NR 507 Advanced Pathophysiology Week 7 Quiz- Version 3 (UPDATE)

NR 507 Advanced Pathophysiology Week 7 Quiz- Version 3 Question 1 2 / 2 pts Uncal herniation occurs when a cerebellar tonsil shifts through the foramen magnum. the cingulate gyrus shifts under the falx cerebri. the diencephalon shifts from the middle fossa straight downward through the tentorial notch into the posterior fossa. Correct! the hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa. Uncal herniation (hippocampal herniation, lateral mass herniation) occurs when the uncus or hippocampal gyrus (or both) shifts from the middle fossa through the tentorial notch into the posterior fossa, compressing the ipsilateral third cranial nerve impairing parasympathetic functioncarried in the periphery of the nerve, then the contralateral third cranial nerve, and finally the mesencephalon, inducing coma. Question 2 2 / 2 pts What are the areas of the brain that mediate several cognitive functions, including vigilance, reasoning, and executive functions? Parietal Occipital Limbic Correct! Prefrontal It is the prefrontal lobe that mediates several cognitive functions, including vigilance, reasoning, and executive functions. Question 3 2 / 2 pts The body compensates to a rise in intracranial pressure by first displacing Correct! cerebrospinal fluid (CSF). arterial blood. cerebral cells. venous blood. A rise in intracranial pressure necessitates an equal reduction in volume of the other contents. The most readily displaced content of the cranial vault is CSF. Question 4 2 / 2 pts Subarachnoid hemorrhage causes communicating hydrocephalus by obstructing the cerebrospinal fluid flow into the subarachnoid space. Correct! the absorption of cerebrospinal fluid by the arachnoid villi. the cerebrospinal fluid flow between the ventricles. blood flow to the arachnoid villi. Hydrocephalus from impaired absorption outside the ventricles is called communicating (extraventricular) hydrocephalus. Question 5 0 / 2 pts With receptive dysphasia (fluent), the individual is able to respond in writing, but not in speech. You Answered respond verbally, but not comprehend speech. Correct Answer comprehend speech, but not respond verbally. speak back, but not comprehend speech. Receptive dysphasia may result in expressive deficits. Question 6 2 / 2 pts Dementia is characterized by easy distractibility and poor concentration. irritability, agitation, and restlessness. Correct! loss of recent and remote memory. deficits in attention and coherence of thought. Memory is the most common cognitive ability lost but the dementias are all characterized by reduction in cognitive functions (intellectual function). Mental abilities are impaired, with a decrease in orienting, recent memory, remote memory, language, executive attentional functions, and alterations in behavior. Question 7 0 / 2 pts In Parkinson disease (PD), the basal ganglia influences the hypothalamic function to produce which grouping of clinical manifestations? You Answered Bradykinesia of chewing, swallowing, and articulation Involuntary contractions of skeletal muscles that impair active and passive movement Asymmetric, regular, rhythmic tremors with slow alternating flexion and extension contractions Correct Answer Inappropriate diaphoresis, orthostatic hypotension, constipation, and urinary retention The basal ganglia influence hypothalamic function (autonomic and neuroendocrine) through pathways connecting the hypothalamus with the basal ganglia and cerebral cortex. Common autonomic symptoms in PD include inappropriate diaphoresis, gastric retention, constipation, and urinary retention. Question 8 0 / 2 pts The existence of regular, deep, and rapid respirations after a severe closed head injury is indicative of neurologic injury to the Correct Answer lower midbrain. supratentorial. pontine area. You Answered cerebral area. Central reflex hyperpnea, a sustained deep rapid but regular pattern (hyperpnea), may result from central nervous system damage or disease that involves the lower midbrain and upper pons. It is seen after increased intracranial pressure and blunt head trauma. Question 9 2 / 2 pts Which disorder has clinical manifestations that include decreased consciousness for up to 6 hours as well as retrograde and posttraumatic amnesia? Correct! Classic concussion Cortical contusion Mild concussion Acute subdural hematoma Evidence of this disorder is the immediate loss of consciousness, which lasts less than 6 hours. Retrograde and anterograde (posttraumatic) amnesia is also present. Question 10 2 / 2 pts Which clinical manifestation is characteristic of cluster headaches? Throbbing headache with intermittent burning sensation Gradual onset of bilateral pain with sensation of a tight band around the head Correct! Severe unilateral tearing, burning, or temporal pain Aura before the headache with photophobia and nausea and vomiting The headache attack usually begins without warning and is characterized by severe, unilateral tearing, burning, periorbital, and retrobulbar or temporal pain lasting 30 minutes to 2 hours. Question 11 2 / 2 pts Amyotrophic lateral sclerosis (ALS) is characterized by demyelination of central nervous system neurons. an autosomal dominant genetic disorder. an autoimmune disorder caused by a virus. Correct! upper and lower motor neuron degeneration. ALS (sporadic motor system disease, sporadic motor neuron disease, motor neuron disease) is a worldwide degenerative disorder diffusely involving lower and upper motor neurons. Question 12 0 / 2 pts The most severe diffuse brain injury caused by rotational acceleration is most likely to be located in the diencephalon. You Answered medial portion of the brainstem. entire brainstem. Correct Answer diencephalon to the brainstem. Severe diffuse axonal injury (DAI), formerly called primary brainstem injury or brainstem contusion, involves severe mechanical disruption of many axons in both cerebral hemispheres and those extending to the diencephalon and brainstem. Question 13 0 / 2 pts Which electrolyte imbalance contributes to lithium toxicity? Hypernatremia Correct Answer Hyponatremia Hypokalemia You Answered Hyperkalemia A potentially serious side effect is lithium toxicity. Lithium is normally removed from the kidneys; however, when the body is sodium depleted, the kidneys reabsorb sodium along with lithium. Question 14 2 / 2 pts Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with schizophrenia. Correct! major depression. panic disorder. mania. Excessive activation of the HPA system resulting in elevated glucocorticoid secretion is found in a large percentage (30% to 70%) of people with major depression suggesting that mechanisms responsible for HPA hormone alterations contribute to the pathophysiology of depression. Question 15 0 / 2 pts Which neurotransmitter receptors are blocked by antipsychotic drugs? You Answered Gamma-aminobutyric acid (GABA) Correct Answer Dopamine Norepinephrine Serotonin The dopamine hypothesis initially suggested that abnormal elevation in dopaminergic transmission contributes to the onset of schizophrenia. This hypothesis was based on pharmacologic studies showing that antipsychotic drugs are potent blockers of brain dopamine receptors. Question 16 0 / 2 pts Benign febrile seizures are characterized by a temperature less than 39° C. You Answered lasting 30 minutes or more. Correct Answer respiratory or ear infections. onset after the fifth year of life. An acute respiratory or ear infection usually is present. Question 17 2 / 2 pts Which defects of neural tube closure are most common? Anterior Midline Lateral Correct! Posterior Posterior defects are most common. Question 18 2 / 2 pts The form of cerebral palsy that results in gait disturbances and instability is Correct! ataxic. spastic. biochemical. dyskinetic. Ataxic cerebral palsy is associated damage to the cerebellum and manifests with gait disturbances and instability. Question 19 0 / 2 pts After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are a result of You Answered hemorrhage postoperatively in which a large volume of blood is lost, causing hypotension with compensatory tachycardia. a concentrated bolus that moves from the stomach into the small intestine, which causes hyperglycemia, resulting in polyuria and eventually hypovolemic shock. Correct Answer a rapid gastric emptying and creation of a high osmotic gradient in the small intestine that causes a sudden shift of fluid from the blood vessels to the intestinal lumen. an anaphylactic reaction in which chemical mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular smooth muscles causing shock. Dumping syndrome occurs with varying severity in 5% to 10% of individuals who have undergone partial gastrectomy or pyloroplasty. Rapid gastric emptying and creation of a high osmotic gradient within the small intestine cause a sudden shift of fluid from the vascular compartment to the intestinal lumen. Plasma volume decreases, causing vasomotor responses, such as increased pulse rate, hypotension, weakness, pallor, sweating, and dizziness. Rapid distention of the intestine produces a feeling of epigastric fullness, cramping, nausea, vomiting, and diarrhea. Question 20 0 / 2 pts The chemoreceptor trigger zone (CTZ) for vomiting is located in the Correct Answer medulla oblongata. midbrain. hypothalamus. You Answered pons. Vomiting is a result of the activation of the chemoreceptor trigger zone in the medulla oblongata. Question 21 0 / 2 pts Which clinical manifestation is not consistent with cancer of the cecum and ascending colon? Correct Answer Constipation You Answered Pain Anemia Mahogany-colored blood mixed with stool Clinical manifestations include pain, a palpable mass in the lower right quadrant, anemia, and dark red or mahogany-colored blood mixed with the stool. Question 22 2 / 2 pts At 2 or 3 weeks of age, an infant who has been fed well and gained weight begins to vomit for no apparent reason. The vomiting has gradually become more forceful. These symptoms may be indicative of which disorder? Esophageal atresia Congenital aganglionic megacolon Correct! Pyloric stenosis Galactosemia Clinical manifestations of pyloric stenosis can present between 2 and 3 weeks after birth; an infant who has fed well and gained weight begins to vomit without apparent reason. The vomiting gradually becomes more forceful. Question 23 0 / 2 pts Congenital aganglionic megacolon (Hirschsprung disease) involves inadequate motility of the colon caused by neural malformation of the _____ nervous system. Correct Answer parasympathetic somatic central sympathetic Congenital aganglionic megacolon is caused by a malformation of the parasympathetic nervous system. Question 24 2 / 2 pts Which of the following medications compensates for the deficiency that occurs as a result of cystic fibrosis? Correct! Pancreatic enzymes Insulin Antibiotics Salt tablets Pancreatic replacement enzymes are administered before or with meals, and high-calorie, high-protein diets with frequent snacks and vitamin supplements are used to treat the malnutrition. Question 25 2 / 2 pts Which disorder is characterized by an increase in the percentages in T cells and complement together with IgA and IgM antigliadin antibodies found in jejunum fluid? Galactosemia Wilson disease Cystic fibrosis Correct! Gluten-sensitive enteropathy (celiac sprue) There are increases in the percentages of T cells, immunoglobulin, and complement in the mucosa of active celiac disease. IgA and IgM antigliadin antibodies have been found in jejunal fluid of persons with untreated disease.