Gould: Pathophysiology for the Health Professions, 4th Edition

Chapter 23: Chronic Neurologic Disorders

Test Bank
MULTIPLE CHOICE
1. In cases of noncommunicating hydrocephalus, why does excess cerebrospinal fluid

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

a.
b.
c.
d.

ANS: C
2. 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
ANS: B
3. 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
ANS: C
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
ANS: A
5. 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
ANS: D
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6. 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
ANS: A
7. 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
ANS: B
8. From the following, choose the two events (in correct sequence) that immediately follow

the aura during a tonic-clonic event:

prodromal signs, then the clonic stage
clonic stage, then the tonic stage
loss of consciousness, then the tonic stage
loss of consciousness and cessation of respiration

a.
b.
c.
d.

ANS: C
9. 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
ANS: C
10. 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
ANS: B
11. 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
ANS: A
12. Which statement does NOT apply to the pathophysiology of multiple sclerosis?

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Test Bank
a.
b.
c.
d.

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

ANS: D
13. 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
ANS: B
14. Which of the following applies to Parkinsons 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.
ANS: A
15. What is the pathophysiologic change in Parkinsons 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
ANS: C
16. Which of the following are common early manifestations of Parkinsons 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
ANS: A
17. In which type of neuron is progressive degeneration occurring with amyotrophic lateral

sclerosis (ALS)?
upper motor neurons
upper and lower motor neurons
motor and sensory neurons
motor, sensory, and autonomic system neurons

a.
b.
c.
d.

ANS: B
18. Which of the following statements does NOT apply to myasthenia gravis?
a. The cholinergic receptors at the neuromuscular junctions are damaged.

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b. It is an autoimmune disorder.
c. Muscle weakness and fatigue occur in the face and neck.
d. Dementia develops in the later stage.
ANS: D
19. Which statement applies to Huntingtons 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
ANS: C
20. What are the characteristic changes in the brain with Alzheimers 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
ANS: A
21. Which disease is associated with excessive dopamine secretion, decreased gray matter in

the temporal lobes, and abnormal hippocampal cells in the brain?

Creutzfeldt-Jakob disease
schizophrenia
panic disorder
depression

a.
b.
c.
d.

ANS: B
22. In which disorders do biochemical abnormalities involving the neurotransmitters in the

brain occur?
1. bipolar disorder
2. schizophrenia
3. Huntingtons disease
4. AIDS dementia
a. 1, 3
b. 1, 4
c. 1, 2, 3
d. 2, 3, 4
ANS: C
23. 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

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c. hyperventilation, tachycardia, intense anxiety

d. memory loss, mood swings, hostile behavior
ANS: A
24. 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
ANS: C
25. 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
ANS: B
26. Which of the following dietary supplements has reduced the incidence of spina bifida in

recent years?
vitamin B6
folic acid
vitamins A and D
zinc and magnesium

a.
b.
c.
d.

ANS: B
27. Which of the following is the most common cause of brain damage in children with

cerebral palsy?
hyperbilirubinemia
hypoglycemia
hypoxia
trauma

a.
b.
c.
d.

ANS: C
28. The ataxic form of cerebral palsy results from damage to the:
a. cerebellum
b. motor cortex
c. basal nuclei
d. pyramidal tracts
ANS: A
29. Which of the following is used both to confirm the diagnosis and classify seizures?
a. characteristics of the aura
b. presence of precipitating factors

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c. electroencephalogram
d. changes in the characteristics of cerebrospinal fluid
ANS: C
30. 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.
ANS: C
31. Which type of seizure commonly occurs in children?
a. generalized absence
b. tonic-clonic
c. focal
d. complex partial
ANS: A
32. All of the following may precipitate a seizure EXCEPT:
a. hypoglycemia
b. severe acidosis
c. brain abscess
d. high fever in young child
ANS: B
33. Which of the following is NOT a typical effect of advanced Parkinsons disease?
a. difficulty chewing and swallowing
b. urinary retention
c. loss of vision
d. orthostatic hypotension
ANS: C
34. 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
ANS: D
35. 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

Copyright 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.

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d. GABA replacement drugs

ANS: C
36. Which of the following are typical early signs of Alzheimers disease?

1. behavioral changes
2. reduced ability to reason and problem solve
3. decreased verbal responses
4. urinary incontinence
a. 1, 2
b. 1, 4
c. 2, 3
d. 1, 3, 4
ANS: A
37. Which of the following is NOT considered to be a common contributing factor to AIDS

dementia?
invasion of the central nervous system by HIV
development of arteriosclerosis
secondary toxoplasmosis infection
development of cerebral lymphoma

a.
b.
c.
d.

ANS: B
38. 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
ANS: B
39. 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
ANS: A
40. 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.
ANS: A
41. Creutzfeldt-Jakob disease is caused by:

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a.
b.
c.
d.

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inheritance of an autosomal dominant trait

infection in the brain by HIV
an autoimmune reaction that damages nerve receptors
infection in the brain by a prion

ANS: D
42. The defective gene for Huntingtons disease can be detected in carriers.
a. true
b. false
ANS: A
43. 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
ANS: E

Copyright 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.