Regional - Quiz 1

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  • 1/66 Questions

    Mrs. Terren is still having pain in her elbow. She broke it 6 months ago and the cast has been off for 4 months. The X-rays all say it is healed but it still hurts her on a regular basis. How would you classify this type of pain?

    • Acute Somatic Pain
    • Chronic Pain
    • Acute Visceral
    • None of above
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Pain Management Quizzes & Trivia
About This Quiz

Review of material for test one going over pain pathways and pain management.

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  • 2. 

    A and B fibers are __________ while C fibers are _________.

    • Unmyelinated, myelinated

    • Slow, Fast

    • Myelinated, unmyelinated

    • Thin, thick

    Correct Answer
    A. Myelinated, unmyelinated
    Explanation
    A fibers and B fibers are myelinated, meaning they are surrounded by a protective layer called myelin. This allows for faster transmission of signals along these nerve fibers. On the other hand, C fibers are unmyelinated, meaning they lack this protective layer. This results in slower transmission of signals along C fibers compared to A and B fibers.

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  • 3. 

    Which of the ascending pathways innervates the peripheral tissue and sends stimuli to the dorsal horn?               

    • First Order neurons

    • Second Order Neurons

    • Third Order Neurons

    • All The Above

    Correct Answer
    A. First Order neurons
    Explanation
    First order neurons are responsible for carrying sensory information from the peripheral tissue to the dorsal horn of the spinal cord. They transmit stimuli such as pain, temperature, and touch from the sensory receptors in the periphery to the central nervous system. Second order neurons then relay this information from the spinal cord to the brain, while third order neurons carry the information from the thalamus to the appropriate sensory cortex in the brain. Therefore, the ascending pathway that innervates the peripheral tissue and sends stimuli to the dorsal horn is the first order neurons.

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  • 4. 

    Which of the following is not an alogen?

    • Bradykinin

    • Serotonin

    • Histamine

    • Epinephrine

    Correct Answer
    A. Epinephrine
  • 5. 

    Which of the ascending pathways sends stimuli  from the thalamus to the postcentral gyrus?               

    • First order Neurons

    • Second order Neurons

    • Third order Neurons

    • All the Above

    Correct Answer
    A. Third order Neurons
    Explanation
    The ascending pathways are responsible for transmitting sensory information from the body to the brain. The postcentral gyrus is the primary somatosensory cortex, where sensory information is processed. The thalamus acts as a relay station for sensory information, receiving signals from the peripheral nerves and sending them to the appropriate areas of the cerebral cortex. The third order neurons in the ascending pathways carry the sensory information from the thalamus to the postcentral gyrus, where it is further processed and interpreted. Therefore, the correct answer is "Third order Neurons."

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  • 6. 

    Which area of the parietal cortex received noxious stimuli from third order neurons?

    • PostCentral Gyrus

    • Limbic System

    • Amygdala

    • Medulla

    Correct Answer
    A. PostCentral Gyrus
  • 7. 

    Which of the following has the incorrect pairing of neuron and its location?

    • First order neurons - from peripheral tissue to dorsal horn

    • Second order neurons - from dorsal horn to thalamus

    • Third order neurons - from thalamus to post central gyrus

    • All of the above are correct

    Correct Answer
    A. All of the above are correct
    Explanation
    This question is asking about the pairing of neurons and their locations. The correct answer is "All of the above are correct." This means that all of the pairings mentioned in the question are incorrect. According to the question, first order neurons should transmit signals from peripheral tissue to the dorsal horn, second order neurons should transmit signals from the dorsal horn to the thalamus, and third order neurons should transmit signals from the thalamus to the postcentral gyrus. However, all of these pairings are incorrect.

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  • 8. 

    Which of the following is incorrect regarding pain fibers?

    • A delta fibers are fast, sharp, myelinated, and well-localized

    • All A fibers (alpha, beta, gamma, and delta) are myelinated

    • C fibers are non-myelinated, slow, and poorly localized.

    • A fibers are responsible for throbbing, aching postop pain

    Correct Answer
    A. A fibers are responsible for throbbing, aching postop pain
    Explanation
    A fibers are not responsible for throbbing, aching postop pain. This is incorrect because A fibers are fast, sharp, myelinated, and well-localized, and they are not associated with throbbing, aching pain. Throbbing, aching pain is typically associated with C fibers, which are slow, non-myelinated, and poorly localized.

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  • 9. 

    Which of the ascending pathways cross the spinal cord and ascend on the contralateral tract?

    • First Order Neurons

    • Second Order Neurons

    • Third Order Neurons

    • All The Above

    Correct Answer
    A. Second Order Neurons
    Explanation
    Second order neurons are the ones that cross the spinal cord and ascend on the contralateral tract. This is because these neurons receive input from the first order neurons, which enter the spinal cord on the same side, and then cross over to the opposite side of the spinal cord before ascending to the brain. Therefore, the correct answer is Second Order Neurons.

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  • 10. 

    You are doing a glucose check on a patient. After you prick his finger he falls to the ground writhing in pain.  He calls you a bastard and claims this is the worst pain of his entire life, he mutters something about the Geneva convention but it is muffled by the tears. Sure, it was a noxious stimuli but this response is highly exaggerated. What is this an example of?

    • Radiculopathy

    • Anesthesia Dolorosa

    • Allodynia

    • Hyperalgesia

    Correct Answer
    A. Hyperalgesia
    Explanation
    Hyperalgesia refers to an increased sensitivity to pain, resulting in a heightened response to a painful stimulus. In this scenario, the patient's reaction to a simple finger prick is excessive and disproportionate, indicating hyperalgesia. The term "noxious stimuli" mentioned in the question further supports this explanation, as hyperalgesia specifically involves an amplified response to painful stimuli. The other options (radiculopathy, anesthesia dolorosa, and allodynia) do not accurately describe the exaggerated pain response exhibited by the patient.

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  • 11. 

    Nociceptive nerve ending will respond to all of the following except….

    • Heat damage

    • Mechanical damage

    • Disease damage

    • Chemical damage

    Correct Answer
    A. Disease damage
  • 12. 

    You have blister on your heel from trying to break in a new pair of shoes. You feel a very well localized, sharp and burning pain when anything touches the blister. What type of pain is this?

    • Acute Deep Somatic

    • Acute True Visceral pain

    • Acute true Parietal pain

    • Acute Superficial somatic pain

    Correct Answer
    A. Acute Superficial somatic pain
  • 13. 

    How are facial first order neurons different from other first order neurons?

    • Are carried by facial nerves to the brain stem where they synapse with second order neurons.

    • Synapse with second order neurons in the dorsal horn

    • Are much thicker and transmit non painful stimuli

    • None of above

    Correct Answer
    A. Are carried by facial nerves to the brain stem where they synapse with second order neurons.
  • 14. 

    Which of the following would be most painful?

    • Surgical incision into the kidney

    • A surgical incision into the skin

    • Both are equally painful

    Correct Answer
    A. A surgical incision into the skin
    Explanation
    A surgical incision into the skin would be more painful than a surgical incision into the kidney. The skin has a higher concentration of nerve endings compared to the kidney, making it more sensitive to pain. Additionally, the skin is directly exposed to the external environment, which can lead to increased pain sensation due to factors such as pressure, temperature, and touch. On the other hand, the kidney is located deep inside the body and is protected by layers of tissue, which can help to dampen the pain sensation.

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  • 15. 

    You are the SRNA today Mr. Payne. You have just given him a dose of opioids post op when your preceptor asks what the major site of action for opioids is. What is your response?

    • Lamina I

    • Lamina V

    • Lamina IV

    • Lamina II

    Correct Answer
    A. Lamina II
  • 16. 

    Which of the following acts on arachidonic acid to convert it to prostacyclins and PGE?

    • Lipoxygenase

    • Factor XII

    • Phospholipase A

    • Cyclooxygenase

    Correct Answer
    A. Cyclooxygenase
    Explanation
    Cyclooxygenase is the correct answer because it is an enzyme that acts on arachidonic acid to convert it to prostacyclins and PGE. Cyclooxygenase is involved in the synthesis of prostaglandins, which are important mediators of inflammation, pain, and fever. It catalyzes the conversion of arachidonic acid into prostaglandin H2, which is then further metabolized into various prostaglandins including prostacyclins and PGE.

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  • 17. 

    Which form of nociceptor would respond to the pain associated  a pinch or pinprick?

    • Mechanonociceptor

    • Silent Nociceptor

    • Polymodal mechoheat nociceptors

    • Somatic Nociceptors

    Correct Answer
    A. Mechanonociceptor
  • 18. 

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    • Wow, she actually though that was english?

    • Ken Leeeeeeeee!!!!!

    • Stupid pixar removed their cartoons from you tube.....

    • All the above

    Correct Answer
    A. All the above
  • 19. 

    Substance P works on what receptors to facilitate transmission of pain?

    • Mu receptors

    • Lamina 2 receptors

    • NK-1 receptors

    • P45 receptors

    Correct Answer
    A. NK-1 receptors
  • 20. 

    Which type of nerve fiber would most likely be used to transmit pain associated with an IV stick?               

    • A alpha fibers

    • C Fibers

    • A delta fibers

    • D fiber

    Correct Answer
    A. A delta fibers
  • 21. 

    The absence of all sensation is known as:

    • Hypoalgesia

    • Analgesia

    • Parasthesia

    • Anesthesia

    Correct Answer
    A. Anesthesia
  • 22. 

    Which of the following does not enhance pain transmission?

    • Histamine

    • Serotonin

    • Prostaglandins

    • Norepinephrine

    Correct Answer
    A. Norepinephrine
  • 23. 

    Mrs. Terren broke her elbow last week when she tripped over her son’s toys in the middle of the night. She is still having dull and aching pain in that elbow, even after it was set and put into a cast. How would you classify this type of pain?

    • Acute Deep Somatic Pain

    • Acute Visceral Pain

    • Chronic Pain

    • Acute Superficial Somatic Pain

    Correct Answer
    A. Acute Deep Somatic Pain
  • 24. 

    Which enzyme acts on phospholipids to turn them into arachidonic acid?

    • Prostaglandin E

    • Cyclo-oxygenase

    • Phospholipase A

    • Lipoxygenase

    Correct Answer
    A. Phospholipase A
    Explanation
    Phospholipase A is the enzyme that acts on phospholipids to convert them into arachidonic acid. This enzyme specifically cleaves the fatty acid chain from the sn-2 position of the phospholipid molecule, releasing arachidonic acid. Arachidonic acid is a precursor for the synthesis of various bioactive molecules, including prostaglandins and leukotrienes, which play important roles in inflammation and other physiological processes.

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  • 25. 

    The lipoxygenase pathway acts on arachidonic acid to convert it into what?

    • Leukotrienes

    • Prostacyclins

    • Prostaglandin E

    • Bradykinin

    Correct Answer
    A. Leukotrienes
    Explanation
    The lipoxygenase pathway is responsible for converting arachidonic acid into leukotrienes. Leukotrienes are inflammatory mediators that play a role in various physiological processes, including allergic reactions and asthma. They are involved in the contraction of smooth muscle, increased vascular permeability, and recruitment of immune cells to the site of inflammation. Therefore, the conversion of arachidonic acid into leukotrienes is an important step in the inflammatory response.

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  • 26. 

    Which form of nociceptor would be involved in feeling heat when holding your hand over a candle?               

    • Mechanonociceptor

    • Silent Nociceptor

    • Polymodal mechoheat nociceptors

    • Somatic Nociceptors

    Correct Answer
    A. Polymodal mechoheat nociceptors
  • 27. 

    What is parasthesia?

    • Functional abnormality of one or more nerve roots

    • Abnormal sensation perceived without an apparent stimulus

    • Pain in the distribution of a nerve or a group of nerves.

    • Pain in an area the lacks sensation

    Correct Answer
    A. Abnormal sensation perceived without an apparent stimulus
    Explanation
    Parasthesia refers to an abnormal sensation that is perceived without any apparent stimulus. This means that individuals experience sensations such as tingling, numbness, or a "pins and needles" feeling without any external cause. It is important to note that parasthesia can occur due to various underlying causes, including nerve damage or compression, certain medical conditions, or side effects of medication.

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  • 28. 

    What  is neuropathic pain?

    • Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.

    • Pain that results directly from a disease process.

    • Pain causes by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli.

    • None of the above

    Correct Answer
    A. Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.
    Explanation
    Neuropathic pain refers to pain that is caused by damage or abnormalities in the nerves of the peripheral or central nervous system. This type of pain can occur as a result of injury, trauma, or certain medical conditions. It is different from pain that directly arises from a disease process or from the activation of peripheral nociceptors. Therefore, the correct answer is "Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures."

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  • 29. 

    The arachidonic acid is produced from….

    • Histamine released from mast cells

    • Phospholipids released from damaged cell membranes

    • Release of alogens from damaged cells

    • Bradykinin released from tissues

    Correct Answer
    A. Phospholipids released from damaged cell membranes
    Explanation
    Arachidonic acid is a fatty acid that is produced from phospholipids, which are a major component of cell membranes. When cell membranes are damaged, phospholipids are released and can be converted into arachidonic acid. This conversion is catalyzed by enzymes such as phospholipase A2. Therefore, the correct answer is "Phospholipids released from damaged cell membranes."

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  • 30. 

    Which of the following is the major neurotransmitter released from C fibers?

    • Glutamate

    • Substance P

    • Dynorphin

    • Capsaicin

    Correct Answer
    A. Substance P
  • 31. 

    What is Radiculopathy?

    • Functional abnormality of one or more nerve roots

    • Abnormal sensation perceived without an apparent stimulus

    • Pain in the distribution of a nerve or a group of nerves.

    • Pain in an area the lacks sensation

    Correct Answer
    A. Functional abnormality of one or more nerve roots
  • 32. 

    Which of the following is not a systemic effect associated with acute pain?

    • Decreased minute ventilation and CO2 production

    • HTN and increased myocardial irritability

    • Decreased intestinal and urinary motility

    • Hypercoagulability

    Correct Answer
    A. Decreased minute ventilation and CO2 production
    Explanation
    Acute pain can cause various systemic effects, such as increased blood pressure (HTN) and myocardial irritability, decreased intestinal and urinary motility, and hypercoagulability. However, it does not typically lead to decreased minute ventilation and CO2 production. Acute pain usually triggers an increase in respiratory rate and depth, resulting in increased minute ventilation and CO2 elimination.

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  • 33. 

    Which form of nociceptor would transmit the pain associated an inflamed gallbladder?

    • Mechanonociceptor

    • Silent Nociceptor

    • Polymodal mechoheat nociceptors

    • Somatic Nociceptors

    Correct Answer
    A. Silent Nociceptor
  • 34. 

    Which of the following is the major neurotransmitter released from A delta fibers?

    • Glutamate

    • Substance P

    • Dynorphin

    • Capsaicin

    Correct Answer
    A. Glutamate
  • 35. 

    Unpleasant or abnormal sensation with or without a stimulus, as commonly seen in diabetics is known as:

    • Hyperalgesia

    • Dysesthesia

    • Anesthesia Dolorosa

    • Radiculopathy

    Correct Answer
    A. Dysesthesia
    Explanation
    Dysesthesia refers to an unpleasant or abnormal sensation that can occur with or without a stimulus. It is commonly observed in individuals with diabetes. This condition is characterized by sensations such as burning, tingling, or numbness, which can be quite uncomfortable for the affected individual. Hyperalgesia refers to an increased sensitivity to pain, anesthesia dolorosa refers to painful numbness, and radiculopathy refers to nerve root damage. However, neither of these terms specifically captures the broader range of abnormal sensations experienced in dysesthesia.

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  • 36. 

    Dimiished response to a noxious stimulus is known as:

    • Radiculopathy

    • Dysesthesia

    • Hypalgesia

    • Parasthesia

    Correct Answer
    A. Hypalgesia
    Explanation
    Hypalgesia refers to a diminished response to a noxious stimulus. It is a condition where the individual experiences reduced sensitivity to painful stimuli. This can be caused by various factors such as nerve damage, certain medications, or neurological disorders. Unlike radiculopathy, which involves compression or irritation of the nerve roots, hypalgesia specifically relates to a decreased perception of pain. Dysesthesia refers to abnormal sensations, and paresthesia refers to abnormal tingling or prickling sensations.

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  • 37. 

    When you combine hyperesthesia, allodynia, and hyperalgesia what do you get?

    • Hyperpathia

    • Radiculopathy

    • Hyperneuralgia

    • Acute Polyradiculopathy

    Correct Answer
    A. Hyperpathia
    Explanation
    When you combine hyperesthesia (increased sensitivity to touch), allodynia (pain response to non-painful stimuli), and hyperalgesia (increased sensitivity to pain), you get hyperpathia. Hyperpathia refers to an abnormal and exaggerated response to painful stimuli. It is characterized by an increased perception of pain, prolonged pain after the stimulus is removed, and a reduced pain threshold.

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  • 38. 

    What is neuralgia?

    • Functional abnormality of one or more nerve roots

    • Abnormal sensation perceived without an apparent stimulus

    • Pain in the distribution of a nerve or a group of nerves.

    • The sensation I am feeling right now having to study all the BS.

    Correct Answer
    A. Pain in the distribution of a nerve or a group of nerves.
    Explanation
    Neuralgia refers to pain that occurs in the distribution of a nerve or a group of nerves. It is characterized by sharp, shooting, or burning pain that can be intermittent or constant. This pain is typically caused by irritation or damage to the nerves, which can be due to various factors such as inflammation, compression, or injury. Neuralgia can affect any part of the body and is often described as a stabbing or electric shock-like sensation. Treatment options for neuralgia may include medications, nerve blocks, physical therapy, or in some cases, surgery.

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  • 39. 

    What is nociceptive pain?

    • Pain that is the result of injury or acquired abnormalities of peripheral or central neural structures.

    • Pain that results directly from a disease process.

    • Pain caused by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli.

    • None of the above

    Correct Answer
    A. Pain caused by activation or sensitization of peripheral nociceptors, which transmit noxious stimuli.
  • 40. 

    Which of the following ascending pathways transmits noxious stimuli?

    • First Order Neurons

    • Second order neurons

    • Third order Neurons

    • All the Above

    Correct Answer
    A. All the Above
    Explanation
    All the above options are correct because all three types of neurons in the ascending pathway - first order, second order, and third order neurons - are involved in transmitting noxious stimuli. First order neurons receive the sensory input from the peripheral nerves and carry it to the spinal cord or brainstem. Second order neurons relay the signals from the first order neurons to higher brain centers. Third order neurons transmit the signals from the second order neurons to the cerebral cortex for perception and interpretation of pain. Therefore, all three types of neurons play a role in transmitting noxious stimuli.

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  • 41. 

    You were doing some exercise today and decided to ride your bike. While out riding you hit a rock, went flying over the handle bars, and landed on your back. Now you are all sore as you walk home. When you get home you decided to take  some Tylenol to relieve your pain. Being a good student you reflect back to pharmacology and ponder how Tylenol is able to relieve you pain. You are happy and feel so smart because you know that Tylenol….

    • Is a COX inhibitor, so it prevents arachidonic acid from converting to Prostaglandins which causes pain.

    • Blocks activation of phospholipase A to inhibit prostanglandin production.

    • Is a leukotriene inhibitor and breaks down bradykinin.

    • Inhibits transmission of Substance P by blocking NK-1 receptors.

    Correct Answer
    A. Is a COX inhibitor, so it prevents arachidonic acid from converting to Prostaglandins which causes pain.
  • 42. 

    What type of fibers innervate the larynx?

    • C fibers

    • B fibers

    • A fibers

    • All the above

    Correct Answer
    A. C fibers
    Explanation
    C fibers innervate the larynx.

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  • 43. 

    You are taking care of Ms. Batiste today. She is asleep in bed and all tangled up. You decide to fluff out her sheets to straighten them. As the soft, fluffy sheets touch her skin she yelps out in pain. Fluffy sheets are ordinarily a non-noxious stimulus, yet she is feeling pain. What is this an example of?

    • Parasthesia

    • Allodynia

    • Hyperalgesia

    • Neuralgia

    Correct Answer
    A. Allodynia
  • 44. 

    During surgery your patient suffered a complication when their trigeminal nerve was accidentally damaged during the procedure. After the surgery is over, the patient experiences numbness in their face, but says they have pain within the area of numbness. This would be an example of:

    • Anesthesia Dolorosa

    • Allodynia

    • Hypesthesia

    • Parasthesia

    Correct Answer
    A. Anesthesia Dolorosa
  • 45. 

    How do corticosteroids help to produce analgesia?

    • Through inhibition of the COX pathway, which turns arachidonic acid into PGE.

    • Through inhibition of phospholipase A which acts on phospolipds to make arachidonic acid

    • Through inhibition of bradykinin which relieves inflammation

    • All the above

    Correct Answer
    A. Through inhibition of phospholipase A which acts on phospolipds to make arachidonic acid
  • 46. 

    The Spinal reticular pain pathway is thought to be responsible for what?

    • Location, density and duration of pain.

    • Arousal and autonomic responses to pain.

    • Unpleasant emotional perception of pain.

    • Activates antinociceptive descending pathways.

    Correct Answer
    A. Arousal and autonomic responses to pain.
  • 47. 

    Which lamina are involved in the immediate transmission of pain resulting shutting a car door on your finger?

    • Lamina II, III, V

    • Lamina V only

    • Lamina I, V

    • Lamina I, II, III

    Correct Answer
    A. Lamina I, V
  • 48. 

    Which of the following is not one of mechanisms responsible for central sensitization in the spinal cord?               

    • Wind up and sensitization of second order neurons

    • Receptor field expansion

    • Up regulation of adrenergic receptors

    • Hyperexcitability of flexion reflexes

    Correct Answer
    A. Up regulation of adrenergic receptors
  • 49. 

    Pain is conducted along the first, second, and third order neurons that transmit noxious stimuli to periphery from cerebral cortex.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The statement is false because pain is actually conducted along the first, second, and third order neurons that transmit noxious stimuli from the periphery to the cerebral cortex, not the other way around. The cerebral cortex is where the brain processes and interprets the pain signals, but the transmission of the signals starts from the periphery and moves towards the brain.

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Quiz Review Timeline (Updated): Mar 17, 2023 +

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  • Current Version
  • Mar 17, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 02, 2009
    Quiz Created by
    Scottishduffy

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