Question 1

Multiple sclerosis and Guillain-Barré syndrome are similar in that they both do what?

Accepted Answer

Acute inflammatory demyelinating polyneuropathy (AIDP) accounts for most occurrences of Guillain- Barré syndrome (GBS). Multiple sclerosis (MS) is an autoimmune disorder diffusely involving degeneration of CNS myelin and loss of axons. These diseases do not have in common permanent destruction of peripheral nerves, inadequate production of neurotransmitters, or blockage of acetylcholine receptor sites.

Question 2

A blunt-force injury to the forehead would result in a contrecoup injury to which region of the brain?

Accepted Answer

The focal injury produces a contrecoup (on the pole opposite the site of impact) injury. The occipital portion of the brain is opposite of the site of impact (the forehead). A blunt-force injury to the forehead would not produce a contrecoup injury to the frontal, temporal, or parietal lobes.

Question 3

A blunt-force injury to the forehead would result in a coup injury to which region of the brain?

Accepted Answer

Coup injuries occur directly below the point of impact. A blunt-force injury would not produce a coup injury to other areas of the brain such as the temporal, parietal, or occipital regions.

Question 4

In which disorder are acetylcholine receptor antibodies (IgG antibodies) produced against acetylcholine receptors?

Accepted Answer

The main defect of myasthenia gravis is the formation of autoantibodies (an immunoglobulin G [IgG] antibody) against receptors at the Ach-binding site on the postsynaptic membrane. Guillain-Barré syndrome is a rare demyelinating disorder caused by a humoral (antibody) and cell-mediated immunologic reaction directed at the peripheral nerves. Multiple sclerosis is a chronic inflammatory disease involving degeneration of CNS myelin, scarring (sclerosis or plaque formation), and loss of axons. Parkinson disease is a slowly progressive brain disorder caused by diminishing dopamine production.

Question 5

Where are atheromatous plaques most commonly found?

Accepted Answer

Over 20 to 30 years, atheromatous plaques (stenotic lesions) tend to form at branches and curves in the cerebral circulation, not at any of the other options provided.

Question 6

What does a healthcare professional explain to a student about myasthenia gravis?

Accepted Answer

Exertional fatigue and weakness that worsens with activity, improves with rest, and recurs with resumption of activity characterizes myasthenia gravis. Myasthenia gravis is not an acute autoimmune disease, does not affect nerve roots, and does not lead to adrenergic crisis.

Question 7

Spinal cord injuries occur most frequently in which region?

Accepted Answer

Vertebral injuries most often occur at vertebrae C1 to C2 (cervical), C4 to C7, and T10 to L2 (thoracic lumbar) because these are the most mobile portions of the spine.

Question 8

A patient who sustained a cervical spinal cord injury 2 days ago suddenly develops severe headache and blurred vision. What should the healthcare professional do?

Accepted Answer

This patient is most likely experiencing autonomic hyperreflexia, which is characterized by paroxysmal hypertension, a pounding headache, blurred vision, sweating above the level of the lesion with flushing, nasal congestion, nausea, piloerection, and bradycardia. The healthcare professional would recognize the symptoms and take the patient's blood pressure and pulse. Autonomic hyperreflexia is an emergency, so giving the patient cool water, pain medication, or facilitating a CT scan are not appropriate.

Question 9

What are the initial clinical manifestations immediately noted after a spinal cord injury? (Select all that apply.)

Accepted Answer

A complete loss of reflex function in all segments below the level of the lesion characterizes a spinal cord injury. Severe impairment below the level of the lesion is obvious; it includes paralysis and flaccidity in muscles, absence of sensation, loss of bladder and rectal control, transient drop in blood pressure, and poor venous circulation. Neither headache nor hypertension is an initial clinical manifestation related to a spinal cord injury.

Question 10

A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient asks how this could have occurred. What response by the healthcare professional is best?

Accepted Answer

GBS is considered to be an autoimmune disease triggered by a preceding bacterial or viral infection. It is not a genetic defect, due to a brain tumor, or transmitted by family pets.

Question 11

What is the type of vascular malformation that most often results in hemorrhage?

Accepted Answer

In an arteriovenous malformation (AVM), arteries feed directly into veins through a vascular tangle of malformed vessels, causing venous hemorrhaging. The other options are not as likely to result in a hemorrhage.

Question 12

A patient has AIDS and reports fever, clumsiness, difficulty with balance and walking, and trouble speaking. What treatment does the healthcare professional educate the patient about?

Accepted Answer

These symptoms are characteristic of toxoplasmosis which is the most common opportunistic infection seen in approximately one third of individuals with AIDS. It is treated with pyrimethamine, anti-parasitic medication. It is not treated with radiation, chemotherapy, or surgery.

Question 13

Which clinical manifestations are characteristic of cluster headaches? (Select all that apply.)

Accepted Answer

The cluster headache attack usually begins without warning and is characterized by severe unilateral tearing, burning, periorbital, and retrobulbar or temporal pain lasting 30 min to 2 hr. A preheadache aura often precedes a migraine. Migraines can include dizziness, nausea, and vomiting. The feeling of a tight band characterizes tension-type headaches.

Quiz 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction