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

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1. Status epilepticus is considered a medical emergency because of the:

Explanation

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

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About This Quiz
Pharmacology Quizzes & Trivia

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... see morehe created. This quiz is from chapters 10, 14, 16 & 17 in the McCance Pathophisiology E-text.
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2. Normal intracranial pressure is ___mmHg.

Explanation

Normal ICP is 5 to 15mmHg.

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3. A sudden, explosive, disorderly discharge of cerebral neurons is termed:

Explanation

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

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4. ___ is the loss of speech or the loss of comprehension of spoken or written language.

Explanation

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

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5. With receptive dysphasia (fluent), the individual is able to:

Explanation

Receptive dysphasia may result in expressive deficits.

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6. Cerebral edema is an increase in the fluid content of the:

Explanation

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

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7. Which vascular malformation of characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?

Explanation

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

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8. Which hormone increases the formation of glucose from amino acids and free fatty acids?

Explanation

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.

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9. The ___ is a large network of neurons within the brainstem that is essential in maintaining wakefulness

Explanation

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

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10. The ___ has 2 main functions: maintenance of constant internal environment and implementation of behavioral patterns.

Explanation

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.

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11. Which clinical finding is considered a diagnostic indicator for an AVM?

Explanation

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.

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12. In children most intracranial tumors are located:

Explanation

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

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13. What is the effect of increased secretions of epinephrine, glucagon, and growth hormone?

Explanation

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

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14. The ___ is responsible for conscious and unconscious synergy and maintaining balance and posture.

Explanation

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

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15. The most critical aspect in diagnosing a seizure disorder and establishing cause is:

Explanation

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

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16. A seizure that starts with the fingers and progressively spreads up the arm and extends to the leg is known as a(n) ___ seizure.

Explanation

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

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17. A herniation of which disk would likely result in motor and sensory changes of the lateral lower legs and soles of the feet?

Explanation

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

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18. 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.

Explanation

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.

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19. What parts of the brain mediate the expression of affect, both emotional and behavioral states?

Explanation

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

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20. The ___ gland regulates the immune response and mediates the apparent effects of circadian rhythms on immunity

Explanation

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

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21. Where is the region responsible for motor aspects of speech?

Explanation

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

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22. Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke?

Explanation

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.

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23. Which cerebral vascular disorder causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?

Explanation

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.

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24. In adults most intracranial tumors are located:

Explanation

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

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25. Parkinson and Huntington diseases are associated with defects in the:

Explanation

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.

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26. Stress-induced norepinephrine results in:

Explanation

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

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27. The ___ controls reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing, and coughing.

Explanation

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

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28. Elaboration of thought and goal oriented behavior are functions of the ___ area of the brain

Explanation

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.

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29. Which description is consistent with a complex partial seizure?

Explanation

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

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30. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

Explanation

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

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31. Which are clinical manifestations caused by damage to the lower pons?

Explanation

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

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32. Which clinical manifestation is characteristic of cluster headache?

Explanation

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.

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33. Stress-induced cortisol released from the adrenal cortex results in:

Explanation

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.

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34. What is the best prognostic indicator of recovery of consciousness or functional outcome?

Explanation

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

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35. Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?

Explanation

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.

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36. The release of which cytokines is triggered by bacterial or viral infections, cancer, and tissue injury that in turn initiate a stress response?

Explanation

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.

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37. Of the following people, who is at highest risk for a CVA?

Explanation

50% of CVAs occur in persons >70. Strokes, however, do occur in a 3:10 ratio (28%) in individuals

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38. What area of the brain mediates several cognitive functions, including vigilance, reasoning, and executive functions?

Explanation

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

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39. The ability of the eyes to track moving objects through a visual field is primarily a function of the ___ colliculi.

Explanation

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.

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40. Which immune cells are suppressed by corticotropin-releasing hormone (CRH)?

Explanation

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.

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41. From which part of the midbrain do cranial nerves IX through XII emerge?

Explanation

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

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42. From which part of the midbrain do cranial nerves V to VIII emerge?

Explanation

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

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Status epilepticus is considered a medical emergency because of the:
Normal intracranial pressure is ___mmHg.
A sudden, explosive, disorderly discharge of cerebral neurons is...
___ is the loss of speech or the loss of comprehension of spoken or...
With receptive dysphasia (fluent), the individual is able to:
Cerebral edema is an increase in the fluid content of the:
Which vascular malformation of characterized by arteries that feed...
Which hormone increases the formation of glucose from amino acids and...
The ___ is a large network of neurons within the brainstem that is...
The ___ has 2 main functions: maintenance of constant internal...
Which clinical finding is considered a diagnostic indicator for an...
In children most intracranial tumors are located:
What is the effect of increased secretions of epinephrine, glucagon,...
The ___ is responsible for conscious and unconscious synergy and...
The most critical aspect in diagnosing a seizure disorder and...
A seizure that starts with the fingers and progressively spreads up...
A herniation of which disk would likely result in motor and sensory...
A right hemisphere embolic CVA has resulted in left-sided paralysis...
What parts of the brain mediate the expression of affect, both...
The ___ gland regulates the immune response and mediates the apparent...
Where is the region responsible for motor aspects of speech?
Microinfarcts resulting in pure motor or pure sensory deficits are the...
Which cerebral vascular disorder causes meningeal irritation,...
In adults most intracranial tumors are located:
Parkinson and Huntington diseases are associated with defects in the:
Stress-induced norepinephrine results in:
The ___ controls reflex activities concerned with heart rate, blood...
Elaboration of thought and goal oriented behavior are functions of the...
Which description is consistent with a complex partial seizure?
Which cytokines initiate the production of corticotropin-releasing...
Which are clinical manifestations caused by damage to the lower pons?
Which clinical manifestation is characteristic of cluster headache?
Stress-induced cortisol released from the adrenal cortex results in:
What is the best prognostic indicator of recovery of consciousness or...
Atrial fibrillation, rheumatic heart disease, and valvular prosthetics...
The release of which cytokines is triggered by bacterial or viral...
Of the following people, who is at highest risk for a CVA?
What area of the brain mediates several cognitive functions, including...
The ability of the eyes to track moving objects through a visual field...
Which immune cells are suppressed by corticotropin-releasing hormone...
From which part of the midbrain do cranial nerves IX through XII...
From which part of the midbrain do cranial nerves V to VIII emerge?
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