Quiz 11 - Pain and Neurological Disorders

Question 1

One location in which nociceptors can be found is the:

a. skin.
b. spinal cord.
c. efferent pathways.
d. hypothalamus.

Answer 1

a. skin

Question 2

A 50-year-old male crushes his hand while working in a sawmill. Long after his injury has healed he still feels burning pain in his hand. This pain is referred to as:

a. neuropathic pain.
b. peripheral pain.
c. psychogenic pain.
d. acute pain.

Answer 2

a. neuropathic pain.

Question 3

The classic triad of manifestations occurring with Parkinson’s disease includes all of the following EXCEPT:

a. tremor.
b. rigidity.
c. akinesia.
d. hyperkinesia.

Answer 3

d. hyperkinesia.

Question 4

The clinical manifestations that arise in Parkinson’s disease result from which one of the following changes in the basal nuclei?

a. degeneration of cholinergic neurons.
b. overstimulation of dopaminergic neurons.
c. lack of dopaminergic inhibition of cholinergic neurons.
d. reduced cholinergic stimulation of dopaminergic neurons.

Answer 4

c. lack of dopaminergic inhibition of cholinergic neurons.

Question 5

A 25-year-old male was in an automobile accident. At impact, his forehead struck the windshield. In this situation, the coup injury would occur in the:

a. frontal region.
b. temporal region.
c. parietal region.
d. occipital region.

Answer 5

a. frontal region.

Question 6

The most common type of traumatic brain injury is:

a. penetrating trauma.
b. diffuse axonal injury.
c. focal brain injury.
d. concussion.

Answer 6

d. concussion.

Question 7

In bacterial meningitis, laboratory analysis of CSF reveals a heavy presence of:

a. basophils.
b. neutrophils
c. lymphocytes.
d. eosinophils.

Answer 7

b. neutrophils

Question 8

Viral meningitis:

a. is always sudden in onset.
b. often occurs with measles, mumps or herpes.
c. is effectively treated with antibiotics.
d. rarely causes encephalopathy.

Answer 8

b. often occurs with measles, mumps or herpes.

Question 9

A 72-year-old male demonstrates left-sided weakness of upper and lower extremities, blurred vision and dizziness. The symptoms disappear in 24 hours. He most likely experienced a:

a. Stoke-in-evolution
b. arteriovenous malformation
c. transient ischaemic attack.
d. cerebral haemorrhage

Answer 9

c. transient ischaemic attack.

Question 10

Which statement is NOT true regarding increasing intracranial pressures?

a. Accumulating CO2 causes vasoconstriction
b. the brain volume increases
c. the blood volume in the vessels increases
d. brain tissue shifts from the compartment of greater pressure to one of lesser pressure

Answer 10

a. Accumulating CO2 causes vasoconstriction

Question 11

A 15-year-old female scrapes her knee while playing soccer and complains of sharp and well-localised pain. Which of the following would most accurately characterise her pain?

Answer 11

somatic pain

Question 12

In viral meningitis, laboratory analysis of CSF reveals a heavy presence of:

Answer 12

Lymphocytes

Question 13

One risk factor for thrombotic stroke is:

Answer 13

high blood cholesterol

Question 14

A 20-year-old male is admitted to the neurological critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the intracranial pressure is recorded at 24 mmHg. This reading is:

Answer 14

higher than normal

Question 15

A 25-year-old female presents to her GP complaining of fever, headache, nuchal rigidity and decreased consciousness. She was previously treated for sinusitis. Which of the following is the most likely diagnosis?

Answer 15

bacterial meningitis

Question 16

The pathological brain changes that occur with Alzheimer’s disease include neurofibrillary tangles and accumulations of senile plaques that are concentrated in:

Answer 16

cerebral cortex and hippocampus.

Question 17

A 60-year-old female with a recent history of head trauma and a long-term history of hypertension presents to the ED for changes in mental status. MRI reveals that she had a haemorrhagic stroke. This type of stroke is often caused by:

Answer 17

aneurysms.

Question 18

A direct consequence of increased intracranial pressure is:

Answer 18

brain tissue hypoxia

Question 19

Which CNS tract is responsible for carrying sensory information from the nociceptors to the brain?

Answer 19

spinothalamic

Question 20

Pain that is felt in a different body part to the source of the pain is called:

Answer 20

referred pain

Question 21

The main source of bleeding in extradural (epidural) haematomas is:

Answer 21

arterial

Question 22

A 20-year-old female pricked her left hand while sewing. Which area in her brain would have received the pain signals and perceived them as pain?

Answer 22

right somatosensory cortex

Question 23

In cerebral vasogenic oedema:

Answer 23

plasma proteins leak into extracellular spaces

Question 24

The main source of bleeding in subdural haematomas is:

Answer 24

venous

Question 25

The pain that occurs to a stimulus such as light stroking that normally does not provoke pain is termed:

Answer 25

allodynia.

Question 26

Neurons damaged by hypoxia or trauma discharge:

Answer 26

glutamate

Question 27

Cerebral oedema is an accumulation of fluid in the:

a. brain ventricles.
b. brain tissue.
c. subarachnoid space.
d. neuroglia.

Answer 27

b. brain tissue.

Question 28

A patient arrives in the ER following a Traumatic Brain Injury (TBI) with a Glasgow Coma Score of 10. His TBI is classified as:

a. Moderate
b. Severe
c. Mild
d. none of the above

Answer 28

a. Moderate

13-15 = mild
9-12 = moderate
3-8 = severe

Question 29

Cutaneous polymodal nociceptors are activated by:

a. mechanical injury only.
b. thermal stimuli such as heat only.
c. light touch and gentle stroking.
d. mechanical injury, heat and chemicals.

Answer 29

d. mechanical injury, heat and chemicals.

Question 30

Vasogenic oedema is clinically important because (ICP = intracranial pressure):

a. it usually has an infectious cause.
b. the blood-brain barrier is disrupted.
c. ICP is higher than in other forms of cerebral oedema.
d. it always causes herniation.

Answer 30

b. the blood-brain barrier is disrupted.

Question 31

A Lucid Interval following a Traumatic Brain Injury is usually seen following a:

a. Intracerebral haematoma
b. Subdural haematoma
c. Subarachnoid haematoma
d. epidural haematoma

Answer 31

d. epidural haematoma

Question 32

In cerebral vasogenic oedema:

a. active transport fails
b. there is autodigestion
c. plasma proteins leak into extracellular spaces
d. cerebrospinal fluid leaves the ventricles

Answer 32

c. plasma proteins leak into extracellular spaces

Question 33

The lowest intensity of a stimulus that is perceived as painful is termed:

a. affective-motivational aspect.
b. pain sensitisation.
c. pain threshold.
d. pain tolerance.

Answer 33

c. pain threshold.