Ch. 16 Generalized Cognitive Disorders LM Flashcards
Which of the following is the leading cause of Traumatic Brain Injury (TBI)?
a) Stroke
b) Infection
c) Closed head injury
d) Tumor
c) Closed head injury is the leading cause of TBI.
What is the primary mechanism of damage in a closed head injury?
a) Direct impact causing a contusion
b) Twisting and shearing forces on axons
c) Disruption of blood flow leading to ischemia
d) Increased intracranial pressure
(b) Twisting and shearing forces on axons are the primary mechanisms of damage in closed head injuries. This is due to the rapid acceleration and deceleration of the brain within the skull, leading to diffuse axonal injury.
What type of brain damage occurs when the brain impacts the skull at the site of impact?
a) Contrecoup injury
b) Diffuse axonal injury
c) Coup injury
d) Acceleration-deceleration injury
(c) Coup injury refers to the focal damage that occurs at the site of impact when the brain hits the skull.
Which areas of the brain are MOST vulnerable to injury in a coup-contrecoup injury?
a) Parietal and occipital lobes
b) Orbitofrontal and temporal regions
c) Brainstem and cerebellum
d) Thalamus and hypothalamus
(b) Orbitofrontal and temporal regions are the most susceptible to injury in coup-contrecoup injuries due to the rough and protruding bones in these areas of the skull.
The Glasgow Coma Scale (GCS) is used to assess which of the following after a head injury?
a) Cognitive function
b) Emotional state
c) Level of consciousness
d) Motor strength
(c) Level of consciousness is assessed using the Glasgow Coma Scale (GCS) after a head injury. This scale helps determine the severity of the injury by evaluating eye-opening, verbal responses, and motor responses.
A 20-year-old male is brought to the emergency room after a motorcycle accident. He was not wearing a helmet. He opens his eyes to pain, moans in response to questions, and withdraws his limbs from painful stimuli. What is his Glasgow Coma Scale (GCS) score?
a) 3
b) 7
c) 9
d) 12
(c) 9 The patient scores a 2 for eye opening (opens to pain), a 2 for verbal response (moans), and a 5 for motor response (withdraws to pain). These add up to a GCS score of 9, indicating moderate head injury.
An MRI of the patient in question 1 reveals damage to the white matter of the corpus callosum. Which mechanism of injury is most likely responsible for this finding?
a) Direct impact
b) Twisting and shearing of neurons
c) Hypoxia
d) Hemorrhage
(b) Twisting and shearing of neurons The corpus callosum, a large white matter tract, is particularly vulnerable to damage from the twisting and shearing forces that occur during acceleration-deceleration injuries.
A 45-year-old woman falls and hits her head on the sidewalk. She loses consciousness briefly but regains it at the scene. However, she cannot remember the events leading up to the fall. This is an example of:
a) Anterograde amnesia
b) Retrograde amnesia
c) Post-traumatic stress disorder
d) Dementia
(b) Retrograde amnesia Retrograde amnesia refers to the inability to recall events that occurred before the injury. In this case, the woman cannot remember the events leading up to her fall, indicating retrograde amnesia.
Years after sustaining a closed head injury, a patient begins experiencing recurrent seizures. This is a possible long-term consequence of closed head injury known as:
a) Chronic traumatic encephalopathy
b) Post-traumatic epilepsy
c) Alzheimer’s disease
d) Parkinson’s disease
(b) Post-traumatic epilepsy Closed head injury increases the risk of developing epilepsy, a condition characterized by recurrent seizures. This can occur months or even years after the initial injury.
Which of the following groups is MOST likely to experience a closed head injury due to falling?
a) Adolescents
b) Young adults
c) Middle-aged adults
d) Older adults
(d) Older adults, along with young children, are more likely to experience closed head injuries due to falls. This is often related to factors such as balance issues, frailty, and decreased bone density.
A 70-year-old patient presents with progressive memory decline, difficulty with language, and visuospatial impairments. An autopsy after their passing reveals the presence of amyloid plaques and neurofibrillary tangles. Which type of dementia is the most likely diagnosis?
a) Frontotemporal Dementia (FTD)
b) Vascular Dementia
c) Parkinson’s Disease Dementia
d) Alzheimer’s Disease (AD)
(d) Alzheimer’s Disease (AD) The presence of amyloid plaques and neurofibrillary tangles, along with the described symptoms, are hallmark characteristics of Alzheimer’s disease.
A 60-year-old individual exhibits significant changes in behavior, including impulsivity, inappropriate social conduct, and a lack of awareness regarding their actions. They are subsequently diagnosed with a cortical dementia. What is the most probable diagnosis?
a) Alzheimer’s Disease (AD)
b) Vascular Dementia
c) Frontotemporal Dementia (FTD)
d) Huntington’s Disease (HD)
(c) Frontotemporal Dementia (FTD) The prominent behavioral changes, particularly the disinhibition and lack of social awareness, strongly suggest Frontotemporal Dementia, specifically the behavioral-variant subtype.
Which of the following statements accurately distinguishes subcortical dementias from cortical dementias?
a) Subcortical dementias primarily affect memory, while cortical dementias affect language and visuospatial skills.
b) Subcortical dementias result in general cognitive deficits, while cortical dementias present with specific cognitive impairments.
c) Subcortical dementias have a faster rate of progression compared to cortical dementias.
d) Subcortical dementias are more common than cortical dementias.
(b) Subcortical dementias result in general cognitive deficits, while cortical dementias present with specific cognitive impairments. Subcortical dementias, like Huntington’s and Parkinson’s diseases, tend to cause more widespread cognitive slowing and executive function difficulties. Cortical dementias, like Alzheimer’s and FTD, often exhibit more distinct impairments in areas like language, memory, or visuospatial abilities.
A patient diagnosed with Parkinson’s disease experiences a gradual decline in cognitive function, including slowed thinking and memory problems. What is the underlying neurobiological mechanism believed to contribute to these cognitive symptoms?
a) Accumulation of amyloid plaques in the brain
b) Formation of neurofibrillary tangles in neurons
c) Dopamine deficiency in the frontal lobe pathways
d) Multiple small strokes affecting various brain areas
(c) Dopamine deficiency in the frontal lobe pathways Parkinson’s disease is characterized by a lack of dopamine in brain regions crucial for executive functions, motor control, and other cognitive processes. This dopamine depletion contributes to the cognitive decline observed in some individuals with Parkinson’s.
Which medication is commonly prescribed for Alzheimer’s disease to enhance the availability of acetylcholine in the brain?
a) L-dopa
b) Donepezil
c) Interferons
d) Aducanamab
(b) Donepezil Donepezil, along with other medications like rivastigmine and galantamine, belongs to a class of drugs called cholinesterase inhibitors. These drugs help increase acetylcholine levels in the brain, which is believed to offer some cognitive benefit in Alzheimer’s disease.
