AR Neuro test questions Flashcards
Damage to the temporal lobe is most likely to result in
The temporal lobe plays an important role in several important functions including auditory sensation and perception, language comprehension, and long-term memory.
a. Incorrect Contralateral neglect is a possible consequence of parietal lobe damage.
b. Incorrect Apraxia is caused by damage to the parietal or frontal lobe.
c. CORRECT Damage to the dominant temporal lobe may cause verbal memory loss, while damage to the nondominant temporal lobe may produce nonverbal memory loss
The onset of puberty in humans occurs when gonadotropin-releasing hormone (GnRH) is secreted by the
At puberty, the gonads (testes and ovaries) produce hormones that, in turn, are responsible for physical sexual maturation.
b. CORRECT Secretion of gonadotropin-releasing hormone by the hypothalamus stimulates production and release of the gonadotropic hormones by the pituitary gland. These hormones then stimulate the gonads to release the sex hormones which trigger sexual development.
Intense hunger, headaches, anxiety, dizziness, weakness, heart palpitations, and confusion are symptoms of which of the following endocrine disorders?
hyperthyroidism hyperglycemia hypothyroidism hypoglycemia
The endocrine disorders produce a combination of physical and neuropsychiatric symptoms.
a. Incorrect Hyperthyroidism is characterized by heat intolerance, tachycardia, hyperactive reflexes, distractibility, and impaired problem-solving.
b. Incorrect Symptoms of hyperglycemia (high blood sugar) include polydipsia, polyuria, polyphagia, fatigue, weight loss, and recurrent infections.
c. Incorrect Hypothyroidism is characterized by cold intolerance, bradycardia, fatigue, mental slowing, and decreased libido.
d. CORRECT The symptoms described in this question are characteristic of hypoglycemia (low blood sugar), which has several causes including excessive production of insulin by the pancreas.
An agonist drug exerts its effects by
Agonists produce effects similar to neurotransmitters.
a. Incorrect This is one of the ways that an antagonist drug exerts its effects.
b. Incorrect This answer describes the action of an inverse agonist.
c. Incorrect This does not describe the action of an agonist drug.
d. CORRECT Agonist drugs exert their effects by mimicking a neurotransmitter and thereby activating or stimulating receptor cells or by facilitating the action of a neurotransmitter at receptor sites.
A primary concern about the long-term use of chlorpromazine is that it may result in the development of which of the following?
acute hypertensive crisis profound anterograde amnesia tardive dyskinesia renal toxicity
This question requires you to know that chlorpromazine is an antipsychotic drug and that antipsychotics are associated with a number of adverse side effects.
a. Incorrect This is a side effect of the MAOIs.
b. Incorrect This is a potential side effect of triazolam and other benzodiazepines.
c. CORRECT The long-term use of an antipsychotic drug – especially chlorpromazine or other conventional antipsychotic – can result in tardive dyskinesia, a neurological movement disorder involving involuntary movements of the lips, tongue, face, trunk, and extremities (e.g., facial grimacing, tongue protrusion, guitar and piano-playing movements).
d. Incorrect This is associated with the use of lithium.
There is evidence that the _____________ plays a role in the etiology of seasonal affective disorder (SAD).
red nucleus suprachiasmatic nucleus tectum striatum
CORRECT Knowing that the suprachiasmatic nucleus (SCN) mediates the sleep-wake cycle and other circadian rhythms may have helped you identify the correct answer to this question. The SCN’s role in SAD is believed to be related to its impact on melatonin levels, which are generally higher in individuals with this disorder and are affected by exposure to light.
Nausea, stomach cramps, excessive thirstiness, increased frequency of urination, muscle weakness, impaired memory, fine hand tremor, and weight gain are side effects most associated with which of the following?
lithium carbamazepine methylphenidate fluoxetine
Unfortunately, some of the symptoms included in the question are side effects of more than one of the drugs listed in the answers, which makes this a difficult question.
a. CORRECT The symptoms given in the question are potential side effects of lithium, which is used to treat bipolar disorder.
b. Incorrect Carbamazepine (Tegretol), an anticonvulsant, is also used to treat bipolar disorder. However, its common side effects include dizziness, drowsiness, nausea and vomiting, headache, and ataxia.
c. Incorrect Methylphenidate, a CNS stimulant, is associated with insomnia, reduced appetite, nervousness, tremor, and cardiac arrhythmias.
d. Incorrect Nausea, appetite loss, anxiety, tremor, dry mouth, sweating, tiredness or weakness, and disturbances in sexuality are common side effects of fluoxetine and other SSRIs.
Individuals who have had a stroke are at risk for a variety of neuropsychiatric symptoms, not just immediately poststroke, but up to six months after the event. What are common symptoms?
Depression followed by anxiety apathy and cognitive impairment
depression (a.) is considered the most common psychiatric complication of stroke. The prevalence of major depression following stroke ranges from 10% to 40%, although a recent finding indicates the rate may be as high as 61% (Bourgeois et al, 2004). Other psychiatric conditions such as anxiety disorders, apathy and cognitive impairment are also common and often comorbid with depression. Two other neuropsychiatric manifestations of stroke include pseudobulbar affect and a catastrophic reaction. Pseudobulbar affect (c.) is a clinical syndrome seen in approximately 10% to 15% of poststroke patients and involves frequent and easily provoked spells of emotion (typically manifested by laughing and crying). Brief fits of crying or laughing occur with appropriate changes in mood in its most common form, however crying or laughing may develop in situations inappropriate to the context in more serious cases. A catastrophic reaction (d.) is seen in about 10% of individuals poststroke and involves a collection of symptoms (e.g., intense desperation and frustration) that is uncharacteristic of the individual’s prestroke personality. A catastrophic reaction is strongly associated with poststroke depression as well as a personal and family history of psychiatric disorders. (See: Kaplan, A. (2005) Neuropsychiatric Symptoms in Poststroke Patients. Psychiatric Times. Vol. XXII, Issue 1; J. A. Bourgeois et al., Poststroke neuropsychiatric illness: An integrated approach to diagnosis and management, Current Treatment Options in Neurology, 2004, 6(5), 403-420.)
- Strokes in this area are rare, however when they do occur, basic primal drives may be severely limited or, conversely, patients may lose their natural inhibitions.
A) the brain stem
B) the cerebellum
C) the limbic system
D) the pons
The Correct Answer is C
C. The limbic system is a group of structures responsible for the primal urges and emotions that ensure self-preservation such as hunger, terror, rage and sexual desire. Growth and reproductive cycles also are governed by the limbic system. Strokes in this area are rare, but when they do occur, basic animal drives may be severely limited or, conversely, patients may lose their natural inhibitions. Below the limbic system is the cerebellum (b.), which controls coordination, balance and posture. Strokes in the cerebellum include early symptoms such as vertigo or dizziness, nausea and vomiting then later symptoms including clumsiness, shaking or difficulty controlling certain muscles. Below the cerebellum, at the base of the brain, or the top of the spinal cord, is the brain stem (a.) which maintains basic life functions, such as breathing, blood pressure, heart rate and digestion. Major strokes affecting the brain stem are frequently fatal and surviving patients often require a form of artificial life support. A stroke in either the brain stem or the cerebrum can also result in a coma as consciousness is maintained by the brain stem, and the cerebrum – which surrounds the brain stem, can cause swelling that puts pressure on the brain stem.
- Which of the following is the most frequently used scale to measure orientation?
A) Galveston Orientation and Amnesia Test
B) Gollingberg Orientation and Awareness Test
C) Gross Orientation and Awareness Test
D) Global Orientation and Amnesia Test
- Which of the following is the most frequently used scale to measure orientation?
The Correct Answer is A
A. The Galveston Orientation and Amnesia Test (GOAT), which assesses temporal orientation primarily, was developed to serially evaluate cognition during the subacute stage of recovery from closed head injury. The scale measures orientation to person, place, and time, and memory for events preceding and following the injury. (See: Levin, H.S., O’Donnell, V.M., & Grossman, R.G. (1975). The Galveston orientation and amnesia test: A practical scale to assess cognition after head injury. Journal of Nervous and Mental Diseases, 167, 675-684.)
Post-concussional syndrome (PCS):
A) refers to somatic and psychological symptoms associated with head trauma.
B) refers to somatic symptoms due to psychological factors following head trauma.
C) is associated with cases of severe head trauma.
D) is associated with poorer prognosis for full recovery.
Post-concussional syndrome (PCS):
The Correct Answer is A
A. Post-concussional syndrome (PCS) refers to somatic and psychological symptoms associated with head trauma including dizziness, impaired memory and concentration, headache, fatigue, depression, irritability, visual impairment, and sleep disturbances. Symptoms of PCS are experienced by up to 50% of individuals with mild brain injury and it is rare in moderate to severe cases (c.). The majority of individuals with post-concussional syndrome fully recover with their symptoms resolving within three to six months of the trauma. Psychological and physiological factors appear to cause the symptoms of PCS and the associated deficits are often more serious than the individual realizes. Psychological factors include: premorbid personality characteristics, the subjective interpretation of the injury, access to social support and desire for secondary gain. (See: Ryan, L. M. & Warden, D.M. (2003). Post concussion syndrome, International Review of Psychiatry,15(4), 310-316.)
- Possible side effects of the benzodiazepines include all of the following, EXCEPT:
drowsiness
short-term memory dysfunction
impaired psychomotor functioning
impaired concept formation
\
- Possible side effects of the benzodiazepines include all of the following, EXCEPT:
impaired concept formation
The Correct Answer is D The benzodiazepines (also known as anxiolytics and "minor tranquilizers") are anti-anxiety agents; they include drugs such as Valium, Xanax, Halcion, and Ativan. Their major side effects include drowsiness, impaired psychomotor abilities, and impaired short-term memory (particularly anterograde amnesia); more rarely, dizziness, ataxia, allergic reactions, nausea, and aggression have been reported as side effects. They are not, however, associated with impaired concept formation.
- The Dopamine Hypothesis was based on research findings indicating that:
psychomotor stimulants activate dopamine receptors
brain dopamine is involved in neuroleptic-induced extrapyramidal motor disturbances
dopamine levels are lower in patients with Schizophrenia
both a and b
- The Dopamine Hypothesis was based on research findings indicating that:
Show Explanation
The Correct Answer is D
The Dopamine Hypothesis was originally based on two important findings: that antipsychotic medications, which can cause motor disturbances, affect dopamine in the brain; and that stimulants activate dopamine receptors. This latter finding is often neglected. However, knowing that stimulants stimulate dopamine helps explain why individuals intoxicated with cocaine or amphetamine often develop psychotic-like symptoms [A.A. Baumeister and J.L. Francis, Historical development of the dopamine hypothesis of schizophrenia, Journal of the History of the Neurosciences, 2002, 11(3), 265-277].
- An individual taking clozapine begins exhibiting symptoms of muscle rigidity, tachycardia, hyperthermia, altered consciousness, and autonomic dysfunction. In this case, the best course of action would be to:
reduce the dose gradually until the symptoms are alleviated
stop the drug immediately and administer electrolytes and fluids
switch to a traditional antipsychotic drug
check to see what other drugs the patient is taking since clozapine does not produce these symptoms
- An individual taking clozapine begins exhibiting symptoms of muscle rigidity, tachycardia, hyperthermia, altered consciousness, and autonomic dysfunction. In this case, the best course of action would be to:
The Correct Answer is B
B. The symptoms listed are characteristic of neuroleptic malignant syndrome (NMS), which is a rare, but serious and potentially lethal syndrome that can result from the use of any neuroleptic or antipsychotic drugs. The syndrome commonly develops within the first 2 weeks of treatment in most cases however it may develop any time during drug therapy and can also occur in people taking anti-Parkinsonism drugs known as dopaminergics if those drugs are discontinued abruptly. All antipsychotics, typical or atypical, may precipitate the syndrome although potent neuroleptics (e.g., haloperidol, fluphenazine) are more frequently associated with NMS. Other agents associated with NMS include prochlorperazine (Compazine), promethazine (Phenergan), clozapine (Clozaril), and risperidone (Risperdal) as well as non-neuroleptic agents that block central dopamine pathways such as metoclopramide (Reglan), amoxapine (Ascendin), and lithium. Generally, intensive care is needed. The neuroleptic or antipsychotic drug is discontinued, and the fever is treated aggressively. A muscle relaxant may be prescribed. Dopaminergic drugs, such as a dopamine agonist, have been reported to be useful.
Which is the most common anticholinergic side-effect?
Light tremor
Blurred vision
Diarrhea
Weight loss
Which is the most common anticholinergic side-effect?
Blurred vision
The Correct Answer is B
B. Anticholinergic effects may be either central or peripheral. Central side effects are cerebral and include impaired concentration, confusion, attention deficit, and memory impairment. Peripheral side effects include dry mouth, constipation, urinary retention, bowel obstruction, dilated pupils, blurred vision, increased heart rate, and decreased sweating. Light tremor (a.) and diarrhea (c.) are not associated side-effects, and while dry mouth may affect appetite and result in weight loss (d.), it is not considered an anticholinergic side-effect either.
