Mock Exam - 2 - BRAIN Website

Question 1

In general, which of the following treatments used for childhood brain tumors is associated with the poorest long-term neuro-cognitive outcomes?

a) corticosteroids
b) chemotherapies
c) whole brain radiation
d) posterior fossa surgical resection

Answer 1

c) whole brain radiation

Whole brain radiation has been shown to have a significant adverse effect on overall IQ, processing speed and attention, due to white matter changes. These long-term cognitive effects are more pronounced in girls and are related to the radiation dose, total area of the brain radiated, and age at treatment.

Question 2

Which of the following is false?

a) Anterograde amnesia is associated with hippocampal damage
b) Retrograde amnesia is associated with mammillary body or thalamic nuclei lesions
c) Severe retrograde amnesia is almost always accompanied by anterograde amnesia
d) The hippocampus is required for retrieval of remote memories

Answer 2

d) The hippocampus is required for retrieval of remote memories

The hippocampus is involved in the formation of memories, not the retrieval.

Question 3

Which of the following is not characteristic of Down’s Syndrome?

a) Most prevalent type is trisomy 21
b) Sleep apnea is common
c) Females tend to have stronger cognitive profiles than males
d) Language skills are acquired at a faster rate relative to other motor or cognitive skills in Down’s Syndrome

Answer 3

d) Language skills are acquired at a faster rate relative to other motor or cognitive skills in Down’s Syndrome

See Handbook of Neurodevelopmental and Genetic Disorders in Children (Chapter on Downs Syndrome, Actually language skills are acquired at a slower rate)

Question 4

You are a neuropsychologist who has been asked to assess Mr. Jones’ decision-making capacity. What are your ethical obligations in this situation?

a) You must obtain informed consent from Mr. Jones before proceeding with the assessment.
b) You must provide Mr. Jones with an explanation of the assessment, consider his preferences and best interest, and obtain his assent.
c) You do not require informed consent from Mr. Jones if he willingly complies with the assessment procedures, because consent is implied.
d) You should only conduct the assessment if Mr. Jones demonstrates an understanding of the purpose of the assessment, foreseeable risks, discomforts and benefits, and the limits of confidentiality.

Answer 4

b) You must provide Mr. Jones with an explanation of the assessment, consider his preferences and best interest, and obtain his assent.

Question 5

A correlation coefficient of .80 means that the proportion of variance in Y that can be accounted for by knowing X is:

a) 64%
b) 80%
c) 20%
d) 36%

Answer 5

a) 64%

Question 6

The vocal intonation that helps us understand the intended meaning of what people say is termed__________and is a __________ hemisphere specialization.

a) Prosody, left
b) Semantics, right
c) Syntax, right
d) Prosody, right

Answer 6

d) Prosody, right

In normal language lateralization, prosody can be localized to the right hemisphere.

Question 7

As you lower the reliability of a test, the Standard Error of Measurement (SEM) ____.

a) increases
b) decreases
c) remains the same
d) can not be determined

Answer 7

a) increases

Question 8

“Does the test sample the domain that it is intended to measure?” refers to which type of validity?

a) Construct validity
b) Content validity
c) Criterion validity
d) Discriminant validity

Answer 8

b) Content validity

Question 9

The hit rate of a test is best when ________

a) the validity coefficient is low
b) the selection ratio is high
c) the base rate is moderate
d) the reliability coefficient is low

Answer 9

c) the base rate is moderate

Question 10

Folate supplementation during pregnancy is recommended to prevent:

a) Childhood Onset Epilepsy
b) Neural Tube Defects
c) Mitochondrial Disorders
d) Down’s Syndrome

Answer 10

b) Neural Tube Defects

Question 11

Which statement is true about the diagnosis of ADHD?

a) Stronger performance on digits backwards than digits forwards supports the diagnosis
b) A continuous performance test is the most sensitive means of detecting ADHD
c) ADHD is a clinically-based diagnosis
d) Impairment on Trails B but not A is a sign that is specific to ADHD

Answer 11

c) ADHD is a clinically-based diagnosis

Question 12

Acalculia of the Spatial Type is often associated with right hemisphere dysfunction and may include all of the following features except:

a) Misalignment of columns resulting in miscalculation
b) Deficits in simple calculations presented auditorally (e.g., 2 + 2 = 5)
c) Reversal errors (e.g., ’12’ for ’21’)
d) Inversion errors (e.g., ‘6’ for ‘9’)

Answer 12

b) Deficits in simple calculations presented auditorally (e.g., 2 + 2 = 5)

Question 13

The Geschwind-Galaburda Theory:

a) is based on the asymmetry of the planum temporale, which is particularly prominent in males
b) is based on the asymmetry of the planum temporale, with the left hemisphere being smaller than the right for most right-handed people
c) proposes that testosterone is implicated in greater development of the right hemisphere
d) would explain males’ strengths in spatial tasks, but does not account for the increased rate of autoimmune disorders in males

Answer 13

c) proposes that testosterone is implicated in greater development of the right hemisphere

Based on observation of the asymmetry of the planum temporale with the left hemisphere being larger than the right in most right handed people. In males, however, there is less asymmetry – which is proposed to be an effect of testosterone in delaying the development of the left hemisphere, although greater development of the right. This theory provides rationale for the greater spatial skills in males, as well as the increased rate of autoimmune disorders in males. Kolb and Whishaw, Fundamentals of Human Neuropsychology – Fifth Edition, 2003, page 663).

Question 14

A patient who can copy a cross, cube, and upside down tree but can not identify what these drawings are of has?

a) Prosopagnosia
b) Apperceptive agnosia
c) Associative agnosia
d) Optic aphasia

Answer 14

c) Associative agnosia
- Apperceptive agnosia involves a failure in perceptual processing of the stimuli, and therefore can not copy stimuli.
- Associative agnosia involves a failure in object identification despite preserved ability to copy and even match stimuli. It often co-occurs with prosopagnosia.
- Optic aphasia is impaired naming of visual objects with the patient still able to identify the object by other means and able to explain characteristics.

Question 15

A test was used as a screening measure for ADHD and 90% of the children with ADHD scored in the abnormal range. This is the test’s ___________. 80% of the children without ADHD obtained scores in the normal range. This is the test’s ______.

a) sensitivity, specificity
b) specificity, sensitivity
c) positive predictive power, specificity
d) sensitivity, negative predictive power

Answer 15

a) sensitivity, specificity

Question 16

Abnormalities in what areas of the brain have been proposed to correlate with impairment in autism?

a) Cerebellum, brain stem, and temporal lobes
b) Cerebellum, brain stem, and basal ganglia
c) Temporal lobes and basal ganglia
d) Basal ganglia and frontal lobes

Answer 16

a) Cerebellum, brain stem, and temporal lobes

Question 17

A 52 y.o. hypertensive, diabetic man awakens unable to speak coherently and has right arm and face weakness but the leg is not affected. Exam shows dysarthria, Broca aphasia, right hemiparesis (face and arm) and hemianesthesia. What is the most likely diagnosis?

a) Left putaminal hemorrhage
b) Left middle cerebral artery (MCA) occlusion
c) Left carotid occlusion
d) Left anterior cerebral artery occlusion
e) Left posterior cerebral artery occlusion

Answer 17

b) Left middle cerebral artery (MCA) occlusion

The distribution of weakness (face and arm, sparing the leg) and Broca aphasia suggests ischemia in MCA distribution. With carotid occlusion, the territory of MCA and ACA would be affected such that the face, arm and leg would be equally affected. Putaminal (subcortical) hemorrhage would not likely cause aphasia.

Question 18

The use of deception in research

a) Should never be done
b) Can be done and is shared with participants only after the study
c) Can be done in all situations, provided that there is scientific value
d) Can be done provided that alternative procedures are not feasible

Answer 18

d) Can be done provided that alternative procedures are not feasible

Question 19

In determining suspicious effort, which should be ruled out?

a) Factitious Disorder
b) Somatoform Disorder
c) Psychotic Disorder
d) All of the above

Answer 19

d) All of the above

Question 20

What is the most reliable indicator of a developmental reading disorder?

a) Poor contextual reading
b) Difficulty acquiring rapid, context-free word-reading skill
c) Poor verbal working memory
d) VIQ – Achievement score discrepancy

Answer 20

b) Difficulty acquiring rapid, context-free word-reading skill

Question 21

All of the following have been reported as being associated with reading disorders except:

a) Reduced volumes in dominant hemisphere perisylvian areas
b) Symmetrical planum temporale
c) Cortical malformations in the frontal and temporal areas
d) Reduced insular and frontal lobe volumes

Answer 21

a) Reduced volumes in dominant hemisphere perisylvian areas

Question 22

What feature of ADHD is typically not seen in NVLD?

a) Inattention
b) Hyperactivity
c) Impulsivity
d) Executive Dysfunction

Answer 22

b) Hyperactivity

Question 23

A 25 year-old woman is referred for neuropsychological assessment by her general practitioner because of memory complaints. Information obtained during the clinical interview indicates that she has no memory of a 6-month period of time in 2001, after witnessing the assault of a close friend. Memory for recent events is intact. Based on this information alone, which of the following is highest on the list of differential diagnoses:

a) adjustment disorder
b) retrograde amnesia
c) conversion disorder
d) psychogenic amnesia

Answer 23

d) psychogenic amnesia

Question 24

Test-retest reliability is most suitable for evaluating

a) Unstable traits such as speed of performance
b) Stable traits, such as aptitude
c) Subjective traits such as creativity
d) Can be used for all of the above

Answer 24

b) Stable traits, such as aptitude

Question 25

You are informed by the test manual that the test you are using has a reliability coefficient of .81. Therefore, _____% is due to measurement error a) 9 b) Square root of 19 c) 10 d) 19

Answer 25

d) 19

Question 26

The Striatum is part of the Basal Ganglia and includes which structures? a) Caudate and Putamen b) Caudate and Globus Pallidus c) Globus Pallidus and Substantia Nigra d) The Striatum includes all of these structures

Answer 26

a) Caudate and Putamen

Question 27

Of the WAIS factor scores, _____ is least sensitive to neuropsychiatric disorders: a) POI b) VCI c) WMI d) PSI

Answer 27

b) VCI

Question 28

In comparing Alzheimer’s Disease (AD) patients to Dementia with Lewy Bodies (DLB) patients, typically: a) AD patients do better on confrontation naming tests b) AD patients have day-to-day fluctuations in cognition but DLB patients do not c) AD patients exhibit parkinsonism while DLB patients do not d) depression and hallucinations are more common in DLB patients while delusions are more common in AD patients

Answer 28

d) depression and hallucinations are more common in DLB patients while delusions are more common in AD patients One of the key features distinguishing Dementia with Lewy Bodies (DLB) from Parkinson’s Dementia is the visual hallucinations seen in DLB. Alzheimer’s patients typically have delusions rather than actual hallucinations.

Question 29

Gender effects have been shown to be least evident on which of the following tests: a) Test of Memory Malingering (TOMM) b) smell identification test c) finger tapping d) MMPI-2

Answer 29

a) Test of Memory

Question 30

With respect to the WAIS-III factor scores, practice effects are: a) Largest for Processing Speed and Smallest for Verbal Comprehension b) Largest for Working Memory and smallest for perceptual Organization c) Largest for Verbal Comprehension and smallest for Processing Speed d) Largest for Perceptual Organization and smallest for Working Memory

Answer 30

d) Largest for Perceptual Organization and smallest for Working Memory

Question 31

In which conditions are confabulations not found? a) Anton’s syndrome b) Gerstmann’s syndrome c) Anosognosia d) Wernicke-Korsakoff syndrome

Answer 31

b) Gerstmann’s syndrome - Gerstman’s syndrome is a controversial entity that consists of right-left confusion, dyslexia, dyscalculia, and finger agnosia. It is usually attributed to lesions in the dominant angular gyrus. - In Anton’s syndrome (denial of blindness), blind patients typically confabulate or fantasize about the appearance of objects presented to them. It occurs most often in elderly patients who undergo opthalmogic surgical procedures and cannot see out of their eyes temporarily. - Anosognoia (failure to acknowledge a deficit, usually left side hemiparesis) is often accompanied by confabulation, denial, and “other defense mechanisms” (clearly written by a psychiatrist). - According to Kaufmann, the confabulations in Wernicke-Korsakoff are an uncommon symptom, unless the patients also have marked memory impairments.

Question 32

Which of one of the following statements regarding Heschl’s gyrus is false: a) Heschl’s gyrus is bilateral and located adjacent to the planum temporale. b) In almost all individuals, the left-sided Heschl’s gyrus, like the left-sided planum temporale, has greater surface area than its right-sided counterpart. c) Each Heschl’s gyrus reflects auditory stimulation predominantly from the contralateral ear. d) Heschl’s gyrus appears to sort auditory stimulation for direction, pitch, loudness, and other acoustic properties rather than words for their linguistic properties.

Answer 32

b) In almost all individuals, the left-sided Heschl’s gyrus, like the left-sided planum temporale, has greater surface area than its right-sided counterpart. The dominant hemisphere planum temporale, which is integral to language function, has greater surface area than its counterpart. Heschl’s gyrus, which processes the auditory qualities of sound, is bilaterally symmetric.

Question 33

In non-fluent aphasia, why is the arm typically more paretic than the leg? a) The motor cortex for the arm is supplied by the middle cerebral artery (MCA), which is usually occluded. The motor cortex for the leg is supplied by the anterior cerebral artery (ACA), which is usually spared. b) The arm has larger cortical representation c) The infarct occurs in the internal capsule d) The motor cortex for the arm is supplied by the ACA, which is usually occluded. e) The motor cortex for the leg is supplied by the MCA, which is usually spared.

Answer 33

a) The motor cortex for the arm is supplied by the middle cerebral artery (MCA), which is usually occluded. The motor cortex for the leg is supplied by the anterior cerebral artery (ACA), which is usually spared.

Question 34

In which disorder(s) is echolalia a symptom? a) Autism b) Isolation aphasia c) Tourette’s syndrome d) All of the above

Answer 34

d) All of the above Echolalia, an involuntary repetition of another’s words, is a manifestation of diverse neurologic conditions. It also occurs within the context of dementia. Note: Mixed transcortical aphasia is the least common of the three transcortical aphasias (behind transcortical motor aphasia and transcortical sensory aphasia, respectively). This type of aphasia can also be referred to as "Isolation Aphasia". This type of aphasia is a result of damage that isolates the language areas (Broca’s, Wernicke’s, and the arcuate fasciculus) from other brain regions. Broca’s, Wernicke’s, and the arcuate fasiculus are left intact; however, they are isolated from other brain regions.

Question 35

Which of the following is not a feature of Asperger’s Disorder: a) Impaired social interactions b) Delayed language development c) Restricted, repetitive and stereotyped patterns of behavior, interests and activities. d) Normal development of age-appropriate self-help and adaptive behavior

Answer 35

b) Delayed language development

Question 36

You are a neuropsychologist who is hired by an attorney (Ms. Smith) to perform a neuropsychological assessment of Mr. Patient to document cognitive deficits related to a brain injury following a motor vehicle accident. The attorney hired by the defendant’s insurance company (Ms. Jones) contacts you to demand that she be present during the evaluation. In this situation, which of the following statements is correct? a) It is acceptable to allow Ms. Smith to observe the evaluation because Mr. Patient is his client, but not Ms. Jones b) It is acceptable to allow Ms. Jones to observe the assessment, but only if Mr. Patient provides his consent. c) It is not acceptable to allow Ms. Jones to observe the assessment due to issues of test security and threats to the validity of the examination. d) It is acceptable to allow Ms. Jones to observe the assessment, but not the clinical interview.

Answer 36

c) It is not acceptable to allow Ms. Jones to observe the assessment due to issues of test security and threats to the validity of the examination.

Question 37

If forced to take only one test to your new position on a desert island with a need for neuropsychological assessment, one would be best served to take a test with high _____ in determining who should be flown to the mainland for more extensive neuropsychological evaluations in moderate base rate conditions. a) face validity b) construct validity c) negative predictive power d) specificity e) positive predictive power

Answer 37

c) negative predictive power

Question 38

Conditions that may lead to worsening neurological deficit in acute stroke patients include: a) Hypoxia b) Hyperglycemia c) Atrial fibrillation (AF) d) All of the above

Answer 38

d) All of the above A& F may cause stroke recurrence. The occurrence of other factors should be avoided in stroke patients, as they worsen neurological deficit. If infection complicates stroke, e.g. pneumonia, urinary tract infection, neurological deficits can worsen.

Question 39

Clinical features of left posterior cerebral artery (PCA) occlusion include: a) Right homonymous hemianopsia and hemianesthesia b) Right hemiballismus c) Vertigo and ataxia d) Right hemiparesis e) Alexia and agraphia

Answer 39

a) Right homonymous hemianopsia and hemianesthesia The answer is a) for most patients; however, PCA may supply the thalamus and also result in hemianesthesia. Alexia without agraphia may result

Question 40

A 50 y.o. normotensive man has an episode of sudden loss of vision in the right eye. This persists for 15 minutes ad then rapidly resolves. He has normal neurological and opthalmological examination. The mechanism of this episode is most likely: a) Demyelination of optic nerve b) Artery-to-artery embolism involving carotid and ophthalmic arteries c) Thrombosis in situ in carotid artery d) Optic nerve compression e) None of the above

Answer 40

b) Artery-to-artery embolism involving carotid and ophthalmic arteries This TIA is known as “amaurosis fugax” due to carotid atherosclerotic disease. This causes transient blindness. Optic nerve demyelination may cause sudden visual loss but would not resolve so quickly. Compression of the optic nerve would cause gradual visual loss and reduced papillary light response.

Question 41

A 50 y.o. man with atrial fibrillation suddenly becomes “confused.” He is alert and attentive. His speech is fluent but he has difficulty following commands. The following other neurological abnormalities might include: a) Hemiparesis b) Acalculia c) Left lower quadrantanopia d) Agraphia e) No focal findings since patient has encephalopathy

Answer 41

b) Acalculia Sudden onset indicates vascular etiology. Because patient appears confused and cannot comprehend normally, indicates Wernicke aphasia. This involves the posterior temporal lobe of the dominant hemisphere, and acalculia may also be present. The visual field fibers pass through this region and ischemia may cause right homonymous hemianopsia. Therefore, patients with Wernicke aphasia may also have accompanying right homonymous hemianopsia but no hemiparesis or hemianesthesia.

Question 42

Which of the following is not a symptom of carotid artery TIA? a) Paresthesias b) Anterograde amnesia c) Hemisensory loss d) Hemianopsia e) Transient aphasia

Answer 42

b) Anterograde amnesia Anteriograde amnesia: Carotid artery TIA, caused by emboli at common carotid bifurcation, leads to hemispheral TIAs with symptoms of contralateral hemiparesis, hemisensory loss, paresthesias, hemianopsia, transient aphasia, and hemi-inattention.

Question 43

Which of the following does not occur in MCA strokes? a) Upper extremity hemiparesis b) Aphasia c) Hemineglect d) Lower extremity hemiparesis

Answer 43

d) Lower extremity hemiparesis Lower extremity hemiparesis. The homunculus shows that the motor strip for the lower extremity is perfused by the Anterior Cerebral Artery in the medial aspect of the hemisphere.

Question 44

Trazodone is a __________ and may affect neuropsychological test results because it can make your patient ___________ . a) Mood stabilizer, restless b) Anxiolytic, drowsy c) Antipsychotic, experience psychomotor slowing d) Antidepressant, drowsy

Answer 44

d) Antidepressant, drowsy Trazadone is actually used often as a hypnotic to help patients sleep.

Question 45

A stroke in which vascular supply would cause dysfluent speech, anomia, intact comprehension and reading? a) Left Internal Carotid Artery b) Right Middle Cerebral Artery c) Left Anterior Cerebral Artery d) Left Middle Cerebral Artery

Answer 45

d) Left Middle Cerebral Artery Left MCA infarcts cause Broca’s aphasia characterized by dysfluent speech, poor repetition, anomia, and intact comprehension and reading.

Question 46

A lesion in the lower left optic radiation causes: a) Right homonymous hemioanopsia with sparing of macular vision b) Bitemporal hemianopsia c) Right upper homonymous quadrantanopsia d) Left lower homonymous quadrantanopsia

Answer 46

c) Right upper homonymous quadrantanopsia Right upper homonymous quadrantanopsia – post optic chiasm, lower optic radiations affect the upper contralateral visual quadrant field, upper optic radiations affect the lower contraleteral visual quadrant field.

Question 47

If you were a patient demonstrating a general lack of concern about your cognitive deficits, were over the age of 60, and had a clean neurological work-up other than borderline MMSE, the most likely diagnosis to rule out would be _________________, with a likelihood of around ___________. a) Alzheimer’s disease, 80% b) unable to determine with data presented c) Pick’s dementia, 20% d) Alzheimer’s disease, 60% e) Cerebrovascular accident, 15%.

Answer 47

a) Alzheimer’s disease, 80%

Question 48

The parvocellular and magnocellular layers of the dorsal lateral geniculate nucleus a) may represent different visual systems. b) analyze the same kind of information from the visual field. c) are connected to the nasal and temporal halves of the retina, respectively. d) receive input from the contralateral and ipsilateral halves of the visual field, respectively.

Answer 48

a) may represent different visual systems.

Question 49

Damage limited to the fusiform region of the right hemisphere would be expected to impair the recognition of ___________ . a) movement of objects through space. b) fruits and vegetables. c) faces. d) object location.

Answer 49

c) faces.

Question 50

A difficulty in scanning the visual scene is ___________ . a) ocular apraxia. b) prosopagnosia. c) visual agnosia. d) optic ataxia.

Answer 50

a) ocular apraxia.

Question 51

A difficulty in using visual guidance to reach for an object is ___________ . a) ocular apraxia. b) prosopagnosia. c) visual agnosia. d) optic ataxia.

Answer 51

d) optic ataxia.

Question 52

Imaging studies of individuals with autism have shown all of the following except: a) delayed maturation of the frontal lobes b) reduced activation of the amygdala during processing of facial emotion c) enlargement of the lateral ventricles d) overall reduced brain size

Answer 52

d) overall reduced brain size

Question 53

The inability to perceive more than one object in a visual scene is called ________ . a) ocular apraxia. b) prosopagnosia. c) visual agnosia. d) simultanagnosia.

Answer 53

d) simultanagnosia.

Question 54

In Alzheimer’s disease, which of the following receptors is most severely depleted? a) Muscarinic acetylcholine b) Nicotinic acetylcholine c) Frontal dopamine d) Nigrostriatal dopamine

Answer 54

a) Muscarinic acetylcholine In Alzheimer’s disease, muscarinic acetylcholine receptors are depleted, especially in the limbic system and association areas. Although they are also found in the brain, nicotinic acetylcholine receptors are found predominantly in the spinal cord and the neuromuscular junction.

Question 55

Which of the dopamine tracks is associated with the positive symptoms of Schizophrenia? a) Nigrostriatal b) Mesolimbic c) Tubero-innfundibular d) Mesocortical

Answer 55

b) Mesolimbic

Question 56

Which of the dopamine tracks is associated with extrapyramidal motor disorders? a) Nigrostriatal b) Mesolimbic c) Tubero-innfundibular d) Mesocortical

Answer 56

a) Nigrostriatal

Question 57

The primary treatment for a communicating hydrocephalus, or normal pressure hydrocephalus is ____________, which results in decreased _________________ in the ventricles. One way to distinguish NPH from a subcortical dementia is ________________. a) Burr-hole suction, CSF, finger oscillation speed b) Burr-hole suction with steroid treatment, choroid plexus production of CSF, falling c) Shunting, blood, aphasia d) shunting, CSF, incontinence

Answer 57

d) shunting, CSF, incontinence

Question 58

Treatments that use ABA designs to determine their efficacy are most vulnerable to the effects of __________ . a) Learning b) History c) Measurement error d) Abulia

Answer 58

a) Learning

Question 59

The most common sites of brain contusion in TBI, due to jagged bony prominences abutting brain tissue in the cranial vaults, are: a) Calcarine fissure and orbitofrontal regions b) Inferiolateral temporal regions c) Parietoccipital cortex and dorsolateral frontal regions d) Anterior temporal lobes and orbitofrontal regions

Answer 59

d) Anterior temporal lobes and orbitofrontal regions While the occipital lobe (and therefore Calcarine fissure) and orbitofrontal areas are both injured in the classic contracoup injury, the occipital lobe does not have a jagged bony prominence to contend with. The rostral or anterior edge of the temporal lobe and the orbitofrontal area of the frontal lobe abut jagged bony prominences.

Question 60

Of the following, which one is not a sign of cerebellar damage? a) intention tremor b) dysdiadochokinesia c) truncal ataxia d) Hoover’s sign

Answer 60

d) Hoover’s sign Hoover’s sign is a common psychogenic symptom. All of the other three are typical signs of cerebellar lesions.

Question 61

When speaking of Tourette’s syndrome, which statement would not be completely accurate? a) It is four times more common in boys b) Abnormal MRI and EEG findings correlate highly w/ diagnosis c) There is autosomal dominant inheritance w/ incomplete penetrance. d) There is increased incidence of ADHD and OCD

Answer 61

b) Abnormal MRI and EEG findings correlate highly w/ diagnosis MRI and other tests are generally unrevealing (Blumenfeld), so Dx is based on clinical presentation. The other statements are completely accurate.

Question 62

Dementia in Parkinson’s Disease is least associated with: a) Akinesia b) Rapid progression of the illness c) Being older d) tremor

Answer 62

d) tremor Dementia is the least closely associated with tremor. According to Kaufman, if dementia occurs at the onset of an illness with parkinsonism, consider diffuse Lewy Body disease in individuals older than 50. In young adults, consider Wilson’s disease, juvenile Huntington’s disease, and drug abuse.

Question 63

Which of the symptoms does not typically characterize Dementia with Lewy Bodies? a) Extrapyramidal signs b) Visual hallucinations and delusions c) Pseudobulbar palsy d) Memory and attentional deficits

Answer 63

c) Pseudobulbar palsy Pseudobulbar palsy is typical of progressive supranuclear palsy (Feinberg & Farah), a subcortical dementia. DLB is considered a mixed dementia, as it is difficult to classify as either cortical or subcortical (Lezak and Feinberg). The other three choices are all classic features of Dementia with Lewy bodies.

Question 64

Which of the following two vascular structures are the only two UNPAIRED vessels near or a part of the Circle of Willis? a) posterior cerebellar artery and posterior communicating artery b) anterior communicating artery and posterior communicating artery c) basilar artery and anterior communicating artery d) basilar artery and posterior communicating artery

Answer 64

c) basilar artery and anterior communicating artery the basilar artery and the anterior communicating artery do not have a “match” if you will on the other side to make it a pair. The PCOMM does, as do all the others mentioned. These two are important with regard to Top of the Basilar vascular diseases and Anterior Comm being the site for many berry aneurysms.

Question 65

With an understanding that dementia can happen late in the course of MS or possibly not at all, which MS features are often associated with cognitive impairment? a) Physical impairments b) Atrophy c) Total lesion volume d) All of the above

Answer 65

d) All of the above Along with A-C, duration of the illness, enlarged cerebral ventricles, corpus callosum atrophy, and cerebral hypometabolism are also associated with MS related cognitive impairment.

Question 66

Symptoms of vertigo, vomiting, transient global amnesia, and nystagmus are indicative of: a) Carotid Artery TIA’s b) Basilar Artery TIA’s c) CVA of the MCA d) Lenticulostriate TIA’s

Answer 66

b) Basilar Artery TIA’s Vertebrobasilar Artery TIA’s symptoms include those mentioned plus, tinnitus, circumoral paresthesias or numbness, dysarthria, dysphagia, drop attacks, ataxia, and cranial nerve abnormalities.

Question 67

Abnormalities with saccades are a hallmark feature of which disease? a) Parkinson’s Disease b) Huntington’s Disease c) Epilepsy d) Dandy-Walker Syndrome

Answer 67

b) Huntington’s Disease It’s a hallmark Sx that usually comes on very early in the course of HD

Question 68

Wernicke’s encephalopathy is caused by thiamine deficiency usually associated with an alcoholic population. What is the classic triad of symptoms? a) ataxia, confusional state, eye movement abnormalities b) vertigo, retrograde amnesia, nystagmus c) confabulation, retrograde amnesia, conduction aphasia d) ataxia, vertigo, transient global amnesia

Answer 68

a) ataxia, confusional state, eye movement abnormalities Remember ACE for ataxia, confusion, and eye mov’t diff’s. Confabulation and retrograde amnesia are also associated with this disorder, but more so with the more chronic form of the disorder called either Wernicke-Korsakoff Syndrom or Korsakoff’s. Kaufman also discusses peripheral neuropathy as part of the symptom picture. And, of course, for WKS, anterograde memory deficits is the hallmark feature. So, really no new learning and w/ regard to retrograde amnesia, remote memory for public and personal autobiographical information is better than more recent memory.

Question 69

Which tremor is associated with parkinsonism? a) postural b) intention c) resting d) action e) benign

Answer 69

c) resting

Question 70

Which seizure type typically is characterized by lip smacking, chewing or other automatic stereotyped movements, emotional changes (e.g., fear, sadness, or déjà vu feelings), as well as hallucinations of auditory, tactile, visual, or olfactory sensory experiences? a) primary generalized seizure b) secondary generalized seizure c) typical simple absence seizures d) partial (simple or complex) seizure

Answer 70

d) partial (simple or complex) seizure See the Pocket Handbook and Kaufman. Partial seizures begin in one part of the brain and may or many not spread to other regions. They usually consist of specific motor, sensory, or psychic alterations, that are often accompanied by stereotyped automatic movements. These seizures often stem from temporal lobe (although about 10% frontal) and accompanied by emotionally changes (fear, sadness, pleasure, déjà vu) Hallucinations or misperceptions are also common ictal phenomena of simple-and complex- partial seizures. Simple partial seizures have no alteration in consciousness as result of seizure discharge. In complex partial seizures there’s always alteration of consciousness.

Question 71

A researcher hypothesizes that students who perform a Milky Way hip flip the night before their Board Written Exam score higher on the exam than students who don’t. She obtains a sample of 40 students and assigns 20 to the “Milky Way hip flip ” group and 20 to the “no Milky Way hip flip” group. She concludes, on the basis of a statistical test, that her hypothesis was correct. In the population, however, there is no difference on the Board Written Exam between students who do and do not perform a Milky Way hip flip the night before they take the exam. What type of error has been made? a) Type I Error b) Type II Error c) Sampling error d) Standard error

Answer 71

a) Type I Error A Type I Error has been made. This type of error occurs when the null hypothesis is rejected when it is true—in other words, when one concludes that a difference exists when it really does not. It’s “thinking you have something when you really don’t.”

Question 72

A study is conducted to assess the effectiveness of a new anti-anxiety medication. The Beck Anxiety Inventory (BAI) is used to measure anxiety levels. If the mean score of subjects who take the drug is compared to the population mean for anxious subjects on the BAI, the statistical test that would be used would be: a) t-test for independent samples b) t-test for correlated samples c) t-test for single sample d) one-way ANOVA

Answer 72

c) t-test for single sample The one sample t-test is appropriate when a study involves only one sample. It is designed to compare the mean of a single sample to a known population mean. It is a seldom used test as we don’t often have a known population mean (EX of population mean = if we knew from a government survey the national average income for psychologists, then we could take a sample of female psychologists and compare to the known population mean).

Question 73

An experimenter is testing the hypothesis that there is no difference between treatment modalities in regards to the scores obtained by patients on a depression measure. His design calls for two groups— psychodynamic treatment versus a CBT treatment. He uses a t-test to analyze the data at time two as there were no differences between the groups at time 1. The results are: Group 1 BDI mean = 12; Group 2 mean = 8. The t-value exceeds the tabled critical value at the .01 level for a 2-tailed test. He should: a) Accept the null and conclude the alternative hypothesis is false. b) Reject the null and conclude the alternative hypothesis is supported. c) Retain the null and conclude that the alternative hypothesis is supported. d) Not make an interpretation, as the researcher should have used a one-tailed test.

Answer 73

b) Reject the null and conclude the alternative hypothesis is supported. If the results are significant at the .01 level, then you reject the null hypothesis and conclude that the alternative hypothesis is true (i.e., that the means are significantly different).

Question 74

In a study in which a one-way ANOVA is used, the null hypothesis would be that a) Sample variances are equal. b) Population variances are equal. c) Sample means are equal. d) Population means are equal.

Answer 74

d) Population means are equal. An ANOVA is designed to test the hypothesis that group means were drawn from the same population; i.e., that means are equal in the population.

Question 75

A drawback of norm-referenced interpretation is that: a) A person’s performance is compared to the performance of other examinees. b) It does not permit comparisons of individual examinee’s scores on different tests. c) It does not indicate where the examinee stands in relation to others of the same population. d) It does not provide absolute standards of performance.

Answer 75

d) It does not provide absolute standards of performance. Norm-referenced interpretation involves comparing an examinee’s score to the scores of others who have taken the same test. A drawback of this type of interpretation is that is does not provide absolute standards of “good” or “bad” performance—the examinee’s score must be interpreted in light of the performance of the norm group as a whole.

Question 76

What is the location of pathology that contributes to the classic triad of Wernicke’s encephalopathy? a) basal forebrain and septal nuclei b) ventral striatum and ventral pallidum c) cingulate gyrus and temporal pole d) mammilary bodies and medial diencephalic structures

Answer 76

d) mammilary bodies and medial diencephalic structures According to Blumenfeld, “pathologically, these patients have bilateral necrosis of the mammilary bodies and a variety of medial diencephalic and other periventricular nuclei.” He associates the anterograde and retrograde amnesia with bilateral diencephalic lesions, as well as impairments in judgment, initiative, impulse control and sequencing tasks to frontal lobe dysfunction.

Question 77

The most likely primary progressive dementia to consider when a patient presents with primary symptoms of changes in comportment and language is a) Parkinson’s b) Huntington’s c) Alzheimer’s d) Fronto-Temporal Dementia e) Primary Progressive Aphasia

Answer 77

d) Fronto-Temporal Dementia

Question 78

When evaluating a child with a Nonverbal Learning Disability (NVLD), you would be most concerned that the child might also have a ____________ Disorder. a) Reading b) Mathematics c) Disorder of Written Expression d) Expressive Language

Answer 78

b) Mathematics

Question 79

Sex-dependent penetrance (complete in males; incomplete in females); lack of asymmetry in the planum temporale; smaller neurons in the left medial geniculate nucleus (MGN) compared to the right MGN; and possible involvement of chromosome 6 and 15 are findings associated with what developmental disorder: a) Asperger’s Disorder b) Dyslexia or Reading Disorder c) ADHD d) Rett’s Disorder

Answer 79

b) Dyslexia or Reading Disorder

Question 80

Item difficulty index (p) is calculated by dividing the number who answered correctly by total number of sample. Items with moderate difficulty level are typically retained. What is the moderate difficulty value of p and why is this value preferred? a) p=0.5 which helps maximize differentiation of subjects b) p=0.35 which produces a more face valid test c) p=0.75 which helps maximize differentiation of subjects d) p=1.0 which produces normal distribution of scores

Answer 80

a) p=0.5 which helps maximize differentiation of subjects

Question 81

Which of the following intervention methods for severe memory disorders involves the prevention of errors during acquisition of information. a) Self-Instruction Training b) Massed practice c) Metacognition Training d) Errorless Learning

Answer 81

d) Errorless Learning

Question 82

Risk factors associated with premature birth include all of the following except: a) Hypoxic ischemic encephalopathy (HIE) b) Intraventricular hemorrhage (IVH) c) Multifocal Leukoencephalopathy d) Periventricular Leukomalacia (PVL)

Answer 82

c) Multifocal Leukoencephalopathy

Question 83

Optic neuritis is epidemiologically and pathophysiologically related to a) AIDS b) Multiple Sclerosis c) Myasthenia gravis d) Meniere’s disease

Answer 83

b) Multiple Sclerosis

Question 84

Which of the following behavioral symptoms is not characteristic of diffuse axonal injury? a) decreased mental efficiency b) decreased complex reasoning ability c) decreased receptive vocabulary d) decreased ability to perform mental arithmetic

Answer 84

c) decreased receptive vocabulary

Question 85

Nuchal rigidity is most likely a sign of which of the following a) Subarachnoid hemorrhage b) Transtentorial herniation c) Communicating hydrocephalus d) Epidural hematoma

Answer 85

a) Subarachnoid hemorrhage

Question 86

All the following are true except: a) All valid tests are reliable. b) The area under the curve (AUC) of an ROC curve reveals the overall accuracy of a test. c) All reliable tests are valid. d) The positive likelihood ratio reveals the likelihood a test-positive patient actually has the condition.

Answer 86

c) All reliable tests are valid.

Question 87

The cognitive profile of depressed patients is characterized by: a) Slowed mental processing and mild attentional problems b) Visual-spatial deficits c) Mild word-finding difficulties and poor memory recognition d) Lack of awareness of their cognitive difficulties

Answer 87

a) Slowed mental processing and mild attentional problems

Question 88

Infarcts and ischemic events are most common in: a) Anterior cerebral artery b) Posterior cerebral artery c) Middle cerebral artery d) Callosomarginal artery

Answer 88

c) Middle cerebral artery

Question 89

Which of the following statements is false regarding Transient Global Amnesia (TGA)? a) It involves an acute onset of retrograde and anterograde amnesia with no obvious cause b) It is commonly accompanied by right hemiplegia c) Following one episode of TGA, there is a low likelihood of subsequent episodes d) During an episode of TGA, an individual typically asks the same question over and over.

Answer 89

b) It is commonly accompanied by right hemiplegia

Question 90

Tourette’s Syndrome is most commonly associated with deficits in _________ . a) olfaction b) auditory memory c) language d) attention

Answer 90

d) attention

Question 91

The telencephalon includes: a) The prosencephalon and the diencephalon b) The thalamus and cerebral cortex c) The entire forebrain d) The cerebral cortex, subcortical white matter, and basal ganglia

Answer 91

d) The cerebral cortex, subcortical white matter, and basal ganglia

Question 92

Which statistical test is used in experimental designs that are most likely to assess causation? a) Chi square b) Pearson r c) ANCOVA d) Discriminate Function Analysis

Answer 92

c) ANCOVA

Question 93

Alexia without agraphia can be associated with a __________, if ___________ is also affected a) Right PCA infarct, angular gyrus b) Left PCA infarct, splenium of corpus callosum c) Left MCA infarct, angular gyrus d) Left ACA infarct, splenium of corpus callosum

Answer 93

b) Left PCA infarct, splenium of corpus callosum

Question 94

Which of the following statements about febrile seizures is false? a) Febrile seizures occur in about 3-4% of children b) One simple febrile seizure is not associated with increased risk for epilepsy c) If one has a single febrile seizure, a second febrile seizure is likely to occur within one year. d) Complex febrile seizures last longer than 15 minutes and may have focal features.

Answer 94

c) If one has a single febrile seizure, a second febrile seizure is likely to occur within one year.

Question 95

When both amygdale have been ablated, the result is usually a) Emotional hyperactivity b) Decreased oral tendencies c) Loss of normal fear d) Hyposexualism

Answer 95

c) Loss of normal fear

Question 96

Which of the following statements is false regarding delirium? a) Delirium refers to a disturbance of consciousness that is accompanied by a change in cognition b) Disorientation to time and place are not commonly associated with delirium. c) Delirium is most common in children and the elderly. d) Symptoms of delirium typically develop very rapidly and fluctuate throughout the day.

Answer 96

b) Disorientation to time and place are not commonly associated with delirium.

Question 97

Papez’s circuit is a heuristic device to describe: a) Disorders of speech b) Disorders of emotion c) Disorders of reading d) Disorders of vision

Answer 97

b) Disorders of emotion

Question 98

What is ventriculomegaly? a) Atypically developed ventricles associated with migrational disorders b) Attenuation of cerebral white matter surrounding the ventricles c) Compressed ventricles associated with mass lesions in the cranium d) Ventricular enlargement with or without hydrocephalus

Answer 98

d) Ventricular enlargement with or without hydrocephalus

Question 99

One of the reasons Parkinson’s disease patients do not show symptoms of the disease until they have lost most of their dopamine-containing axons from the substantia nigra is that: a) the remaining cells gradually begin to produce serotonin instead, which is much more potent than dopamine b) all of the cell loss occurs in a very brief (less than one week) period of time c) the receptors on the relevant postsynaptic membranes develop denervation supersensitivity. d) the caudate nucleus gradually takes over the functions of the substantia nigra.

Answer 99

c) the receptors on the relevant postsynaptic membranes develop denervation supersensitivity.

Question 100

People born without a corpus callosum (i.e., agenesis of the corpus callosum) a) cannot verbally describe an object in their left hand if they cannot see it b) are exceptionally skilled at motor tasks involving their hands. c) show a general impairment in language abilities. d) are (in terms of behavior) virtually indistinguishable from people born with a corpus callosum.

Answer 100

d) are (in terms of behavior) virtually indistinguishable from people born with a corpus callosum.