The development of mental health disorders

CHOICE THE RIGHT ANSWER1Alterations in __ have been associated with the development of mental health disorders such as depression, bipolar disorder, and schizophrenia.

chromosomes 1 and 2

chromosomes 5 and 6

chromosomes 8 and 15

chromosomes 3 and 10

2A migraine occurs as a result of:

trigeminal nerve inhibition.

cerebral vasoconstriction.

neurogenic inflammation leading to neuronal sensitization.

inhibition of serotonin receptors.

3Which of the following neurotransmitters are generally considered excitatory?

Glutamate

Dopamine and glutamate

Dopamine

Gamma aminobutyric acid

Serotonin

4In a generalized anxiety disorder, anticipatory anxiety and attentional bias to threats are thought be caused by:

cingulate cortex and amygdala abnormalities.

hypothalamic-pituitary thyroid system dysregulation.

serotonin and GABA surges.

cholecystokinin receptor gene on chromosome 11p.

5What is the relationship between the hypothalamic pituitary axis and depression?

Increased production of corticotropin-releasing hormone

Reduction in cortisol

Low levels of gamma aminobutyric acid

Reduced production of corticotropin-releasing hormone

6A patient with refractory depression will receive electroconvulsive therapy. She would like more information about this therapy. What information should be provided to her?

You will have to reduce your intake of food after, due to the risk of vomiting.

The procedure is painless, so usually no anesthesia is necessary.

The procedure produces a brief brain seizure that activates various brain areas.

You will need to be on bedrest for 2 days after the procedure.

7Which of the following types of nerve cells produce myelin?

Astrocytes

Schwann

Neurocytes

Microglia

8Neuroanatomic and neurotransmitter alterations in the pathophysiology of schizophrenia include which of the following?

Loss of cortical tissue and alteration in dopamine pathways

Alteration in dopamine pathways

Shrinkage of the ventricles

Loss of cortical tissue

All of these are correct.

9Which of the following neurologic disorders is characterized by cortical nerve cell processes that have become twisted and dilated?

Delirium

Alzheimer disease

Parkinson disease

Multiple sclerosis

10A patient reports that he senses that he is detached from society. His family reports he doesn’t seem to enjoy many experiences. These symptoms are a description of:

delusions.

avolition.

anhedonia.

alogia.

11A man is complaining of a unilateral throbbing headache that is severe. He also gets a runny nose, and his eye gets teary. These headaches make him feel restless. He says they come and go, but he can get several in a day. These findings are consistent with:

cluster headaches.

tension headaches.

migraine headache without aura.

headache due to an aneurysm.

12A 30-year-old male patient is in the emergency room because he was belligerent, confused, and delirious. His girlfriend called the police because of this behavior, and she said it started after smoking marijuana. Suspicions are that the marijuana was altered with phencyclidine (PCP). Which receptors are mainly altered by PCP?

Serotonin receptors

N-methyl-D-aspartate (NMDA)

Monoamine receptors

Dopamine receptors

13A nurse is putting together a presentation on meningitis. Which of the following microorganisms has been linked to meningitis?

E. coli

N. meningitis

Cl. difficile

S. pneumonia, H. influenza, and N. meningitis

S. pneumonia

H. influenza

14Which of the following essential amino acids is a precursor to serotonin?

Glutamate

Choline

Dopamine

Tryptophan

15A patient with schizophrenia has hallucinations and delusions. These thoughts and behaviors are termed:

negative symptoms.

cognitive symptoms.

affective symptoms.

positive symptoms.

16A 25-year-old was playing baseball and was hit in the head by a bat. At first he lost consciousness for a short period and then was alert, so he decided to just go home and put ice on his head. While at home, he started having a headache, became confused, and started to vomit. The most likely type of cerebral injury is a(n):

epidural hematoma.

subdural hematoma.

subarachnoid hemorrhage.

intracerebral hemorrhage.

17Benign febrile seizures are characterized by or associated with:

respiratory or ear infections.

extremely high temperatures.

onset after 5 years old.

lasting 30 minutes or more.

18A woman is diagnosed with trigeminal neuralgia. Where would her pain be located?

Neck

Trapezius

Cheek and mandibular area

Occiput

19What symptoms must be present for a patient to be diagnosed with major depressive disorder?

Insomnia

Fatigue

Feeling of sadness

Indecisiveness

20Which of the following neurotransmitters is widely reduced in depression?

Monoamine

Glutamine

Serotonin

Epinephrine

21A 35-year-old man comes in complaining of right leg anterior shin pain. He states he has been training to run a half marathon. He is able to run, but the pain has been getting worse over the last 2–3 weeks. A __ fracture is suspected.

greenstick

incomplete

pathologic

stress

22Characteristics of the shoulder joint include:

the joint capsule is composed of collagen without blood vessel.

it is an amphiarthroses-type joint with a gel-like nucleus cushion.

it contains a joint capsule with many ligaments supporting its attachment.

the joint cavity consists of hyaluronic acid, which is a solid substance that keeps the joint stable.

23Changes that occur in the cartilage as a result of aging includes:

increased hyaluronic acid.

decreased water content.

decreased nerve supply.

increased glycosaminoglycans.

24Which of the following statements describes osteoprotegerin (OPG)?

Women have a higher level of OPG in comparison to men.

OPG stimulates RANKL.

When bound to an osteoclast, it promotes resorption.

It acts as a RANKL receptor decoy.

25Bone matrix hydroxyapatite crystals are composed of calcium and:

sodium and water.

potassium and sodium.

magnesium and water.

phosphate and water.

26A mother and father are being taught how to properly swaddle their newborn girl to avoid developmental hip dysplasia. Important points to teach are that swaddling should be in a position that:

keeps the hips fully adducted.

allows for hip flexion and abduction.

does allow the infant to move too much to avoid dislocation.

keeps the legs fully extended.

27A 60-year-old woman is complaining that her ring finger seems to pop out of place, and sometimes when she flexes her finger, it locks. She denies any trauma. She has a history of hypertension and type 2 diabetes mellitus. The cause of her finger locking and popping is due to:

ligament tear at the base of the finger.

abnormal thickening of the flexor tendon at the metacarpophalangeal joint.

abnormal thickening of the extensor tendon at the proximal interphalangeal joint.

overuse with tendinitis.

28Developmental hip dysplasia occurs as a result of:

lack of normal physiologic laxity during the newborn period.

lack of femoral head cartilage development.

lack of normal contact between the femoral head and acetabulum.

femoral head and acetabulum compressing together.

29A patient is complaining of elbow pain. Which manifestations would be consistent with epicondylitis?

Erythema

Warmth

Focal tenderness

Edema

30Which of the following findings is(are) consistent with structural scoliosis?

Symmetrical hip height

Asymmetrical shoulder height

Symmetrical scapula

Asymmetrical shoulder height and rib prominence

Rib prominence

31Which of the following scenarios is suspicious for child abuse?

A 4-year-old breaks his femur (midshaft) while learning to ride a bike.

A 3-year-old has a left arm radial head subluxation that he sustained while he was playing with his 15- year old cousin who was swinging him around holding his hands.

A 12-year-old fell and hit a curb while riding his bike and landed on his shoulder and broke his clavicle

A 10-year-old fractured his ulna and radius while skateboarding. His sister was with him and corroborates how he fell.

32Which of the following is the differences between cartilage and bone?

Cartilage is made of collagen, and bone is not.

Bone is calcified, whereas cartilage is not.

There is no diffusion of substances in cartilage.

Cartilage is more vascular than bone.

33Why does the risk of osteoporosis increase after menopause?

RANK and RANKL binding decreases.

RANKL levels decrease leading to increase osteoblast apoptosis.

RANKL levels increase leading to increased osteoclastic activity.

Osteoprotegerin (OPG) increases.

34A 14-year-old boy who plays soccer comes in complaining of anterior knee pain that is worse when he runs and jumps and gets better when he rests his knee. His father says he’s been getting tall very quickly in the past few months. An X-ray of the knee is normal. What is the likely cause of his knee pain?

The anterior patellar tendon is separating from the tibial tubercle.

The distal femur is encroaching on the knee joint.

The quadriceps muscle is strained.

The patella is loose and unstable.

35Which types of medication should be avoided in someone with gout?

Angiotensin-converting enzyme inhibitors

Nonsteroidal anti-inflammatory agents

Glucocorticoids

Thiazide diuretics

36Which of the following dual energy X-ray absorptiometry (DEXA) scan finding is consistent with osteoporosis?

A T score of 2.9 in a 50-year-old woman who is not menopausal

A T score of 2.0 in a 55-year-old postmenopausal woman

A T score of 1.0 in a 60-year-old woman

A T score of 0.5 in a 70-year-old man

37Which of the following are manifestations of developmental hip dysplasia in a 2-month-old infant?

The hips can be easily subluxed with physical maneuvers.

Gluteal creases are symmetric.

Hip adduction is limited.

Femur height is equal.

38Carpal tunnel syndrome is a result of:

thickening of the fascia.

radial head wrist tendinitis.

median nerve compression.

carpal ligament tear.

39__ is a risk factor for the development of slipped capital femoral epiphysis in children.

Obesity

Playing sports

Type 1 diabetes mellitus

Rheumatoid arthritis

40A 70-year-old man is complaining of calf pain that gets better when he leans forward or sits. He has a history of low back pain for several years and was told it was due to arthritis of his spine, but he never had this calf pain. He feels like his legs are a bit weaker. This pain pattern is characteristic of:

osteoporosis.

ankylosing spondylitis.

spinal stenosis.

lumbar strain.

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