Nokea
Which of these is the most important cause of adult onset epilepsy?
- A. neurocysticercosis
- B. neurotoxoplasmosis
- C. primary amoebic meningoencephalitis
- D. African trypanosomiasis
Correct Answer: A
Rationale: The correct answer is A: neurocysticercosis. Neurocysticercosis is the most common cause of adult onset epilepsy worldwide. It is caused by the larval stage of the tapeworm Taenia solium. The larvae can infect the brain and lead to seizures. Neurotoxoplasmosis (B) is more commonly associated with HIV patients. Primary amoebic meningoencephalitis (C) is caused by the amoeba Naegleria fowleri and is rare. African trypanosomiasis (D) does not typically cause epilepsy. Therefore, neurocysticercosis is the most important cause of adult onset epilepsy due to its global prevalence and direct impact on the brain leading to seizures.
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Which is the most common neurotransmitter in the brain?
- A. serotonin
- B. glutamate
- C. dopamine
- D. GABA
Correct Answer: B
Rationale: Glutamate is the most abundant excitatory neurotransmitter in the brain and is involved in nearly all excitatory brain functions. It plays a key role in synaptic plasticity, learning, and memory. Glutamate binds to receptors on postsynaptic neurons, promoting the transmission of signals. However, excessive glutamate activity can lead to excitotoxicity, causing neuronal damage and contributing to conditions like stroke and neurodegenerative diseases.
Which is the smallest cranial nerve?
- A. olfactory nerve (I)
- B. occulomotor nerve (III)
- C. trochlear nerve (IV)
- D. abducent nerve (VI)
Correct Answer: C
Rationale: The trochlear nerve (IV) is the smallest cranial nerve. It innervates the superior oblique muscle, which helps control eye movement.
A 33-year-old female presents with drooping of her eyelid that seem to occur while reading or watching television. This appears to get worse later in the day. She also reports that at times she sees "double." A few weeks ago, she was prescribed an antibiotic medication for a urinary tract infection. She does not recall the name of the antibiotic. On physical exam, bilateral ptosis, with the left affected more than the right is seen. Pupillary function intact. A glove is filled with ice, and subsequently applied to the patient's eyelid. After two minutes, the patient's ptosis has improved. Which of the following is most likely to yield rapid symptom improvement?
- A. Corticosteroids
- B. Plasma exchange
- C. Acetylcholinesterase inhibitor
- D. Thymectomy
Correct Answer: C
Rationale: The patient's symptoms of ptosis and diplopia that worsen with activity and improve with rest are classic for myasthenia gravis. The ice pack test, which improves ptosis, further supports this diagnosis. Acetylcholinesterase inhibitors, such as pyridostigmine, are the first-line treatment for symptomatic improvement in myasthenia gravis. Corticosteroids and plasma exchange are used for long-term management or severe cases, while thymectomy is a surgical option for thymoma-associated myasthenia gravis.
A patient reports sudden weakness on one side of their body. The nurse should:
- A. Perform a neurologic assessment focusing on motor function and sensation.
- B. Measure the patient's oxygen saturation.
- C. Inspect the patient's skin color.
- D. Check the patient's blood glucose levels.
Correct Answer: A
Rationale: Sudden weakness on one side of the body may indicate a neurological issue, such as a stroke. A focused neurologic assessment is essential. Oxygen saturation, skin color, and blood glucose levels are secondary considerations.
When testing for motor function, the nurse should be aware of:
- A. Symmetry and strength of muscle movements.
- B. The patient's skin color and temperature.
- C. The patient's blood glucose levels.
- D. The patient's heart rate and rhythm.
Correct Answer: A
Rationale: Motor function testing involves assessing symmetry and strength of muscle movements. Skin color, blood glucose levels, and heart rate are unrelated to motor function.