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PATHOPHYSIOLOGY
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Homework for Chapter 16, Part 2 - Alterations of Neurologic Function:
Headache, Infections, Degenerative Diseases, and Tumors
Instructions:
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Use your lecture notes and textbook to find the answers to these questions.
When finished, enter your answers on the electronic version of the homework posted on
Canvas.
You may do this up to three times until you are happy with your grade.
1. Which type of headache involves activation of the trigeminal nerve on one side of the head, causing
unilateral pain?
A) migraine
B) cluster
C) tension-type
D) sinus
2. Which type of headache occurs more frequently in women than in men?
A) migraine headaches
B) tension-type headaches
C) cluster headaches
D) sinus headaches
3. A 17-year-old male has been experiencing headaches that feel like a tight band around his head. He
says that he has these about half the time, and they have been continuing for three months. This would
best be classified as:
A) classic migraine
B) migraine without aura
C) chronic cluster headache
D) chronic tension-type headache
4. The most common source of community-acquired meningitis is:
A) Streptococcus pneumoniae.
B) fungal infection.
C) Haemophilus influenzae.
D) human immunodeficiency virus (HIV).
5. In meningitis, the infection is thought to enter the CNS through the:
A) spinal nerves.
B) sinuses.
C) choroid plexus.
D) cerebral capillaries.
6. A 25-year-old female presents to her physician complaining of fever, headache, nuchal rigidity, and decreased
consciousness. She was previously treated for sinusitis. Which of the following is the most likely diagnosis?
A) Aseptic meningitis
B) Bacterial meningitis
C) Fungal meningitis
D) Nonpurulent meningitis
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7. Symptoms of bacterial meningitis can include all of the following EXCEPT:
A) mild frontal headache.
B) skin rash.
C) nuchal rigidity.
D) vomiting.
8. In bacterial meningitis, the CSF has:
A) decreased glucose levels.
B) increased protein and lactate.
C) neutrophilic infiltration.
D) all of the above
9. Viral meningitis:
A) has less severe symptoms than bacterial meningitis
B) is nearly always fatal
C) usually affects the ventricles, brain tissue, and meninges
D) is caused by Neisseria species
10. Most causes of encephalitis are:
A) bacterial.
B) viral.
C) fungal.
D) toxoid.
11. The neurologic disorder LEAST likely to be caused by HIV is:
A) stroke.
B) peripheral neuropathies.
C) encephalopathy.
D) central nervous system (CNS) tumors.
12. The development of sensory and motor symptoms in multiple sclerosis is caused by:
A) degeneration of sensory and motor neurons in the peripheral nervous system.
B) loss of neurotransmitter function in the spinal cord.
C) immunologic and inflammatory demyelination of central nervous system neurons.
D) receptor abnormalities at the neuromuscular junction and in the skin.
13. An attack of multiple sclerosis can be triggered by:
A) steroidal anti-inflammatory drugs
B) increased temperature
C) prolonged physical inactivity
D) a diet high in polyunsaturated fat
14. Symptoms of multiple sclerosis (MS) include:
A) disorders with gait and movement.
B) bowel problems.
C) visual disturbances.
D) all of the above.
15. Amyotrophic lateral sclerosis (ALS) is caused by the degeneration of:
A) lower and upper motor neurons in the spinal cord.
B) skeletal muscle tissue.
C) myelin in the peripheral nervous system.
D) myelin in the central nervous system.
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16. Damage to neurons in ALS appears to be associated with:
A) glutamate toxicity
B) inflammatory damage
C) excess acetylcholine
D) T cell mediated attack
17. Classic amyotrophic lateral sclerosis (ALS) presents with:
A) progressive dementia.
B) muscle weakness and atrophy.
C) severe paresthesias.
D) autonomic dysfunction.
18. A patient with myasthenia gravis is also likely to have:
A) Guillain-Barré syndrome
B) Duchenne’s muscular dystrophy
C) an immune deficiency
D) systemic lupus erythematosus
19. Myasthenia gravis results from:
A) viral infection of skeletal muscle.
B) atrophy of motor neurons in the spinal cord.
C) demyelination of skeletal motor neurons.
D) autoimmune injury at the neuromuscular junction.
20. Patients with myasthenia gravis often have tumors or pathologic changes in the:
A) brain.
B) pancreas.
C) thymus.
D) lungs.
21. The most common primary CNS tumors in adults are:
A) meningiomas.
B) medulloblastomas.
C) astrocytomas.
D) angiomas.
22. A 45-year-old male presents with seizures. An MRI reveals a meningioma most likely originating
from the:
A) dura mater and arachnoid membrane.
B) astrocytes.
C) pia mater.
D) CNS neurons.
23. Benign tumors that arise from the Schwann cells surrounding axons of the cranial nerves are:
A) meningiomas
B) neurilemmomas
C) metastatic carcinomas
D) ependymomas
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Critical Thinking Questions
24. A 25-year-old woman reports severe headaches that last for about a day, are preceded by a period of
tiredness and irritability, and are accompanied by blurred vision and sometimes nausea and vomiting.
She is probably experiencing:
A) migraine headaches
B) tension-type headaches
C) encephalitis
D) meningitis
25. The symptoms of which of the following are most similar to meningitis?
A) subdural hematoma
B) epidural hematoma
C) subarachnoid hemorrhage
D) classic concussion
26. Abnormally active T cells are involved in which disorder?
A) multiple sclerosis
B) amyotrophic lateral sclerosis
C) myasthenia gravis
D) HIV encephalopathy
27. A patient visits his doctor complaining of weakness and muscle fatigue. The doctor asks the patient to
raise his arms above his head thirty times, but after twenty repetitions he is exhausted. After a short
break he is able to complete the activity. The patient probably has:
A) Duchenne’s muscular dystrophy
B) Parkinson disease
C) amyotrophic lateral sclerosis
D) myasthenia gravis
28. Which of the following would be most likely to occur as a result of an ependymoma?
A) inability to smell strong odors
B) blockage of CSF flow through the ventricular system
C) loss of hearing
D) pain in the face and scalp