chapter 7-8-9

Question 1

Which of the following are prenatal 01 perinatal causes of developmental delay'7
A. Hypoxic encephalopathy
B. Cytomegalovirus
C. Lissencephaly
D. Toxoplasmosis
E. All of the above

Answer 1

E

Question 2

Which of the following are significant risk factors for perinatal neurologic injury?
A. Cesarean section after a trial of labor
B. Maternal diabetes
C. Low socioeconomic status
D. Umbilical prolapse
E. All of the above

Answer 2

E

Question 3

All of the following statements about ocular findings in developmental disorders are
correct EXCEPT which?
A. Nystagmus is seen in Leigh’s disease
B. Ophthalmoplegia is typical with Refsum’s disease
C. Wilson’s disease increases the risk of cataracts.
D. Homocystinuria is associated with lens dislocation

Answer 3

B

Question 4

Which of the following statements about identification of eausu of developmental delay
is true?
A. About 60-80% of developmental delay can be given an etiology
B. Fewer than 30% of patients with developmental delay can be given an etiologic diagnosis
C. Determination of an etiology usually provides a specific intervention which can be applied
D. Developmental delay identified in one child does not alter the frequency of developmental delay in subsequent children

Answer 4

A

Question 5

The following questions pertain to developmental milestones. For each question, indicate
at which time the milestone is reached. Select from the following list.
A. Birth, to 6 months
B. 6 months to 1 year
C. 1 year to 2 years
D. 2 years to 3 years
E. After 3 years
Counts 4 objects and can tell a story.

Answer 5

E

Question 6

The following questions pertain to developmental milestones. For each question, indicate
at which time the milestone is reached. Select from the following list.
A. Birth, to 6 months
B. 6 months to 1 year
C. 1 year to 2 years
D. 2 years to 3 years
E. After 3 years
Laughs.

Answer 6

A

Question 7

The following questions pertain to developmental milestones. For each question, indicate
at which time the milestone is reached. Select from the following list.
A. Birth, to 6 months
B. 6 months to 1 year
C. 1 year to 2 years
D. 2 years to 3 years
E. After 3 years
Knows full name. Pretends as part of play.

Answer 7

D

Question 8

The following questions pertain to developmental milestones. For each question, indicate
at which time the milestone is reached. Select from the following list.
A. Birth, to 6 months
B. 6 months to 1 year
C. 1 year to 2 years
D. 2 years to 3 years
E. After 3 years
Feeds self. Indicates desires by pointing.

Answer 8

C

Question 9

Which of the following statements are true-regarding imaging in patients with
developmental delay?
1. Imaging shows a cause in about a third of patients with global developmental delay
2. MRI is more sensitive for cerebral dysgenesis than CT
3. Diagnostic yield of imaging is greater for patients with focal findings
4. Diagnostic yield of imaging is greater for patients with cerebrai palsy
Select: A = 1, 2, 3. B - 1. 3. C = 2,4. D - 4 only. E = All

Answer 9

E

Question 10

Which of the following statements are true regarding clinical findings in disorders with
developmental delay?
1. Glycogen storage diseases are commonK associated with organomegaly
2. Sjogren’s syndrome is associated with increased skin thickness and stiffness
3. Isovaleric acidemia is associated with the odor of sweaty feet
4. Spinal muscular atrophy presents with neonatal spasticity
Select: A = 1.2.3.B= i.3.C = 2, 4. D = 4 only. E – AH

Answer 10

A

Question 11

Which of the following are common behavioral disturbances in patients with Alzheimer's
disease?
A. psychosis
B. Agitation
C. Aggression
D. Depression
E. All of the above

Answer 11

E

Question 12

Depression is common in patients with AD. Which of the following statements is NOT
true regarding depression in AD?
A. SSRls can help depression in AD
B. Tricyclics are the preferred antidepressants for patients with AD
C. Depression in AD is more common if there is a family history or pre-disease personal history of depression
D. Patients with depression are more likely to complain of memory loss than patients with AD
E. All are true

Answer 12

B

Question 13

Psychotic symptoms are common in Dementia with Lewy Bodies. Which of the
following statements is NOT true for psychosis in DLB?
A. The majority of patients with DLB have psychotic symptoms
B. Psychosis in DLB is treated by most typical neuroleptics
C. Cholinesterase inhibitors are helpful for treatment of psychosis in DLB
D. Patients with DLB have clinical features of parkinsonism

Answer 13

A

Question 14

A 76-year-oid female presents with progressive dementia associated with disinhibition.
poor impulse control, and poor judgment. She seems unable to express normal social
emotions. Which of the following conditions is the most likely diagnosis?
A. Frontotemporal dementia
B. Alzheimer’s disease
C. Huntington’s disease
D. Pseudodementia

Answer 14

no answer (highlight)

Question 15

For each of the clinical presentations in the following questions, select the most likely
diagnosis from the following list.
A. Alzheimer's disease
B. Frontotemporal dementia
C. Dementia with Lewy bodies
D. Vascular dementia
E. All of these

80-year-old man presents with progressive dementia plus signs of parkinsonism with
rigidity, bradykinesia, and tremor. He has hallucinations of children playing in the corn er
of the room.

Answer 15

A

Question 16

For each of the clinical presentations in the following questions, select the most likely
diagnosis from the following list.
A. Alzheimer's disease
B. Frontotemporal dementia
C. Dementia with Lewy bodies
D. Vascular dementia
E. All of these

54-year-old female with progressive dementia and depression. Examination is normal
except for the mental status testing.

Answer 16

C

Question 17

For each of the clinical presentations in the following questions, select the most likely
diagnosis from the following list.
A. Alzheimer's disease
B. Frontotemporal dementia
C. Dementia with Lewy bodies
D. Vascular dementia
E. All of these

66-year-old man with dementia which has been progressive in a step-wise fashion. Has a
history of diabetes and hypertension. Examination shows incoordination of the right hand
and a left upgoing plantar response. He has obvious signs of depression.

Answer 17

D

Question 18

For each of the clinical presentations in the following questions, select the most likely
diagnosis from the following list.
A. Alzheimer’s disease
B. Frontotemporal dementia
C. Dementia with Lewy bodies
D. Vascular dementia
E. All of these
A 68-year-oid man presents with progressive dementia and some disinhibition. Early in
the course, he was described as having a propensity for sweets, which was a departure
from his earlier behavior. Later, at the :ime of presentadon, he exhibits hypersexuality.

Answer 18

B

Question 19

Which of the following statements regarding depression in Parkinson’s disease are true?
1. Depression is a common accompaniment
2. Psychosis is common
3. Patients with major depression progress faster in PD than patients without
depression
4. Depression in PD is more likely with older age of onset of disease
Select: A - L 2, V B - i, 3. C = 2, 4. D - 4 only. E = All

Answer 19

A

Question 20

Which of the following statements are true regarding behavior disturbance in
Huntington’s disease?
1. Depression occurs in the majority7 of patients
2. Depression is worst in later stages of the disease
3. Suicide is more common in HD with depression than in other neurologic
diseases with depression
4. Aggression is uncommon
Select: A = 1,2, 3. B = L 3.C = 2,4. D~4 only. E = All

Answer 20

B

Question 21

Which of the following psychiatric disorders are more common in patients with
Tourette’s svndrome?
1. ADHD
2. Personality disorder
3. Anxiety
4. Oppositional defiant disorder
Select . A = 1, 2, 3 . B = 1, 3. C = 2, 4. D = 4 only. E = All

Answer 21

E

Question 22

Which of the following statements are true regarding behavior disturbances in Multiple
Sclerosis?
1. Depression is rare, with fewer than 20% of patients exhibiting depression
2. Depression in MS is correlated with disease duration
3. Depression in MS is more common in females
4. Depression in MS is more likely in patients experiencing an exacerbation of MS symptoms
Select: A= i, 2,3. B = 1,3. C = 2,4. D = 4 only. E = All

Answer 22

D

Question 23

Behavioral alterations are common in epilepsy. For each behavioral state, select whether
the condition is more likely to be ictai, postictal, or interictal.
A. Ictal
B. Postictal
C. Interictal
D. Any of the above
Confusion.

Answer 23

B

Question 24

Behavioral alterations are common in epilepsy. For each behavioral state, select whether
the condition is more likely to be ictai, postictal, or interictal.
A. Ictal
B. Postictal
C. Interictal
D. Any of the above
Depression.

Answer 24

D

Question 25

Behavioral alterations are common in epilepsy. For each behavioral state, select whether
the condition is more likely to be ictai, postictal, or interictal.
A. Ictal
B. Postictal
C. Interictal
D. Any of the above
Unprovoked laughter.

Answer 25

A

Question 26

Depression is common following stroke. Which of the following statements are true of
depression in stroke patients?
1. Depression in stroke patients results in longer hospital stays
2. Depression is more common with lesions near the frontal pole
3. Pre-stroke depression increases the likelihood of post-stroke depression

Answer 26

No Highlights

Question 27

Which of the psychiatric term definitions is incorrect?
A Abulia - Reduced impulse to act and think associated w\n\ indifference about consequence of action
B. Delusion - Sensory misperception in the absence of an external stimulus
C. Dementia - Progressive mental decline which interferes with activities of daily living
E. Apathy - Dulled emotional tone with detachment or indifference

Answer 27

B

Question 28

Which of the following clinical features of psychiatric symptoms suggests a neurologic
rarher than a primary psychiatric disorder?
A. More rapid improvement with therapy than is normally clinically seen
B. L ate age of onset without a prior psychiatric history
C. Multiple psychosocial stressors
D. Slow-gradual progression
E. All of me above

Answer 28

B

Question 29

Which of the following statements is true regarding KlV-associatcd dementia (HAD)”?
A. Patients present as a cortica1 dementia
B. Psychotic symptoms are much less common man in other causes of dementia
C. More than 50” a of Hi V patients show HAD at autopsy
D. Development of HAD has no effect on prognosis
E. All arc true

Answer 29

C

Question 30

Which of the following psychiatric manifestations is most likely in a patient in the early
stages of new variant Creutzfeldt-iakob disease?
A. Suicidal ideation
B. Obsessive features
C. Panic attacks
D. Irritability

Answer 30

D

Question 31

Which of the following degenerative conditions is not associated with an increased
incidence of psychiatric conditions?
A. Frontotemporal dementia
B. Progressive supranuclear palsy
C. Corticobasal degeneration
D. Idiopathic basal ganglia calcifications
E. All are associated with psychiatric symptoms

Answer 31

E

Question 32

Which of the following are clinical features of acute intermittent porphyria?
1. Abdominal pain
2. Peripheral neuropathy
3. Seizures
4. Hallucinations
Select: A = 1, 2, 3. B = i, 3 C = 2,4. D = 4 only. E = All

Answer 32

E

Question 33

Which of the following statements regarding cancer and psychiatric complications is not
true?
A. It is rare For a patient to present with a primary psychiatric diagnosis and be found to have a brain tumor
B. Single CNS metastases rarely have neuropsychiatry implications, whereas multiple lesions commonly present with neuropsychiatry symptoms
C. Supralentorial lesions are more likely than infratentorial lesions to produce neuropsychiatry symptoms
D. The most common cancers io produce paraneoplastic syndromes are ovarian
and small-cell lung cancer

Answer 33

B

Question 34

A 48-year-old woman presents with a history of several years of depression requirmg
antidepressants, though the response to treatment is unimpressive. She presents to the
neurologist after a seizure. Examination is normal except for depression, mild memory
loss, aird anosmia. Which is the most likely diagnosis?
A. Bifrontal infarction
B. Olfactory-groove meningioma
C. Metastatic breast cancer
D. Limbic encephalitis

Answer 34

B

Question 35

Differentiation of dementia such as Alzheimer’s disease from depression-related
cognitive impairment (DRCI) is an important clinical *»sL Wh’:L ufdic following
statements regarding differentiation is not correct?
A. Patients with DRCI usually have normal bedside mental status exam whereas memory dtfic’n is evident in most patients with AD
B. Patients with DRCI are more likely to complain of memory problems than patients with AD
C. Patients with DRCI have difficulty with attention whereas recognition is preserved; whereas in AD there are problems vvith recognition and attention may be normal
D. Language is preserved in DRCI whereas it is usually abnormal in patients with AD
E. All are correct

Answer 35

E

Question 36

Management of psychiatric symptoms in patients with neurologic conditions is difficult
because of interactions of the medications wiih their neurologic conditions. Which of the
following are important considerations for therapy in these patients?
A. SSRIs are used more than tricyclic antidepressants for depression in dementia
B. Atypical neuroleptics are used more commonly than typical neuroleptics for
patients with parkinsonism
C. Anticholinergic drugs should be avoided in patients with dementia
D. All are true

Answer 36

D