Patho Test 2
Where are most intracranial tumors located in adults?
Above the tentorium cerebelli
Extradural hematoma
Accumulation of blood, usually arterial, above dura mater, but beneath the skull
The transient nature of spinal shock is directly related to which of the following mechanisms?
Accumulation of edema within the spinal cord
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
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:
Agnosia
Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?
Arteriovenous malformation
Which are the most common primary CNS tumors?
Astrocytomas
A major contributing process in a cerebrovascular accident (CVA) is the development of atheromatous plaques in cerebral circulation. Where do these plaques most commonly form?
At branches of arteries
A peculiar sensation that immediately precedes a seizure is called a:
Aura
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
What complication is occurring for a person who has a spinal cord injury above T6 and who is experiencing paroxysmal hypertension and has piloerection and sweating above the spinal cord lesion?
Autonomic hyperreflexia
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
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
Why is the edema of the upper cervical cord after spinal cord injury considered life threatening?
Because of the apnea from the impairment to the diaphragm
Why does the person who has a spinal cord injury experience faulty control of sweating and radiation causing them to assume the temperature of the air?
Because the hypothalamus is unable to regulate body heat as a result of sympathetic nervous system damage
Where are most intracranial tumors located in children?
Below the tentorium cerebelli
Of the following people, who are at highest risk for a cerebrovascular accident?
Black men over 65 years of age
Of the following groups, who are at highest risk for a cerebrovascular accident?
Blacks over 65 years of age
Intracerebral hematoma
Bleeding into the brain parenchyma
A 65 y/o female loses her balance while walking in the woods
Blunted affect
A 65-year-old female loses her balance while walking in the woods, causing her to fall and hit her head. She loses consciousness and is in a coma for 5 days. She is diagnosed as having diffuse brain injury. Which of the following would most likely occur in this patient?
Blunted affect
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
Which areas of the spinal cord are more easily injured?
Cervical and lumbar regions
For legal purposes, brain death is defined as:
Cessation of brain function
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:
Cheyne-Stokes
The breathing patteren that reflects respirations based primarily on CO2
Cheyne-Stokes
The breathing pattern that reflects respirations based primarily on CO2 levels in the blood is:
Cheyne-Stokes.
Which disorder has clinical manifestations of a decreased consciousness up to 6 hours, retrograde and post traumatic amnesia, and loss of reflexes with brief bradycardia and transient apnea?
Classic concussion
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:
Cyanosis
What is the central component of the pathogenic model of multiple sclerosis?
Demyelination of nerve fibers in the CNS
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?
Diabetes
What damage occurs to the brain in classic cerebral concussions?
Diffuse cerebral disconnection from the reticular activating system
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?
Dyskinetic
Atrial fibrillation, rheumatic heart disease and valvular prosthetics are risk factors for which type of stroke?
Emboli
An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would you expect to see?
Enlarged ventricles
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
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 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
A 15-year-old 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.
A patient who sustained a cervical spinal cord injury is scheduled for fusion surgery in 2 days. Suddenly he develops a blood pressure of 250/120, a severe headache, blurred vision, and bradycardia. What is the explanation for these clinical manifestations?
He is developing autonomic hyperreflexia.
During infancy, what is the fastest growing part of the body?
Head
Vasogenic edema with increased capillary permeability occurs after what type of stroke?
Hemorrhagic
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
A 40-year-old male complains of abnormal movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms and eventually affect the entire body. The most likely diagnosis is:
Huntington disease.
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
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?
Hyperventilation
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:
III
A decrease in cerebral perfusion pressure us r/t which of the following changes?
Increase in ICP
An infant is dx with non-communicating hydrocephalus. An immediate concern for this pt is:
Interstitial edema
Which are characteristics of myasthenia gravis?
It causes muscle weakness and fatigability.
A patient begins having problems with tiredness, weakness, and visual changes. Her diagnosis is multiple sclerosis (MS). Which is the best description of MS?
It is a central nervous system demyelination, possibly from an immunogenetic virus.
Which are characteristics of amyotrophic lateral sclerosis (ALS)?
It results in upper and lower motor neuron degeneration.
Which intervertebral disk has herniated for the patient who complains of motor and sensory changes of the lateral lower legs and soles of the feet?
L5-S1
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?
Lead
What are the initial clinical manifestations associated with acute spinal cord injury?
Loss of deep tendon reflexes and flaccid paralysis
Subdural hematoma
May be acute or chronic accumulation of venous blood
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 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
A 16-year-old male took a recreational drug that altered his level of arousal. Physical exam revealed an absent Babinski sign, equal and reactive pupils, and roving eye movements. Which of the following is the most likely diagnosis?
Metabolically induced coma
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
Concussion
Moving object striking a stationary head
In which disorder are acetylcholine receptors antibodies (IgG antibodies) produced against acetylcholine receptors?
Myasthenia gravis
_____ are most at risk of spinal cord injury from minor trauma.
Older adults
The most severe diffuse brain injury caused by rotational acceleration is most likely to be located:
Peripheral to the brainstem
Which of the following diseases is screened for in all newborns?
Phenylketonuria (PKU)
_____ defects of neural tube closure are most common.
Posterior
________defects of neural tube closure are most common.
Posterior
Contusion
Produced by epidural hemorrhage and subdural or intracranial hematoma
What are indications that spinal shock is terminating?
Reflex emptying of the bladder
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
A patient who has a right hemisphere cerebrovascular accident caused by an emboli has left-sided paralysis and reduced sensation of the left foot and leg. What is the location of the emboli?
Right anterior cerebral artery
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 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:
Seizure
Which clinical manifestation is characteristic of cluster headaches?
Severe unilateral tearing, burning, or temporal pain
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
What sequence causes bradycardia that occurs during autonomic hyperreflexia?
Stimulation of the carotid sinus to the vagus nerve to the sinoatrial node
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?
Stupor
Which cerebral vascular disorder causes meningeal irritation, photophobia, and positive Kernig positive Brudzinski signs?
Subarachnoid hemorrhage
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):
TIA
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
_____ are most at risk of spinal cord injury from minor trauma.
The elderly
After a cervical spinal cord injury, the patient's body temperature fluctuates markedly. What is the most accurate explanation of this phenomenon?
The patient's sympathetic nervous system has been damaged disturbing thermal control.
What are characteristics of meningiomas?
They compress from outside the spinal cord.
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
To prevent Reye syndrome in infants, which of the following instructions should be given to parents?
Treat fevers with acetaminophen not Apsirin
To prevent Reye syndrome in infants, which of the following instructions should be given to parents?
Treat fevers with acetaminophen, not aspirin.
Most causes of encephalitis are:
Viral
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 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 65-year-old male recently suffered a cerebral vascular accident. He is now unable to recognize and identify objects by touch because of injury to the sensory cortex. This condition is a form of:
agnosia.
True microcephaly can be caused by:
an autosomal recessive gene
True microcephaly can be caused by:
an autosomal recessive gene.
The main source of bleeding in extradural (epidural) hematomas is:
arterial
The main source of bleeding in extradural (epidural) hematomas is:
arterial.
The type of vascular malformation that most often hemorrhages is:
arteriovenous malformation.
The most common primary CNS tumors in adults are:
astrocytomas
The most common primary CNS tumors in adults are:
astrocytomas.
Myasthenia gravis results from:
autoimmune injury at the neuromuscular junction
Myasthenia gravis results from:
autoimmune injury at the neuromuscular junction.
The cause of multiple sclerosis (MS) seems to be an interaction between:
autoimmunity and genetic susceptibility
The cause of multiple sclerosis (MS) seems to be an interaction between:
autoimmunity and genetic susceptibility.
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 hyperreflexia.
A compensatory alteration in the diameter of cerebral blood vessels in response to increased ICP is called:
autoregulation
A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called:
autoregulation.
Dilated and fixed pupils can be cx by:
brain stem hypoxia
Cerebral edema is an accumulation of fluid in the:
brain tissue
Cerebral edema is an accumulation of fluid in the:
brain tissue.
A 15 y/o female is admitted ICU with a severe closed head injury. This dx puts her at risk for:
cerebral edema
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
Spinal shock is characterized by:
cessation of spinal cord function below the lesion
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
The most common type of traumatic brain injury is:
concussion
A 19-month-old boy developed a premature closure of one or more of the cranial sutures. The most likely diagnosis is:
craniosynostosis
An example of an anterior midline defect of neural tube closure is:
cyclopia
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 51-year-old 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.
Hydrocephalus in adults is most common cx by:
defective CSF reabsorption
Hydrocephalus in adults is most often caused by:
defective CSF reabsorption.
One risk factor for thrombotic stroke is:
dehydration
One risk factor for thrombotic stroke is:
dehydration.
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
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 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 45-year-old male presents with seizures. An MRI reveals a meningioma most likely originating from the:
dura mater and arachnoid membrane
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:
dyspnea
A newborn child has a herniation of brain and meninges through a defect in the occipital area of the skull. This condition is known as:
encephalocele.
A 30-year-old female had a seizure that started with her fingers and progressive1y spread up her arm and then extended to her leg. This condition is known as:
focal motor seizure.
A patient was in an automobile accident in which his forehead struck the windshield. In this situation, the coup injury would occur in the _____ region.
frontal
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 disorder that cxs excessive movement is:
hyperkinesia
A 75-year-old male experienced a lacunar stroke. This type of stroke is most often associated with:
hypertension.
A major contributing process in cerebrovascular accidents (CVA) is the development of atheromatous plaques in cerebral circulation. These most commonly form:
in cerebral arteries
An infant is diagnosed with noncommunicating hydrocephalus. An immediate concern for this patient is:
interstitial edema.
When thought content and arousal level are intact but a patient cannot communicate, the patient has:
locked-in syndrome.
Dementia is manifested by:
loss of recent and remote memory
Dementia is manifested by:
loss of recent and remote memory.
An initial clinical manifestation associated with acute spinal cord injury is:
loss of voluntary control below the injury
An initial clinical manifestation associated with acute spinal cord injury is:
loss of voluntary control below the injury.
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 39-year-old 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 patient is:
meningeal infection.
A 75-year-old female suffers a stroke and now has impaired comprehension and production of language. This condition is most likely caused by occlusion of the:
middle cerebral artery.
The most severe brain injury cx by rotational acceleration is most likely to be located:
more peripheral to the brain stem
Classic amyotrophic lateral sclerosis (ALS) presents with:
muscle weakness and atrophy
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:
myelomeningocele
A patient was in an automobile accident in which his forehead struck the windshield. In this situation, the contrecoup injury would occur in the _____ region.
occipital
Viral meningitis:
often occurs with measles, mumps, or herpes
Paralysis of the lower extremities is called:
paraplegia
Paralysis of the lower extremities is called:
paraplegia.
Arousal is mediated by the:
reticular activating system
Arousal is mediated by the:
reticular activating system.
Mild concussion is characterized by:
retrograde amnesia
The cognitive disorder that results in the loss of memory of events that occurred before a head injury is:
retrograde amnesia
A cause of hydrocephalus in subarachnoid hemorrhage is:
scarring of meninges and impairment of CSF resorption
The most common type of cerebral palsy is:
spastic
A newborn child is diagnosed with a vertebral arch defect and meningocele. This condition would most likely result in:
spina bifida
A newborn child is diagnosed with a vertebral arch defect and meningocele. This condition would most likely result in:
spina bifida.
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:
spondylolisthesis
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
Vasogenic edema is clinically important because:
the BBB is disrupted
Vasogenic edema is clinically important because:
the blood-brain barrier is disrupted.
The most common site of HIV infection in children is:
the central nervous system.
Patients with myasthenia gravis often have tumors or pathologic changes in the:
thymus
A 20-year-old 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(n):
tonic-clonic seizure.
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):
transient ischemic attack.
Most causes of encephalitis are:
viral.