Quiz 6-8 Questions Flashcards
Which neurotransmitter, produced by the midbrain raphe nuclei, has major effects on mood? A. Serotonin B. Acetylcholine C. Gamma-aminobutyric acid (GABA) D. Norepinephrine E. Dopamine
A. Serotonin
What is the function of the reticular formation?
A. Modulates nociceptive and pain information
B. Integrates sensory and cortical information
C. Regulates somatic motor activity, autonomic function, and consciousness
D. All of the above
D. All of the above
Normal sleep-wake cycles require which parts of the consciousness system to be functional?
A. Only the basal forebrain, thalamus, and cerebral cortex
B. All brainstem and cerebral components of the consciousness system
C. The consciousness system does not regulate sleep-wake cycles.
D. Only the brainstem components of the consciousness system
B. All brainstem and cerebral components of the consciousness system
What area of the brain actively induces sleep? A. Ascending reticular activating system B. Brainstem C. Basal forebrain D. None of the above
A. Ascending reticular activating system
Which of the following neurotransmitters act on the anterior cingulate cortex to help direct attention toward an object? A. Dopamine B. Acetylcholine C. Serotonin D. Norepinephrine E. Both A and D
B. Acetylcholine
The intralaminar thalamic nuclei are important for which of the following? A. Arousal and motor behavior B. Pituitary and adrenal gland function C. Reward and punishment behavior D. Spatial and somatic mapping
A. Arousal and motor behavior
What is the MOST appropriate term to describe brain tissue damage from a cascade of biochemical, cellular, and molecular events; hypoxia; edema; and increased intracranial pressure? A. Secondary brain injury B. Primary brain injury C. Concomitant brain injury D. Exposure brain injury
A. Secondary brain injury
Which of the following neuromuscular patient presentations are LEAST likely to be seen as a direct result of a traumatic brain injury? A. Upper and lower extremity paresis B. Chorea form movements C. Abnormal tone D. Abnormal gait patterns
B. Chorea form movements
What is the MOST likely classification of the altered state of consciousness for a patient with traumatic brain injury who presents with a completely nonfunctional arousal system; no auditory, visual, cognitive, or communicative function; and is ventilator dependent? A. Neurogenic reserve state B. Vegetative state C. Minimally conscious state D. Comatose state
D. Comatose state
A patient with traumatic brain injury appears to have relatively intact visual fixation and visual pursuit and does not withdraw from noxious stimulus, but rather localizes to it. What is the MOST appropriate classification of the state of alteration of consciousness for this patient? A. Minimally conscious state B. Comatose state C. Vegetative state D. Ozymandias state
A. Minimally conscious state
Which of the following is a sympathetic nervous system response that is MORE likely to be present after traumatic brain injury? A. Increased heart rate B. Decreased blood pressure C. Slowed respiration rate D. Hypothermic state
A. Increased heart rate
The Glasgow Coma Scale is the most widely used clinical scale that measures levels of consciousness and helps define and classify the level of brain injury sustained. Which of the following is NOT a traditional scoring component of this scale? A. Eye opening response B. Motor response C. Length of post-traumatic amnesia D. Verbal response
C. Length of post-traumatic amnesia
Which of the following is the MOST important protocol for preventing common secondary impairments for patients in comatose states after brain injury?
A. Eliminate the use of tilt-in-space wheelchairs to enable proper positioning in rigid-frame chairs.
B. Position lower extremities in full extension whenever possible while in bed.
C. Encourage plantarflexion of the foot by serial casting.
D. Reposition patients every 2 hours to decrease likelihood of skin breakdown.
D. Reposition patients every 2 hours to decrease likelihood of skin breakdown.
Glial cells contribute which of the following?
A. Communication between neurons and blood vessels
B. Neural cell death
C. Action potential propagation
D. Both A and B
E. All of the above
E. All of the above
Demyelination of an axon:
A. Results in decreased membrane resistance, allowing a leakage of electrical current.
B. Results in slowed propagation of action potentials.
C. May prevent propagation of action potentials.
D. Both A and B
E. A, B, and C
E. A, B, and C
Peripheral demyelination:
A. Typically affects small diameter axons before large diameter axons.
B. Is a characteristic feature of multiple sclerosis.
C. Affects the structure of oligodendrocytes.
D. Typically affects the Schwann cells of large, well-myelinated axons.
E. Typically affects the axon at the ventral root of the spinal cord.
D. Typically affects the Schwann cells of large, well-myelinated axons.
Guillain-Barré syndrome:
A. Involves demyelination of peripheral axons.
B. Results from an autoimmune attack on Schwann cells.
C. May affect cranial nerves controlling the muscles involved in swallowing, breathing, and facial expression.
D. Both A and B
E. A, B, and C
E. A, B, and C
Multiple sclerosis:
A. Results from an autoimmune attack on oligodendrocytes.
B. Involves demyelination of axons in the CNS.
C. Has signs and symptoms associated with both motor and sensory impairment.
D. Both A and B
E. A, B, and C
E. A, B, and C
Based on knowledge of the epidemiology of multiple sclerosis (MS), which of the following patients is most likely to develop MS? A) A 65-year-old white man B) A 38-year-old African-American woman C) A 30-year-old white woman D) A 54-year-old African-American man
C) A 30-year-old white woman
Which of the following is true with regard to geographic distribution and MS?
A) The highest frequency of MS occurs in areas of the southern United States and Europe and Northern Australia.
B) The highest frequency of MS occurs in areas of the northern United States and Europe, Scandinavian countries and southern Australia.
C) The highest frequency of MS occurs in tropical areas of Asia, Africa, and South America.
D) Geographical location does not affect frequency of MS.
B) The highest frequency of MS occurs in areas of the northern United States and Europe, Scandinavian countries and southern Australia.
The most common form of MS is A) benign MS. B) primary progressive MS. C) malignant MS. D) relapsing-remitting MS.
D) relapsing-remitting MS.
Which of the following environmental conditions can result in a pseudoexacerbation in patients with MS? A) Cold temperatures B) Hot temperatures C) High altitude D) High humidity
B) Hot temperatures
Your MS patient’s chart indicates he has a scotoma. This refers to
A) a loss of peripheral vision.
B) blurred vision that occurs with fatigue.
C) a dark spot that appears in the center of the visual field.
D) a loss of the pupillary light reflex.
C) a dark spot that appears in the center of the visual field.
Which of the following are common symptoms in patients with MS?
A) Hypotonia, weakness, paresthesia, fatigue
B) Fatigue, bradycardia, spasticity, weakness
C) Weakness, resting tremors, hypotonia, visual disturbances
D) Visual disturbances, urinary dysfunction, spasticity, pain
D) Visual disturbances, urinary dysfunction, spasticity, pain
Which of the following is true with regard to fatigue and MS?
A) Fatigue is a relatively rare symptom in patients with MS.
B) Fatigue is directly related to severity of disease.
C) Fatigue comes on abruptly and resembles an overwhelming flu-like exhaustion.
D) Most patients report only mild fatigue that occurs primarily after exercise.
C) Fatigue comes on abruptly and resembles an overwhelming flu-like exhaustion.
Which of the following statements is true with regard to life expectancy in patients with MS?
A) Prognosis is fairly good; for most patients life expectancy is not reduced.
B) Prognosis is poor; the majority of patients with MS will die within 5 years of symptom onset.
C) Life expectancy is significantly related to whether or not patients are taking disease-modifying agents.
D) Men diagnosed with MS tend to live only 5 to 7 years, while women live an average of 10 years after diagnosis.
A) Prognosis is fairly good; for most patients life expectancy is not reduced.
Which of the following statements is true with regard to the prognosis of patients with MS?
A) Onset with only one symptom is associated with a favorable prognosis.
B) Older age (after 45) is associated with a more favorable prognosis.
C) The strongest indicator of a favorable prognosis is a positive attitude.
D) Patients with primary progressive MS have the best prognosis.
A) Onset with only one symptom is associated with a favorable prognosis.
Which of the following is true with regard to disease-modifying drugs (such as Betaseron, Avonex, and Copaxone) and their use in patients with MS?
A) They are indicated for patients with both progressive and relapsing remitting forms of MS.
B) They result in a reversal of existing symptoms in 30% to 50% of patients.
C) In some patients, they result in a reduced number of relapses and severity of attacks.
D) They reduce spasticity but have little effect on other signs/symptoms.
C) In some patients, they result in a reduced number of relapses and severity of attacks.
During an acute exacerbation patients with MS should
A) continue with their typical levels of exercise or ambulation; this will help to decrease the severity of the exacerbation.
B) adjust their exercise and activity levels; they will fare better if they allow themselves to rest for a few days.
C) be placed on absolute bedrest; activity during the exacerbation will increase the severity of symptoms.
D) increase their activity level; activity will help shorten the exacerbation period.
B) adjust their exercise and activity levels; they will fare better if they allow themselves to rest for a few days.
Management of fatigue in patients in MS can be best addressed by
A) teaching patients activity pacing and energy conservation techniques.
B) discontinuing participation in all aerobic exercise.
C) using a knee-ankle-foot orthosis to stabilize LE muscles use during ambulation.
D) discontinuing all strength training.
A) teaching patients activity pacing and energy conservation techniques.
Individuals with multiple sclerosis who are MORE likely to benefit from a maintenance therapy program fall within which range of scores on the Expanded Disability Status Scale? A. 0 to 2.5 B. 3 to 5 C. 5.5 to 7 D. 7.5 to 9.5
D. 7.5 to 9.5
ACh receptor subtypes include: A. Adrenergic and noradrenergic B. Nicotinic and muscarinic C. Alpha and beta D. Alpha and gamma E. None of the above
B. Nicotinic and muscarinic
How does onabotulinumtoxinA (BOTOX) therapeutically produce paresis in overactive muscles?
A. Acts as an antagonist by binding to the ACh receptor on the postsynaptic membrane.
B. Rapidly degrades ACh in the synaptic cleft.
C. Facilitates the reuptake and sequestration of ACh into the presynaptic cell.
D. Disrupts the protein structure of the muscle cell receptor, thus preventing ACh from binding.
E. Inhibits the release of ACh from the presynaptic terminal at the neuromuscular junction.
E. Inhibits the release of ACh from the presynaptic terminal at the neuromuscular junction.
The binding of ACh at the neuromuscular junction results in: A. An inhibitory postsynaptic potential. B. Presynaptic facilitation. C. Presynaptic inhibition. D. An excitatory postsynaptic potential.
D. An excitatory postsynaptic potential.
Which of the following neurotransmitters is paired with its correct description?
A. Glutamate; excitatory transmitter, is important in learning and development.
B. Dopamine; inhibitory transmitter, increases attention to sensory information.
C. GABA; excitatory transmitter, modulates neural activity in the CNS.
D. Acetylcholine; excitatory transmitter, affects mood, arousal, and pain perception.
E. Both A and C
A. Glutamate; excitatory transmitter, is important in learning and development.
Myasthenia gravis:
A. Is caused by the destruction of gamma-aminobutyric acid (GABA) receptors on the postsynaptic membrane of muscles.
B. Results in the decreased release of ACh at the neuromuscular junction.
C. Is an autoimmune disease that destroys ACh receptors on the postsynaptic membrane of muscles, thus interferes with ACh binding for repetitive muscle contractions.
D. Is successfully treated with removal of the pituitary gland.
E. All of the above
C. Is an autoimmune disease that destroys ACh receptors on the postsynaptic membrane of muscles, thus interferes with ACh binding for repetitive muscle contractions.
