quiz 5

A 44-year-old female presents for her second course of chemotherapy. She was recently diagnosed with stage IV breast cancer. In the past five weeks, the patient has undergone breast-conserving therapy, including a lumpectomy of the left breast and single-agent chemotherapy utilizing paclitaxel. Vital signs today reveal a temperature of 37.0°C (98.6°F), blood pressure of 112/66 mmHg, heart rate of 76 beats/min, and respiratory rate of 16 breaths/min. The patient has felt nauseated and has had issues with vomiting for the past month, each time shortly after receiving her treatment. She asks her oncologist why her treatments are leading to these severe symptoms. The physician explains that specialized areas of the brain allow for molecules in the blood to cross the blood-brain barrier. Which of the following sites of exposure is likely causing this patient's symptoms?

• Neurohypophysis

• Organum Vasculosum Lamina Terminalis

• Area Postrema

• Median Eminence of the hypothalamus

• Subfornical Region

A 50-year-old gravida 2, para 2 female presents to the primary care physician with urinary incontinence. The patient reports daily episodes of a sudden need to void, and she has started to wear adult diapers to prevent accidents. She denies pain with urination or fecal incontinence. Several years ago, the patient noticed intermittent motor and sensory loss, primarily affecting her left arm and leg. She recently developed decreased visual acuity in her left eye alongside painful ocular movements. The patient states her symptoms are worse in the summer. She works as a paralegal and follows a vegetarian diet. She has had irregular medical care and is currently taking no medications. Vital signs include a temperature of 36.7°C (98.1°F), blood pressure of 119/75 mmHg, heart rate of 72 beats/min, and respiratory rate of 16 breaths/min. Further laboratory workup is most likely to reveal which of the following?

• Elevated post-void residual volume on bladder ultrasound

• Positive Leukocyte esterase and nitrites on urinalysis

• Urethral hypermobility on Q-tip test

• Serum B12 deficiency

• Elevated IgG and myelin basic protein on CSF analysis

A 24-year-old man is brought to the emergency room after he was involved in a motor vehicle accident. He complains of pain in his right shoulder. Physical examination shows bruising and tenderness to palpation just below the right coracoid process. He is unable to flex the right elbow or supinate the right forearm against resistance. There is decreased sensation to light touch over the anterolateral forearm. Which of the following labeled structures of the brachial plexus is most likely to be injured?

• G

• g

A 38-year-old man comes to the physician because of a 3-week history of right-sided knee pain. He works as a bricklayer and reports that the pain worsens when he kneels. He has no history of trauma. Examination of the right knee shows erythema, fluctuant swelling, and tenderness on palpation of the kneecap. Passive flexion of the right knee elicits pain. Which of the following structures is most likely affected in this patient?

• Tibial tubercle

• Anserine bursa

• Medial meniscus

• Suprapatellar bursa

• Prepatellar bursa

A 21-year-old woman comes to the physician for a follow-up examination. Four months ago, she underwent posterior arthrodesis for thoracolumbar scoliosis. She has recovered well from the surgery but noticed difficulties combing her hair with her right hand. A photograph of the patient's back is shown. The nerve that was most likely injured in the surgery originates from which of the following spinal roots?

• C8-T1

• C6-C8

• C1-C3

• C3-C5

• C5–C7

A 33-year-old man is brought to the emergency department 20 minutes after he fell from the roof of his house. On arrival, he is unresponsive to verbal and painful stimuli. His pulse is 72/min and blood pressure is 132/86 mm Hg. A CT scan of the head shows a fracture in the anterior cranial fossa and a 1-cm laceration in the left anterior orbital gyrus. If the patient survives, which of the following would ultimately be the most common cell type at the injured region of the frontal lobe?

• Neurons

• Astrocytes

• Microglia

• Fibroblasts

• Oligodendrocytes