Pathopharmacology Test 2 - Chapters 10, 14, 16 & 17

The situation is a true medical emergency because a single seizure can last more than 30 minutes, resulting in hypoxia of the brain.

Normal ICP is 5 to 15mmHg.

A sudden, explosive, disorderly discharge of cerebral neurons describes a seizure.

Receptive dysphasia may result in expressive deficits.

Aphasia is the loss of speech and comprehension of the written language.

In an AV malformation, arteries feed directly into veins through a vascular tangled of malformed vessels.

Cerebral edema is an increase in the fluid content of the brain tissue; a net accumulation of water within the brain.

Approximately 70% of all tumors diagnosed in children are located infratentorially.

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.

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.

The reticular formation is essential for maintaining wakefulness. The remaining options are not essential to this function.

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.

Cortisol also enhances the elevation of blood glucose promoted by other hormones, such as epinephrine, glucagon, and growth hormone.

The cerebellum is responsible for the conscious and unconscious muscle synergy and for maintaining balance and posture.

Although Hx may be supplemented with the remaining options, it remains the pivotal tool for establishing cause.

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.

Clinical manifestations of posterolateral protrusions include radicular pain exacerbated by movement and straining (medial calf suggests L5, lateral calf suggests S1 root compression).

This type of seizure most often begins in the face and fingers and progressively spreads to other body parts.

Expression of affect (emotional and behavioral states) is mediated by extensive connections with the limbic system and prefrontal cortex.

Broca speech area is responsible for the motor aspects of speech.

Approximately 70% to 75% of all intracranial tumors diagnosed in adults are located supratentorially.

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.

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.

The pineal gland regulates the immune response and mediates the apparent effects of circadian rhythm on immunity.

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.

Norepinephrine regulates blood pressure by constricting smooth muscle in all blood vessels. During stress, norepinephrine raises blood pressure by constricting peripheral vessels.

The medulla oblongata makes up the myelencephalon and is the lowest portion of the brainstem. Reflex activities are controlled in this area.

A complex partial seizure results in impaired consciousness as well as the inability to respond to exogenous stimuli.

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.

A number of stress factors initiate CRH production, including high levels of IL-1 and IL-6.

A flaccid state with little or no motor response to stimuli is characteristic of damage to the pons.

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.

To date there are no specific indicators. Eitiology of the injury and time since onset of injury are the currently used prognostic indicators.

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.

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.

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.

50% of CVAs occur in persons >70. Strokes, however, do occur in a 3:10 ratio (28%) in individuals <65. Stroke tends to run in families. The incidence of stroke is 2.5 times higher in blacks than whites. Stroke prevalence in 2005 for black men was 2.3 million compared to 3.4 million in black women. For the first time ever stroke in blacks is almost twice that of whites.

It is the prefrontal lobe that mediates several cognitive functions, including vigilance, reasoning and executive functions.

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.

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.

The nuclei of cranial nerves IX through XII are located in the medulla oblongata.

The nuclei of the cranial nerves V through VIII are located in the pons.