Deck 12: Neurology

Question 1

The autonomic nervous system consists of sympathetic and parasympathetic components. A shorthand way of recalling the different functions of these systems is to think of the sympathetic nervous system as responding to ______________, and the parasympathetic nervous system to __________________.

A) Input from the organs of special sense; input from muscles
B) Input from joints; input from blood vessels
C) Fight or flight; rest and digestion
D) Reproductive urges; dreams

Answer 1

Fight or flight; rest and digestion

Question 2

The autonomic nervous system is a part of the:

A) Central nervous system
B) Peripheral nervous system
C) Group of nerves that innervate the face
D) Group of nerves that innervate the eyes, nose, ears, skin, and tongue (mediating sight, smell, hearing, touch, and taste).

Answer 2

Peripheral nervous system

Question 3

The autonomic nervous system primarily controls:

A) Muscles and body movement
B) Functions of internal organs, such as the salivary glands, heart, blood vessels, and bronchi

Answer 3

Functions of internal organs, such as the salivary glands, heart, blood vessels, and bronchi

Question 4

Sympathetic effects of the autonomic nervous system in response to stressful stimulation include all of the following, EXCEPT:

A) A decrease in heart rate and blood pressure
B) Increased metabolism of fat and glycogen
C) Increased blood flow to skeletal muscles
D) An increase in the size of the pupils

Question 5

Pick the one INCORRECT statement about epinephrine and norepinephrine:

A) Epinephrine increases heart rate; norepinephrine decreases it.
B) Both are catecholamines
C) Both are sympathetic chemical transmitters
D) Both are synthesized from the amino acid, phenylalanine

Question 6

Catecholamines are primarily synthesized in:

A) The thyroid gland
B) The pituitary gland
C) The adrenal gland
D) The hypothalamus

Question 7

Unlike alpha 1 receptors in blood vessels, which produce __________, beta 2 receptors in the lungs cause _____________________________.

A) Vasodilatation; bronchoconstriction
B) Vasodilatation; bronchodilation
C) Vasoconstriction; bronchoconstriction
D) Vasoconstriction; bronchodilation

Question 8

Alpha adrenergic antagonists are most likely to cause:

A) A decrease in blood pressure and relaxation of the urethral sphincter
B) Increases in blood pressure and bladder outlet obstruction

Question 9

The parasympathetic nervous system primarily relies on which of the following chemical transmitters:

A) Acetylcholine
B) Buprenorphine
C) Epinephrine
D) Dopamine

Question 10

The ciliary ganglion innervates:

A) The back of the throat
B) Hair
C) The urinary bladder
D) The eye

Question 11

Atropine is:

A) A potent catecholamine, similar in its effects to epinephrine
B) A weak dopamine agonist
C) A potent anticholinergic agent
D) A beta adrenergic blocking agent

Question 12

A child is brought to the Emergency Department after an accidental ingestion of nightshade, a plant (Atropa belladonna) whose berries he found growing wild near his school. If the child ate a large quantity of the berries, he is most likely to appear:

A) Febrile, hallucinatory, tachycardic-his pupils will be dilated
B) Sweating, drooling, with copious diarrhea
C) Calm, composed, and generally unaffected by the berries
D) Short of breath-he will be wheezing.

Question 13

Excessive stimulation of nicotinic receptors is most likely to produce:

A) Piloerection
B) Tachycardia
C) Vomiting and diarrhea
D) Pulmonary edema

Question 14

The vagus nerve (the tenth cranial nerve) carries impulses from the parasympathetic nervous system to the heart and the upper gastrointestinal tract. A person who faints as a result of excessive discharge from the vagus nerve does so because of:

A) Tachycardia and hypertension
B) Bradycardia and hypotension
C) Excessive sweating
D) Urinary retention

Question 15

Cholinesterases:

A) Increase the metabolism of epinephrine, decreasing the effects of this adrenergic hormone
B) Increase the metabolism of acetylcholine, decreasing the impact of this neurotransmitter on postganglionic receptors
C) Decrease the metabolism of acetylcholine, increasing the duration of exposure of postganglionic receptors to the effect of this agent

Question 16

An animal suddenly notices that a predator is stalking it and preparing to attack. Physiological responses to this stress, including vasodilatation in skeletal muscles, widening of the pupils, increases in heart rate and blood pressure, and dilation of the bronchioles result from:

A) Increased activity of the sympathetic nervous system
B) Increased activity of the parasympathetic nervous system
C) Sudden discharges from the vagus nerve
D) A mixture of parasympathetic and sympathetic stimuli

Question 17

A person whose adrenal gland has been destroyed is unlikely to mount a ___________ response to the stress of systemic infection.

A) Hypotensive
B) Hypertensive

Question 18

Which of the following statements is NOT correct

A) Acetylcholine is a vasodilator
B) Dopamine and norepinephrine are pressors
C) A sympathomimetic agent is one that acts like acetylcholine
D) A sympatholytic agent is one that blocks the effects of epinephrine and/or norepinephrine

Question 19

Preganglionic fibers in the autonomic nervous system run from the ______________ to the ___________________.

A) Central nervous system; ganglion near the organ it innervates
B) Ganglion; innervated organ
C) Innervated organ; central nervous system
D) Central nervous system; innervated organ

Question 20

Which of the following vitamin deficiencies is most likely to influence memory and social skills?

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin E

Question 21

Which of the following illnesses is sometimes accompanied by progressive deterioration in cognitive function?

A) Amyotrophic lateral sclerosis (ALS-Lou Gehrig disease)
B) Herpes simplex infection
C) Varicella-zoster virus reactivation
D) Parkinson's disease

Question 22

Although dementia is uncommon in adolescents and young adults, some young adults can lose cognitive skills and social function. Which of the following is a common cause?

A) Traumatic brain injury
B) Hyperthyroidism
C) Osteosarcoma
D) Color blindness

Question 23

Which of the following pathological changes are seen in the brains of patients with Alzheimer's disease?

A) Neurofibrillary tangles
B) Microscopic infarcts in the white matter of the brain
C) Demyelination of axons
D) Atrophy of the basal ganglia

Question 24

A radiological technique used to identify the loss of neurons in specific areas of the brain is known as:

A) PET scanning
B) Functional MRI
C) Volumetric neuroimaging
D) Transcranial Doppler ultrasonography

Question 25

A child is born with cerebral palsy. From birth he has trouble with motor function, vision, and speech. As an adult he gets and keeps a physically demanding job as a commercial fisherman. He has a 20-year career. He has a wife and children, and he participates actively in his community until he loses control of fine motor function in one of his hands. A few months later he suddenly notices he is going blind. A physician diagnoses optic neuritis, and a magnetic resonance image (MRI) of the brain shows that he likely has developed multiple sclerosis. At this point he should:

A) Consider hospice care
B) Discuss treatment options with his neurologist
C) Cash out his life insurance policy and take a long and well-deserved trip to the tropics
D) Ask for patient-controlled analgesia (a PCA pump)

Question 26

In the chair stand test, individuals are asked to:

A) Get up from a seated position onto a straight-backed chair to see if they have fear of heights
B) Walk 50 feet; the time taken to perform the test is measured
C) Get up and down from a seated position to an unsupported standing position as many times as possible in 30 sec
D) Reach as far as they can to the left and the right from a seated position, without falling or having to stand

Question 27

The part of the brain that receives information about smells from the olfactory bulb is called the:

A) Occiput
B) Rhinencephalon
C) Optic radiations
D) Neurocranium

Question 28

The trigeminal nerve is also known as:

A) Cranial nerve V
B) The phrenic nerve
C) The vagus nerve
D) The facial nerve

Question 29

The cerebral cortex:

A) Surrounds the brain in a bony shell; protecting it from injury
B) Is the part of the brain consisting of a molecular, middle, and granular layer; it contributes to motor coordination
C) Is referred to as the gray matter of the brain; it consists of six layers, many of which contain the cell bodies of neurons
D) Is also known as the white matter of the central nervous system; it is composed mainly of myelinated nerve fibers

Question 30

The pons is located in which part of the central nervous system:

A) The brain stem
B) The spinal cord
C) The medulla oblongata
D) The basal ganglia

Question 31

Important structures that leave the pons cerebelli include:

A) Both lobes of the brain
B) The corticospinal tracts
C) Most of the cerebral veins
D) Several cranial nerves

Question 32

The central brain structure that helps to control body temperature is known as the __________. This same structure releases a variety of releasing hormones and influences body water balance and appetite.

A) Cerebral peduncle
B) Caudate nucleus
C) Hypothalamus
D) Pituitary gland

Question 33

All sensory stimuli are funneled through this subdivision of the diencephalon, except for smell sensations from the olfactory nerve.

A) Thalamus
B) Premotor cortex
C) Primary motor area
D) Internal capsule

Question 34

All of the following statements about the middle cerebral artery are true, EXCEPT:

A) It feeds into the Circle of Willis at the base of the brain
B) It receives its blood flow from the internal carotid arteries
C) It supplies blood directly to the cerebellum
D) It supplies blood to the center of the brain, including its parietal lobes

Question 35

The thick band of white matter connecting the left and right cerebral hemispheres to each other is called:

A) The habenula
B) The corpus striatum
C) The hippocampus
D) The corpus callosum

Question 36

Injury to which of the following structures of the brain is most likely to cause movement disorders (such as are found in Parkinson's disease)?

A) The frontal lobes
B) The basal ganglia
C) The pituitary gland
D) The amygdala

Question 37

Inflammation of the membranes surrounding the brain is known as:

A) Iritis
B) Neuritis
C) Meningitis
D) Encephalitis

Question 38

A disease in which there are repeated abnormal electrical discharges in the brain is known as:

A) Epilepsy
B) Seizure
C) Stroke
D) Dementia

Question 39

Which of the following diseases or conditions LEAST resembles a stroke on physical examination?

A) A brain abscess
B) A metastatic brain tumor
C) Complicated migraine
D) Alcohol withdrawal with Todd's paralysis
E) None of the above. They may all, at times, appear to resemble a stroke.

Question 40

An athletic young woman notices that she cannot move her left knee as well as she used to move it, and that she is having trouble skiing. An orthopedist finds nothing wrong with the joint. A magnetic resonance image of the brain demonstrates a single enhancing lesion in the brain. From the data presented, the most likely reason this patient does not have multiple sclerosis is:

A) The lesion affects movement
B) The lesion affects her knee
C) Only one lesion is identified on the scan
D) She does not complain of headache

Question 41

Which of the following is the best device to use for intrathecal injections in an adult?

A) A 30-gauge, 5/8-in needle
B) A 22-gauge, needleless system
C) A 20-gauge, 2 1/2-in needle
D) An 18 French urethral catheter

Question 42

Studies have shown that addictive behaviors may be influenced by (name of neurotransmitter) in the (name of brain structure).

A) Norepinephrine; parietal lobe
B) Serotonin; occipital lobe
C) Dopamine; nucleus accumbens
D) Levodopa; basal ganglia

Question 43

On rounds you are told that a patient has a "depressed level of consciousness." This means:

A) That the patient is sad
B) That the patient is suicidal
C) That the patient is not fully awake or alert
D) That the patient is demented

Question 44

Neuromuscular blocking drugs are used in critical care settings to paralyze _____________ muscles. They should not be used without having _______________ readily available for use.

A) Smooth muscles; antiemetics
B) Cardiac muscles; atropine
C) Cardiac muscles; a transcutaneous pacemaker
D) Skeletal muscles; an advanced airway and mechanical ventilator

Question 45

Neuromuscular blocking drugs inactivate, compete with, or antagonize the effects of ___________________?

A) Acetylcholine
B) Dopamine
C) Epinephrine
D) Cortisol

Question 46

Neuromuscular blocking drugs DO NOT:

A) Prevent conscious movement
B) Alter memory
C) Provide pain relief
D) Both B and C

Question 47

An alcoholic patient who has been suffering continuous seizures for more than half an hour is unlikely to benefit from the administration of which of the following agents?

A) Lorazepam
B) Theophylline
C) Magnesium
D) Phenobarbitol

Question 48

An alcoholic patient, who previously was known to have a normal memory, seems to have lost immediate recall after awakening in the ICU. He does not have a full range of extraocular movement either-his lateral gaze seems paralyzed. Neuroimaging shows no evidence of stroke. The patient likely has a deficiency of which of the following vitamins?

A) Vitamins A and C
B) Vitamins D and E
C) Folate and thiamine
D) Vitamin K

Question 49

An alcoholic patient with high fever, headache, delirium, a spotted rash covering much of his body, and a rigid neck is most likely to benefit from:

A) Thiamine, folate, and magnesium, for chronic complications of alcohol abuse
B) Ativan, for status epilepticus
C) Haloperidol, for altered mental status
D) Ceftriaxone, ampicillin, and dexamethasone, for bacterial meningitis

Question 50

All of the following are common causes of seizures, except:

A) A drug overdose with a tricyclic antidepressant
B) A drug overdose with a benzodiazepine, such as valium
C) Alcohol withdrawal
D) Heatstroke
E) Meningitis
F) Profound hyponatremia

Question 51

The body part affected by "Coup-contrecoup" injuries is:

A) The brain
B) The adrenal glands
C) The gonads
D) The abdomen

Question 52

An osmotic diuretic used to reduce cerebral edema is:

A) Bumetanide
B) Prednisone
C) Mannitol
D) Recombinant tissue plasminogen activator

Question 53

Which of the following are NOT characteristics of dementia?

A) Sudden loss of the ability to move an arm or a leg
B) Sudden onset of headache
C) Gradual withdrawal from social relationships
D) Onset before age 40

Question 54

Mary notices that her retired mother, who formerly worked outside the home, now has difficulty recalling the names of people with whom she worked closely a few years ago. She hesitates and stammers before remembering their names, but, with enough time she usually is able to recollect names and specific details about her former colleagues. She manages the family finances, has no trouble remembering phone numbers, and manages her home and other activities of daily living easily. Her difficulties would best be categorized as:

A) Alzheimer's disease
B) Huntington's chorea
C) Mild cognitive impairment
D) Frontotemporal dementia/Pick's disease

Question 55

The ability to remember how to carry out specific tasks and functions is called:

A) Immediate memory
B) Long-term memory
C) Declarative memory
D) Procedural memory

Question 56

An individual who "sundowns":

A) Has difficulty performing difficult tasks at night or twilight
B) Becomes confused easily at night or twilight
C) Rarely stays awake after twilight
D) Consumes most of his daily calories after twilight

Question 57

A tetanus-prone wound may have any or all the following characteristics, EXCEPT:

A) It is made by a sharp, clean object, like a scalpel
B) Its edges are jagged and it is deep
C) It has dirt and debris visible within it
D) It is made by an animal bite

Question 58

Which of the following microorganisms lives best at cooler than normal body temperatures?

A) Lymphatic filariasis
B) Lepromatous leprosy
C) Necator americanus
D) Trichuris trichura

Question 59

A runner falls while jogging in the woods and opens a gash in her knee. When she gets home she finds she is bleeding from a jagged laceration, several millimeters deep, and about 2 cm long. There is dirt and blood in the wound. After rinsing out the laceration with warm, salty water, she should be most concerned that it might become infected with:

A) Clostridium tetani
B) Clostridium difficile
C) Escherichia coli 0157
D) Rickettsia prowaseki

Question 60

A critical element in the treatment of the patient with tetanus is:

A) To begin broad-spectrum antibiotic therapy
B) To begin narrow-spectrum antibiotic therapy, aimed at gram-positive skin flora
C) To get vaccinated if his or her routine vaccinations for wound infection are not up to date
D) To monitor oneself for fever, and call his or her health care provider if fever (100.5°F or above) occurs in the days following treatment.

Question 61

Neisseria gonorrhea and Neisseria meningitidis both:

A) Can cause urinary tract infection
B) Are commonly transmitted from person to person by injection with previously used needles and syringes
C) Are gram-positive bacilli
D) Are gram-negative cocci

Question 62

A virion is:

A) A complete virus, made up of its nucleic acid core, its protein envelope, and sometimes an outer surface composed of lipids
B) An inactivated virus
C) A naked virus; one that has no envelope
D) A small infectious particle made up of proteins only, without any nucleic acids

Question 63

The West Nile virus, a virus that infects crows, jays, and ravens, usually causes symptomatic injury to which of the following in humans?

A) Blood
B) Connective tissue
C) Neuronal tissue
D) Skin

Question 64

When the American Red Cross and other blood banking agencies screen donated blood for viral infections, they usually detect infection with all of the following, except:

A) Hepatitis B virus
B) Hepatitis C virus
C) Human immunodeficiency virus
D) West Nile virus

Question 65

Which of the following viral infections is almost uniformly fatal?

A) Epstein-Barr virus, the virus that causes mononucleosis and some lymphomas
B) Herpes virus 8, the virus that causes Kaposi's sarcoma
C) Rabies virus
D) West Nile virus

Question 66

Injuries to the head that result in a brief period of loss of consciousness or amnesia occur commonly in contact sports, such as boxing, football, and soccer, and in high-velocity sports, like snowboarding, skiing, and bicycling. These injuries were formerly known as "concussions" but are now called:

A) Subdural hematomas
B) Astrocytomas
C) Traumatic brain injuries
D) Transient ischemic attacks

Question 67

A child with pica who likes to eat paint chips may develop which of the following illnesses?

A) Ergot poisoning
B) Lead poisoning
C) Mercury poisoning
D) Salicylate poisoning

Question 68

During the assessment of a patient after an injury, which of the following findings may point to significant neurological injury?

A) Fractures of several long bones
B) A Glasgow Coma Scale that is below normal
C) Difficulty breathing
D) A depressed skull fracture

Question 69

A rapidly progressing loss of normal cognitive function may be caused by infection with which of the following?

A) Creutzfeldt-Jakob virus
B) Human immunodeficiency virus infection
C) Herpes simplex encephalitis
D) Rhabdovirus

Question 70

From the following list, identify all of the diseases or conditions able to produce coma.

A) Overdose with sedatives
B) Asphyxia
C) A stroke in Broca's area of the brain
D) A hemorrhagic stroke causing herniation of the brain

Question 71

Which of the following neuropathies affects the lower extremities?

A) Meralgia paresthetica
B) Carpal tunnel syndrome
C) Diabetic sensory neuropathy
D) Trigeminal neuralgia

Question 72

Matching
Match the listed structures of the brain with their definitions.

-Gyri

A) Delicate membrane located on the surface of the brain
B) Deep grooves between convolutions of the brain
C) Rounded, hilly surfaces of the cerebral cortex
D) Gap between the left and right cerebral cortex

Question 73

Matching
Match the listed structures of the brain with their definitions.

-Longitudinal fissure

A) Delicate membrane located on the surface of the brain
B) Deep grooves between convolutions of the brain
C) Rounded, hilly surfaces of the cerebral cortex
D) Gap between the left and right cerebral cortex

Question 74

Matching
Match the listed structures of the brain with their definitions.

-Pia mater

A) Delicate membrane located on the surface of the brain
B) Deep grooves between convolutions of the brain
C) Rounded, hilly surfaces of the cerebral cortex
D) Gap between the left and right cerebral cortex

Question 75

Matching
Match the listed structures of the brain with their definitions.

-Sulci

A) Delicate membrane located on the surface of the brain
B) Deep grooves between convolutions of the brain
C) Rounded, hilly surfaces of the cerebral cortex
D) Gap between the left and right cerebral cortex

Question 76

See if you can match the brain diseases and conditions with their causes.

-Creutzfeldt-Jakob disease

A) Permanent interruption of blood supply to a portion of the brain
B) Temporary interruption of blood supply to a portion of the brain
C) Prion infection of the brain
D) Autosomal dominant inheritance

Question 77

See if you can match the brain diseases and conditions with their causes.

-Huntington's disease

A) Permanent interruption of blood supply to a portion of the brain
B) Temporary interruption of blood supply to a portion of the brain
C) Prion infection of the brain
D) Autosomal dominant inheritance

Question 78

See if you can match the brain diseases and conditions with their causes.

-Stroke (cerebrovascular accident)

A) Permanent interruption of blood supply to a portion of the brain
B) Temporary interruption of blood supply to a portion of the brain
C) Prion infection of the brain
D) Autosomal dominant inheritance

Question 79

Link the name of the agonist drug with the function it produces.

-Bromocryptine

A) Used to treat Parkinson's disease
B) Used in shock to raise blood pressure
C) Used to manage pain
D) Used to treat anxiety
E) Used to treat bronchospasm

Question 80

Link the name of the agonist drug with the function it produces.

-Norepinephrine
Indicate whether the statement is true or false.

A) Used to treat Parkinson's disease
B) Used in shock to raise blood pressure
C) Used to manage pain
D) Used to treat anxiety
E) Used to treat bronchospasm