Pathopharmacology Quiz 2 - Stress, Neurologic/Cognitive, Cerebral Hemodynamics, Motor Function, Neuromuscular Junction
Again, Dr. Nmezi gets full credit for creating the quiz. My only intent is to offer others a user-friendly, high-tech medium with which to utilize the Study Guide he created. This quiz covers chapters 10, 14, 16 & 17 in the McCance Pathophysiology E-text.
- 1.
Stress-induced norepinephrine results in:
- A.
Decreased blood flow to the brain and skin
- B.
Peripheral vasoconstriction
- C.
Increased glycogen synthesis in the liver
- D.
Decreased muscle contraction as a result of an energy depletion
Correct Answer
B. PeripHeral vasoconstrictionExplanation
Norepinephrine regulates blood pressure by constricting smooth muscle in all blood vessels. During stress, norepinephrine raises blood pressure by constricting peripheral vessels.Rate this question:
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- 2.
Stress-induced cortisol released from the adrenal cortex results in:
- A.
Stimulation of gluconeogenesis
- B.
Increased lipolysis
- C.
Stimulation of glycogenolysis
- D.
Increased peripheral uptake and use of glucose
Correct Answer
A. Stimulation of gluconeogenesisExplanation
One of the primary effects of cortisol is the stimulation of gluconeogenesis, or the formation of glucose from noncarbohydrate sources, such as amino acids or free fatty acids in the liver.Rate this question:
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- 3.
What is the effect of increased secretions of epinephrine, glucagon, and growth hormone?
- A.
Hyperglycemia
- B.
HTN
- C.
Bronchodilation
- D.
Pupil dilation
Correct Answer
A. HyperglycemiaExplanation
Cortisol also enhances the elevation of blood glucose promoted by other hormones, such as epinephrine, glucagon, and growth hormone.Rate this question:
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- 4.
Which hormone increases the formation of glucose from amino acids and free fatty acids?
- A.
Epinephrine
- B.
Norepinephrine
- C.
Cortisol
- D.
Growth hormone
Correct Answer
C. CortisolExplanation
One of the primary effects of cortisol is the stimulation of gluconeogenesis, or the formation of glucose from noncarbohydrate sources, such as amino or free fatty acids in the liver.Rate this question:
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- 5.
Which immune cells are suppressed by corticotropin-releasing hormone (CRH)?
- A.
B cells and eosinophils
- B.
Cytokines and neutrophils
- C.
Cytotoxic T cells and NK cells
- D.
Helper T cells and monocyte-macrophage cells
Correct Answer
D. Helper T cells and monocyte-macropHage cellsExplanation
Direct suppressive effects of CRH (corticotropin-releasing hormone) have been reported also on two immune cell types possessing CRH receptors - the monocyte/macrophage and CD4 (T helper) lymphocytes.Rate this question:
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- 6.
The ___ gland regulates the immune response and mediates the apparent effects of circadian rhythms on immunity
- A.
Anterior pituitary
- B.
Adrenal
- C.
Basal ganglia
- D.
Pineal
Correct Answer
D. PinealExplanation
The pineal gland regulates the immune response and mediates the apparent effects of circadian rhythm on immunity.Rate this question:
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- 7.
Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?
- A.
IL-1 and IL-6
- B.
IL-2 and TNF-
- C.
IFN and IL-12
- D.
TNF-B and IL-4
Correct Answer
A. IL-1 and IL-6Explanation
A number of stress factors initiate CRH production, including high levels of IL-1 and IL-6.Rate this question:
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- 8.
The release of which cytokines is triggered by bacterial or viral infections, cancer, and tissue injury that in turn initiate a stress response?
- A.
IL-1 and IL-2
- B.
IL-12, TNF-, and colony-stimulating factor
- C.
IFN, TNF-B, and IL-6
- D.
IL-4 and IL-24
Correct Answer
C. IFN, TNF-B, and IL-6Explanation
The release of immune inflammatory mediators IL-6, TNF-B, and interferon is triggered by bacterial or viral infections, cancer and tissue injury that in turn initiates a stress response through the (hypothalamic-pituitary-adrenal) HPA pathway.Rate this question:
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- 9.
The ___ is a large network of neurons within the brainstem that is essential in maintaining wakefulness
- A.
Midbrain
- B.
Reticular Activating System
- C.
Medulla oblongata
- D.
Pons
Correct Answer
B. Reticular Activating SystemExplanation
The reticular formation is essential for maintaining wakefulness. The remaining options are not essential to this function.Rate this question:
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- 10.
Elaboration of thought and goal oriented behavior are functions of the ___ area of the brain
- A.
Thalamic
- B.
Limbic System
- C.
Prefrontal
- D.
Occipital lobe
Correct Answer
C. PrefrontalExplanation
The prefrontal area is responsible for the goal-oriented behavior (i.e. ability to concentrate), short-term memory recall, and the elaboration of thought and inhibition on the limbic (emotional) areas of the CNS. The remaining options are not involved in these functions.Rate this question:
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- 11.
Where is the region responsible for motor aspects of speech?
- A.
Wernicke area in the temporal area
- B.
Broca area in the frontal lobe
- C.
Wronka area in the parietal lobe
- D.
Barlow area in the occipital lobe
Correct Answer
B. Broca area in the frontal lobeExplanation
Broca speech area is responsible for the motor aspects of speech.Rate this question:
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- 12.
Parkinson and Huntington diseases are associated with defects in the:
- A.
Thalamus
- B.
Medulla oblongata
- C.
Cerebellum
- D.
Basal ganglia
Correct Answer
D. Basal gangliaExplanation
Parkinson and Huntington diseases are conditions associated with defects of the basal ganglia. There is no current data to support any role of the other options in these diseases.Rate this question:
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- 13.
The ___ has 2 main functions: maintenance of constant internal environment and implementation of behavioral patterns.
- A.
Thalamus
- B.
Epithalamus
- C.
Subthalamus
- D.
Hypothalamus
Correct Answer
D. HypothalamusExplanation
Hypothalamic function falls into 2 major areas: 1- maintenance of a constant internal environment and 2- implementation of behavioral patterns. These functions are not addressed by the remaining options.Rate this question:
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- 14.
The ability of the eyes to track moving objects through a visual field is primarily a function of the ___ colliculi.
- A.
Inferior
- B.
Superior
- C.
Mid
- D.
Posterior
Correct Answer
B. SuperiorExplanation
The superior colliculi are involved with voluntary and involuntary visual motor movements (e.g. the ability of the eyes to track moving objects in the visual field). This is not the primary function of the remaining options.Rate this question:
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- 15.
What parts of the brain mediate the expression of affect, both emotional and behavioral states?
- A.
Hypothalamus and subthalamus
- B.
Parietal and frontal lobes
- C.
Limbic system and prefrontal cortex
- D.
Basal ganglia
Correct Answer
C. Limbic system and prefrontal cortexExplanation
Expression of affect (emotional and behavioral states) is mediated by extensive connections with the limbic system and prefrontal cortex.Rate this question:
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- 16.
The ___ controls reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing, and coughing.
- A.
Pons
- B.
Midbrain
- C.
Cerebellum
- D.
Medulla oblongata
Correct Answer
D. Medulla oblongataExplanation
The medulla oblongata makes up the myelencephalon and is the lowest portion of the brainstem. Reflex activities are controlled in this area.Rate this question:
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- 17.
From which part of the midbrain do cranial nerves V to VIII emerge?
- A.
Midbrain
- B.
Pons
- C.
Medulla oblongata
- D.
Lateral colliculi
Correct Answer
B. PonsExplanation
The nuclei of the cranial nerves V through VIII are located in the pons.Rate this question:
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- 18.
From which part of the midbrain do cranial nerves IX through XII emerge?
- A.
Midbrain
- B.
Pons
- C.
Medulla oblongata
- D.
Lateral colliculi
Correct Answer
C. Medulla oblongataExplanation
The nuclei of cranial nerves IX through XII are located in the medulla oblongata.Rate this question:
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- 19.
The ___ is responsible for conscious and unconscious synergy and maintaining balance and posture.
- A.
Cerebrum
- B.
Cerebellum
- C.
Diencephalon
- D.
Brainstem
Correct Answer
B. CerebellumExplanation
The cerebellum is responsible for the conscious and unconscious muscle synergy and for maintaining balance and posture.Rate this question:
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- 20.
Which are clinical manifestations caused by damage to the lower pons?
- A.
Abnormal flexion with or without extensor response of the lower extremities
- B.
Abnormal extension response of the upper and lower extremities
- C.
Abnormal extension to the upper extremities and flexion of the lower extremities
- D.
Abnormal flaccid response of the upper and lower extremities
Correct Answer
D. Abnormal flaccid response of the upper and lower extremitiesExplanation
A flaccid state with little or no motor response to stimuli is characteristic of damage to the pons.Rate this question:
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- 21.
What is the best prognostic indicator of recovery of consciousness or functional outcome?
- A.
GCS
- B.
Glasgow Outcome Score
- C.
Etiology of injury and time since onset of coma
- D.
Pupillary reaction and reflective eye movements
Correct Answer
C. Etiology of injury and time since onset of comaExplanation
To date there are no specific indicators. Eitiology of the injury and time since onset of injury are the currently used prognostic indicators.Rate this question:
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- 22.
A sudden, explosive, disorderly discharge of cerebral neurons is termed:
- A.
Reflex
- B.
Seizure
- C.
Epilepsy
- D.
Convulsion
Correct Answer
B. SeizureExplanation
A sudden, explosive, disorderly discharge of cerebral neurons describes a seizure.Rate this question:
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- 23.
Which description is consistent with a complex partial seizure?
- A.
Alternative tonic and clonic movements
- B.
Consciousness is impaired as well as the ability to respond to exogenous stimuli
- C.
Focal motor movement without loss of consciousness
- D.
One seizure followed by another in less than 1 minute
Correct Answer
B. Consciousness is impaired as well as the ability to respond to exogenous stimuliExplanation
A complex partial seizure results in impaired consciousness as well as the inability to respond to exogenous stimuli.Rate this question:
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- 24.
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
Correct Answer
B. Development of cerebral hypoxiaExplanation
The situation is a true medical emergency because a single seizure can last more than 30 minutes, resulting in hypoxia of the brain.Rate this question:
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- 25.
The most critical aspect in diagnosing a seizure disorder and establishing cause is:
- A.
CT scan
- B.
CSF fluid analysis
- C.
Skull x-ray films
- D.
Health Hx
Correct Answer
D. Health HxExplanation
Although Hx may be supplemented with the remaining options, it remains the pivotal tool for establishing cause.Rate this question:
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- 26.
A seizure that starts with 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
Correct Answer
A. Simple partialExplanation
This type of seizure most often begins in the face and fingers and progressively spreads to other body parts.Rate this question:
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- 27.
What area of the brain mediates several cognitive functions, including vigilance, reasoning, and executive functions?
- A.
Limbic
- B.
Prefrontal
- C.
Parietal
- D.
Occipital
Correct Answer
B. PrefrontalExplanation
It is the prefrontal lobe that mediates several cognitive functions, including vigilance, reasoning and executive functions.Rate this question:
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- 28.
___ is the loss of speech or the loss of comprehension of spoken or written language.
- A.
Agnosia
- B.
Aphasia
- C.
Akinesia
- D.
Dysphasia
Correct Answer
B. ApHasiaExplanation
Aphasia is the loss of speech and comprehension of the written language.Rate this question:
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- 29.
With receptive dysphasia (fluent), the individual is able to:
- A.
Respond in writing but not in speech
- B.
Speak back, but not comprehend speech
- C.
Comprehend speech, but not respond verbally
- D.
Respond verbally, but not comprehend speech
Correct Answer
C. Comprehend speech, but not respond verballyExplanation
Receptive dysphasia may result in expressive deficits.Rate this question:
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- 30.
Normal intracranial pressure is ___mmHg.
- A.
5 to 15
- B.
7 to 20
- C.
12 to 14
- D.
80 to 120
Correct Answer
A. 5 to 15Explanation
Normal ICP is 5 to 15mmHg.Rate this question:
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- 31.
Cerebral edema is an increase in the fluid content of the:
- A.
Ventricles
- B.
Brain tissue
- C.
Neurons
- D.
Meninges
Correct Answer
B. Brain tissueExplanation
Cerebral edema is an increase in the fluid content of the brain tissue; a net accumulation of water within the brain.Rate this question:
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- 32.
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-S3
Correct Answer
C. L5-S1Explanation
Clinical manifestations of posterolateral protrusions include radicular pain exacerbated by movement and straining (medial calf suggests L5, lateral calf suggests S1 root compression).Rate this question:
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- 33.
Of the following people, who is at highest risk for a CVA?
- A.
White females >65
- B.
Black females >70
- C.
Black males >65
- D.
White males >70
Correct Answer
B. Black females >70Explanation
50% of CVAs occur in persons >70. Strokes, however, do occur in a 3:10 ratio (28%) in individualsRate this question:
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- 34.
A right hemisphere embolic CVA has resulted in left-sided paralysis and reduced sensation of the left foot and leg. The vessel most likely affected by the emboli is the right ___ artery.
- A.
Middle cerebral
- B.
Vertebral
- C.
Posterior cerebral
- D.
Anterior cerebral
Correct Answer
D. Anterior cerebralExplanation
Symptomatology of an embolic stroke in the right anterior cerebral artery would include left-sided contralateral paralysis or paresis (greater in foot and thigh) and mild upper extremity weakness with mild contralateral lower extremity sensory deficiency with loss of vibratory and/or position sense and loss of 2 point discrimination.Rate this question:
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- 35.
Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
- A.
Hemorrhagic
- B.
Thrombotic
- C.
Embolic
- D.
Lacunar
Correct Answer
C. EmbolicExplanation
High risk sources for the onset of embolic stroke are Afib (15%-20% of strokes), LV aneurysm or thrombus, left atrial thrombus, MI, rheumatic valvular disease, mechanical prosthetic valve, nonbacterial thrombotic endocarditis, bacterial endocarditis, PFO, and primary intracrdiac tumors.Rate this question:
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- 36.
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
Correct Answer
C. LacunarExplanation
A lacunar stroke (lacunar infarct) is a microinfarct smaller than 1cm in diameter. Because of the subcortical location and small area of infarction, these strokes may have pure motor and sensory deficits.Rate this question:
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- 37.
Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?
- A.
Cavernous angioma
- B.
Capillary telangiectasia
- C.
Arteriovenous angioma
- D.
Arteriovenous malformation
Correct Answer
D. Arteriovenous malformationExplanation
In an AV malformation, arteries feed directly into veins through a vascular tangled of malformed vessels.Rate this question:
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- 38.
Which clinical finding is considered a diagnostic indicator for an AVM?
- A.
Systolic bruit over the carotid artery
- B.
Decreased LOC
- C.
HTN with bradycardia
- D.
Diastolic bruit over the temporal artery
Correct Answer
A. Systolic bruit over the carotid arteryExplanation
A systolic bruit over the carotid artery in the neck, the mastoid process, or (in a young person) the eyeball is almost always the diagnostic of an AVM.Rate this question:
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- 39.
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
Correct Answer
B. Subarachnoid hemorrhageExplanation
Assessment findings related to a subarachnoid hemorrhage include meningeal irritation and inflammation causing neck stiffness (nuchal rigidity), photophobia, blurred vision, irritability restlessness, and low grade fever. A (+) Kernig sign (in which straightening the knee with the hip and knee in a flexed position produces pain in the back and neck regions) and Brudzinski sign (in which passive flexion of the neck produces neck pain and increased rigidity) may appear.Rate this question:
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- 40.
Which clinical manifestation is characteristic of cluster headache?
- A.
Aura before the HA with photophobia and N/V
- 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 HA with intermittent burning sensation
Correct Answer
B. Severe unilateral tearing, burning, or temporal painExplanation
The HA attack usually begins without warning and is characterized by severe, unilateral tearing, burning, periorbital and retrobullar or temporal pain lasting 30 minutes to 2 hours.Rate this question:
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- 41.
In adults most intracranial tumors are located:
- A.
Above the tentorium cerebelli (supratentorially)
- B.
Below the tentorium cerebelli (infratentorially)
- C.
Laterally
- D.
Posterolaterally
Correct Answer
A. Above the tentorium cerebelli (supratentorially)Explanation
Approximately 70% to 75% of all intracranial tumors diagnosed in adults are located supratentorially.Rate this question:
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- 42.
In children most intracranial tumors are located:
- A.
Above the tentorium cerebelli (supratentorially)
- B.
Below the tentorium cerebelli (infratentorially)
- C.
Laterally
- D.
Posterolaterally
Correct Answer
B. Below the tentorium cerebelli (infratentorially)Explanation
Approximately 70% of all tumors diagnosed in children are located infratentorially.Rate this question:
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Mar 19, 2023Quiz Edited by
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