Disorders Questions - p. 3
61. What is the most common neurodegenerative disease?
- A. Alzheimer's disease
- B. Parkinson's disease
- C. multiple sclerosis
- D. Huntington's disease
Show Answer
Correct answer: A
Alzheimer's disease is the most common neurodegenerative disease. It affects around 55 million people in the world, and accounts for roughly 60-70% of all cases of dementia.
62. A patient suffers a stroke and afterward is able to speak fluently, but her speech consists largely of nonsensical and made-up words. She also has significant difficulty understanding spoken language. What is this type of language disorder called?
- A. global aphasia
- B. Wernicke's aphasia
- C. anomic aphasia
- D. Broca's aphasia
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Correct answer: B
Wernicke’s aphasia is characterized by fluent but meaningless speech, often containing made-up or inappropriate words, along with impaired comprehension of spoken language. It is most commonly associated with damage to Wernicke’s area, often due to stroke.
63. A child is born with a congenital defect that blocks the right interventricular foramen. Which ventricle or ventricles would enlarge due to cerebrospinal fluid buildup?
- A. the right lateral ventricle
- B. both lateral ventricles
- C. the third ventricle
- D. the fourth ventricle
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Correct answer: A
Obstruction of the right interventricular foramen prevents cerebrospinal fluid from flowing from the right lateral ventricle into the third ventricle. As a result, cerebrospinal fluid accumulates proximal to the blockage, causing enlargement of the right lateral ventricle only, while the other ventricles remain normal in size.
64. Chronic traumatic encephalopathy (CTE) is characterized by the abnormal accumulation of which misfolded protein as its primary neuropathological hallmark?
- A. tau
- B. beta-amyloid
- C. alpha-synuclein
- D. prion protein
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Correct answer: A
CTE is classified as a tauopathy; it is defined by the accumulation of hyperphosphorylated tau in neurons and other cells like astrocytes to form abnormal clusters or aggregates.
65. Which of the following is NOT typically classified as a prion disease?
- A. variant Creutzfeldt-Jakob disease (vCJD)
- B. fatal insomnia
- C. kuru
- D. Huntington's disease
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Correct answer: D
While mutant huntingtin protein may display "prion-like" behavior, Huntington's disease is not considered a prion disease.
66. A 19-year-old college student presents to the ER with a severe headache, high fever, confusion, and neck stiffness. After an assessment, the physician immediately starts intravenous antibiotics and orders a lumbar puncture. What condition does the physician seem to most strongly suspect?
- A. subarachnoid hemorrhage
- B. bacterial meningitis
- C. epidural hematoma
- D. ischemic stroke
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Correct answer: B
Meningitis is an inflammation of the meninges (the membranes that surround the brain and spinal cord). The most severe cases of meningitis tend to involve bacterial infections, and symptoms include headache, neck stiffness, fever, and altered mental status.
67. Which of the following is a common treatment for Alzheimer's disease?
- A. L-DOPA
- B. amphetamines
- C. NMDA receptor agonists
- D. acetylcholinesterase inhibitors
Show Answer
Correct answer: D
The most common treatments for Alzheimer’s disease involve drugs that inhibit the activity of acetylcholinesterase, an enzyme that breaks down the neurotransmitter acetylcholine. The drugs, called acetylcholinesterase inhibitors, increase levels of acetylcholine, which is thought to promote healthy cognition and memory.
68. Methamphetamine is FDA-approved in the United States to treat which psychiatric condition?
- A. depression
- B. ADHD
- C. panic disorder
- D. obsessive-compulsive disorder
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Correct answer: B
Methamphetamine is approved by the FDA for the treatment of ADHD, and was commonly prescribed (as Desoxyn) in the 1960s to early 1970s to treat pediatric hyperactivity before tighter controls on the medication in 1971 led to a drastic decline in use.
69. Which of the following is an accepted mechanism underlying tinnitus?
- A. cochlear damage causing compensatory hyperactivity in auditory pathways
- B. complete loss of activity in the auditory cortex
- C. excessive earwax directly stimulating auditory nerve firing
- D. increased blood flow to the cochlea producing phantom sounds
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Correct answer: A
The mechanisms underlying tinnitus are not well understood, but it’s thought that hearing loss might be linked to tinnitus in a number of ways. Damage to the cochlea, for example, may lead to increased signaling in other auditory structures to compensate for the reduction in auditory input from the cochlea, and the resultant amplification of neural noise may lead to tinnitus.
70. Which of the following best describes the primary neural mechanism underlying a concussion?
- A. death of neurons caused by prolonged oxygen deprivation
- B. axon stretching and neuronal damage due to brain movement within the skull
- C. accumulation of cerebrospinal fluid leading to increased intracranial pressure
- D. degeneration of dopamine-producing neurons in the basal ganglia
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Correct answer: B
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.
71. Which type of seizure begins in a localized region of one cerebral hemisphere, but can spread to involve additional brain areas?
- A. absence seizure
- B. generalized (tonic-clonic) seizure
- C. focal (partial) seizure
- D. myoclonic seizure
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Correct answer: C
In seizures called focal seizures, excessive neural activity begins in one specific area of the brain called the seizure focus, but it can also propagate to other areas of the brain.
72. Which of the following best describes the defining difference between a transient ischemic attack (TIA), also known as a "mini-stroke," and a stroke?
- A. a TIA causes mild symptoms, while a stroke causes more severe symptoms
- B. a TIA does not cause lasting damage to the brain, while a stroke does
- C. a TIA only affects small blood vessels, while a stroke affects larger vessels
- D. a TIA occurs in individuals under the age of 45 only
Show Answer
Correct answer: B
The defining difference between a TIA and an actual stroke is that TIAs do not result in a brain infarct, or death of brain tissue, while a true stroke does.
73. Which of the following neurodegenerative diseases specifically targets and causes the degeneration of motor neurons?
- A. Parkinson's disease
- B. Alzheimer's disease
- C. amyotrophic lateral sclerosis (ALS)
- D. Huntington's disease
Show Answer
Correct answer: C
ALS is a neurodegenerative disorder, meaning it is characterized by the degeneration and death of neurons. Specifically, the affected neurons in ALS are upper and lower motor neurons. Upper motor neurons extend from the cerebral cortex or brainstem and carry motor information down to the spinal cord. Lower motor neurons extend from the spinal cord or brainstem to skeletal muscle to cause movement.
74. Many symptoms of Parkinson’s disease are caused by dopamine deficiency, yet patients are treated with L-DOPA rather than dopamine itself. Why isn’t dopamine administered directly?
- A. dopamine is converted into serotonin in the bloodstream
- B. dopamine causes excessive activation of motor neurons in the spinal cord
- C. dopamine cannot cross the blood-brain barrier, but L-DOPA can
- D. dopamine is less potent than L-DOPA at activating dopamine receptors
Show Answer
Correct answer: C
While dopamine administered as a drug cannot pass the blood-brain barrier to enter the brain, L-DOPA can, and this characteristic has helped to make L-DOPA the most common treatment for Parkinson’s disease.
75. Which of the following is a cell type that a glioma would most likely originate from?
- A. astrocyte
- B. neuron
- C. Schwann cell
- D. meningeal cell
Show Answer
Correct answer: A
Gliomas are a category of brain tumors that begin in glial cells. The most common glioma is astrocytoma, which arises from the glial cells called astrocytes.
76. A patient presents with numbness and tingling in the thumb, index finger, and middle finger, along with decreased grip strength. The patient is diagnosed with carpal tunnel syndrome. Which nerve is most likely affected?
- A. ulnar nerve
- B. radial nerve
- C. axillary nerve
- D. median nerve
Show Answer
Correct answer: D
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.
77. A patient presents with a sudden, severe “worst headache of their life.” Imaging confirms rupture of a saccular (berry) aneurysm in the Circle of Willis. Which type of brain hemorrhage most commonly results from this event?
- A. epidural hemorrhage
- B. subdural hemorrhage
- C. subarachnoid hemorrhage
- D. intraparenchymal hemorrhage
Show Answer
Correct answer: C
Subarachnoid hemorrhage can be caused by a variety of conditions, but the most common and severe cases typically result from the rupture of a brain aneurysm. Subarachnoid hemorrhage usually begins suddenly, with a severe headache that develops within seconds, sometimes referred to as a thunderclap headache.
78. Which of the following best describes deep brain stimulation (DBS)?
- A. surgical removal of brain tissue to reduce symptoms
- B. electrodes implanted in the brain deliver controlled electrical stimulation
- C. magnetic fields applied outside the skull alter brain activity
- D. drugs delivered through the bloodstream to affect the brain
Show Answer
Correct answer: B
Deep brain stimulation is a neurosurgical approach that involves the use of brain-implanted electrodes to treat a variety of neurological and psychiatric conditions. It is primarily used to treat Parkinson’s disease, but has also been approved by the FDA for use in treating epilepsy and obsessive-compulsive disorder, and is being studied as a potential treatment for a number of other disorders.
79. Fatal insomnia is a neurodegenerative prion disease that only occurs when the mutated prion protein gene is inherited from a parent.
- A. True
- B. False
Show Answer
Correct answer: B
Fatal insomnia is a very rare terminal condition characterized by difficulty sleeping that becomes progressively worse over time. Although the disease is typically genetic in origin, sporadic cases without a clear genetic basis have also been documented. Thus, the statement is false.
80. Neurofibrillary tangles are a common feature of Alzheimer's disease pathology. They consist of clusters of misfolded tau protein that form:
- A. inside neurons
- B. outside neurons
- C. inside glial cells
- D. both inside and outside neurons
Show Answer
Correct answer: A
Tau protein is normally found inside neurons and involved in maintaining neuronal structure. It is found in a misfolded state in Alzheimer’s, and it accumulates inside neurons in clusters called neurofibrillary tangles.
81. If one parent has Huntington's disease, what is the probability that their child will inherit the disease-causing mutation?
- A. 0.25
- B. 0.37
- C. 0.5
- D. 0.75
Show Answer
Correct answer: C
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-causing mutation, their child has a 50% chance of inheriting it.
82. Which of the following neurotransmitters is often implicated in ADHD, partly because many of the medications used to treat the disorder increase its levels in the brain?
- A. acetylcholine
- B. histamine
- C. dopamine
- D. GABA
Show Answer
Correct answer: C
Dopamine is often implicated in ADHD because medications that are commonly used to treat the condition, such as amphetamine and methylphenidate, cause increased transmission of dopamine and norepinephrine.
83. Which of the following is a subtype of frontotemporal dementia (FTD)?
- A. Lewy body dementia
- B. posterior cortical atrophy
- C. vascular dementia
- D. nonfluent variant primary progressive aphasia
Show Answer
Correct answer: D
Frontotemporal dementia, or FTD, is a term used to describe a collection of related brain disorders that involve the neurodegeneration of the frontal and temporal lobes. The three main subtypes of FTD are: behavioral variant FTD, semantic variant primary progressive aphasia, and nonfluent variant primary progressive aphasia.
84. What is the name of the abnormal protein aggregates that are most commonly associated with Parkinson's disease?
- A. neurofibrillary tangles
- B. Pick bodies
- C. Lewy bodies
- D. amyloid plaques
Show Answer
Correct answer: C
Protein aggregates in Parkinson's disease are known as Lewy bodies, named after Fritz Lewy, who discovered them in 1910.
85. Hydrocephalus occurs when cerebrospinal fluid accumulates in the:
- A. thalamus
- B. spinal cord
- C. ventricles
- D. brainstem
Show Answer
Correct answer: C
Hydrocephalus is a condition that involves the accumulation of cerebrospinal fluid (CSF) in the ventricles. It can occur due to excess production of CSF, impaired reabsorption of CSF into the bloodstream, or a blockage in the ventricular system that causes CSF to accumulate.
86. How is hydrocephalus typically treated?
- A. With drugs that increase the production of cerebrospinal fluid (CSF)
- B. With a device called a shunt that drains CSF from the ventricles
- C. By reducing fluid intake to reduce the amount of CSF produced
- D. There is no accepted treatment for hydrocephalus
Show Answer
Correct answer: B
A cerebral shunt is the most common treatment for hydrocephalus. A shunt system consists of a plastic tube connected to a valve and a catheter. One end of the catheter is placed in a ventricle where CSF is accumulating, and the other is typically placed in the abdominal cavity. The shunt diverts CSF to the abdominal cavity, where it can safely drain and be absorbed into the bloodstream.
87. A woman sustains a spinal cord injury that completely damages the right half of her cervical spinal cord at C6. Which of the following deficits would she most likely exhibit?
- A. loss of pain and temperature sensation on the right side below the injury
- B. loss of tactile discrimination on the right side below the injury
- C. weakness or paralysis on the left side below the injury
- D. loss of proprioception on the left side below the injury
Show Answer
Correct answer: B
Damage to the right half of the spinal cord disrupts the dorsal column pathway (which is responsible for tactile discrimination, vibration, pressure, and proprioception) before it decussates, leading to loss of these sensations on the right (ipsilateral) side below the injury.
88. Which of the following structures/systems is most commonly affected in cases of vertigo?
- A. olfactory cortex
- B. vestibular system
- C. motor cortex
- D. auditory cortex
Show Answer
Correct answer: B
The vestibular system, which includes structures in the inner ear and their connections to the brain, plays a key role in balance and a sense of stability. Vertigo is typically associated with a disruption in function of either the vestibular system or one of the regions it communicates with to maintain our sense of balance.
89. Type 1 narcolepsy is most strongly associated with which pattern of orexin (hypocretin) levels?
- A. high orexin levels
- B. low orexin levels
- C. normal orexin levels
Show Answer
Correct answer: B
Narcolepsy type 1 is linked to a loss of orexin-producing neurons in the hypothalamus, leading to low orexin levels. Orexin neurons have an excitatory effect on several regions of the brain that are involved in promoting wakefulness and suppressing REM sleep. Thus, the loss of these neurons leads to deficiencies in maintaining wakefulness and is linked to the dysregulation of REM sleep.
