MARYVILLE PATHO NURS 611 EXAM 2.
DR. WUNDERLICH EXAM QUESTIONS
AND ANSWERS GRADED A+ 2025/2026
Which body system is responsible for conserving energy and body resources -
ANS Parasympathetic nervous system
which system responds to stress by preparing the body to defend itself - ANS Sympathetic
nervous system (SNS)
how is blood flow redistributed by the sympathetic nervous system (SNS) - ANS blood flow to
the muscles is increased while blood flow to GI and integumentary is decreased
how are primary brain injuries classified - ANS focal or diffuse (aka multifocal)
focal brain injuries - ANS specific, grossly observable brain lesions that occur in a precise
location
Epidural and subdural hemorrhages
diffuse brain injuries - ANS include brain injury due to hypoxia, meningitis, encephalitis, and
damage to blood vessels
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,The brain is confined in a limited space so increased pressure can cause collateral dysfunction:
Diabetes Insipidus (ADH not secreted thus polyuria)
autonomic hyperreflexia - ANS affected at the t5-t6 level or above; characterized by
paroxysmal HTN (up to 300 mmHg systolic), a pounding headache, blurred vision, sweating
above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection
caused by pilomotor spasm, and bradycardia (30-40 beats/min)
location of lesions in cases of autonomic hyperreflexia - ANS individual most likely to be
affected have lesions at the T5-T6 level or above
sequence of events that lead to hyperreflexia induced bradycardia - ANS bradycardia (30-
40bpm) is a sx of hyperreflexia
Stimulation of the carotid sinus -->vagus nerve -->sinoatrial (SA) node. The intact ANS reflexively
responds with an arteriolar spasm that increases blood pressure. Baroreceptors in the cerebral
vessels, the carotid sinus, and the aorta sense the HTN and stimulate the PNS. The heart rate
decreases, but the visceral and peripheral vessels do not dilate because efferent impulses
cannot pass through the cord
Alzheimer's disease - ANS leading cause of dementia and one of the most common causes of
severe cognitive dysfunction in older adults
what are the greatest risk factors for Alzheimer's disease - ANS age, family history
what are the proposed protective factors for Alzheimer's disease - ANS low calorie diets,
estrogen replacement at time of menopause, NSAIDs, physical activity, antioxidants, the
presence of apoE2
what genetic susceptibility tests are used to screen for early-onset AD - ANS PSEN 1
(presenilin) on chromosome 14, PSEN 2, and APP (amyloid precursor protein) on chromosome
21
When can a specific diagnosis of AD be given - ANS postmortem examination
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, what is the single greatest risk factor for stroke - ANS hypertension (87% of occurrences)
what are common risk factors for stroke - ANS arterial HTN, insulin resistance and DM,
elevated cholesterol or low high density lipoprotein (HDL), elevated lipoprotein- A level,
hyperhomocysteinemia, congestive heart disease and PVD, asymptomatic carotid stenosis,
polycythemia and thrombocythemia, a-fib, postmenopausal hormone therapy, high sodium
intake above 2300mg, low potassium intake less than 4700mg, smoking, lack of physical activity,
obesity, chronic sleep deprivation
which autoimmune disease typically presents 2-4 weeks following a bacterial/viral infection
such as respiratory or GI illness (ex: flu) - ANS Guillain-Barre syndrome
Describe the progression of Guillain-Barre symptoms - ANS typical first manifestations are
numbness, pain, paresthesias, or weakness in the limbs. Paresis/paralysis may present in an
ascending pattern
when can improvement be expected with Guillain-Barre - ANS weakness usually plateaus or
improves by the 4th week in 90% of cases
Myasthenia Gravis - ANS a chronic autoimmune disease that is mediated by Ach receptor
antibodies that act at the neuromuscular junction. The antibodies prevent normal reception for
muscle contraction
myasthenia gravis clinical manifestations - ANS -exertional fatigue and weakness that
worsens with activity, improves with rest, and recurs with resumption of activity
-a recent history of recurring upper resp tract infections
-diplopia, ptosis, and ocular palsies
-facial droop and an expressionless face; difficulty chewing and swallowing associated with
dietary changes and weight loss; drooling
-episodes of choking and aspiration
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
DR. WUNDERLICH EXAM QUESTIONS
AND ANSWERS GRADED A+ 2025/2026
Which body system is responsible for conserving energy and body resources -
ANS Parasympathetic nervous system
which system responds to stress by preparing the body to defend itself - ANS Sympathetic
nervous system (SNS)
how is blood flow redistributed by the sympathetic nervous system (SNS) - ANS blood flow to
the muscles is increased while blood flow to GI and integumentary is decreased
how are primary brain injuries classified - ANS focal or diffuse (aka multifocal)
focal brain injuries - ANS specific, grossly observable brain lesions that occur in a precise
location
Epidural and subdural hemorrhages
diffuse brain injuries - ANS include brain injury due to hypoxia, meningitis, encephalitis, and
damage to blood vessels
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,The brain is confined in a limited space so increased pressure can cause collateral dysfunction:
Diabetes Insipidus (ADH not secreted thus polyuria)
autonomic hyperreflexia - ANS affected at the t5-t6 level or above; characterized by
paroxysmal HTN (up to 300 mmHg systolic), a pounding headache, blurred vision, sweating
above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection
caused by pilomotor spasm, and bradycardia (30-40 beats/min)
location of lesions in cases of autonomic hyperreflexia - ANS individual most likely to be
affected have lesions at the T5-T6 level or above
sequence of events that lead to hyperreflexia induced bradycardia - ANS bradycardia (30-
40bpm) is a sx of hyperreflexia
Stimulation of the carotid sinus -->vagus nerve -->sinoatrial (SA) node. The intact ANS reflexively
responds with an arteriolar spasm that increases blood pressure. Baroreceptors in the cerebral
vessels, the carotid sinus, and the aorta sense the HTN and stimulate the PNS. The heart rate
decreases, but the visceral and peripheral vessels do not dilate because efferent impulses
cannot pass through the cord
Alzheimer's disease - ANS leading cause of dementia and one of the most common causes of
severe cognitive dysfunction in older adults
what are the greatest risk factors for Alzheimer's disease - ANS age, family history
what are the proposed protective factors for Alzheimer's disease - ANS low calorie diets,
estrogen replacement at time of menopause, NSAIDs, physical activity, antioxidants, the
presence of apoE2
what genetic susceptibility tests are used to screen for early-onset AD - ANS PSEN 1
(presenilin) on chromosome 14, PSEN 2, and APP (amyloid precursor protein) on chromosome
21
When can a specific diagnosis of AD be given - ANS postmortem examination
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, what is the single greatest risk factor for stroke - ANS hypertension (87% of occurrences)
what are common risk factors for stroke - ANS arterial HTN, insulin resistance and DM,
elevated cholesterol or low high density lipoprotein (HDL), elevated lipoprotein- A level,
hyperhomocysteinemia, congestive heart disease and PVD, asymptomatic carotid stenosis,
polycythemia and thrombocythemia, a-fib, postmenopausal hormone therapy, high sodium
intake above 2300mg, low potassium intake less than 4700mg, smoking, lack of physical activity,
obesity, chronic sleep deprivation
which autoimmune disease typically presents 2-4 weeks following a bacterial/viral infection
such as respiratory or GI illness (ex: flu) - ANS Guillain-Barre syndrome
Describe the progression of Guillain-Barre symptoms - ANS typical first manifestations are
numbness, pain, paresthesias, or weakness in the limbs. Paresis/paralysis may present in an
ascending pattern
when can improvement be expected with Guillain-Barre - ANS weakness usually plateaus or
improves by the 4th week in 90% of cases
Myasthenia Gravis - ANS a chronic autoimmune disease that is mediated by Ach receptor
antibodies that act at the neuromuscular junction. The antibodies prevent normal reception for
muscle contraction
myasthenia gravis clinical manifestations - ANS -exertional fatigue and weakness that
worsens with activity, improves with rest, and recurs with resumption of activity
-a recent history of recurring upper resp tract infections
-diplopia, ptosis, and ocular palsies
-facial droop and an expressionless face; difficulty chewing and swallowing associated with
dietary changes and weight loss; drooling
-episodes of choking and aspiration
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
