Disorders Questions - p. 2
31. Tremors in Parkinson's disease are typically worse when a patient is:
- A. at rest/not moving
- B. attempting to make a movement (e.g., reaching for something)
- C. they are equally prominent when at rest and when attempting to move
Show Answer
Correct answer: A
The hallmark tremor of Parkinson's disease is often referred to as a "resting tremor." This type of tremor is worse at rest (when not moving), and typically subsides when someone makes a voluntary movement (e.g., reaching for something).
32. True or false: The majority of people who experience an amputation also experience phantom limb sensations.
- A. True
- B. False
Show Answer
Correct answer: A
Phantom limb is a condition in which someone who has lost a part of their body continues to experience phantom sensations coming from that body part. Phantom sensations are thought to be experienced by almost all amputees, and most suffer from some degree of phantom pain.
33. The headache phase of a migraine is typically thought to be attributable to activation of this cranial nerve:
- A. CN V (trigeminal)
- B. CN VII (facial)
- C. CN IX (glossopharyngeal)
- D. CN X (vagus)
Show Answer
Correct answer: A
The headache phase of a migraine is thought to be attributable to activation of the trigeminal nerve, a cranial nerve that acts as the main sensory nerve for the head. The trigeminal nerve supplies a variety of pain-sensitive structures, which might explain the characteristic head and eye pain of migraine. Activation of the trigeminal nerve also prompts the release of neurotransmitters that can dilate cranial blood vessels and further stimulate and sensitize pain receptors.
34. Which of the following brain regions is thought to play a central role in the pathophysiology of Tourette syndrome?
- A. vermis
- B. hippocampus
- C. amygdala
- D. basal ganglia
Show Answer
Correct answer: D
The basal ganglia are deeply involved in motor control and inhibition, and dysfunction in these circuits is strongly associated with Tourette syndrome and other tic disorders.
35. After a stroke, a patient is able to understand language but has great difficulty speaking. She can only produce one word at a time and speaks in short, fragmented sentences. Damage to which area of the brain below is most likely responsible for her symptoms?
- A. Wernicke's area
- B. primary auditory cortex
- C. Broca's area
- D. angular gyrus
Show Answer
Correct answer: C
Broca’s area is primarily involved in speech production. Damage to this region can result in Broca’s aphasia, which is characterized by difficulty forming complete sentences and speaking fluently, despite relatively preserved language comprehension.
36. Which of the following is the primary treatment for Wernicke-Korsakoff syndrome?
- A. antipsychotic medication
- B. dopamine agonists
- C. selective serotonin reuptake inhibitors (SSRIs)
- D. thiamine (vitamin B1) supplementation
Show Answer
Correct answer: D
Wernicke-Korsakoff syndrome is most often caused by a deficiency of thiamine (vitamin B1), commonly associated with chronic alcohol use. Treatment typically involves prompt administration of thiamine to prevent or limit further neurological damage.
37. The term for a large, long-lasting depolarization followed by a train of action potentials that often precedes a seizure is:
- A. Afterhyperpolarization
- B. Paroxysmal depolarizing shift
- C. Temporal summation
- D. Depolarization block
Show Answer
Correct answer: B
A paroxysmal depolarizing shift is a hallmark of epileptiform activity in neurons. It’s characterized by a prolonged depolarization, often lasting hundreds of milliseconds, followed by a high-frequency burst of action potentials. This pattern can be recorded in neurons during seizure onset.
38. Which of the following brain structures is most closely associated with the abnormal brain activity seen in obsessive-compulsive disorder (OCD)?
- A. visual cortex
- B. medulla
- C. basal ganglia
- D. hypothalamus
Show Answer
Correct answer: C
The basal ganglia are involved in habit formation and the regulation of motor and cognitive routines. In OCD, abnormal activity in the basal ganglia is thought to contribute to the intrusive thoughts and repetitive behaviors that characterize the disorder.
39. Which of the following drugs is a dopamine precursor commonly used in the treatment of Parkinson’s disease?
- A. norepinephrine
- B. domperidone
- C. levodopa
- D. carbidopa
Show Answer
Correct answer: C
Levodopa (L-DOPA) is a precursor to dopamine that crosses the blood-brain barrier and is converted into dopamine in the brain. It is the most common treatment for Parkinson's disease.
40. The use of lobotomy as a psychiatric treatment in the mid-20th century declined rapidly after the development of which drug?
- A. lithium
- B. fluoxetine
- C. alprazolam
- D. chlorpromazine
Show Answer
Correct answer: D
Chlorpromazine, introduced in the 1950s, was the first effective antipsychotic medication. Its ability to manage symptoms of schizophrenia and other psychiatric disorders provided a safer and more effective alternative to lobotomy, leading to a dramatic decline in the use of the surgical technique.
41. What is the most common cause of spontaneous subarachnoid hemorrhage?
- A. ischemic stroke
- B. rupture of a brain aneurysm
- C. meningitis
- D. seizure
Show Answer
Correct answer: B
The most common cause of spontaneous (non-traumatic) subarachnoid hemorrhage is the rupture of a brain aneurysm.
42. Fatal insomnia is a prion disease marked by progressively worsening sleep disturbances. It involves neurodegeneration that is most pronounced in which of the brain regions below?
- A. hippocampus
- B. cerebellum
- C. thalamus
- D. amygdala
Show Answer
Correct answer: C
In fatal insomnia, damage to the sleep-promoting regions of the thalamus is thought to be especially important to causing the insomnia that occurs in the disease.
43. Which of the following neurodegenerative diseases is most strongly linked to being directly inherited from a parent?
- A. Huntington's disease
- B. Parkinson's disease
- C. Alzheimer's disease
- D. Amyotrophic lateral sclerosis (ALS)
Show Answer
Correct answer: A
Huntington’s disease is the classic example of an inherited neurodegenerative disorder. It is caused by a mutation in the HTT gene, and anyone who inherits this mutation from a parent will eventually develop the disease.
44. What is typically the main symptom of trigeminal neuralgia?
- A. Progressive facial muscle weakness
- B. Persistent numbness in the cheek and jaw
- C. Sudden, severe, stabbing facial pain
- D. Difficulty swallowing and speaking
Show Answer
Correct answer: C
Trigeminal neuralgia, also known as tic douloureux, is a disorder of cranial nerve V, the trigeminal nerve. The trigeminal nerve is the main sensory nerve for the face; it also controls motor functions of the jaw like biting and chewing. Trigeminal neuralgia is a pain disorder that causes sudden intense pain, typically on one side of the face.
45. Which of the following is considered a positive symptom of schizophrenia?
- A. blunted emotion
- B. auditory hallucinations
- C. difficulty experiencing pleasure
- D. memory deficits
Show Answer
Correct answer: B
Positive symptoms of schizophrenia involve the development of a behavior or thought pattern that isn’t normally present, such as hallucinations and/or delusions. Negative symptoms involve the loss of a normal function, and cognitive symptoms are those that affect someone’s ability to think clearly.
46. Damage to which of the following brain regions is most commonly associated with alien hand syndrome?
- A. corpus callosum
- B. hippocampus
- C. substantia nigra
- D. cerebellum
Show Answer
Correct answer: A
Although there are a number of areas of the brain that may be damaged in alien hand syndrome, some of the most common variants of the syndrome involve damage to the corpus callosum. When the corpus callosum is damaged, it may impair the ability of the left and right cerebral hemispheres to coordinate movement between limbs, and to inhibit unwanted movements in the alien hand.
47. About one-third of people with migraines experience neurological symptoms just before or during the onset of a headache. This is known as a/an:
- A. prodrome
- B. postdrome
- C. aura
- D. trigeminal activation
Show Answer
Correct answer: C
A migraine aura consists of neurological symptoms such as visual disturbances, tingling, or speech changes that occur immediately before or during the onset of a migraine headache.
48. The causes of restless legs syndrome are not fully understood, but a deficiency of this mineral in the brain is a common neurological feature of the condition:
- A. calcium
- B. magnesium
- C. zinc
- D. iron
Show Answer
Correct answer: D
The mechanisms underlying restless legs syndrome (RLS) are not well understood. Genetic factors play a large role in susceptibility, but it’s thought that in most patients environmental factors must interact with genetics to bring about the condition. The most commonly-identified environmental factor in RLS is iron deficiency, and iron deficiency in the brain is the best-known neurological feature of RLS.
49. Chronic traumatic encephalopathy (CTE) is a neurological condition linked primarily to:
- A. Autoimmune inflammation of the meninges
- B. Repeated head injuries and concussions
- C. Deficiency of dopamine in the basal ganglia
- D. Accumulation of beta-amyloid plaques in the cortex
Show Answer
Correct answer: B
Chronic traumatic encephalopathy, or CTE, is a neurological condition linked primarily to repetitive head trauma. Most cases of CTE occur in those who play sports where head injuries are common, but anyone who has experienced repeated head trauma is at risk. CTE symptoms may include: memory deficits, abnormal behavior such as paranoia, aggression and impulsivity, and mood disturbances such as depression.
50. Which of the following best describes the primary mechanical event that causes a concussion?
- A. tearing of the meninges leads to cerebrospinal fluid leakage
- B. reduction in cerebral blood flow due to a blood clot
- C. head impact or sudden movement makes the brain move within the skull
- D. compression of cranial nerves by swelling of brain tissue
Show Answer
Correct answer: C
A concussion is a type of traumatic brain injury that occurs when rapid movement of the head or an impact to the head causes the brain to move within the skull, potentially stretching axons and damaging cell membranes of neurons.
51. A patient reports having a deficit in his ability to perceive movement, where moving objects appear to “jump” from one position to another rather than moving smoothly. This condition, known as akinetopsia, is commonly linked to damage to what part of the brain?
- A. middle temporal visual area (V5)
- B. parahippocampal gyrus
- C. primary visual cortex (V1)
- D. fusiform gyrus
Show Answer
Correct answer: A
Akinetopsia, or “motion blindness,” is typically linked to damage to the middle temporal visual area, also known as visual area 5 (V5).
52. Multiple sclerosis, an immune-mediated disease that targets myelin, primarily affects the:
- A. central nervous system
- B. peripheral nervous system
- C. autonomic nervous system
- D. enteric nervous system
Show Answer
Correct answer: A
Multiple sclerosis is a central nervous system disorder that is characterized by damage to myelin, the insulatory material that surrounds the axons of neurons. This damage is linked to disruptions in healthy neuronal function, which are thought to lead to the symptoms of the disease.
53. A 70-year-old man develops right-sided weakness and difficulty speaking. Imaging shows a blood clot blocking his middle cerebral artery, causing death of brain tissue in the frontal lobe. Which type of stroke has occurred?
- A. hemorrhagic stroke
- B. ischemic stroke
- C. transient ischemic attack (TIA)
Show Answer
Correct answer: B
Ischemia is a term that refers to a reduction in blood supply to a bodily tissue, and ischemic strokes occur when blood flow to a part of the brain is blocked or restricted. This is most commonly due to a blood clot blocking a blood vessel.
54. Which of the following is an accepted treatment for Seasonal Affective Disorder (SAD)?
- A. blue-light blocking glasses worn throughout the day
- B. melatonin supplementation in the morning
- C. ketogenic diet
- D. bright light therapy
Show Answer
Correct answer: D
Bright light therapy is the most common treatment for seasonal affective disorder. Morning exposure to bright light may help to realign the circadian rhythm and improves mood symptoms in some patients.
55. Carpal tunnel syndrome is a condition caused by the compression of which nerve?
- A. median nerve
- B. ulnar nerve
- C. radial nerve
- D. carpal nerve
Show Answer
Correct answer: A
Carpal tunnel syndrome is a common condition caused by the compression of the median nerve, which carries sensations from the thumb, index finger, middle finger, and part of the ring finger—primarily on the palm side of the hand—as well as controls most of the muscles in the thumb, some muscles in the forearm that help with finger and wrist movements, and muscles in the index and middle fingers.
56. Hydrocephalus involves the abnormal buildup of which substance within the brain?
- A. blood
- B. cerebrospinal fluid
- C. lymph
- D. interstitial fluid
Show Answer
Correct answer: B
Hydrocephalus is a condition that involves the build-up of cerebrospinal fluid, or CSF, a fluid that is produced in the cavities of the brain known as the ventricles.
57. In Alzheimer’s disease, abnormal protein clusters known as amyloid plaques form primarily in which location?
- A. in the axons of neurons
- B. outside neurons in the extracellular space
- C. in the cell bodies of neurons
- D. amyloid plaques aren't associated with Alzheimer's disease
Show Answer
Correct answer: B
Amyloid plaques are extracellular deposits composed mainly of amyloid beta peptides. Although amyloid beta is produced inside neurons, it is released and aggregates outside neurons, forming plaques in the extracellular space.
58. A corpus callosotomy is typically a "last-resort" procedure to treat what condition?
- A. schizophrenia
- B. obsessive-compulsive disorder
- C. epilepsy
- D. chronic pain
Show Answer
Correct answer: C
A corpus callosotomy involves surgically cutting part or all of the corpus callosum, the major fiber tract connecting the two cerebral hemispheres. In some patients with severe, medication-resistant epilepsy, seizures rapidly spread from one hemisphere to the other through these fibers. By interrupting that pathway, the surgery reduces the spread and severity of seizures.
59. Huntington's disease is caused by a mutation in what gene?
- A. amyloid precursor protein (APP) gene
- B. huntingtin (HTT) gene
- C. tumor protein p53 (TP53) gene
- D. dystrophin (DMD) gene
Show Answer
Correct answer: B
The pathology of Huntington’s disease can be traced back to a mutation in a single gene called huntingtin. The mutation that causes Huntington’s disease is a dominant mutation. Thus, if one parent has the disease, their child has a 50% chance of developing it, too.
60. Which of the following is an accepted mechanism underlying tinnitus?
- A. a complete suppression of activity in the auditory cortex
- B. increased auditory pathway signaling to compensate for reduced cochlear input
- C. abnormal vibration of the tympanic membrane causing persistent sound perception
- D. excessive activation of vestibular hair cells
Show Answer
Correct answer: B
The mechanisms underlying tinnitus are not well understood, and likely vary from case to case. One mechanism, however, is thought to involve damage to the cochlea, which may lead to increased signaling in other auditory structures to compensate for the reduction in auditory input from the cochlea. The resultant amplification of neural noise may lead to tinnitus.
