Chapter 23

What are the characteristic changes in the brain with Alzheimer's disease? a. cortical atrophy with plaques and neurofibrillary tangles, impairing conduction b. increased ACH and decreased GABA and serotonin levels c. obstruction of many small arteries and arterioles throughout the cerebral cortex d. vacuoles forming in the neurons, rapidly destroying them

a. cortical atrophy with plaques and neurofibrillary tangles, impairing conduction

Which of the following are typical early signs of Alzheimer's disease? 1. behavioral changes 2. reduced ability to reason and problem solve 3. decreased verbal responses 4. urinary incontinence a. 1, 2 b. 1, 4 c. 2, 3 d. 1, 3, 4

a. 1, 2

Which statement is TRUE about amyotrophic lateral sclerosis (ALS)? a. Cognitive function remains normal. b. ALS affects primarily young women. c. Sensory neurons are damaged initially. d. Cause of death is usually a cardiac arrhythmia.

a. Cognitive function remains normal

Which of the following applies to Parkinson's disease? a. Onset occurs in men and women over 60 years of age. b. There is a strong genetic component. c. The majority of cases are predisposed by intake of antipsychotic medications. d. It rarely develops in women.

a. Onset occurs in men and women over 60 years of age

Which of the following are typical characteristics associated with schizophrenia? a. disorganized thought processes, short attention span, delusions b. lack of energy and motivation, poor concentration, insomnia c. hyperventilation, tachycardia, intense anxiety d. memory loss, mood swings, hostile behavior

a. disorganized thought processes, short attention span, delusions

Which type of seizure commonly occurs in children? a. generalized absence b. tonic-clonic c. focal d. complex partial

a. generalized absence

Which of the following is characteristic of generalized seizures? a. the localization of the seizure activity b. the uncontrolled discharge of neurons in both hemispheres c. seizures that persist for several hours d. loss of consciousness and all motor function

b. the uncontrolled discharge of neurons in both hemispheres

Which of the following are common early signs of multiple sclerosis? a. paralysis of the lower body, impaired cognitive function b. tremors, weakness in the legs, visual problems c. sensory deficit in the legs and trunk, memory loss, urinary incontinence d. tremors, speech impairment, hearing loss

b. tremors, weakness in the legs, visual problems

In which type of neuron is progressive degeneration occurring with amyotrophic lateral sclerosis (ALS)? a. upper motor neurons b. upper and lower motor neurons c. motor and sensory neurons d. motor, sensory, and autonomic system neurons

b. upper and lower motor neurons

All of the following are typical signs of hydrocephalus in the neonate EXCEPT: a. enlarged head with bulging fontanels b. vomiting, headache, and paralysis c. irritability and feeding difficulties d. eyes are turned downward with sclerae showing above the pupils

b. vomiting, headache, and paralysis

In which disorders do biochemical abnormalities involving the neurotransmitters in the brain occur? 1. bipolar disorder 2. schizophrenia 3. Huntington's disease 4. AIDS dementia a. 1, 3 b. 1, 4 c. 1, 2, 3 d. 2, 3, 4

c. 1, 2, 3

The best description of a myelomeningocele is: a. asymptomatic failure of the posterior spinous processes of the vertebrae to fuse b. herniation of the meninges and CSF through a vertebral defect c. herniation of the meninges, CSF, and spinal cord or nerves through a vertebral defect d. herniation of brain tissue through a defect in the cranium

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

Which of the following is the most common cause of brain damage in children with cerebral palsy? a. hyperbilirubinemia b. hypoglycemia c. hypoxia d. trauma

c. hypoxia

From the following, choose the two events (in correct sequence) that immediately follow the aura during a tonic-clonic event: a. prodromal signs, then the clonic stage b. clonic stage, then the tonic stage c. loss of consciousness, then the tonic stage d. loss of consciousness and cessation of respiration

c. loss of consciousness, then the tonic stage

Which statement is TRUE about the condition depression? a. It is classified as a mood disorder. b. Episodes of intense fear are recurrent. c. It is marked by periods of sadness, hopelessness and inability to concentrate. d. a, b e. a, c

e. a, c

What is the typical initial effect of a herniated intervertebral disc at the L4 to L5 level? a. back pain and weakness at waist level b. muscle weakness in both legs c. lower back pain radiating down the leg d. urinary incontinence

c. lower back pain radiating down the leg

Which statement applies to Huntington's disease? It: a. is inherited as an autosomal recessive trait b. is manifested in individuals by age 20 years c. presents with choreiform movements in the upper body and decreased ability to concentrate d. causes decreased levels of all neurotransmitters in the CNS

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

The ataxic form of cerebral palsy results from damage to the: a. cerebellum b. motor cortex c. basal nuclei d. pyramidal tracts

a. cerebellum

Which of the following applies to cerebral palsy? a. nonprogressive brain damage to the fetus or neonate b. a genetic defect affecting metabolism and causing degeneration in the neurons c. a developmental error during early growth of the peripheral nervous system d. a chromosomal defect resulting in abnormalities in many body structures

a. nonprogressive brain damage to the fetus or neonate

How is the presence of spina bifida diagnosed? a. prenatally by ultrasound or detection of AFP in maternal blood or amniotic fluid b. only after birth by direct observation of the sac c. after birth when the sac herniates as CSF builds up d. only with a spinal x-ray

a. prenatally by ultrasound or detection of AFP in maternal blood or amniotic fluid

Which of the following is characteristic of multiple sclerosis? a. remissions and exacerbations b. predictable pattern of progression in all patients c. onset in men and women more than 60 years of age d. full recovery of function during remissions

a. remissions and exacerbations

Failure of the spinous processes to fuse but without herniation of the meninges is called: a. spina bifida occulta b. meningocele c. myelomeningocele d. encephalocele

a. spina bifida occulta

Which of the following are common early manifestations of Parkinson's disease? a. tremors at rest in the hands and difficulty initiating voluntary movements b. extreme weakness in the legs and spastic movements in the arms c. visual deficits and speech impairment d. loss of facial expressions and altered posture and gait

a. tremors at rest in the hands and difficulty initiating voluntary movements

The defective gene for Huntington's disease can be detected in carriers. a. true b. false

a. true

What causes a herniated intervertebral disc? a. a tear in the nucleus pulposus b. a protrusion of the nucleus pulposus through the annulus fibrosis c. displacement of the annulus fibrosis between the laminae d. failure of the spinous processes to restrict movement of the intervertebral disc

b. a protrusion of the nucleus pulposus through the annulus fibrosis

How would a seizure consisting of bizarre or inappropriate activity be classified? a. an absence seizure b. a psychomotor seizure c. a focal seizure d. a Jacksonian seizure

b. a psychomotor seizure

Which of the following is NOT considered to be a common contributing factor to AIDS dementia? a. invasion of the central nervous system by HIV b. development of arteriosclerosis c. secondary toxoplasmosis infection d. development of cerebral lymphoma

b. development of arteriosclerosis

Communicating hydrocephalus causes increased intracranial pressure because of: a. atresia at the foramen magnum b. failure of the subarachnoid to absorb CSF c. obstruction in the lumbar area of the spinal cord d. scar tissue from encephalitis blocking flow of CSF

b. failure of the subarachnoid to absorb CSF

Which of the following dietary supplements has reduced the incidence of spina bifida in recent years? a. vitamin B6 b. folic acid c. vitamins A and D d. zinc and magnesium

b. folic acid

Which disease is associated with excessive dopamine secretion, decreased gray matter in the temporal lobes, and abnormal hippocampal cells in the brain? a. Creutzfeldt-Jakob disease b. schizophrenia c. panic disorder d. depression

b. schizophrenia

All of the following may precipitate a seizure EXCEPT: a. hypoglycemia b. severe acidosis c. brain abscess d. high fever in young child

b. severe acidosis

In cases of noncommunicating hydrocephalus, why does excess cerebrospinal fluid accumulate? a. Absorption of CSF through the arachnoid villi is impaired. b. Excessive amounts of CSF are produced in the ventricles. c. An obstruction is present in the aqueduct of Sylvius or other channel. d. Flow around the spinal cord is blocked.

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

Which statement does NOT apply to status epilepticus? a. Seizures are recurrent or continuous without full recovery between episodes. b. Severe hypoxia and acidosis develop. c. This condition occurs only in idiopathic seizures. d. If the episode persists, there may be additional brain damage.

c. This condition occurs only in idiopathic seizures

What does the clonic stage of a seizure consist of? a. a sudden strong skeletal muscle contraction and rigidity of trunk and limbs b. a cry and contraction of abdominal and thoracic muscles c. alternating contractions and relaxation of skeletal muscles d. cessation of all skeletal muscle activity

c. alternating contractions and relaxation of skeletal muscles

Which of the following classes of drugs may provide temporary improvement in cases of myasthenia gravis? a. skeletal muscle relaxants b. dopamine replacement drugs c. anticholinesterase agents d. GABA replacement drugs

c. anticholinesterase agents

What is the pathophysiologic change in Parkinson's disease? a. degeneration of motor fibers in the pyramidal tracts b. excess secretion of stimulatory neurotransmitters in the CNS c. degeneration of the basal nuclei with a deficit of dopamine d. deficit of acetylcholine and degeneration of the motor cortex in the frontal lobe

c. degeneration of the basal nuclei with a deficit of dopamine

Which of the following is used both to confirm the diagnosis and classify seizures? a. characteristics of the aura b. presence of precipitating factors c. electroencephalogram d. changes in the characteristics of cerebrospinal fluid

c. electroencephalogram

Which of the following is NOT a typical effect of advanced Parkinson's disease? a. difficulty chewing and swallowing b. urinary retention c. loss of vision d. orthostatic hypotension

c. loss of vision

Which of the following statements does NOT apply to myasthenia gravis? a. The cholinergic receptors at the neuromuscular junctions are damaged. b. It is an autoimmune disorder. c. Muscle weakness and fatigue occur in the face and neck. d. Dementia develops in the later stage.

d. Dementia develops in the later stage

What characteristic is common to all individuals with cerebral palsy? a. some loss of cognitive function b. one or more types of seizure c. serious multiple communication difficulties d. a form of motor disability

d. a form of motor disability

Creutzfeldt-Jakob disease is caused by: a. inheritance of an autosomal dominant trait b. infection in the brain by HIV c. an autoimmune reaction that damages nerve receptors d. infection in the brain by a prion

d. infection in the brain by a prion

Which statement does NOT apply to the pathophysiology of multiple sclerosis? a. demyelination of axons b. it affects the brain, spinal cord, and cranial nerves c. it affects motor, sensory, and autonomic fibers d. progressive random degeneration of peripheral nerves

d. progressive random degeneration of peripheral nerves

Which of the following is a typical early sign of amyotrophic lateral sclerosis (ALS)? a. impaired ventilation b. cognitive impairment c. poor control of eye movement d. weakness and muscle atrophy in upper limbs

d. weakness and muscle atrophy in upper limbs