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MRCPsych > Applied neuroscience > Flashcards

Applied neuroscience Flashcards

1
Q

Triad in Balint’s syndrome

A
  1. Simultanagnosia
  2. Optic ataxia
  3. Oculomotor apraxia
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2
Q

What is simultanoagnosia?

A

Inability to attend to more than 1 item of a complex scene at a time

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3
Q

What is optic ataxia?

A

Inability to guide reaching/pointing despite adequate vision

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4
Q

What is oculomotor apraxia?

A

Inability to voluntarily direct saccades to a visual target

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5
Q

How does balint’s syndrome occur?

A

Bilateral damage to superior parieto-occipital region

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6
Q

Causes of balint’s syndrome (4)

A

CO poisoning
Watershed infarction
Leucodystrophy
Posterior cortical variant of AD

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7
Q

A lesion in which area is associated with acquired prosopagnosia?

A

Bilateral occipto-temporal region (FUSIFORM GYRUS)

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8
Q

What causes alexia without agraphia?

A

Infarction to left posterior cerebral artery affecting splenium of corpus callosum and left visual cortex

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9
Q

Is the speech fluent in Broca’s aphasia?

A

No

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10
Q

Which test is used in animal models of depression?

A

Forced swim test - measure effect of antidepressant drugs

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11
Q

Which test can differentiate organic from psychiatric stupor?

A

Caloric testing - ocular nystagmus present in psychiatric stupor & tonic deviation in organic

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12
Q

Damage to which cranial nerve would cause nystagmus in horizontal gaze only?

A

Abducens

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13
Q

4 primary symptoms of Gerstmann syndrome

A
  1. Dysgraphia/agraphia
  2. Dyscalcula/acalculia
  3. Finger agnosia
  4. Right-left disorientation
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14
Q

Lesion to which area is associated with Gerstmann syndrome

A

Dominant angular and supramarginal gyri (parietal lobe)

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15
Q

Symptoms of Wallenberg syndrome

A

Ipsilateral facial numbness
Diplopia
Ataxia

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16
Q

Which patients might struggle with Wisconsin card sorting test?

A

Person with damage to frontal lobe or caudate

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17
Q

What are the hold tests in the WAIS?

A

Vocabulary
Information
Object assembly
Picture completion

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18
Q

What are the non-hold tests in WAIS?

A

Block design
Digit span
Similarities
Digital symbol

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19
Q

How is deterioration quotient derived in WAIS?

A

Difference between hold and non-hold scores

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20
Q

What are hold tests in WAIS supposed to be resistant to?

A

Age-related decline so they may be sensitive for organic brain damage such as dementia

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21
Q

In which type of cognitive decline may somebody retain full insight into their cognitive difficulties?

A

Vascular dementia

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22
Q

Which test can be used to assess response inhibtion?

A

Go-no go test

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23
Q

The clinical sign of finger-nose ataxia is seen in lesions of which structure?

A

Inferior olivary nucleus

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24
Q

What does the inferior olivary nucleus do?

A

Serves motor coordination via projecting fibres to the cerebellum

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25
Q

What does the Hayling sentence completion test measure?

A

Response initiation and suppression

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26
Q

Poor performance in Hayling’s sentence completion test suggests

A

Frontal deficits

Has set-shifting deficits

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27
Q

Damage to which part of the brain is associated with forced utilisation behaviour?

A

Orbitofrontal lobe

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28
Q

What is forced utilisation behaviour?

A

When an object is placed in front of a subject, they will use the object even when instructed not to do so

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29
Q

What are some examples of frontal lobe function tests?

A
  1. Verbal fluency tests
  2. Category tests
  3. Trail making test
  4. Wisconsin card sorting test
  5. Stroop colour word interference test
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30
Q

If a patient demonstrates neglect, what part of the brain is usually affected?

A

Right hemisphere - often inferior parietal or prefrontal regions

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31
Q

What is the ability to recognise a number/letter scratched into skin called?

A

Graphesthesia

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32
Q

What symptoms may somebody have with dorsolateral prefrontal syndrome?

A 
Poor planning ability 
Cognitive dysfunction 
Poor impulse control 
Explosive outbursts
Inappropriate behaviour
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33
Q

What 3 criteria are needed to be met to diagnosis vegetative state?

A
  1. Cycles of eye opening and closing
  2. Complete lack of awareness of self or environment
  3. Complete or partial preservation of hypothalamic and brainstem funtion
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34
Q

Absence of ankle jerk with upgoing plantars noted in

A

Subacute combined degeneration of the spinal cord

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35
Q

In frontotemporal dementia, what type of memory is relatively preserved?

A

Episodic - day to day memory

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36
Q

A reduction in score on Seashore Musical Aptitude test may be seen in what type of brain lesion?

A

Right temporal lobe

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37
Q

What is a lesion of the ventromedial frontal cortex associated with?

A

Apathy - pseudodepressive syndrome

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38
Q

What is semantic paraphrasia?

A

Mis-selection of words due to semantic confusion e.g. apple for orange

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39
Q

What is phonemic paraphrasia?

A

Word sounds similar to what was intended e.g. shark and sharp

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40
Q

Frontal lobe tests

A 
Similarities
Lexical fluenxy 
Luria motor test 
Go-on go test 
Cognitive estimates
Trail making test
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41
Q

Normal forward score in digit span

A

7+/- 2

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42
Q

Normal backwards score in digit span

A

5+/-1

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43
Q

Parietal lobe tests (8)

A 
Copying shapes 
Identifying fingers
Calculation ability 
Graphaesthesia 
Right left orientation 
Stereognosis 
2 point discrimination 
Visual inattention
44
Q

Features of unilateral frontal lobe lesion (6)

A 
Contralateral spastic hemiplegia 
Slight elevation of mood 
Frontal release signs 
Ansomia
Motor speech disorder with agraphia 
Loss of verbal fluenxy
45
Q

Features of bilateral frontal lobe lesion

A

Bilateral hemiplegia
Spastic bulbar (pseudobulbar) palsy
Abulia
Decomposition of gait and sphincter incontinence

46
Q

What is a gelastic seizure?

A

Epileptic fit of incessant laughter not necessarily euphoria

47
Q

Which lesion could result in a gelastic seizure?

A

Left prefrontal

48
Q

Features of unilateral temporal lobe lesion

A

Homonymous upper quadrantanopia
Wernicke’s aphasia
Impairment of auditory verbal learning

49
Q

What is hypermetamorphopsia?

A

Compulsion to attend to all visual stimuli

50
Q

When would you see hypermetamorphopsia?

A

Bilateral temporal lobe lesions

51
Q

When would you see kluver-bucy syndrome?

A

Bilateral temporal lobe lesions

52
Q

Age for WAIS-III

A

16-89

53
Q

What can you use to measure IQ of somebody aged <16?

A

Wechsler Adult Intelligent Scale for Children III

54
Q

How many subtests is WAIS composed of?

A

11

55
Q

How many verbal tests in WAIS?

A

6

56
Q

How many performance tests in WAIS?

A

5

57
Q

What is unique about Raven’s progressive matrix?

A

Test for IQ that is independent of education and cultural influences

58
Q

Which test can you use to test premorbid IQ?

A

National Adult Reasing Test

59
Q

What does the stroop test measure?

A

Set shifting abilities & response inhibition

60
Q

Which tests test set-shifting ability and therefore executive functioning? (4)

A

Trail making test
Wisconsin card sorting test
Hayling test
Brixton task

61
Q

What is the most widely used memory test battery for adults?

A

Wechsler Memory Scale-Revised

62
Q

What would you see in amnesic condition on Weschler Memory Scale?

A

Low memory quotient and relatively preserved IQ

63
Q

What test could you use to test short-term visual memory?

A

Benton visual retention test - show a figure for 10 seconds then patient draws it from memory

64
Q

What neurocognitive deficits might you see in schizophrenia?

A

Lower IQ
Short term memory disturbance
Deficits in higher order reasoning
Poor scores on category test, Wisconsin card sort test and Trail B of Halstead-Reitan Battery

65
Q

What needs to be intact for arousal?

A

Ascending reticular activating system

66
Q

Intact functioning of which lobe is required for maintenance of attention?

A

Right frontal lobe

67
Q

What is stupor?

A

Patient appears to be asleep but when vigorously stimulated may become alert as manifested by eye opening and ocular movement

68
Q

Damage to which area causes akinetic mutism

A

Diencephalic or bilateral anterior cingulate damage

69
Q

How is akinetic mutism characterised?

A 
Immobility 
Eye closure
Little or no vocalisation 
Sleep wake cycles are seen 
Absence of spasticity and rigidty
70
Q

What does a vegetative state result from?

A

Isolated actions of the ARAS and the thalamus

71
Q

How can you differentiate akinetic mutism from vegetative state?

A

In vegetative state, there will be spasiticity and rigidity

72
Q

Locked in syndrome results in paralysis from which level?

A

Below the level of the 3rd nerve nuclei

73
Q

Location of executive function

A

Dorsolateral frontal lobe

74
Q

What 3 things can memory be divided into?

A
  1. Short term
  2. Long term
  3. Sensory
75
Q

What can long term memory be further divided into?

A
  1. Declarative/explicit

2. Non-declarative/implicit

76
Q

What can explicit memory be further divided into?

A

Semantic

Episodic

77
Q

What can implicit memory be further divided into?

A

Procedural memory
Associative
Non-associative
Priming

78
Q

What can sensory memory be further divided into?

A

Haptic - acquired through touch
Iconic - acquired through sight
Echoic - acquired through auditory stimuli

79
Q

What is episodic memory?

A

Personal experiences

80
Q

What is semantic memory?

A

Stores info about facts

81
Q

Which part of brain used for encoding declarative verbal memories?

A

Left hippocampus

82
Q

Which part of brain used for encoding non-verbal memories?

A

Right hippocampus

83
Q

Key area of semantic memory?

A

Anterior temporal lobe

84
Q

What memory deficit may be seen in somebody with Parkinson’s disease

A

Deficit in procedural memory with preservation of declarative

85
Q

What is long-term potentiation?

A

Strengthening of connection between 2 neurons on repeated communication

86
Q

What is long term potentiation mediated by?

A

NMDA mediated Ca2+ entry in glutamate neurons

87
Q

What memory loss is seen in transient global amnesia?

A

Pronounced anterograde and variable retrograde amnesia

88
Q

Feature of dissociative amnesia

A

Episodic memory loss - retrograde only

89
Q

Does repetition require high-level processing?

A

No

90
Q

When can repetition occur?

A

If broca’s, wernicke’s and arcuate fascisulus are intact

91
Q

Fluency, repetition, comprehension and naming in Wernicke’s

A

F - intact
R - lost
C - lost
N - lost

92
Q

Fluency, repetition, comprehension and naming in Broca’s

A

F - lost
R - Lost
C - intact
N - lost

93
Q

Fluency, repetition, comprehension and naming in conduction aphasisa

A

F - intact
C - lost
R - intact
N - lost

94
Q

Fluency, repetition, comprehension and naming in transcortical sensory aphasia

A

F - intact
R - intact
C - lost
N - lost

95
Q

Fluency, repetition, comprehension and naming in transcortical motor aphasia

A

F - lost
R - intact
C - intact
N - lost

96
Q

What sign is virtually diagnostic of corticobasal degeneration?

A

Progressive, isolated limb apraxia

97
Q

What is the most common type of apraxia?

A

Ideomotor

98
Q

What is ideomotor apraxia?

A

Disorder of goal-direted movement - patient knows what to do but not how to do it

99
Q

Which area is implicated in ideomotor apraxia?

A

Left hemisphere - frontal and parietal association areas

100
Q

What is Marchiafava-Bignami disease due to?

A

Symmetrical demyelination and necrosis of corpus callosum and adjacent anterior commissure

101
Q

What does lesion of CN III result in?

A

Paralysis of ipsilateral upper eyelid and pupil
Unable to aDduct and look up or down
Pupil turned out

102
Q

Paralysis of which CN results in diplopia in more than 1 direction?

A

CN III

103
Q

What does the trochlear nerve innervate?

A

Superior oblique muscle - can look down

104
Q

If patient complains of double vision on horizontal gaze, which CN is likely damaged?

A

Abducens

105
Q

In caloric testing, what happens when you use cold water?

A

Nystagmus to opposite side

106
Q

In caloric testing, what happens when you use warm water?

A

Nystagmus to same side

MRCPsych (19 decks)

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