Mock Exam 1 - BRAIN Website

Question 1

It is hypothesized that schizophrenia may be related to an excess of which neurotransmitter:

a) Serotonin
b) GABA
c) Dopamine
d) Glutamate

Answer 1

c) Dopamine

Question 2

Structural abnormalities in the brains of patients with obsessive compulsive disorder have been identified in several areas. Which of the following areas have not been found to be affected?

a) Cingulate gyrus
b) Orbital frontal cortex
c) Substantia nigra
d) Caudate nucleus

Answer 2

c) Substantia nigra

Question 3

A patient presents with quite limited spontaneous speech, an inability to repeat statements made by the examiner, yet an ability to follow instructions provided by the examiner. This patient may be suffering from:

a) Wernicke’s Aphasia
b) Conduction Aphasia
c) Broca’s Aphasia
d) Global Aphasia

Answer 3

c) Broca’s Aphasia

Question 4

Another patient presents with quite fluent, spontaneous speech, yet an inability to repeat statements made by the examiner, and an ability to follow instructions provided by the examiner. This patient may be suffering from:

a) Wernicke’s Aphasia
b) Conduction Aphasia
c) Broca’s Aphasia
d) Global Aphasia

Answer 4

b) Conduction Aphasia

Question 5

A 76 year old woman presents with marked confusion, disorientation, and impaired memory that reportedly became noticeable within the past week. Among the following choices, which is the most likely diagnosis?

a) Depression
b) Dementia
c) Delirium
d) Dystonia

Answer 5

c) Delirium

The diagnostic criteria for dementia requires impairment in 2 or more cognitive functions, which interfere with social/occupational functioning. There must not be clouding of consciousness. Clouding of consciousness, especially in the context of confusion, disorientation, hallucinations, disturbance of attention, or marked behavioral change is typically indicative of delirium. Dystonia involves slow, involuntary, arrhythmic muscle contractions that produce forced, distorted postures. Dystonia may occur as a separate disease entity, or may be the symptom of another disease (Parkinson’s). Levodopa may induce dystonia. (INS Dictionary).

Question 6

Which of the following measures would likely be least sensitive to the effects of a brain injury?

a) Achievement Test
b) IQ Test
c) Memory Test
d) Continuous Performance Test (CPT)

Answer 6

a) Achievement Test

Standardized achievement testing may not be sensitive to the effects of closed head injuries. Long term follow-up studies are needed, however, to determine whether the academic achievement of children with severe injuries gradually lags behind that of their uninjured peers. (Yeates, Ris, & Taylor, Page 102).

Question 7

What is the classic triad of symptoms seen in acute Wernicke-Korsakoff Syndrome?

a) Ataxia, vertigo, and vomiting
b) Ataxia, eye movement abnormalities, and confusional state
c) Extrapyramidal movement disorder, hallucinations, and personality changes
d) Gradually-developing anterograde amnesia, constructional deficits, and anosmia

Answer 7

b) Ataxia, eye movement abnormalities, and confusional state

Use the mnemonic “ace” if it helps. Acute Wernicke-Korsakoff syndrome causes ataxia, confusion, and eye movement abnormalities. The other symptom sets listed are related to other disorders, though not pathognominic for any of them (e.g., increased intracranial pressure with downward herniation for “a”, Lewy Body Dementia for “b”, and Alzheimer’s for “c”).

Question 8

Heschl’s gyrus is associated with which of the following?

a) Primary visual cortex
b) Primary auditory cortex
c) Secondary auditory cortex
d) Somatosensory cortex

Answer 8

b) Primary auditory cortex

Question 9

A right-handed patient sustains a PCA infarct that results in damage to the left posterior white matter and the splenium of the corpus callosum, with relative gray matter sparing. Which of the following symptom clusters is most likely to occur?

a) Alexia without agraphia (a.k.a. posterior alexia or associative alexia)
b) Alexia with agraphia
c) Frontal or anterior alexia (a.k.a. literal alexia)
d) Wernecke’s aphasia and agraphia
e) A conduction aphasia and agraphia

Answer 9

a) Alexia without agraphia (a.k.a. posterior alexia or associative alexia)

Alexia without agraphia (aka Posterior alexia, associative alexia) may spare the angular gyrus, but generally involves white matter tracts in the posterior dominant hemisphere and underlying inter-hemispheric commissures (e.g., splenium of the corpus callosum). Frontal alexia is defined in #3, below.

Question 10

Which of the following is most likely to result in dementia?

a) Parkinson’s Disease
b) Huntington’s Disease
c) Sydenham’s Chorea
d) Primary Dystonia
e) Essential Tremor

Answer 10

b) Huntington’s Disease

Huntington’s is most strongly associated with dementia. Parkinson’s Disease can result in dementia, but dementia is less common, especially in middle-aged populations. The others are not uniquely associated with dementia.

Question 11

Evidence of which form of validity is most needed for a job screening test?

a) Concurrent validity
b) Content validity
c) Predictive validity
d) Face validity

Answer 11

c) Predictive validity

Question 12

Which is most true of a person with Transient Global Amnesia?

a) oriented and able to correctly provide personal information
b) confabulates
c) shows anterograde amnesia but not retrograde amnesia
d) shows retrograde amnesia but not anterograde amnesia
e) shows decreased level of consciousness

Answer 12

a) oriented and able to correctly provide personal information

Question 13

Seizures originating in what area are associated with fear and panic?

a) dorsolateral frontal convexity
b) supplementary motor area
c) caudate
d) amygdala

Answer 13

d) amygdala

Question 14

Which of the following is a differentiating factor in comparing “familial” Alzheimer’s (in which a genetic link has been established) from the more common “nonfamilial” Alzheimer’s?

a) Age of onset
b) Core clinical/behavioral features
c) Post-mortem neuropathological changes
d) None of the above (e.g., aside from genetics the two syndromes are identical)

Answer 14

a) Age of onset

Interestingly, other than age of onset, there are not consistent clinical differences between familial and nonfamilial AD. Familial cases tend to have earlier onset (middle adulthood vs over 65).

Question 15

If brain damage involves structures surrounding the cribiform plate, it is likely that which cranial nerve would be involved?

a) Olfactory
b) Optic
c) Facial
d) Hypoglossal

Answer 15

a) Olfactory

The olfactory nerve travels across the cribiform plate of the ethmoid bone to synapse in the olfactory bulbs. The sense of smell may be lost following head trauma due to damage to the olfactory nerves as they penetrate the olfactory plate.

Question 16

A patient who is unable to recognize his family members, or his doctor of many years, is likely suffering from ________. If this problem is the result of a unilateral disorder, it is likely that the lesion is in the ______ hemisphere.

a) Simultanagnosia, Left
b) Simultanagnosia, Right
c) Prosopagnosia, Left
d) Prosopagnosia, Right

Answer 16

d) Prosopagnosia, Right

Agnosia handout, page 2. Prosopagnosia is the inability to recognize known faces, and to learn new ones. Lesions are typically bilateral in the occipitotemporal cortex and underlying white matter; if unilateral, it results from right hemisphere lesions.

Question 17

Which of the following is not characteristic of multiple sclerosis?

a) Dysarthria
b) Aphasia
c) Nystagmus
d) Tremor

Answer 17

b) Aphasia

Kaufman “Since the cerebral cortical ‘gray matter’ which has no myelin is relatively spared, MS patients rarely develop signs of cerebral cortical dysfunction, such a seizures or aphasia.”

Question 18

Anomic aphasia is typically caused by damage to the following area of the left hemisphere:

a) Thalamus
b) Angular Gyrus
c) Wernicke’s and Broca’s Areas
d) Arcuate Fasciculus

Answer 18

b) Angular Gyrus

Question 19

Which one of the following statements is true?

a) Approximately 5% of all causes of dementia are reversible
b) Approximately 25% of all causes of dementia are reversible
c) Approximately 45% of all causes of dementia are reversible
d) Approximately 65% of all causes of dementia are reversible

Answer 19

a) Approximately 5% of all causes of dementia are reversible

“More than 50 different illnesses produce symptoms of dementia. Available studies indicate that, on average, 5% of all causes of dementia are reversible and 11% have some specific treatment available, although not typically resulting in symptom reversal. Kasniak, A. (2002). Dementia. In Encyclopedia of the human brain, Vol. 1. Elsevier.

Question 20

An examiner gives a patient the WASI while he is on an inpatient rehabilitation unit. The patient is then seen as an outpatient to track his recovery, where he is administered the WAIS-III. What sources of variability or error variance might affect his scores and obscure real changes in his functioning?

a) Differences in items/content (i.e., item heterogeneity)
b) Time differences
c) Scorer differences
d) All of the above

Answer 20

d) All of the above

Question 21

Which one of the following is true about malingering?

a) Any patient who is involved in a personal injury case or has a lawyer must be malingering
b) Patients with genuine organic illnesses will not exaggerate their symptoms
c) Malingering patients typically demonstrate more difficulties with memory than they do with attention
d) Malingering is detectable through face-to-face clinical interviews alone

Answer 21

c) Malingering patients typically demonstrate more difficulties with memory than they do with attention

Question 22

PTA, or Post Traumatic Amnesia, refers to:

a) The fact that most children cannot remember traumatic events that happened to them.
b) A period of time following a TBI in which the patient cannot remember what had happened to cause the injury.
c) A period of time following a TBI in which new memories cannot be consistently formed.
d) The memory difficulties typically associated with Post-Traumatic Stress Disorder.

Answer 22

c) A period of time following a TBI in which new memories cannot be consistently formed.

Question 23

An individual with which type of dementia is most likely to show retrieval rather than retention deficits:

a) Alzheimer’s Dementia
b) Parkinson’s Disease
c) Diffuse Lewy Bodies Dementia
d) Pick’s Disease

Answer 23

b) Parkinson’s Disease

Question 24

Leukoaraiosis refers to:

a) Diffuse white matter changes seen in older patients
b) Watershed white matter damage associated with anoxia
c) Destruction of white matter in the peripheral nervous system
d) An attack on the cerebral and spinal cord myelin following an infection or immunization

Answer 24

a) Diffuse white matter changes seen in older patients

Question 25

The primary visual area lies along the ______.

a) Calcarine fissure
b) Central sulcus
c) Sylvian fissure
d) Lateral fissure

Answer 25

a) Calcarine fissure

Page 368 of Blumenfeld. Figure 10.1 / and text. The primary visual cortex for the contralateral hemifield lies along the calcarine fissure of the occipital lobe.

Question 26

The criterion validity of a test is limited by which of the following:

a) The test’s standard deviation
b) The test’s reliability
c) Validity shrinkage
d) The standard deviation of the criterion variable

Answer 26

a) The test’s standard deviation

Question 27

Functional neuroimaging (PET, fMRI) in patients with schizophrenia has shown:

a) enlarged ventricles
b) no difference relative to normal controls
c) hypofrontality
d) hyperfrontality

Answer 27

c) hypofrontality

Question 28

When trying to teach something to a patient with severe memory impairment, you prevent the patient from guessing or making mistakes during the learning phase. This is an example of:

a) Prospective Memory Training
b) Graduated Exposure
c) Priming
d) Errorless Learning

Answer 28

d) Errorless Learning

Question 29

Double simultaneous stimulation is used to screen for ______.

a) Agnosia
b) Hyperarousal
c) Neglect
d) Ocular Apraxia

Answer 29

c) Neglect

Question 30

Which is not a neuropathological feature associated with Alzheimer’s Dementia?

a) Neuritic Plaques
b) Neurofibrillary Tangles
c) Granulovacular Bodies
d) Lewy Bodies

Answer 30

d) Lewy Bodies

Question 31

Frontal memory disorders are characterized by all but:

a) Attentional deficits interfere with encoding
b) Loss of autobiographical knowledge
c) Confabulation
d) Limited memory for temporal order of events

Answer 31

b) Loss of autobiographical knowledge

Question 32

Few studies have been conducted on pesticide exposures, however, the deficits associated with them appear to be similar to the core pattern in solvent toxicity, including:

a) Mental slowing and anxiety/depression
b) Visual spatial deficits
c) Agraphia and alexia
d) Peripheral neuropathy and optic ataxia

Answer 32

a) Mental slowing and anxiety/depression

From Lezak. On acute exposure to pesticides we see headaches, blurred vision, restlessness, anxiety, depression, mental slowing, slurred speech, and ataxia. For chronically exposed individuals, the most frequent complaints are irritability, confusion and depression, as well as attention, memory, and response speed deficits.

Question 33

In pediatric patients, about ____ % of brain tumors are in the posterior fossa and ___% are supratentorial.

a) 50, 50
b) 10, 90
c) 70, 30
d) 30, 70

Answer 33

c) 70, 30

Question 34

Which of the following is not a feature of Gerstmann’s Syndrome?

a) Acalculia
b) Ideational apraxia
c) Left/right confusion
d) Finger agnosia

Answer 34

b) Ideational apraxia

Question 35

Broca’s aphasia is commonly accompanied by which of the following?

a) Right hemiplegia
b) Contralateral superior quadrantanopsia
c) Gerstmann’s syndrome
d) Right visual neglect

Answer 35

a) Right hemiplegia

Question 36

Which region of the brain seems to be involved both in habit learning and in OCD?

a) Amygdala
b) Caudate
c) Hippocampus
d) Dorsolateral Prefrontal Cortex

Answer 36

b) Caudate

Question 37

Which of the following is not one of the more common symptoms or signs of elevated intracranial pressure?

a) Headache
b) Generally altered mental status, especially irritability and depressed level of alertness and attention
c) Focal cortical symptoms, such as aphasia
d) Nausea and vomiting

Answer 37

c) Focal cortical symptoms, such as aphasia

Question 38

Which of the following is a potentially reversible cause of dementia?

a) Vascular Dementia
b) Traumatic Brain Injury
c) Subdural Hematoma
d) Dementia with Lewy Bodies

Answer 38

c) Subdural Hematoma

Kasniak, A. (2002). Dementia. In Encyclopedia of the human brain, Vol. 1. Elsevier. Among the more common potentially reversible causes are those due to prescription and nonprescription drug toxicity, metabolic disorder, brain tumors, subdural hematoma, and depression. The more common dementia types that are presently irreversible include Alzheimer’s disease, Parkinson’s disease, dementia with Lewy bodies, Huntington’s disease, frontotemporal dementias, vascular dementia, and traumatic brain injury.”

Question 39

Alexia refers to:

a) The lack of development of normal reading skills.
b) Impaired auditory processing of language
c) An aquired deficit in the interpretation of written language.
d) An inability to understand spoken language.

Answer 39

c) An aquired deficit in the interpretation of written language.

Question 40

Dysarthria, dysphagia and hypoactive jaw and gag reflexes without associated cognitive or emotional changes is known as:

a) Pseudobulbar palsy
b) Bulbar palsy
c) Suprabulbar palsy
d) Meniere’s Disease

Answer 40

b) Bulbar palsy

Question 41

Use of a highly specific sign or symptom (e.g., contralateral neglect) in identifying brain damage will results in a high rate of:

a) false negative errors
b) false positive errors
c) true positive errors
d) true negative errors

Answer 41

a) false negative errors

Question 42

Which of the following Wechsler scale subtests is the best indicator of premorbid intelligence?

a) Vocabulary
b) Digit Span
c) Block Design
d) Similarities

Answer 42

a) Vocabulary

Question 43

Practice effects are most likely to be seen on which Wechsler scale subtest?

a) Vocabulary
b) Similarities
c) Picture Completion
d) Digit Span

Answer 43

c) Picture Completion

Question 44

Which statement is correct?

a) In Multiple Sclerosis intellectual changes typically develop later than physical deteriorations
b) In Alzheimer’s Disease intellectual changes typically develop later than physical deteriorations
c) In Cerebrovascular Accidents (CVA’s ) physical deteriorations typically develop later than intellectual deteriorations
d) In Parkinson’s Disease, physical changes typically develop later than intellectual changes.

Answer 44

a) In Multiple Sclerosis intellectual changes typically develop later than physical deteriorations

Page 360 in Kaufman “The late development of intellectual changes in MS distinguishes it from AD and CVA’s. In AD, which affects the gray matter exclusively, intellectual impairment occurs first and becomes profound long before the onset of physical impairments. In CVAs, both gray and white matter damage cause simultaneous intellectual and physical impairment. Particularly in multi-infarct dementia, intellectual and physical deficits progress together.

Question 45

Which of the following statements is true with regard to differentiating depression from dementia (Alzheimer’s/AD)?

a) Cognitive deficits in persons with depression are often more severe than in persons with AD.
b) Persons with depression show memory retention deficits while persons with AD show retrieval deficits.
c) Persons with depression are more likely to show impaired naming ability, verbal fluency, and visuospatial ability.
d) Persons with depression may exert less effort on the performance of neuropsychological tests.

Answer 45

d) Persons with depression may exert less effort on the performance of neuropsychological tests.

Kasniak, A. (2002). Dementia. In Encyclopedia of the human brain, Vol. 1. Elsevier. Cognitive deficits in depression tend to be less severe and extensive than in AD. AD patients show more consistent impairment on memory tests than depressed patients. Persons with depression are less likely than those with AD to show impaired naming ability, verbal fluency, and visuospatial ability. Depressed patient are more likely to appear to exert less effort, and may complain more about their cognitive difficulties.

Question 46

Which brain region is most often affected by hydrocephalus?

a) Posterior regions
b) Frontal lobes
c) Temporal lobes
d) All of these are equally affected

Answer 46

a) Posterior regions

According to the Fletcher et al chapter, when hydrocephalus occurs, the ventricles expand in a posterior to anterior direction and white matter is damaged. Due to these factors, the posterior regions of the brain may be particularly susceptible. This may partially explain the PIQ < VIQ findings… interestingly, children who show proportionally greater thinning of the posterior brain regions relative to anterior tend to show the PIQ < VIQ pattern. When the thinning is comparable, so too are the IQ scores. (Dennis et al, 1981).

Question 47

The brain’s major inhibitory neurotransmitter is _______, which is primarily affected by benzodiazepines and barbiturates.

a) Acetylcholine
b) GABA
c) Glutamate
d) Dopamine

Answer 47

b) GABA

Question 48

A lesion of Brodman’s area 44 in the dominant hemisphere is most closely associated with which of the following?

a) Dysfluent aphasia
b) Diminished sensation in the right face and hand
c) Poor speech comprehension and fluent aphasia
d) Right hemispace neglect

Answer 48

a) Dysfluent aphasia

Question 49

What pattern of IQ performance is typically observed in children with early-onset hydrocephalus?

a) VIQ > PIQ
b) PIQ > VIQ
c) VIQ = PIQ, with both being on average 10 points below age matched norms
d) VIQ = PIQ, with both being on average 10 points above age matched norms

Answer 49

a) VIQ > PIQ

This came from a chapter by Fletcher et al (??? which book). This finding is somewhat controversial. On average, this is true, but there is substantial variability between cases with shunted hydrocephalus.

Question 50

Lesions of the temporal lobe can cause:

a) Contralateral inferior quadranopia
b) Contralateral superior quadranopia
c) Bitemporal hemianopia
d) Contralateral homonymous hemianopia

Answer 50

b) Contralateral superior quadranopia

Page 442 Blumenfeld. Lesions of the temporal lobe can cause contralateral superior quadranopia due to interruption of the lower portions of the optic radiations. This is sometimes referred to as the “pie in the sky” phenomenon.

Question 51

Gait difficulties, urinary incontinence, and cognitive decline are highly indicative of which condition?

a) Pseudotumor cerebri
b) Subdural hematoma
c) Tonsillar herniation
d) Normal pressure hydrocephalus

Answer 51

d) Normal pressure hydrocephalus

Question 52

Following a stroke, a 75 year-old woman is left with impaired language comprehension, but normal fluency and repetition. Her symptoms are most consistent with:

a) Mixed Transcortical Aphasia
b) Transcortical Sensory Aphasia
c) Transcortical Motor Aphasia
d) Wernicke’s Aphasia

Answer 52

b) Transcortical Sensory Aphasia

Question 53

Which statement is false regarding cerebral palsy (CP)?

a) Injuries causing CP can occur pre-natally, post-natally, during infancy or early childhood.
b) When the cause of CP can be established, prematurity and low birthweight are usually implicated.
c) Epilepsy and mental retardation frequently co-occur with CP
d) Less than 5% of persons with CP have normal intelligence

Answer 53

d) Less than 5% of persons with CP have normal intelligence

Question 54

Which of the following disorders has been most closely linked to degeneration of acetylcholine-synthesizing neurons in the basal forebrain?

a) Huntington’s Disease
b) Alzheimer’s Disease
c) Parkinson’s Disease
d) Normal-Pressure Hydrocephalus
e) Multiple Sclerosis

Answer 54

b) Alzheimer’s Disease

Although Alzheimer’s is more than a simple degeneration of the nucleus basalis of Meynert, this is a key site of degeneration and likely accounts for the prominent early memory decline. The other disorders may also involve the nucleus basalis of Meynert and/or cholinergic systems at one point or another, but less directly or centrally.

Question 55

A lesion of the arcuate fasciculus would most likely cause the following subtype of aphasia:

a) Wernicke’s Aphasia
b) Conduction Aphasia
c) Broca’s Aphasia
d) Global Aphasia

Answer 55

b) Conduction Aphasia

Question 56

Which treatments of tumors are generally not associated with mental status changes?

a) All chemotherapies except methotrexate
b) Methotrexate, but generally not other chemotherapies
c) Cranial (whole brain) radiotherapy
d) Medications such as opiates used for pain

Answer 56

a) All chemotherapies except methotrexate

Most chemotherapies do not cause mental status changes because they cannot cross the blood brain barrier. The exception is methotrexate, which is administered intrathecally (into the subarachnoid space usually by spinal tap). The benefit of this med is that it often protects from leukemic cells entering the CNS… but it has a cost. It often induces confusional states, LD’s, and ‘permanent intellectual impairment.’

Question 57

Cerebellar pathways affect all but one of the following:

a) Motor learning
b) Balance
c) Higher-order cognitive processes
d) Anosmia
e) Respiratory movements

Answer 57

d) Anosmia

The cerebellum is involved in both a variety of motor and cognitive processes. Anosmia is a deficit of olfaction, where the sense of smell the is diminished or lost . It is also known as olfactory loss and can occur to single or to both nostrils.

Question 58

Lateral cerebellar lesions primarily affect:

a) Trunk control
b) Posture and balance
c) Motor planning
d) Gait

Answer 58

c) Motor planning

The lateral cerebellar hemisphere affects distal limb coordination and motor planning. Trunk control, posture and balance, and gait result from medial cerebellar lesions.

Question 59

Which of the following statements is true?

a) The left hemisphere has more association cortex than the right hemisphere.
b) The left hemisphere has more gray matter/less white matter relative to the right hemisphere.
c) The two hemispheres have equal amounts of gray and white matter.
d) The right hemisphere has fewer interconnections than the left hemisphere.

Answer 59

b) The left hemisphere has more gray matter/less white matter relative to the right hemisphere.

The right hemisphere has more white matter, less gray matter, more association cortex, and more interconnections.

Question 60

A person who can not identify an object by touch may have:

a) Anomia
b) Associative Agnosia
c) Astereognosis
d) Alexia

Answer 60

c) Astereognosis

Question 61

Autopsy studies of dementia pugilistica typically reveal all of the following except:

a) Neuronal loss
b) Infarcts in the basal ganglia
c) Astrocyte proliferation

Answer 61

b) Infarcts in the basal ganglia

Question 62

Which symptoms below are characteristic of normal aging:

a) Decreased verbal fluency
b) Decreased selective and sustained attention
c) Decreased working memory skills
d) Decreased “crystallized” knowledge
e) Difficulties with language comprehension
f) A & C
g) B & C

Answer 62

f) A & C

Question 63

Neglect can occur with lesions in all of the following areas except:

a) Right internal capsule
b) Right frontal lobe
c) Right thalamus or basal ganglia
d) Right midbrain

Answer 63

a) Right internal capsule

Question 64

The structure involved in the “master clock” for circadian rhythms is the:

a) Arcuate nucleus
b) Median eminence
c) Suprachiasmatic nucleus
d) Dentate gyrus

Answer 64

c) Suprachiasmatic nucleus

Question 65

A test designed as a general screening for brain impairment should have:

a) High specificity
b) High sensitivity
c) Face validity
d) Low sensitivity but high specificity

Answer 65

b) High sensitivity

Question 66

Infarction of the inferior portion of the pons or medulla can cause:

a) Pseudobulbar palsy
b) “Man in barrel” syndrome
c) Locked in syndrome
d) Alien hand syndrome
e) “Pie in sky” visual defect

Answer 66

c) Locked in syndrome

Question 67

___ is the neurotransmitter primarily found in neurons of the raphe nuclei.

a) Dopamine
b) Acetylcholine
c) Histamine
d) Serotonin

Answer 67

d) Serotonin

Question 68

A person with phonological alexia is most likely to make the following error:

a) Reads “ought” for “thought”
b) Reads “think” for “thought”
c) Reads “hot’ for “thought”
d) Reads “though” for “thought”

Answer 68

d) Reads “though” for “thought”

Question 69

Which statement is true regarding the relationship between depression and dementia:

a) Depression decreases as the severity of dementia increases
b) CT and MRI reliably differentiate between depression and dementia
c) Cognitive symptoms associated with depression develop insidiously while cognitive symptoms associated with dementia develop rapidly.
d) Both depression and dementia result in similar deficits in immediate recall and recognition on memory tests.

Answer 69

a) Depression decreases as the severity of dementia increases

Question 70

Which disorder is characterized by café au lait spots and Lisch nodules?

a) Tuberous sclerosis
b) Neurofibromatosis Type 1
c) Sturge-Weber syndrome
d) Angelman’s syndrome

Answer 70

b) Neurofibromatosis Type 1

Question 71

Which of the following is not a common characteristic in Tourette’s Syndrome?

a) Changing of tic locations and types
b) Waxing and waning of tics
c) Comorbidity with ADHD and/or OCD symptoms
d) Coprolalia

Answer 71

d) Coprolalia

Question 72

Which of the following is not commonly associated with Central Alexia (aka alexia with agraphia)?

a) Finger agnosia
b) Right hemisensory loss (e.g., right homonymous field defect)
c) Right-left confusion
d) Acalculia
e) Environmental sound agnosia (aka auditory sound agnosia)

Answer 72

e) Environmental sound agnosia (aka auditory sound agnosia)

Options a, c, and d are all associated with Gertsmann Syndrome, which would be compatible with the probable lesion location. Right visual field defects are common in central alexia, which makes sense unless the lesion is tiny.

Question 73

Which area of the brain has been shown to be most involved in response initiation and inhibition?

a) Orbital frontal lobe
b) Dorsolateral frontal lobe
c) Medial frontal lobe
d) Caudate

Answer 73

a) Orbital frontal lobe

Question 74

Analysis of motion and spatial relationships between objects and between the body and visual stimuli is most likely to occur in the ________________.

a) Primary visual cortex
b) Frontal association cortex
c) Temporal-occipital association cortex
d) Parietal-occipital association cortex

Answer 74

d) Parietal-occipital association cortex

Question 75

Which of the following statements is true regarding myelination?

a) Myelination is complete by the end of the 7th month of gestation.
b) Sensory areas of the brain are myelinated before motor areas.
c) Neural tube defects result from disruption of the myelination process
d) Striatal neurons are primarily involved in myelination.

Answer 75

b) Sensory areas of the brain are myelinated before motor areas.

Question 76

In lesions of the dominant inferior parietal lobe, centering on the angular gyrus, you would expect that the patient could:

a) Name individual letters in isolation
b) Likely have some hemisensory loss and/or right homonymous visual field deficit
c) Read nonwords
d) Write (not just copy) words

Answer 76

b) Likely have some hemisensory loss and/or right homonymous visual field deficit

Question 77

The pattern of “dementia with psychomotor slowing” occurs in all except which of the following disorders?

a) HIV-related dementia
b) Progressive supranuclear palsy
c) Huntington’s disease
d) Alzheimer’s dementia

Answer 77

d) Alzheimer’s dementia

Question 78

The memory deficit typically seen in mild AD is characterized by:

a) Poor immediate repetition
b) Poor new learning and encoding of information when there is intention to learn
c) Deficits in recognition memory
d) Deficits in autobiographical memory

Answer 78

b) Poor new learning and encoding of information when there is intention to learn

Question 79

The pattern of new learning in the course of normal aging is characterized by:

a) Somewhat poorer initial learning but intact delayed recall of what they learned
b) Normal initial learning, but poor recognition memory
c) Vastly impaired initial learning with severe interference effects on delayed recall
d) Somewhat poorer initial learning with very impaired delayed recall

Answer 79

a) Somewhat poorer initial learning but intact delayed recall of what they learned

Question 80

The type of memory deficit most apparent in patients with alcoholic Korsakoff amnesia is a deficit in:

a) Initial encoding of new material
b) Recall of personal information
c) Poor retrieval despite adequate encoding
d) Recognition memory

Answer 80

a) Initial encoding of new material

Question 81

A right MCA stroke in the distribution of the inferior division would most likely cause:

a) Left hemineglect, decreased voluntary movements, and left-sided weakness
b) Left hemineglect, decreased tone, and left-sided weakness
c) Left hemineglect, decreased tone, and relatively normal left-sided strength
d) Left hemineglect, decreased voluntary movements, and relatively normal left-sided strength

Answer 81

d) Left hemineglect, decreased voluntary movements, and relatively normal left-sided strength

Question 82

What is the most likely cause for transient global amnesia?

a) Carotid artery TIA
b) Basilar artery TIA
c) Carotid artery stroke
d) Basilar artery stroke

Answer 82

b) Basilar artery TIA

Question 83

Alexia without agraphia is most likely due to damage to what region(s)?

a) Infarction of left posterior artery territory including the splenium of the corpus callosum
b) Angular gyrus
c) Border zones of MCA including Broca’s area
d) Arcuate Fasciculus

Answer 83

a) Infarction of left posterior artery territory including the splenium of the corpus callosum

Question 84

Research has shown that right-sided brain damage can lead to subtle language deficits in all of the following except?

a) Prosody
b) Grammatical rules and structure
c) Articulation
d) Use of abstract constructs

Answer 84

b) Grammatical rules and structure

Question 85

Research has shown that individuals with mild cognitive impairment will develop dementia at a rate of?

a) 1-2 % per year, no different than the general population
b) <1% per year, at a lower rate than the general population
c) 25% per year, at a greater prevalence than the general population
d) 10-15% per year, at a greater prevalence than the general population

Answer 85

d) 10-15% per year, at a greater prevalence than the general population

Question 86

Which area of memory is found to be most intact in normal aging?

a) Working memory
b) Learning and Recall
c) Recognition
d) Remote memory

Answer 86

d) Remote memory

Question 87

Which of the following is true about Lewy Body Dementia?

a) It presents with Parkinsonian motor symptoms but the cognitive functioning more similarly looks like Alzheimer’s dementia.
b) It is a variant of Parkinson Dementia in which Lewy Bodies are present in the substantia nigra.
c) Patients are responsive to l-dopa like Parkinson’s dementia, but are insensitive to DA blocking agents.
d) Auditory hallucinations are frequently present.

Answer 87

a) It presents with Parkinsonian motor symptoms but the cognitive functioning more similarly looks like Alzheimer’s dementia.

Question 88

Confabulation is frequently seen in all but which of the following conditions:

a) Temporal Frontal Dementia
b) Primary Progressive Aphasia
c) Pick’s Disease
d) Wernicke-Korsakoff’s Syndrome

Answer 88

b) Primary Progressive Aphasia

Question 89

Which statement is false?

a) Rolandic epilepsy occurs nocturnally and is usually in remission by age 15
b) Landau-Kleffner syndrome is characterized by an acquired aphasia, and seizures are most commonly generalized motor seizures.
c) Febrile seizures occur in 2-4% of all children, and most go on to develop temporal lobe epilepsy.
d) Lennox-Gastaut is a mixed seizure disorder in which the seizures are difficult to control, and status epilepticus is common.

Answer 89

c) Febrile seizures occur in 2-4% of all children, and most go on to develop temporal lobe epilepsy.

Question 90

Difficulty recalling events prior to amnesia onset is called ________________, while difficulty recalling previously learned information because new information interfered with it is called __________________.

a) Retrograde amnesia; retroactive interference
b) Retrograde amnesia; proactive interference
c) Anterograde amnesia; retroactive interference
d) Anterograde amnesia; proactive interference

Answer 90

a) Retrograde amnesia; retroactive interference

Question 91

Which of the following would not be expected from frontal lobe damage?

a) Acute eye deviation with persistent neglect
b) Contralateral hemiplegia
c) Anosmia
d) Acalculia

Answer 91

d) Acalculia

Question 92

Which of the following is true regarding childhood leukemia?

a) Chemotherapy, such as methotrexate, does not cause cognitive impairments as it is administered intrathecally and does not pass the blood/brain barrier.
b) Whole brain and partial brain radiation therapy is equally damaging in regards to cognitive impairment.
c) Older children are comparatively more vulnerable to radiation-induced cognitive impairment than younger due to plasticity issues.
d) Children who have been treated with radiation therapy often present with cognitive impairment that can look like a nonverbal learning disability (i.e., performance based IQ more affected than verbal based IQ, particularly processing speed).

Answer 92

d) Children who have been treated with radiation therapy often present with cognitive impairment that can look like a nonverbal learning disability (i.e., performance based IQ more affected than verbal based IQ, particularly processing speed).

Question 93

Which of the following is not an advantage of an MRI over CT?

a) MRI has greater resolution, being able to detect smaller objects
b) There is no distortion from bone
c) It detects hemorrhages and hematomas more accurately
d) It can be applied to intra- and extracranial arteries

Answer 93

c) It detects hemorrhages and hematomas more accurately

Question 94

Which of the following is not a typical means of determining premorbid IQ?

a) Barona Regression Equation
b) Reading Tests (e.g., NART, WRAT-3)
c) Reading Comprehension Tests (WIAT-II)
d) Demographically based regression equations

Answer 94

c) Reading Comprehension Tests (WIAT-II)

Question 95

A neuropsychologist assesses a patient and finds an 18 point difference between the patient’s WAIS-III Full Scale IQ (FSIQ) score and WMS-III General Memory Index (GMI) score. What other information is crucial in order to find the statistical significance of this difference at the .05 level?

a) The patient’s gender
b) The patient’s performance on memory recognition measures
c) The patient’s age
d) The patient’s FSIQ

Answer 95

d) The patient’s FSIQ

FSIQ and GMI scores are highly correlated in patients with IQ’s in the average range, but are less related for patients at the lower and upper ends of the intelligence spectrum. It is not uncommon to see 25 point differences between FSIQ and GMI scores in patients with very low or very high IQ’s.

Question 96

In order to determine whether a change in a patient’s scores from Time 1 to Time 2 represents a clinically significant change, a neuropsychologist must take into account:

a) Measurement error, practice effects, regression to the mean
b) Validity shrinkage, Flynn effect, multicollinearity
c) Criterion validity, internal consistency, effort
d) Test bias, discriminant validity, multiple regression

Answer 96

a) Measurement error, practice effects, regression to the mean

This question refers to reliable change indices (RCI’s) which take into account measurement error, practice effects and regression to the mean.

Question 97

Which of the following is most consistent with a mild traumatic brain injury?

a) Galveston Orientation and Amnesia Test (GOAT) score of 15
b) Glascow Coma Scale (GCS) score of 8
c) Post-Traumatic Amnesia (PTA) of 12 hours
d) Loss of consciousness of 2 hours

Answer 97

c) Post-Traumatic Amnesia (PTA) of 12 hours

Question 98

Which of the following best describes the condition in which a patient will admit to sensory or motor impairment, but will be unconcerned about it?

a) Anosognosia
b) Anosodiaphoria
c) Phonagnosia
d) Auditory affective agnosia

Answer 98

b) Anosodiaphoria

In anosognosia the patient is unaware or does not admit to the condition, whereas in anosodiaphoria the patient will admit to the impairment, but is not concerned. The other two options are unrelated agnosias.

Question 99

Which statement is not true of Huntington’s Disease dementia:

a) severity of dementia is correlated with caudate atrophy
b) it generally begins within one year of chorea
c) it is correlated with severity of depression
d) is consistent with a subcortical dementia

Answer 99

c) it is correlated with severity of depression

Question 100

A 63-year-old man had a shower of emboli from the posterior circulation. Subsequently, he exhibits difficulty recognizing objects because of failure to perceive them. He is unable to draw objects, and he cannot match them to a sample. With what syndrome is he presenting?

a) Apperceptive Visual Agnosia
b) Prosopagnosia
c) Simultangnosia
d) Cortical blindness

Answer 100

a) Apperceptive Visual Agnosia