Deck 20: Diseases and Disorders of the Neurological System
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Deck 20: Diseases and Disorders of the Neurological System
1
What are the two major divisions of the nervous system?
A) endocrine and exocrine nervous systems
B) upper and lower nervous systems
C) spinal and extremity nervous systems
D) central and peripheral nervous systems
E) cerebral and autonomic nervous systems
A) endocrine and exocrine nervous systems
B) upper and lower nervous systems
C) spinal and extremity nervous systems
D) central and peripheral nervous systems
E) cerebral and autonomic nervous systems
D
2
What is the term for delayed or slowed body movements?
A) akinesia
B) aneurysm
C) paraplegia
D) epilepsy
E) bradykinesia
A) akinesia
B) aneurysm
C) paraplegia
D) epilepsy
E) bradykinesia
E
3
What functional cell of the nervous system is responsible for transmission of information from one cell to another?
A) nerves
B) neurons
C) ganglions
D) glial cells
E) lymphocytes
A) nerves
B) neurons
C) ganglions
D) glial cells
E) lymphocytes
B
4
What drug for epilepsy inhibits both vitamin D and folate metabolism?
A) valproate
B) carbamazepine
C) gabapentin
D) phenytoin
E) topiramate
A) valproate
B) carbamazepine
C) gabapentin
D) phenytoin
E) topiramate
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5
What is the term for the body of a neuron?
A) dendrite
B) axon
C) filament
D) soma
E) myelin
A) dendrite
B) axon
C) filament
D) soma
E) myelin
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6
What is the term for a loss of voluntary movement?
A) akinesia
B) aneurysm
C) paraplegia
D) epilepsy
E) bradykinesia
A) akinesia
B) aneurysm
C) paraplegia
D) epilepsy
E) bradykinesia
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7
What inhibitory neurotransmitter controls body posture and movement?
A) acetylcholine
B) glutamate
C) dopamine
D) serotonin
E) norepinephrine
A) acetylcholine
B) glutamate
C) dopamine
D) serotonin
E) norepinephrine
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8
What is the primary issue with attempting to feed stroke patients?
A) loss of taste sensation
B) reduced saliva production
C) loss of appetite
D) potential for weight gain
E) dysphagia
A) loss of taste sensation
B) reduced saliva production
C) loss of appetite
D) potential for weight gain
E) dysphagia
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9
What lifestyle factor is the strongest predictor of stroke risk?
A) cigarette smoking
B) alcohol consumption
C) taking illicit drugs
D) obesity
E) drinking soda pop
A) cigarette smoking
B) alcohol consumption
C) taking illicit drugs
D) obesity
E) drinking soda pop
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10
Extended seizure activity lasting over 5 minutes is called:
A) grand-mal
B) petit-mal
C) tonic-clonic
D) epilepsy
E) status epilepticus
A) grand-mal
B) petit-mal
C) tonic-clonic
D) epilepsy
E) status epilepticus
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11
What percentage of the population can expect to have a seizure within their lifetime?
A) 5%
B) 10%
C) 20%
D) 30%
E) 50%
A) 5%
B) 10%
C) 20%
D) 30%
E) 50%
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12
The classic ketogenic diet is typically initiated with what macronutrient ratio?
A) 4 fat to 1 protein and carbohydrate
B) 4 carbohydrate to 1 protein
C) 4 protein to 1 carbohydrate
D) 4 protein to 1 fat
E) 4 carbohydrate to 1 fat
A) 4 fat to 1 protein and carbohydrate
B) 4 carbohydrate to 1 protein
C) 4 protein to 1 carbohydrate
D) 4 protein to 1 fat
E) 4 carbohydrate to 1 fat
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13
Within what approximate time frame does necrosis (cell death) occur due to lack of blood, oxygen and glucose supplied to the brain?
A) at least 30 minutes
B) 20-25 minutes
C) 12-18 minutes
D) 4-10 minutes
E) 1-3 minutes
A) at least 30 minutes
B) 20-25 minutes
C) 12-18 minutes
D) 4-10 minutes
E) 1-3 minutes
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14
Epilepsy is considered as a diagnosis when there are how many unprovoked seizures?
A) 2
B) 3
C) 4
D) 5
E) 6
A) 2
B) 3
C) 4
D) 5
E) 6
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15
In the United States, what demographic is at highest risk of stroke?
A) Asian Americans
B) African Americans
C) Caucasians (European ancestry)
D) Native Americans
E) Hispanics
A) Asian Americans
B) African Americans
C) Caucasians (European ancestry)
D) Native Americans
E) Hispanics
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16
What disease or disorder is characterized by demyelination of cells within the CNS, inflammation, and development of scar tissue?
A) Parkinson's
B) multiple sclerosis
C) Alzheimer's
D) myasthenia gravis
E) amyotrophic lateral sclerosis
A) Parkinson's
B) multiple sclerosis
C) Alzheimer's
D) myasthenia gravis
E) amyotrophic lateral sclerosis
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17
Where is the neurotransmitter dopamine produced within the brain?
A) pons
B) occipital lobe
C) substantia nigra
D) thalamus
E) hypothalamus
A) pons
B) occipital lobe
C) substantia nigra
D) thalamus
E) hypothalamus
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18
What symptom, visible in the hands, is characteristic of Parkinson's disease?
A) blue discolor
B) red discolor
C) tremor
D) severe edema
E) swollen joints
A) blue discolor
B) red discolor
C) tremor
D) severe edema
E) swollen joints
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19
What type of diets are recommended for people with seizures / epilepsy?
A) high carbohydrate diets
B) fruit-only diets
C) ketogenic diets
D) low-fat diets
E) dense protein diets
A) high carbohydrate diets
B) fruit-only diets
C) ketogenic diets
D) low-fat diets
E) dense protein diets
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20
What are the two branches of the autonomic nervous system?
A) endocrine and exocrine
B) upper and lower
C) sympathetic and parasympathetic
D) central and peripheral
E) voluntary and involuntary
A) endocrine and exocrine
B) upper and lower
C) sympathetic and parasympathetic
D) central and peripheral
E) voluntary and involuntary
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21
How many distinct types of multiple sclerosis (MS) are there?
A) 6
B) 5
C) 4
D) 3
E) 2
A) 6
B) 5
C) 4
D) 3
E) 2
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22
What is the best estimate for KL's protein needs?
A) 0.6-0.9 g/kg
B) 0.9-1.1 g/kg
C) 1.15 g/kg
D) 1.2-1.5 g/kg
E) 1.5-2.0 g/kg
A) 0.6-0.9 g/kg
B) 0.9-1.1 g/kg
C) 1.15 g/kg
D) 1.2-1.5 g/kg
E) 1.5-2.0 g/kg
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23
Quadriplegia or tetraplegia refers to paralysis involving what part(s) of the body?
A) all four limbs
B) the entire body
C) the legs and feet
D) the arms and hands
E) hands and fingers
A) all four limbs
B) the entire body
C) the legs and feet
D) the arms and hands
E) hands and fingers
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24
Injury to what segment of the spine results in damage to the chest and abdominal muscles?
A) cervical
B) thoracic
C) lumbar
D) sacral
E) coccyx
A) cervical
B) thoracic
C) lumbar
D) sacral
E) coccyx
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25
What level of energy intake per day is the most appropriate for KL?
A) 1,800 kcal
B) 2,100 kcal
C) 2,400 kcal
D) 2,700 kcal
E) 3,000 kcal
A) 1,800 kcal
B) 2,100 kcal
C) 2,400 kcal
D) 2,700 kcal
E) 3,000 kcal
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26
Which gland is often abnormal in patients with myasthenia gravis?
A) thymus gland
B) thyroid gland
C) adrenal glands
D) pituitary gland
E) pineal gland
A) thymus gland
B) thyroid gland
C) adrenal glands
D) pituitary gland
E) pineal gland
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27
What age group has the highest rate of traumatic brain injuries due to motor vehicle accidents?
A) young adults 18-25
B) middle-aged adults
C) children under 5
D) elderly
E) adolescents
A) young adults 18-25
B) middle-aged adults
C) children under 5
D) elderly
E) adolescents
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28
Which of the following might reduce KL's metabolic requirements?
A) use of paralytic drugs
B) use of appetite stimulant
C) use of morphine
D) KL's gender
E) KL's race
A) use of paralytic drugs
B) use of appetite stimulant
C) use of morphine
D) KL's gender
E) KL's race
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29
What is the primary medicinal treatment for Guillain-Barré syndrome (GBS)?
A) oral anticholinesterase drugs
B) retrodopa
C) high-dose intravenous immunoglobulin
D) high-dose intravenous vitamin C
E) riluzole
A) oral anticholinesterase drugs
B) retrodopa
C) high-dose intravenous immunoglobulin
D) high-dose intravenous vitamin C
E) riluzole
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30
What is the strongest known risk factor for MS?
A) cigarette smoking
B) genetics
C) obesity
D) living in northern climates
E) vegetarian diet
A) cigarette smoking
B) genetics
C) obesity
D) living in northern climates
E) vegetarian diet
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31
What is the only current medicinal treatment for ALS, which appears to affect the release of the neurotransmitter glutamate?
A) riluzole
B) benserazide
C) carbidopa
D) levodopa
E) immunoglobulin
A) riluzole
B) benserazide
C) carbidopa
D) levodopa
E) immunoglobulin
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32
What is the chemical precursor to dopamine?
A) retrodopa
B) levodopa
C) monoamine oxidase
D) carbidopa
E) benserazide
A) retrodopa
B) levodopa
C) monoamine oxidase
D) carbidopa
E) benserazide
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33
What is likely the best way to feed KL while he is in the hospital?
A) nasogastric tube
B) nasoenteric tube
C) parenteral nutrients
D) baby food orally
E) keep NPO (withhold oral food & fluids)
A) nasogastric tube
B) nasoenteric tube
C) parenteral nutrients
D) baby food orally
E) keep NPO (withhold oral food & fluids)
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34
What is the best means of determining KL's caloric needs while in the hospital?
A) Mifflin-St Jeor equation
B) Harris-Benedict equation
C) WHO standards
D) indirect calorimetry
E) Glasgow coma scale
A) Mifflin-St Jeor equation
B) Harris-Benedict equation
C) WHO standards
D) indirect calorimetry
E) Glasgow coma scale
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35
What amino acids are needed in higher amounts in patients with pressure ulcers?
A) lysine and tyrosine
B) tyrosine and valine
C) arginine and glutamine
D) valine and cysteine
E) lysine and cysteine
A) lysine and tyrosine
B) tyrosine and valine
C) arginine and glutamine
D) valine and cysteine
E) lysine and cysteine
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36
What percentage of patients with GBS completely recover within 18 months of onset?
A) 15%
B) 25%
C) 40%
D) 60%
E) 85%
A) 15%
B) 25%
C) 40%
D) 60%
E) 85%
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37
The first stage of Alzheimer's disease is characterized by:
A) depression and anger
B) hand tremors and confusion
C) headaches and depression
D) memory loss and confusion
E) memory loss and muscle weakness
A) depression and anger
B) hand tremors and confusion
C) headaches and depression
D) memory loss and confusion
E) memory loss and muscle weakness
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38
In myasthenia gravis, an autoimmune reaction damages or destroys the cellular receptors for what neurotransmitter?
A) dopamine
B) serotonin
C) epinephrine
D) norepinephrine
E) acetylcholine
A) dopamine
B) serotonin
C) epinephrine
D) norepinephrine
E) acetylcholine
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39
What medications act to reduce the breakdown of L-dopa outside the blood-brain barrier?
A) COMT inhibitors
B) dopamine agonists
C) MAO-B inhibitors
D) decarboxylase inhibitors
E) anticholinergic meds
A) COMT inhibitors
B) dopamine agonists
C) MAO-B inhibitors
D) decarboxylase inhibitors
E) anticholinergic meds
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40
What are the two major physical changes in the brain that are characteristic of Alzheimer's disease?
A) aluminum deposition and edema
B) amyloid plaques and neurofibrillary tangles
C) amyloid plaques and hypertrophy
D) calcification and hypertrophy
E) aluminum deposition and neurofibrillary tangles
A) aluminum deposition and edema
B) amyloid plaques and neurofibrillary tangles
C) amyloid plaques and hypertrophy
D) calcification and hypertrophy
E) aluminum deposition and neurofibrillary tangles
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41
The _______________ status of patients at the onset of the injury is an important consideration for a successful recovery.
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42
ALS affects involuntary types of neurons, such as those involved in memory, reasoning, vision, and hearing, as well as muscular processes such as heartbeat and digestion.
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43
The components of a neuron are the soma, _______________, axon, and axon terminals.
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44
For most stroke patients, evidence supports delayed initiation (2 weeks) of nutrition support due to risk of weight gain.
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45
The percentage of individuals relieved from seizures with anti-epileptic drugs is around _______________ percent.
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46
Although the exact cause of Parkinson's disease is unclear, it results in the loss of serotonin-producing cells in the thalamus portion of the brain.
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47
Traumatic brain injuries are classified as either penetrating brain injuries or closed-head injuries.
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48
Most inflammatory conditions of the spinal cord are treated with NSAIDs.
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49
_______________ are not considered to be a stroke, but are episodes of ischemia that lead to momentary symptoms consistent with the loss of oxygen to the brain.
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50
Because the ketogenic diet is low in fiber and _______________ and insufficient in other nutrients, supplementation is recommended to avoid deficiencies.
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51
The somatic division of the PNS carries messages forward to the CNS from the sensory organs, and outward from the CNS to the muscles for action.
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52
Individuals with stroke do not experience the _______________ phase that is seen in the acute period after traumatic brain injury.
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53
The major variations of ketogenic diets in use today include the classic ketogenic diet, the _______________ triglyceride diet, the low-glycemic-index treatment, and the modified Atkins diet.
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54
A(n) _______________ stroke occurs as a neurological dysfunction caused by focal cerebral, spinal, or retinal infarction.
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55
Ischemic strokes are the least most common form, accounting for about 10% of all strokes.
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56
A high protein intake interferes with optimal levels of L-dopa due to competition for protein carriers.
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57
Partial seizures can be further classified as simple partial or complex partial.
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58
The term developmental delay is a catch-all phrase used to describe any lag in reaching age-appropriate developmental milestones.
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59
Febrile seizures are triggered by high _______________.
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60
Endorphins are _______________ that naturally occur in the brain.
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61
Because spinal cord injury patients have lower metabolic rates, preventing excessive _______________ is crucial.
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62
Approximately _______________ percent of Guillain-Barré syndrome (GBS) patients report onset of symptoms 1-3 weeks after an infection.
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63
Define the term stroke.
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64
_______________ is a term used to describe a cluster of symptoms including bradykinesia with rigidity and/or tremor.
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65
Multiple sclerosis is an immune-mediated disease characterized by destruction of the _______________ and the formation of scar tissue.
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66
Explain the clinical manifestations of ALS.
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67
Define Guillain-Barré syndrome.
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68
Vitamin _______________ is required as a cofactor for one of the enzymes needed for the conversion of L-dopa to dopamine.
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69
Distinguish between complete and partial spinal cord injuries.
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70
Paraplegia is defined as paralysis involving the lower body below the _______________.
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71
Discuss the prevention of stroke and acute care following stroke.
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72
Approximately 30 percent of patients with GBS require mechanical _______________.
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73
Describe how a neuron passes its message on to another neuron and how this model ensures specificity.
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74
Explain the primary roles of the parietal lobe.
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75
Myasthenia gravis is a(n) _______________ neuromuscular disease that affects the skeletal muscles and results in varying levels of weakness and fatigue.
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76
Many patients with severe head injuries require surgery for removal or repair of _______________ and contusions.
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77
Amyotrophic lateral sclerosis, commonly known as _______________ disease, is a progressive neurological disease that affects the motor neurons of the nervous system.
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78
Describe the pathophysiology of primary and secondary traumatic brain injury.
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79
List the two forms of amyotrophic lateral sclerosis (ALS).
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80
Discuss the etiology and pathophysiology of Parkinson's disease (PD).
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