EXAM 3 MED SURGE 1 - COMPLETE REVIEW WITH ANSWERS AND RATIONALES

EXAM 3 MED SURGE 1 - COMPLETE REVIEW WITH ANSWERS AND RATIONALES 1. The major cause of Parkinson's disease is _____. A) Loss of serotonin-producing neurons B) Overabundance of serotonin-producing neurons C) Loss of dopamine-producing neurons D) Overabundance of dopamine-producing neurons Rationale: Parkinson's disease is primarily caused by the progressive degeneration and loss of dopamine-producing neurons in the substantia nigra region of the brain. This loss leads to decreased dopamine levels, which results in the characteristic motor symptoms such as tremors, rigidity, bradykinesia, and postural instability. ________________________________________ 2. What is the primary characteristic of multiple sclerosis (MS)? A) Progressive loss of myelin sheath around nerves B) Destruction of neurons in the hippocampus C) Increased sensitivity to stimuli D) Overproduction of neurotransmitters Rationale: Multiple sclerosis is an autoimmune disease characterized by demyelination—the progressive destruction of the myelin sheath that surrounds and protects nerve fibers in the central nervous system. This damage disrupts nerve signal transmission, leading to various neurological symptoms. ________________________________________ 3. What is a characteristic symptom of rheumatoid arthritis? A) Joint stiffness that is worse in the evening B) Joint pain with morning stiffness lasting longer than 30 minutes C) Skin rashes and blisters D) Joint deformity only in the late stages Rationale: Rheumatoid arthritis is characterized by inflammatory joint pain with prolonged morning stiffness typically lasting more than 30 minutes. This morning stiffness is a key diagnostic feature that distinguishes RA from osteoarthritis, where morning stiffness is usually shorter in duration. ________________________________________ 4. Which of the following best describes the initial, major neuronal defect (loss) in Parkinson's disease? A) Loss of dopamine secreting neurons B) Loss of GABA secreting neurons C) Loss of serotonin secreting neurons D) Loss of acetylcholine secreting neurons Rationale: The primary neuronal defect in Parkinson's disease is the loss of dopamine-secreting neurons in the substantia nigra pars compacta. This dopamine deficiency in the basal ganglia leads to the movement disorders characteristic of the disease. ________________________________________ 5. Describe how marasmus differs from kwashiorkor in terms of physical characteristics. A) Marasmus involves increased fat stores, whereas kwashiorkor does not B) Marasmus and kwashiorkor present the same physical characteristics C) Marasmus leads to high serum albumin levels, unlike kwashiorkor D) Marasmus is characterized by severe muscle wasting and loss of subcutaneous fat, while kwashiorkor is characterized by edema and a large abdomen Rationale: Marasmus results from overall calorie deficiency and presents with severe muscle wasting, loss of subcutaneous fat, and an emaciated appearance. Kwashiorkor results from protein deficiency despite adequate calorie intake and is characterized by edema, ascites (large abdomen), and fatty liver. Serum albumin is low in kwashiorkor but may be normal in marasmus. ________________________________________ 6. Which vitamin is frequently lacking in patients suffering from chronic alcoholism? A) Vitamin B12 B) Vitamin A C) Vitamin D D) Folate Rationale: Chronic alcoholism commonly leads to folate deficiency due to poor dietary intake, impaired absorption, and increased excretion. Folate deficiency can result in macrocytic anemia and other complications. While thiamine deficiency (Wernicke-Korsakoff syndrome) is also common, folate deficiency is frequently seen in alcoholic patients. ________________________________________ 7. Who should we test for Clostridium difficile infection? A) All patients in hospital treated with antibiotics B) Anyone with recent antibiotic use C) All patients with diarrhea D) Patients in hospital with diarrhea and recent antibiotic use Rationale: The most appropriate patients to test for C. difficile are hospitalized patients who develop diarrhea and have a history of recent antibiotic use. This combination represents the classic risk profile for C. difficile infection. Testing all patients with diarrhea or all antibiotic-treated patients would result in unnecessary testing and potential false positives. ________________________________________ 8. Which of the following patients presenting with diarrhea is at high risk of having Clostridium difficile colitis? A) A patient who recently traveled to South America B) A patient who ate contaminated food C) A patient taking antibiotics for pneumonia D) A patient taking high doses of anti-inflammatory medications Rationale: Antibiotic use is the single most important risk factor for C. difficile infection. Antibiotics disrupt the normal gut flora, allowing C. difficile to overgrow and produce toxins. Travel-related diarrhea and contaminated food are more likely associated with other pathogens