Quiz 8

"Please explain the pathophysiology of osteoarthritis to me," says another nurse. "Is it just wear and tear so that the cartilage wears out?" Your best response is "Yes; repeated use just wears out the cartilage, until it becomes thin and denuded. That causes pain and will eventually cause joint inflammation." "Yes; with increasing age, the inflammation from repeated joint use accumulates and causes the cartilage to get thin and ragged until it disappears." "No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone." "No; autoimmune cells infiltrate the joint and collect on the cartilage in a mass called 'pannus' that eventually thins and destroys the cartilage."

"No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone"

The stage of spinal shock that follows spinal cord injury is characterized by reflex urination and defecation. autonomic dysreflexia. absent spinal reflexes below the level of injury. motor spasticity and hyperreflexia below the level of injury.

absent spinal reflexes below the level of injury

A tool used to assess levels of consciousness is magnetic resonance imaging (MRI). intracranial pressure (ICP) monitoring. Glasgow Coma Scale (GCS). central perfusion pressure (CPP).

Glasgow Coma Scale (GCS).

What type of fracture generally occurs in children? Greenstick Stress Nightstick Colles

Greenstick

The earliest manifestation of scleroderma is thick, tight, shiny skin. skin hyper/hypopigmentation. renal impairment. Raynaud phenomenon.

Raynaud phenomenon

Which statement is true about the incidence of multiple sclerosis? The age of onset ranges from 20 to 50 years. MS is more common in men than women. There is a higher incidence of MS in military veterans. There is a higher rate of MS in African-Americans.

The age of onset ranges from 20 to 50 years.

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes lesions affecting the palms of hands and the soles of feet. dry, scaly patches in the antecubital area and behind the knees. cracked, scaly areas in the webs of fingers. a butterfly pattern rash on the face across the bridge of the nose.

a butterfly pattern rash on the face across the bridge of the nose

Pain is thought of as a subjective experience that is difficult to measure objectively. associated with changes in vital signs reflecting its intensity. experienced in the same way by all individuals. always the result of tissue damage that activates nociceptors.

a subjective experience that is difficult to measure objectively.

Leakage of CSF from the nose or ears is commonly associated with epidural hematoma. temporal skull fracture. basilar skull fracture. cerebral aneurysm.

basilar skull fracture

Inflammation of the sacs that overlie bony prominences is called epicondylitis. arthritis. tendinitis. bursitis.

bursitis

The physiologic change most likely to lead to an increase in intracranial pressure is cerebral vasodilation. hypernatremia. respiratory hyperventilation. REM sleep.

cerebral vasodilation.

Tophi are renal calculi composed of uric acid. deposits of urate crystals in tissues. painful edematous joints. spots that coalesce in a malar rash.

deposits of urate crystals in tissues

A risk factor for osteoporosis is endometriosis. early menopause. late menopause. ovarian cysts.

early menopause

Anticholinesterase inhibitors may be used to manage muscular dystrophy. myasthenia gravis. fibromyalgia. rheumatoid arthritis.

myasthenia gravis.

The first indication of brain compression from increasing intracranial pressure (ICP) may be decorticate posturing. absence of verbalization. sluggish pupil response to light. Glasgow Coma Scale score of 13.

sluggish pupil response to light.

Cerebral aneurysm is most frequently the result of embolic stroke. subarachnoid hemorrhage. subdural hemorrhage. meningitis.

subarachnoid hemorrhage.

Rickets is characterized by soft, weak bones resulting from a deficiency of calcium. estrogen. phosphate. vitamin D.

vitamin D

Healing of a fractured bone with a poor alignment is called malunion. nonunion. disunion. delayed union.

malunion

________ edema occurs when ischemic tissue swells because of cellular energy failure. Interstitial Osmotic Vasogenic Cytotoxic

Cytotoxic

The person at highest risk of a greenstick fracture from falling off a tall ladder is age 68. 44. 8. 23.

8

Which neurologic disorder is commonly referred to as Lou Gehrig disease? Multiple sclerosis Parkinson disease Alzheimer disease Amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis

Myasthenia gravis is an autoimmune disease in which neuronal demyelination disrupts nerve transmission. muscles become increasingly bulky but weakened. acetylcholine receptors are destroyed or dysfunctional. acetylcholine release from motor neurons is disrupted.

acetylcholine receptors are destroyed or dysfunctional

Risk factors for hemorrhagic stroke include atherosclerosis. dysrhythmias. acute hypertension. sedentary lifestyle.

acute hypertension

The most common source of osteomyelitis is an infection that migrates via the bloodstream. direct invasion from a fracture. surgical contamination. a joint prosthesis.

an infection that migrates via the bloodstream

A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for delayed healing. malunion. nonunion. dysunion.

delayed healing

The dementia of Alzheimer disease is associated with structural changes in the brain, including deposition of amyloid plaques in the brain. degeneration of basal ganglia. hypertrophy of frontal lobe neurons. significant aluminum deposits in the brain.

deposition of amyloid plaques in the brain

Acceleration-deceleration movements of the head often result in polar injuries in which injury is localized to the site of initial impact. widespread neuronal damage is incurred. bleeding from venules fills the subdural space. focal injuries occur in two places at opposite poles.

focal injuries occur in two places at opposite poles

Muscular dystrophy includes a number of muscle disorders that are genetically transmitted. easily prevented and managed. autoimmune in nature. demyelinating focused.

genetically transmitted

Gouty arthritis is a complication of group A streptococcal infection. autoimmune destruction of joint collagen. excessive production of urea. inadequate renal excretion of uric acid.

inadequate renal excretion of uric acid

Dopamine precursors and anticholinergics are all used in the management of Parkinson disease, because they increase dopamine activity in the basal ganglia. induce regeneration of neurons in the basal ganglia. prevent progression of the disease. produce excitation of basal ganglia structures.

increase dopamine activity in the basal ganglia.

It is true that scleroderma involves inflammation and fibrosis of connective tissue. autoantibodies against acetylcholine receptors. infection by beta-hemolytic streptococcus. inflammation caused by antigenic fragments of dead organisms.

inflammation and fibrosis of connective tissue

Clinical manifestations of a stroke within the right cerebral hemisphere include cortical blindness. right visual field blindness. expressive and receptive aphasia. left-sided muscle weakness and neglect.

left-sided muscle weakness and neglect

Pain in fibromyalgia involves muscle inflammation. autoimmune destruction of muscle tissue. nerve inflammation. changes in pain transmission in the spinal cord.

nerve inflammation

Pain with passive stretching of a muscle is indicative of noncontractile tissue injury. contractile tissue injury. vascular insufficiency. skeletal muscle damage.

noncontractile tissue injury

A bone disorder that results from insufficient vitamin D is referred to as rickets. osteoporosis. osteomalacia. subluxation.

osteomalacia

A malignant bone-forming tumor is referred to as a(n) rhabdosarcoma. liposarcoma. osteosarcoma. chondrosarcoma.

osteosarcoma

Before making a diagnosis of Alzheimer disease a brain biopsy demonstrating organic changes is necessary. biochemical tests for aluminum toxicity must be positive. other potential causes of dementia must be ruled out. increased protein is found in a lumbar puncture.

other potential causes of dementia must be ruled out.

Rupture of a cerebral aneurysm should be suspected if the patient reports ringing in the ears. transient episodes of numbness. transient episodes of vertigo. sudden, severe headache.

sudden, severe headache.

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be systemic manifestations of inflammation. localized pain in weight-bearing joints. reduced excretion of uric acid by the kidney. firm, crystallized nodules or "tophi" at the affected join

systemic manifestations of inflammation.

A unique characteristic feature of fibromyalgia is the presence of tender point pain. head pain. contractures. muscle atrophy.

tender point pain