GNRS 515 Patho Exam 3 Questions With Complete
Solutions
34y/o woman with pains in both hands for few months, stiffness
improves as the day goes on. Multiple joints swollen. X-ray
hands shows some erosions. What is the single most accurate
test?
A.Rheumatoid factor (RF)
B.Anti-cyclic citrullinated peptide (anti-CCP)
C.Sedimentation rate
D.ANA
E.Joint fluid aspirate Correct Answers B.Anti-cyclic
citrullinated peptide (anti-CCP)
Anti-CCP is the single most accurate test for RA
•It is > 95% specific for RA
•It appears earlier than RF in the course of the disease
RF is present in only 75-85% of patients. It is NON specific and
could be present in other diseases
A 10-year-old female was brought to the ER following a sudden
onset of convulsions. The primary care provider thinks that she
experienced an explosive, disorderly discharge of cerebral
neurons referred to as:
1.Reflex
2.Seizure
3.Inattentiveness
4.Brain death Correct Answers 2.Seizure
,An explosive disorderly discharge of neurons is a seizure.
A reflex is an expected response.
Inattentiveness is a form of neglect.
Brain death is a cessation of function.
A 15-year-old male was struck by a motor vehicle and suffered a
traumatic brain injury. Paramedics found him unconscious at the
scene of the accident. During the ambulance ride, he regained
consciousness and was able to maintain a conversation with the
medical staff. Upon arrival to hospital, he was alert and oriented.
Physical exam reveals confusion and impaired responsiveness.
What is the probable nature of his brain injury based on this
history?
1.Mild concussion
2.Subdural hematoma
3.Epidural hematoma
4.Mild diffuse axonal injury Correct Answers 3.Epidural
hematoma
Individuals with epidural hematomas lose consciousness at
injury; one-third then become lucid for a few minutes to a few
days.
Mild concussion is characterized by immediate but transitory
confusion that lasts for one to several minutes, possibly with
amnesia for events preceding the trauma.
Subdural hematomas begin with headache, drowsiness,
restlessness or agitation, slowed cognition, and confusion. These
symptoms worsen over time and progress to loss of
,consciousness, respiratory pattern changes, and pupillary
dilation.
Individuals with mild diffuse axonal injury display decerebrate
or decorticate posturing and may experience prolonged periods
of stupor or restlessness.
A 19-year-old male college student reports to his primary care
provider that he cannot stay awake in class regardless of how
much sleep he gets. A drug that stimulates which of the
following areas would best treat his problem?
1.Corpora quadrigemina
2.Reticular activating system
3.Cerebellum
4.Hypothalamus Correct Answers 2.Reticular activating system
The reticular activating system is responsible for wakefulness.
A 20-year-old male is admitted to the neurological critical care
unit with a severe closed head injury. When an intraventricular
catheter is inserted, the ICP is recorded at 24 mm Hg. How
should the nurse interpret this reading? This reading is:
1.Higher than normal
2.Lower than normal
3.Normal
4.Borderline Correct Answers 1.Higher than normal
Normal ICP is 5 to 15 mm Hg; at 24 mm Hg, the patient's is
higher than normal.
, A 20-year-old male suffers a severe closed head injury in a
motor vehicle accident. He remains in a vegetative state (VS) 1
month after the accident. Which of the following structures is
maintaining him in a vegetative state?
1.Cerebral cortex
2.Brainstem
3.Spinal cord
4.Cerebellum Correct Answers 2.Brainstem
When a person loses cerebral function, the reticular activating
system and brainstem can maintain a crude waking state known
as a VS. Cognitive cerebral functions, however, cannot occur
without a functioning reticular activating system.
A 20-year-old male was at the supermarket when he fell to the
ground. Bystanders reported that he lost consciousness and his
body tensed up then relaxed, then tensed and relaxed several
times. He most likely was experiencing a(n):
1.Partial seizure
2.Absence seizure
3.Myoclonic seizure
4.Tonic-clonic seizure Correct Answers 4.Tonic-clonic seizure
A tonic-clonic seizure involves repeated contraction and
relaxation.
A partial seizure involves only one body part.
An absence seizure is without movement.
A myoclonic seizure is a simple seizure with minimal jerking
present.
Solutions
34y/o woman with pains in both hands for few months, stiffness
improves as the day goes on. Multiple joints swollen. X-ray
hands shows some erosions. What is the single most accurate
test?
A.Rheumatoid factor (RF)
B.Anti-cyclic citrullinated peptide (anti-CCP)
C.Sedimentation rate
D.ANA
E.Joint fluid aspirate Correct Answers B.Anti-cyclic
citrullinated peptide (anti-CCP)
Anti-CCP is the single most accurate test for RA
•It is > 95% specific for RA
•It appears earlier than RF in the course of the disease
RF is present in only 75-85% of patients. It is NON specific and
could be present in other diseases
A 10-year-old female was brought to the ER following a sudden
onset of convulsions. The primary care provider thinks that she
experienced an explosive, disorderly discharge of cerebral
neurons referred to as:
1.Reflex
2.Seizure
3.Inattentiveness
4.Brain death Correct Answers 2.Seizure
,An explosive disorderly discharge of neurons is a seizure.
A reflex is an expected response.
Inattentiveness is a form of neglect.
Brain death is a cessation of function.
A 15-year-old male was struck by a motor vehicle and suffered a
traumatic brain injury. Paramedics found him unconscious at the
scene of the accident. During the ambulance ride, he regained
consciousness and was able to maintain a conversation with the
medical staff. Upon arrival to hospital, he was alert and oriented.
Physical exam reveals confusion and impaired responsiveness.
What is the probable nature of his brain injury based on this
history?
1.Mild concussion
2.Subdural hematoma
3.Epidural hematoma
4.Mild diffuse axonal injury Correct Answers 3.Epidural
hematoma
Individuals with epidural hematomas lose consciousness at
injury; one-third then become lucid for a few minutes to a few
days.
Mild concussion is characterized by immediate but transitory
confusion that lasts for one to several minutes, possibly with
amnesia for events preceding the trauma.
Subdural hematomas begin with headache, drowsiness,
restlessness or agitation, slowed cognition, and confusion. These
symptoms worsen over time and progress to loss of
,consciousness, respiratory pattern changes, and pupillary
dilation.
Individuals with mild diffuse axonal injury display decerebrate
or decorticate posturing and may experience prolonged periods
of stupor or restlessness.
A 19-year-old male college student reports to his primary care
provider that he cannot stay awake in class regardless of how
much sleep he gets. A drug that stimulates which of the
following areas would best treat his problem?
1.Corpora quadrigemina
2.Reticular activating system
3.Cerebellum
4.Hypothalamus Correct Answers 2.Reticular activating system
The reticular activating system is responsible for wakefulness.
A 20-year-old male is admitted to the neurological critical care
unit with a severe closed head injury. When an intraventricular
catheter is inserted, the ICP is recorded at 24 mm Hg. How
should the nurse interpret this reading? This reading is:
1.Higher than normal
2.Lower than normal
3.Normal
4.Borderline Correct Answers 1.Higher than normal
Normal ICP is 5 to 15 mm Hg; at 24 mm Hg, the patient's is
higher than normal.
, A 20-year-old male suffers a severe closed head injury in a
motor vehicle accident. He remains in a vegetative state (VS) 1
month after the accident. Which of the following structures is
maintaining him in a vegetative state?
1.Cerebral cortex
2.Brainstem
3.Spinal cord
4.Cerebellum Correct Answers 2.Brainstem
When a person loses cerebral function, the reticular activating
system and brainstem can maintain a crude waking state known
as a VS. Cognitive cerebral functions, however, cannot occur
without a functioning reticular activating system.
A 20-year-old male was at the supermarket when he fell to the
ground. Bystanders reported that he lost consciousness and his
body tensed up then relaxed, then tensed and relaxed several
times. He most likely was experiencing a(n):
1.Partial seizure
2.Absence seizure
3.Myoclonic seizure
4.Tonic-clonic seizure Correct Answers 4.Tonic-clonic seizure
A tonic-clonic seizure involves repeated contraction and
relaxation.
A partial seizure involves only one body part.
An absence seizure is without movement.
A myoclonic seizure is a simple seizure with minimal jerking
present.
