MOCK EXAM 1.txt

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MOCK EXAM 1.txt
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ABCN NP practice exams
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  1. 1. It is hypothesized that schizophrenia may be related to an excess of which neurotransmitter:
    a) Serotonin
    b) GABA
    c) Dopamine
    d) Glutamate
    c.  Dopamine
  2. 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
  3. c) Substantia nigra
  4. 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) Global Aphasia
    B) Broca’s Aphasia
    C) Wernicke’s Aphasia
    D) Conduction Aphasia
    B) Broca’s Aphasia
    (this multiple choice question has been scrambled)
  5. 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
    B) Conduction Aphasia
    (this multiple choice question has been scrambled)
  6. 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
    • c. 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).
  7. 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)
    • a.  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).
  8. 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
    • b.  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”).
  9. 8. Heschl’s gyrus is associated with which of the following?

    A) Secondary auditory cortex
    B) Primary visual cortex
    C) Primary auditory cortex
    D) Somatosensory cortex
    C) Primary auditory cortex
    (this multiple choice question has been scrambled)
  10. 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) Wernecke’s aphasia and agraphia
    B) A conduction aphasia and agraphia
    C) Alexia without agraphia (a.k.a. posterior alexia or associative alexia)
    D) Alexia with agraphia
    E) Frontal or anterior alexia (a.k.a. literal alexia)
    C) Alexia without agraphia (a.k.a. posterior alexia or associative alexia)
    (this multiple choice question has been scrambled)
  11. 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
    • b.  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.
  12. 11. Evidence of which form of validity is most needed for a job screening test?

    A) Concurrent validity
    B) Content validity
    C) Face validity
    D) Predictive validity
    D) Predictive validity
    (this multiple choice question has been scrambled)
  13. 12. Which is most true of a person with Transient Global Amnesia?

    A) shows retrograde amnesia but not anterograde amnesia 
    B) shows decreased level of consciousness
    C) oriented and able to correctly provide personal information 
    D) confabulates 
    E) shows anterograde amnesia but not retrograde amnesia 
    C) oriented and able to correctly provide personal information
    (this multiple choice question has been scrambled)
  14. 13. Seizures originating in what area are associated with fear and panic?

    A) dorsolateral frontal convexity
    B) caudate 
    C) supplementary motor area 
    D) amygdala
    D) amygdala
    (this multiple choice question has been scrambled)
  15. 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) Core clinical/behavioral features
    B) Post-mortem neuropathological changes
    C) Age of onset
    d) None of the above (e.g., aside from genetics the two syndromes are identical)
    C) 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).
    (this multiple choice question has been scrambled)
  16. 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
    • 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.
  17. 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) Prosopagnosia, Right
    B) Simultanagnosia, Left
    C) Simultanagnosia, Right
    D) Prosopagnosia, Left
    A) Prosopagnosia, Right

    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.
    (this multiple choice question has been scrambled)
  18. 17. Which of the following is not characteristic of multiple sclerosis
    A) Aphasia
    B) Dysarthria
    C) Tremor
    D) Nystagmus
    A) Aphasia

    Page 354 in 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.”
    (this multiple choice question has been scrambled)
  19. 18. Anomic aphasia is typically caused by damage to the following area of the left hemisphere: 

    A) Thalamus
    B) Wernicke’s and Broca’s Areas
    C) Angular Gyrus
    D) Arcuate Fasciculus
    C) Angular Gyrus
    (this multiple choice question has been scrambled)
  20. 19. Which one of the following statements is true?

    A) Approximately 65% of all causes of dementia are reversible
    B) Approximately 5% of all causes of dementia are reversible
    C) Approximately 45% of all causes of dementia are reversible
    D) Approximately 25% of all causes of dementia are reversible
    B) 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.
    (this multiple choice question has been scrambled)
  21. 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
    d) All of the above
  22. 21. Which one of the following is true about malingering?

    A) Malingering patients typically demonstrate more difficulties with memory than they do with attention
    B) Any patient who is involved in a personal injury case or has a lawyer must be malingering
    C) Malingering is detectable through face-to-face clinical interviews alone
    D) Patients with genuine organic illnesses will not exaggerate their symptoms
    A) Malingering patients typically demonstrate more difficulties with memory than they do with attention
    (this multiple choice question has been scrambled)
  23. 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.
    C) A period of time following a TBI in which new memories cannot be consistently formed.
    (this multiple choice question has been scrambled)
  24. 23. An individual with which type of dementia is most likely to show retrieval rather than retention deficits:

    A) Parkinson’s Disease 
    B) Alzheimer’s Dementia 
    C) Pick’s Disease
    D) Diffuse Lewy Bodies Dementia 
    A) Parkinson’s Disease
    (this multiple choice question has been scrambled)
  25. 24. Leukoaraiosis refers to:
    A) Diffuse white matter changes seen in older patients
    B) Destruction of white matter in the peripheral nervous system
    C) Watershed white matter damage associated with anoxia






















    d) An attack on the cerebral and spinal cord myelin following an infection or immunization
    A) Diffuse white matter changes seen in older patients
    (this multiple choice question has been scrambled)
  26. 25. The primary visual area lies along the ______.

    A) Sylvian fissure
    B) Central sulcus
    C) Calcarine fissure
    D) Lateral fissure
    C) Calcarine fissure
    (this multiple choice question has been scrambled)
  27. 26. The criterion validity of a test is limited by which of the following:

    A) The test’s reliability
    B) The standard deviation of the criterion variable
    C) The test’s standard deviation
    D) Validity shrinkage






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

    Criterion related validity is based on some external criterion which the researcher believes is another indicator of the same variable that a tests intends to measure.For example, the validity of a test of depression might reasonably be established by using it on a group of people who are receiving treatment for depression and comparing scores with a control group.

    There are two types of criterion validity differing only in terms of the timing of the criterion :
    Concurrent validity.  This is the degree to which a test corresponds to an external criterion that is known concurrently (i.e. occurring at the same time). If the new test is validated by a comparison with a currently existing criterion, we have concurrent validity. Very often, a new IQ or personality test might be compared with an older but similar test known to have good validity already.

    Predictive validity:  This is the degree to which a test accurately predicts a criterion that will occur in the future. For example, a prediction may be made on the basis of a new intelligence test, that high scorers at age 12 will be more likely to obtain university degrees several years later. If the prediction is born out then the test has predictive validity.
    (this multiple choice question has been scrambled)
  28. 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
    c) hypofrontality
  29. 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) Errorless Learning
    B) Graduated Exposure
    C) Priming
    D) Prospective Memory Training
    A) Errorless Learning
    (this multiple choice question has been scrambled)
  30. 29. Double simultaneous stimulation is used to screen for ______.

    A) Agnosia
    B) Hyperarousal
    C) Neglect 
    D) Ocular Apraxia
    C) Neglect
    (this multiple choice question has been scrambled)
  31. 30. Which is not a neuropathological feature associated with Alzheimer’s Dementia?

    A) Neurofibrillary Tangles 
    B) Lewy Bodies
    C) Neuritic Plaques 
    D) Granulovacular Bodies 














    d) Lewy Bodies
    B) Lewy Bodies
    (this multiple choice question has been scrambled)
  32. 31. Frontal memory disorders are characterized by all but:
    A) Loss of autobiographical knowledge
    B) Confabulation
    C) Attentional deficits interfere with encoding
    D) Limited memory for temporal order of events
    A) Loss of autobiographical knowledge
    (this multiple choice question has been scrambled)
  33. 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
    A) Mental slowing and anxiety/depression

    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.
    (this multiple choice question has been scrambled)
  34. 33. In pediatric patients, about ____ % of brain tumors are in the posterior fossa and ___% are supratentorial.

    A) 10, 90
    B) 70, 30
    C) 30, 70
    D) 50, 50
    B) 70, 30

    The posterior cranial fossa is part of the intracranial cavity, located between the foramen magnum and tentorium cerebelli. It contains the brainstem and cerebellum. This is the most inferior of the fossae. It houses the cerebellum, medulla and pons. Anteriorly it extends to the apex of the petrous temporal. Posteriorly it is enclosed by the occipital bone. Laterally portions of the squamous temporal and mastoid part of the temporal bone form its walls.

    SupratentorialA word used by doctors and nurses to imply that a patient’s problems are all in their mind. The tentorium is a membrane just under the brain, so “supratentorial” refers to what is above that, namely the brain. This term can be used in front of the patient or patient’s family because it sounds like technical jargon.
    (this multiple choice question has been scrambled)
  35. 34. Which of the following is not a feature of Gerstmann’s Syndrome? 

    A) Left/right confusion
    B) Finger agnosia
    C) Ideational apraxia 
    D) Acalculia
    C) Ideational apraxia

    Primary symptoms Gerstmann syndrome is characterized by four primary symptoms: Dysgraphia/agraphia: deficiency in the ability to write; Dyscalculia/acalculia: difficulty in learning or comprehending mathematics[2][3]Finger agnosia: inability to distinguish the fingers on the hand[2][3]Left-right disorientation[2][3]Causes

    This disorder is often associated with brain lesions in the dominant (usually left) hemisphere including the angular and supramarginal gyri near the temporal and parietal lobe junction. There is significant debate in the scientific literature as to whether Gerstmann Syndrome truly represents a unified, theoretically motivated syndrome. Thus its diagnostic utility has been questioned by neurologists and neuropsychologists alike. The angular gyrus is generally involved in translating visual patterns of letter and words into meaningful information, such as is done while reading.
    (this multiple choice question has been scrambled)
  36. 35. Broca’s aphasia is commonly accompanied by which of the following?

    A) Contralateral superior quadrantanopsia
    B) Right visual neglect
    C) Right hemiplegia
    D) Gerstmann’s syndrome 
    C) Right hemiplegia
    (this multiple choice question has been scrambled)
  37. 36. Which region of the brain seems to be involved both in habit learning and in OCD?
    A) Dorsolateral Prefrontal Cortex
    B) Caudate
    C) Amygdala
    D) Hippocampus
    B)  Caudate

    The caudate nucleus is one of three basic structures that make up the basal ganglia. Along with the putamen and globus pallidus, as well in conjunction with the thalamus and two related structures (the substantia nigra and subthalamic nucleus), the caudate nucleus constitutes a system that is responsible largely for voluntary movement.[1] While this system has long been associated with motor processes due primarily to the basal ganglia’s role in Parkinson’s disease, there is mounting evidence that the structures that make up the basal ganglia –– the caudate nucleus included –– play important roles in various other nonmotor functions as well
    (this multiple choice question has been scrambled)
  38. 37. Which of the following is not one of the more common symptoms or signs of elevated intracranial pressure?

    A) Focal cortical symptoms, such as aphasia
    B) Headache
    C) Generally altered mental status, especially irritability and depressed level of alertness and attention
    D) Nausea and vomiting
    A) Focal cortical symptoms, such as aphasia
    (this multiple choice question has been scrambled)
  39. 38. Which of the following is a potentially reversible cause of dementia?

    A) Vascular Dementia
    B) Traumatic Brain Injury
    C) Dementia with Lewy Bodies
    D) Subdural Hematoma
    D) Subdural Hematoma

    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.”
    (this multiple choice question has been scrambled)
  40. 39. Alexia refers to:

    A) An aquired deficit in the interpretation of written language.
    B) Impaired auditory processing of language 
    C) An inability to understand spoken language.
    D) The lack of development of normal reading skills.
    A) An acquired deficit in the interpretation of written language.
    (this multiple choice question has been scrambled)
  41. 40. Dysarthria, dysphagia and hypoactive jaw and gag reflexes without associated cognitive or emotional changes is known as:

    A) Suprabulbar palsy
    B) Meniere’s Disease
    C) Bulbar palsy
    D) Pseudobulbar palsy 
    C) Bulbar palsy

    Bulbar palsy refers to impairment of function of the cranial nerves IX, X, XI and XII, which occurs due to a lower motor neuron lesion either at nuclear or fascicular level in the medulla oblongata or from lesions of the lower cranial nerves outside the brainstem.

    In contrast, pseudobulbar palsy describes impairment of function of cranial nerves IX-XII due to upper motor neuron lesions of the corticobulbar tracts in the mid-pons. For clinically evident dysfunction to occur, such lesions must be bilateral as these cranial nerve nuclei receive bilateral innervation.
    (this multiple choice question has been scrambled)
  42. 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) true positive errors 
    B) false negative errors
    C) true negative errors
    D) false positive errors
    B)  false negative error
    (this multiple choice question has been scrambled)
  43. 42. Which of the following Wechsler scale subtests is the best indicator of premorbid intelligence?

    A) Vocabulary 
    B) Block Design 
    C) Digit Span 
    D) Similarities
    A) Vocabulary
    (this multiple choice question has been scrambled)
  44. 43. Practice effects are most likely to be seen on which Wechsler scale subtest?

    A) Similarities 
    B) Picture Completion 
    C) Vocabulary 
    D) Digit Span
    B) Picture Completion
    (this multiple choice question has been scrambled)
  45. 44. Which statement is correct?

    A) In Cerebrovascular Accidents (CVA’s ) physical deteriorations typically develop later than intellectual deteriorations
    B) In Alzheimer’s Disease intellectual changes typically develop later than physical deteriorations
    C) In Multiple Sclerosis intellectual changes typically develop later than physical deteriorations
    D) In Parkinson’s Disease, physical changes typically develop later than intellectual changes.
    C) In Multiple Sclerosis intellectual changes typically develop later than physical deteriorations
    (this multiple choice question has been scrambled)
  46. 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 may exert less effort on the performance of neuropsychological tests.
    C) Persons with depression are more likely to show impaired naming ability, verbal fluency, and visuospatial ability.
    D) Persons with depression show memory retention deficits while persons with AD show retrieval deficits. 
    B) Persons with depression may exert less effort on the performance of neuropsychological tests.
    (this multiple choice question has been scrambled)
  47. 46. Which brain region is most often affected by hydrocephalus?

    A) Temporal lobes
    B) Frontal lobes
    C) All of these are equally affected
    D) Posterior regions
    D) 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).
    (this multiple choice question has been scrambled)
  48. 47. The brain’s major inhibitory neurotransmitter is _______, which is primarily affected by benzodiazepines and barbiturates.

    A) Dopamine
    B) GABA
    C) Acetylcholine 
    D) Glutamate 
    B) Gaba 

    GABA is the chief inhibitoryneurotransmitter in the mammalian central nervous system. It plays a role in regulating neuronal excitability throughout the nervous system. In humans, GABA is also directly responsible for the regulation of muscle tone.[2]
    (this multiple choice question has been scrambled)
  49. 48. A lesion of Brodmann’s area 44 in the dominant hemisphere is most closely associated with which of the following?

    A) Dysfluent aphasia
    B) Poor speech comprehension and fluent aphasia
    C) Diminished sensation in the right face and hand
    D) Right hemispace neglect
    A) Dysfluent aphasia

    Brodmann area 44, or BA44, is part of the frontal cortex in the human brain. Situated just anterior to premotor cortex(BA6) and on the lateral surface, inferior to BA9.This area is also known as pars opercularis (of the inferior frontal gyrus). Together with left-hemisphere BA 45, the left hemisphere[1] BA 44 comprisesBroca's area a region involved in semantic tasks
    (this multiple choice question has been scrambled)
  50. 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
    B) PIQ > VIQ

    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.
    (this multiple choice question has been scrambled)
  51. 50. Lesions of the temporal lobe can cause:

    A) Contralateral superior quadranopia
    B) Bitemporal hemianopia
    C) Contralateral homonymous hemianopia
    D) Contralateral inferior quadranopia
    A) Contralateral superior quadranopia

    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.
    (this multiple choice question has been scrambled)
  52. 51. Gait difficulties, urinary incontinence, and cognitive decline are highly indicative of which condition?

    A) Tonsillar herniation 
    B) Subdural hematoma
    C) Pseudotumor cerebri
    D) Normal pressure hydrocephalus
    D) Normal pressure hydrocephalus
    (this multiple choice question has been scrambled)
  53. 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
    • b) Transcortical Sensory Aphasia
    • Transcortical sensory aphasia (TSA) is a kind of aphasia that involves damage to specific areas of the temporal lobe of the brain, resulting in symptoms such as poor comprehension and naming, have fluent spontaneous speech and exhibit paraphasia. In all of these ways, TSA is very similar to a more commonly known language disorder,receptive aphasia. However, transcortical sensory aphasia differs from receptive aphasia (aka Wernicke's)  in that patients still have intact repetition and exhibit echolalia, or the compulsive repetition of words
  54. 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
  55. d) Less than 5% of persons with CP have normal intelligence
  56. 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) Parkinson’s Disease
    C) Normal-Pressure Hydrocephalus
    D) Multiple Sclerosis
    E) Alzheimer’s Disease
    E) 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.
    (this multiple choice question has been scrambled)
  57. 55. A lesion of the arcuate fasciculus would most likely cause the following subtype of aphasia:

    A) Wernicke’s Aphasia
    B) Global Aphasia
    C) Broca’s Aphasia
    D) Conduction Aphasia
    D) Conduction Aphasia
    (this multiple choice question has been scrambled)
  58. 56. Which treatments of tumors are generally not associated with mental status changes?

    A) Medications such as opiates used for pain
    B) Cranial (whole brain) radiotherapy
    C) All chemotherapies except methotrexate
    D) Methotrexate, but generally not other chemotherapies
    C) 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.’
    (this multiple choice question has been scrambled)
  59. 57. Cerebellar pathways affect all but one of the following:

    A) Anosmia
    B) Balance
    C) Higher-order cognitive processes
    D) Motor learning
    E) Respiratory movements
    A) Anosmia
    (this multiple choice question has been scrambled)
  60. 58. Lateral cerebellar lesions primarily affect:

    A) Gait
    B) Trunk control
    C) Posture and balance
    D) Motor planning
    D)  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.
    (this multiple choice question has been scrambled)
  61. 59. Which of the following statements is true?

    A) The left hemisphere has more association cortex than the right hemisphere.
    B) The right hemisphere has fewer interconnections than the left hemisphere.
    C) The left hemisphere has more gray matter/less white matter relative to the right hemisphere.
    D) The two hemispheres have equal amounts of gray and white matter.
    C) The left hemisphere has more gray matter/less white matter relative to the right hemisphere.
    (this multiple choice question has been scrambled)
  62. 60. A person who can not identify an object by touch may have:

    A) Associative Agnosia
    B) Alexia
    C) Anomia
    D) Astereognosis
    D) Astereognosis
    (this multiple choice question has been scrambled)
  63. 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
    D) Prominent neurofibrillary tangles
    B) Infarcts in the basal ganglia
    (this multiple choice question has been scrambled)
  64. 62. Which symptoms below are characteristic of normal aging:

    A) Decreased verbal fluency
    B) Decreased “crystallized” knowledge 
    C) B & C
    D) Decreased selective and sustained attention
    E) A & C
    F) Difficulties with language comprehension
    G) Decreased working memory skills
    E):  Decreased verbal fluency and Decreased working memory skills
    (this multiple choice question has been scrambled)
  65. 63. Neglect can occur with lesions in all of the following areas except:

    A) Right midbrain
    B) Right frontal lobe
    C) Right thalamus or basal ganglia
    D) Right internal capsule
    D) Right internal capsule

    The internal capsule is a unique location where a large number of motor and sensory fibers travel to and from the cortex. Damage of any kind in this location will cause some relatively unique findings that can allow you to localize the lesions to the internal capule by exam alone.

    Symptoms and Signs:Weakness of the face, arm, and/or leg (pure motor stroke)Known as one of the classic types of lacunar infarcts, a pure motor strokeis the result of an infarct in the internal capsule.  

    Pure motor stroke caused by an infarct in the internal capsule is the most common lacunar syndrome.
    Upper motor neuron signshyperreflexia, Babinski sign, Hoffman present, clonus, spasticity
    Mixed sensorimotor stroke
    Since both motor and sensory fibers are carried in the internal capsule, a stroke to the posterior limb of the internal capsule (where motor fibers for the arm, trunk and legs and sensory fibers are located) can lead tocontralateral weakness and contralateral sensory loss
    (this multiple choice question has been scrambled)
  66. 64. The structure involved in the “master clock” for circadian rhythms is the:

    A) Arcuate nucleus
    B) Median eminence
    C) Dentate gyrus
    D) Suprachiasmatic nucleus 
    A) Arcuate nucleus
    (this multiple choice question has been scrambled)
  67. 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
    B) High sensitivity
    (this multiple choice question has been scrambled)
  68. 66. Infarction of the inferior portion of the pons or medulla can cause:

    A) Pseudobulbar palsy
    B) Locked in syndrome 
    C) “Man in barrel” syndrome 
    D) “Pie in sky” visual defect
    E) Alien hand syndrome 
    B) Locked in syndrome
    (this multiple choice question has been scrambled)
  69. 67. ___ is the neurotransmitter primarily found in neurons of the raphe nuclei.

    A) Acetylcholine
    B) Dopamine
    C) Histamine
    D) Serotonin
    D) Serotonin
    (this multiple choice question has been scrambled)
  70. 68. A person with phonological alexia is most likely to make the following error:

    A) Reads “hot’ for “thought”
    B) Reads “though” for “thought”
    C) Reads “ought” for “thought”
    D) Reads “think” for “thought”
    B) Reads “though” for “thought”
    (this multiple choice question has been scrambled)
  71. 69. Which statement is true regarding the relationship between depression and dementia:

    A) Cognitive symptoms associated with depression develop insidiously while cognitive symptoms associated with dementia develop rapidly. 
    B) Depression decreases as the severity of dementia increases 
    C) CT and MRI reliably differentiate between depression and dementia 
    D) Both depression and dementia result in similar deficits in immediate recall and recognition on memory tests.
    B) Depression decreases as the severity of dementia increases
    (this multiple choice question has been scrambled)
  72. 70. Which disorder is characterized by café au lait spots and Lisch nodules?

    A) Tuberous sclerosis 
    B) Neurofibromatosis Type 1
    C) Angelman’s syndrome
    D) Sturge-Weber syndrome 
    B) Neurofibromatosis Type 1
    (this multiple choice question has been scrambled)
  73. 71. Which of the following is not a common characteristic in Tourette’s Syndrome?

    A) Comorbidity with ADHD and/or OCD symptoms
    B) Coprolalia
    C) Waxing and waning of tics
    D) Changing of tic locations and types
    B) Coprolalia
    (this multiple choice question has been scrambled)
  74. 72. Which of the following is not commonly associated with Central Alexia (aka alexia with agraphia)?

    A) Right hemisensory loss (e.g., right homonymous field defect)
    B) Right-left confusion
    C) Acalculia
    D) Finger agnosia
    E) Environmental sound agnosia (aka auditory sound agnosia)
    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.
    (this multiple choice question has been scrambled)
  75. 73. Which area of the brain has been shown to be most involved in response initiation and inhibition?

    A) Caudate
    B) Dorsolateral frontal lobe 
    C) Medial frontal lobe 
    D) Orbital frontal lobe 
    D) Orbital frontal lobe
    (this multiple choice question has been scrambled)
  76. 74. Analysis of motion and spatial relationships between objects and between the body and visual stimuli is most likely to occur in the ________________.

    A) Frontal association cortex 
    B) Parietal-occipital association cortex
    C) Primary visual cortex 
    D) Temporal-occipital association cortex 
    B) Parietal-occipital association cortex
    (this multiple choice question has been scrambled)
  77. 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.
    B) Sensory areas of the brain are myelinated before motor areas.
    (this multiple choice question has been scrambled)
  78. 76. In lesions of the dominant inferior parietal lobe, centering on the angular gyrus, you would expect that the patient could:

    A) Likely have some hemisensory loss and/or right homonymous visual field deficit
    B) Write (not just copy) words
    C) Read nonwords
    D) Name individual letters in isolation
    A) Likely have some hemisensory loss and/or right homonymous visual field deficit

    The angular gyrus is a region of the brain in the parietal lobe, that lies near the superior edge of the temporal lobe, and immediately posterior to thesupramarginal gyrus; it is involved in a number of processes related to language, number processing and spatial cognition, memory retrieval, attention, and theory of mind. It is Brodmann area 39 of the human brain.

    The angular gyrus is the part of the brain associated with complex language functions (ie reading, writing and interpretation of what is written). Lesion to this part of the brain shows symptoms of the well-known Gerstmann syndrome: effects include finger tap agnosia, alexia (inability to read), acalcula (inability to use arithmetic operations), agraphia (inability to copy), and left-right confusion.
    (this multiple choice question has been scrambled)
  79. 77. The pattern of “dementia with psychomotor slowing” occurs in all except which of the following disorders?

    A) Progressive supranuclear palsy
    B) HIV-related dementia
    C) Huntington’s disease
    D) Alzheimer’s dementia
    D) Alzheimer’s dementia
    (this multiple choice question has been scrambled)
  80. 78. The memory deficit typically seen in mild AD is characterized by:

    A) Deficits in recognition memory
    B) Poor immediate repetition
    C) Deficits in autobiographical memory
    D) Poor new learning and encoding of information when there is intention to learn
    D) Poor new learning and encoding of information when there is intention to learn
    (this multiple choice question has been scrambled)
  81. 79. The pattern of new learning in the course of normal aging is characterized by:

    A) Normal initial learning, but poor recognition memory
    B) Vastly impaired initial learning with severe interference effects on delayed recall
    C) Somewhat poorer initial learning with very impaired delayed recall
    D) Somewhat poorer initial learning but intact delayed recall of what they learned
    D) Somewhat poorer initial learning but intact delayed recall of what they learned
    (this multiple choice question has been scrambled)
  82. 80. The type of memory deficit most apparent in patients with alcoholic Korsakoff amnesia is a deficit in:

    A) Poor retrieval despite adequate encoding
    B) Recall of personal information
    C) Initial encoding of new material
    D) Recognition memory
    C) Initial encoding of new material
    (this multiple choice question has been scrambled)
  83. 81. A right MCA stroke in the distribution of the inferior division would most likely cause:

    A) Left hemineglect, decreased tone, and left-sided weakness
    B) Left hemineglect, decreased voluntary movements, 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
    D) Left hemineglect, decreased voluntary movements, and relatively normal left-sided strength

    The MCA is by far the largest cerebral artery and is the vessel most commonly affected by cerebrovascular accident. The MCA supplies most of the outer convex brain surface, nearly all the basal ganglia, and the posterior and anterior internal capsules.
    (this multiple choice question has been scrambled)
  84. 82. What is the most likely cause for transient global amnesia?

    A) Basilar artery TIA
    B) Carotid artery stroke
    C) Carotid artery TIA
    D) Basilar artery stroke
    A) Basilar artery TIA

    The basilar artery is part of the blood supply system for the brain and central nervous system. It is formed where the two vertebral arteries join together at the base of the skull. The basilar artery carries oxygenated blood to the cerebellum, brain stem, and occipital lobes. Several arteries branch from the basilar artery at the upper portion of the brain stem, delivering blood to various parts of the brain. Two posterior cerebral arteries lead to the temporal lobes and the occipital cortices. A pair of superior cerebellar arteries, another pair of anterior inferior cerebellar arteries, and several paramedian and circumferential pontine arteries also branch from the basilar artery. Interruption of the blood flow through the basilar artery can lead to severe brain damage, organ malfunction, or death. An aneurysm, or bulge in the artery wall, may push that portion of the brain, or rupture and hemorrhage. A thrombosis, or blood clot, may block the artery and prevent blood from passing through. Because of its location and importance in providing oxygen and nutrients to vital portions of the brain, an aneurysm or thrombosis in the basilar artery is particularly dangerous.
    (this multiple choice question has been scrambled)
  85. 83. Alexia without agraphia is most likely due to damage to what region(s)?

    A) Arcuate Fasciculus
    B) Border zones of MCA including Broca’s area
    C) Angular gyrus
    D) Infarction of left posterior artery territory including the splenium of the corpus callosum
    D) Infarction of left posterior artery territory including the splenium of the corpus callosum

    The posterior cerebral artery(PCA) is one of a pair of blood vesselsthat supply oxygenated blood to the posterior aspect of the brain (occipital lobe)
    (this multiple choice question has been scrambled)
  86. 84. Research has shown that right-sided brain damage can lead to subtle language deficits in all of the following except?

    A) Articulation
    B) Prosody 
    C) Grammatical rules and structure
    D) Use of abstract constructs
    C) Grammatical rules and structure
    (this multiple choice question has been scrambled)
  87. 85. Research has shown that individuals with mild cognitive impairment will develop dementia at a rate of?

    A) 5-10% per year, at a greater prevalence than the general population in clinic samples
    B) 25% per year, at a greater prevalence than the general population
    C) 1-2 % per year, no different than the general population
    D) <1% per year, at a lower rate than the general population
    A) 5-10% per year, at a greater prevalence than the general population -- higher in clinic samples -- community rates not greatly higher than general population.
    (this multiple choice question has been scrambled)
  88. 86. Which area of memory is found to be most intact in normal aging?

    A) Remote memory
    B) Learning and Recall
    C) Working memory
    D) Recognition
    A) Remote memory
    (this multiple choice question has been scrambled)
  89. 87. Which of the following is true about Lewy Body
    A) Patients are responsive to l-dopa like Parkinson’s dementia, but are insensitive to DA blocking agents.
    B) It is a variant of Parkinson Dementia in which Lewy Bodies are present in the substantia nigra.
    C) Auditory hallucinations are frequently present.
    D) It presents with Parkinsonian motor symptoms but the cognitive functioning more similarly looks like Alzheimer’s dementia.
    D) It presents with Parkinsonian motor symptoms but the cognitive functioning more similarly looks like Alzheimer’s dementia.

    Lewy body dementia, the second most common type of progressive dementia after Alzheimer's disease, causes a progressive decline in mental abilities.It may also cause visual hallucinations, which generally take the form of objects, people or animals that aren't there. This can lead to unusual behavior such as having conversations with deceased loved ones.Another indicator of Lewy body dementia may be significant fluctuations in alertness and attention, which may include daytime drowsiness or periods of staring into space. And, like Parkinson's disease, Lewy body dementia can result in rigid muscles, slowed movement and tremors.In Lewy body dementia, protein deposits, called Lewy bodies, develop in nerve cells in regions of your brain involved in thinking, memory and movement (motor control).
    (this multiple choice question has been scrambled)
  90. 88. Confabulation is frequently seen in all but which of the following conditions:

    A) Primary Progressive Aphasia
    B) Wernicke-Korsakoff’s Syndrome
    C) Temporal Frontal Dementia
    D) Pick’s Disease
    A) Primary Progressive Aphasia
    (this multiple choice question has been scrambled)
  91. 89. Which statement is false?

    A) Lennox-Gastaut is a mixed seizure disorder in which the seizures are difficult to control, and status epilepticus is common.
    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) Rolandic epilepsy occurs nocturnally and is usually in remission by age 15
    C) Febrile seizures occur in 2-4% of all children, and most go on to develop temporal lobe epilepsy.
    (this multiple choice question has been scrambled)
  92. 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; proactive interference
    B) Anterograde amnesia; proactive interference
    C) Anterograde amnesia; retroactive interference
    D) Retrograde amnesia; retroactive interference
    D) Retrograde amnesia; retroactive interference
    (this multiple choice question has been scrambled)
  93. 91. Which of the following would not be expected from frontal lobe damage?

    A) Anosmia
    B) Contralateral hemiplegia
    C) Acalculia
    D) Acute eye deviation with persistent neglect
    C) Acalculia
    (this multiple choice question has been scrambled)
  94. 92. Which of the following is true regarding childhood leukemia?

    A) Whole brain and partial brain radiation therapy is equally damaging in regards to cognitive impairment.
    B) Older children are comparatively more vulnerable to radiation-induced cognitive impairment than younger due to plasticity issues.
    C) 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).
    D) Chemotherapy, such as methotrexate, does not cause cognitive impairments as it is administered intrathecally and does not pass the blood/brain barrier.
    C) 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).
    (this multiple choice question has been scrambled)
  95. 93. Which of the following is not an advantage of an MRI over CT?

    A) It can be applied to intra- and extracranial arteries
    B) There is no distortion from bone
    C) MRI has greater resolution, being able to detect smaller objects
    D) It detects hemorrhages and hematomas more accurately
    D) It detects hemorrhages and hematomas more accurately
    (this multiple choice question has been scrambled)
  96. 94. Which of the following is not a typical means of determining premorbid IQ?

    A) Demographically based regression equations
    B) Barona Regression Equation
    C) Reading Comprehension Tests (WIAT-II) 
    D) Reading Tests (e.g., NART, WRAT-3)
    C) Reading Comprehension Tests (WIAT-II)
    (this multiple choice question has been scrambled)
  97. 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 FSIQ
    B) The patient’s performance on memory recognition measures 
    C) The patient’s gender 
    D) The patient’s age 
    A) 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.
    (this multiple choice question has been scrambled)
  98. 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) Test bias, discriminant validity, multiple regression
    B) Validity shrinkage, Flynn effect, multicollinearity
    C) Criterion validity, internal consistency, effort 
    D) Measurement error, practice effects, regression to the mean 
    D) 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.
    (this multiple choice question has been scrambled)
  99. 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) Post-Traumatic Amnesia (PTA) of less than 1 hour 
    C) Loss of consciousness of 2 hours
    D) Glascow Coma Scale (GCS) score of 8
    B) Post-Traumatic Amnesia (PTA) of less than 1 hour
    (this multiple choice question has been scrambled)
  100. 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) Phonagnosia
    C) Anosodiaphoria
    D) Auditory affective agnosia
    C) 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
    (this multiple choice question has been scrambled)
  101. 99. Which statement is not true of Huntington’s Disease dementia:

    A) is consistent with a subcortical dementia
    B) it is correlated with severity of depression 
    C) it generally begins within one year of chorea 
    D) severity of dementia is correlated with caudate atrophy 
    B) it is correlated with severity of depression
    (this multiple choice question has been scrambled)
  102. 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) Cortical blindness
    B) Apperceptive Visual Agnosia
    C) Prosopagnosia
    D) Simultangnosia
    B) Apperceptive Visual Agnosia
    (this multiple choice question has been scrambled)

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