NUR 2520 EXAM 2 MIDTERM EXAM WITH
COMPLETE SOLUTIONS | 2025 A+ GRADED
Professor's Name:
Date:
INSTRUCTIONS: Information in BOLD should be added to every exam cover sheet.
1. The length of the examination: If your exam is a take home, please specify the
amount of time (in hours) needed to complete this exam during the stated range of
dates.
2. The number of pages of the examination: Please write how many pages are in the
exam and number each page. For example, "1 of 10, 2 of 10," etc. This is very important
to ensure that exams are duplicated correctly.
3. Indicate what materials may be brought into the examination room (textbook, notes,
casebooks, supplemental materials, etc.) Indicate if no materials are allowed. Usage of
computers should be stated clearly. If your exam will be completed using Exam4
(secure) or MyWCL (non-secure), indicate it here. You do not need to provide
instructions about using Exam4 or MyWCL. The students have already received this
information. You may allow the students the option of handwriting their exams in
bluebooks which will be provided in the exam room.
4. You will receive "0" credit for any unanswered question.
5. If scantron answer sheets are used, give detailed instructions. Only anonymous grading
numbers should be written in the space marked identification number and the
corresponding bubbles should be filled in. If using scantron answer sheets for True and
False questions, please indicate which letter should be used for True and which letter
should be used for False (for example, A=True, B=False). If your exam contains
multiple-choice questions and you do not want to use Scantron answer sheets, describe
how your students should mark their answers (Circle correct answer on the question
sheet, write in a blue book, type them in their document, etc.)
6. No corrections will be made once the exam is distributed. If there is a typo or
ambiguity in a question, state your assumption and answer accordingly.
7. Only your anonymous-grading number should appear on your blue book and
examination copy. DO NOT USE EITHER YOUR NAME OR SOCIAL SECURITY
NUMBER.
8. If you are graduating at the end of the semester, please write "GRADUATING" on
the outside of your exam envelope and on each Blue Book.
9. All materials, including the questions, handwritten answers (if applicable) and
scratch materials at the end of the exam, inserted into your self-sealing exam
envelope and handed to the proctor.
10. The use of electronic devices (iPods, cell phones, mp3 players, etc.) is prohibited
during the exam. This policy is at your discretion, however we recommend this
language to prevent cheating and honor code violations.
,Definition of MS - a. Is a chronic, progressive, degenerative disorder of the CNS
characterized by disseminated demyelination of nerve fibers of the brain and spinal
cord.
Causes of MS - -Viral infection
-Immunologic
-Genetic factors
-Temperate climates
-Multiple genes confer susceptibility
precipitating factors for MS - infection, smoking, physical injury, emotional stress,
excessive fatigue, pregnancy, poor health
Diagnostic Studies for MS - *No definitive test*
MRI (Characteristic white-mater lesions scattered through the brain or spinal cord)
Characteristics of MS - · Genetic
· Females more than men
· Tinnitus (ringing in ears)
· ↓ Hearing
· Nystagmus (involuntary eye movement)
· Diplopia (double vision)
· Dysarthria
· Dysphagia
· Onset 20-40
· Urinary retention
· Spastic bladder
· Constipation
· Weakness may progress to paralysis
· Muscle spasticity
· Ataxia
· Vertigo
Drug therapy for MS - *a. Immunomodulator drugs are used initially to modify the
disease progression and prevent relapse*
i. Interferon β-1b (betaseron, extavia) & Glatiramer acetate (Copaxone) are given
subcutaneously every other day
ii. Interferon β-1a (avonex (IM), rebif (subq 3x weekly))
iii. Teriflunomide (Aubagio): an immunomodulatory agent with anti-inflammatory
properties.
*b. Corticosteroids (methylprednisolone, prednisone, ACTH)+
i. Helpful in treating acute exacerbations by reducing edema and acute inflammation at
the site of demyelination
ii. If ineffective: Plasmapheresis and IVIg G
c. Other drug therapy
i. Tricyclic antidepressants & Antiseizure used to treat chronic pain s/s
, ii. Dalfampridine (Ampyra) nerve conductor enhancer: used to improve walking speed
(NOT for patients with history of seizure or kidney disease
Drug therapy for symptoms of MS - i. Cholinergic
1. Urecholine
2. Neostigmine
ii. Anticholinergics Used to treat bladder symptoms
1. Propantheline
2. Oxybutynin
iii. CNS stimulants Used to treat fatigue
1. Ritalin
2. Provigil
iv. Muscle relaxants Used to reduce spasticity
1. Valium
2. Lioresal
3. Dentrium
4. Zanaflex
5. Nerve conduction enhancer
a. Selective Potassium Channel Blocker
i. Ampyra
Drug therapy for aggressive MS - i. IV natalizumab (Tysabri): a monoclonal antibody
and is given monthly when patients have had an inadequate response to other drugs.
ii. IV mitoxantrone (Novantrone): an antineoplastic medication, has serious effects,
including cardiotoxicity, leukemia, and infertility.
iii. Dimethyl fumarate (Tecfidera): provides a new approach to treating MS by activating
the Nrf2 pathway. This pathway provides a way for cells in the body to defend
themselves against the inflammation and oxidative stress caused by MS. Dimethyl
fumarate is used to treat relapsing-remitting MS.
important neurotransmitters for MS - glutamate and aspartate
Definition of Parkinson's disease - *A chronic, progressive neurodegenerative disorder
characterized by slowness in the initiation & execution of movement (Bradykinesia)*
-Increased muscle tone (rigidity)
-Tremor at rest and impaired postural reflexes and gait disturbance
-Is a disease of the basal ganglia characterized by slowness in the initiation & execution
of movement (bradykinesia), increased muscle tone (rigidity), tumor at rest, and
impaired postural reflexes.
Drug therapy for PD - a. Dopaminergic
b. Dopamine receptor agonist
c. Anticholinergic
d. Antihistamine
e. Monoamine Oxidase Inhibitors
f. COMT Inhibitors
COMPLETE SOLUTIONS | 2025 A+ GRADED
Professor's Name:
Date:
INSTRUCTIONS: Information in BOLD should be added to every exam cover sheet.
1. The length of the examination: If your exam is a take home, please specify the
amount of time (in hours) needed to complete this exam during the stated range of
dates.
2. The number of pages of the examination: Please write how many pages are in the
exam and number each page. For example, "1 of 10, 2 of 10," etc. This is very important
to ensure that exams are duplicated correctly.
3. Indicate what materials may be brought into the examination room (textbook, notes,
casebooks, supplemental materials, etc.) Indicate if no materials are allowed. Usage of
computers should be stated clearly. If your exam will be completed using Exam4
(secure) or MyWCL (non-secure), indicate it here. You do not need to provide
instructions about using Exam4 or MyWCL. The students have already received this
information. You may allow the students the option of handwriting their exams in
bluebooks which will be provided in the exam room.
4. You will receive "0" credit for any unanswered question.
5. If scantron answer sheets are used, give detailed instructions. Only anonymous grading
numbers should be written in the space marked identification number and the
corresponding bubbles should be filled in. If using scantron answer sheets for True and
False questions, please indicate which letter should be used for True and which letter
should be used for False (for example, A=True, B=False). If your exam contains
multiple-choice questions and you do not want to use Scantron answer sheets, describe
how your students should mark their answers (Circle correct answer on the question
sheet, write in a blue book, type them in their document, etc.)
6. No corrections will be made once the exam is distributed. If there is a typo or
ambiguity in a question, state your assumption and answer accordingly.
7. Only your anonymous-grading number should appear on your blue book and
examination copy. DO NOT USE EITHER YOUR NAME OR SOCIAL SECURITY
NUMBER.
8. If you are graduating at the end of the semester, please write "GRADUATING" on
the outside of your exam envelope and on each Blue Book.
9. All materials, including the questions, handwritten answers (if applicable) and
scratch materials at the end of the exam, inserted into your self-sealing exam
envelope and handed to the proctor.
10. The use of electronic devices (iPods, cell phones, mp3 players, etc.) is prohibited
during the exam. This policy is at your discretion, however we recommend this
language to prevent cheating and honor code violations.
,Definition of MS - a. Is a chronic, progressive, degenerative disorder of the CNS
characterized by disseminated demyelination of nerve fibers of the brain and spinal
cord.
Causes of MS - -Viral infection
-Immunologic
-Genetic factors
-Temperate climates
-Multiple genes confer susceptibility
precipitating factors for MS - infection, smoking, physical injury, emotional stress,
excessive fatigue, pregnancy, poor health
Diagnostic Studies for MS - *No definitive test*
MRI (Characteristic white-mater lesions scattered through the brain or spinal cord)
Characteristics of MS - · Genetic
· Females more than men
· Tinnitus (ringing in ears)
· ↓ Hearing
· Nystagmus (involuntary eye movement)
· Diplopia (double vision)
· Dysarthria
· Dysphagia
· Onset 20-40
· Urinary retention
· Spastic bladder
· Constipation
· Weakness may progress to paralysis
· Muscle spasticity
· Ataxia
· Vertigo
Drug therapy for MS - *a. Immunomodulator drugs are used initially to modify the
disease progression and prevent relapse*
i. Interferon β-1b (betaseron, extavia) & Glatiramer acetate (Copaxone) are given
subcutaneously every other day
ii. Interferon β-1a (avonex (IM), rebif (subq 3x weekly))
iii. Teriflunomide (Aubagio): an immunomodulatory agent with anti-inflammatory
properties.
*b. Corticosteroids (methylprednisolone, prednisone, ACTH)+
i. Helpful in treating acute exacerbations by reducing edema and acute inflammation at
the site of demyelination
ii. If ineffective: Plasmapheresis and IVIg G
c. Other drug therapy
i. Tricyclic antidepressants & Antiseizure used to treat chronic pain s/s
, ii. Dalfampridine (Ampyra) nerve conductor enhancer: used to improve walking speed
(NOT for patients with history of seizure or kidney disease
Drug therapy for symptoms of MS - i. Cholinergic
1. Urecholine
2. Neostigmine
ii. Anticholinergics Used to treat bladder symptoms
1. Propantheline
2. Oxybutynin
iii. CNS stimulants Used to treat fatigue
1. Ritalin
2. Provigil
iv. Muscle relaxants Used to reduce spasticity
1. Valium
2. Lioresal
3. Dentrium
4. Zanaflex
5. Nerve conduction enhancer
a. Selective Potassium Channel Blocker
i. Ampyra
Drug therapy for aggressive MS - i. IV natalizumab (Tysabri): a monoclonal antibody
and is given monthly when patients have had an inadequate response to other drugs.
ii. IV mitoxantrone (Novantrone): an antineoplastic medication, has serious effects,
including cardiotoxicity, leukemia, and infertility.
iii. Dimethyl fumarate (Tecfidera): provides a new approach to treating MS by activating
the Nrf2 pathway. This pathway provides a way for cells in the body to defend
themselves against the inflammation and oxidative stress caused by MS. Dimethyl
fumarate is used to treat relapsing-remitting MS.
important neurotransmitters for MS - glutamate and aspartate
Definition of Parkinson's disease - *A chronic, progressive neurodegenerative disorder
characterized by slowness in the initiation & execution of movement (Bradykinesia)*
-Increased muscle tone (rigidity)
-Tremor at rest and impaired postural reflexes and gait disturbance
-Is a disease of the basal ganglia characterized by slowness in the initiation & execution
of movement (bradykinesia), increased muscle tone (rigidity), tumor at rest, and
impaired postural reflexes.
Drug therapy for PD - a. Dopaminergic
b. Dopamine receptor agonist
c. Anticholinergic
d. Antihistamine
e. Monoamine Oxidase Inhibitors
f. COMT Inhibitors
