merck quiz

A neuron generates and propagates an axon potential along it's axon. Then transmits this signal across a synapse by releasing neurotransmitters, which trigger a reaction in another neuron or an effector cell. The signal the ____ receiving cell

may stimulate or inhibit

The amino acids; _______________ and aspartate, neurotransmitters in the CNS. are the major excitatory. They occur in the cortex, cerebellum, and spinal cord. In neurons, synthesis of nitric oxide (NO) increases in response to __________________. Excess _______________can be toxic, increasing intracellular Ca, free radicals, and proteinase activity. These neurotransmitters may contribute to tolerance to opioid therapy and mediate hyperalgesia

glutamate

____________ is generated by the raphe nucleus and midline neurons of the pons and upper brain stem

serotonin

______ is the neurotransmitter of most postganglionic sympathetic fibers and many central neurons (eg, in the locus coeruleus and hypothalamus). The precursor tyrosine is converted to dopamine

norepinephrine

_______ a peptide, occurs in central neurons (in the habenula, substantia nigra, basal ganglia, medulla, and hypothalamus) and is highly concentrated in the dorsal root ganglia. Its release is triggered by intense afferent painful stimuli. It modulates the neural response to pain and mood; it modulates nausea and vomiting through the activation of NK1A receptors that are localized in the brain stem

substance P

_______ are opioids.  

Endorphins & Enkephalins

The preganglionic cell bodies of the _________ system are located in the intermediolateral horn of the spinal cord between T1 and L2 or L3

sympathetic

is a form of low blood pressure that happens when you stand up from sitting or lying down. _____________ can make a person feel dizzy or lightheaded, and maybe even cause them to faint.

Orthostatic hypotension 

Which of the following signs/symptoms is not cited by Merck as being associated with autonomic insufficiency?

Watery Eyes

Upon eye examination: you see an unreactive pupil also known as This type of pupil suggests a parasympathetic lesion.

Adie's Pupil

is a condition in which a patient usually cannot be aroused, and the eyes do not open in response to any stimulation

coma

posturing indicates that the upper brain stem motor centers, which facilitate flexion, have been damaged and that only the lower brain stem centers (eg,vestibulospinal tract, reticulospinal tract), which facilitate extension, are responding to sensory stimuli

decerebrate

An inspiratory gasp with respiratory pauses of about 3 sec after full inspiration (apneustic breathing) typically indicates

pontine or medullary lesions

 A reduced amount of carbon dioxide, usually caused by hyperventilation is called:

Hypocapnia

Patients _____ have complex reflexes, including eye movements, yawning, and involuntary movements to noxious stimuli.

May

nial nerves, resulting in inability to show facial expression, move, speak, or communicate, except by coded eye movements. It typically results from a pontine hemorrhage or infarct that causes quadriplegia and disrupts and damages the lower cranial nerves and the centers that control horizontal gaze

locked in syndrome

_______ is an acute, transient, usually reversible, fluctuating disturbance in attention, cognition,and consciousness level. Causes include almost any disorder,

intoxication, or drug. Diagnosis is clinical, with laboratory and usually imaging tests to identify the cause. Treatment is correction of the cause and supportive measures.

Delirium

Which of the following is NOT listed in Merck as one of the most common causes of delerium?

Hypertension

Which of the following is NOT listed by Merck as some of the most common types of dementia:

Multiple Sclerosis

is the impaired ability to do previously learned motor activities despite intact motor function.

Apraxia

Memantine, an NMDA (N-methyl-D-aspartate) antagonist, may help slow progression of moderate to severe dementia and can be used with a cholinesterase inhibitor. Which of the following is NOT also an NMDA antagonist?

None of the Choices are Correct. All are NMDA receptor antagonists

Sometimes known as Diabetes Type 3, ___________ causes progressive cognitive deterioration and is characterized by senile plaques, β-amyloid deposits, and neurofibrillary tangles in the cerebral cortex and subcortical gray matter.

Alzheimer's Disease

Which of the following is NOT listed by the Merck as having preliminary, observational, preventative evidence suggestive of reducing the risk of Alzheimer's disease:

High Omega 6 Diet

 What does lacunar disease affect?

small blood vessels of the brain

Emotional incontinence can be a sign/symptom of dementia. It is inappropriate and uncontrollable laughing, crying, or rage. It is also known as:

Pseudobulbar Palsy

 Frontotemporal dementia is closely related with, and sometimes aka:

pick's Disease

About ___ % of adults have a seizure at some time during their life. Two thirds of these people never have another one

2

eizures are provoked by a temporary disorder or stressor (eg, metabolic disorders, CNS infections, cardiovascular disorders, drug toxicity or withdrawal).

Nonepileptic

You have epilepsy if you have one seizure

false

Alcohol withdrawal can induce a seizure

true

seizures are often preceded by an aura. During the seizure, patients may stare, consciousness is impaired, but patients have some awareness of the environment (eg, they purposefully withdraw from noxious stimuli).

Complex partial

seizures are brief, lightning-like jerks of a limb, several limbs, or the trunk. They may be repetitive, leading to a tonic-clonic seizure. The jerks may be bilateral or unilateral. Unlike other seizures with bilateral motor movements, consciousness is not lost unless the myoclonic seizure progresses into a generalized tonic-clonic seizure

Myoclonic

Febrile seizures require a _____ as part of the presentation

fever

nerve stimulation: Intermittent electrical stimulation of the left _____________ nerve with an implanted pacemaker-like device (vagus nerve stimulator) is used as an adjunct to drug therapy in patients who have intractable seizures and are not candidates for epilepsy surgery

vagus

 Almost ____ % of all people in the US report sleep-related problems. Disordered sleep can cause emotional disturbance, memory difficulty, poor motor skills, decreased work efficiency, and increased risk of traffic accidents. It can even contribute to cardiovascular disorders and mortality

50%

_______ sleep constitutes about 75 to 80% of total sleep time in adults. It consists of 4 stages in increasing depth of sleep. Slow, rolling eye movements, which characterize quiet wakefulness and early stage 1 sleep, disappear in deeper sleep stages. Muscle activity decreases as well. Stages 3 and 4 are referred to as deep sleep because arousal threshold is high; people may perceive these stages as high-quality sleep.

Nonrapid eye movement (NREM))

refers to behaviors that are not conducive to sleep. They include consumption of caffeine or sympathomimetic or other stimulant drugs (typically near bedtime, but even in the afternoon for people who are particularly sensitive), exercise or excitement (eg, a thrilling TV show) late in the evening, and an irregular sleep-wake schedule. Patients who compensate for lost sleep by sleeping late or by napping further fragment their nocturnal sleep.

Inadequate sleep hygiene

consists of episodes of partial or complete closure of the upper airway during sleep, leading to cessation of breathing for > 10 sec. Sometimes patients awaken, gasping. These episodes disrupt sleep and result in a feeling of unrefreshing sleep and EDS.

Obstructive sleep apnea

Neurocysticercosis: Among about 20 helminths that can cause neurologic disorders, the_____________ tapeworm Taenia solium causes by far the most cases in the Western Hemisphere

pork

Prion diseases are progressive, fatal, and untreatable degenerative brain disorders. Prion diseases usually occur sporadically, with a worldwide annual incidence of about 1/1 million. Prion diseases result from misfolding of a normal cell-surface brain protein called prion protein (PrP), whose exact function is unknown. They include all of the following except:

Herpes Zoster

Many cases of infectious meningitis begin with a vague prodrome of viral symptoms. The classic meningitis triad of fever, headache, and nuchal rigidity develops over hours or days. Passive flexion of the neck is restricted and painful, but rotation and extension are typically not as painful. In severe cases, attempts at neck flexion may induce flexion of the hip or knee this is known as:

Brudzinski’s sign

are the most common cause of meningitis in adults. Especially at risk are alcoholics and people with chronic otitis, sinusitis, mastoiditis, CSF leaks, recurrent meningitis, pneumococcal pneumonia, sickle cell disease, or asplenia. Incidence of pneumococcal meningitis is decreasing because of routine vaccination.

Pneumococci

septic meningitis is inflammation of the meninges with CSF lymphocytic pleocytosis and no cause apparent after routine CSF stains and cultures. ____________ are the most common cause.

Viruses (viral)

Also known as congenital dystrophia brevicollis: malformation __________ (fusion of cervical vertebrae) is a congenital deformity and limited motion of the neck but usually no neurologic consequences.

Klippel-Feil

.impaired epiphyseal bone growth, resulting in shortened, malformed bones) sometimes causes the foramen magnum to narrow or fuse with the atlas and thus may compress the spinal cord or brain stem.

Achondroplasia

cavity in the central part of the spinal cord) is common in patients with Chiari malformation. It may cause segmental flaccid weakness and atrophy, which first appear or are most severe in the distal upper extremities; pain and temperature senses may be lost in a capelike distribution over the neck and proximal upper extremities, but light touch is preserved.

Syringomyelia

Intracranial tumors may involve the brain or other structures (eg, cranial nerves, meninges). The tumors usually develop during early or middle adulthood but may

develop at any age; they are becoming more common among the elderly. Brain tumors are found in about ____ % of routine autopsies

2%

Which of the following is not a primary intracranial tumor originating in brain parenchyma?

acoustic neuroma

Of the following choices, which type of brain tumor/lesion is more common?

metastases

Of the following choices, which is the most malignant?

glioblastoma multiforme