked recessive disorder that results in progressive mental retardation and compulsively bitten lips and fingers.
Choose one answer.
a. Angelman Syndrome
b. Lech-Nyhan Syndrome
c. Neurofibromatosis
d. Batten disease
b. Lech-Nyhan Syndrome
Which condition is exemplified by a patient who cannot communicate either through speech or through body movement, but is fully conscious, with intact cognitive function?
Choose one answer.
a. Locked-in syndrome
b. Akinetic mutism
c. Minimally conscious state
d. Vegetative state
a. Locked-in syndrome
What are the brainstem syndromes called that involve damage to one or more of the cranial nerve nuclei?
Choose one answer.
a. Progressive Spinal Muscular Atrophy
b. Nuclear Palsies
c. Gamma Neuropathies
d. Primary Cranial Nerve Hyperphagia
b. Nuclear Palsies
Your patient was admitted to the ICU after being struck by a vehicle that was driving 25 mph down Tamiami. He is currently awake, alert, and oriented and his neurological exam appears normal. Upon assessment of his oculovestibular reflex, you would expect
Choose one answer.
a. Conjugate eye movement
b. Dysconjugate eye movement
c. No eye movement
d. Nystagmus
a. Conjugate eye movement
Which of following is a commonly occurring degenerative disorder of the basal ganglia involving the dopaminergic nigrostriatal pathway?
Choose one answer.
a. Parkinson disease
b. Huntington disease
c. Hydrocephalus
d. Paralysis
a. Parkinson disease
Which of the following is NOT a classic motor manifestation of Parkinson disease?
Choose one answer.
a. Bradykinesia
b. Tremor at rest
c. Flexibility
d. Hypoakinesia
c. Flexibility
Which of the following is NOT on of the three types of postural abnormalities that occur with Parkinson Disease?
Choose one answer.
a. Disorders of postural fixation
b. Disorders of equilibrium
c. Disorders of righting
d. Disorders of the diaphragm
d. Disorders of the diaphragm
Pathologically, in patients with dementia findings include all of the following EXCEPT?
Choose one answer.
a. Senile plaques
b. Neurofibrillary tangles
c. Loss of cholinergic cells in the basal nucleus of Meynert
d. Good memory
d. Good memory
Parkinson's disease is diagnosed based on four cardinal symptoms. Which of the following is NOT a diagnostic symptom?
Choose one answer.
a. Cogwheel rigidity
b. Resting tremor
c. bradykinesia
d. dysphagia
d. dysphagia
Parkinson's disease is characterized by what combinations of major neurologic features?
Choose one answer.
a. Tremor, increased muscle tone, and bradykinesia.
b. Jerky uncontrolled movements of the limbs, trunk and face; progressive loss of mental abilities; and development of psychological disorders
c. Generalized weakness and muscle wasting affecting limb and trunk muscles first, then progresses to respiratory system
d. Failure to thrive, blindness, seizures, and progressive paralysis
a. Tremor, increased muscle tone, and bradykinesia.
Which statement best describes a result of pontine dysfunction?
Choose one answer.
a. Loss of spontaneous blinking
b. Roving eye movements cease
c. Ocular dipping
d. Conjugate, horizontal, roving eye movements may well be present
a. Loss of spontaneous blinking
All of the following are classified as posture disorders except:
Choose one answer.
a. Dystonic posture
b. Decerebrate posture
c. Basal ganglion posture
d. Spastic posture
d. Spastic posture
A _________ is an early manifestation that may occur hours to days before a seizure.
Choose one answer.
a. Prodroma
b. Aura
c. Memory
d. Detection
a. Prodroma
If muscular atrophies affect the motor nuclei of the cranial nerves instead of the anterior horn cells the disorder is labeled _______.
Choose one answer.
a. progressive spinal muscular atrophy
b. progressive bulbar palsy
c. spinal shock
d. pyramidal motor syndrome
b. progressive bulbar palsy
Rigidity produced by tonic reflex activity is mediated by _______ motor neurons.
Choose one answer.
a. upper
b. gamma
c. lower
d. alpha
b. gamma
An Atonic seizure is characterized by all of the following EXCEPT:
Choose one answer.
a. loss of postural tone
b. clonic jerks
c. tone loss that may result a head nod
d. tone loss that may result in falls
b. clonic jerks
The Tonic phase of a seizure consists of?
Choose one answer.
a. A state of muscle contraction in which there is excessive muscle tone
b. A state of alternating contraction and relaxation of muscles
c. The period immediately following the cessation of seizure activity
d. None of the above choices
a. A state of muscle contraction in which there is excessive muscle tone
During the maintenance of a seizure a patient will exhibit these physiological occurrences?
Choose one answer.
a. Adenosine Triphosphate (ATP) consumption will increase by 250%
b. Cerebral oxygen consumption will increase by 60%
c. Available stores of glucose and oxygen will be readily depleted
d. All of the following are true
d. All of the following are true
If a person reports an inability to focus their attention and a failure to perceive objects and other stimuli, then they most likely have a cognitive network deficit relating to ....
Choose one answer.
a. Selective attention
b. Image processing
c. Vigilance detection
d. a working memory
a. Selective attention
In reguards to alterations in awareness, all of the following are clinical manifestations of selective attention deficits EXCEPT
Choose one answer.
a. Vigilance
b. detection
c. working memory
d. aura
d. aura
The end of spinal shock occurs when the spinal reflexes return within a few days to weeks, and all of the following characteristics occur when spinal shock resolves EXCEPT...
Choose one answer.
a. Flaccid paralysis
b. Spasticity
c. Increased muscle tone
d. Hyperactive reflexes
a. Flaccid paralysis
In stage 4, the last stage of intracranial hypertension, brain tissue shifts (herniates)
Choose one answer.
a. from the compartment of greater pressure to a compartment of lessor pressure
b. from the compartment of lessor pressure to the compartment of greater pressure
c. upward towards the cortex
d. outward toward the auditory canal
a. from the compartment of greater pressure to a compartment of lessor pressure
Which of the following is FALSE regarding status epilepticus?
Choose one answer.
a. the patient is NO longer in a postictal state when the next seizure begins
b. most often due to a abrupt discontinuation of antiseizure medications
c. IS a medical emergency
d. continuous seizure >5 minutes or single seizure >30 minutes
a. the patient is NO longer in a postictal state when the next seizure begins
Supratentorial disorders produce a decrease level of arousal by all of the following mechanisms EXCEPT
Choose one answer.
a. Diffuse bilateral cortical dysfunction
b. Bilateral subcortical dysfunction
c. Localized hemispheric dysfunction
d. Destruction of the RAS and its pathways
d. Destruction of the RAS and its pathways
Tactile Agnosia is the:
Choose one answer.
a. Inability to recognize objects by touch
b. Inability to distinguish right from left
c. Inability to recognize objects and pictures
d. Ignorance or denial of existence of the disease
a. Inability to recognize objects by touch
Word blindness refers to:
Choose one answer.
a. Inability to recognize written symbols
b. Inability to recognize speech sounds
c. Loss of capacity to recognize tones and melodies
d. Inability to recognize faces
a. Inability to recognize written symbols
Which motor neuron DIRECTLY influences the skeletal muscle?
Choose one answer.
a. Upper motor neuron
b. Astrocytes
c. Lower motor neuron
d. Third order neurons
c. Lower motor neuron
Pick which statement below is incorrect
Choose one answer.
a. Paresis(weakness) is impairment of motor function, partial paralysis with incomplete loss of muscle power
b. Paralysis is loss of motor function, inability of a muscle group to overcome gravity
c. Hemiparesis or hemiplegia is paresis or paralysis of the upper and lower extremities on one side
d. Diplegia is the paralysis of both upper or lower extremities as a result of cerebral hemisphere injuries
e. Upper cord damage results in paraparesis or paraplegia
e. Upper cord damage results in paraparesis or paraplegia
Which diseased area of the brain will produce a deficit in of vigilance, detection and a working memory?
Choose one answer.
a. Cortical Association Area
b. Hippocampal Area
c. Frontal Area
d. Thalamus
c. Frontal Area
The cognitive network deficit of working memory is characterized by all of the following clinical signs EXCEPT.....
Choose one answer.
a. Inability to set goals or form goals
b. Indecisiveness
c. Failure to initiate and maintain behavior
d. Failure to search or scan the environment
d. Failure to search or scan the environment
The ability to recall spatial positions of visual events in memory when the event is removed from view is known as__________
Choose one answer.
a. Working memory
b. Detection
c. Alzheimers
d. long term memory loss
a. Working memory
Delirium is an acute hyperkinetic confusional state that typically develops over 2 to 3 days.
Answer:
True False
T
An acute confusional state is not an acute medical problem.
Answer:
True False
F
Akinesia is an increased control of voluntary muscle movements.
Answer:
True False
F
Movements are complex patterns of activity controlled by the CNS.
Answer:
True False
T
True or False: The exact cause of Alzheimer Disease in unknown.
Answer:
True False
T
Basal ganglia motor syndromes are movement disorders that involve either a paucity or an excess of movements.
Answer:
True False
T
The pathophysiology of NTBI (non-traumatic brain injury) is one of hypoxia and ischemia.
Answer:
True False
T
Cheyne-stokes respiration is an abnormal rhythm of breathing that alternates between hyperventilation and apnea. (T/F)
T
Breathing patterns of coma can be categorized as hemispheric or brainstem.
Answer:
True False
T
Content of thought is mediated by attentional systems, memory systems, language systems, and executive systems.
Answer:
True False
T
Environmental influences may play a role in the pathogenesis of dementia
Answer:
True False
T
Denervated muscles (muscles that have lost their nervous system input) undergo atrophy over weeks to months, mostly from disuse.
Answer:
True False
T
Alzheimer disease is the most common cause of Dimentia.
Answer:
True False
T
Disorders of expression involve motor aspects of communication and include hypermimesis, hypomimesis, dyspraxias and apraxias.
Answer:
True False
T
Dysmnesia, also known as amnesia, originates from pathologic conditions in the hippocampus and related temporal lobe structures.
Answer:
True False
T
Dysmnesia is a disorder of the domain-independent declarative memory network defined as the loss of past memories (retrograde amnesia) coupled with an inability to form new memories (anterograde amnesia) despite intact attentional networks.
Answer:
True False
T
A lesion found in the posterosuperior temporal lobe is associated with Wernicke dysphagia.
Answer:
True False
T
Symptomatic epilepsy refers to syndromes that arise spontaneously without a known cause, presumably having a genetic basis.
Answer:
True False
F
Paresis and paralysis caused by a disorder of the lower motor neurons are called flaccid paresis and flaccid paralysis because the muscle has reduced or absent tone and is accompanied by hyporeflexia or areflexia.
Answer:
True False
T
Protein deposits (plaques) and neurofibrillary tangles are major histopathologic changes that occur in Alzheimer disease.
Answer:
True False
T
The principal pathologic feature of Huntington disease (HD) is degeneration of the basal ganglia, particularly the caudate and putamen nuclei, and the frontal cerebral cortex.
Answer:
True False
T
In normal pressure hydrocephalus, reduction in CSF through a diuresis regimen often is used.
Answer:
True False
T
Hypokniesia is loss of voluntary movement despite preserved consciousness and normal peripheral nerve and muscle function.
Answer:
True False
T
Hypotonia results from pyramidal tract and cerebellar damage.

Answer:
True False
T
Yawning, vomiting, and hiccups are complex reflex-like motor responses that are integrated by neural mechanisms in the upper brainstem.
Answer:
True False
F
Purposeful movements of the body require an intact spinothalamic system.
Answer:
True False
F
Parkinsonian bradykinesia is the most prevalent and crippling symptom of Parkinson disease and is often overlooked in the early stages.
Answer:
True False
T
During a partial seizure (focal seizure; including subtypes) consciousness may be maintained if seizure activity is limited to ONE hemisphere.
Answer:
True False
T
True or False: Etiology of injury and time since onset of coma are currently the best prognostic indicators of recovery of consciousness or functional outcome.
Answer:
True False
T
Pupillary changes are not a valuable guide to evaluating the presence and level of brainstem dysfunction.
Answer:
True False
F
The pyramidal motor syndrome is a series of motor dysfunctions that result from interruption of the pyramidal system. The injury may be in the cerebral cortex, the subcortical white matter, the internal capsule, the brainstem, or the spinal cord.
Answer:
True False
T
Spasticity results from overactivation of the alpha motor neurons and is accompanied by hyperreflexia and clonus.
Answer:
True False
T
A disorder in Vigilance may be produced by disease in the right frontal areas
Answer:
True False
T
Which is NOT a cause of an abscess in the brain or spinal cord?
Choose one answer.
a. Surgery
b. contiguous focus of infection
c. hematogenous spread
d. antibiotics and steroids
e. cryptogenically
d. antibiotics and steroids
_________ aneurysms are a weakening in the arterial wall caused by a fracture line, penetrating missile, after neurosurgical procedures, or after an angiogram.
Choose one answer.
a. Traumatic
b. Mycotic
c. Fusiform
d. Saccular
a. Traumatic
In the autonomic dysreflexia pathway, reflex stimulus to the major sympathetic outflow results in all of the following EXCEPT:
Choose one answer.
a. vasospasm
b. pallor of skin
c. hypotension
d. pilomotor spasm
c. hypotension
Which of the following statements regarding brain and spinal cord abscesses is NOT true?
Choose one answer.
a. Clinical manifestations depend on the location of the abscess.
b. Antibiotic therapy is always adequate and effective treatment regardless of the location and size of the abscess.
c. Late manifestations may include: distractibility, memory deficit, decreased visual acuity, ataxia & dementia
d. Extradural brain abscesses are associated with localized pain and purulent drainage from the nasal passages or auditory canal, fever, and/or next stiffness
b. Antibiotic therapy is always adequate and effective treatment regardless of the location and size of the abscess.
All of the following statements about brain metastases are true EXCEPT...
Choose one answer.
a. Brain metastases are approximately 10 times more common than primary brain tumors in adults.
b. Lung and breast are the most common tumors to have brain metastases within 1-3 years of diagnoses.
c. Brain metastases are least likely to be found in the frontal lobe with adults
d. The brain metastatic process requires a series of sequential events, called the "metastatic cascade
c. Brain metastases are least likely to be found in the frontal lobe with adults
Which of the following is not a cardinal sign of CNS infection
Choose one answer.
a. Fever
b. Head, or spine pain
c. Generalized or focal neurologic dysfunction
d. Oliguria
d. Oliguria
Which of the following is associated with category 2 HIV associated dementia (HAD)?
Choose one answer.
a. Clouding of consciousness
b. Decline in work or other activities of daily living
c. Behavior indicative of denial
d. Significant impairment in work and other ADLs
d. Significant impairment in work and other ADLs
What is the primary cause of cerebral hemorrhage?
Choose one answer.
a. contusion
b. atherosclerosis
c. trauma
d. hypertension
d. hypertension
In classic cerebral concussion, loss of consciousness lasts as long as 6 hrs and reflexs are lost causing falls. Which of the following is NOT usually seen?
Choose one answer.
a. Transient cessation of respirations
b. Briet periods of bradycardia
c. Decrease in BP lasting 30 seconds or less
d. Tachycardia with heart rate up to 140
d. Tachycardia with heart rate up to 140
A 30 year old male goes to a health clinic with complaints of severe headaches lasting 30 mins to 2 hours that occur during the daytime for several days. It is a unilateral tearing, burning, and periorbital or temporal pain. What is a possible diagnosis for this headache?
Choose one answer.
a. Cranial headache
b. Cluster headache
c. Intracerebral tumor causing a headache
d. Brudzinski sign
b. Cluster headache
The irritation and damage to CN VIII can cause the following:
Choose one answer.
a. Deafness, Tinnitus, Vertigo
b. Difficulty Swallowing
c. Visual Field deficit and ocular pressure
d. Death
a. Deafness, Tinnitus, Vertigo
Which of the following is false regarding CNS tumors in children?
Choose one answer.
a. CNS tumors represent the second most common group of tumors in children
b. approximately 70% of all intracranial tumors in children are located infratentorially
c. peripheral nerve tumors are rare in children
d. all are true
d. all are true
Clinical manifestations of Encephalitis are?
Choose one answer.
a. Fever, delirium, confusion
b. Seizure activity and involuntary movements
c. Cranial nerve palsies
d. All of the following are clinical manifestations that may be present
d. All of the following are clinical manifestations that may be present
Which of the following is defined as an infection of the CNS that is an acute febrile illness of viral origin with nervous system involvement.
Choose one answer.
a. Viral Meningitis
b. TB Meningitis
c. Encephalitis
d. Echovirus Menigitis
c. Encephalitis
Where are fifty percent of metastatic spinal cord tumors located?
Choose one answer.
a. Extradural
b. Intramedullary
c. Intradural
d. Extramedullary
a. Extradural
When the force of an impact produces brain contusions, the focal injury may be _____ (directly bellow the point of impact) or _____ (on the pole opposite the site of impact.
Choose one answer.
a. Coup; Contrecoup
b. Contrecoup; Coup
a. Coup; Contrecoup
Which of the following is not characteristic of focal or multifocal neuropathy?
Choose one answer.
a. Affect sensory and motor fibers in one or more nerves
b. can involve one or more cranial nerves
c. flexus injuries and radiculopathies fall into this neuropahty
d. affect the cell body of only one type of peripheral neuron
d. affect the cell body of only one type of peripheral neuron
What type of cerebral hematoma gradually fills with blood and forms a vascular membrane in approximately 2 weeks?
Choose one answer.
a. Intradural tumor
b. Acute subdural
c. Chronic subdural
d. Lacunar stroke
c. Chronic subdural
The signs and symptoms of a herniated intervertebral disk are determined by the location and size of the herniation into the spinal canal. Therefore, all of the following symptoms are present with a herniated disk in the lumbosacral area EXCEPT..
Choose one answer.
a. Paresthesia and pain in the upper extremities
b. Limited range of motion in the lumbar spine
c. Pain that radiates along the sciatic nerve
d. Tenderness with palpation along the sciatic nerve
a. Paresthesia and pain in the upper extremities
Aseptic viral meningitis can include involvement of cranial nerves _____?
Choose one answer.
a. V
b. III
c. V & VII
d. X
c. V & VII
Intracerebral hematoma (intraperenchymal hemorrhage) is associated with which of the following?
Choose one answer.
a. occur in 2-3% of head injuries
b. occur due to MVAs and falls
c. commonly located in the frontal and temporal lobes
d. all of the above
d. all of the above
What is true regarding intracranial aneurysms?
Choose one answer.
a. 85-95% occur in the anterior portion of the circle of Willis
b. In 20-25% of cases there are more than one aneurysm present
c. Peak incidence of rupture is from 50-60 years of age, with women having a slightly greater amount of incidences
d. All of the above statements are true.
d. All of the above statements are true.
Because of the extremely slow-growing nature of most meningiomas:
Choose one answer.
a. Increased ICP is less common
b. results in temporary disruption of cord-mediated functions
c. Results in bleeding into the neural tissue because of blood vessel damage
d. Results in a decreasing level of consciousness
a. Increased ICP is less common
Clinical manifestations of meningiomas of the olfactory groove include all of the following except:
Choose one answer.
a. visual failure
b. personality change
c. anosomia
d. Urinary Incontinence
d. Urinary Incontinence
Of the following terms and definitions, which is NOT correctly associated?
Choose one answer.
a. Bacterial Meningitis - primarily infection of pia mater and arachnoid, the subarachnoid space, the ventricular system, and the CSF. Meningococcus and pneumococcus are responsible.
b. Aseptic (viral) Meningitis - limited to meninges, caused by enteroviral viruses, mumps, HSV, etc..
c. Tubercular Meningitis - most common and serious form of CNS tuberculosis, on rise d/t HIV, cerebral ischemia occurs; symptoms include headache, low grade fever, nausea, vomiting, fatigue
d. Lyme Disease - dog bite-borne viral infection; [caused by Borrelia burgdorferi; incubates 3-32 days then migrates to skin, lymph nodes and other body systems; stage 1 acute, stage 2 dissemination of antibodies, stage 3 chronic; treated with antibiotics]
d. Lyme Disease - dog bite-borne viral infection; [caused by Borrelia burgdorferi; incubates 3-32 days then migrates to skin, lymph nodes and other body systems; stage 1 acute, stage 2 dissemination of antibodies, stage 3 chronic; treated with antibiotics]
When are women MOST susceptible for migraine headaches?
Choose one answer.
a. Before and during Menstruation
b. After Menstruation
c. Early Childhood
d. Late adulthood
a. Before and during Menstruation
During the "headache phase" of a patient with a migraine, how long do symptoms typically last?
d. 4-72 hours (about one day)
Which of the following is NOT a type of mild concussion?
Choose one answer.
a. Confusion and disorientation accompanied by amnesia
b. Momentary confussion and retrograde amnesia that develop after 5 to 10 minutes
c. Confussion and retrograde amnesia present from impact
d. Momentary confussion lasting 15 to 20 minutes
d. Momentary confussion lasting 15 to 20 minutes
90% of patients present with this type of Multiple Sclerosis
Choose one answer.
a. Relapsing-Remitting
b. Primary Progressive
c. Secondary Progressive
d. Progressive-Relapsing
a. Relapsing-Remitting
Choose one answer.
a. Minor increased body temperature
b. Increases in serum Ca++ levels
c. Physical or Emotional Stress
d. Sleep
d. Sleep
Myasthenia Gravis is a chronic autoimmune disease mediated by acetylcholine receptor antibodies at the neuromuscular junction. Which of the following is NOT a manifestation of myasthenia gravis?
Choose one answer.
a. Foremost complaint of muscular fatigue and progressive weakness.
b. Recent history of recurring URI's
c. Respiratory muscles of the diaphragm and chest wall become stronger and ventilation is improved
d. Muscles of the eyes, face, mouth, throat, and neck are usually affected first
c. Respiratory muscles of the diaphragm and chest wall become stronger and ventilation is improved
All of the following cause inflammatory changes in the nerve root EXCEPT
Choose one answer.
a. Inflammatory arachnoiditis
b. Sarcoidosis
c. Neurosyphilis
d. Herniated disk
d. Herniated disk
Presynaptic autoimmune diseases include neurotonia with autoantibodies to the __________ channels and the Lambert-Eaton myasthenic syndrome with autoantibodies to _______ channels.
Choose one answer.
a. potassium; calcium
b. calcium; potassium
c. sodium; potassium
d. potassium; sodium
e. sodium; calcium
a. potassium; calcium
Which of the following IS NOT an example of a penetrating injury?
Choose one answer.
a. A bullet wound from a handgun
b. Injury from a screwdriver
c. Injury from a bat striking you over the head
d. Injury from an ice-pick
c. Injury from a bat striking you over the head
Plexus injuries involve the nerve plexus ______ to the spinal roots but _______ to the formation of the peripheral nerves.
Choose one answer.
a. distal; proximal
b. proximal; distal
c. anterior; posterior
d. posterior; anterior
a. distal; proximal
A glioma that arises from ependymal cells that form the walls of the ventricles and grow either into the ventricle or into adjacent brain tissue is known as an
Choose one answer.
a. Angioma
b. Neurofibroma
c. Medulloblastoma
d. Ependymoma
d. Ependymoma
______ _______ carries impulses to the brain?
Choose one answer.
a. Spinothalamic tract
b. Autonomic hyperreflexia
c. Splanchic nerve
d. motor output
a. Spinothalamic tract
Which of the following is true about Saccular Aneurysms (berry aneurysms)?
Choose one answer.
a. They have the highest incidence of rupturing or bleeding between ages 20 and 50.
b. Occur in approximately 2% of the population
c. Saccular Aneurysms may be round with a narrow stalk connecting it to the parent artery, broad based without a stalk, or cylindric in shape.
d. All of the above statements are true.
d. All of the above statements are true.
Which of the following are not clinical manifestations of complete spinal cord transection.
Choose one answer.
a. loss of motor function
b. muscle flaccidity
c. loss of all reflexes below level of injury
d. preservation of some sensation below level of injury
d. preservation of some sensation below level of injury
Which of the following are not clinical manifestations of partial spinal cord transection.
Choose one answer.
a. Syndromic craniosynostosis
b. Anterior cord syndrome
c. Cauda equina syndrome
d. Syndrome of neuropraxia
a. Syndromic craniosynostosis
Spinal cord tumors manifest as vascular insult by thrombosis of vessels supplying the spinal cord, all of the following are manifestations except:
Choose one answer.
a. Compressive Syndrome
b. Irritative Syndrome
c. Syringomyleic Syndrome
d. immunodeficiency Syndrome
d. immunodeficiency Syndrome
Spinal cord tumors are named to reflect their cell type, growth rate, and structure of origin. When a spinal tumor is originating within the neural tissue it is classified as a ......
Choose one answer.
a. Tramedullary tumor
b. Extramedullary tumor
c. Intradural tumor
d. Extradural tumor
a. Tramedullary tumor
Spondylolisthesis is a stress factor allowing a vertebra to do what in relation to the vertebra below?
Choose one answer.
a. Slide backwards
b. Shift laterally
c. Slide forward
d. Compress down
c. Slide forward
Spondylolysis is a degenerative process of the vertebral column and associated soft tissue and is characterized by a structural defect of the spine. What is the MOST COMMON site affected by Spondylolysis?
Choose one answer.
a. The cervical spine
b. The thoracic spine
c. The lumbar spine
d. The sacral spine
c. The lumbar spine
What is the largest cerebral artery and the vessel that is most commonly affected by cerebrovascular accident (CVA)?
Choose one answer.
a. Internal Carotid
b. Basilar Artery
c. External Carotid
d. Middle cerebral artery (MCA)
d. Middle cerebral artery (MCA)
The area of the brain infarcted by a CVA involving the Posterior cerebral artery (PCA) is?
Choose one answer.
a. Northern territory
b. Southern territory
c. Eastern territory
d. Central territory
d. Central territory
Clinical manifestations of Subarachnoid Hemorrhage include which of the following:
Choose one answer.
a. A positive Kernig sign.
b. A positive Brudzinski sign.
c. Explosive headache often associated with nausea and vomiting.
d. Motor deficits
e. Blurred vision
f. All choices are correct.
f. All choices are correct.
______________ is the major cause of rapidly developing and subacutely developing subdural hematomas.
Choose one answer.
a. Tearing of the bridging veins
b. Arterial rupture
c. Skull fracture
d. Intracerebral hemorrhage
a. Tearing of the bridging veins
Amyotrophic lateral sclerosis(ALS) involving upper motor neurons consists of the following except?
Choose one answer.
a. weakness of movement patterns
b. progressing to paralysis
c. associated with hypotonia
d. in some cases, atrophy secondary to disuse
c. associated with hypotonia
The triad of clinical manifestations of HIV-associated dementia (HAD) includes neurocognitive impairment, behavioral disturbance and ___________?


Choose one answer.
a. motor abnormalities
b. cognitive regression
c. medical student's syndrome
d. spasmotic dysphonia
e. synesthesia
a. motor abnormalities
A far less commonly occurring glioma is _
Choose one answer.
a. Astrocytoma
b. Oligodendroglioma
c. Ependymoma
d. Oligoastrocytoma
b. Oligodendroglioma
Pick which statement is incorrect
Choose one answer.
a. Thrombotic strokes(cerebral Thrombosis) arise from arterial occlusions caused by thrombi formed in the arteries supplying the brain or in the intracranial vessels.
b. An embolic stroke involves fragments that break from a thrombus formed outside of the brain or in the heart, aorta,common carotid, or thorax.
c. Transient ischemic attack (TIA) is a brief episode of neurologic dysfunction caused by a focal disturbance of brain or retinal ischemia with clinical symptoms typically lasting less than 1 hour and without evidence of infarction.
d. A lacunar stroke (lacunar infarct) is a microinfarct smaller than 1 cm in diameter and involves the small perforating arteries, predominantly in the basal ganglia, internal capsules and pons.
e. Hemorrhagic stroke is a cerebral thrombus formed due to decreased blood pressure.
e. Hemorrhagic stroke is a cerebral thrombus formed due to decreased blood pressure.
Arteries that feed directly into veins through a vascular tangle are called arteriovenous malformations and they are often shaped like a ______.
Choose one answer.
a. Cone
b. Circle
c. Square
d. Triangle
a. Cone
Which of the following viruses is known to develop chronic CNS disease?
Choose one answer.
a. HIV
b. Lyme disease
c. Herpes simplex
d. Rubella
a. HIV
Visceral distention include all of the following except?
Choose one answer.
a. Bowel
b. Bladder
c. abdomen
d. Carotids
d. Carotids
Abscesses are localized collections of pus within the parenchyma of the brain and spinal cord.
Answer:
True False
T
Unconsciousness, flacidity, or decebrate posture are associated with a 94% mortality.
Answer:
True False
T
True or False: Approximately 40% to 60% of all persons with Acquired Immunodeficiency Syndrome (AIDS) have neurologic complications?
Answer:
True False
T
Astrocytomas are the most common primary CNS tumors.
Answer:
True False
T
Astrocytomas occur only in the brain.
Answer:
True False
F
Autonomic neuropathies have a progressive course and are usually irreversible?
(Ture/False)
Answer:
True False
F
Bleeding from an AVM into the subarachnoid space causes clinical manifestations identical to those associated with a ruptured aneurysm.
Answer:
True False
T
True or False: An angioma is a fast growing blood vessel tumor arising from congenitally malformed arteriovenous connections.
Answer:
True False
F
A positive Brudzinski sign is a possible clinical manifestation of subarachnoid hemorrhage and is characterized by increased pain and rigidity when the neck is passively flexed.
Answer:
True False
T
cerebral hemorrhage resolves through reabsorption.
Answer:
True False
T
In regards to Cerebellar Type Multiple Sclerosis, a charcot triad describes a combination of dysarthria, intentional tremor, and nystagmus.
Answer:
True False
T
The local manifestations of a cranial tumor are caused by the destructive action of the tumor itself on a particular site in the brain and compression causing decreased cerebral blood flow. The general manifestations result from increased ICP
Answer:
True False
T
Ischemic cerebrovascular disease is the most common type of CVA.
Answer:
True False
T
In the Tx of thrombotic CVA, systemic anticoagulants (TPA, Heparin) have been shown to be effective, including aspirin.
Answer:
True False
T
Neuroprotective medications (Ca Channel blockers, GABA agonists, NMDA antagonists) have been shown to reduce the risk of poor outcomes with ischemic strokes.
Answer:
True False
F
The pathologic findings in DDD include disk protrusion, spondylolysis, and/or subluxation and degeneration of vertebrae (spondylolisthesis) and spinal stenosis.
Answer:
True False
T
The severity of a diffuse brain injury correlates with the direction and velocity of the rotation; how much shearing force was applied to the brain.
Answer:
True False
T
Diffuse bran injury results in shearing, tearing, or stretching nerve fibers, damaging the axon.
Answer:
True False
T
An artery is the source of bleeding in 85% of extradural (epidural) hematomas.
Answer:
True False
T
Fungal Meningitis is less common than bacterial or viral meningitis, is chronic, more common in impaired immune system, caused by histoplasmosis, cryptococcosis, candidiasis, and aspergillosis.
Answer:
True False
T
Acute inflammatory demyelinating polyneuropathy (AIDP) accounts for most cases of Guillain Barre Syndrome and is characterized by descending paralysis with a typically distant start.
Answer:
True False
F
Guillain-Barre syndrome is an acquired acute inflammatory demyelinating or axonal polyneuropathy with four subtypes.
Answer:
True False
T
In Guillain-Barre, ventilatory support and management of the autonomic nervous system dysfunction are two dominant aspects of therapeutic management.
Answer:
True False
T
Intracerebral hematomas occur in 2% to 3% of head injuries usually associated with MVAs and falls from some distance.
Answer:
True False
T
Human immunodeficiency virus (HIV) is classified as a retrovirus.
Answer:
True False
T
Hyperextension of the spine can result in fracture or nonfracture injuries with spinal cord damage.
Answer:
True False
T
Most cases of low back pain are idiopathic, and clinicians are unable to provide a precise diagnosis for most individuals with this disorder.
Answer:
True False
T
The most common causes of low back pain include lumbar disk herniation, degenerative disk disease, spondylolysis, spondylolisthesis, and spinal stenosis
Answer:
True False
T
True or False: Multiple sclerosis is a primary autoimmune disorder diffusely involving degeneration of CNS myelin and loss of axons.
Answer:
True False
T
True or False: Multiple sclerosis is described as occurring when a previous viral insult to the nervous system has occurred in a genetically susceptible individual with a subsequent abnormal immune response in the CNS.
Answer:
True False
T
A meningioma is a sharply circumscribed mass that derives its shape from the space it occupies.
Answer:
True False
T
Severe diffuse axonal injury (DAI) was formally called primary brainstem injury or brainstem contusion.
Answer:
True False
T
A spinal cord concussion results in a temporary disruption of cord-mediated functions.
Answer:
True False
T
Secondary spinal cord injury begins within a few minutes after injury.
Answer:
True False
T
Hyperflexion produces translation (subluxation) of vertebrae, which compromises the central canal and compresses spinal cord parenchyma or vascular structures.
Answer:
True False
T
Spinal shock is characterized by a complete loss of reflex function in all segments below the level of the lesion.
Answer:
True False
T
CVA's (stroke syndromes) are classified according to pathophysiology and are thus ischemic(thrombotic or embolic), global hypoperfusion (as in shock), or hemorrhagic.
Answer:
True False
T
With a subarachnoid hemorrhage (SAH), blood escapes from defective or injured vasculature into the epidural space.
Answer:
True False
F
Intramedullary spinal cord tumors (notably ependymomas) involve the central gray matter of the spinal cord, and may produce syringomyelic syndrome, or inflammation of the spinal cord.
Answer:
True False
T
Tension-type headache is the most common type of headache characterized by a mild to moderate bilateral headache with a sensation of a tight band or pressure around the head.
Answer:
True False
T
Amyotrophic lateral sclerosis(ALS) involving lower motor neurons is associated with spastic paresis.
Answer:
True False
F
Toxoplasmosis is the MOST common oppertunistic infection occurring in 1/3 of AIDS cases.
True/False
T
Tubercular Meningitis is the most common and serious form of CNS tuberculosis.
True/False
T
T/F Diagnosis of high grade astrocytomas most commonly takes 3 to 6 months from onset of the first clinical manifestation.
T