Exam 2 Flashcards
(95 cards)
0
Q
Which of the following causes ascending paralysis and may be associated with a Campylobacter jejuni infection? (p. 798-789) A. Diabetic neuropathy B. Myasthenia gravis C. Guillain–Barré syndrome D. Charcot–Marie–Tooth disease
A
C. Guillain-Barré syndrome
1
Q
A polyneuropathy is most likely to have a __________ distribution. (p. 798)
A. Unilateral
B. Symmetric
A
B. Symmetric
2
Q
Diabetic neuropathy primarily affects the most distal _______ axons and causes paresthesias. (p. 799)
A. Sensory
B. Motor
A
A. Sensory
3
Q
Myasthenia gravis results from disruption of \_\_\_\_\_\_\_\_\_ receptors. (p. 800) A. Presynaptic acetylcholine B. Postsynaptic acetylcholine C. Presynaptic calcium D. Postsynaptic calcium
A
B. Postsynaptic acetylcholine receptors
4
Q
The clinical features of \_\_\_\_\_\_\_\_\_\_\_\_ involve ptosis and diplopia? (p. 800) A. Duchenne muscular dystrophy B. Myasthenia gravis C. Guillain–Barré syndrome D. Becker muscular dystrophy
A
B. Myasthenia Gravis
5
Q
Lambert-Eaton syndrome is caused by autoantibodies that inhibit \_\_\_\_\_\_\_\_\_ and causes myasthenia of the legs and arms. (p. 801) A. Presynaptic calcium channels B. Postsynaptic calcium channels C. Presynaptic acetylcholine receptors D. Postsynaptic acetylcholine receptors
A
A. Presynaptic calcium channels
6
Q
Prolonged disuse of an fractured arm, while casted, will primarily affect \_\_\_\_\_\_ muscle fibers. (p. 802) A. Type I B. Type II C. Type III D. Type IV
A
B. Type II
7
Q
Which dystrophinopathy is most common? (p. 802) A. Glucocorticoid dystrophinopathy B. Duchenne muscular dystrophy C. Myasthenia gravis D. Becker muscular dystrophy
A
B. Duchenne muscular dystrophy
8
Q
Which of the following conditions is associated with a complete absence of dystrophin? (p. 803) A. Duchenne muscular dystrophy B. Becker muscular dystrophy C. Myasthenia gravis D. Guillain–Barré syndrome
A
A. Duchenne muscular dystrophy
9
Q
Acute renal failure may result from rhabdomyolysis secondary to \_\_\_\_\_\_\_\_. (p. 806) A. Statin medications B. Dystrophin mutations C. Chronic glucocorticoids exposure D. Binge drinking
A
D. Binge drinking
Ethanol myopathy
10
Q
Bilateral vestibular schwannomas are a hallmark for which condition? (p. 806)
A. Neurofibromatosis type 1
B. Myasthenia gravis
C. Neurofibromatosis type 2
D. Malignant peripheral nerve sheath tumors
A
C. Neurofibromatosis type 2
11
Q
Which type of neurofibroma is virtually pathognomonic for neurofibromatosis type 1? (p. 807) A. Localized cutaneous B. Plexiform C. Diffuse D. Galápagian
A
A. Localized cutaneous
12
Q
Approximately 50% of all cases of malignant peripheral nerve sheath tumors develop within individuals with _________. (p. 808)
A. Neurofibromatosis type 1
B. Neurofibromatosis type 2
A
A. Neurofibromatosis type 1
13
Q
A reactive proliferation of Schwann cells, which produce a painful nodule, is most likely to be a\_\_\_\_\_\_\_\_\_\_\_. (p. 808) A. Schwannoma B. Neurofibroma C. Ethanol myopathy D. Traumatic neuroma
A
D. Traumatic neuroma
14
Q
Reversible axonal injury leads to cell body enlargement and \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. (p. 811) A. Pyknosis B. Keratinization C. Karyorrhexis D. Central chromatolysis
A
D. Central chromatolysis
15
Q
The “red neurons” in the image shown to the right indicate the presence of a(n) ____________________. (p. 811-812)
A. Reversible axonal injury
B. Irreversible axonal injury
A
B. Irreversible axonal injury
16
Q
Which cells are primarily responsible for gliosis within the central nervous system? (p. 811-812) A. Astrocytes B. Ependymal cells C. Oligodendrocytes D. Nissl cells
A
A. Astrocytes
17
Q
Which 3 morphological changes are associated with severe cerebral edema? (p. 812) A. Flattening of the gyri B. Hydrocephalus ex vacuo C. Compression of the ventricles D. Narrowing of the sulci
A
A. Flattening of the gyri
C. Compression of the ventricles
D. Narrowing of the sulci
18
Q
Which of the following is most likely to develop following severe neurodegeneration? (p. 813) A. Communicating hydrocephalus B. Subfalcine (cingulate) herniation C. Hydrocephalus ex vacuo D. Noncommunicating hydrocephalus
A
C. Hydrocephalus ex vacuo
19
Q
What is the name of the specific cerebral herniation identified via the
black arrow in the picture shown to the right?
A. Tonsillar herniation
B. Transtentorial (uncinate)
C. Subfalcine (cingulate)
D. Arnold-Chiari malformation
A
C. Subfalcine (cingulate)
20
Q
Which 2 of the following are mechanisms of cerebrovascular disease? (p. 814) A. Thrombotic occlusion of vessels B. Lexy body deposition C. Vasculitis D. Vascular rupture
A
A. Thrombotic occlusion of vessels
D. Vascular rupture
21
Q
A “flame-shaped” hemorrhage inside the pons, following a severe transtentorial (uncinate) herniation, is known as a \_\_\_\_\_\_\_\_\_\_\_\_\_\_. (p. 814) A. Arnold-Chiari malformation B. Duret hemorrhage C. Neural tube defect D. Syringomyelia (syrinx)
A
B. Duret hemorrhage
22
Q
The leukocytes present at the site of a cerebral infarction are \_\_\_\_\_\_\_\_\_\_\_\_, which surround intact vessels. (p. 815, Figure 22-6 A) A. Macrophages B. Oligodendrocytes C. Astrocytes D. Leukocytes
A
A. Macrophages
23
Q
Focal cerebral ischemia is the result of arterial occlusion and is most commonly caused by a(n) ____________. (p. 816)
A. Thrombosis
B. Embolism
A
B. Embolism
24
```
The most common cause of non-traumatic subarachnoid hemorrhage is ____________ (p. 817)
A. Chronic hypertension
B. Rupture of a saccular aneurysm
C. Motor vehicle accident
D. Cerebral edema
```
B. Rupture of a saccular aneurysm
25
```
The leading cause of a primary brain parenchymal hemorrhage is ________________. (p. 817)
A. Hypertension
B. Polyarteritis nodosa
C. Neuronophagia
D. β-amyloid plaque
```
A. Hypertension
26
```
Which of the following is the most common vascular malformation of the brain? (p. 818)
A. Cavernous angioma
B. Capillary telangiectasia
C. Isolated fistula
D. Arteriovenous malformation
```
D. Arteriovenous malformation
27
Health care providers should order a rapid brain MRI for patients who they suspect may have recently developed a concussion. (p. 821)
A. True
B. False
B. False
28
Epidural hematomas involve the disruption of ___________, while subdural hematomas involve the disruption of ___________. (p. 821)
A. Veins, arteries
B. Arteries, veins
B. Arteries, veins
29
```
Spina bifida occulta and myelomeningocele are associated with maternal folate deficiency and are considered to be ________________. (p. 822)
A. Posterior fossa anomalies
B. Neural tube defects
C. Traumatic vascular injuries
D. Perinatal brain injuries
```
B. Neural tube defects
30
```
A fluid-filled cavity located within the spinal cord is called _____________. (p. 823)
A. Syringomyelia (syrinx)
B. Hydromyelia
C. Arnold-Chiari malformation
D. Anencephaly
```
A. Syringomyelia (syrinx)
31
```
Which of the following is the most common mechanism for a central nervous system infection? (p. 824)
A. Direct implantation
B. Local extension
C. Hematogenous spread
D. Retrograde extension via the PNS
```
C. Hematogenous spread
32
```
Which form of meningitis demonstrates extremely high neutrophil counts on a CSF examination? (p. 825)
A. Aseptic meningitis
B. Acute pyogenic meningitis
C. Tuberculous meningitis
D. Spirochetal meningitis
```
B. Acute pyogenic meningitis
33
```
Which 2 of the following microbes may cause spirochetal infections of the CNS? (p. 826)
A. Staphylococcus aureus
B. Human immunodeficiency virus
C. Treponema pallidum
D. Borrelia burgdorferi
```
C. Treponema pallidum
| D. Borrelia burgdorferi
34
```
Relapsing and remitting episodes of neurologic impairments are characteristically associated with _______________. (p. 833)
A. Huntington disease
B. Parkinson disease
C. Multiple sclerosis
D. Amyotrophic lateral sclerosis
```
C. Multiple sclerosis
35
Your (future) 31-year-old female patient reports a rapid onset of: pain near her right suboccipital region, unilateral visual impairment, and 2 episodes of urinary incontinence in the past 48 hours. Which of the follow-up will provide you with the most information regarding her risk for multiple sclerosis? (p. 833)
A. An eye exam for papilledema
B. A 3-view cervical spinal x-rays series
C. Asking about a family history of MS
D. A Tensilon test
C. Asking about a family history of MS
36
```
Gastric carcinoma and chronic alcoholism are commonly associated with _________ deficiency and may cause confusion, ataxia, and profound memory disturbances. (p. 835)
A. Vitamin B12
B. Thiamine
C. Zinc
D. Hyperglycemia
```
B. Thiamine
37
```
Large deposits of β-amyloid are most likely to be present in the brains of individuals suffering from __________. (p. 837)
A. Vitamin B12 deficiency
B. Botulism
C. Parkinson disease
D. Alzheimer disease
```
D. Alzheimer's disease
38
```
Motor disturbances that are the result of damaged dopaminergic neurons of the substantia nigra are most likely to be attributed to _____________. (p. 839)
A. Alzheimer disease
B. Parkinson disease
C. Thiamine deficiency
D. Amyotrophic lateral sclerosis
```
B. Parkinson's disease
39
```
Intracellular Lewy body inclusions indicated the presence of _______________. (p. 839)
A. Alzheimer disease
B. Rabies virus
C. Cytomegalovirus
D. Parkinson disease
```
D. Parkinson's disease
40
```
Which of the following is a neurodegenerative condition that develops following the inheritance of a CAG trinucleotide repeat expansion, which causes severe cerebral atrophy? (p. 840)
A. Huntington disease
B. Amyotrophic lateral sclerosis
C. Alzheimer disease
D. Oligodendroglioma
```
A. Huntington disease
41
```
Which of the following causes upper and lower motor neuron death? (p. 841)
A. Vitamin B12 deficiency
B. Dementia
C. Amyotrophic lateral sclerosis
D. Parkinson disease
```
C. Amyotrophic lateral sclerosis
42
```
Which of the following is the most aggressive type of diffuse astrocytoma? (p. 842)
A. Anaplastic astrocytoma
B. Glioblastoma
C. Medulloblastoma
D. Primary CNS lymphoma
```
B. Glioblastoma
43
```
Which tumor of the CNS is most likely to develop along the central canal of the spinal cord? (p. 844)
A. Well-differentiated astrocytoma
B. Anaplastic astrocytoma
C. Ependymoma
D. Medulloblastoma
```
C. Ependymoma
44
```
Which of the following is most likely to develop along the dura and may invade into the overlying bone? (p. 846)
A. Ependymoma
B. Glioblastoma
C. Medulloblastoma
D. Meningioma
```
D. Meningioma
45
```
Which of the following are most likely to metastasize to the CNS? (p. 846)
A. Carcinomas
B. Sarcomas
C. Hemo-mo-momas
D. Never-mets-to-da-CNS-omas
```
A. Carcinomas
46
```
The tunica media is separated from the tunica adventitia by the ____________. (p. 327)
A. Endothelium
B. Tunica intima
C. Internal elastic lamina
D. External elastic lamina
```
D. External elastic lamina
47
Which of the following causes more clinically significant vascular disorders? (p. 327)
A. Arterial lesions
B. Venous lesions
A. Arterial lesions
48
```
Atherosclerosis is most likely to involve which of the following? (p. 327)
A. Arterioles
B. Large elastic arteries
C. Postcapillary venules
D. Collecting venules
```
B. Large elastic arteries
49
```
Which layer of the vessel wall contains endothelial cells? (p. 327)
A. Tunica intima
B. Tunica media
C. Tunica adventitia
D. External elastic lamina
```
A. Tunica intima
50
```
Which percentage of the general population are hypertensive? (p. 332)
A. 5%
B. 25%
C. 55%
D. 85%
```
B. 25%
51
```
Without appropriate treatment, ______ of hypertensive individuals will die from a stroke? (p. 332)
A. 1%
B. 33%
C. 50%
D. 99%
```
B. 33%
52
```
Which of the following is a standard response following vascular injury? (p. 334)
A. Medial thickening
B. Intimal thickening
C. Intimal narrowing
D. Adventitial narrowing
```
B. Intimal thickening
53
```
Which of the following is not a category of arteriosclerosis? (p. 335)
A. Arteriolosclerosis
B. Mönckenberg medial sclerosis
C. Endotheliosclerosis
D. Atherosclerosis
```
C. Endotheliosclerosis
54
```
Following vascular injury, extracellular matrix and _________ accumulate within the tunica intima. (p. 335)
A. Edema
B. Smooth muscle cells
C. Transudate
D. Skeletal muscle cells
```
B. Smooth muscle cells
55
```
Metabolic syndrome is not characterized by the presence of ___________. (p. 338)
A. Insulin resistance
B. Dyslipidemia
C. Abdominal aortic aneurysm
D. Central obesity
```
B. Dyslipidemia
56
The 2 key features of atheroma development are intimal thickening and lipid accumulation. (p. 340)
A. True
B. False
A. True
57
```
Virtually everyone older than ______ years will demonstrate the presence of fatty streaks (p. 340)
A. 15
B. 30
C. 45
D. 60
```
A. 15
58
```
Which of the following are not a component of a atherosclerotic plaque? (p. 341)
A. Smooth muscle cells
B. Necrotic debris
C. Macrophages
D. B cells
```
D. B cells
59
```
Which of the following is not considered to be major clinical consequences of atherosclerosis? (p. 342)
A. Myocardial infarction
B. Neovascularization
C. Peripheral vascular disease
D. Aortic aneurysm
```
B. Neovascularization
60
```
Which of the following individuals is at the greatest risk for developing an abdominal aortic aneurysm? (p. 345)
A. A 22-year-old male
B. A 31-year-old female
C. A 48-year-old male
D. A 62-year-old male
```
D. A 62-year-old male
61
```
When blood plays apart the laminar planes of the media to form a blood-filled channel within the aortic wall, it is termed a ___________. (p. 346)
A. True aneurysm
B. False aneurysm
C. Saccular aneurysm
D. Vascular dissection
```
D. Vascular dissection
62
```
An abdominal aortic measuring 5.7 cm in diameter is at a(n) _____ risk of rupture each year. (p. 346)
A. 1%
B. 11%
C. 33%
D. 66%
```
B. 11%
63
```
The mortality rate for elective AAA surgery is ____, while the rate for emergency surgery is 50%. (p. 346)
A. 5%
B. 40%
C. 60%
D. 95%
```
A. 5%
64
```
The 2 most common pathogenic mechanisms of vasculitis are immune-mediated inflammation and _____________. (p. 348)
A. Physical trauma
B. Exposure to toxins
C. Irradiation
D. Direct vascular infection
```
D. Direct vascular infection
65
Which type of aortic dissection is the most severe and the most common? (p. 348)
A. Type A
B. Type B
A. Type A
66
```
The abrupt onset of ocular symptoms is most likely to be associated with which of the following conditions? (p. 351)
A. Giant cell arteritis
B. Takayasu arteritis
C. Polyarteritis nodosa
D. Kawasaki disease
```
A. Giant cell arteritis
67
```
Fibrinoid necrosis is most likely to be associated with which 2 of the following conditions? (p. 352)
A. Polyarteritis nodosa
B. Abdominal aortic aneurysm
C. Giant cell arteritis
D. Kawasaki disease
```
A. Polyarteritis nodosa
| D. Kawasaki disease
68
```
Buerger disease occurs almost exclusively in ______________. (p. 354)
A. Females
B. Obese individuals
C. Older adults (>55 years)
D. Smokers
```
D. Smokers
69
```
Kaposi sarcoma is a lymphatic neoplasm associated with which microbial agent? (p. 360)
A. Escherichia coli
B. Cytomegalovirus
C. Human herpesvirus
D. Epstein-Barr Virus
```
C. Human herpes virus
| HHV8; defining disease of AIDS patients
70
```
The development of hepatic angiosarcomas is commonly associated with exposure to which of the following? (p. 362)
A. Carbon monoxide
B. Halogens
C. Lead
D. Polyvinyl chloride
```
D. Polyvinyl chloride
71
```
Which of the following is a common end point for various cardiac pathologies? (p. 365)
A. Congestive heart failure
B. Myocardial infarction
C. Ventral septal defect
D. Neurohumoral activation
```
A. Congestive heart failure
72
```
Which mechanism is most likely to cause an increase in intraventricular pressure? (p. 365)
A. Conduction disorder
B. Obstruction to flow
C. Regurgitant flow
D. Rupture of a great vessel
```
B. Obstruction to flow
73
```
Increased stroke volume that is produced in response to over stretching cardiac muscle tissue is termed ___________. (p. 366)
A. Congenital heart failure
B. Neurohumoral activation
C. Frank-Starling mechanism
D. Purkinje neurofascilitation
```
C. Frank Starling mechanism
74
Systemic hypertension will causes _________ thickening of the left ventricular wall with reduced lumen size. (p. 366-367)
A. Concentric
B. Eccentric
A. Concentric
75
```
What is the most common cause of left-sided cardiac failure? (p. 367)
A. Aortic valve stenosis
B. Physiologic hypertrophy
C. Weight lifting
D. Ischemic heart disease
```
D. Ischemic heart disease
76
```
Right-sided heart failure resulting from pulmonary hypertension is termed __________. (p. 368)
A. Angina pectoris
B. Bradycardia
C. Cor pulmonale
D. Tachycardia
```
C. Cor pulmonale
77
```
Congenital heart disease accounts for ______ of all birth defects. (p. 368)
A. 2%
B. 30%
C. 75%
D. 98%
```
B. 30%
78
```
Which of the following is a condition that is most likely to interfere with cardiac embryogenesis? (p. 369)
A. Pertussis
B. Teratogens
C. Mumps
D. Rubella
```
B. Teratogens
79
Shunting of blood from the __________ is most likely to result in cyanosis. (p. 370)
A. Left-to-right ventricle
B. Right-to-left ventricle
B. Right to left ventricle
80
Which pattern of aortic coarctation is most likely to have a patent ductus arteriosus? (p. 373)
A. Infantile (preductal)
B. Adult (postductal)
A. Infantile (preductal)
81
```
What percentage of all cases of ischemic heart disease are associated with the presence of coronary artery atherosclerosis? (p. 374)
A. 3%
B. 25%
C. 75%
D. 90%
```
D. 90%
82
```
Anginal symptoms typically begin when there is obstruction of greater than _____ of a coronary artery. (p. 375 & 376)
A. 5%
B. 20%
C. 70%
D. 90%
```
C. 70%
83
```
Which 2 of the following are valuable laboratory markers to diagnose a myocardial infarction? (p. 382)
A. Inflammasome
B. Cardiac troponins
C. Cardiac-specific lysosomes
D. Creatine kinase
```
B. Cardiac troponins
| D. Creatine kinase
84
The symptoms associated with myocardial infarction are commonly relieved by nitroglycerin and rest. (p. 382)
A. True
B. False
B. False
85
Patients experiencing an acute myocardial infarction will commonly demonstrate a rapid and scarcely palpable pulse. (p. 382)
A. True
B. False
A. True
86
```
Failure of a cardiac valve to open completely is termed _____. (p. 388)
A. Cor pulmonale
B. Insufficiency
C. Stenosis
D. Thrills
```
C. Stenosis
87
```
Which of the following is most likely to cause acute cor pulmonale? (p. 388)
A. Deep vein thrombosis
B. Kawasaki disease
C. Mitral valve stenosis
D. Pulmonary embolism
```
D. Pulmonary embolism
88
Calcific aortic stenosis commonly causes eccentric cardiac hypertrophy. (p. 390)
A. True
B. False
B. False
| Concentric left ventricular hypertophy
89
Acute endocarditis involves a _______ heart valve. (p. 393)
A. Previously normal
B. Previously abnormal
A. Previously normal
90
```
When acute rheumatic fever develops within adults, _________ is the predominant clinical feature. (p. 391)
A. Arthritis
B. Carditis
C. Weakness
D. Dyspnea
```
B. Carditis
91
```
Which of the following is most likely to result following the development of friable mitral valve vegetation? (p. 393)
A. Deep vein thrombosis
B. Pulmonary embolism
C. Systemic embolism
D. Right ventricular hypertrophy
```
C. Systemic embolism
92
Dilated cardiomyopathy commonly involves an increase _________ of up to 3 times. (p. 398)
A. Stroke volume
B. Diameter of the right ventricular wall
C. Weight
D. Diameter of the left ventricular wall
C. Weight
93
```
What is the fundamental cardiac defect in patients with dilated cardiomyopathy? (p. 398)
A. Amyloid deposition
B. Diastolic dysfunction
C. Ineffective contraction
D. Arrhythmia
```
C. Ineffective contraction
94
```
Which of the following is the most common primary tumor of adult cardiac tissue? (p. 404)
A. Leiomyoma
B. Myxoma
C. Angiosarcoma
D. Lipoma
```
B. Myxoma
