Mock Exam 1 Questions

Mock Exam 1 Questions

1. It is hypothesized that schizophrenia may be related to an excess of which neurotransmitter:

a) Serotonin
c) Dopamine
d) Glutamate

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. 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) Wernicke’s Aphasia
b) Conduction Aphasia
c) Broca’s Aphasia
d) Global Aphasia

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

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

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)

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

8. Heschl’s gyrus is associated with which of the following?

a) Primary visual cortex
b) Primary auditory cortex
c) Secondary auditory cortex
d) Somatosensory cortex

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) Alexia without agraphia (a.k.a. posterior alexia or associative alexia)
b) Alexia with agraphia
c) Frontal or anterior alexia (a.k.a. literal alexia)
d) Wernecke’s aphasia and agraphia
e) A conduction aphasia and agraphia

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

11. Evidence of which form of validity is most needed for a job screening test?

a) Concurrent validity
b) Content validity
c) Predictive validity
d) Face validity

12. Which is most true of a person with Transient Global Amnesia?

a) oriented and able to correctly provide personal information
b) confabulates
c) shows anterograde amnesia but not retrograde amnesia
d) shows retrograde amnesia but not anterograde amnesia
e) shows decreased level of consciousness

13. Seizures originating in what area are associated with fear and panic?

a) dorsolateral frontal convexity
b) supplementary motor area
c) caudate
d) amygdala

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) Age of onset
b) Core clinical/behavioral features
c) Post-mortem neuropathological changes
d) None of the above (e.g., aside from genetics the two syndromes are identical)

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

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) Simultanagnosia, Left
b) Simultanagnosia, Right
c) Prosopagnosia, Left
d) Prosopagnosia, Right

17. Which of the following is not characteristic of multiple sclerosis?

a) Dysarthria
b) Aphasia
c) Nystagmus
d) Tremor

18. Anomic aphasia is typically caused by damage to the following area of the left hemisphere:

a) Thalamus
b) Angular Gyrus
c) Wernicke’s and Broca’s Areas
d) Arcuate Fasciculus

19. Which one of the following statements is true?

a) Approximately 5% of all causes of dementia are reversible
b) Approximately 25% of all causes of dementia are reversible
c) Approximately 45% of all causes of dementia are reversible
d) Approximately 65% of all causes of dementia are reversible

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

21. Which one of the following is true about malingering?

a) Any patient who is involved in a personal injury case or has a lawyer must be malingering
b) Patients with genuine organic illnesses will not exaggerate their symptoms
c) Malingering patients typically demonstrate more difficulties with memory than they do with attention
d) Malingering is detectable through face-to-face clinical interviews alone

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.

23. An individual with which type of dementia is most likely to show retrieval rather than retention deficits:

a) Alzheimer’s Dementia
b) Parkinson’s Disease
c) Diffuse Lewy Bodies Dementia
d) Pick’s Disease

24. Leukoaraiosis refers to:

a) Diffuse white matter changes seen in older patients
b) Watershed white matter damage associated with anoxia
c) Destruction of white matter in the peripheral nervous system
d) An attack on the cerebral and spinal cord myelin following an infection or immunization

25. The primary visual area lies along the ______.

a) Calcarine fissure
b) Central sulcus
c) Sylvian fissure
d) Lateral fissure

26. The criterion validity of a test is limited by which of the following:

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

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

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) Prospective Memory Training
b) Graduated Exposure
c) Priming
d) Errorless Learning

29. Double simultaneous stimulation is used to screen for ______.

a) Agnosia
b) Hyperarousal
c) Neglect
d) Ocular Apraxia

30. Which is not a neuropathological feature associated with Alzheimer’s Dementia?

a) Neuritic Plaques
b) Neurofibrillary Tangles
c) Granulovacular Bodies
d) Lewy Bodies

31. Frontal memory disorders are characterized by all but:

a) Attentional deficits interfere with encoding
b) Loss of autobiographical knowledge
c) Confabulation
d) Limited memory for temporal order of events

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

33. In pediatric patients, about ____ % of brain tumors are in the posterior fossa and ___% are supratentorial.

a) 50, 50
b) 10, 90
c) 70, 30
d) 30, 70

34. Which of the following is not a feature of Gerstmann’s Syndrome?

a) Acalculia
b) Ideational apraxia
c) Left/right confusion
d) Finger agnosia

35. Broca’s aphasia is commonly accompanied by which of the following?

a) Right hemiplegia
b) Contralateral superior quadrantanopsia
c) Gerstmann’s syndrome
d) Right visual neglect

36. Which region of the brain seems to be involved both in habit learning and in OCD?

a) Amygdala
b) Caudate
c) Hippocampus
d) Dorsolateral Prefrontal Cortex

37. Which of the following is not one of the more common symptoms or signs of elevated intracranial pressure?

a) Headache
b) Generally altered mental status, especially irritability and depressed level of alertness and attention
c) Focal cortical symptoms, such as aphasia
d) Nausea and vomiting

38. Which of the following is a potentially reversible cause of dementia?

a) Vascular Dementia
b) Traumatic Brain Injury
c) Subdural Hematoma
d) Dementia with Lewy Bodies

39. Alexia refers to:

a) The lack of development of normal reading skills.
b) Impaired auditory processing of language
c) An aquired deficit in the interpretation of written language.
d) An inability to understand spoken language.

40. Dysarthria, dysphagia and hypoactive jaw and gag reflexes without associated cognitive or emotional changes is known as:

a) Pseudobulbar palsy
b) Bulbar palsy
c) Suprabulbar palsy
d) Meniere’s Disease

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) false negative errors
b) false positive errors
c) true positive errors
d) true negative errors

42. Which of the following Wechsler scale subtests is the best indicator of premorbid intelligence?

a) Vocabulary
b) Digit Span
c) Block Design
d) Similarities

43. Practice effects are most likely to be seen on which Wechsler scale subtest?

a) Vocabulary
b) Similarities
c) Picture Completion
d) Digit Span

44. Which statement is correct?

a) In Multiple Sclerosis intellectual changes typically develop later than physical deteriorations
b) In Alzheimer’s Disease intellectual changes typically develop later than physical deteriorations
c) In Cerebrovascular Accidents (CVA’s ) physical deteriorations typically develop later than intellectual deteriorations
d) In Parkinson’s Disease, physical changes typically develop later than intellectual changes.

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 show memory retention deficits while persons with AD show retrieval deficits.
c) Persons with depression are more likely to show impaired naming ability, verbal fluency, and visuospatial ability.
d) Persons with depression may exert less effort on the performance of neuropsychological tests.

46. Which brain region is most often affected by hydrocephalus?

a) Posterior regions
b) Frontal lobes
c) Temporal lobes
d) All of these are equally affected

47. The brain’s major inhibitory neurotransmitter is _______, which is primarily affected by benzodiazepines and barbiturates.

a) Acetylcholine
c) Glutamate
d) Dopamine

48. A lesion of Brodman’s area 44 in the dominant hemisphere is most closely associated with which of the following?

a) Dysfluent aphasia
b) Diminished sensation in the right face and hand
c) Poor speech comprehension and fluent aphasia
d) Right hemispace neglect

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

50. Lesions of the temporal lobe can cause:

a) Contralateral inferior quadranopia
b) Contralateral superior quadranopia
c) Bitemporal hemianopia
d) Contralateral homonymous hemianopia

51. Gait difficulties, urinary incontinence, and cognitive decline are highly indicative of which condition?

a) Pseudotumor cerebri
b) Subdural hematoma
c) Tonsillar herniation
d) Normal pressure hydrocephalus

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

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

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) Alzheimer’s Disease
c) Parkinson’s Disease
d) Normal-Pressure Hydrocephalus
e) Multiple Sclerosis

55. A lesion of the arcuate fasciculus would most likely cause the following subtype of aphasia:

a) Wernicke’s Aphasia
b) Conduction Aphasia
c) Broca’s Aphasia
d) Global Aphasia

56. Which treatments of tumors are generally not associated with mental status changes?

a) All chemotherapies except methotrexate
b) Methotrexate, but generally not other chemotherapies
c) Cranial (whole brain) radiotherapy
d) Medications such as opiates used for pain

57. Cerebellar pathways affect all but one of the following:

a) Motor learning
b) Balance
c) Higher-order cognitive processes
d) Anosmia
e) Respiratory movements

58. Lateral cerebellar lesions primarily affect:

a) Trunk control
b) Posture and balance
c) Motor planning
d) Gait

59. Which of the following statements is true?

a) The left hemisphere has more association cortex than the right hemisphere.
b) The left hemisphere has more gray matter/less white matter relative to the right hemisphere.
c) The two hemispheres have equal amounts of gray and white matter.
d) The right hemisphere has fewer interconnections than the left hemisphere.

60. A person who can not identify an object by touch may have:

a) Anomia
b) Associative Agnosia
c) Astereognosis
d) Alexia

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

62. Which symptoms below are characteristic of normal aging:

a) Decreased verbal fluency
b) Decreased selective and sustained attention
c) Decreased working memory skills
d) Decreased “crystallized” knowledge
e) Difficulties with language comprehension
f) A & C
g) B & C

63. Neglect can occur with lesions in all of the following areas except:

a) Right internal capsule
b) Right frontal lobe
c) Right thalamus or basal ganglia
d) Right midbrain

64. The structure involved in the “master clock” for circadian rhythms is the:

a) Arcuate nucleus
b) Median eminence
c) Suprachiasmatic nucleus
d) Dentate gyrus

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

66. Infarction of the inferior portion of the pons or medulla can cause:

a) Pseudobulbar palsy
b) “Man in barrel” syndrome
c) Locked in syndrome
d) Alien hand syndrome
e) “Pie in sky” visual defect

67. ___ is the neurotransmitter primarily found in neurons of the raphe nuclei.

a) Dopamine
b) Acetylcholine
c) Histamine
d) Serotonin

68. A person with phonological alexia is most likely to make the following error:

a) Reads “ought” for “thought”
b) Reads “think” for “thought”
c) Reads “hot’ for “thought”
d) Reads “though” for “thought”

69. Which statement is true regarding the relationship between depression and dementia:

a) Depression decreases as the severity of dementia increases
b) CT and MRI reliably differentiate between depression and dementia
c) Cognitive symptoms associated with depression develop insidiously while cognitive symptoms associated with dementia develop rapidly.
d) Both depression and dementia result in similar deficits in immediate recall and recognition on memory tests.

70. Which disorder is characterized by café au lait spots and Lisch nodules?

a) Tuberous sclerosis
b) Neurofibromatosis Type 1
c) Sturge-Weber syndrome
d) Angelman’s syndrome

71. Which of the following is not a common characteristic in Tourette’s Syndrome?

a) Changing of tic locations and types
b) Waxing and waning of tics
c) Comorbidity with ADHD and/or OCD symptoms
d) Coprolalia

72. Which of the following is not commonly associated with Central Alexia (aka alexia with agraphia)?

a) Finger agnosia
b) Right hemisensory loss (e.g., right homonymous field defect)
c) Right-left confusion
d) Acalculia
e) Environmental sound agnosia (aka auditory sound agnosia)

73. Which area of the brain has been shown to be most involved in response initiation and inhibition?

a) Orbital frontal lobe
b) Dorsolateral frontal lobe
c) Medial frontal lobe
d) Caudate

74. Analysis of motion and spatial relationships between objects and between the body and visual stimuli is most likely to occur in the ________________.

a) Primary visual cortex
b) Frontal association cortex
c) Temporal-occipital association cortex
d) Parietal-occipital association cortex

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.

76. In lesions of the dominant inferior parietal lobe, centering on the angular gyrus, you would expect that the patient could:

a) Name individual letters in isolation
b) Likely have some hemisensory loss and/or right homonymous visual field deficit
c) Read nonwords
d) Write (not just copy) words

77. The pattern of “dementia with psychomotor slowing” occurs in all except which of the following disorders?

a) HIV-related dementia
b) Progressive supranuclear palsy
c) Huntington’s disease
d) Alzheimer’s dementia

78. The memory deficit typically seen in mild AD is characterized by:

a) Poor immediate repetition
b) Poor new learning and encoding of information when there is intention to learn
c) Deficits in recognition memory
d) Deficits in autobiographical memory

79. The pattern of new learning in the course of normal aging is characterized by:

a) Somewhat poorer initial learning but intact delayed recall of what they learned
b) Normal initial learning, but poor recognition memory
c) Vastly impaired initial learning with severe interference effects on delayed recall
d) Somewhat poorer initial learning with very impaired delayed recall

80. The type of memory deficit most apparent in patients with alcoholic Korsakoff amnesia is a deficit in:

a) Initial encoding of new material
b) Recall of personal information
c) Poor retrieval despite adequate encoding
d) Recognition memory

81. A right MCA stroke in the distribution of the inferior division would most likely cause:

a) Left hemineglect, decreased voluntary movements, and left-sided weakness
b) Left hemineglect, decreased tone, 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

82. What is the most likely cause for transient global amnesia?

a) Carotid artery TIA
b) Basilar artery TIA
c) Carotid artery stroke
d) Basilar artery stroke

83. Alexia without agraphia is most likely due to damage to what region(s)?

a) Infarction of left posterior artery territory including the splenium of the corpus callosum
b) Angular gyrus
c) Border zones of MCA including Broca’s area
d) Arcuate Fasciculus

84. Research has shown that right-sided brain damage can lead to subtle language deficits in all of the following except?

a) Prosody
b) Grammatical rules and structure
c) Articulation
d) Use of abstract constructs

85. Research has shown that individuals with mild cognitive impairment will develop dementia at a rate of?

a) 1-2 % per year, no different than the general population
b) <1% per year, at a lower rate than the general population
c) 25% per year, at a greater prevalence than the general population
d) 10-15% per year, at a greater prevalence than the general population

86. Which area of memory is found to be most intact in normal aging?

a) Working memory
b) Learning and Recall
c) Recognition
d) Remote memory

87. Which of the following is true about Lewy Body Dementia?

a) It presents with Parkinsonian motor symptoms but the cognitive functioning more similarly looks like Alzheimer’s dementia.
b) It is a variant of Parkinson Dementia in which Lewy Bodies are present in the substantia nigra.
c) Patients are responsive to l-dopa like Parkinson’s dementia, but are insensitive to DA blocking agents.
d) Auditory hallucinations are frequently present.

88. Confabulation is frequently seen in all but which of the following conditions:

a) Temporal Frontal Dementia
b) Primary Progressive Aphasia
c) Pick’s Disease
d) Wernicke-Korsakoff’s Syndrome

89. Which statement is false?

a) Rolandic epilepsy occurs nocturnally and is usually in remission by age 15
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) Lennox-Gastaut is a mixed seizure disorder in which the seizures are difficult to control, and status epilepticus is common.

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; retroactive interference
b) Retrograde amnesia; proactive interference
c) Anterograde amnesia; retroactive interference
d) Anterograde amnesia; proactive interference

91. Which of the following would not be expected from frontal lobe damage?

a) Acute eye deviation with persistent neglect
b) Contralateral hemiplegia
c) Anosmia
d) Acalculia

92. Which of the following is true regarding childhood leukemia?

a) Chemotherapy, such as methotrexate, does not cause cognitive impairments as it is administered intrathecally and does not pass the blood/brain barrier.
b) Whole brain and partial brain radiation therapy is equally damaging in regards to cognitive impairment.
c) Older children are comparatively more vulnerable to radiation-induced cognitive impairment than younger due to plasticity issues.
d) 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).

93. Which of the following is not an advantage of an MRI over CT?

a) MRI has greater resolution, being able to detect smaller objects
b) There is no distortion from bone
c) It detects hemorrhages and hematomas more accurately
d) It can be applied to intra- and extracranial arteries

94. Which of the following is not a typical means of determining premorbid IQ?

a) Barona Regression Equation
b) Reading Tests (e.g., NART, WRAT-3)
c) Reading Comprehension Tests (WIAT-II)
d) Demographically based regression equations

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 gender
b) The patient’s performance on memory recognition measures
c) The patient’s age
d) The patient’s FSIQ

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) Measurement error, practice effects, regression to the mean
b) Validity shrinkage, Flynn effect, multicollinearity
c) Criterion validity, internal consistency, effort
d) Test bias, discriminant validity, multiple regression

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) Glascow Coma Scale (GCS) score of 8
c) Post-Traumatic Amnesia (PTA) of 12 hours
d) Loss of consciousness of 2 hours

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) Anosodiaphoria
c) Phonagnosia
d) Auditory affective agnosia

99. Which statement is not true of Huntington’s Disease dementia:

a) severity of dementia is correlated with caudate atrophy
b) it generally begins within one year of chorea
c) it is correlated with severity of depression
d) is consistent with a subcortical dementia

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) Apperceptive Visual Agnosia
b) Prosopagnosia
c) Simultangnosia
d) Cortical blindness