Neurobehavioral, Psychophysiological, and Endocrine Disorders

Question 1

____ ____ ____ (___) is also known as traumatic head injury and cerebral trauma and refers to an injury to the brain that is caused by an external force and that involves temporary or permanent impairments in cognitive, emotional, behavioral, and/or physical functioning. TBI may be the result of a ____ - or ____ -____ ____.

Answer 1

Traumatic Brain Injury (TBI); Closed- or Open-Head Injury

Question 2

A ____ -____ ____ results from a nonpenetrating blow to the head and often includes injury to the brain at the site of the blow (“____ “) as well as bruising on the opposite side of the brain that occurs when the force of the blow pushes against the opposite side of the skull (“____ “). The brain may also be affected by ____ (bleeding) and ____ (collection of fluid around the damaged tissue).

Answer 2

Closed-Head Injury; Coup; Contrecoup; Hemorrhage; Edma

Question 3

A closed-head injury usually causes an ____ or ____ of ____ and some degree of ____ and ____ ____.

Answer 3

Alteration or Loss of Consciousness; Anterograde and Retrograde Amnesia

Question 4

An ____ -____ ____ occurs when the skull is penetrated (e.g., by gunshot). In contrast to a closed-head injury, an open-head injury does not usually cause a loss of consciousness and produces more ____ ____ and more highly ____ ____.

Answer 4

Open-Head Injury; Localized Damage; Specific Symptoms

Question 5

The ____ of ____ of TBI is determined by considering several factors, including the person’s initial score on the ____ ____ ____ (___), the duration of the ____ ____ (___), and the duration of the ____ of ____ (___).

Answer 5

Level of Severity; Glasgow Coma Scale (GCS); Posttraumatic Amnesia (PTA); Loss of Consciousness (LOC)

Question 6

____ ____ of ___: Cognitive deficits following TBI are common and include an ____ of ____, ____, ____ ____, and impaired speed-of-processing, attention, and executive functions.

Answer 6

Cognitive Consequences of TBI; Alteration of Consciousness, Disorientation, Memory Impairment

Question 7

____ of ____: Many (but not all) individuals with TBI experience an ____ or ____ of ____ that may last for only a few seconds to minutes or persist for a long period of time.

Answer 7

Alteration of Consciousness; Alteration or Loss of Consciousness

Question 8

Level of consciousness immediately following the injury is one of the factors that is used as a ____ of ____ and may be assessed with the Glasgow Coma Scale. It is often defined in terms of six levels: ____, ____, ____, ____, ____, and ____.

Answer 8

Predictor of Recovery; Conscious, Confused, Delirious, Obtunded, Stuporous, and Comatose

Question 9

____ is a common consequence of moderate to severe TBI and is usually the result of diffuse cerebral injury. The research has found that most patients exhibiting disorientation show a similar pattern of recovery, with orientation to ____ occurring first, followed by ____ and then ____.

Answer 9

Disorientation; Person; Place; Time

Question 10

____ ____ following TBI often includes both anterograde and retrograde amnesia. The term ____ ____ (___) is usually used to refer to post-injury anterograde amnesia, and its duration has been found to be a good predictor of the persistence of cognitive, motor, personality, and other types of symptoms caused by the injury. For example, in one study, 80% Of patients with a duration of less than two weeks experienced ____ ____ compared to only 46% of patients with a PTA duration of four to six weeks.

Answer 10

Memory Impairment; Posttraumatic Amnesia (PTA); Good Recovery

Question 11

Many patients with TBI also exhibit some degree of ____ ____ with recent memories being affected more than remote memories. For these patients, recovery of long-term memories usually involves a “____ ____ ____ “ in which the most remote memories return first.

Answer 11

Retrograde Amnesia; Shrinking Retrograde Amnesia

Question 12

____ from ___ is moderated by a number of factors including the severity of the injury and the individual’s age, gender, socioeconomic status, and pre-injury physical and mental functioning. In addition, research has linked less favorable outcomes to ____ factors, especially the presence of allele e4 on the Apolipoprotein E (ApoE) gene.

Answer 12

Recovery from TBI; Genetic

Question 13

For many patients (especially those with mild TBI), the greatest amount of recovery occurs during the ____ ____ ____, with considerable additional recovery occurring through the ____ ____.

Answer 13

First Three Months; First Year

Question 14

____ ____ (___) refers to a pattern of somatic and psychological symptoms that occur in up to 50% or more of individuals who have experienced a mild brain injury. ____ ____ ____ of ___ are headache, dizziness, nausea, blurred vision, and drowsiness. ____ ____ include insomnia and fatigue; tinnitus; cognitive impairment (especially in memory, attention, concentration, and information processing speed); and irritability, depression, or anxiety.

Answer 14

Postconcussional Syndrome (PCS); Common Initial Symptoms of PCS; Subsequent Symptoms

Question 15

The extent to which PCS is due to ____ and/or ____ ____ continues to be debated, but the experts generally agree that, in most cases, it is due to a ____ of ____. ____ ____ ____ is the primary organic factor that has been linked to PCS; while psychological factors include the individual’s ____ ____ of the injury, premorbid ____ ____, desire for ____ ____, and access to ____ ____.

Answer 15

Organic and/or Psychological Factors; Combination of Factors; Diffuse Axonal Injury; Subjective Interpretation; Personality Characteristics; Secondary Gain; Social Support

Question 16

The majority of patients with PCS fully recover within ____ to ____ ____ of the head injury, but some have ____ ____. For those whose symptoms last for more than ____ ____, symptoms may be ____.

Answer 16

One to Three Months; Persisting Symptoms; One Year; Permanent

Question 17

When using the DSM-5, a person with postconcussional syndrome would receive a diagnosis of ____ or ____ ____ ____ ____ to ____ ____ ____ when the following criteria are met: The person’s symptoms meet the criteria for Major or Mild Neurocognitive Disorder; There is evidence of a ____ ____ ____ with at least one of the following — loss of consciousness, posttraumatic amnesia, disorientation and confusion, and/or neurological singes (e.g., seizures, visual field cuts, hemiparesis); The neurocognitive disorder occurs immediately after the ____ ____ ____ or immediately after ____ of ____ and continues past the ____ ____ -____ ____.

Answer 17

Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury; Traumatic Brain Injury; Traumatic Brain Injury; Recovery of Consciousness; Acute Post-Injury Period

Question 18

A ____ ____ (___) is also referred to as a stroke and refers to a sudden or gradual onset of neurological symptoms resulting from disruption in the blood supply to the brain. There are three major causes of stroke: ____ (blockage of an artery by a blood clot), ____ (sudden blockage of an artery by material from another part of the bloodstream), and ____.

Answer 18

Cerebrovascular Accident (CVA); Thrombosis; Embolism; Hemorrhage

Question 19

The major risk factors for stroke are ____ and ____ (thickening of the lining of the arterial walls); and other factors that increase the risk include atrial fibrillation, ____ ____, diabetes mellitus, cigarette smoking, and increasing age (risk increases rapidly after age 60).

Answer 19

Hypertension and Atherosclerosis; Atrial Fibrillation

Question 20

The symptoms of stroke depend on the ____ and ____ of the ____. Regarding location, different symptoms are associated with stroke involving the ____, ____, or ____ ____ ____ (see Table 3), ____ common symptoms include ____ ____, ____ ____ involving the face, arm, and leg, and ____ ____ ____ ____ (homonymous hemianopia). In addition, dominant (left) hemisphere damage may produce ____ and ____ ____, while non-dominant (right) hemisphere damage may cause ____ ____ and ____ ____.

Answer 20

Location and Extent of the Damage; Middle, Anterior, or Posterior Cerebral Artery; Contralateral Hemiplegia; Contralateral Hemianesthesia; Contralateral Visual Field Loss; Aphasia and Ideomotor Apraxia; Contralateral Neglect and Dressing Apraxia

Question 21

____ symptoms are common after a stroke. ____ occurs most often, with depressive symptoms affecting up to 40% of patients. For some patients. depressive symptoms occur ____ ____ the stroke; but, for others, they do not occur until ____ ____ later.

Answer 21

Neuropsychiatric; Depression; Immediately Following; Several Months

Question 22

Other ____ ____ associated with stroke include anxiety, mania, apathy, pathological crying or laughter, psychosis, and dementia.

Answer 22

Neuropsychiatric Symptoms

Question 23

Stroke Symptoms and the Cerebral Artery: ____ ____ ____ – contralateral hemiplegia and hemianesthesia, contralateral homonymous hemianopia, dysarthria, aphasia (dominant hemisphere affected), apraxia and sensory neglect (nondominant hemisphere affected); ____ ____ ____ – contralateral homonymous hemianopia, memory loss, unilateral cortical blindness, visual agnosia; ____ ____ ____ – contralateral hemiplegia, gait apraxia, apathy, depression, confusion, impaired judgment and insight, bowel and bladder incontinence, mutism.

Answer 23

Middle Cerebral Artery; Posterior Cerebral Artery; Anterior Cerebral Artery

Question 24

____ of ____: Damage to the motor areas of the brain is associated with several disorders including ____ ____ and ____ ____.

Answer 24

Disorders of Movement; Huntington’s Disease and Parkinson’s Disease

Question 25

____ ____ is an inherited degenerative disease that is due to an autosomal dominant gene and is characterized by a combination of psychiatric, cognitive, and motor symptoms. Offspring of people with Huntington’s disease have a ¬_% ____ of developing the disorder, and it is usually diagnosed when individuals are between the ages of _ and _.

Answer 25

Huntington’s Disease; 50% Chance; 30 and 50

Question 26

In many Huntington’s patients, ____ and ____ symptoms appear first and include depression, apathy, anxiety, antisocial tendencies, and forgetfulness. Early motor symptoms are ____ and ____. These are followed by ____ ____ and “____ -____ movements of the ____, which are the earliest of ____ (jerky, involuntary movements of the extremities).

Answer 26

Emotional and Cognitive; Fidgeting and Clumsiness; Facial Grimaces and Piano-Playing; Fingers; Chorea

Question 27

As Huntington’s disease progresses chorea worsens and causes a characteristic “____ -____ “ ____, and ____ (slow, writhing movements) become increasingly prominent. ____ ____ ____ ____ to deficits in planning skills, problem-solving, and decision-making, and, eventually, to ____. Huntington’s disease has been linked to a ____ of ___ -____ ____ and ____ ____ in the ____ ____, especially in the caudate nucleus, putamen, and globus pallidus.

Answer 27

Dance-Like Gate; Athetosis; Cognitive Impairments Gradually Progress; Dementia; Loss of GABA-Secreting Neurons and Glutamate Excitotoxicity; Basal Ganglia

Question 28

____ ____ is due to a progressive degeneration Of dopamine-containing cells in the substantia nigra, which affects other areas of the brain that connect with these cells including certain areas in the thalamus and frontal lobes Although its cause is ____, there is evidence that exposure to ____, ____, and other ____ over an extended period of time may play a role.

Answer 28

Parkinson’s Disease; Unknown; Herbicides, Pesticides, and other Toxins

Question 29

Symptoms of Parkinson’s disease are categorized as ____ or ____: ____ ____ include tremor at rest (e.g., “pill-rolling’ between the thumb and forefinger); muscle rigidity (which causes a mask-like facial expression); and akathisia (“cruel restlessness”). ____ ____ include postural disturbances; speech difficulties; bradykinesia (slowed movement); and akinesia (a reduction or absence of spontaneous movement).

Answer 29

Positive or Negative; Positive Symptoms; Negative Symptoms

Question 30

In about 20% of individuals with Parkinson’s Disease, ____ precedes motor signs; and up to 50% experience prominent symptoms of ____ at some time during their illness. The fact that some patients develop depression as an ____ ____ provides evidence for the claim that depression is ____ to the disease rather than just a reaction to it.

Answer 30

Depression; Depression; Initial Symptoms; Endogenous

Question 31

The motor symptoms of Parkinson’s disease are initially alleviated by ____, which is a dopamine agonist (i.e., a drug that facilitates the effects of dopamine). However, because the ____ of ____ continues even with treatment, eventually there are too ____ ____ to ____ from ____, and recent treatments include ____ ____ (usually human fetal cells) into the ____ ____.

Answer 31

L-Dopa; Degeneration of Cells; Few Cells; Benefit from Dopamine; Injecting Cells; Basal Ganglia

Question 32

____ ____ (____): A ____ is due to abnormal electrical activity in the brain that causes one or more of the following symptoms: (a) an ____ that signals the onset of the seizure (e.g., a feeling, odor, or noise); (b) a ____ of ____; and (c) some type of ____ ____.

Answer 32

Seizure Disorders (Epilepsy); Seizure; Aura; Loss of Consciousness; Abnormal Movement

Question 33

The ____ of a ____ ____ involves obtaining a thorough medical history and conducting a physical exam. This is followed by an ____ (___), which is used to obtain evidence of abnormal electrical activity in the brain. In addition, CT, MRI, or other imaging technique may be used to determine if the seizures are related to a ____ ____ or other ____.

Answer 33

Diagnosis of a Seizure Disorder; Electroencephalograph (EEG); Brain Lesion; Abnormality

Question 34

There are two basic types of seizures — ____ and ____.

Answer 34

Generalized and Partial

Question 35

____ ____ are bilaterally symmetrical and do not have a focal onset. Included in this category are ____-____ and ____ ____. ____ -____ (____ ____) ____ include a tonic stage in which the muscles contract and the body stiffens; a ____ stage that involves rhythmic shaking of the limbs; and ____ (postseizure) depression or confusion with amnesia for the ictal event.

Answer 35

Generalized Seizures; Tonic-Clonic and Absence Seizures; Tonic-Clonic (Grand Mal) Seizures; Clonic; Postictal

Question 36

____ (____ ____) ____ are brief attacks involving a loss of consciousness without prominent motor symptoms. During an absence seizure, the person often exhibits a “____ ____ “ with frequent ____ ____. There is some evidence that the ____ plays a role in the generation of absence seizures.

Answer 36

Absence (Petit Mal) Seizures; Blank Stare; Eye Blinking; Thalamus

Question 37

____ ____ begin in one side of the brain and affect one side of the body initially, although they sometimes spread and become generalized seizures. There are two main types of ____ ____ — ____ ____ ____ do not involve a loss of consciousness, while ____ ____ ____ entail some alteration in consciousness.

Answer 37

Partial Seizures; Partial Seizures; Simple Partial Seizures; Complex Partial Seizures

Question 38

Partial seizures may arise in various regions of the brain but are most often due to ____ ____ ____ in one of the lobes of the ____ ____, with ____ ____ ____ being the most common cause of partial seizures.

Answer 38

Abnormal Electrical Activity; Cerebral Cortex; Temporal Lobe Epilepsy

Question 39

Symptoms associated with seizures occurring in the ____ ____ – automatisms (e.g., lip smacking, chewing, stereotyped swimming movements); hallucinations; sudden feeling of fear, happiness, sadness or other alteration in emotion; sense of déjå vu or jamais vu (feeling of familiarity or unfamiliarity, respectively, with an object or place); changes in personality; alteration in sexual behavior (e.g., hypo- or hypersexuality); autonomic signs (flushed face, pupillary dilation, changes in heart and breathing rates).

Answer 39

Temporal Lobe

Question 40

Symptoms associated with seizures occurring in the ____ ____ – motor symptoms (e.g., jerky movements in the arm or leg on the opposite side of the body); “speech arrest” (inability to talk) or other speech disturbance; olfactory hallucinations or illusions; autonomic symptoms.

Answer 40

Frontal Lobe

Question 41

Symptoms associated with seizures occurring in the ____ ____ – unusual physical sensations on the opposite side of the body (e.g., numbing, tingling, or burning).

Answer 41

Parietal Lobe

Question 42

Symptoms associated with seizures occurring in the ____ ____ – rapid eyeblinking; unusual visual phenomena (e.g., flashing lights, balls of light, strange colors in the visual field opposite the affected lobe).

Answer 42

Occipital Lobe

Question 43

____ ____ (___) is a progressive disease of the nervous system that involves a degeneration of the myelin that surrounds nerve fibers in the brain and spinal cord. MS is believed to be an ____ ____ that involves the production of antibodies that attack the body’s own ____ and can be triggered by ____, ____, or ____ ____.

Answer 43

Multiple Sclerosis (MS); Autoimmune Response; Myelin; Genetic, Viral, or Environmental Factors

Question 44

MS is more common in ____ than in ____, and its onset Is most often between the ages of _ and _. There are several types of MS. At initial diagnosis, about 80 to 85% of individuals have the ____-____ ____, which is characterized by alternating periods of ____ (acute worsening of symptoms) and ____ (partial or complete recovery). The majority of these individuals eventually convert to the ____ ____ ____, which involves a gradual worsening of symptoms without ____ ____ of relapse and remission.

Answer 44

Women; Men; 20 and 40; Relapsing-Remitting Type; Relapse; Remission; Secondary Progressive Type; Distinct Periods

Question 45

The symptoms of MS vary, depending on the location and severity of ____, but common initial symptoms are ____ ____ (which may cause eye pain and/or blurred or double vision); ____ that worsens in the ____; ____ ____ (e.g., muscle weakness, clumsiness, loss of balance); and ____ ____ such as itching, pain, or numbness in the arms, legs, face, or trunk or an “____ ____ “ that runs down the back into the legs (Lhermittes sign).

Answer 45

Demyelination; Optic Neuritis; Fatigue; Afternoon; Motor Impairments; Sensory Abnormalities; Electric Sensation

Question 46

Additional symptoms that arise as the ____ ____ include tremors; speech and swallowing problems; hearing loss; depression, anxiety, or other mood symptoms; cognitive impairment (especially deficits in attention, memory, information processing speed, and executive functions); sexual dysfunction; and loss of bladder and bowel control.

Answer 46

MS Progresses

Question 47

Some degree of ____ ____ affects _ to _% of individuals with MS; however, for most of these individuals, the impairment is ____ and may be due to ____ or other treatable factor rather than to MS. In addition, while some patients exhibit ____ ____ ____ early in the disorder, in general, the risk for ____ ____ ____ as the disease ____.

Answer 47

Cognitive Impairment; 50 to 70%; Mild; Depression; Subtle Cognitive Problems; Cognitive Dysfunction Increases; Progresses

Question 48

Traumatic brain injury (TBI) may be the result of either a closed- or open-head injury. A closed-head injury usually causes an alteration or loss of (1) ____ and some degree of anterograde and retrograde amnesia. Level of severity is often determined by considering the person’s initial score on the (2) ____ duration of (3) ____, and duration of loss of consciousness. The term posttraumatic amnesia is usually used to refer to (4) ____ amnesia.

Answer 48

(1) consciousness; (2) Glasgow Coma Scale; (3) posttraumatic amnesia; (4) anterograde

Question 49

When retrograde amnesia occurs, (5) ____ memories return first. Recovery from TBI is moderated by a number of factors but, in general, the greatest amount of recovery occurs during the first (6) ____ months. As described in the DSM-5, the diagnosis of Neurocognitive Disorder Due to Traumatic Brain Injury requires that symptoms meet the criteria for Major or Mild Neurocognitive Disorder plus evidence of a traumatic brain injury with loss of (7) ____, (8) ____, disorientation and confusion, and/or neurological signs.

Answer 49

(5) remote; (6) three; (7) consciousness; (8) posttraumatic amnesia

Question 50

Common symptoms of a stroke (cerebrovascular accident) include contralateral hemiplegia, contralateral (9) ____, and contralateral visual field loss. When the stroke involves the (10) ____ cerebral artery, symptoms may also include dysarthria, aphasia, or apraxia.

Answer 50

(9) hemianesthesia; (10) middle

Question 51

Huntington’s disease is due to an (11) ____ dominant gene and is characterized by a combination of psychiatric, cognitive, and motor symptoms. It has been linked to degeneration of (12) ____ -secreting cells and glutamate excitotoxicity in certain structures of the basal ganglia. Parkinson’s disease is due to the degeneration of (13) ____ -containing cells in the substantia nigra and involves tremor at rest, (14) ____ (“cruel restlessness”), muscle rigidity, and (15) ____ (a reduction or absence of spontaneous movement).

Answer 51

(11) autosomal; (12) GABA; (13) dopamine; (14) akathisia; (15) akinesia

Question 52

(16) ____ (grand mal) seizures involve stiffening of the body followed by rhythmic shaking of the limbs, while (17) ____ (petit mal) seizures are characterized by a loss of consciousness without prominent motor symptoms. (18) ____ seizures be4n in one side of the brain and affect one side of the body, at least initially.

Answer 52

(16) Tonic-clonic; (17) absence; (18) Partial

Question 53

Multiple sclerosis is a progressive disease of the nervous system that involves degeneration of the (19) ____ that surrounds nerve fibers in the brain and spinal cord. Initial symptoms include optic neuritis, fatigue, motor impairments, and (20) ____ abnormalities.

Answer 53

(19) myelin; (20) sensory