E-Book, Englisch, 336 Seiten, ePub
Waite / Sheakley Thieme Test Prep for the USMLE®: Medical Physiology Q&A
1. Auflage 2018
ISBN: 978-1-63853-416-7
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 336 Seiten, ePub
ISBN: 978-1-63853-416-7
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
is the choice of medical students...
-- Ethan Young (Fourth-year medical student, University of South Dakota, Sanford School of Medicine)
-- Chris Moser (Third-year medical student, Alabama College of Osteopathic Medicine)
from Gabi Waite and Maria Sheakley transforms high-yield concepts into challenging multiple choice questions organized by body system. Readers will learn how to synthesize, integrate, and apply physiological concepts to clinical situations in a format mirroring the USMLE® exam.
Key Highlights
- More than 750 USMLE®-style multiple choice questions on physiology and pathophysiology, categorized as easy, moderate, and difficult, with detailed explanations
- Questions begin with a clinical vignette and approximately 20% are image-based, mirroring the USMLE-format.
- Every question tagged by organ system, difficulty level, disease, and normal, abnormal or therapeutic process, enabling electronic format question sorting
This essential resource will help you assess your knowledge and fully prepare for board examinations.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
1 Cellular Physiology
2 The Nervous System
3 Musculoskeletal and Integumentary Systems
4 Blood and Immune Systems
5 Cardiovascular and Lymphatic Systems
6 Respiratory System
7 Renal and Urinary Systems
8 Gastrointestinal System
9 Endocrine System
10 Reproductive System
11 Multisystem Processes
Chapter 2
The Nervous System
LEARNING OBJECTIVES
? Describe the structure, normal stimuli, transduction at the receptor level, and function of the central nervous system (CNS).
? Describe the structure, normal stimuli, transduction at the receptor level, and function of the autonomic nervous system.
? Describe the structure, normal stimuli, transduction at the receptor level, and function of the senses of vision, hearing, equilibrium, taste, and smell.
? Describe the structure, normal stimuli, transduction at the receptor level, and function of the sensory and motor control systems.
2.1 Questions
| Easy | Medium | Hard |
1. A 34-year-old woman presents with bladder dysfunction, lower extremity paralysis, and bilateral loss of pain and thermal sensation in her legs for 2 days. Her discriminative touch, vibratory sense, and proprioception is preserved. A magnetic resonance image (MRI) reveals a vertebral bone tumor causing spinal compression. Which of the following best describes the spinal compression responsible for the patient’s symptoms?
A. Anterior cord syndrome
B. Cauda equina syndrome
C. Central cord syndrome
D. Compression of exiting roots at C5-C6
E. Compression of exiting roots at L3
2. A 61-year-old male patient with a 10-year history of hypertension suffers a hemorrhagic stroke, disrupting blood flow to the left vagus nerve. Which of the following is most likely to appear in the clinical presentation?
A. The tongue will deviate toward the left.
B. The tongue will deviate toward the right.
C. The uvula will deviate toward the left.
D. The uvula will deviate toward the right.
E. There will be no clinically perceptible deficit.
3. A patient complains of double vision and difficulty walking down steps for 3 months. He is referred to a neurologist for examination. A brain lesion is determined to be responsible for the deficits described. The lesion most likely involves which of the following cranial nerves?
A. Abducens nerve
B. Facial nerve
C. Optic nerve
D. Trigeminal nerve
E. Trochlear nerve
4. Which of the following is a morphine-like neurotransmitter that acts as a natural painkiller?
A. Acetylcholine
B. Dopamine
C. Endorphin
D. Epinephrine
E. Serotonin
5. A 17-year-old boy presents to the emergency department with a cerebellar hemorrhage. On exam, he exhibits jerky eye movements, sways when standing, and has a “drunk-like” gait. Which region of the cerebellum is most likely affected by the hemorrhage?
A. Anterior lobe
B. Dentate nucleus
C. Flocculonodular lobe
D. Interposed nucleus
E. Posterior lobe
6. A 38-year-old mother of three complains of sleeplessness for 6 months. History and physical exam are unremarkable. She agrees to an overnight sleep study, during which normal sawtooth waves are observed on her electroencephalogram (EEG). This EEG pattern is associated with which period of sleep?
A. REM
B. Stage 1
C. Stage 2
D. Stage 3
7. A 48-year-old woman has a stroke that affects the posterior part of Brodmann area 22, resulting in a lesion in the Wernicke area. Which of the following will most likely be observed in the clinical presentation of this patient?
A. Expressive speech deficit
B. Loss of right-sided touch/pressure sensation below the neck
C. Loss of coordinated motor movements
D. Primary visual processing deficit
E. Receptive speech deficit
8. A 39-year old woman presents with progressive weakness in her left hand over several months, and multiple episodes of bladder incontinence. She admits that her vision has been blurry lately, and that all of her symptoms are exaggerated on hot days. She is diagnosed with multiple sclerosis. Damage to which of the following cell types is responsible for this condition?
A. Astrocytes
B. Ependymal cells
C. Microglia
D. Oligodendrocytes
E. Schwann cells
9. A college student presents with signs of meningitis, and a lumbar puncture is performed to collect cerebrospinal fluid (CSF) for analysis. Which of the following cells are responsible for the production of CSF?
A. Astrocytes
B. Ependymal cells
C. Microglia
D. Oligodendrocytes
E. Schwann cells
2.2 Answers and Explanations
| Easy | Medium | Hard |
1. Correct: Anterior cord syndrome (A)
Anterior cord syndrome is an incomplete spinal cord injury of the anterior regions of the spinal cord. This condition causes paralysis below the level of the lesion, bilateral loss of pain and thermal sensation starting two to three levels below the injury, and bladder and bowel dysfunction. Because the posterior columns are not affected, discriminative touch, vibratory sense, and proprioception are preserved below the lesion. (B) Cauda equina syndrome occurs due to compression of the spine at the level of L1/L2 through S2. This condition results in bladder and bowel dysfunction, saddle anesthesia, lower extremity weakness, sexual dysfunction, and lower back pain. (C) Central cord syndrome is an incomplete spinal cord injury of the cervical spine that presents with weakness in the extremities, irregular pain and thermal sensation, and urinary retention. (D) Compression of exiting roots at C5-C6 would cause weakness of the forearm and wrist extensors and sensory loss of the C6 dermatome. (E) Compression of exiting roots at L3 would cause weakness of knee extension, pain over the anterior thigh, decreased sensation over the medial thigh, and a diminished patellar tendon reflex.
2. Correct: The uvula will deviate toward the right. (D)
Lesions of the vagus nerve result in uvular deviation away from the lesion. The left vagus nerve is involved in this patient; therefore the uvula deviates to the right. (A, B) The hypoglossal nerve, not the vagus nerve, controls the skeletal muscle of the tongue; therefore A and B are incorrect. (C) The uvula deviates away from the lesion, not toward it, as described for answer D. (E) There is a deficit as explained in answer D.
3. Correct: Trochlear nerve (E)
To walk down stairs, the eyes must be able to move downward. Downward movement of the eye involves the inferior rectus muscle, which is innervated by the oculomotor nerve, and the superior oblique muscle, which is innervated by the trochlear nerve. Damage to the trochlear nerve on one side will prevent the affected eye from moving downward. The two eyes will not be able to focus on the same region in the visual field, producing double vision. (A) The abducens nerve (CN X) is a somatic efferent nerve that controls movement of a single muscle, the lateral rectus, which abducts the eye. (B) The facial nerve (CN VII) controls the muscles of facial expression and conveys taste sensations from the anterior two-thirds of the tongue. (C) The optic nerve (CN II) is a sensory nerve for vision, originating at the retina. (D) The trigeminal nerve (CN V) has both motor and sensory components and mediates general sensation of the face and scalp, opening/closing of the mouth, and tension of the tympanic membrane.
4. Correct: Endorphin (C)
Endorphins are endogenous opioid neuropeptides produced by the central nervous system and pituitary gland. Their principal function is to inhibit the transmission of pain signals by antagonizing opioid receptors, particularly in the midbrain. (A, B, D, E) Acetylcholine, dopamine, epinephrine, and serotonin are common neurotransmitters, and some relationships to pain reduction have been shown, but they are not directly involved in inhibiting pain.
5. Correct: Flocculonodular lobe (C)
Deficits of the flocculonodular lobe can result in loss of oculomotor control, loss of integration of vestibular information for eye and head control, and loss of maintenance of balance equilibrium and muscle tone, as seen in this patient. (A) The anterior lobe is responsible for mediating unconscious proprioception. (B) The dentate nucleus is responsible for the planning, initiation, and control of voluntary movements. (D) The interposed nucleus is responsible for coordinating agonist/antagonist muscle pairs; therefore, a lesion in this area causes tremor. (E) The posterior lobe plays an important role in fine motor coordination, specifically in the inhibition of involuntary movement.
6. Correct: REM (A)
In REM sleep, brain waves increase to levels experienced when a person is awake and have a characteristic sawtooth pattern. Heart rate increases, blood pressure rises, and most dreams occur during this stage. (B) In Stage 1 (light) sleep, one drifts in and out of sleep and can be awakened easily. Stage 1 sleep is associated with 4–7 Hz theta waves. (C) In Stage 2, brain waves become slower...
