Pathology: Chap 19

Front 1

True or false?

Axons receive signals between neurons, anddendrites send out signals between neurons.

Back 1

False: The opposite is true.

Front 2

True or false?

Ependymal cells line the cerebral ventricles.

Back 2

True

Front 3

In addition to the nervous system, what is the other primaryinternal communication system?

Back 3

Endocrine system

Front 4

What cell type is responsible for making myelin in the centralnervous system?

Back 4

Oligodendrocytes

Front 5

True or false?

Every part of the brain has the same basicfunction as another part of the brain.

Back 5

False: Although true for other tissues, the brain has different functions in each area.

Front 6

True or false?

The cerebellum lies above the tentorium cerebelli.

Back 6

False: It lies below.

Front 7

What structure in the brain is responsible for communicationbetween the cerebral hemispheres?

Back 7

Corpus callosum

Front 8

In what layer of brain do the higher functions occur?

Back 8

The cortex

Front 9

True or false?

There are 32 pairs of spinal nerves.

Back 9

False: There are 31.

Front 10

True or false?

The sympathetic nervous response is also called“fight-or-flight” response.

Back 10

True

Front 11

What are the two components of the autonomic nervous system(ANS)?

Back 11

Sympathetic & parasympathetic nervous systems

Front 12

The ______ roots of the spinal nerves areresponsible for motor function, while the _______ roots of the spinalnerves are responsible for sensory function.

Back 12

Ventral, dorsal

Front 13

True or false?

Hydrocephalus ex vacuo is due to decreasedbrain volume, rather than increased CSF pressure.

Back 13

True

Front 14

True or false?

Hyponatremia causes cerebral edema.

Back 14

True, among other causes

Front 15

What are the three main types of herniation of the brain?

Back 15

Subfalcine, tentorial, and tonsillar

Front 16

Increased intracranial pressure can be seen during an eyeexam. What is the term for this finding?

Back 16

Papilledema

Front 17

True or false?

Most cases of cerebral palsy are due to prebirthconditions.

Back 17

True

Front 18

Name two neural tube defects.

Back 18

Spina bifida, meningomyelocele

Front 19

True or false?

Most adults who have a seizure will haveanother one.

Back 19

False: Two-thirds will not have another.

Front 20

True or false?

A concussion is brain injury that lasts for a longperiod of time.

Back 20

False: It is a temporary injury

Front 21

True or false?

Contrecoup contusion occurs on the side of thebrain opposite the blunt force trauma.

Back 21

True

Front 22

What are the three main types of intracranial bleeds?

Back 22

-Epidural hematoma,

-Subdural hematoma

-Subarachnoid hemorrhage

Front 23

True or false?

Transient ischemic attacks last only minutes orhours.

Back 23

True

Front 24

Hypertension is most closely associated with which type ofintracranial bleed?

Back 24

Intracerebral hemorrhage

Front 25

True or false?

Twenty percent (20%) of the population hassaccular aneurysms but only a small portion develop bleeding.

Back 25

False: 2%

Front 26

Global hypoxia of the brain can lead to______________, a type of damage that occurs after restoration ofblood supply.

Back 26

laminar cortical necrosis

Front 27

True or false?

Brain abscesses can come from infected sinuses.

Back 27

True

Front 28

Viral infections can occur in the CNS; for example, thetemporal lobes are infected by ______________, while the brainstemmotor neurons are infected by ____________.

Back 28

herpesvirus,poliovirus

Front 29

What two groups are especially at risk for developingmeningococcal meningitis and should get a vaccine to help prevent the disease?

Back 29

-College freshmen

-Military recruits

Front 30

True or false?

Prions, like viruses, have DNA or RNA.

Back 30

False: Prions are only protein.

Front 31

True or false?

Oligodendrocytes produce myelin.

Back 31

True

Front 32

True or false? Multiple sclerosis affects mostly men.

Back 32

False: Women are more likely to be affected.

Front 33

What is the rare demyelinating disorder caused by rapidcorrection of hyponatremia?

Back 33

Central pontine myelinolysis

Front 34

What substance causes brain injury in Wilson’s disease?

Back 34

Copper

Front 35

Give two examples of lysosomal storage disorders.

Back 35

Gaucher’s, Hurler’s, Tay-Sach’s, Niemann-Pick’s

Front 36

True or false?

PKU is treated by lifelong restriction ofphenylalanine.

Back 36

True

Front 37

True or false?

Hyperglycemia and ketoacidosis from diabetescan cause neurologic symptoms including coma.

Back 37

True

Front 38

True or false?

Alzheimer’s disease is the most common cause ofadult dementia.

Back 38

True

Front 39

What diagnosis is generally made before the onset ofAlzheimer’s disease?

Back 39

Mild cognitive impairment (MCI)

Front 40

True or false?

Parkinson’s is caused by degeneration ofneurons in the cortex.

Back 40

False: Basal ganglia

Front 41

What neurodegenerative disorder primarily affects the motorneurons?

Back 41

Amyotrophic lateral sclerosis (Lou Gehrig’s disease)

Front 42

True or false?

Most brain tumors are primary brain tumors.

Back 42

False: Most are metastatic

Front 43

What is the term for the highest grade of astrocytic tumorsaccording to the World Health Organization (WHO)?

Back 43

Glioblastoma multiforme

Front 44

Ascending paralysis that can occur after an infection is called_____________________.

Back 44

Guillain-Barré syndrome

Front 45

True or false?

Acoustic neuromas seen in neurofibromatosis,type 2 (NF2) are actually schwannomas.

Back 45

True

Front 46

A 72-year-old Caucasian female is brought to her primary physician’s office by herson after becoming lost in her own home. She enters the room with a marked shuffling gait.A review of systems is positive for incontinence but is otherwise unremarkable; she deniesthe presence of tremor. A CT shows enlarged ventricles. What is the most likely etiology forher constellation of symptoms?

A. MS

B. Parkinsonism

C.Alzheimer

D. Normal pressure hydrocephalus

Back 46

D. Normal pressure hydrocephalus

Front 47

Which is the most likely cause of acute purulent meningitis in a two-year-old?

A. Escherichia Coli

B. Strep. Pneumoniae

C. Haemophilus influenza

D. Neisseria meningitidis

Back 47

C. Haemophilus influenza

Front 48

A 22-year-old Hispanic male is brought to the emergency department following amotor vehicle accident in which he was an unrestrained passenger. He is conscious on exam,and complains of double vision. A quick exam reveals a dilated right pupil and impairedocular movement. What has caused his symptoms?

A. Herniation of the brain stem through the foramen magnum

B. Herniation of the ipsilateral side of the temporal lobe through the tentoriu

C. Herniation of the lower medial aspect of the hemisphere under the falx cerebri

D. None of the above

Back 48

B. Herniation of the ipsilateral side of the temporal lobe through the tentoriu

Front 49

What type of edema is caused by diabetic ketoacidosis?

A. Vasogenic edma

B. Cytotoxic edema

C. Both of he above

D. None of the above

Back 49

B. Cytotoxic edema

Front 50

A 10-year-old Caucasian male is brought to the ER by his parents after they wereunable to wake him up for dinner. Earlier in the afternoon, he’d been hit in the side of thehead by a baseball. He was only unconscious for approximately 30 seconds, but when hewoke up, he claimed he was fine. What vessel was damaged?

A. Middle meningeal artery

B. A bridging vein

C. Carotid artery

D. Basilar artery

Back 50

A. Middle meningeal artery

Front 51

Which of the following tumors arises from ependymal cells lining the ventricles?

A. Ependymomas

B. Subependymomas

C. Glioblastomas

D. Medulloblastomas

Back 51

A. Ependymomas

Front 52

A nine-month-old African American male is seen at his pediatrician’s office forfailure to meet motor milestones. Physical exam reveals abnormal muscle tone and limbspasticity. His past medical history is significant for prematurity with a low birth weight andhyperbilirubinemia. What is your diagnosis?

A.Epilepsy

B. Cerebral palsy

C. Arnold chiari malformation

D. Agyria

Back 52

B. Cerebral palsy

Front 53

Your mother calls you concerned that your 50-year-old father may be having a stroke.She reports that he cannot close his right eye, raise his right eyebrow, or smile with the righthalf of his mouth. She tells you that, though his speech is garbled, he is understandable; shedenies additional symptoms. From which neurological condition does he suffer?

A. Guillain Barre

B.Amyotrophic lateral sclerosis

C. Bell’s palsy

D. MS

Back 53

C. Bell’s palsy

Front 54

Which hereditary disease features accumulation of glucocerebroside in macrophagesand/or neurons?

A. Tay Sachs

B. Cerebral palsy

C. Hurler

D. Gaucher’s

Back 54

D. Gaucher’s

Front 55

Reviewing the history of your recently deceased 45-year-old patient, you notice thathis dementia, personality changes, and physical limitations progressed in a stepwise fashion,with distinct declines in function every few months. What is the most likely cause of thisrapidly progressing disease?

A. AD

B. Frontotemporal dementia

C. vCJD

D. Vascular dementia

Back 55

D. Vascular dementia

Front 56

Which of the following cells makes cerebral spinal fluid?

A. Astrocytes

B. Oligodendrogliomas

C. Ependymal cells

D. Microglia

Back 56

C. Ependymal cells

Front 57

A 24-year-old female visits her campus clinic complaining of new-onset blurryvision in one eye. Six months prior, she had come to the clinic complaining of weakness andspasticity in her right leg. Oligoclonal bands of immunoglobulin were identified in her CSF,confirming your suspicions. From what disease does she suffer?

A. Multiple sclerosis

B. Guillain Barre

C. Amyotrophic lateral sclerosis

D. TIAS

Back 57

A. Multiple sclerosis

Front 58

Autopsy on a 65-year-old Caucasian female with a past medical history of dementiareveals general atrophy of the cerebral cortex with narrowed gyri and broad sulci as well asneurofibrillary tangles and plaques of amyloid-like protein on histology. What was the causeof her dementia?

A. Alzheimer’s disease

B. Parkinson Disease

C. Lewy body dementia

D. Huntington disease

Back 58

A. Alzheimer’s disease

Front 59

Progressive multifocal leukoencephalopathy is a form of fatal encephalitis caused bywhich of the following viruses?

A. CMV

B. Herpesvirus

C. JC virus

D. Arbovirus

Back 59

C. JC virus

Front 60

A 55-year-old Hispanic female is worked up for new-onset seizures. Her MRIreveals a solitary lesion in the parasagittal region that appears to be growing on the surface ofthe brain. What type of tumor does she have?

A. Glioblastoma multiforme

B. Meningioma

C. Astrocytoma

D. Oligodendroglioma

Back 60

B. Meningioma

Front 61

A 43-year-old Caucasian woman is brought to the clinic by her husband. Her illnessbegan several years earlier with increased nervousness, irritability, and depression and hadprogressed to include a jerky gait with strange dance-like movements of her upper and lowerextremities. Her family history was significant for a mother with similar symptoms andpsychosis who died at 45 shortly after being committed to an asylum. What is her diagnosis?

A. Parkinsonism

B. Parkinson disease

C. CJD

D. Huntington’s disease

Back 61

D. Huntington’s disease

Front 62

A 65-year-old Caucasian male’s physical exam is remarkable for an emotionlessfacial expression, stooped posture, a shuffling gait, and a slow, coarse, resting tremor of hisright hand. Where is his lesion and what medication can be used to treat his disease?

A. Substantia nigra, L-dopa

B. Basal ganglia, supportive treatment

C. Frontal cortex, supportive treatment

D. Wenicke area, L-dopa

Back 62

A. Substantia nigra, L-dopa

Front 63

True or false?

Neurons do not divide; therefore, diseased or dead neurons cannot bereplaced.

Back 63

True

Front 64

True or false?

About 25% of patients who have a TIA have a nonhemorrhagic infarctwithin five years.

Back 64

True

Front 65

True or false?

Respiratory failure is the leading cause of death in a patient sufferingfrom amyotrophic lateral sclerosis.

Back 65

True

Front 66

True or false?

Aseptic meningitis is acute inflammation of the meninges caused bysomething other than an infectious agent.

Back 66

False: Aseptic meningitis is caused by a virus, and is only referred to as aseptic because bacterial cultures are negative.

Front 67

True or false?

In patients with CNS trauma caused by a penetrating object, thedisruption of tissue is the leading contribution to patient morbidity and mortality.

Back 67

False: The velocity of a penetrating object contributes to blast effect, which is far more deadly as it can cause immediate death by herniating the cerebellar tonsils through the foramen magnum.

Front 68

True or false?

The most common leukodystrophy is metachromatic leukodystrophy.

Back 68

True

Front 69

Match the following anatomic locations to their characteristics below:

i: Cortex

ii: Nerve tracts

iii: Brain stem

iv: Midbrain

v: Pons

vi: Medulla oblongata

vii: Cerebellum

viii: Dura

ix: Arachnoid

x: Pia

xi: Falx cerebri

xii: Tentorium cerebelli

xiii: Choroid plexus

xiv: Arachnoid granulations

A. The innermost meningeal membrane

B. Uppermost part of the brain stem, important in eye movement and hearing

C. Responsible for carrying electrical signals between the brain and body

D. Lowest part of the brainstem, modulates heart rate and blood pressure

E. Responsible for absorbing CSF

F. Composed of the midbrain, pons, and medulla oblongata

G. Dura mater that encloses the superior sagittal sinus

H. Thick sheet of fibrous tissue stuck to skull and surrounding the spinal cord

I. Home to reasoning, emotion, voluntary motion, and speech

J. The dura separating the cerebral hemisphere from the cerebellum

K. Middle and largest part of the brain stem, important in respiration

L. Mediates balance, fine motor activity, and proprioceptive sense

M. Thin membrane between dura and subarachnoid space

N. Responsible for the production of CSF

Back 69

A. The innermost meningeal membrane = x: Pia

B. Uppermost part of the brain stem, important in eye movement and hearing = iv: Midbrain

C. Responsible for carrying electrical signals between the brain and body = ii: Nerve tracts

D. Lowest part of the brainstem, modulates heart rate and blood pressure = vi: Medulla oblongata

E. Responsible for absorbing CSF = xiv: Arachnoid granulations

F. Composed of the midbrain, pons, and medulla oblongata = iii: Brain stem

G. Dura mater that encloses the superior sagittal sinus = xi: Falx cerebri

H. Thick sheet of fibrous tissue stuck to skull and surrounding the spinal cord = viii: Dura

I. Home to reasoning, emotion, voluntary motion, and speech = i: Cortex

J. The dura separating the cerebral hemisphere from the cerebellum = xii: Tentorium cerebelli

K. Middle and largest part of the brain stem, important in respiration = v: Pons

L. Mediates balance, fine motor activity, and proprioceptive sense = vii: Cerebellum

M. Thin membrane between dura and subarachnoid space = ix: Arachnoid

N. Responsible for the production of CSF = xiii: Choroid plexus