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360 Cards in this Set
- Front
- Back
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descending pathway
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b. Efferent pathways
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ascending pathway
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a. Afferent pathways
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motor and sensory pathways regulating voluntary motor control of skeletal muscle
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c. Somatic nervous system
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motor and sensory components involved with regulation of the body’s internal environment through involuntary control of organ systems.
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d. Autonomic nervous system
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2. _____ pathways carry sensory information toward the central nervous system (CNS).
a. Ascending b. Descending c. Somatic d. Efferent |
a. Ascending
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3. True or False Glucose is the predominant fuel for neurons and insulin is required for cellular glucose uptake in the central nervous system.
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false (insulin not required)
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long conductive projections from the nerve cell body that carry nerve impulses away from the nerve cell
body. |
c. Axons
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conducting substance that transmits impulses across the synapse
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h. neurotransmitter
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general classification of cells that support the CNS and is considered the glue around neurons
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f. Neuroglia
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the region between neurons in which impulses are transmitted chemically
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g. Synapse
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forms and maintains the myelin sheath
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e. Schwann Cells
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insulating substance made of a lipid layer covering segments of the axon resulting in increased velocity
of ion flow along the axon |
d. Myelin
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cell bodies in the peripheral nervous system that are grouped together (also called plexus)
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a. Ganglia
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receptive extensions that receive stimuli and carry the nerve impulse toward the nerve cell body.
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b. Dentrites
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5. True or False Microglia perform phagocytosis in the central nervous system (CNS).
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true
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6. Which nerves are capable of regeneration?
a. Nerves within the brain and spinal cord b. Peripheral nerves that are cut or severed c. Myelinated nerves in the peripheral nervous system d. Unmyelinated nerves of the peripheral nervous system |
c. Myelinated nerves in the peripheral nervous system
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7. All of the following are true about nerve regeneration EXCEPT:
a. Regeneration depends on location of the injury b. Regeneration occurs more fully with crushing injury rather than with a cut injury. c. Regeneration is influenced by the inflammatory response and scarring d. Regeneration occurs more successfully if the injury is closer to the nerve cell body. |
d. Regeneration occurs more successfully if the injury is closer to the nerve cell body.
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8. True or False Each postsynaptic membrane contains only one type of receptor that receives a specific neurotransmitter.
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false
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9. True or False Chemical synapses between neurons can send messages in both directions.
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false
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10. During a synapse, what change occurs after the neurotransmitter binds to the receptor?
a. The permeability of the presynaptic neuron changes and consequently its membrane potential. b. The permeability of the postsynaptic neuron changes and consequently its membrane potential. c. The postsynaptic cell prevents any change in permeability and destroys the action potential. d. The presynaptic cell synthesizes and secretes additional neurotransmitter.The brain receives approximately |
b. The permeability of the postsynaptic neuron changes and consequently its membrane potential.
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11. The brain receives approximately ____% of the cardiac output.
a. 80 b. 40 c. 20 d. 10 |
20
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12. Where is the region responsible for motor aspects of speech?
a. Wernicke area in the temporal lobe b. Broca area in the frontal lobe c. Wronka area in the parietal lobe d. Barlow area in the occipital lobe |
b. Broca area in the frontal lobe
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13. True or False The hypothalamus functions in maintenance of a constant internal environment and implementation of behavioral patterns.
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true
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14. The _____ is responsible for conscious and unconscious muscle synergy and maintaining balance and posture.
a. cerebrum b. Cerebellum c. Diencephalon d. brainstem |
cerebellum
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15. The _____ controls reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing, and coughing.
a. pons b. Midbrain c. Cerebellum d. medulla oblongata |
d. medulla oblongata
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16. When discussing an injury to T3, you know that T2 is ___________________ the T3. (select all that apply)
a. Superior b. Inferior c. in the caudal direction d. in the cephalic direction |
Superior in cephalic direction
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17. True or False The blood-brain barrier is composed of the three meninges covering the brain cells.
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false
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18. True or False The fight-or-flight response is primarily mediated by the parasympathetic nervous system.
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false
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19. True or False The parasympathetic nervous system functions to conserve and restore energy.
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true
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20. The _____ provides for collateral blood flow to the brain.
a. carotid arteries b. basal artery c. circle of Willis d. vertebral arteries |
circle of willis
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A. Innervates muscles that move the eye downward and inward
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Trochlear nerve( CN IV )
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B. Has motor and sensory functions to face, mouth, nose, and eyes
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Trigeminal nerve ( CN V )
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C. Controls size, shape, and equality of pupils
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Oculomotor nerve( CN III )
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D. Causes motor functions to pharynx and salivary glands and sensory functions from pharynx and tongue
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Glossopharyngeal nerve( CN IX )
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E. Innervated muscles that move the eye laterally
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Abducens nerve( CN VI )
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F. Carries sensory and motor action to the tongue
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Hypoglossal nerve ( CN XII )
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Carries impulse for sense of smell
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Olfactory nerve ( CN I )
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Carries motor and sensory fibers of abdominal organs
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Vagus nerve ( CN X )
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Transmits impulses for sense of hearing
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Vestibulocochlear nerve ( CN VIII )
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Carries sensory and motor fibers to pharynx and larynx
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Spinal accessory nerve ( CN XI )
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22. Where is the neurotransmitter norepinephrine secreted?
a. In the somatic nervous system b. In the parasympathetic preganglion c. In the sympathetic postganglion d. In the parasympathetic postganglion |
c. In the sympathetic postganglion
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23. What is an effect of the sympathetic nervous system?
a. decreases blood pressure b. Increases blood sugar levels c. Reduces heart rate d. Causes pupillary constriction |
b. Increases blood sugar levels
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24. True or False Most of the blood vessels involved in the control of blood pressure are innervated by sympathetic nerves.
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true
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25. True or False Principal cellular changes associated with aging include lipofuscin deposition as well as the presence of neurofibrillary tangles and senile plaques.
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true
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26. True or False Lumbar punctures are performed at the level of L1-L2 because the spinal cord ends just above the L1 vertebra.
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false
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27. Which test of the nervous system is useful in detecting and localizing foci that initiate seizure activity?
a. Angiography b. CT c. Pet scan d. EEG |
eeg
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1. True or False In the gate control theory, stimuli such as touch, vibration or thermal stimuli travel along large A fibers and cause the closing of the pain gate which diminishes pain perception.
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true
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2. True or False The fingers are more sensitive to pain than the back because the fingers have more nociceptors to pain.
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true
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3. Where in the central nervous system does pain perception occur?
a. Parietal lobe b. Frontal lobe c. Thalamus d. Limbic system |
parietal lobe
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4. Massage therapy relieves pain by stimulating the large, fast, heavily myelinated A-beta fibers which:
a. open the pain gate. b. close the pain gates through an inhibitory interneuron c. causes indirect excitation through release of inflammatory mediators. |
b. close the pain gates through an inhibitory interneuron
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a. Inflammatory mediator
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bradykinins, leukotrienes, prostaglandins
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b. Excitatory transmitters
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glutamate
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c. Inhibitory transmitter
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GABA, Endorphins
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6. How do enkephalins and endorphins act to relieve pain?
a. Inhibit cells in the substantia gelatinosa b. Stimulate the descending efferent nerve fibers c. Attach to opiate receptor sites d. Block transduction of nociceptors |
c. Attach to opiate receptor sites
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7. Which are characteristics of visceral pain?
a. It is sharp and well defined when transmitted by A-delta fibers. b. It is derived from internal organs and is perceived as poorly localized. c. It arises from connective tissue, muscle, bone, or skin. d. It is derived from connective tissue and perceived as dull, aching, and poorly localized when transmitted by C fibers. |
b. It is derived from internal organs and is perceived as poorly localized.
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8. Figure 15-6 Where is liver/gallbladder pain often referred to?
a. Sacral area b. Superior and inferior to the scapula c. Left arm d. Lower right abdomen |
b. Superior and inferior to the scapula
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9. True or False Depression frequently accompanies acute pain experiences.
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false
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10. True or False Chronic pain conditions are thought to arise from a misinterpretation of nociceptive input.
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true
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11. True or False Persistent chronic pain produces a physiologic response similar to that of acute pain.
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false
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12. True or False Temperature regulation is mediated hormonally by the thalamus.
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false
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13. True or False Fever is a complex, integrated cascade of behavioral, neurologic, and endocrine responses to an exogenous pyrogen.
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true
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14. True or False Early treatment of fever is important because fever has no therapeutic benefit.
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false
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15. Which disorder of temperature regulation is caused by prolonged high core or environmental temperatures that produce dehydration, decreased plasma volumes, hypotension, decreased cardiac output, and tachycardia?
a. Heat cramps b. Heat stroke c. Malignant hyperthermia d. Heat exhaustion |
heat exhaustion
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16. True or False During heat stroke, sweat production on the face is maintained even during dehydration, to cool blood in the cerebral arteries.
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true
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17. In acute hypothermia, what physiologic change shunts blood away from the colder skin to the body core in an effort to decrease heat loss?
a. Hypotension b. Peripheral vasoconstriction c. Voluntary muscle movements d. Shivering |
b. Peripheral vasoconstriction
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19. Which of the following is a child’s sleep cycle length?
a. 45 to 60 minutes b. 90 to 100 minutes c. 20 to 45 minutes d. 60 to 75 minutes |
a. 45 to 60 minutes
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Dreaming occurs
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REM
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Can be further divided into four stages
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non-REM
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Accounts for 70-80% of sleep
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non-REM
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occurs after an individual progresses through stages I through IV and is sometimes referred to as stage V
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REM
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Body temperature decreases due to basal metabolic rate decrease.
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non-REM
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Most likely time for respiratory obstruction to occur
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REM
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Also know as paradoxical sleep
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REM
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20. Loud snoring, a decrease in oxygen saturation, fragmented sleep, chronic daytime sleepiness, and fatigue are clinical manifestations of which sleep disorder?
a. Obstructive sleep apnea b. Upper airway resistance syndrome c. Somnambulism d. Narcolepsy |
a. Obstructive sleep apnea
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21. What are expected changes in sleep patterns of older adults?
a. They experience frequent awakenings during the night and wake earlier in the morning b. They experience sound sleep during the night with about 50% of the time spent in REM sleep and dreaming. c. Commonly, they have increases in total sleep time. d. They awaken often, but with rapid return to sleep; they often have difficulty awakening in the morning. |
a. They experience frequent awakenings during the night and wake earlier in the morning
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22. A type of parasomnia _____ (dream anxiety attack)is/are characterized by sudden apparent arousal in which a child expresses intense fear or another strong emotion while in a sleep state .
a. Night terrors b. Insomnia c. Somnambulism d. Enuresis |
a. Night terrors
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23. Coronary artery disease is most affected by _____ sleep.
a. non-REM b. light c. rapid eye movement (REM) d. delta waves |
REM
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24. Pinkeye is characterized by inflammation of the:
a. eyelids. b. sebaceous glands. c. meibomian glands. d. conjunctiva. |
d. conjunctiva.
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25. Glaucoma occurs because of:
a. decreased production of aqueous humor b. increased production of vitreous humor c. obstructed outflow of aqueous humor d. excessive destruction of vitreous humor |
c. obstructed outflow of aqueous humor
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27. How does glaucoma cause blindness?
a. By infection of the cornea b. By pressure on the optic nerve c. By creating opacity of the lens d. By obstruction of the venous return from the retina |
b. By pressure on the optic nerve
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28. A sensorineural hearing loss may be a result of: (Select all that apply.)
a. Ménière disease. b. aging. c. diabetes mellitus. d. noise exposure. e. outer ear trauma |
a. Ménière disease.
b. aging. c. diabetes mellitus. d. noise exposure. |
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29. True or false Presbycusis is conductive hearing loss associated with aging.
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false (sensorineural)
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fluid causes separtation of the photorecptors from the retinal pigment epithelium resulting in impairment and blindness.
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h. Retinal detachment
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cloudy or opaque are on the ocular lens
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f. Cataract
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hypertonic muscle of one of the eyes resulting in failure of the two eyes to simultaneously focus on the same image.
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a. Strabismus
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double vision
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b. Diplopia
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reduction or dimness of vision
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d. Amblyopia
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edema and inflammation of the optic nerve at ist point of entrance into the eyeball.
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g. papilledema
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involuntary rhythmic movement of the eye or eyes
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c. Nystagumus
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defect of the central fied of vision
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e. Scotoma
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1. If your patient is in a coma, which of the following findings would be consistent with a metabolically induced coma?
a. Papilledema b. Asymmetric deep tendon reflexes c. Decorticate posture d. Pinpoint pupils |
d. Pinpoint pupils
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2. Which is a description of Cheyne-Stokes respirations?
a. A sustained deep rapid, but regular pattern of breathing b. A smooth increase in rate and depth followed by a gradual smooth decrease in rate and depth c. A prolonged inspiratory period followed gradually by a short expiratory period d. A completely irregular breathing pattern with random shallow, deep breaths and irregular pauses |
b. A smooth increase in rate and depth followed by a gradual smooth decrease in rate and depth
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3. True or False In normal breathing, the neural center in the cerebrum produces a rhythmic breathing pattern even when PaCO2 is low. With decreased consciousness, the pattern of regular breathing is maintained by the brainstem.
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false
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4. Figue 16-3. True or False Testing for oculocephalic reflex response (doll’s eyes phenomenon) is best performed by moving a patient from a supine to a sitting position and observing the eye movement.
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false
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5. True or False Brain death has occurred when there is no discernible evidence of cerebral hemisphere function or function of the brainstem’s vital centers for 1 to 6 hours.
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true
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6. True or False Criteria for brainstem death are the same for children as for adults, but with a longer observation period.
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true
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7. True or False Vegetative state is another term for locked-in syndrome.
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false
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8. The prognosis indicators for a traumatic coma are:
a. Absence of eye opening and muscle tone in 24 hours predicts death or severe disability b. Good prognosis if recovery of consciousness by 6 months. c. 95% death rate in individuals whose papillary reflexes or reflexive eye movements are absent at 6 hrs after the onset of coma d. Recovery or consciousness after a year in a coma will have moderate disability e. Emergence from a vegetative state can be expected up to 6 months. |
c. 95% death rate in individuals whose papillary reflexes or reflexive eye movements are absent at 6 hrs after the onset of coma
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9. It is observed that a person with a severe closed head injury has all four extremities in rigid extension and forearm hyperpronation and legs with plantar extension. This finding is documented as __________ posturing.
a. decorticate b. Decerebrate c. Spastic d. cerebellar |
b. Decerebrate
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10. Table 16-9 Which of the following is the currently used terminology for what was traditionally called a “grand mal” seizure?
a. Simple seizure b. Atonic seizure c. Tonic-clonic seizure d. Jacksonian seizure |
c. Tonic-clonic seizure
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11. A seizure that starts in the fingers and progressively spreads up the arm and extends to the leg is known as a(n) _____ seizure.
a. simple partial b. Focal c. Psychomotor d. Aversive |
simple partial
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The period immediately following the cessation of seizure activity
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e. Postictal state
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A peculiar sensation preceding a seizure or a migraine that may take the form of a gustatory (taste), visual or auditory experience, dizziness or numbness or just a “funny feeling.”
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a. Aura
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A state of muscle contraction in which there is excessive muscle tone
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c. Tonic phase
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A state of alternating contraction and relaxation of muscles
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d. Clonic phase
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Early clinical manifestations (malaise, HA, sense of depression) that may occur hours to a few days before the onset of a seizure.
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b. Prodroma
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13. Status epilepticus is considered a medical emergency because of the:
a. loss of consciousness. b. development of cerebral hypoxia. c. possibility of a head injury during the seizures. d. decrease in brain metabolism. |
b. development of cerebral hypoxia.
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14. Table 16-11. In a male adolescent patient without symptoms of infection or history of trauma, which of the following is a likely cause of seizures?
a. Kernicterus b. Intracranial hemorrhage c. Illicit drug use d. Stroke |
c. Illicit drug use
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15. All of the following might be useful in assessing cause and type of seizures EXCEPT
a. basic metabolic panel b. EEG c. Spinal tap for evaluation of CSF (cerebrospinal fluid) d. Vagus nerve stimulation test e. CT f. health history |
d. Vagus nerve stimulation test
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16. _____ is the loss of speech or the loss of comprehension of spoken or written language.
a. Agnosia b. Aphasia c. Akinesia d. Dysphasia |
b. Aphasia
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17. Dementia is characterized by:
a. deficits in attention and coherence of thought. b. easy distractibility and poor concentration. c. loss of recent and remote memory. d. irritability, agitation, and restlessness. |
c. loss of recent and remote memory.
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18. Which neurologic disorder is the most common cause of severe cognitive dysfunction in older adults?
a. Huntington disease c. Alzheimer disease b. Delirium d. Parkinson disease |
. Alzheimer disease
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19. The body compensates to a rise in intracranial pressure by first displacing:
a. cerebrospinal fluid (CSF). b. arterial blood. c. venous blood. d. cerebral cells. |
csf
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20. Clinical manifestations of early increase intracranial pressure include all of the following EXCEPT:
a. Confusion b. Drowsiness c. Slight pupillary changes d. Cheyne-stokes respirations |
d. Cheyne-stokes respirations
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21. Cerebral edema is an increase in the fluid content of the:
a. ventricles. b. brain tissue. c. neurons. d. meninges. |
b. brain tissue.
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22. True or False Hydrocephalus is characterized by excess of fluid within the cranial vault.
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true
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23. There are three mechanisms that can case hydrocephalus. Which of the following is NOT a mechanism?
a. Increased CSF production b. Decreased absorption of CSF c. Obstruction within the ventricular system d. Intramedullary tumor growth |
d. Intramedullary tumor growth
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24. Subarachnoid hemorrhage causes communicating hydrocephalus by obstructing:
a. the cerebrospinal fluid flow between the ventricles. b. the cerebrospinal fluid flow into the subarachnoid space. c. blood flow to the arachnoid villi. d. the absorption of cerebrospinal fluid by the arachnoid villi. |
d. the absorption of cerebrospinal fluid by the arachnoid villi.
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25. Which dyskinesia involves involuntary movements of the face, trunk, and extremities?
a. Paroxysmal b. Tardive c. Hyperkinesia d. Cardive |
tardive
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26. Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of increased:
a. dopamine. b. gamma-aminobutyric acid (GABA). c. norepinephrine (NE). d. acetylcholine. |
dopamine
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Expressive dysphasia
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f. Broca dysphasia
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Receptive dysphasia
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c. Wernicke aphasia
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Decrease in voluntary movement
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e. Akinesia
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Abnormal involuntary movement
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a. Paroxysmal dyskinesia
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Lower motor neuron disorders
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b. Flaccidity
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Upper motor neuron disorders
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d. Spasticity
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28. Huntington disease is also known as chorea. True or False Choreiform movements begin in the face and arms, eventually affecting the entire body.
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true
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29. The clinical manifestations of Parkinson disease (PD) include:
a. muscle tremor; slow, rigid movements; and postural abnormalities. b. muscle weakness, difficulty chewing, and drooping eyelids. c. decreased memory, depression, and indifference. d. paralysis and absent sensation below the level of the lesion. |
a. muscle tremor; slow, rigid movements; and postural abnormalities.
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30. Clinical manifestations of Parkinson disease are caused by a deficit in which neurotransmitter?
a. Gamma-aminobutyric acid (GABA) b. Dopamine c. Norepinephrine (NE) d. Acetylcholine |
b. Dopamine
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31. Parkinson disease is a degenerative disorder of the:
a. hypothalamus. b. anterior pituitary. c. frontal lobe. d. basal ganglia |
d. basal ganglia
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1. A man was in an automobile accident in which his forehead struck the windshield. A blunt force injury to the forehead would result in a coup injury to the _____ region.
a. Frontal c. Parietal b. Temporal d. Occipital |
frontal
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2. A blunt force injury to the forehead would result in a contrecoup injury to the _____ region.
a. Frontal c. Parietal b. Temporal d. Occipital |
occipital
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Produces immediate but short-lasting unconsciousness
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a. Contusion
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Caused most commonly by motor vehicle accidents
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b. Extradural hematoma
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May be acute or chronic accumulation of venous blood
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c. Subdural hematoma
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4. What damage is most likely to occur to the brain in a classic cerebral concussion?
a. Diffuse cerebral disconnection from the reticular activating system b. Cerebral edema throughout the cerebral cortex c. Cerebral edema throughout the diencephalon d. Disruption of axons extending from the diencephalon and brainstem |
a. Diffuse cerebral disconnection from the reticular activating system
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5. Spinal cord injuries are most likely to occur in which of the following regions?
a. Cervical and thoracic b. Thoracic and lumbar c. Lumbar and sacral d. Cervical and lumbars |
d. Cervical and lumbars
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6. Which disorder has clinical manifestations that include decreased consciousness for up to 6 hours as well as retrograde and posttraumatic amnesia?
a. Mild concussion b. Classic concussion c. Cortical contusion |
b. Classic concussion
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7. _____ are most at risk of spinal cord injury from minor trauma.
a. Children b. Adolescents c. Adults d. Older adults |
d. Older adults
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8. True or False Because spinal cord swelling increases the degree of dysfunction, it is difficult to distinguish between permanent and temporary loss of function until the swelling is resolved.
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true
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9. The edema of the upper cervical cord after spinal cord injury is considered life threatening because of:
a. hypovolemic shock from blood lost during the injury. b. the apnea from the impairment to the diaphragm. c. a head injury was more likely to occur during the injury. d. the spinal shock immediately after the injury. |
b. the apnea from the impairment to the diaphragm.
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10. What are the initial clinical manifestations noted immediately after a spinal cord injury?
a. Headache, bradycardia, and elevated blood pressure b. Confusion, irritability, and retrograde amnesia c. Loss of deep tendon reflexes, flaccid paralysis, transient drop in blood pressure. d. Hypertension, neurogenic shock, and tachycardia |
c. Loss of deep tendon reflexes, flaccid paralysis, transient drop in blood pressure.
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11. Which of the following indicate that spinal shock is terminating?
a. Voluntary movement below the level of injury b. Reflex emptying of the bladder c. Paresthesia below the level of injury d. Decreased deep tendon reflexes and flaccid paralysis |
b. Reflex emptying of the bladder
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12. True or False Autonomic hyperreflexia is likely to occur before spinal shock is resolved.
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false
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13. What complication is occurring for a person who has a spinal cord injury above T6 and is experiencing paroxysmal hypertension as well as piloerection and sweating above the spinal cord lesion?
a. Craniosacral dysreflexia b. Parasympathetic dysreflexia c. Autonomic hyperreflexia d. Healing of the spinal cord lesion |
c. Autonomic hyperreflexia
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14. A man who sustained a cervical spinal cord injury 2 days ago suddenly develops severe hypertension and bradycardia. He reports severe head pain and blurred vision. The most likely explanation for these clinical manifestations is that he is:
a. experiencing acute anxiety. b. developing spinal shock. c. developing autonomic hyperreflexia. d. experiencing parasympathetic areflexia. |
c. developing autonomic hyperreflexia.
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15. A herniation of which disk would likely result in motor and sensory changes of the lateral lower legs and soles of the feet?
a. L2-L3 b. L3-L5 c. L5-S1 d. S2-S3s |
L5- S1
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16. Low back pain is very common, affecting 60-80% of the population at some point in their life. All of the following are included in medical management of low back pain EXCEPT:
a. Analgesics b. Physical therapy c. Exercise d. diskectomy e. education |
diskectomy
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17. Of the following people, who is at highest risk for a cerebrovascular accident (CVA)?
a. White women older than 65 years of age b. Black women older than 70 years of age c. Black men older than 65 years of age d. White men older than 70 years of ages |
b. Black women older than 70 years of age
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18. Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
a. Hemorrhagic b. thrombotic c. embolic d. lucunar |
embolic
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19. Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke?
a. Embolic b. Hemorrhagic c. Lacunar d. thrombotic |
lacunar
|
|
|
20. Treatment for cerebrovascular accidents (strokes) that are confirmed to be ischemic type (not hemorrhagic type) includes administration of thrombolytics within _______ hours of onset of symptoms reduces dependency at 6 months post event.
a. 2 b. 3 c. 6 d. 8 |
3
|
|
|
21. Table 17-6 A right hemisphere embolic cerebrovascular accident has resulted in left-sided paralysis and reduced sensation of the left foot and leg with loss of two point discrimination. The vessel most likely affected by the emboli is the right _____ artery.
a. middle cerebral b. Vertebral c. posterior cerebral d. anterior cerebral |
d. anterior cerebral
|
|
|
22. True or False Rebleeding after a subarachnoid hemorrhage is a significant risk and occurs most often up to 4 weeks after the initial hemorrhage.
|
false
|
|
|
23. Which cerebral vascular disorder causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?
a. Intracranial hemorrhage b. Subarachnoid hemorrhage c. Epidural hemorrhage d. Subdural hemorrhage |
b. Subarachnoid hemorrhage
|
|
|
24. The typical age of onset of migraine headaches is
a. In infancy b. Before 25 years of age c. Mid thirties d. After 50 |
b. Before 25 years of age
|
|
|
25. Which type of headache occurs more in males than females?
a. Migraine with aura b. Migraine without aura c. Cluster headaches d. Tension headaches |
c. Cluster headaches
|
|
|
26. Which clinical manifestation is characteristic of cluster headaches?
a. Aura before the headache with photophobia and nausea and vomiting b. Severe unilateral tearing, burning, or temporal pain c. Gradual onset of bilateral pain with sensation of a tight band around the head d. Throbbing headache with intermittent burning sensation |
b. Severe unilateral tearing, burning, or temporal pain
|
|
|
27. Astocytoma (or glioblastome) may present with the following – check all that apply
a. Headache with accompanying subtle neurobehavioral changes b. Seizures c. Focal neurologic manifestations (loss of muscle control/tone or sensation of a particular area) d. vomiting e. papilledema |
a. Headache with accompanying subtle neurobehavioral changes
b. Seizures c. Focal neurologic manifestations (loss of muscle control/tone or sensation of a particular area) d. vomiting e. papilledema |
|
|
28. True or False Tubercular meningitis is on the rise in the United States especially in persons with acquired immunodeficiency syndrome (AIDS).
|
true
|
|
|
29. True or False Neck stiffness in meningitis reflects irritability of spinal accessory and cervical spinal nerves and is often accompanied by vomiting.
|
true
|
|
|
30. True or False The most common causes of encephalitis are arthropod-borne bacterial infections.
|
false (virus)
|
|
|
31. True or False About half of all people with acquired immunodeficiency syndrome (AIDS) have neurologic complications.
|
true
|
|
|
a. Complication of mastoiditis
|
Brain abscess
|
|
|
b. Opportunistic infection
|
Cryptococcus neoformans
|
|
|
c. CNS manifestation of tuberculosis
|
Meningitis
|
|
|
d. Mosquito-borne viral infection
|
Encephalitis
|
|
|
e. Tick-borne bacterial infection
|
Lyme disease
|
|
|
33. True or False The peripheral nervous system is the main location of the lesions characteristic of multiple sclerosis (MS).
|
false
|
|
|
34. Which of the following best describes multiple sclerosis (MS)?
a. It is a central nervous system (CNS) demyelination, possibly from an immunogenetic virus. b. It is an inadequate supply of acetylcholine at the neurotransmitter junction as a result of an autoimmune disorder. c. It is a depletion of dopamine in the central nervous system as a result of a virus. d. It is a degenerative disorder of lower and upper motor neurons caused by viral-immune factors. |
a. It is a central nervous system (CNS) demyelination, possibly from an immunogenetic virus.
|
|
|
35. Amyotrophic lateral sclerosis (ALS) is characterized by:
a. urinary and fecal incontinence b. demyelination of central nervous system neurons. c. upper and lower motor neuron degeneration. d. an autoimmune disorder caused by a virus. |
c. upper and lower motor neuron degeneration.
|
|
|
36. Multiple sclerosis (MS), Guillain-Barré syndrome (GBS) and Myasthenia Graves are similar in that they all:
a. result from an auto immune reaction. b. cause permanent destruction of peripheral nerves. c. result from inadequate production of neurotransmitters. d. block acetylcholine receptor sites at the myoneuronal junction. |
a. result from an auto immune reaction.
|
|
|
37. Guillain-Barré syndrome (GBS):
a. is preceded by a viral illness. b. involves a deficit in acetylcholine. c. results in asymmetric paralysis. d. is an outcome of HIV. |
a. is preceded by a viral illness.
|
|
|
38. True or False Guillain-Barré syndrome causes muscle weakness that can progressively worsen for up to 4 weeks.
|
false (plateaus)
|
|
|
39. True or False Myasthenia gravis is characterized by extreme fatigue that improves with rest.
|
true
|
|
|
40. In which disorder are acetylcholine receptor antibodies (IgG antibodies) produced against acetylcholine receptors?
a. Guillain-Barré syndrome b. Multiple sclerosis c. Myasthenia gravis d. Parkinson disease |
c. Myasthenia gravis
|
|
|
1. True or False Schizophrenia is believed to develop as a result of neurodevelopmental defects occurring during fetal life even though diagnosis is made often in the late teens/early 20s.
|
true
|
|
|
2. True or False People with schizophrenia commonly experience incoherent speech, delusions, and hallucinations during a psychotic episode.
|
true
|
|
|
3. Which neurotransmitter receptors are blocked by antipsychotic drugs (neuroleptics)?
a. Norepinephrine b. Gamma-aminobutyric acid (GABA) c. Serotonin d. Dopamines |
dopamines
|
|
|
Perceptions are experienced without external stimulation of the sense organs
|
d. Hallucinations
|
|
|
Persistent beliefs are contrary to educational and cultural background
|
a. Delusions
|
|
|
5. True or False Loci on chromosomes 18 and 22 have been linked to bipolar disorder and schizophrenia.
|
true
|
|
|
Fluent speech that is difficult to comprehend
|
b. Formal thought disorder
|
|
|
Absence of spontaneous speech
|
e. Alogia
|
|
|
Inability to have emotional experiences
|
c. Anhedonia
|
|
|
Characterized by a deficit in spontaneous or goal-directed activities
|
f. Avolition
|
|
|
6. Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with:
a. schizophrenia. b. major depression. c. mania. d. panic disorder. |
b. major depression.
|
|
|
7. What is the link between major depression and cortisol secretion?
a. Individuals with depression show suppression of plasma cortisol when given dexamethasone. b. Individuals with depression have a decreased plasma cortisol level despite administration of exogenous corticosteroids. c. Individuals with depression continue to exhibit elevated plasma cortisol levels throughout the evening and early morning. d. Individuals with depression have normal plasma cortisol levels throughout the day when they take antidepressant medication as prescribed. |
c. Individuals with depression continue to exhibit elevated plasma cortisol levels throughout the evening and early morning.
|
|
|
8. From 20% to 30% of individuals with depression have dysregulated:
a. protein production. b. pituitary function. c. eating patterns. d. thyroid function. |
d. thyroid function.
|
|
|
9. True or False Mania is elevated euphoria that can be induced by treating a patient with TCAs (tricyclic antidepressant).
|
true
|
|
|
10. The common property among the three types of medications used to treat depression is that they:
a. increase neurotransmitter levels within the synapse. b. increase neurotransmitter levels in the presynapse. c. decrease neurotransmitter levels in the postsynapse. d. decrease neurotransmitter levels within the synapse. |
a. increase neurotransmitter levels within the synapse.
|
|
|
11. Individuals who eat cheese, sour cream, liver, and avocado when taking monoamine oxidase inhibitors (MAOIs) may experience:
a. kidney damage. b. hypertensive crisis. c. orthostatic hypotension. d. weight gain. |
b. hypertensive crisis.
|
|
|
12. What are the most common side effects of selective serotonin reuptake inhibitors (SSRIs)?
a. Orthostatic hypotension and weight gain b. Dry mouth and sexual dysfunction c. Sleep disturbances and nausea d. Hypertensive crisis and agitation |
c. Sleep disturbances and nausea
|
|
|
13. What is thought to be the alteration produced by electroconvulsive therapy (ECT) when treating individuals with depression?
a. It produces an alteration in the monoamine systems. b. It produces an alteration in serotonin. c. It produces an alteration in norepinephrine. d. It produces an alteration in the limbic system. |
a. It produces an alteration in the monoamine systems.
|
|
|
14. True or False Individuals with panic disorder are effectively treated with cognitive behavioral therapy (CBT).
|
true
|
|
|
15. True or False Exposure to a terrifying event may result in an onset of generalized anxiety disorder (GAD).
|
false
|
|
|
16. Generalized anxiety disorder (GAD) is diagnosed when a person spends _____ months worrying excessively.
a. 3 b. 6 c. 9 d.12 |
6
|
|
|
17. True or False People with posttraumatic stress disorder (PTSD) who have been exposed to trauma-related stimuli generally exhibit increased activation of the amygdala and diminished activity in some prefrontal cortical areas.
|
true
|
|
|
18. Which neurotransmitter is inhibited in panic disorders?
a. Norepinephrine b. Serotonin c. Dopamine d. Gamma-aminobutyric acid (GABA) |
GABA
|
|
|
19. Persistent symptoms of posttraumatic stress disorder include:
a. depression. b. hypertension. c. difficulty sleeping. d. poor nutrition. |
difficulty sleeping
|
|
|
Characterized by elevated levels of euphoria
|
b. Mania
|
|
|
Involves psychotic episodes
|
a. Schizophrenia
|
|
|
Repetitive, intrusive thoughts
|
e. Obsessive compulsive disorder
|
|
|
Unremitting feeling of sadness and despair
|
c. Depression
|
|
|
Intensive autonomic arousal including lightheadedness, dyspnea, generalized sweating, and racing heart
|
d. Panic disorder
|
|
|
1. In the average newborn, the posterior fontanel is closed by _______ of age and the anterior fontanel is closed by ________ of age.
a. 1 month, 6 months b. 12 months, 8 years c. 3 months, 20-24 months d. 2 weeks, 4 years |
c. 3 months, 20-24 months
|
|
|
2. _____ refers to a herniation or protrusion of brain and meninges through a defect in the skull.
a. Encephalocele b. Meningocele c. Arachnoidocele d. Acephalocele |
a. Encephalocele
|
|
|
3. _____ is a hernial protrusion of a sac-like cyst containing meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the posterior arch of a vertebra.
a. Encephalocele b. Meningocele c. Spina bifida occulta d. Myelomeningocele |
d. Myelomeningocele
|
|
|
4. True or False Meningoceles occur at a greater frequency in the lumbar spine area.
|
false
|
|
|
5. The life-threatening problems associated with myelomeningocele include:
a. upward displacement of the cerebellum into the diencephalon. b. motor and sensory lesions below the level of the myelomeningocele. c. downward displacement of the cerebellum, brainstem, and fourth ventricle. d. encephalitis causing generalized cerebral edema and hydrocephalus. |
c. downward displacement of the cerebellum, brainstem, and fourth ventricle.
|
|
|
6. Prompt surgical repair of a myelomeningocele is critical in the prevention of:
a. infection. b. paternal abandonment. c. mental retardation. d. additional nervous system damage. |
d. additional nervous system damage.
|
|
|
7. A _____ is the test done on amniotic fluid and maternal blood to test for neural tube defect.
a. total protein b. culture c. α-fetoprotein (AFP) or a Quad test that includes the AFP as one of four tests. d. C-reactive protein |
c. α-fetoprotein (AFP) or a Quad test that includes the AFP as one of four tests.
|
|
|
8. Which nutritional deficiency in a pregnant woman is associated with neural tube defect (NTD)?
a. Iron c. zinc b. Vitamin C d. folate |
d. folate
|
|
|
9. True or False Spina bifida occulta occurs in 10% to 25% of infants.
|
true
|
|
|
10. Spina bifida occulta is characterized by all of the following EXCEPT:
a. Abnormal growth of skin along the spine b. A midline dimple with a sinus tract c. A cutaneous port-wine angioma d. A subcutaneous lipoma e. Coarse tufted growth of hair along the spine |
a. Abnormal growth of skin along the spine
|
|
|
11. Head circumference measurements are used to evaluate
a. Acrania c. Arnold Chiari malformation b. Craniosynostosis d. Cerebral palsy |
b. Craniosynostosis
|
|
|
12. An infant with hydrocephalus has characteristically:
a. shrunken ventricles. b. bulging fontanels. c. retarded head growth. d. decreased production of cerebrospinal fluid (CSF). |
b. bulging fontanels.
|
|
|
13. True or False The definitive diagnostic tool for hydrocephalus is computed tomography.
|
true
|
|
|
14. True or False Although cerebral palsy is nonprogressive, its clinical manifestations change with growth and
|
true
|
|
|
15. The clinical manifestations of dyskinetic cerebral palsy include:
a. increased muscle tone and prolonged primitive reflexes. b. exaggerated deep tendon reflexes, clonus, and rigidity of extremities. c. scoliosis, contractures, and stiffness of trunk muscles. d. jerky uncontrolled and abrupt fine musculoskeletal movements. |
d. jerky uncontrolled and abrupt fine musculoskeletal movements.
|
|
|
16. Children with phenylketonuria (PKU) are unable to synthesize:
a. the essential amino acid phenylalanine to tyrosine. b. renin, erythropoietin, and antidiuretic hormone. c. aldosterone, cortisol, and androgens. d. neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine. |
a. the essential amino acid phenylalanine to tyrosine.
|
|
|
17. True or False Children with Tay-Sachs disease usually die between ages 2 and 5 years.
|
true
|
|
|
18. True or False Seizures and seizure patterns may change as the child grows and develops.
|
true
|
|
|
19. True or False Children with juvenile myoclonic epilepsy commonly have normal neurologic examinations, normal intelligence, and positive family history of seizures.
|
true
|
|
|
20. Benign febrile seizures are characterized by all of the following EXCEPT
a. are rare before 9 months of age and after 5 years of age b. occur with a rise in temp above 102.2 c. an acute respiratory or ear infection is usually present d. may have repeated seizures within a 24 hour period |
d. may have repeated seizures within a 24 hour period
|
|
|
21. Reye syndrome is associated with children who have taken aspirin while experiencing:
a. measles or mumps. b. influenza B or chickenpox. c. bacterial upper respiratory infections. d. bacterial ear infections. |
b. influenza B or chickenpox.
|
|
|
22. Lead absorption in children causes anemia by impairing the:
a. lysing of erythrocytes. b. absorption of vitamin B12. c. absorption of folic acid. d. absorption of iron. |
d. absorption of iron.
|
|
|
23. Bacterial meningitis is caused by all of the following bacteria EXCEPT
a. Strep pneumo (Streptococcus pneumoniae) b. Haemophilus influenza type B (HIB) c. Neisseria meningitides (meningococcus) d. Chlamydia trachomatis |
d. Chlamydia trachomatis
|
|
|
24. True or False The actual location of a brain tumor dictates the presenting signs and symptoms.
|
true
|
|
|
25. True of False Headaches in young children should be thoroughly investigated as this is not a common complaint in this age group.
|
true
|
|
|
1. True or False In adults, hematopoiesis takes place exclusively in the long bones of the extremities.
|
false
|
|
|
2. Which bone cells are responsive to parathyroid hormone, produce osteocalcin when stimulated by 1,25-dihydroxyvitamin D, and synthesize osteoid?
a. Osteoclasts c. Fibrocytes b. Osteocytes d. Osteoblasts |
osteoblasts
|
|
|
3. Which of the following cells function to maintain bone matrix by concentrating nutrients in the matrix?
a. Osteoclasts c. osteoblasts b. Osteocytes d. osteophytes |
osteocytes
|
|
|
4. True or False An osteocyte is a transformed osteoblast that obtains nutrients from capillaries in the canaliculi and helps maintain mineral homeostasis.
|
true
|
|
|
5. The bone cells that are large and multinucleated and contain lysosomes filled with hydrolytic enzymes are the:
a. osteoblasts. b. osteoclasts. c. osteocytes. d. fibrocytes. |
osteoclasts
|
|
|
6. The basic structural unit in compact bone is:
a. small channels called canaliculi. b. osteocytes within the lacunae. c. tiny spaces within the lacunae. d. the haversian system. |
d. the haversian system.
|
|
|
8. After puberty the epiphyseal plate calcifies and the epiphysis merges with the:
a. epiphyseal line. b. epiphyseal plate. c. metaphysis. d. articular cartilage. |
c. metaphysis.
|
|
|
9. True or False Remodeling is a three-phase process in which existing bone is resorbed and new bone is laid down to replace it.
|
true
|
|
|
10. When bone is “resorbed” during the process of growth and repair, the original bone:
a. is replaced. b. hardens. c. is removed. d. is synthesized. |
is removed
|
|
|
shaft rigid compact bone that can tolerated bending force, midportion of a long bone
|
b. Diaphysis
|
|
|
also know as the growth plate
|
e. Epiphyseal plate
|
|
|
broad neck of a long bone
|
c. Metaphysis
|
|
|
The outer layer of the all bones containing blood vessels and nerves is the:
|
a. Periosteum
|
|
|
broad end of a long bone that allows weight bearing to be distributed over a wide area
|
d. Epiphysis
|
|
|
11. Place the steps of bone repair in the correct order
_____ Callus replacement _____ Procallus formation _____ Hematoma formation _____ Callus formation _____ Remodeling |
1. Hematoma formation
2. Procallus formation 3.Callus formation 4. Callus replacement 5. Remodeling |
|
|
Fibroblasts, capillary buds, and osteoblasts move into the wound to produce granulation tissue.
|
d. Procallus formation
|
|
|
Periosteal and endosteal surfaces of the bone are formed to the size and shape of the bone before the injury.
|
c. Remodeling
|
|
|
Osteoblasts form membranous or woven bone. Enzymes increase the phosphate content and permit the phosphate to join with calcium to be deposited.
|
e. Callus formation
|
|
|
Fibrin and platelets form a meshwork within the initial framework for healing.
|
b. Hematoma formation
|
|
|
Osteoblasts continue to restore callus with lamellar bone or trabecular bone.
|
a. Callus replacement
|
|
|
13. True or False Fibrous joins are relatively immovable.
|
true
|
|
|
14. True or False The joint that holds teeth into the socket does so by a tendon.
|
false
|
|
|
15. True or False The synchondosis joint between the sterum and the ribs is considered an immovable joint.
|
false
|
|
|
16. True or False The joint capsule is avascular.
|
false
|
|
|
17. The function of the synovial membrane’s type A cells within the intima is to:
a. release mast cells to initiate the inflammatory process after joint injury. b. ingest and remove bacteria and debris by phagocytosis in the joint cavity. c. secrete hyaluronate, a binding agent that gives synovial fluid its viscous quality. d. store fat cells and glycogen to provide adenosine triphosphate (ATP) for joint activity. |
b. ingest and remove bacteria and debris by phagocytosis in the joint cavity.
|
|
|
18. With the loss of synovial fluid:
a. there is no change in joint function b. rapid deterioration of the articular cartilage occurs c. sharpey fibers become inflamed d. tendons will have increased incidence of rupture |
b. rapid deterioration of the articular cartilage occurs
|
|
|
19. Articular cartilage is anchored to the underlying bone via:
a. sharpey fibers. c. glycoproteins b. collagen. d. elastin fibers |
b. collagen.
|
|
|
20. The part of an injured joint that becomes insensitive to pain and regenerates slowly and minimally is the:
a. synovium. c. bursa b. articular cartilage. d. tendon |
b. articular cartilage.
|
|
|
21. True or False Fascia is the three part connective tissue framework that encases skeletal muscle and provides a structure for a network of nerve fibers, blood vessels and lymphatic channels.
|
true
|
|
|
22. The greater the innervation ratio of a particular organ, the greater its:
a. fatigue. c. strenght b. movement. D. endurance |
endurance
|
|
|
23. Whether motor nerves are fast or slow determines the type of muscle fibers in the motor unit. Which is a characteristic of type II (white) muscle fibers?
a. Slow contraction speed b. Fast conduction velocities c. Profuse capillary supply d. Oxidative metabolism |
b. Fast conduction velocities
|
|
|
24. True or False Because ocular muscles have more type II muscle fibers, they are able to respond rapidly to visual change.
|
true (fast twitch)
|
|
|
25. Which of the following correctly describes a muscle contraction’s four-step process?
a. Coupling, contraction, relaxation, excitation b. Contraction, relaxation, excitation, coupling c. Relaxation, excitation, coupling, contraction d. Excitation, coupling, contraction, relaxation |
d. Excitation, coupling, contraction, relaxation
|
|
|
26. Which ion directly controls the contraction of muscles?
a. Sodium b. Potassium c. Calcium d. Magnesium |
calcium
|
|
|
27. Which hormone influences the rate of protein synthesis of skeletal muscles?
a. Insulin b. Cortisol c. Parathyroid hormone d. Growth hormone |
insulin
|
|
|
28. With increased muscular activity, such as intense exercise or ischemia, an increase in ________________ occurs because of the breakdown of glycogen needed to form ATP (thus causing a change in muscle pH.)
a. Lactic acid b. Calcium c. Oxygen d. creatine |
lactic acid
|
|
|
29. During exercise, when aerobic glycogen pathways providing ATP are working over an extended time period, this system becomes exhausted and can no longer respond to the need for ATP. What symptoms would you expect to see? (select all that apply)
a. increased muscle strength b. muscle soreness c. fatigue d. weakness |
b. muscle soreness
c. fatigue d. weakness |
|
|
30. In _____ contractions, the muscle maintains a constant tension as it moves.
a. isotonic b. Isometric c. Hypertonic d. hypotonic |
isotonic
|
|
|
31. An EMG test is useful for
a. Assessment of soft tissues b. Assessment of knee or shoulder problems c. Assessment of nerve innervation of a muscle d. Osteoclast resorption |
c. Assessment of nerve innervation of a muscle
|
|
|
32. Which statement is false about aging and the musculoskeletal system?
a. Bones become more brittle with aging. b. Cartilaginous rigidity increases because of decreasing water content and increasing concentrations of glycosaminoglycans. c. Height is lost with aging because of increased spinal curvature (often because of asymptomatic vertebral fractures d. Bone mass is gained in healthy young women up to the age of 30. e. Men do not experience bone loss. |
e. Men do not experience bone loss.
|
|
|
fractures of the upper humerus population
|
b. Elderly
|
|
|
fractures of the pelvis population
|
b. Elderly
|
|
|
fractures of the hand population
|
c. People in the workforce
|
|
|
fractures of the clavicle population
|
a. Young people
|
|
|
fractures of the vertebrae population
|
b. Elderly
|
|
|
3. A(n) _____ fracture is a fracture at a site of a preexisting bone abnormality, usually by a force that would not normally cause a fracture.
a. Idiopathic b. Incomplete c. Pathologic d. Greenstick |
c. Pathologic
|
|
|
4. _____ fractures usually occur in individuals who engage in a new activity that is strenuous and repetitive.
a. Stress b. Greenstick c. Insufficiency d. Pathologic |
a. Stress
|
|
|
5. True or False Bone is unique among body tissue because after a fracture that destroys bone, a new bone is formed, but there is no scar tissue.
|
true
|
|
|
6. _____ is the temporary displacement of two bones in which the bone surfaces partially lose contact.
a. Dislocation b. Subluxation c. Malunion d. Nonunion |
subluxation
|
|
|
_____ fracture that is hidden or not readily discernible caused by minor force or energy
|
e. Occult
|
|
|
_____skin broken over fracture Caused by moderate to sever energy that is continuous and exceeds tissue
|
a. Open
|
|
|
_____ Break in only one cortex of bone (fracture only through a portion of the bone) caused by minor direct or indirect energy or common in children
|
b. Greenstick
|
|
|
_____ the cortex of the bone buckle but does not break
|
g. Torus fracture
|
|
|
_____ fracture with two or more pieces caused by direct or indirect moderate to severe force
|
h. Comminuted fracture
|
|
|
_____ fracture that curves around cortices and may become displace by twist caused by direct or indirect
|
c. Spiral
|
|
|
_____ fracture with one end wedged into opposite end of inside fractured fragment caused by compressive axial energy or force directly to distal fragment
|
d. Impacted
|
|
|
_____ horizontal break through bone caused by direct or indirect energy toward bone.
|
f. Transverse
|
|
|
7. Improper reduction or immobilization of a fractured femur results in which of the following after cast removal?
a. The muscles around the fracture site are weak. b. The fracture requires 6 to 8 weeks of physical therapy. c. The skin under the cast is dry and flaky. d. The bone is not straight in proper anatomic position (malunion). |
d. The bone is not straight in proper anatomic position (malunion).
|
|
|
8. Which of the following attaches skeletal muscle to bone?
a. Tendon b. Ligament c. Bursa d. Mesentery |
tendon
|
|
|
9. A tear in a ligament is known as a:
a. fracture. b. strain. c. disunion. d. sprain. |
sprain
|
|
|
10. True or False An avulsion is commonly seen in young athletes when the tendon separates from the bony attachment site.
|
true
|
|
|
11. What is the diagnosis of a person who has tennis elbow characterized by tissue degeneration or irritation of the extensor carpi brevis tendon?
a. Lateral epicondylitis b. Medial tendinitis c. Bursitis d. Lateral tendinitis |
a. Lateral epicondylitis
|
|
|
12. The pain associated with tendon and ligament injuries is usually described as being:
a. dull and diffuse and persists over the distribution of the tendon or ligament. b. sharp and localized and persists over the distribution of the tendon or ligament. c. pins-and-needle sensations distal to injury on movement. d. intermittent and aching over the distribution of the tendon or ligament. |
b. sharp and localized and persists over the distribution of the tendon or ligament.
|
|
|
13. Rhabdomyolysis is characterized by:
a. paralysis of skeletal muscles resulting from impaired nerve supply. b. smooth muscle degeneration resulting from ischemia. c. lysis of skeletal muscle cells through the initiation of the complement cascade. d. release of myoglobin from damaged striated muscle cells that can lead to renal failure. |
d. release of myoglobin from damaged striated muscle cells that can lead to renal failure.
|
|
|
14. True or False Compartment syndromes are a localized form of crush syndromes.
|
true
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15. A woman with a bone density of 675 mg/cm2 would be described as having:
a. osteoplasia. b. osteoporosis. c. osteopenia. d. osteomalacia. |
c. osteopenia.
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16. True or False Bone formation continues at a pace faster than resorption until maximum bone density and strength is reached which is around 45 years of age.
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false (30 y.o.)
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17. By the time osteoporosis is visible on x-ray, up to ____% of bone has been lost.
a. 30 b. 40 c. 50 d. 60 |
30%
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18. Considering the pathophysiology of osteoporosis, which hormone exerts antiapoptotic effects on osteoblasts, but proapoptotic effects on osteoclasts?
a. Parathyroid hormone b. Glucocorticoid c. Growth hormone d. Estrogen |
estrogen
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19. True or False A balance between receptor activator of nuclear RANKL and osteoprotegerin (OPG) is necessary to prevent osteoporosis.
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true
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20. True or False In osteomalacia the remodeling cycle proceeds normally through osteoid formation, but mineral calcification and deposition do not occur.
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true
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21. Which disorder is characterized by the formation of abnormal new bone at an accelerated rate beginning with excessive resorption of spongy bone?
a. Osteomalacia b. Paget disease c. Osteoporosis d. Osteosarcoma |
paget diease
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22. True or False Osteomyelitis is a bone infection caused only by bacteria.
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false
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23. True or False Cutaneous, sinus, ear, and dental infections are primary sources of bacteria in hematogenous bone infections.
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true
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24. Which statement is false about factors that contribute to the difficulty in treating bone infections?
a. Bone contains multiple microscopic channels that are impermeable to the cells and biochemicals of the body’s natural defenses. b. Microcirculation of bone is highly vulnerable to damage and destruction by bacterial toxins, leading to ischemic necrosis of bone. c. Bone cells have a limited capacity to replace bone destroyed by infections. d. Bacteria are walled off by macrophages and T lymphocytes so that the antibiotics cannot penetrate the infected area. |
d. Bacteria are walled off by macrophages and T lymphocytes so that the antibiotics cannot penetrate the infected area.
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25. Bone death as a result of osteomyelitis is due to:
a. formation of immune complexes at the site of infection. b. localized ischemia. c. TNF-a and IL-1. d. impaired nerve innervation at the site of infection. |
b. localized ischemia.
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26. Which of the following is a characteristic of osteosarcoma?
a. Slow-growing tumor that begins in the bone marrow and infiltrates the trabeculae b. Solitary tumor that most often affects the metaphyseal region of the femur or tibia c. An aggressive tumor most often found in the bone marrow of long bones d. A tumor that infiltrates the trabeculae in spongy bone and implants in surrounding tissue by seeding |
c. An aggressive tumor most often found in the bone marrow of long bones
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27. Which statement is false about giant cell tumors?
a. They are an overexpression of genes including osteoprotegerin ligand (OPGL). b. They are malignant, solitary, irregularly shaped tumors. c. They are typically located in the epiphysis in the femur, tibia, radius, and humerus. d. They are slow-growing tumors that extend over the articular cartilage. |
b. They are malignant, solitary, irregularly shaped tumors.
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29. What is a primary defect in osteoarthritis (OA)?
a. loss and damage of articular cartilage, synovitis and thickening of the joint capsule b. IgG destroys the synovial membrane. c. Synovial membranes become inflamed. d. Cartilage-coated osteophytes create bone spurs. |
a. loss and damage of articular cartilage, synovitis and thickening of the joint capsule
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age related disorder arthritis
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a. Osteoarthritis
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adult men more than women until after age 55 arthritis
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a. Osteoarthritis
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occurs more frequently in women arthritis
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b. Rheumatoid arthritis
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“use” related joint pain that is relieved by rest arthritis
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a. Osteoarthritis
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pain and stiffness are predominant symptoms in one or more joints arthritis
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a. Osteoarthritis
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pain and swelling in multiple joints as well as stiffness that improves after a few hours arthritis
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b. Rheumatoid arthritis
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nodules over extensor surfaces or boney prominences arthritis
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b. Rheumatoid arthritis
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morning stiffness for longer than 1 hour arthritis
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b. Rheumatoid arthritis
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patient may exhibit fatigue, fever, and weakness. arthritis
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b. Rheumatoid arthritis
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30. Which joint disease is characterized by joint stiffness on movement and joint pain of weight-bearing joints that usually is relieved by rest?
a. Gouty arthritis b. Rheumatoid arthritis c. Osteoarthritis d. Suppurative arthritis |
c. Osteoarthritis
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31. _____ is a chronic inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints.
a. Ankylosing spondylitis b. Rheumatoid arthritis c. Paget disease d. Fibromyalgia |
a. Ankylosing spondylitis
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32. True or False Diagnosis of ankylosing spondylitis includes serum analysis for the presence of the histocompatibility antigen HLA-B27.
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true
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33. What causes the crystallization within the synovial fluid of the joint affected by gouty arthritis?
a. Reduced excretion of purines b. Overproduction of uric acid c. Increase in the glycosaminoglycan levels d. Overproduction of proteoglycans |
b. Overproduction of uric acid
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34. People with gout are at high risk for:
a. renal calculi. b. joint trauma. c. anemia. d. hearing loss. |
a. renal calculi.
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35. The pathophysiology of gout is closely linked to the metabolism of:
a. purine. b. pyrimidine. c. vitamin E. d. amino acid. |
a. purine.
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36. True or False The calcium crystals that appear in the cartilage, synovial membranes, tendons, and soft tissue of people with chronic gout are called tophi.
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false (seen in subq tissue)
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37. Clinical manifestations of fibromyalgia include:
a. hot, tender, and edematous muscle groups bilaterally. b. fasciculations of the upper and lower extremity muscles. c. exercise intolerance and painful muscle cramps. d. burning or gnawing pain at multiple tender points and profound fatigue. |
d. burning or gnawing pain at multiple tender points and profound fatigue.
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39. True or False Alcohol abuse is the most common cause of toxic myopathy.
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true
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a. Caused by sedatives and narcotics, particularly street heroin
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Rhabdomyolysis
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b. Caused by viruses, bacteria, and parasites
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Myositis
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c. Exercise intolerance with normal production of lactic acid
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Myoadenylate deaminase deficiency
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d. Impairs the breakdown of glycogen and production of lactic acid
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McArdle disease
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e. Autoimmune disease
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Polymyositis
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1. True or False Bone growth takes place at the same rate at both ends of the bones because they are under hormonal control.
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false
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2. The _____ is cartilage that retains the ability to form and calcify new cartilage and deposit bone until the skeleton matures.
a. epiphyseal line c. epiphyseal cartilage b. physeal plate d. metaphyseal plate |
b. physeal plate
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3. Genu varum(bowlegs) and genu valgum (knock knee) should resolve by which age (respectively)
a. 4 years and 6 years c. 12 months and 3 years b. 30 months and 6 years d. by the time the child is running for both conditions |
b. 30 months and 6 years
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4. The total mass of muscle in the body can be estimated from which serum laboratory test value?
a. Albumin c. Creatinine b. Blood urea nitrogen d. Creatine |
Creatinine
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5. The most common skeletal defect of the upper extremity is:
a. vestigial tabs. c. rickets. b. Paget disease. d. syndactyly |
syndactyly (webbing of fingers)
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6. True or False Treatment for hip dysplasia should be initiated around a year of age when the child begins to walk.
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false (earlier is better)
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7. Which of the following is a very late sign or symptom of developmental dysplasia of the hip (DDH)? (all of the following are signs of hip dysplasia)
a. Asymmetry of the gluteal or thigh folds b. Leg length discrepancy c. Waddling gait d. Pain |
pain
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8. Which serum laboratory test is elevated in all forms of osteogenesis imperfecta?
a. Phosphorus c. Alkaline phosphatase b. Calcium d. total protein |
Alkaline phosphatase
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9. Which disorder is characterized by failure of bones to ossify resulting in soft bones and skeletal deformity?
a. Osteogenesis imperfecta b. Rickets c. Osteochondrosis d. Legg-Calvé-Perthes disease |
b. Rickets
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10. An insufficient dietary intake of vitamin _____ can lead to rickets in children.
a. C b. B12 c. B6 d. D |
vit D
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11. True or False Poor posture results in structural scoliosis.
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false
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12. In scoliosis, curves in the thoracic spine greater than _____ degrees result in decreased pulmonary function.
a. 40 b. 50 c. 60 d. 80 |
80
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13. True or False In osteomyelitis, infection may spread to adjacent joints in the leg because the epiphyseal plate of the proximal femur is located within the hip joint and the distal femur is partially located within the knee.
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true
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14. True or False Staphylococcus aureus may cause osteomyelitis in newborns and older children.
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true
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|
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15. Osteochondrosis is caused by a(n):
a. imbalance between calcitonin and parathyroid hormone. b. nutritional deficiency of calcium and phosphorus. c. bacterial infection of the bone. d. vascular impairment and trauma to bone. |
d. vascular impairment and trauma to bone.
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|
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16. How are the clinical manifestations and onset of JRA different from RA in adults?
a. JRA begins insidiously with systemic signs of inflammation. b. JRA predominantly affects large joints. c. JRA has more severe joint pain than RA. d. JRA has a rapid onset of generalized aches as the first symptom. |
b. JRA predominantly affects large joints.
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17. Which bones are affected in Legg-Calvé-Perthes disease?
a. Heads of the femur b. Distal femurs c. Heads of the humerus d. Distal tibias |
a. Heads of the femur
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18. The pain experienced in Legg-Calvé-Perthes disease is referred to as involving:
a. elbows and upper and lower arms that is aggravated by activity and relieved by rest. b. knees, inner thighs, and groin and is described as a continuous ache and relieved by anti-inflammatory drugs. c. knees, inner thighs, and groin that is aggravated by activity and relieved by rest. d. elbows and upper and lower arms and is described as a continuous ache and relieved by anti-inflammatory drugs. |
c. knees, inner thighs, and groin that is aggravated by activity and relieved by rest.
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19. Osgood-Schlatter disease is characterized by:
a. lateral epicondylitis of the elbow. b. inflammation of the anterior cruciate ligament. c. bursitis of the subscapular bursa in the glenohumeral joint. d. tendinitis of the anterior patellar tendon. |
d. tendinitis of the anterior patellar tendon.
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|
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20. Cerebral palsy is usually a result of:
a. brain ischemia during birth. b. prematurity. c. congenital defects. d. genetic defect. |
a. brain ischemia during birth.
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21. Pulmonary complications in children with Duchenne muscular dystrophy are contributed to by:
a. chronic heart failure. b. kyphoscoliosis. c. impaired formation of alveoli. d. anemia. |
b. kyphoscoliosis.
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23. True or False Bone tumors are uncommon in childhood but of the malignant bone tumors occurring in children, osteosarcomas and Ewing sarcomas are the most common.
|
true
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24. Rhabdomyosarcoma can develop anywhere _____ muscle is located.
a. Cardiac c. Involuntary b. Smooth d. striated |
striated
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Onset at approximately age 3 with rapid progression and frequent mental retardation
|
a. Duchenne muscular dystrophy
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The face is expressionless and pouting of the lips makes whistling impossible.
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b. Facioscapulohumeral muscular dystrophy
|
|
|
Often called benign Duchenne muscular dystrophy because it shares the inheritance link, but produces milder symptoms
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e. Becker muscular dystrophy
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|
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Autosomal dominant with a slow rate of progression and frequent mental retardation.
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d. Myotonic dystrophy
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Distal muscles of the lower extremities are involved causing footdrop.
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c. Scapuloperoneal muscular dystrophy
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