Patho 370 (Chapters 44,45,47,51,52)

Dopamine precursors and anticholinergics are all used in the management of Parkinson disease, because they

increase dopamine activity in the basal ganglia

Anticholinesterase inhibitors may be used to manage

myasthenia gravis

Bone healing may be impaired by

nicotine use

A tool used to assess levels of consciousness is

glasglow coma scale (GCS)

One of the most common causes of acute pain is

headache

Complete healing of a bone fracture occurs when

the callus has been completely replaced with mature bone

"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

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

Intracranial pressure normally ranges from ______ mm Hg.

0-15

Which treatment is helpful in neuropathic pain but not used for acute pain?

Anticonvulsants

Which group of clinical findings indicates the poorest neurologic functioning?

Assumes decorticate posture with light touch, no verbal response

________ edema occurs when ischemic tissue swells because of cellular energy failure.

Cytotoxic

Muscular dystrophy includes a number of muscle disorders that are

genetically transmitted

Ascending paralysis with no loss of sensation is characteristic of

Guillain-Barré syndrome

It is true that scleroderma involves

Inflammation of fibrosis connective tissue

________ occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes.

Nystagmus

The disorders characterized by softening and then enlargement of bones is referred to as

Paget disease

Orthostatic hypotension may be a manifestation of

Parkinson disease

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is

air embolus

The earliest manifestation of scleroderma is

Raynaud phenomenon

Which statement is true about the incidence of multiple sclerosis?

The age of onset ranges from 20 to 50 years

Parkinson disease is associated with

a deficiency of dopamine in the substantia nigra

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called

a.tophaceous gout

Most muscle strains are caused by

abnormal muscle contraction

The stage of spinal shock that follows spinal cord injury is characterized by

absent spinal reflexes below the level of injury

Myasthenia gravis is an autoimmune disease in which

acetylcholine receptors are destroyed or dysfunctional

Risk factors for hemorrhagic stroke include

acute hypertension

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of

amyotrophic lateral sclerosis (ALS)

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be

an autoimmune process

Rheumatoid arthritis involves joint inflammation caused by

autoimmune injury

Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to

autoimmune mechanisms

Leakage of CSF from the nose or ears is commonly associated with

basilar skull fracture

It is true that encephalitis is usually

because of a viral infection in brain cells

The most important preventive measure for hemorrhagic stroke is

blood pressure control

The most common symptom of multiple myeloma is

bone pain

A severe complication of elevated intracranial pressure is

brain herniation

Secondary injury after head trauma refers to

brain injury resulting from the body's response to tissue damage

A compound, transverse fracture is best described as a bone that is

broken and protruding through the skin

Inflammation of the sacs that overlie bony prominences is called

bursitis

The physiologic change most likely to lead to an increase in intracranial pressure is

cerebral vasodilation

Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion. This is necessary because subarachnoid hemorrhage predisposes to

cerebral vasospasm

Pain in fibromyalgia involves

changes in pain transmission in the spinal cord

It is true that epidural bleeding is

characterized by a lucid interval immediately after injury

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a ________ headache.

migraine

A fracture in which bone breaks into two or more fragments is referred to as

comminuted

The gate control theory of pain transmission predicts that activity in touch receptors will

decrease pain signal transmission in the spinal cord

The chief pathologic features of osteoarthritis are

degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium

Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis, because

demyelination is mediated by immune mechanisms

The dementia of Alzheimer disease is associated with structural changes in the brain, including

deposition of amyloid plaques in the brain

Tophi are

deposits of urate crystals in tissues

Following a bone fracture, the most likely event to occur is

development of a blood clot beneath the periosteum

The pain of nonarticular rheumatism ("growing pain") is worse

during the night

Modulation of pain signals is thought to be mediated by the release of

endorphins

In older women, osteoporosis is thought to be primarily because of

estrogen deficiency

Paget's disease is characterized by

excessive bone resorption followed by excessive formation of fragile bone

Pain that waxes and wanes and is exacerbated by physical exertion is likely related to

fibromyalgia syndrome

Acceleration-deceleration movements of the head often result in polar injuries in which

focal injuries occur in two places at opposite poles

Seizures that involve both hemispheres at the outset are termed

generalized

The most common type of osteomyelitis is

hematogenous

Prosthetic joint infection is most often because of

hematogenous transfer

Autonomic dysreflexia is characterized by

hypertension and bradycardia

An example of inappropriate treatment for head trauma would be

hypoventilation

The pathophysiology of rheumatoid arthritis involves

immune cells accumulating in pannus and destroying articular cartilage

Gouty arthritis is a complication of

inadequate renal excretion of uric acid

It is true that scleroderma involves

inflammation and fibrosis of connective tissue

Ankylosing spondylitis is characterized by

inflammation, stiffness, and fusion of spinal joints.

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for

intervention

The most important determinant for prescribing therapy for acute stroke is

ischemic versus hemorrhagic cause

Clinical manifestations of a stroke within the right cerebral hemisphere include

left-sided muscle weakness and neglect

The most common site affected in Paget's disease is the

lower spine

The initial treatment of an individual experiencing a seizure is concentrated on

maintaining an airway

_________ is a form of spina bifida in which a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord.

meningocele

Pain with passive stretching of a muscle is indicative of

noncontractile tissue injury

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency?

osteomalacia

The most common presenting sign/symptom with rheumatic fever is

polyarthritis

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is

positive antinuclear antibodies

Most sensory afferent pain fibers enter the spinal cord by way of the ________ nerve roots

posterior

The classic manifestations of Parkinson disease include

rest tremor and skeletal muscle rigidity

The disease that is similar to osteomalacia and occurs in growing children is

rickets

What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission?

slower rate of action potential

The first indication of brain compression from increasing intracranial pressure (ICP) may be

sluggish pupil response to light

A unique characteristic feature of fibromyalgia is the presence of

tender point pain

Compartment syndrome occurs secondary to

soft-tissue damage

In the acute phase of stroke, treatment is focused on

stabilization of respiratory and cardiovascular function

Cerebral aneurysm is most frequently the result of

subarachnoid hemorrhage

The displacement of two bones in which the articular surfaces partially lose contact with each other is called

subluxation

In contrast to osteoarthritis, rheumatoid arthritis may be associated with

systemic aching in the musculoskeletal system

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be

systemic manifestations of inflammation

Slow pain sensation is transmitted primarily by

unmyelinated C fibers

"Tell me again the name of that chemical that makes crystals when my gout flares up," asks the client. The nurse's best response is

uric acid

Rickets is characterized by soft, weak bones resulting from a deficiency of

vitamin D

Referred pain may be perceived at some distance from the area of tissue injury, but generally felt

within the same dermatome