ADVANCED PATHOPHYSIOLOGY EXAM
3.2024/2025.WITH VERIFIED QUESTIONS AND
ANSWERS.
What are the treatment goals for treating MS? ------CORRECT ANSWER------Decrease
attack/exacerbation rate
-Decrease annualized relapse rate (ARR)
-Slow progression of disease
-Prevent/limit ADRs
-Symptom management (fatigue, bladder dysfunction, cognitive dysfunction, constipation,
depression)
When monitoring MS patients should follow-up with their neurologists every _________. Get
an MRI every ___________. ------CORRECT ANSWER-----When monitoring MS patients should
follow-up with their neurologists every 6 months-1 year. Get an MRI every 1 year (based on
need).
What is the difference between seizure and epilepsy? ------CORRECT ANSWER-----Seizure: a
discrete clinical event that results in the abnormal synchronous discharge of a set of neurons in
the brain.
Epilepsy: at least 2 unprovoked seizures occurring more than 24 hours apart.
What is Status Epilepticus? ------CORRECT ANSWER-----Failure of the termination mechanisms
for seizure leading to abnormally prolonged seizures. Length of seizure beyond 5 minutes and
duration beyond the risk of long-term consequence (30 minutes).
Which part of the brain is responsible for visual memory, organizing sensory information,
emotional responses? ------CORRECT ANSWER-----Temporal lobe
Which lobe of the brain is responsible for sensations (touch, feeling pain, spacial
representation)? ------CORRECT ANSWER-----Parietal lobe
Which part of the brain is responsible for planning, abstract thinking, organizing, reward
system, pleasure? ------CORRECT ANSWER-----Frontal Lobe
Which part of the brain is responsible for vision? ------CORRECT ANSWER-----Occipital lobe
Which part of the brain is responsible for voluntary movement (face, neck, trunk, upper/lower
extremities)? ------CORRECT ANSWER-----Motor Cortex
,Which part of the brain is responsible for sensations of tingling, numbness, touch, smell of
burnt rubber, parasthesisas? ------CORRECT ANSWER-----Somatosensory Cortex
Which part of the brain is responsible for speech? and which part is responsible for speech
terms of the formation of thoughts and word? ------CORRECT ANSWER-----Broca's: speech
Wernicke's: formation of thought/words
Which part of the brain is responsible for hearing? ------CORRECT ANSWER-----Auditory Cortex
Which part of the brain is responsible for sensory information processing, perceptual
disturbances? ------CORRECT ANSWER-----Association Cortex
When does Epilepsy most often present in patients? ------CORRECT ANSWER-----Most often in
infancy and childhood
What are the International League Against Epilepsy (ILAE) Epilepsy etiologies? ------CORRECT
ANSWER-----1. Genetic
2. Structural
3. Infectious
4. Metabolic
5. Immune
6. Unknown
What is the pathophysiology of Seizures? ------CORRECT ANSWER-----1. Excessive excitation of
cortical neurons (hyperexcitable/hypersynchronization)
-Abnormal functioning of Na/K pump, ligand-activated channels, voltage-gated channels.
-Abnormal ATPase functioning
-Abnormal synaptic vesicle protein 2-A
-Changes in receptors, second messaging systems
2. Disorder inhibition of cortical neurons
3. Transitory imbalance in neurotransmitters
-Enhanced excitatory neurotransmission (Glutamate/Aspartate, and NMDA/AMPA receptors)
How is the action potential process different in the CNS compared to in the heart? ------
CORRECT ANSWER-----There is no phase 2 "plateau phase":
-Calcium influx (Slow calcium channels open)
-Potassium efflux
Which ions are involved in the excessive excitation of cortical neurons during seizure? ------
CORRECT ANSWER-----K, Na, Ca, Cl, Mg
,In the state of seizures, we should see ______________ (increase/decrease) of seratonin,
____________ (increase/decrease) of norepinephrine, _______________ (increase/decrease)
of glutamate, ______________ (increases/decreases) of GABA. ------CORRECT ANSWER-----In
the state of seizures, we should see:
-Increase of seratonin
-Increase of norepinephrine
-Increase of glutamate
-Increases of GABA
True or false. Abnormalities in sodium, calcium, and potassium can stimulate the release of
Glutamate. ------CORRECT ANSWER-----True
What 3 medication have been associated with lowering the seizure threshold? ------CORRECT
ANSWER------Clozapine
-Bupropion
-Carbamazepine
What are some seizure recurrence risk factors? ------CORRECT ANSWER------Abnormal EEG
-Seizure occurs during sleep
-Family history
-Prior acute seizure
-Mental retardation or cerebral palsy
*NOT seizure type
*NOT seizure length
*NOT age of onset
What type of seizure involves one hemisphere of the brain and may be with or without
dyscognitive features. ------CORRECT ANSWER-----Focal Seizures
What type of seizure involves the loss of consciousness for 5-20 seconds but the patient does
not lose postural control? ------CORRECT ANSWER-----Absence Seizure
What type of seizure involves bilateral muscle jerks and twitching? ------CORRECT ANSWER-----
Myoclonic Seizure
What type of seizure involves continuous shaking? ------CORRECT ANSWER-----Clonic Seizure
What type of seizure involves stiffness (with gasp, wheeze, yelp)? ------CORRECT ANSWER-----
Tonic Seizure
What type of seizure involves going from stiff to shaking, stiff to shaking? ------CORRECT
ANSWER-----Tonic-Clonic Seizure
, What type of seizure involves no movement, and the patient just falls? ------CORRECT ANSWER--
---Atonic Seizure
If the seizure patient has dejavu what part of the brain is involved? ------CORRECT ANSWER-----
Parietal or Temporal lobe
If the seizure patient has sweating, salivating, pale skin, lip smack what part of the brain is
involved? ------CORRECT ANSWER-----Autonomic area
What type of seizure is caused by fever? ------CORRECT ANSWER-----Febrile Seizure
Do women or men more often have multiple sclerosis? ------CORRECT ANSWER-----Women (2-
3:1)
Which disease has the following risk factors:
-Epstein-barr virus (EBV)
-Live above the 37th parallel
-Caucasian
-Female
-Vitamin D deficiency: Decreased time between clinical isolated syndrome (CIS) and 2nd
exacerbation
-Smoking ------CORRECT ANSWER-----Multiple Sclerosis
What is the main pathophysiological theory for multiple sclerosis? ------CORRECT ANSWER-----
It's an autoimmune/neurodegenerative disease:
-inflammation
-demyelination/remyelination
-permanent axonal damage
What are the Myelin forming cells of the CNS? ------CORRECT ANSWER-----Oligodendrocytes
What do T-Helper cell types 1 & 17 do? ------CORRECT ANSWER-----Pro-inflammatory
What does T-Helper cell type 2 do? ------CORRECT ANSWER-----Anti-inflammatory
Which T cell types exhibit plasticity? ------CORRECT ANSWER-----T-Helper 17 & T-Regulatory
What is the pathophysiology of Multple Sclerosis? ------CORRECT ANSWER-----1. Autoreactive T
cells express Very Late Antegen-4 (VLA-4, aka α4-integrin) on their cell surface and secrete
Matrix Metalloproteinases (MMP).
2. VLA-4 binds to Vascular Cell Adhesion Molecule (VCAM) receptors on the blood brain barrier
(BBB) and MMP results in dysregulation of the BBB, allowing cell entry into the CNS.
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