Exam 3

Question 1

Describe what a linear transformation of raw z-scores, t-scores, and IQ scores looks like.

Are Percentiles linear or non-linear?

(Q1)

Answer 1

A linear transformation is a transformation of the form X’ = a + bX. If a measurement system approximated an interval scale before the linear transformation, it will approximate it to the same degree after the linear transformation. Other properties of the distribution are similarly unaffected.

Percentiles are non-linear transformations. That is, the amount of raw score difference between 55%-60% does not necessarily represent the same amount of raw score difference as between 94%-99%

Question 2

According to Posner & Peterson’s model of attention; the posterior attention system is responsible for _______________ whereas the anterior attention system is associated with ____________________

Answer 2

Posterior: Orienting– prioritize sensory input and locating signal sources location detection. Think: parietal=where=posterior
Anterior: signal detection / alerting. Think anterior=alerting

Alerting starts in locus coeruleus (norepi)

Question 3

The most common neurologic manifestation of HIV is:

(Q5)

Answer 3

emotional lability and delirium associated with HIV-associated dementia.

HIV can cause encephalopathy, causing HAND.

HIV Associ Neurocog Disorder (HAND): affects cognition, motor, behavior. Pt can have low concentration, memory loss, irritability, depression, slowed motor.

Question 4

Explain the difference between malingering on testing and performance related to fictitious disorder.

(Q6)

Answer 4

Malingering is intentional and motivated by an external reward. Factitious disorder is behavior motivated by an intrinsic reward such as assuming the sick role.

patients who are also motivated by an intrinsic reward can be demonstrating a negative response bias, but not a positive one.

Question 5

True or False: There a single Standard Error of Measurement for a test score, regardless of the level of performance?

(Q7)

Answer 5

False.

The “Standard Error of Measurement” (SEM) refers to the statistical estimate of how much a person’s score on a test might vary if they were to take the same test multiple times, essentially representing the degree of error inherent in a single measurement, and therefore impacting how we interpret an individual’s performance on a test compared to their “true” ability level.

A single “standard error of measurement” (SEM) is not applied across all performance levels on a test; the SEM is typically calculated for the entire test and remains relatively consistent across different performance levels, but it can vary slightly depending on the specific test design and the individual’s score

Question 6

What is considered the classic indication of normal pressure hydrocephalus? (classic triad of sx)

(Q8)

Answer 6

1. Gait disturbance
2. Dementia/mental decline
3. urinary incontinence

Headaches are worse in AM.

Question 7

What are key signs that are indicative of increased intracranial pressure?

Answer 7

Cushing’s Triad (hypertension, bradycardia, irregular respirations) = triad in sudden increase in ICP.

Breathing: shallow, slow, apnea
Headache worse in the morning, or when coughing, straining
Diplopia, blurry, or optic disc edema
Confusion, Attentional problems
Drowsy, nausea, low coordination

Question 8

What is the difference between ICP and Normal Pressure Hydrocephalus?

Answer 8

Increased cranial pressure (ICP) and normal pressure hydrocephalus (NPH) are both disorders that affect cerebrospinal fluid (CSF) circulation, but they have different causes, symptoms, and treatments

ICP is caused by elevated pressure without ventricular enlargement, while NPH is caused by CSF accumulation that leads to ventricular enlargement.

Both ICP and NPH are treated by draining CSF. ICP treatments may also include breathing support and anti-swelling medications. NPH treatments traditionally involve surgery to implant a shunt that drains excess CSF to the abdomen.
ICP symptoms include headaches, blurred vision, and vomiting. NPH symptoms include gait imbalance, urinary incontinence, and dementia

ICP is also known as idiopathic intracranial hypertension (IIH) or pseudotumor cerebri. IIH is more likely to affect obese young women, while NPH is more likely to develop in adulthood.

Question 9

The amygdale have been consistently identified as playing a crucial role in:

(Q9)

Answer 9

The perception of emotional cues and The production of emotional responses

Question 10

diencephalic amnesia versus bilateral temporal lobe amnesia

(Q10)

Answer 10

Diencephalic amnesia - Seen in Korsakoff’s = trouble with temporal order of events.

Bilateral temporal lobe amnesia has impaired factual and long-term memory, and difficulty recognizing faces. Might have problems with temporal order, but this is more characteristic of diencephalic amnesia.

BOTH have problems with anterograde amnesia, retrograde amnesia, rate of forgetting, and autobiographical memory loss.
BOTH can occur with intact intellectual and perceptual functions.

Question 11

The striatum receives most of its blood supply from the….?

(Q11)

Answer 11

Middle cerebral artery and Lenticulostriate arteries

Question 12

Statistical significance versus clinical significance

(Q12)

Answer 12

Statistical significance measures the likelihood that a research finding is due to a real effect and is a direct function of sample size, while clinical significance assesses the impact of those findings on clinical practice

Question 13

Explain a typical commissurotomy patient

If you placed a common object such as a key or pencil in the left hand and out of sight of the person… what would happen?

(Q14)

Answer 13

A commissurotomy, also known as a “split-brain” procedure, is a brain surgery that severs the corpus callosum, the area of the brain that connects the two hemispheres. This procedure is used to treat severe epilepsy in people who are unable to be controlled by anticonvulsants alone or who are not suitable for other types of surgery

The hemispheres cannot communicate in these patients, making one hand unaware of what the other is doing. And only input to the left hemisphere (i.e. the right hand) would allow verbal naming

Question 14

Bipolar I versus Bipolar II

Hypomania versus Mania

(Q15)

Answer 14

Bipolar I
People with bipolar I experience more severe manic episodes, also known as mania, and may not experience depressive episodes. Manic episodes can sometimes cause a break from reality, known as psychosis.

Bipolar II
People with bipolar II experience less severe manic episodes, known as hypomania, and at least one major depressive episode. People with bipolar II tend to have longer and more frequent depressive episodes than people with bipolar I

Hypomania
A less severe form of mania that typically lasts a few days. It can involve increased energy, talkativeness, or irritability, but it usually doesn’t significantly impact your ability to function socially or at work.
Hypomania can evolve into mania, or it can switch to depression, and the pattern isn’t predictable

Mania
A period of at least one week of abnormally elevated or irritable mood that can severely impact your ability to function. Symptoms include increased energy, talkativeness, rapid speech, decreased need for sleep, racing thoughts, and distractibility

Mania tends to require more aggressive treatment than hypomania. Treatments for both conditions include psychotherapy, medication, and self-care strategies.

Question 15

What is cortical blindness?

(Q16)

Answer 15

Cortical blindness (CB) is defined as loss of vision without any ophthalmological causes and with normal pupillary light reflexes due to bilateral lesions of the striate cortex in the occipital lobes. Cortical blindness is a part of cerebral blindness, defined as loss of vision secondary to damage to the visual pathways posterior to the lateral geniculate nuclei. Cortical blindness results from total destruction of the primary visual cortex.

Patients with cortical blindness may have blindsight in which they still have some perception outside of conscious awareness.

They can have anosognosia as in Anton’s syndrome and be unaware of their deficit.

Cortical blind patients can catch a ball and put an envelope in a slot

Question 16

What characteristic most reliably distinguishes vascular dementia from Alzheimer’s dementia?

(Q18)

Answer 16

Focal neurological findings and the presence of either diffuse or focal cognitive findings is the most reliable distinguisher for VD.

While stepwise progression is associated with vascular or multi-infarct dementia, it is not a reliable distinction from AD.

MRI in vascular dementia may show infarcts but atrophy is not specific to VD.

Consolidation deficits on memory testing are indicative of AD but encoding deficits are not considered indicative of vascular dementia. In fact, memory performance on testing is often better than seen in AD.

Question 17

Both achromatopsia and prospognosia are caused by lesions … where?

Answer 17

fusiform gyrus of the occipitotemporal cortex

The “fusiform gyrus of the occipitotemporal cortex” refers to a specific brain region located on the underside of the temporal and occipital lobes, primarily involved in high-level visual processing, particularly the recognition of complex stimuli like faces, and considered a key part of the ventral visual pathway; essentially, it’s a part of the occipitotemporal cortex known as the fusiform gyrus, which is spindle-shaped and crucial for object recognition and visual categorization.

It forms part of Brodmann area 37, along with the inferior and middle temporal gyri.

Question 18

Describe the thalamic nuclei

Answer 18

There are about 60 nucelei.
The thalamic nuclei are groups of cells in the thalamus, an egg-shaped structure in the center of the brain that relays sensory and motor information

The thalamus is divided into three groups of thalamic nuclei on each side: lateral, medial, and anterior.

Each sensory system, except for olfaction, has a thalamic nucleus that receives, processes, and sends information to the associated cortical area. For example, the lateral geniculate nucleus receives visual information from the retina and sends it to the visual cortex

https://www.youtube.com/watch?v=L8SezbBHWJI

Question 19

Sensitivity vs specificity

(Q21)

Answer 19

“sensitivity” refers to a test’s ability to correctly identify individuals who have a disease (i.e., detecting true positives)

“specificity” refers to a test’s ability to correctly identify individuals who do not have a disease (i.e., detecting true negatives).

Essentially, sensitivity focuses on catching all cases of a disease, while specificity aims to minimize false positives.

Question 20

Explain these things… and for god’s sake stop confusing them…

Retrograde amnesia

Proactive interference

Anterograde amnesia

Retroactive interference

(Q22)

Answer 20

Retrograde amnesia is a form of memory loss that causes an inability to remember events from the past

Retroactive interference is when new information makes it difficult to recall previously learned information

Anterograde amnesia is a type of memory loss that occurs when you can’t form new memories

Proactive interference is when previously learned information makes it difficult to learn or recall new information. Think: Proactive=Trial B on CVLT

Question 21

What are the primary diffuse modulatory systems in the brain, along with their associated neurotransmitters and nuclei

(Q23)- dont understand this Q

A “diffuse modulary system” is a group of neurons that influences many other neurons in the brain (AKA a nucleus)

Answer 21

Noradrenergic system:
Neurotransmitter - Norepinephrine (noradrenaline), Nucleus - Locus coeruleus

Serotonergic system:
Neurotransmitter - Serotonin (5-HT), Nucleus - Raphe nuclei

Dopaminergic system:
Neurotransmitter - Dopamine, Nucleus - Ventral tegmental area (VTA) and substantia nigra pars compacta

Cholinergic system:
Neurotransmitter - Acetylcholine, Nucleus - Basal forebrain complex (including Basal Meynert+medial spetal nucleus) + mesopontine tegmentum

Question 22

A lesion in the cerebellum will cause upper extremity tremor: ipsilateral or contralateral ?

(Q26)

Answer 22

Ipsilateral

Cerebellar circuits decussate twice before reaching the lower motor neurons. Therefore, each side of the cerebellum controls the same side of the body, not the opposite side

Trunk is more medial and extremities are lateral in cerebellum

Question 23

Describe the longitudinal course of neurocognitive impairments in individuals with schizophrenia

(Q27)

Answer 23

Measureable cognitive deficits, most often in attention, are seen prior to the first psychotic break

Deficits are moderate to severe across several domains, including attention, working memory, verbal learning and memory, and executive functions. These deficits pre-date the onset of frank psychosis and are stable throughout the course of the illness in most patients (not degenerative).

Meds don’t fix EF problems

Question 24

Atrophy associated with normal aging generally reflects a loss of:
myelin / gray matter / white matter?
(Q30)

Answer 24

Myelin

Myelin sheaths can degenerate, forming splits and balloons. This can lead to a disruption in the timing of neuronal circuits, which may contribute to cognitive decline

Question 25

what is Delusional Disorder, Erotomanic Type (Q32)

Answer 25

People with erotomania may believe that someone important or famous is in love with them, and may try to contact them or stalk them. They may also experience obsessiveness and fantasizing

Question 26

The Papez circuit refers to: (Q33)

Answer 26

Neuroanatomical structures involved in emotion and memory, including hippocampus, cingulate, mamillary bodies, fimbria, and insula MATCH Mamillary bodies Anterior Thalamic Nuclei Cingulate gyrus Hippocampus

Question 27

In reviewing a patient’s medical records prior to an assessment you notice that the patient is reported to have a deficit of the first cranial nerve (CN I). You expect the patient to: a) Perform poorly on tests requiring visual scanning and also have difficulty in recognizing friends’ voices b) Perform poorly on the Smell Identification Test, and also have difficulty with impulse control c) Perform poorly on tests involving auditorily-presented information and also have difficulty in recognizing friends’ voices d) Perform poorly on the Smell Identification Test, and also have agraphesthesia (Q34)

Answer 27

b) Perform poorly on the Smell Identification Test, and also have difficulty with impulse control BUT this confuses me... 1 is Olfactory, and its a Sensory nerve... so I picked d here... CN 1 is right next to orbitomedial PFC so if CN1 is damaged, that part of PFC may also be damaged. OFC damage can cause impulsivity. graphasthesia (recognizing letters or # written on skin) is processed in somatosensory cortex

Question 28

You are designing a longitudinal study of neuropsychological outcomes in normal adults utilizing the same test battery for 4 assessments over a 4 year span. Which of the following statements is most true regarding practice effects: a) An equal improvement in the test scores across the four assessments is expected, due to practice effects. b) The greatest improvement in test scores due to practice effects will be evident between the first and second assessments. c) The greatest improvement in test scores due to practice effects will be evident between the third and fourth assessments. d) Practice effects are unlikely if the assessments are at least one year apart (Q36)

Answer 28

b) The greatest improvement in test scores due to practice effects will be evident between the first and second assessments. ok fine.

Question 29

Describe the Flynn Effect (Q37)

Answer 29

The Flynn effect is a statistical phenomenon that describes the increase in average IQ scores over time IQ scores increase at a rate of about 0.33 points per year, or 3.3 points per decade The Flynn effect suggests that people are more likely to score higher on an older version of an IQ test than on a current version Some possible explanations for the Flynn effect include: Education: The tenor of education has changed, with more people having access to higher quality education. Access to information: The internet has made it easier to research almost any topic. Exposure to complex tasks: The world has become more complex, with new inventions and developments requiring a developed mind to understand them. Improved nutrition: The average adult in an industrialized nation is taller than a comparable adult of a century ago. However, a study from Northwestern University found evidence of a reverse Flynn effect in the United States between 2006 and 2018. In this study, scores for verbal reasoning, matrix reasoning, and letter and number series dropped, while scores for 3D rotation generally increased

Question 30

Deficits in what cognitive domain is most commonly seen in early deterioration of children with x-linked adrenoleukodystrophy? (Q38)

Answer 30

Visual-perception This is a neurodegenerative condition seen in children that typically involves cerebral demyelination. Cognitive dysfunction is generally correlated with the extent of white matter changes on MRI. Hematopoetic stem cell transplant is the most effective treatment. Visual-spatial functioning is an excellent predictor of neurocognitive function after stem cell transplant for cerebral X-ALD. See work of Elsa Shapiro; Cox et al (2006), Archives of Neurology, 63; 69-73

Question 31

The limbic system is important for _ _ , which involves this key structure ___ Which are the pairs: 4 Functions: 4 Structures (Q42)

Answer 31

The limbic system is located deep within the brain, beneath the cerebral cortex and above the brainstem.

Question 32

Procedural memory is often associated with the.... (Q43)

Answer 32

Procedural memory is considered a type of implicit memory, meaning you don't have to consciously recall the steps to perform an action, it just happens automatically The basal ganglia and cerebellum are key brain structures involved in procedural memory processing, also motor cortex in general.

Question 33

In patients in the early stages of Alzheimer’s disease, WAIS profiles usually show: a) Block Design is higher than Vocabulary b) High scores are obtained on Information, Vocabulary, and Comprehension c) High scores are obtained on digit symbol and digits backward d) Low scores are obtained on similarities and digits forward (Q44)

Answer 33

b) High scores are obtained on Information, Vocabulary, and Comprehension Early Onset AD patients displayed worsened deficits in visual perception, praxis, and executive tasks (p < 0.05) in a 2022 study. EO cases have worse prognosis. EO with APOE have worse prognosis.

Question 34

In Lewy Body Dementia, Lewy bodies are found in the ____ (Q46)

Answer 34

They can be found throughout the brain, but are particularly prevalent in the **cerebral cortex, midbrain, brainstem** Lewy bodies are primarily made up of a protein called alpha-synuclein which clumps together abnormally The presence of Lewy bodies disrupts the normal function of brain cells, leading to symptoms of Lewy Body Dementia like cognitive decline, visual hallucinations, and motor impairments

Question 35

Explain a bit about .. Progressive supranuclear palsy (PSP)

Answer 35

Progressive supranuclear palsy (PSP) is a rare neurological disorder that affects body movements, walking and balance, and eye movements. PSP is caused by damage to nerve cells in areas of the brain that control thinking and body movements. People with progressive supranuclear palsy have higher amounts of a protein called tau in the brain. Higher levels of tau cause nerve cells to die. Sometimes called Atypical Parkinsonism One of the motor neuron FTD

Question 36

Supplementary motor area partial seizures often include... (Q48)

Answer 36

Fencing posture with extension of contralateral upper extremity, tonic posturing, speech arrest and unusual sounds A supplementary motor area (SMA) seizure is a type of frontal lobe epilepsy that causes brief, sudden tonic posturing of one or more extremities. Other characteristics include: Vocalization Consciousness is initially preserved Frequent seizures, up to 10 per day Most often occur during sleep The tonic posturing is often described as a fencing posture SMA seizures are often misdiagnosed as pseudoseizures or sleep disorders. However, clinical phenomena can help distinguish between the two: SMA seizures: Short in duration, stereotypic, and often occur during sleep. They often present with a tonic contraction of the upper extremities in abduction. Pseudoseizures: Long in duration, nonstereotypic, and occur in the awake state. The supplementary motor area controls a number of functions, including: Postural stabilization, Coordination of both sides of the body, Control of internally generated movements, and Control of sequences of movements

Question 37

Ideomotor versus Ideational apraxia (Q49)- this felt strange

Answer 37

Ideomotor apraxia - think **motor** Patients have difficulty performing familiar actions on command, such as waving goodbye. They may also have trouble with spatiotemporal orientation and positioning, and their movements may be abnormal. However, they can usually recognize gestures and movements. Ideational apraxia - think **sequencing** Patients have trouble carrying out complex tasks in the correct order, such as putting on socks before shoes. They may also have difficulty organizing a list of steps to complete a task. Patients with ideational apraxia may be able to carry out individual motor acts, but they can't complete a complex motor plan. Ideomotor apraxia is more common in patients with stroke or neurodegenerative disorders

Question 38

limb kinetic apraxia

Answer 38

Limb kinetic apraxia (LKA) is a disorder that makes it difficult to perform precise, voluntary movements with the hands, arms, or legs. People with LKA may have difficulty with tasks like: Rotating a coin, Using a screwdriver, Grasping objects with a pincer, and Tapping. LKA is caused by an injury to the premotor cortex or corticofugal tract, which are parts of the brain that contain learned movement patterns. It's often associated with lesions in the left hemisphere of the brain, and it can occur alongside language impairment (aphasia). LKA is diagnosed by observing the patient's movements. Tasks used to diagnose LKA include asking the patient to imitate meaningless gestures or to pantomime meaningful gestures

Question 39

Constructional apraxia

Answer 39

**Constructional apraxia** is a neurological disorder that makes it difficult for people to copy drawings, build objects, or assemble patterns: Symptoms People with constructional apraxia have trouble drawing objects, copying figures, or building blocks or patterns with sticks. They may also have difficulty with clear handwriting or geometric designs. Causes Constructional apraxia is often caused by damage to the parietal lobe of the brain, usually from a stroke in the right hemisphere. It can also be a symptom of neurodegenerative conditions like Alzheimer's disease, Parkinson's disease with dementia, and cortical Lewy body disease. Assessment Constructional apraxia can be a useful tool for assessing patients with suspected or known neurological impairment. For example, construction tasks can be used to screen for Alzheimer's disease and monitor disease progression. Constructional apraxia is different from other types of apraxia. It reflects a loss of the ability to integrate spatial relations with the motor actions needed to complete a task

Question 40

Explain a bit about Wilson's Disease Wilson’s disease, an autosomal recessive disease of copper metabolism, has an early affinity for degeneration of the ____, resulting in _____

Answer 40

Wilson's disease is a rare genetic disorder that causes copper to build up in the body, especially in the liver, brain, and eyes. The disease is caused by a mutation in the ATP7B gene, which is responsible for transporting copper in the body. When the ATP7B gene is mutated, the body can't get rid of excess copper, which can damage organs. Striatum, tremor WD-**Liver-related** Vomiting, weakness, fluid build-up in the abdomen, swelling of the legs, yellowish skin, and itchiness WD-**Brain or neurological sx** Tremors, muscle stiffness, trouble speaking, personality changes, anxiety, and auditory or visual hallucinations

Question 41

Explain a bit about Shy Dragar Syndrome

Answer 41

Multiple system atrophy (MSA), formerly called Shy-Drager syndrome, is a rare condition of the brain and nervous system. MSA affects the body's ability to control automatic processes (body functions that you don't have to think about) such as breathing, digestion, heart rate, movement, and blood pressure

Question 42

Explain a bit about Olivo-ponto-cerebellar atophy (OPCA)

Answer 42

(OPCA) is a neurodegenerative disease that causes the gradual deterioration of nerve cells in the brain, specifically in the cerebellum, pons, and inferior olivary nucleus. OPCA is now known as **multiple system atrophy (MSA) with cerebellar subtype (MSA-C).** Symptoms of OPCA include: * Difficulty walking * Slurred speech * Abnormal eye movements * Balance problems * Clumsiness * Abnormal sweating * Bowel or bladder problems * Difficulty swallowing * Cold hands and feet

Question 43

True/False Lewy Bodies are typically found in the basal ganglia

Answer 43

false

Question 44

True/False Parkinson's sx in LBD are not normally responsive to L-dopa

Answer 44

true

Question 45

Explain a bit about Locked In Syndrome

Answer 45

Cause: typically a ventral pons lesion affecting bilateral corticospinal and corticobulbar tracts; vertical eye movements and eye opening (blinks) are spared; "spinal cord and cranial nerves receive no input from cortex" LIS patient can see, hear, smell, taste, and think.

Question 46

True/False Using ethnically corrected norms helps with test specificity

Answer 46

true

Question 47

Explain a bit about Anton's Syndrome

Answer 47

Anton-Babinski syndrome visual anosognosia (denial of loss of vision) associated with confabulation (defined as the emergence of memories of events and experiences which never took place) in the setting of obvious visual loss and cortical blindness. bilateral occip lobe damage (cortical blindness) such as bilateral PCA stroke. Other causes: MS, trauma

Question 48

True/False Cortical blindness Pts can detect facial expressions in others without realizing it

Answer 48

true this is AKA "affective blindsight"

Question 49

Statistical Power is?

Answer 49

the extent to which the study can detect a difference when a difference exists

Question 50

True/False: damage to medial temporal lobes or diencephalon can cause deficits in declarative memory

Answer 50

true

Question 51

Posner & Peterson (1990) attention model includes what 3 parts

Answer 51

1. anterior network - alerting - NorEpi 2. posterior network - orienting - Ach 3. executive control network (aka focal attention, selective attention) - Dopamine

Question 52

Dorsal versus Ventral Attention Systems

Answer 52

Dorsal: top-down, includes visual spatial orienting; frontal eye fields and superior part of parietal-occip junction Ventral: bottom-up re-orienting; includes temp-parietal junction, ventral frontal cortex

Question 53

sustained vigilance of attention is reliant on more the left or the right hemisphere

Answer 53

right Vigilance tasks rely heavily on mechanisms of the right cerebral cortex (Posner & Petersen 1990). Both classical lesion data and more recent imaging data confirm that tonic alertness is heavily lateralized to the right hemisphere.

Question 54

Progressive multifocal leukoencephalopathy (PML)

Answer 54

fatal brain demyelinating disorder caused by the human polyomavirus JC (JCV). (PML) is an opportunistic infection that develops in immunosuppressed patients with HIV.

Question 55

True/False Standard deviation of the sample must be known to calculate the Standard Error of Measurement

Answer 55

true

Question 56

True/False Confidence intervals based on the Standard Error of Measurement assume error distributions are normally distributed and homoscedastic.

Answer 56

true

Question 57

True/False Standard Error of Measurement (SEM) is inversely related to the reliability of a test, meaning that as the SEM increases, the reliability of the test decreases, and vice versa.

Answer 57

true

Question 58

What is anarithmia

Answer 58

loss of the ability to count Difficulty performing math operations Disturbances in basic concept formation and inability to acquire computational skills

Question 59

What is anomic aphasia (dysnomia)

Answer 59

Difficulty recalling words and information from memory on demand

Question 60

What is ageometria (ageometresia)

Answer 60

Problems due to disturbances in mathematical reasoning

Question 61

What is dyscalculia

Answer 61

Problems with mathematics and difficulties with problem-solving

Question 62

What is dysgraphia

Answer 62

Problems with spelling, written expression, or handwriting

Question 63

What is surface dyslexia

Answer 63

Problems with visual recognition of forms and structures of words. Phonics are okay. Sx's: Trouble reading irregular words, and may mispronounce them over-relying on pronunciation rules. Trouble spelling irregular words. Slow to read, avoids reading, trouble sight reading new words. Difficulty with whole word recognition. Trouble identifying letters that look similar but with different orientation (b for d) May read word in reverse (rat for tar) Irregular word examples: yacht, plaid, colonel, island, debt

Question 64

What is phonological dyslexia

Answer 64

Most common type of dyslexia. Deficits: Matching sounds to symbols. Sounding out words, esp unfamiliar Decoding words. Spelling (due to phonic issue) Slow reading, avoids reading

Question 65

What is deep dyslexia

Answer 65

Acquired reading disorder that causes people to make errors when reading words. Errors can be semantic, conjugational, derivational, or visual. Cannot pronounce non-words. Left hemisphere damage. For example: City may be read as town. Large is read as big. Skate is read as scale. Thing is read as think. Alcohol is read as alcoholic. Governor is read as government.

Question 66

What are 4 categories of dyslexia

Answer 66

1. primary: genetic 2. secondary: due to brain development issues in womb 3. developmental: basically both #1&2, more common in boys; term used when can't tell if 1 or 2 4. acquired: aka trauma dyslexia; has a specific cause (1&2 are harder to nail down precise cause)

Question 67

Learning difficulties assoc. w/ dyslexias

Answer 67

Left-right disorder (can be aka directional dyslexia) dysgraphia dyscalculia (can be aka math dyslexia) auditory processing disorder (can be aka auditory dyslexia)

Question 68

What is visual dyslexia

Answer 68

Trouble recalling what the eyes saw. This can affect learning how to spell or form letters because they can't remember what the word or letter looked like (shape, sequence of letters). Sx: text in and out of focus, text looks blurred, losing place in text, difficulty tracking lines of text, text appears doubled, jumping lines, eye strain or headache when reading

Question 69

What is rapid naming dyslexia

Answer 69

Problems with rapidly naming colors, numbers, letters (they are slow reading overlearned words) Linked with reading speed and processing speed for reading. sx: problems retrieving words substituting words leaving words out slow to respond orally slow to read, write use nonsense words in place of real ones use non-verbal gestures rather than speech

Question 70

What is double deficit dyslexia

Answer 70

Impaired in 2 elements of reading: 1- naming speed 2- identifying sounds in words It's a combo of rapid naming + phonological dyslexia. Not uncommon. Regarded as the most severe type of dyslexia.

Question 71

Dorsolateral frontal cortex is known for:

Answer 71

working memory cognitive flexibility planning inhibition / impulse inhibition abstract reasoning empathy cognitive control / self-control control of emotions suppressing showing strong emotions delaying gratification making utilitarian decisions / act fairly resist influence by others and make best/fair decision resolving moral dilemmas processing unfair offers in a game (ultimatum game) social decision making DLC size is reduced in antisocial/criminal/aggressive Left DLC stronger assoc w antisocial, impulsive, poor behavioral control DLC is strongly connected to posterior cortex such as parietal + motor areas of frontal lobe, which helps it regulate those regions

Question 72

What is orbito-frontal cortex known for

Answer 72

decision making emotional processing modulating reactive aggression fine tuning reward processing and decision making (seen in thoughts about food) interpreting value of a reward reality filtering learning from non-rewarding situations inhibiting socially inapprop behaviors sensory integration processing expectations OFC is connected to primary sensory cortex- DLC is not. OFC is more connected to limbic

Question 73

What is medial frontal cortex known for

Answer 73

regulate attention regulating motivation goal directed behavior initiate movement in limb/eye/speech inhibitory control habit formation learning, consolidation retrieving long-term memory complex social cognition like what others think of you processing emotion of pain Linked to apathy, akinesia, mutism; depression, anxiety, schiz, alzheimer's. Can have low insight Lesions in neighboring ACC can cause hypokinesia, akinesia, cataplexy

Question 74

Major types of seizure / classification of seizures

Answer 74

Question 75

Difference between neurofibromatosis 1 and 2

Answer 75

both are autosomal dominant. NF1 is more common NF1 cafe au lait spots, optic gliomas, bone deformity, more tumors in skin + large somatic nerves. Assoc with reduced intelligence. 15% kids get optic gliomas. 66% of optic gliomas resolve on their own. NF2: hearing loss, vision loss, balance loss, tumors in skull+spine; often vestibular

Question 76

Noonan Syndrome features

Answer 76

Think: face melting in sun at noon 90%: hypertelorism (wide set eyes) 90+%: low set, posterior rotated ears, thick outer tissue of ear hearing loss 90+%: deep philtrum short stature webbed neck low hairline at neck ptosis small lower jaw, dental issues high palate, poor tongue control lower to normal IQ but preserved verbal skills in both genders heart disease, bleeding issues, skeletal malformations autosomal dominant mutation (50% heritable) or new mutation 14 genes implicated; dx is still based on phenotype

Question 77

Heritability of Huntington's

Answer 77

autosomal dominant (not sex linked) - so 1 copy will cause expression of disease. 50% chance of expressing when 1 parent has disease. It's from CAG repeats on chrom #4 (IT-15 gene aka HTT gene); more repeats predicts worse disease and earlier onset of disease. More repeats are likely to happen when father passes the gene

Question 78

Turner Syndrome

Answer 78

only in females 45,X 45,XO females have only 1 X chrom, or are partially missing an X Turner with mosaicism is when not ALL cells have the missing X, some cells are XX and others are XO If phenotypically male then no dx is made (Sex-Determining Region on Y gets translocated to x during sperm formation, and that X is given by father which produces a XX male aka Chapelle syndrome) signs: webbed neck short low set ears low hairline at neck swollen hands/feet at birth no breasts, no periods infertile risk up for: heart defects, diabetes, hypothyroid, hearing loss, vision loss. normal IQ but problems with spatial skills, math

Question 79

Kleinfelter Syndrome

Answer 79

47,XXY males random error in cell division (not heritable genetic disorder) signs: tall small testes gynecomastia azoospermia / low sperm count loss in fertility due to low sperm count or testes malformation, some treatments show promise higher aneuploidy in their sperm (has extra chrom) lower IQ, language or reading issues many men have no sx

Question 80

Marfan's syndrome

Answer 80

SX are mild to severe autosomal dominant genetic disorder Affects connective tissue sx [sounds like Gumby]: tall, long thin limbs, short torso, arm wingspan is longer than height, long narrow face, loose joints, chest caves in or out Impaired: organs, blood vessels, bone deformities

Question 81

Neglect is considered to be a failure to respond/report or orient to novel stimuli due to .... (Q70)

Answer 81

Focal and possibly generalized lesions involving right parietal/frontal lesions

Question 82

The standard deviation of a test is equal to: a) 2 times the variance b) ½ the variance c) Variance, squared d) The square root of the variance (Q72)

Answer 82

d) The square root of the variance The standard deviation of a test is equal to the average distance of each test score from the mean score; essentially, it measures how spread out the scores are relative to the average score Variance and standard deviation are both statistical measurements that describe the spread of data in a set. Variance A measure of how spread out the numbers in a data set are from the mean and each other. Variance is the average squared deviation from the mean

Question 83

Kluver-Bucy syndrome is associated with... (Q79)

Answer 83

Nonaggressive behavior, hyper-orality and hyper-sexuality lüver-Bucy syndrome is a rare behavioral impairment that causes people to put objects in their mouths and engage in inappropriate sexual behavior. Other symptoms may include: Visual agnosia (inability to visually recognize objects) Loss of normal fear and anger responses Memory loss Distractibility Seizures Dementia Klüver–Bucy syndrome is a syndrome resulting from lesions of the medial temporal lobe,

Question 84

A lesion in the right lateral geniculate nucleus (LGN) of the thalamus, may cause... (Q81)

Answer 84

Left homonymous visual field defects A left homonymous visual field defect, also known as homonymous hemianopia, is a condition that causes a person to lose vision in the left half of their visual field in both eyes

Question 85

Motor neglect is due to.... (Q82)

Answer 85

Motor neglect is a neuropsychological condition that can occur after damage to the brain's parietal and frontal cortex, basal ganglia, internal capsule, lenticulostriate nuclei, and thalamus. The cingulum bundle, a major pathway in the medial motor system, is consistently damaged in patients with motor neglect. Is characterized by better movement in the ipsilesional rather than contralateral space Includes reluctance to move limbs on the left (limb akinesia or intentional neglect) Includes a delay in initiating movement (hypokinesia) Motor neglect, also known as hemimotor neglect, is a neuropsychological condition that occurs after damage to one side of the brain. It's characterized by the underuse of one side of the body, even though there are no issues with strength, reflexes, or sensation

Question 86

Explain a bit about Magnetic Resonance Spectroscopy (MRS) (Q84)

Answer 86

can be used to indirectly measure regional brain activity during seizures and help localize their region of onset MRS identifies metabolic changes in the epileptogenic brain, which could be used to lateralize seizure focus, detect bilateral brain abnormalities such as bilateral temporal lobe epilepsy, identify the metabolic abnormalities in the epileptic brain, assess metabolic abnormalities in the epileptogenic zone Magnetic resonance spectroscopy (MRS) is a noninvasive diagnostic technique that can help identify the seizure focus in patients with epilepsy MRS is a promising method for evaluating epilepsy patients because it has a higher sensitivity for detecting mesial temporal disease. MRS can also help detect bilateral brain abnormalities such as bilateral temporal lobe epilepsy

Question 87

Explain a bit about BOLD fMRI

Answer 87

Blood Oxygenation Level Dependent (BOLD) functional magnetic resonance imaging (fMRI) is a technique that measures brain activity by detecting changes in blood oxygen levels in the brain BOLD fMRI is used to study brain function, and is used in clinical applications such as surgical planning and monitoring treatment outcome

Question 88

Explain a bit about diffusion and perfusion MRI

Answer 88

Diffusion MRI Measures the movement of water molecules in tissue to provide information about the tissue's microstructure. This can help identify the presence of macromolecules and membranes, and the balance of water inside and outside of cells. Diffusion MRI can also help detect the effects of prolonged or severe hypoperfusion on cellular function. Perfusion MRI Uses tracers to monitor blood flow through tissues. This can help detect cerebral hypoperfusion, which can indicate potentially reversible ischemia or irreversible cellular damage. Perfusion MRI can also provide information about neoangiogenesis, vascular attenuation, and microvascular leakiness. Diffusion and perfusion MRI can be used together to provide more information about brain tumors and other conditions. For example, a combination of diffusion and perfusion MRI can help differentiate between treatment-related changes and recurrent tumors.

Question 89

Spatial agraphia versus pure agraphia

Answer 89

Peripheral visuospatial agraphia (spatial)—writing impairment due to errors of orientation to the writing instrument and/or writing surface, commonly caused by hemispatial neglect syndrome, in which the affected person is unaware of half of the page (usually the left half); there may be errors in word spacing or grouping Pure agraphia is a term used to refer to an isolated impairment of writing without an associated relevant impairment in either language ability or praxis

Question 90

Which of the following tumors would be most likely to cause bitemporal hemianopia? a. Meningioma b. Medulloblastoma c. Pituitary adenoma d. Pineoblastoma (Q92)

Answer 90

Pituitary adenoma A pituitary adenoma is a benign tumor that grows in the pituitary gland, which is located at the base of the brain. Pituitary adenomas are also known as pituitary neuroendocrine tumors (PitNETs) Bitemporal hemianopsia is a partial loss of vision in the outer half of both the right and left visual fields. It's usually caused by damage to the optic chiasm, the area where the optic nerves from each eye cross near the pituitary gland Pituitary adenomas are usually slow-growing and can be classified by their size and whether they produce hormones Symptoms of pituitary adenomas include: Headaches Vision problems Weight gain Easy bleeding or bruising Changes in bone structure Menstrual irregularities Lactation Erectile dysfunction Heat intolerance

Question 91

Receiver operating characteristic (ROC) curves are used to...

Answer 91

Determine the diagnostic accuracy of a given test or helping to determine which of two tests is more accurate for diagnosing a certain condition How it's constructed To construct an ROC curve, you calculate the TPR and FPR for each possible threshold, and then plot the TPR on the y-axis against the FPR on the x-axis. What it shows The area under the ROC curve is a summary measure that averages diagnostic accuracy across all test values. A perfect test will hug the left side of the graph and be perfectly horizontal across the top.

Question 92

apolipoprotein E-4 (ApoE-4) gene.. tell me more.

Answer 92

Apolipoprotein E4 (APOE4) is a gene that increases the risk of developing Alzheimer's disease It increases susceptibility to Alzheimer’s Disease. It is related to earlier onset of Alzheimer’s Disease. It increases susceptibility to Lewy Body Dementia. People who have two copies of the APOE4 gene, known as APOE4 homozygotes, have a 60% chance of developing AD by age 85. APOE4 homozygotes make up about 2% of the population, but account for about 15% of all AD cases The risk of developing AD varies by ancestry. For example, African Americans with APOE4 have a lower risk than people with European ancestors, while people of East Asian descent have a much higher risk