Deck 23: Chronic Neurologic Disorders

Question 1

In which type of neuron is progressive degeneration occurring with amyotrophic lateral sclerosis (ALS)?

A) upper motor neurons
B) upper and lower motor neurons
C) motor and sensory neurons
D) motor,sensory,and autonomic system neurons

Answer 1

upper and lower motor neurons

Question 2

What characteristic is common to all individuals with cerebral palsy?

A) some loss of cognitive function
B) one or more types of seizure
C) serious multiple communication difficulties
D) a form of motor disability

Answer 2

a form of motor disability

Question 3

Which of the following is characteristic of generalized seizures?

A) the localization of the seizure activity
B) the uncontrolled discharge of neurons in both hemispheres
C) seizures that persist for several hours
D) loss of consciousness and all motor function

Answer 3

the uncontrolled discharge of neurons in both hemispheres

Question 4

How is the presence of spina bifida diagnosed?

A) prenatally by ultrasound or detection of AFP in maternal blood or amniotic fluid
B) only after birth by direct observation of the sac
C) after birth when the sac herniates as CSF builds up
D) only with a spinal x-ray

Question 5

Which of the following is characteristic of multiple sclerosis?

A) remissions and exacerbations
B) predictable pattern of progression in all patients
C) onset in men and women more than 60 years of age
D) full recovery of function during remissions

Question 6

Which statement does NOT apply to the pathophysiology of multiple sclerosis?

A) demyelination of axons
B) it affects the brain,spinal cord,and cranial nerves
C) it affects motor,sensory,and autonomic fibers
D) progressive random degeneration of peripheral nerves

Question 7

From the following,choose the two events (in correct sequence)that immediately follow the aura during a tonic-clonic event:

A) prodromal signs,then the clonic stage
B) clonic stage,then the tonic stage
C) loss of consciousness,then the tonic stage
D) loss of consciousness and cessation of respiration

Question 8

How would a seizure consisting of bizarre or inappropriate activity be classified?

A) an absence seizure
B) a psychomotor seizure
C) a focal seizure
D) a Jacksonian seizure

Question 9

The best description of a myelomeningocele is:

A) asymptomatic failure of the posterior spinous processes of the vertebrae to fuse
B) herniation of the meninges and CSF through a vertebral defect
C) herniation of the meninges,CSF,and spinal cord or nerves through a vertebral defect
D) herniation of brain tissue through a defect in the cranium

Question 10

What does the clonic stage of a seizure consist of?

A) a sudden strong skeletal muscle contraction and rigidity of trunk and limbs
B) a cry and contraction of abdominal and thoracic muscles
C) alternating contractions and relaxation of skeletal muscles
D) cessation of all skeletal muscle activity

Question 11

Which of the following are common early signs of multiple sclerosis?

A) paralysis of the lower body,impaired cognitive function
B) tremors,weakness in the legs,visual problems
C) sensory deficit in the legs and trunk,memory loss,urinary incontinence
D) tremors,speech impairment,hearing loss

Question 12

What are the characteristic changes in the brain with Alzheimer's disease?

A) cortical atrophy with plaques and neurofibrillary tangles,impairing conduction
B) increased ACH and decreased GABA and serotonin levels
C) obstruction of many small arteries and arterioles throughout the cerebral cortex
D) vacuoles forming in the neurons,rapidly destroying them

Question 13

Which of the following applies to Parkinson's disease?

A) Onset occurs in men and women over 60 years of age.
B) There is a strong genetic component.
C) The majority of cases are predisposed by intake of antipsychotic medications.
D) It rarely develops in women.

Question 14

All of the following are typical signs of hydrocephalus in the neonate EXCEPT:

A) enlarged head with bulging fontanels
B) vomiting,headache,and paralysis
C) irritability and feeding difficulties
D) eyes are turned downward with sclerae showing above the pupils

Question 15

Which of the following applies to cerebral palsy?

A) nonprogressive brain damage to the fetus or neonate
B) a genetic defect affecting metabolism and causing degeneration in the neurons
C) a developmental error during early growth of the peripheral nervous system
D) a chromosomal defect resulting in abnormalities in many body structures

Question 16

Which of the following are common early manifestations of Parkinson's disease?

A) tremors at rest in the hands and difficulty initiating voluntary movements
B) extreme weakness in the legs and spastic movements in the arms
C) visual deficits and speech impairment
D) loss of facial expressions and altered posture and gait

Question 17

What is the pathophysiologic change in Parkinson's disease?

A) degeneration of motor fibers in the pyramidal tracts
B) excess secretion of stimulatory neurotransmitters in the CNS
C) degeneration of the basal nuclei with a deficit of dopamine
D) deficit of acetylcholine and degeneration of the motor cortex in the frontal lobe

Question 18

Which of the following statements does NOT apply to myasthenia gravis?

A) The cholinergic receptors at the neuromuscular junctions are damaged.
B) It is an autoimmune disorder.
C) Muscle weakness and fatigue occur in the face and neck.
D) Dementia develops in the later stage.

Question 19

Which statement applies to Huntington's disease? It:

A) is inherited as an autosomal recessive trait
B) is manifested in individuals by age 20 years
C) presents with choreiform movements in the upper body and decreased ability to concentrate
D) causes decreased levels of all neurotransmitters in the CNS

Question 20

In cases of noncommunicating hydrocephalus,why does excess cerebrospinal fluid accumulate?

A) Absorption of CSF through the arachnoid villi is impaired.
B) Excessive amounts of CSF are produced in the ventricles.
C) An obstruction is present in the aqueduct of Sylvius or other channel.
D) Flow around the spinal cord is blocked.

Question 21

The defective gene for Huntington's disease can be detected in carriers.

Question 22

Which of the following is NOT considered to be a common contributing factor to AIDS dementia?

A) invasion of the central nervous system by HIV
B) development of arteriosclerosis
C) secondary toxoplasmosis infection
D) development of cerebral lymphoma

Question 23

The ataxic form of cerebral palsy results from damage to the:

A) cerebellum
B) motor cortex
C) basal nuclei
D) pyramidal tracts

Question 24

Communicating hydrocephalus causes increased intracranial pressure because of:

A) atresia at the foramen magnum
B) failure of the subarachnoid to absorb CSF
C) obstruction in the lumbar area of the spinal cord
D) scar tissue from encephalitis blocking flow of CSF

Question 25

Which statement is TRUE about amyotrophic lateral sclerosis (ALS)?

A) Cognitive function remains normal.
B) ALS affects primarily young women.
C) Sensory neurons are damaged initially.
D) Cause of death is usually a cardiac arrhythmia.

Question 26

Which of the following is used both to confirm the diagnosis and classify seizures?

A) characteristics of the aura
B) presence of precipitating factors
C) electroencephalogram
D) changes in the characteristics of cerebrospinal fluid

Question 27

Which of the following is NOT a typical effect of advanced Parkinson's disease?

A) difficulty chewing and swallowing
B) urinary retention
C) loss of vision
D) orthostatic hypotension

Question 28

Which of the following is the most common cause of brain damage in children with cerebral palsy?

A) hyperbilirubinemia
B) hypoglycemia
C) hypoxia
D) trauma

Question 29

What causes a herniated intervertebral disc?

A) a tear in the nucleus pulposus
B) a protrusion of the nucleus pulposus through the annulus fibrosis
C) displacement of the annulus fibrosis between the laminae
D) failure of the spinous processes to restrict movement of the intervertebral disc

Question 30

What is the typical initial effect of a herniated intervertebral disc at the L4 to L5 level?

A) back pain and weakness at waist level
B) muscle weakness in both legs
C) lower back pain radiating down the leg
D) urinary incontinence

Question 31

Creutzfeldt-Jakob disease is caused by:

A) inheritance of an autosomal dominant trait
B) infection in the brain by HIV
C) an autoimmune reaction that damages nerve receptors
D) infection in the brain by a prion

Question 32

Which disease is associated with excessive dopamine secretion,decreased gray matter in the temporal lobes,and abnormal hippocampal cells in the brain?

A) Creutzfeldt-Jakob disease
B) schizophrenia
C) panic disorder
D) depression

Question 33

Which statement does NOT apply to status epilepticus?

A) Seizures are recurrent or continuous without full recovery between episodes.
B) Severe hypoxia and acidosis develop.
C) This condition occurs only in idiopathic seizures.
D) If the episode persists,there may be additional brain damage.

Question 34

Which type of seizure commonly occurs in children?

A) generalized absence
B) tonic-clonic
C) focal
D) complex partial

Question 35

All of the following may precipitate a seizure EXCEPT:

A) hypoglycemia
B) severe acidosis
C) brain abscess
D) high fever in young child

Question 36

Failure of the spinous processes to fuse but without herniation of the meninges is called:

A) spina bifida occulta
B) meningocele
C) myelomeningocele
D) encephalocele

Question 37

Which of the following are typical characteristics associated with schizophrenia?

A) disorganized thought processes,short attention span,delusions
B) lack of energy and motivation,poor concentration,insomnia
C) hyperventilation,tachycardia,intense anxiety
D) memory loss,mood swings,hostile behavior

Question 38

Which of the following dietary supplements has reduced the incidence of spina bifida in recent years?

A) vitamin B₆
B) folic acid
C) vitamins A and D
D) zinc and magnesium

Question 39

Which of the following is a typical early sign of amyotrophic lateral sclerosis (ALS)?

A) impaired ventilation
B) cognitive impairment
C) poor control of eye movement
D) weakness and muscle atrophy in upper limbs

Question 40

Which of the following classes of drugs may provide temporary improvement in cases of myasthenia gravis?

A) skeletal muscle relaxants
B) dopamine replacement drugs
C) anticholinesterase agents
D) GABA replacement drugs

Question 41

Which statement is TRUE about the condition depression?

A) It is classified as a mood disorder.
B) Episodes of intense fear are recurrent.
C) It is marked by periods of sadness,hopelessness and inability to concentrate.
D) a,b
E) a,c