pathophysiology - Assessment Questions

Multiple-Choice Questions

Question 1 (1 point)
Which pressure is increased as part of a systemic reflex in response to reduced brain perfusion?

1. Cerebrospinal fluid pressure
2. Intracranial Pressure
3. Mean Arterial Pressure (Systemic)
4. Cerebral Perfusion Pressure 

Question 2 (1 point)
Which pressure, if raised, can lead to compression of the vessels inside the skull?

1. Mean Arterial Pressure (Systemic)
2. Cerebral Perfusion Pressure
3. Cerebrospinal fluid pressure
4. Intracranial Pressure 

Question 3 (1 point)
Reduced venous return from the brain would result in an increase in what pressure?

1. mean arterial blood pressure
2. cerebral perfusion pressure
3. intravascular pressure
4. intracranial pressure

Question 4 (1 point)
Which pressure, if it drops, can lead to brain ischaemia?

1. Intracranial Pressure
2. Cerebral Perfusion Pressure
3. Cerebrospinal fluid pressure
4. Mean Arterial Pressure (Systemic) 

Question 5 (1 point)
As ICP rises following focal brain injury, the brain is further compromised by:

1. Vasodilation
2. Venous haemorrhage
3. Vascular compression
4. Arterial haemorrhage 

Question 6 (1 point)
Which of the answers below would correctly complete the following statement?
The cerebro ischaemic response (Cushing's reflex) states that upon raised intracranial pressure, the _____ increases to overcome the _____ and ensure that the _____ is above 60mmHg.

1. MABP; ICP; CPP
2. MABP; CPP; ICP
3. ICP; CPP; MABP
4. CPP; MABP; ICP

Question 7 (1 point)
After head injury, ICP will increase quickly due to which of the following?

1. Arterial haemorrhage 
2. Vascular compression
3. Vasodilation
4. Venous haemorrhage 

Question 8 (1 point)
If Zac deteriorates, he may require a pain stimulus as part of his GCS assessment. In response to a pain stimulus, Zac may exhibit ……………….. if he has significant damage to the motor cortex in the cerebrum.

1. decerebrate extension 
2. localised to pain
3. exhibited decorticate flexion 
4. withdrawn from pain 

Question 9 (1 point)
Zac has an occipital laceration which occurred when he hit his head on the kerb. A contrecoup injury is most likely to have occurred to his

1. frontal lobe
2. parietal lobe
3. cerebellum
4. temporal lobe

Question 10 (1 point)
Zac hit his head, possibly experiencing a traumatic brain injury. Which of the following is a primary injury?

1.  Subdural haematoma
2. Neurogenic shock
3. Neural ischaemia
4. Diffuse axonal injury

Question 11 (1 point)
As part of his care, Zac will be assessed for post-traumatic amnesia. The rationale for this is that;

1. the data will be used to predict the likelihood of Zac experiencing future seizures
2. the data is used in conjunction with the Glasgow coma scale data to determine the degree and severity of diffuse axonal injury and traumatic brain injury severity
3. the data will be used to determine how much help Zac will need with his ADLs
4. the data will be used to determine what type of intracranial haemorrhage Zac might have experienced.

Question 12 (1 point)
Zac hit his head, experiencing a traumatic brain injury (TBI). Which of the following is considered a tertiary presentation subsequent to a TBI?

1. contrecoup contusion
2. hypoxaemia
3. subdural haematoma
4. neural ischaemia

Question 13 (1 point)
Which of the following is a direct result of the baroreceptor reflex towards end-stage elevation in ICP?

1. High blood pressure
2. Widening pulse pressure
3. Bradycardia
4. Reactive pupils 

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Question 14 (1 point)
If Zac were to deteriorate, an irregular respiratory pattern would indicate the following pathophysiological change;

1. pressure on the meninges
2. loss of the oculocephalic reflex
3. increased reflexive motor responses
4. brainstem responses to changes in PaCO2

Question 15 (1 point)
Which of the following cues from Zac's data is indicative of raised ICP?

1. elevated systolic, lowered diastolic blood pressure, tachycardia
2. elevated systolic blood pressure, widening pulse pressure, tachycardia
3. sluggish pupillary reflex
4. nausea and vomiting

Question 16 (1 point)
If Zac's motor response deteriorates and is weak due to problems in the motor cortex, which structure is primarily affected?

1. basal ganglia (basal nuclei)
2. cerebellum
3. neuromuscular junction
4. upper motor neuron

Question 17 (1 point)
Cues for brain function deterioration due to rising ICP include all of the following except:

1. Bradycardia
2. High blood pressure
3. Reactive pupils
4. Widening pulse pressure 

Question 18 (1 point)
Haemorrhage into brain tissue is known as

1. intracerebral haemorrhage
2. intraventricular haemorrhage
3. intralobe haemorrhage
4. intercerebral haemorrhage

Question 19 (1 point)
A subdural haematoma occurs when the

1. subependymal veins are damaged
2. intracerebral vessels are torn
3. cortical bridging veins are ruptured
4. superficial arterial and venous vessels are ruptured

Question 20 (2 points)
Identify the injury types in which the primary injury involves/affects the entire brain. Select only TWO (2) options

1. open skull fracture
2. concussion
3. diffuse axonal injury
4. contusion
5. intracerebral haemorrhage
6. haematoma

Question 21 (4 points)
If Zac were to remain untreated, which of the following would be evidence of life- threatening deterioration due to raised intra-cranial pressure? Select only FOUR (4) options

1. decreased blood pressure
2. hyporeflexia
3. bradycardia
4. neurogenic shock
5. widening pulse pressure
6. exopthalmus
7. altered respiratory pattern
8. tachycardia
9. rhinitis
10. decorticate posturing
11. fixed pupils
12. GCS 12