Exam #1 Flashcards
(37 cards)
- The four main stages of neural development are:
meiosis, mitosis, migration, myelination
mitosis, meiosis, differentiation, myelination
differentiation, mitosis, migration, myelination
proliferation, migration, differentiation, myelination
The Correct Answer is “D”
D. Neural development involves the stages of proliferation, migration, differentiation, and myelination. The proliferation stage includes the production of cells. Migration is the second stage of development during which the cells move or migrate to its ultimate destination in the nervous system. Following migration is differentiation, in which cells develop the unique characteristics of nerve cells. During the fourth stage, myelination, the axons of some cells become surrounded (insulated) by glial cells. Meiosis is the process of cell division that produces cells with one-half the number of chromosomes as the parent cell. Mitosis is the process of cell division that produces cells with the same number of chromosomes as the parent cell.
- Premature ejaculation is most effectively treated with which of the following medications?risperidone
fluoxetine
lithium
bupropion
The Correct Answer is “B”
B. An estimated 30 to 40 percent of the male population is affected by premature ejaculation (PE), which is categorized into two types based on onset of the problem. The most common form is primary premature ejaculation, with symptoms having been present throughout adulthood. Secondary premature ejaculation begins during adulthood in a man who hasn’t experienced the problem before and is sometimes associated with a neurological disorder. The most frequently used therapy for PE are SSRIs and some tricyclic antidepressants as it is well-established they often induce a variable delay in the ejaculatory reflex by increasing central serotoninergic transmission. Fluoxetine (Prozac) is the best choice because it is the only SSRI listed. The only other antidepressant choice in this question is bupropion (Welbutrin), which is an atypical antidepressant known for not causing the same sexual side effects as the SSRIs. In fact, there is some evidence that bupropion increases sexual responsiveness. (See: Waldinger, M.D. (2005). Lifelong premature ejaculation: definition, serotonergic neurotransmission and drug treatment. World Journal of Urology. 23:102 -108.)
41. Absence seizures are characterized by minimal motor activity (e.g., jerking of the eyelids or facial muscles) and a lack of awareness (e.g., staring unresponsive to the environment) for a brief period of time. Another name for absence seizures is: © Academic Review psychomotor seizure grand mal seizure petit mal seizure partial seizure
The Correct Answer is “C”
C. In general, seizures are divided into two main types: partial (or focal) and generalized. Generalized seizures include the absence (petit mal) and tonic-clonic (grand mal) types. Generalized tonic-clonic, or grand mal, (b.) seizures involve episodes of violent shaking, during which the person becomes stiff and blue. Absence, or petit mal, seizures are very brief (usually less than 10 seconds, but can be as long as 30) episodes of staring during which awareness and responsiveness are impaired. Absence seizures usually begin between ages 4 and 14, rarely after age 20 and in almost 70% of cases, stop by age 18. Studies indicate children that have absence seizures before 9 years of age are more likely to outgrow them than those whose seizures start after age 10 and about half of the children with absence seizures also experience infrequent generalized tonic-clonic seizures. Before an absence seizure there is no warning, often the individual doesn’t realize they’ve had one and immediately afterward are fully alert. While simple absence seizures involve just stares, many absence seizures are considered complex, which includes a change in muscle activity such as eye blinks, which is the most common. Some other common movements include hand movements (e.g., rubbing fingers together), muscle contraction or relaxation and tasting movements of the mouth. Absence seizures can resemble episodes of daydreaming and are often confused with complex partial seizures. Partial (d.) seizures usually start with uncontrollable twitching of a small part of the body and then can eventually affect the entire body. It is called a partial seizure because of how it initially develops and sometimes is called “partial seizure with secondary generalization.” Partial seizures are subdivided into simple, meaning having no alteration of consciousness, and complex partial seizures which means altering consciousness. Unlike complex partial seizures, absence seizures are of briefer duration (seconds rather than minutes), are never preceded by an aura, begin frequently and end abruptly and typically have no confusion following the seizure. Unfortunately, for treatment purposes, the most effective medications for complex partial seizures either increase the frequency of, or are ineffective against, absence seizures and the medications that prevent absence seizures have little or no effect on complex partial seizures.
- Complex Partial Seizure Disorder, formerly known as Temporal Lobe Epilepsy, is known to originate in the temporal lobe. However, absence seizures, formerly known as petit mal seizures, are believed to originate in the:cerebelum
thalamus
occipital lobe
parietal lobe
The Correct Answer is “B”
Absence or Petit Mal Seizures are very brief (30 seconds or less) and are characterized by minimal motor activity and a lack of awareness. Absence seizures usually begin in childhood and most outgrow the condition by adulthood. Researchers believe that absence seizures originate in the thalamus (the central relay station for sensory information going to the cortex).
- A split-brain patient is shown a picture of an object to his left visual field then told to pick the object out from behind a screen. Which of the following will the patient will be able to do?
pick the object with either hand
pick the object with only his left hand
pick the object with only his right hand
able to say what the object was however unable to pick it with either hand
The Correct Answer is “B”
B. The visual information about the object crosses in the patient’s optic chiasm and ends up in the right hemisphere so when the person is asked to pick out the object he will be able to correctly pick out the object because touch information from the left hand crosses over to the right hemisphere.
- Which of the following disorders is associated with individuals having amyloid plaques and neurofibrillary tangles and in some cases when advanced, dementia?Multiple sclerosis
Parkinson’s disease
Lewy body dementia
Niemann-Pick disease
The Correct Answer is “B”
B. Although Parkinson’s disease is primarily a movement disorder, many individuals with the disease also have amyloid plaques and neurofibrillary tangles like those found in Alzheimer’s Disease (AD) and some develop symptoms of dementia when the disease is advanced. It is unknown if Parkinson’s and AD may be related in a yet-unknown way or simply coexist in some people. Lewy body dementia (LBD) (c.) is one of the most common types of progressive dementia. In LBD, cells die in the brain’s cortex and the substantia nigra with many of the remaining nerve cells containing abnormal structures called Lewy bodies that are the hallmark of the disease. LBD usually occurs sporadically and individuals with LBD live an average of 7 years after symptoms begin. Symptoms include memory impairment, poor judgment, confusion, visual hallucinations, parkinsonian symptoms such as a shuffling gait and flexed posture, and day-to-day fluctuations in the severity of symptoms. Lewy bodies are often found in the brains of people with Parkinson’s and AD, suggesting that LBD may be linked with the two or the diseases may sometimes coexist in the same person. Niemann-Pick disease (d.) is a group of inherited disorders that affect metabolism. Individuals with Niemann-Pick disease cannot properly metabolize cholesterol and other lipids so excessive amounts of cholesterol accumulate in the liver and spleen and excessive amounts of other lipids accumulate in the brain. These diseases usually begin in young school-age children but may also appear during the teen years or early adulthood. Symptoms may include dementia, confusion, and problems with learning and memory.
- Tumors, head injuries, viral infection, vascular or other neurological disorders that damage the medial temporal region of the brain affect:
retrograde and anterograde memory
retrograde memory and general intellectual abilities
anterograde memory and general intellectual abilities
retrograde and anterograde memory and general intellectual abilities
The Correct Answer is “A”
A. Neurological disorders that damage the medial temporal region can cause organic amnesia. In organic amnesia, anterograde amnesia (an impaired ability to form new permanent memories) is often the outstanding cognitive impairment, though retrograde amnesia (impairment of memory for events that occurred before the onset of amnesia) can also occur. Despite the severe impairment in new learning ability, general intellectual or language abilities and short-term memory are generally intact.
- According to the Geschwind-Galaburda hypothesis, which of the following predisposes individuals to dyslexia, childhood allergies, stuttering, left-handedness, and good right-hemisphere skill?emotional conflict in early childhood
adrenal gland damage
Vitamin B deficiency
high levels of testosterone
The Correct Answer is “D”
D. The Geschwind-Galaburda hypothesis was proposed to explain sex differences in cognitive abilities by relating them to lateralization of brain function. Geschwind and Galaburda (1987) suggested that differences in the rates of maturation between the two cerebral hemispheres is mediated by circulating testosterone levels in a fetus’ developing brain and impact hemispheric dominance, with high concentrations or excessive testosterone delaying development in the left hemisphere relative to the right hemisphere and male brains maturing later than females. According to the hypothesis, beyond left-handedness, such “anomalous” hemispheric dominance is also associated with other health effects such as immune dysfunction and developmental disorders of language and speech. Although others have also hypothesized that handedness is a marker of prenatal hormonal exposures or other factors, it remains controversial. (See: Geschwind N., Galaburda A. M. (1987). Cerebral Lateralization: Biological Mechanisms, Associations, and Pathology. The MIT Press Cambridge, MA.)
- Bupropion is a form of antidepressant known as a ______.
NDRI NRI MAOI SSRI
The Correct Answer is “A”
A. Bupropion (also known as Wellbutrin and Zyban) is a norepinephrine dopamine reuptake inhibitor (NDRI) prescribed for depression, smoking cessation and, off-label, for distractability due to ADHD. Side effects include abdominal pain, constipation, decrease in appetite, dizziness, dry mouth, increased sweating, nausea, trembling, difficulty sleeping, unusual dreams and may induce pre-existing seizures or psychosis. NRIs (b.) include selective norepinephrine reuptake inhibitors (e.g., Strattera, a non-stimulant used for the treatment of ADHD), and work by blocking the reuptake of norepinephrine. Common side effects include decreased appetite, dizziness, fatigue, and irritability, and, in adults, sexual dysfunction and menstrual cramps.
- The distinction between primary and complex emotions is based on
the intensity of the emotion. whether or not the emotion results in positive or negative affect. whether or not the emotion requires self-awareness. the level of cognitive control that can be exercised over the emotion.
The Correct Answer is “C”
During the first six year of life, infants develop and express emotions that are classified as primary emotions. These are interest, joy, disgust, sadness, anger, and fear. Emotions that require self-awareness are called complex emotions. Complex emotions can be divided into those in which the self is the object of attention and do not involve self-evaluation (e.g., embarrassment, envy, and empathy) and those that require both self-awareness and self-evaluation, or the ability to compare oneself to an internal or external standard (e.g., shame, pride, guilt). Both types of complex emotions emerge between the second and third years of life.
- There is currently no treatment that prevents or stops cognitive deterioration, however medications are available that can alleviate symptoms temporarily. Currently available drugs to treat dementia, particularly AD, target which of the following?
ventricular system cholinergic system hormonal system limbic system
The Correct Answer is “B”
B. Cholinergic refers to synaptic transmission that is mediated by the release of acetylcholine. Acetylcholine (a cholinergic neurotransmitter) was the first to be implicated in Alzheimer’s and appears to be the neurotransmitter most involved, especially in early memory and attention deficits. However, serotonin, norepinephrine, and glutamate also seem to be involved but may be more important for symptoms that appear in the later stages of the disorder. Five drugs have been approved for the treatment of Alzheimer’s disease: donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne, formerly Reminyl), tacrine (Cognex), and memantine (Namenda). Donepezil, rivastigmine, galantamine, and tacrine belong to a class of drugs called acetylcholine esterase inhibitors that raise the levels of acetylcholine in the brain by blocking an enzyme that destroys acetylcholine. Tacrine is associated with severe liver problems so it is rarely used. These medications appear to temporarily improve or stabilize cognitive symptoms and memory problems for about 30 -50% of individuals with mild to moderate Alzheimer’s disease. Unlike the others, Memantine is used to treat symptoms of moderate to severe Alzheimer’s disease. Memantine works by blocking glutamate, an excitotoxin, from attaching to NMDA receptors in the brain. Research indicates excitotoxins such as glutamate may cause some of the neuron degeneration that occurs with Alzheimer’s disease.
- The hypnagogic state refers to:
the transition state of semiconsciousness between sleeping and waking the transition state of semiconsciousness between being awake and falling asleep a condition in which someone about to fall asleep, or just upon awaking, realizes that s/he is unable to move, or speak, or cry out a condition in which there is a sudden loss of partial or complete muscle tone during excitement or arousal
The Correct Answer is “B”
B. The hypnagogic state is that state between being awake and falling asleep. The hypnopompic state (a.) is between sleeping and waking. Various sensory experiences such as auditory, visual, kinesthetic and tactile hallucinations are experienced by some during these states. Sleep paralysis is a condition in which someone, about to drop off to sleep, or just upon waking from sleep realizes that s/he is unable to move, or speak, or cry out (c.). Like the previous two states, this may last from a few seconds to several minutes. Sleep paralysis with hypnagogic and hypnopompic hallucinations is commonly reported as an experience of a “sensed” presence accompanied by fear. Sleep paralysis most often has an adolescent onset and is often thought to be associated with narcolepsy. Narcolepsy is a condition in which people are overcome with irresistible sleep attacks that occur unpredictably. Another distinguishing feature of the condition is cataplexy, a sudden loss of partial or complete muscle tone during excitement or arousal (d.) Although conscious during a cataplectic episode, individuals may experience hallucinations during prolonged attacks and subsequently fall asleep.
- Which of the following is not a selective serotonin reuptake inhibitor?
clomipramine escitalopram fluoxetine paroxetine
The Correct Answer is “A”
Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed class of antidepressants in the US and many other countries. They work by inhibiting the reuptake of serotonin from the synapse and thereby increasing the level of serotonin available in the brain. They are called selective because they have a negligible effect on other neurotransmitters, such as norepinephrine and dopamine. Escitalopram (better known as Lexapro, one of its brand names), fluoxetine (Prozac), and paroxetine (Paxil) are all examples of SSRIs. Clomipramine (brand name Anafranil) is a tricyclic antidepressant. Tricyclics are believed to increase the availability of both serotonin and norepinephrine.
- Medications used to treat symptoms of Parkinson’s Disease block the effects of:
dopamine serotonin acetylcholine GABA
The Correct Answer is “C”
If you incorrectly chose “A,” remember that Parkinson’s is characterized by insufficient amounts of dopamine; thus, medical treatment seeks to increase dopamine, not block it. Another treatment strategy is to block acetylcholine receptors to help restore the normal balance between dopamine and acetylcholine. In Parkinson’s, the loss of dopamine results in a relative excess of acetylcholine. Medications aim to restore the balance by increasing dopamine and/or blocking acetylcholine receptors.
- Wernicke’s, Broca’s and conduction aphasia share which of the following difficulties?
repeating what is said word prosody reception expression
The Correct Answer is “A”
A. Difficulty repeating words just spoken and recalling the name of familiar objects are characteristic of all three disorders. Conduction aphasia is due to damage to the nerve fibers that connect Broca’s to Wernicke’s area and the most typical result is difficulty repeating what one has heard. Wernicke’s, or receptive aphasia, primarily affects comprehension which results in impairment in spoken and written language, and anomia or problems recalling words. Broca’s aphasia is characterized by difficulty expressing language, including difficulty repeating what is said.
- The person who is unable to recognize certain objects when she grasps them and is unaware of that deficit is suffering from
agnosia. ataxia. aphasia. akinesia.
The Correct Answer is “A”
Agnosia is the inability to identify something. It could be not recognizing a familiar face, a tone or sound, or not recognizing a body part when touched. If the incomprehension comes from language deficits, the usual term is aphasia. So for non-language comprehension deficits, the common term is agnosia. For instance, individuals with damage to the parietal lobe are sometimes unable to recognize objects touched with the contralateral hand. This condition is known as tactile agnosia. Ataxia refers most often to lack of muscle coordination. Akinesia refers to lack of voluntary motion, such as what occurs in some forms of catatonia.
- Starvation in Anorexia is believed to be precipitated by:
high levels of serotonin low levels of serotonin low levels of tryptophan low levels of serotonin and tryptophan
The Correct Answer is “A”
A. High levels of serotonin have been linked to both appetite suppression and anxiety while low levels have been linked to depression and appear to contribute to binge eating. Research by Kaye et al (1997) proposes that anxiety is caused by high levels of serotonin and individuals with Anorexia temporarily relieve anxiety through starvation which reduces tryptophan, which then reduces the level of serotonin. The lowered serotonin fosters a sense of calm and personal control. Inversely, low levels of serotonin are believed to precipitate binge eating in Bulimia as sweets and carbohydrates increase serotonin and elevate mood. (See: Kaye W.H., Weltzin T.E. Serotonin activity in anorexia and bulimia nervosa: relationship to the modulation of feeding and mood. Journal of Clinical Psychiatry, 1991; 52:41-58. and Kaye W.H. Serotonin function in eating disorders. Biological Psychiatry, 1997: 42:56.)
- The “temporal lobe personality” is characterized byinability to attend to details.
apathy and flat affect.
inappropriate euphoria.
paranoia and argumentativeness.
The Correct Answer is “D”
The term “temporal lobe personality” refers to a pattern of personality disturbances seen in people with lesions to the temporal lobe. Signs include an emphasis on trivial aspects of daily life, pedantic speech, perseveration of speech, paranoia, preoccupation with theological or philosophical issues, argumentativeness, and occasional aggressive outbursts. Temporal lobe lesions can be caused by a number of conditions such as stroke, brain tumors, or head trauma; in addition, signs of this personality syndrome are sometimes present in patients with temporal lobe epilepsy.
- The third and fourth stages of sleep, sometimes referred to as deep sleep is characterized by delta brain waves; however, the first stage of sleep is characterized by:alpha waves
beta waves
K-complexes
sleep spindles
The Correct Answer is “A”
Stage 1 of the sleep cycle is characterized by alpha waves which then give way to the slower theta waves. Stage 2 consists primarily of theta waves and intermittent sleep spindles and K-complexes. The 5th stage is REM sleep, which is also known as paradoxical sleep since the EEG pattern is characteristic of alertness (beta waves) but the sleeper’s responsiveness to the environment is low.
- Deficits in prospective memory is mostly likely the result of damage to which of the following areas of the brain?occipito-temporal region
parietal lobe
prefrontal region
corpus callosum
The Correct Answer is “C”
C. Prospective memory refers to the ability to remember to perform an action at a particular point in the future. For example, remembering to pick up the dry cleaning on the way home from work. It is not entirely clear which part of the brain is involved in prospective memory, but it has been hypothesized that the prefrontal cortex is most likely involved since it relates to executive functioning. It has also been suggested that the medial temporal area may play a role, however there is no evidence the occipito-temporal area (a.) is involved in prospective memory. The parietal lobe (b.) controls somatosensory functions. The corpus callosum (d.) is a bundle of nerve fibers connecting the right and left hemispheres.
- An individual with apperceptive visual agnosia would have difficulty:locating an object in space
perceiving the placement of their limbs in space
identifying familiar faces
identifying an object from an atypical view
The Correct Answer is “D”
D. Visual agnosia refers to the inability to recognize familiar objects by sight. The type of visual agnosia described in this question is referred to as apperceptive agnosia and involves an inability to recognize familiar objects, especially in low-light conditions, when there are many shadows, when objects overlap, or from an atypical view.
- An individual who produces normal sounding speech that makes little or no sense and is usually unaware of this deficit is most likely to have damage in the:cingulate sulcus
temporal lobe
corpus callosum
frontal lobe
The Correct Answer is “B”
This is a description of Wernicke’s aphasia, also known as receptive or fluent aphasia, which can be caused by damage to Wernicke’s area in the temporal lobe.
- Anticholinergic effects include all of the following EXCEPT:constipation
diarrhea
blurred vision
dizziness
The Correct Answer is “B”
Anticholinergic (side) effects occur as a result of interference with acetylcholine in the brain and peripheral nervous system. Tricyclic antidepressants and antipsychotics often have anticholinergic effects which include dry mouth, blurred vision, constipation, dizziness, urinary retention, tachycardia, and confusion.
- Benzodiazepines such as alprazolam and diazepam function asGABA agonists.
GABA antagonists.
serotonin agonists.
serotonin antagonists.
The Correct Answer is “A”
Benzodiazepines are a class of anti-anxiety drugs that include alprazolam (brand name Xanax), diazepam (Valium), Flunitrazepam (Rohypnol), and Lorazepam (Ativan). Benzodiazepines act by enhancing the effects of the neurotransmitter GABA. A drug that increases the effects of a particular neurotransmitter is called an agonist for that transmitter. GABA is an inhibitory neurotransmitter; i.e., it inhibits neurons from firing and therefore has a general quieting effect on the brain.
