NR 603 WEEK 2 PULMONARY 2026 FINAL
REVIEW QUESTIONS ANSWERS BUNDLED
PRACTICE COLLECTION
◉ In myasthenia gravis, weakness is a result of insufficient
acetylcholine transmission at the neuromuscular junction; however,
weakness can also occur with overdosing of the cholinergic
medications used to treat myasthenia. What symptom helps
differentiate a myasthenic crisis from a cholinergic crisis?
Answer Choices
1 Respiratory failure
2 Bilateral ptosis
3 Muscle fasciculations
4 Diplopia
5 Normal muscle stretch reflexes
ANS: 3.
Answer: Muscle Fasiculations
Signs of cholinergic overdosage include muscle fasciculation,
rhinorrhea, lacrimation, salivation, increased bronchial secretions,
nausea, or diarrhea. The presence of any of these suggests that the
,patient's weakness may be due to cholinergic crisis. The other signs
are due to weakness and can occur in either condition.
◉ A 54-year-old man presents after having a generalized seizure.
The patient is HIV positive, but he has been unable to afford
antiretroviral therapy since losing his job 2 years ago. Other than
cachexia, the physical exam is unremarkable. Upon further inquiry,
the patient also notes that he has become short-tempered and
hypercritical; at times, he seems confused. An MRI of the brain is
performed, and it reveals several cortical ring-enhancing lesions.
Question
What is the most likely diagnosis?
Answer Choices
1 AIDS dementia complex
2 Cryptococcal meningitis
3 Cytomegalovirus encephalitis
4 Progressive multifocal leukoencephalopathy
5 Toxoplasma encephalitis
ANS:5.
Answer: Toxoplasma encephalitis
The patient's symptoms and MRI findings are most consistent with
the diagnosis of toxoplasma encephalitis. Toxoplasmosis is the most
common cerebral mass lesion among HIV-positive patients. Infection
with the Toxoplasma gondii parasite is relatively common and
usually asymptomatic. Reactivation occurs in HIV positive patients
,due to failing cellular immunity, and it causes a multifocal
necrotizing encephalitis. Seizures may be the initial manifestation of
central nervous system (CNS) infection; other common clinical
manifestations include focal neurologic deficits, such as impaired
speech and hemiparesis. Personality change, lethargy, headache, and
confusion are also observed. The MRI in patients with toxoplasma
encephalitis characteristically reveals multiple, ring-enhancing
lesions with surrounding edema; these lesions usually occur
bilaterally in the frontal and parietal cortices.
AIDS dementia complex describes a constellation of cognitive
symptoms seen among HIV positive patients. The condition occurs
when HIV virus disseminates to the CNS. Within the CNS, the virus
tends to concentrate in the basal ganglia and subcortical regions.
Symptoms include a constellation of cognitive, behavioral, and
motor disturbances that cause varying degrees of functional
impairment. Characteristic MRI findings include non-enhancing
white matter, cerebral atrophy, and ventricular enlargement. The
diagnosis requires that other central nervous system infections,
carcinoma, as well as general medical conditions and substance
abuse have been excluded.
Cryptococcal meningitis is caused by the encapsulated fungus
Cryptococcus neoformans. Among HIV positive patients, the illness
may be the result of new infection or reactivation of latent infection.
Presenting signs are often nonspecific; they include headache, fev
, ◉ A 1-year-old boy presents with increasing lethargy. He is barely
responsive, and his parents deny any trauma or injury. What is the
most common cause of nontraumatic altered levels of
consciousness?
Answer Choices
1 Seizure disorder
2 Diabetic ketoacidosis
3 Inborn errors of metabolism
4 Toxic ingestion
5 Infection
ANS:5.
Answer: infection
Awareness of self and the surrounding environment or
consciousness may be altered into different abnormal states of
consciousness. Consciousness can shift from loss of clear thinking or
confusion, usually accompanied by disorientation, to delirium, a
succession of confused and unconnected ideas manifested in
children as extreme mental and motor excitement, to lethargy, a
profound type of slumber where movement or speech is limited, to
stupor or deep sleep where arousal is achieved only by repeated
vigorous stimuli, finally to coma, unresponsiveness to even painful
stimuli. Non-traumatic coma is most common in infants and toddlers
with another smaller peak of occurrence in adolescence. The most
common cause of non-traumatic altered level of consciousness in
children is infection of either the brain (encephalitis), meninges
(meningitis), or both; infections account for more than 1/3 of cases.
REVIEW QUESTIONS ANSWERS BUNDLED
PRACTICE COLLECTION
◉ In myasthenia gravis, weakness is a result of insufficient
acetylcholine transmission at the neuromuscular junction; however,
weakness can also occur with overdosing of the cholinergic
medications used to treat myasthenia. What symptom helps
differentiate a myasthenic crisis from a cholinergic crisis?
Answer Choices
1 Respiratory failure
2 Bilateral ptosis
3 Muscle fasciculations
4 Diplopia
5 Normal muscle stretch reflexes
ANS: 3.
Answer: Muscle Fasiculations
Signs of cholinergic overdosage include muscle fasciculation,
rhinorrhea, lacrimation, salivation, increased bronchial secretions,
nausea, or diarrhea. The presence of any of these suggests that the
,patient's weakness may be due to cholinergic crisis. The other signs
are due to weakness and can occur in either condition.
◉ A 54-year-old man presents after having a generalized seizure.
The patient is HIV positive, but he has been unable to afford
antiretroviral therapy since losing his job 2 years ago. Other than
cachexia, the physical exam is unremarkable. Upon further inquiry,
the patient also notes that he has become short-tempered and
hypercritical; at times, he seems confused. An MRI of the brain is
performed, and it reveals several cortical ring-enhancing lesions.
Question
What is the most likely diagnosis?
Answer Choices
1 AIDS dementia complex
2 Cryptococcal meningitis
3 Cytomegalovirus encephalitis
4 Progressive multifocal leukoencephalopathy
5 Toxoplasma encephalitis
ANS:5.
Answer: Toxoplasma encephalitis
The patient's symptoms and MRI findings are most consistent with
the diagnosis of toxoplasma encephalitis. Toxoplasmosis is the most
common cerebral mass lesion among HIV-positive patients. Infection
with the Toxoplasma gondii parasite is relatively common and
usually asymptomatic. Reactivation occurs in HIV positive patients
,due to failing cellular immunity, and it causes a multifocal
necrotizing encephalitis. Seizures may be the initial manifestation of
central nervous system (CNS) infection; other common clinical
manifestations include focal neurologic deficits, such as impaired
speech and hemiparesis. Personality change, lethargy, headache, and
confusion are also observed. The MRI in patients with toxoplasma
encephalitis characteristically reveals multiple, ring-enhancing
lesions with surrounding edema; these lesions usually occur
bilaterally in the frontal and parietal cortices.
AIDS dementia complex describes a constellation of cognitive
symptoms seen among HIV positive patients. The condition occurs
when HIV virus disseminates to the CNS. Within the CNS, the virus
tends to concentrate in the basal ganglia and subcortical regions.
Symptoms include a constellation of cognitive, behavioral, and
motor disturbances that cause varying degrees of functional
impairment. Characteristic MRI findings include non-enhancing
white matter, cerebral atrophy, and ventricular enlargement. The
diagnosis requires that other central nervous system infections,
carcinoma, as well as general medical conditions and substance
abuse have been excluded.
Cryptococcal meningitis is caused by the encapsulated fungus
Cryptococcus neoformans. Among HIV positive patients, the illness
may be the result of new infection or reactivation of latent infection.
Presenting signs are often nonspecific; they include headache, fev
, ◉ A 1-year-old boy presents with increasing lethargy. He is barely
responsive, and his parents deny any trauma or injury. What is the
most common cause of nontraumatic altered levels of
consciousness?
Answer Choices
1 Seizure disorder
2 Diabetic ketoacidosis
3 Inborn errors of metabolism
4 Toxic ingestion
5 Infection
ANS:5.
Answer: infection
Awareness of self and the surrounding environment or
consciousness may be altered into different abnormal states of
consciousness. Consciousness can shift from loss of clear thinking or
confusion, usually accompanied by disorientation, to delirium, a
succession of confused and unconnected ideas manifested in
children as extreme mental and motor excitement, to lethargy, a
profound type of slumber where movement or speech is limited, to
stupor or deep sleep where arousal is achieved only by repeated
vigorous stimuli, finally to coma, unresponsiveness to even painful
stimuli. Non-traumatic coma is most common in infants and toddlers
with another smaller peak of occurrence in adolescence. The most
common cause of non-traumatic altered level of consciousness in
children is infection of either the brain (encephalitis), meninges
(meningitis), or both; infections account for more than 1/3 of cases.
