Week 8.2

Question 1

How can we test a patient’s ventral stream?

Answer 1

• ask them to draw a line in the plane of a given object
• can’t if there is ventral stream damage
• ask them to put a card in a slot, can because that requires an unconscious knowledge of the relationship between the objects

Question 2

What is prosopagnosia?

Answer 2

the inability to recognize faces, but a retained emotional response to familiar faces

Question 3

What is capgras syndrome?

Answer 3

the ability to recognizes faces as familiar but without any emotional response, leading one to the belief their loved one has been replaced

Question 4

Which perceptual stream is damaged in those with prosopagnosia?

Answer 4

the ventral stream

Question 5

Which cerebral hemisphere mediates confabulation?

Answer 5

the left

Question 6

What are the four important structures for decision making?

Answer 6

• amygdala
• OFC
• DLPFC
• anterior cingulate cortex

Question 7

What role does the amygdala play in decision making?

Answer 7

subconscious evaluation of meaning

Question 8

When you walk into a room and “feel” something is wrong, which brain structure is responsible?

Answer 8

the amygdala

Question 9

What role does the OFC play in decision making?

Answer 9

it is your intuition

Question 10

How can we test the OFC?

Answer 10

with the gambling task

Question 11

OFC lesions will cause what behavioral change?

Answer 11

loss of quick, intuitive judgements

Question 12

What role does the DLPFC play in decision making?

Answer 12

it directs working memory and is the “decider”

Question 13

Damage to the DLPFC will cause what behavioral change?

Answer 13

the individual will become very impulsive

Question 14

What is the role of the anterior cingulate cortex in decision making?

Answer 14

it learns from error and decides whether behavior is successfully proceeding toward the desired goals

Question 15

Which decision making center has very little input from sensory systems?

Answer 15

the DLPFC

Question 16

Which systems of thinking, fast or slow, is capable of learning?

Answer 16

both are

Question 17

Why is the fast system of thinking so quick?

Answer 17

it relies on hardwired rules of thumb

Question 18

Which system of thinking, fast or slow, is more causal?

Answer 18

fast

Question 19

The hyper-fast system of thinking is mediated by which brain structure?

Answer 19

the amygdala

Question 20

What is the availability bias?

Answer 20

reliance on easily recalled (often emotionally charged) events to make decisions

Question 21

What is another name for cognitive inertia?

Answer 21

the anchoring bias

Question 22

When it comes to clinical practice, how should you utilize slow and fast thinking?

Answer 22

• rely on fast thinking when you’ve had lots of similar experience
• use slow thinking to reject simple solutions offered by the OFC then make a decision after a period of not thinking about it using “your gut” if the decision is complex

Question 23

What is hypothetical-deductive reasoning?

Answer 23

the best diagnostic method

Question 24

What are the steps of hypothetical-deductive reasoning?

Answer 24

• formulate a probabilistic differential
• continue to refine it by incorporating new data
• be comfortable with residual uncertainty

Question 25

How is sensitivity calculated?

Answer 25

TP / (TP + FN)

Question 26

How is specificity calculated?

Answer 26

TN / (TN + FP)

Question 27

A highly specific test allows you to do what?

Answer 27

rule in disease with a positive test

Question 28

A highly sensitive test allows you to do what?

Answer 28

rule out disease with a negative test

Question 29

What is another name for post-test probability?

Answer 29

positive or negative predictive value

Question 30

What is the equation for positive predictive value?

Answer 30

sensitivity(pre-test) + (1-specificity)(1-pretest)

Question 31

What is the equation for negative predictive value?

Answer 31

(specificity) (1-pretest)
- ——————————————-
(specificity) (1-pretest) + (1-sensitivity)(pretest)

Question 32

What is a coma?

Answer 32

pathologic absence of consciousness

Question 33

What are the four levels of consciousness?

Answer 33

• alert
• lethargic
• stupor
• coma

Question 34

If someone is in a coma, it means one of two things has been damaged?

Answer 34

• the RAS

- the cortex, diffusely

Question 35

Describe the pathway between the RAS and the cortex

Answer 35

• RAS
• thalamic reticular nucleus
• cerebral cortex

Question 36

What are the six types of coma?

Answer 36

• psychogenic
• diffuse cortical
• diencephalic
• supratentorial early
• supratentorial late
• subtentorial

Question 37

Parasympathetic innervation of the eye induces what pupillary state?

Answer 37

constricted

Question 38

Describe the state of someone’s pupils in the various types of coma.

Answer 38

• psychogenic: mid-range, reactive
• diffuse cortical: small, reactive
• diencephalic: small, reactive
• early supratentorial: small, reactive
• late supratentorial: mid-range, unreactive
• subtentorial: mid-range, unreative

Question 39

What is the oculocephalic reflex?

Answer 39

“dolls eye reflex” which maintains a forward gaze when the head is turned (same as VOR)

Question 40

How can we test a coma patient’s slow eye movements?

Answer 40

• oculocephalic reflex

- cold caloric

Question 41

Normal response to cold calorics is what?

Answer 41

slow eye movement ipsilaterally

Question 42

True or false, slow eye movements are sensitive to toxic-metabolic processes.

Answer 42

moderately true

Question 43

Describe the eye movements for each type of coma.

Answer 43

• diffuse cortical: intact or abnormal
• diencephalic: intact
• early supratentorial: intact
• late supratentorial: abnormal
• subtentorial: abnormal