Gould's Pathophysiology - Chapter 14 Neurological Disorders

What is the effect of an enlarging brain abscess on cardiovascular activity?

Systemic vasoconstriction and slower heart rate.

Herpes zoster can be identified by a typical:

Unilateral rash and pain along a cranial nerve or dermatome.

In which type of neuron is progressive degeneration occurring with amyotrophic lateral sclerosis (ALS)?

Upper and lower motor neurons.

Which of the following are typical early signs of Alzheimer's disease?

1. Behavioral changes 2. Reduced ability to reason or problem solve

In which disorders do biochemical abnormalities involving neurotransmitters in the brain occur?

1. Bipolar disorder 2. Schizophrenia 3. Huntington's disease

Which of the following factors predispose(s) an individual to a CVA?

1. Hypertension 2.Smoking cigarettes 3. History of coronary artery disease 4. Diabetes mellitus

In the weeks following CVA, why might some neurological function return?

1. Presence of collateral circulation 2. Immediate therapy to dissolve thrombi and maintain perfusion 3. Reduced inflammation in the area 4. Development of alternative neuronal pathways

The rabies virus is usually transmitted by:

Bites from infected animals.

What causes a herniated intervertebral disc?

A protrusion of the nucleus pulposus through the annulus fibrosis.

How does a depressed skull fracture cause brain damage?

A section of skull bone is displaced below the level of the skull, causing pressure on the brain.

An epidural hematoma is located between the:

Dura mater and the skull.

Which of the following is used to confirm the diagnosis of, and classify seizures?

Electroencephalogram.

Communicating hydrocephalus causes increased intracranial pressure because of:

Failure of the subarachnoid to absorb CSF.

Which of the following dietary supplements has reduced the incidence of spina bifida in recent years?

Folic acid.

The largest category of primary malignant brain tumors that arise from cells in the central nervous system (CNS) are called:

Gliomas.

Common manifestations of rabies infection include:

Headache, foaming at the mouth, and difficulty swallowing.

Following a head injury, what is the most likely cause of secondary damage to the brain?

Hematoma or infection

Which type of cerebrovascular accident (CVA) has the poorest prognosis?

Hemorrhagic CVA.

The best description of myelomeningocele is:

Herniation of the meninges, CSF, and spinal cord or nerves through a vertebral defect.

All of the following may precipitate a seizure EXCEPT:

Hypoventilation.

Which of the following is the most common cause of brain damage in children with cerebral palsy?

Hypoxia.

In a case of bacterial meningitis, where does swelling and purulent exudate from?

In the pia mater, arachnoid, and surface of the entire brain.

Through what area does the cerebrospinal fluid circulate around the brain and spinal cord?

In the subarachnoid space.

What would be the effect of damage to the auditory association area in the left hemisphere?

Inability to understand what is heard.

Which of the following causes papilledema?

Increased pressure of cerebrospinal fluid (CSF) at the optic disc.

What is the typical change in blood pressure in a patient who has increased intracranial pressure?

Increasing pulse pressure.

Creutzfeldt-Jakob disease is caused by:

Infection of the brain by a prion.

Which statement is TRUE about tetanus infection?

Infection usually develops in deep puncture wounds.

In cases of Guillain-Barre syndrome, what does the pathophysiology include?

Inflammation and demyelination of peripheral nerves, leading to ascending paralysis.

Which of the following applies to the corticospinal tract?

It is a pyramidal tract for efferent impulses.

Which statement is TRUE about depression?

It is classified as a mood disorder.

Which of the following statements applies to a lumbar puncture?

It is usually performed at L3-L4.

Which statement applies to Huntington's disease?

It presents with choreiform movements in the upper body and decreased ability to concentrate.

Which of the following is the usual location language centers?

Left hemisphere.

Signs and symptoms of a stroke depend upon:

Location of obstruction, size of artery, and area affected.

What does a vegetative state refer to?

Loss of awareness and intellectual function but continue brainstem function.

From the following, choose the two events (in correct sequence) that immediately follow the aura during a tonic-clonic event:

Loss of consciousness, then the tonic stage.

Which of the following impairments results from infection by the polio virus?

Loss of function of motor neurons of the spinal cord and medulla.

What is the usual result of damage to the right occipital lobe?

Loss of left visual field.

Which of the following is NOT a typical effect of advanced Parkinson's disease?

Loss of vision.

What is the typical initial effect of a herniated intervertebral disc at the L4 to L5 level?

Lower back pain radiating down the leg.

All of the following apply to CVA EXCEPT:

Maximum necrosis and infarction develop within several hours of onset.

Secondary brain tumors usually arise from:

Metastasized breast or lung tumors.

In many types of encephalitis, such as St. Louis encephalitis, how are the viruses transmitted?

Mosquitoes and tick bites

With regard to meningitis, choose the correct combination of microbe and the age group commonly affected.

N. meningitides: children and youth

Which of the following applies to cerebral palsy?

Nonprogressive brain damage to the fetus or neonate.

As intracranial pressure rises, the pupil of the eye, ipsilateral to the lesion, becomes dilated and unresponsive to light because of pressure on the:

Peripheral nervous system (PNS) fibers in cranial nerve III.

How would a seizure of bizarre or inappropriate activity be classified?

Psychomotor seizure.

How does the heart rate change as intracranial pressure increases?

Rate decreases.

What is the best definition of aphasia?

The inability to comprehend or express language appropriately.

Expressive aphasia is most likely to result from damage to:

The left frontal lobe.

Which of the following is characteristic of generalized seizures?

The uncontrolled discharge of neurons in both hemispheres.

Which of the following does NOT apply to Reye's syndrome?

There is no permanent damage in the body.

Which of the following is a TRUE statement about transient ischemic attacks (TIAs)?

They can warn of potential cerebrovascular accidents.

Typical signs of TIA include:

Transient muscle weakness in a hand or leg.

Which of the following are common early manifestations of Parkinson's disease?

Tremors at rest in the hands and repetitive motion of the hands.

Which of the following applies to Parkinson's disease?

Usually develops in men and women over the 60 years of age.

All of the following are typical signs of hydrocephalus in the neonate EXCEPT:

Vomiting, headache, and paralysis.

Which of the following is a typical early sign of amyotrophic lateral sclerosis (ALS)?

Weakness and muscle atrophy in upper limbs.

What is the probable source of an embolus causing a cerebrovascular accident (CVA)?

Common carotid artery.

Brain injury where the brain is injured when it bounces off of the skull due to sudden acceleration or deceleration is referred to as a/an:

Contrecoup injury

What are the characteristic changes in the brain of a patient with Alzheimer's disease?

Cortical atrophy with plaques and neurofibrillary tangles, impairing conduction.

Following a spinal injury at C5, what is the expected effect during the period of spinal shock?

Possible periods of apnea.

How is the presence of spina bifida diagnosed?

Prenatally by ultrasound or detection of alpha-fetoprotein (AFP) in maternal blood or amniotic fluid.

Which of the following conditions is NOT part of the criteria for a declaration of "brain death"?

Presence of any head injury.

The primary reason for seizures frequently occurring with head injuries is:

Presence of blood irritates the neurons.

Which type of seizure occurs commonly in children?

Absence.

What does the clonic stage of a seizure consist of?

Alternating contractions and relaxation of skeletal muscles.

In cases of noncommunicating hydrocephalus, why does excess cerebrospinal fluid accumulate?

An obstruction is present in the aqueduct of Sylvius or other channel.

Which of the following classes of drugs may provide improvement in cases of myasthenia gravis?

Anticholinesterase agents.

Which of the following are common early signs of multiple sclerosis?

Areas of numbness, weakness in the legs, visual problems.

Collateral circulation is most likely to be present when a CVA results from:

Atherosclerosis

Which type of fracture typically occurs at the base of the skull?

Basilar.

Which of the following conditions is marked by focal signs?

Brain abscess.

What does the term otorrhea mean?

CSF leaking from the ear.

Which of the following statements about berry aneurysms in the brain is NOT true?

CSF remains free of blood.

The stroke scale used to rapidly diagnose a stroke includes:

Capacity for speech, level of consciousness, motor skills, eye movements.

Where are β1-adrenergic receptors located?

Cardiac muscle

The ataxic form cerebral palsy results from damage to the:

Cerebellum.

Which of the following characteristics indicates that the CSF is normal?

Clear and colorless fluid.

Which statement is TRUE about amyotrophic lateral sclerosis (ALS)?

Cognitive function remains normal.

Which of the following statements is TRUE about malignant brain tumors?

Primary brain tumors rarely metastasize outside the CNS.

Which signs are indicative of post-polio syndrome?

Progressive fatigue and weakness.

Huntington's disease is diagnosed by:

DNA analysis

What is an early indicator of increased intracranial pressure?

Decreasing responsiveness.

What is the pathophysiological change in Parkinson's disease?

Degeneration of the basal nuclei with a deficit of dopamine.

Which of the following statements does NOT apply to myasthenia gravis?

Dementia develops in the lateral stage.

What is a major function of the limbic system?

Determines emotional responses.

Which of the following is NOT considered to be a common contributing factor to AIDS dementia?

Development of arteriosclerosis.

Which of the following are typical characteristics associated with schizophrenia?

Disorganized thought processes, short attention span, delusions.

Which statement best describes herniation resulting from increased intracranial pressure?

Displacement of brain tissue downward toward the spinal cord.

Which statement does NOT apply to the pathophysiology of multiple sclerosis?

Progressive random degeneration of peripheral nerves.

What is the rationale for vomiting in a patient who has increased intracranial pressure?

Pressure on the emetic center in the medulla

Which statement does NOT apply to status epilepticus?

Person does not lose consciousness.

Which of the following is characteristic of multiple sclerosis?

Remissions and exacerbations.

Which disease is associated with excessive dopamine secretion, decreased gray matter in the temporal lobes, and abnormal hippocampal in the brain?

Schizophrenia.

What are the significant early signs of a ruptured cerebral aneurysm?

Severe headache, nuchal rigidity, and photophobia

What are significant signs of acute bacterial meningitis ?

Severe headache, nuchal rigidity, and photophobia.

All of the following apply to tetanus infection EXCEPT:

Signs of fever,vomiting, stiff neck, and paralysis.

Vertebral fractures are classified as:

Simple, compression, wedge, dislocation.

What characteristic is common to all individuals with cerebral palsy?

Some degree of motor disability.

Following an injury at L2 to L3, what would indicate recovery from spinal shock?

Spastic paraplegia.

Failure of the spinous process to fuse, but without herniation of the meninges, is called:

Spina bifida occulta.

What are the signs of autonomic dysreflexia in a person with cervical spinal injury?

Sudden marked increase in blood pressure with bradycardia.

Why are focal or generalized seizures sometimes an early indication of a brain tumor?

Surrounding inflammation stimulates neurons to discharge spontaneously.