Nokea
Acetylcholine and norepinephrine act because of their affect on receptors at the ________ membrane.
- A. axonal
- B. cell body
- C. presynaptic
- D. postsynaptic
Correct Answer: D
Rationale: Acetylcholine and norepinephrine exert their effects by binding to receptors on the postsynaptic membrane of neurons. When these neurotransmitters bind to their receptors, they trigger changes in the postsynaptic neuron's membrane potential, either exciting or inhibiting the neuron. This interaction is essential for transmitting signals across synapses and enabling communication within the nervous system.
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A patient is being evaluated for an acute onset of a high fever, severe headache, vomiting, and a change in mental status. Which assessment finding would confirm a definitive diagnosis of meningitis?
- A. Initial Glasgow Coma Scale score <15
- B. Pseudomonas aeruginosa on blood culture
- C. Normal MRI
- D. White blood cells (WBC) in cerebrospinal fluid (CSF)
Correct Answer: D
Rationale: The correct answer is D: White blood cells (WBC) in cerebrospinal fluid (CSF). In meningitis, an infection of the meninges, the CSF will show an elevated WBC count indicating an inflammatory response. This finding is crucial for confirming the diagnosis as it directly reflects the presence of infection in the central nervous system.
A: While a Glasgow Coma Scale score <15 may indicate altered mental status, it is not specific to meningitis.
B: Pseudomonas aeruginosa on blood culture suggests a bacterial infection but does not confirm meningitis specifically.
C: A normal MRI may not show definitive signs of meningitis, as the diagnosis is primarily made through CSF analysis.
Trace the flow of blood for a nephron.
- A. peritubular capillaries, efferent arteriole, glomerulus, afferent arteriole
- B. efferent arteriole, glomerulus, afferent arteriole, peritubular capillaries
- C. afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries
- D. afferent arteriole, glomerulus, peritubular capillaries, efferent arteriole
Correct Answer: C
Rationale: The correct sequence is afferent arteriole, glomerulus, efferent arteriole, and peritubular capillaries. Blood enters the nephron through the afferent arteriole, is filtered in the glomerulus, exits through the efferent arteriole, and then flows into the peritubular capillaries, where reabsorption and secretion occur. This pathway ensures efficient filtration and processing of blood in the kidneys.
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 63-year-old patient taking carbidopa/levodopa 25/100 mg four times a day for PD is experiencing end-of-dose wearing off. The best recommendation is to:
- A. Add tolcapone.
- B. Add entacapone.
- C. Consider deep-brain stimulation (DBS).
- D. Change carbidopa/levodopa to three times a day.
Correct Answer: B
Rationale: Entacapone, like tolcapone, is a COMT inhibitor that can help manage wearing-off symptoms by extending the duration of levodopa's effect.
Which of the following is the most common cause of neonatal meningitis?
- A. Haemophilus influenzae b
- B. Streptococcus agalactiae
- C. Neisseria meningitidis
- D. Streptococcus pneumoniae
Correct Answer: B
Rationale: The correct answer is B: Streptococcus agalactiae. This bacterium is the most common cause of neonatal meningitis due to its ability to colonize the maternal genital tract and be transmitted to the newborn during delivery. It is a leading cause of early-onset neonatal sepsis and meningitis. Haemophilus influenzae b, Neisseria meningitidis, and Streptococcus pneumoniae are more commonly associated with meningitis in older children and adults, rather than in neonates. Therefore, choice B is the most appropriate answer based on the specific context of neonatal meningitis.