Nokea
A client with a history of relapsing-remitting multiple sclerosis is expecting her first child. What would be indicated for this client?
- A. Suggest reproductive counseling, as multiple sclerosis can be genetic.
- B. Instruct to expect a period of remission after delivery of the baby.
- C. Instruct to expect an exacerbation of symptoms while pregnant.
- D. Discuss pain control during labor, as contractions will be severe.
Correct Answer: B
Rationale: Pregnancy often leads to a temporary remission of MS symptoms, but there is an increased risk of relapse postpartum. Reproductive counseling and pain management are important but secondary to understanding the disease course during pregnancy.
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Which of the following lifestyle factors is the strongest predictor of stroke risk?
- A. cigarette smoking
- B. alcohol consumption
- C. taking illicit drugs
- D. obesity
Correct Answer: A
Rationale: Cigarette smoking is a major risk factor for stroke, as it contributes to the development of atherosclerosis (narrowing and hardening of arteries) and increases the likelihood of blood clots. Quitting smoking significantly reduces stroke risk.
Which of the following would indicate side effects of the gold therapy?
- A. Symptoms of gastric irritation
- B. Generalized edema
- C. Elevated blood pressure
- D. Symptoms of visual disturbance
Correct Answer: A
Rationale: Gastric irritation is a common side effect of gold therapy.
A 38-year-old female presents with muscle fatigue that is worse by the end of the day. She reports to have myalgias in the back of her neck, and at times her head "drops." She also states to sees "double" when watching television, or reading for a prolonged period of time. On physical examination, ptosis is produced when asking the patient to look at the ceiling without blinking. Pupillary function is intact. Appropriate serologic testing is obtained. On repetitive nerve stimulation, the amplitude of the compound muscle action potential progressively declines. Which of the following is most likely the diagnosis?
- A. Botulism
- B. Lambert-Eaton myasthenic syndrome
- C. Acute inflammatory demyelinating polyradiculopathy
- D. Myasthenia gravis
Correct Answer: D
Rationale: The patient's symptoms of fatigable weakness, ptosis, and diplopia, along with the decremental response on repetitive nerve stimulation, are classic for myasthenia gravis. This autoimmune disorder is caused by antibodies against acetylcholine receptors at the neuromuscular junction, leading to impaired muscle contraction. Botulism and Lambert-Eaton syndrome also cause weakness but have different clinical and electrophysiological features. Multiple sclerosis and acute inflammatory demyelinating polyradiculopathy do not typically present with fatigable weakness.
The anal reflex mainly depends on which segment
- A. S1
- B. S2
- C. S3
- D. S4
Correct Answer: C
Rationale: The anal reflex tests the S3 and S4 nerve roots, which innervate the external anal sphincter. This reflex is important in assessing sacral nerve function.
Which part of the limbic system is involved in an animal's feeling of hunger?
- A. thalamus
- B. pons
- C. hippocampus
- D. hypothalamus
Correct Answer: D
Rationale: The hypothalamus is a key part of the limbic system and is involved in regulating hunger, thirst, and other homeostatic processes. It receives signals from the body about energy needs and releases hormones that stimulate or suppress appetite. The hypothalamus also plays a role in regulating the autonomic nervous system and maintaining the body's internal balance. Its involvement in hunger highlights its importance in survival and behavior.