Erin Urbanowicz
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Quiz on NSF Week 7, created by Erin Urbanowicz on 01/10/2019.

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Erin Urbanowicz
Created by Erin Urbanowicz about 5 years ago
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NSF Week 7

Question 1 of 30

1

Your patient has experienced traumatic events in his past. During which stage of the memory processing of the traumatic event might there be a target for intervention?

Select one of the following:

  • consolidation

  • encoding

  • reconsolidation

  • retrieval

Explanation

Question 2 of 30

1

A 65 year-old right-handed man was brought to the emergency room by his wife one hour after sudden onset of right upper arm/hand weakness and difficulty talking. His wife reported that he seems to understand what she is saying because he is responding appropriately to her questions. However, she states he is only able to produce a few words (e.g."something...wrong...can't talk...doctor"). A physical exam revealed full visual fields, but weakness of the right arm and the right lower face. Which one of the following types of aphasia does the patient demonstrate?

Select one of the following:

  • broca's aphasia

  • Anomic Aphasia

  • Global Aphasia

  • Wernicke's Aphasia

Explanation

Question 3 of 30

1

According to the DSM-5, which of the following is a symptom of Autism Spectrum Disorder?

Select one of the following:

  • Difficulty with social interaction

  • Outbursts of anger and disruptive behavior

  • severe anxiety

  • intellectual disability

Explanation

Question 4 of 30

1

A 19 year old presents to clinic with her mother. She suffered from a traumatic brain injury in a motor vehicle accident when celebrating her 18th birthday. She has had significant problems with school performance and daily functioning. Her mother is concerned about her daughter's cognitive ability since the accident and wants to know if her daughter has an intellectual disability. What additional finding would be required for diagnosis of an intellectual disability?

Select one of the following:

  • A score of <80 on IQ testing following the accident

  • Presence of MRI abnormality

  • Rating of a 'severe' impairment on neuropsychological testing in any of the following domains: working memory, attention, or executive skills

  • History of difficulties with cognitive and adaptive skills prior to the accident

Explanation

Question 5 of 30

1

A 7 year old child presents to your clinic with his foster parents. They are concerned about his school performance and wonder if he may have ADHD. On exam, you note that he is small for his age with a head circumference <5%, has a thin upper lip with flat philtrum, and is very hyperactive (see image). His language skills are on par with those of a 4 year old. Based on this constellation of symptoms, you believe this can be attributed to the most common teratogenic cause of intellectual disability. What prenatal exposure do you suspect?

Select one of the following:

  • cigarette smoke

  • alcohol

  • methamphetamines

  • valproic acid

Explanation

Question 6 of 30

1

Which thalamic nucleus communicates with other thalamic nuclei and also prevents overstimulation of cortex via GABAergic cortical relays?

Select one of the following:

  • Pulvinar

  • Reticular

  • Intralaminar

  • Anterior

Explanation

Question 7 of 30

1

Which of the following functions does the pineal body regulate?

Select one of the following:

  • Circadian rhythms through the release of melatonin

  • Food intake through the release of leptin

  • Water intake by measuring blood osmolality

  • "Fight or Flight" response through the release of Corticotropin Releasing Hormone

Explanation

Question 8 of 30

1

Thalamic pain syndrome (Dejerine-Roussy syndrome) results from a lesion of which thalamic nucleus?

Select one of the following:

  • Mediodorsal

  • Pulvinar

  • ventral posterior

  • reticular

Explanation

Question 9 of 30

1

Which of the following hypothalamic nuclei are associated with the Papez circuit and memory?

Select one of the following:

  • paraventricular nuclei

  • mammillary bodies

  • supraoptic nuclei

  • preoptic nuclei

Explanation

Question 10 of 30

1

Orexin, a neuropeptide responsible for wakefulness, arousal, and increased appetite, is released by which hypothalamic nucleus/nuclei?

Select one of the following:

  • Ventromedial nuclei

  • mammillary body

  • arcuate nucleus

  • lateral nuclei

Explanation

Question 11 of 30

1

On the SLUMS, a patient's memory is tested by determining if a list of 5 words can be registered immediately and recalled again in 5 minutes. What type of memory is being tested with 5 minute recall?

Select one of the following:

  • Working

  • Sensory

  • Declarative

  • Implicit

Explanation

Question 12 of 30

1

A 45 year old man has had a stroke in his dominant hemisphere. On mental status evaluation, you determine that he constructs sentences with articles and prepositions, with average sentence length of 7-8 words. The sentences have normal intonation and he does not make frequent pauses in his speech. He frequently answers 'yes' to open-ended questions. You have difficulty understanding the content of his responses, despite normal articulation. Which area is most likely affected by his stroke?

Select one of the following:

  • Parahippocampal gyrus

  • Superior parietal lobe

  • Posterior superior temporal gyrus

  • cingulate gyrus

Explanation

Question 13 of 30

1

Which nucleus is involved in memory formation, providing cholinergic input to the hippocampus?

Select one of the following:

  • Raphne nucleus

  • Locus Ceruleus

  • Nucleus basalis of Meynert

  • Nucleus Accumbens

Explanation

Question 14 of 30

1

A 33 year old man has 5 days of progressively worsening mental status with fever. He has a first-time seizure in the emergency room. An MRI brain shows hemorrhagic lesions in the bilateral temporal lobes. Based on the most likely diagnosis, what next steps do you take?

Select one of the following:

  • Send CSF culture, give ceftriaxone IV

  • Send CSF culture, give oral acyclovir

  • CSF PCR, no available treatments

  • CSF PCR, give IV acyclovir

Explanation

Question 15 of 30

1

A 19 year old man has new onset of altered mental status, fever, and new-onset seizures. His MRI brain shows temporal lobe cerebritis. A lumbar puncture shows normal glucose and protein, but a mild pleiocytosis (18 white blood cells) with lymphocytic predominance (92% lymphocytes). These findings suggests that he has which of the following?

Select one of the following:

  • Enterovirus

  • West Nile Virus

  • Neisseria Meningtidis

  • Bartonella Henselae

Explanation

Question 16 of 30

1

A general pediatrician screens an 18 month old girl at a well-child visit and finds a lack of joint attention by history and examination. She refers her on for a formal diagnostic evaluation at a development clinic with a multidisciplinary autism spectrum disorders team. On her exam, which of the following suggests an absence of joint attention?

Select one of the following:

  • She became overly fixated on one toy and spent the rest of the appointment spinning its wheels

  • She does not follow instructions when you ask her to run down the hallway

  • She will not simultaneously regard a toy to which her mother and doctor are both pointing

  • She repetitively licks the screen of her mother's tablet

Explanation

Question 17 of 30

1

In the Papez circuit, which brain structure receives input from various cortical areas and is the primary source of input to the hippocampus?

Select one of the following:

  • Subiculum

  • Entorhinal cortex

  • Fornix

  • Cingulum

Explanation

Question 18 of 30

1

Delirium can be distinguished from depression, dementia, and schizophrenia based on the mental status exam. Which of the following symptoms are characteristic of delirium, and not typical of depression, dementia, or schizophrenia?

Select one of the following:

  • Delusions and hallucinations

  • Tearfulness and other mood changes

  • acute onset with fluctuating symptoms

  • Impaired short-term memory

Explanation

Question 19 of 30

1

Iatrogenic causes of delirium often include medications. Which of the following medications is likely to cause and/or worsen delirium in hospital patients?

Select one of the following:

  • Haloperidol (antipsych)

  • Lorazepam (benzo)

  • clonidine (alpha-2 agonist)

  • acetaminophen

Explanation

Question 20 of 30

1

The anatomic distribution of which abnormality in the brain is most closely correlated with the clinical progression of Alzheimer's disease?

Select one of the following:

  • Plaques composed of oxidized lipids

  • Neurofibrillary tangles composed of tau

  • Lewy bodies composed of alpha synuclein

  • Prion plaques composed of prion protein

Explanation

Question 21 of 30

1

What is the name of the extracellular protein aggregate that is a marker of Alzheimer's disease?

Select one of the following:

  • Beta Amyloid

  • Neurofibrillary tangle

  • Alpha Synuclein

  • Prion protein

Explanation

Question 22 of 30

1

REM sleep behavior disorder is a core feature of which dementia?

Select one of the following:

  • Alzheimer Disease

  • Frontotemporal dementia

  • Lewy body dementia

  • Vascular Dementia

Explanation

Question 23 of 30

1

What MRI finding would you most likely observe in a patient with moderate to severe Alzheimer's disease?

Select one of the following:

  • Abnormal T2 signal w/in the hippocampus

  • Abnormal T2 signal w/in the brainstem

  • Frontal lobe atrophy

  • Bilateral hippocampal atrophy

Explanation

Question 24 of 30

1

A 57-year old lawyer presents with a 1-2 year history of increased impulsivity and disinhibition, leading to the recent loss of his job. His wife describes him as having a tendency to become fixated on one idea without being able to let it go (over the same time period). During the exam, he is extremely jovial and intermittently makes inappropriate comments. Lab workup is normal. What type of neurocognitive disorder is most likely?

Select one of the following:

  • Alzheimer's Dementia

  • Lewy Body Dementia

  • Mild Cognitive impairment

  • Frontotemporal dementia

Explanation

Question 25 of 30

1

What is the most common type of Creutzfeldt-Jakob disease (CJD)?

Select one of the following:

  • Sporadic

  • Iatrogenic

  • Variant

  • Familial

Explanation

Question 26 of 30

1

What is the major output tract of the amygdala?

Select one of the following:

  • Stria terminalis

  • Fornix

  • Cingulum

  • Medial forebrain bundle

Explanation

Question 27 of 30

1

An elderly patient dies from aspiration pneumonia, after a prolonged cognitive decline over several years, characterized mostly by memory loss. There was not significant motor dysfunction. Neuropathological examination of the brain and spinal cord is most likely to reveal which of the following?

Select one of the following:

  • Alpha-synuclein positive Lewy bodies in the cortex and midbrain

  • Tau-positive inclusions in the anterior horn cells of the spinal cord

  • Amyloid-beta and Tau positive plaques throughout the cortex

  • Amyloid-beta deposits in vessel walls only

Explanation

Question 28 of 30

1

An adult patient dies after approximately two years of progressive muscle weakness, eventually requiring ventilator support. Early symptoms included hyperreflexia and spasticity. Cognitive function was intact, and no significant cortical atrophy was seen on gross examination. Neuropathological examination of the brain and spinal cord is most likely to reveal which of the following?

Select one of the following:

  • Alpha-synuclein positive Lewy bodies in the cortex and midbrain

  • Tau-positive inclusions in the anterior horn cells of the spinal cord

  • Amyloid-beta and Tau positive plaques throughout the cortex

  • Amyloid-beta deposits in vessel walls only

Explanation

Question 29 of 30

1

Which of the following is required to make a diagnosis of ADHD?

Select one of the following:

  • Family history of ADHD

  • Inattention

  • Hyperactivity

  • Age of onset in childhood

Explanation

Question 30 of 30

1

Which of the following is a common dose dependent side effect of first line medications used to treat ADHD?

Select one of the following:

  • Polyuria

  • Elevated blood pressure

  • Blurry vision

  • diarrhea

Explanation