Neurocognitive Disorders Flashcards
Early memory loss associated with NCD due to Alzheimer’s disease has been linked to lower-than-normal levels of which of the following in the hippocampus, cortex, and basal forebrain?
A. epinephrine
B. norepinephrine
C. GABA
D. ACh
Answer D is correct. You may encounter a few questions on the EPPP that you’ll be able to answer correctly even though they contain unfamiliar information. For this question, you may not know that low levels of ACh (acetylcholine) in the specific areas of the brain listed in the question have been linked to the memory loss associated with Alzheimer’s disease. However, as long as you know that ACh plays a role in learning and memory or that it has been linked to Alzheimer’s disease, you would have been able to identify the correct answer.
Neurocognitive disorders that are due to prion disease most often have a:
A. very rapid progression of impairment.
B. gradual and steady progression of impairment.
C. stepwise progression of impairment.
D. fluctuating course with plateaus of impairment.
Answer A is correct. As described in the DSM-5, the neurocognitive disorders that are due to prion disease (e.g., Creutzfeldt-Jakob disease) are distinguished from other neurocognitive disorders “by their rapid progression and prominent cerebellar and motor symptoms” (p. 636).
The DSM-5 requires the presence of which of the following for a diagnosis of delirium?
A. disorientation to time and place
B. impaired attention and awareness
C. a perceptual disturbance
D. impaired memory
Answer B is correct. The DSM-5 diagnosis of delirium requires a disturbance in attention and awareness plus an additional disturbance in cognition which can be, for example, disorientation to time and place, a perceptual disturbance, or impaired memory. In other words, of the four symptoms listed in the answers, only impaired attention and awareness is required for the diagnosis.
Identifying the temporal sequence of the onset of motor and cognitive symptoms is most useful for distinguishing between NCD due to Parkinson’s disease and:
A. NCD due to HIV infection.
B. NCD with Lewy bodies.
C. NCD due to prion disease.
D. vascular NCD.
Answer B is correct. To identify the correct answer to this question, you need to know that NCD due to Parkinson’s disease and NCD with Lewy bodies both involve motor and cognitive symptoms but that the temporal sequence of the onset of these symptoms differs: Motor symptoms precede cognitive symptoms in NCD due to Parkinson’s disease, while cognitive symptoms precede (or, in some cases, are concurrent with) motor symptoms in NCD with Lewy bodies.
Beth, a 68-year-old retired physician exhibits impaired attention and judgment, seems disoriented, and has short-term memory loss that she doesn’t seem to be aware of. Her husband tells you that she “just hasn’t seemed the same” for the past year or so and that the changes he’s noticed have occurred gradually. Beth’s symptoms are most suggestive of which of the following?
A. major depressive disorder (pseudodementia)
B. persistent depressive disorder
C. neurocognitive disorder due to Alzheimer’s disease
D. neurocognitive disorder due to Prion’s disease
Answer C is correct. NCD due to Alzheimer’s disease and depression that includes prominent cognitive symptoms (pseudodementia) can be difficult to differentiate. However, Beth’s denial or minimization of her memory problems and the gradual onset of her symptoms are more characteristic of Alzheimer’s disease than depression.
Which of the following is not one of the DSM-5 diagnostic criteria for the behavioral variant of frontotemporal neurocognitive disorder?
A. dietary changes
B. loss of empathy
C. ataxia
D. apathy
Answer C is correct. The behavioral variant of frontotemporal neurocognitive disorder involves changes in behavior and personality that include the diagnostic criteria listed in answers A, B, and D. However, ataxia (answer C) is not a diagnostic criterion for this disorder but is one of the motor symptoms that is characteristic of neurocognitive disorder due to prion disease and neurocognitive disorder due to Huntington’s disease.
Research has found that, on the Revised NEO Personality Inventory, people with Alzheimer’s disease often obtain:
A. high scores on neuroticism and conscientiousness.
B. low scores on neuroticism and conscientiousness.
C. high scores on neuroticism and low scores on conscientiousness.
D. low scores on neuroticism and high scores on conscientiousness.
Answer C is correct. Terracciano et al. (2021) found that individuals who obtained high scores on neuroticism and low scores on conscientiousness on the Revised NEO Personality Inventory had more deposits of amyloid and tau (the hallmarks of Alzheimer’s disease) than did participants who obtained low scores on neuroticism and high scores on conscientiousness.
