1.
You are looking at the autopsied brain of a person who suffered from Alzheimer's Disease. Which of the following structural changes would best confirm his or her diagnosis?
Correct Answer
E. A, C, & D
Explanation
In addition to the structural changes listed above, Alzheimer's can also cause degeneration of the amygdala, basal nucleus of the frontal lobe, locus cereleus and raphe nucleus.
2.
You meet a new client and learn that she has cerebral palsy. Before you even read her chart, you know that she will either have occulta, meningocele, or myelomeningocele.
Correct Answer
B. False
Explanation
Occulta, meningocele, and myelomeningocele are the three kinds of spina bifida (listed here from mildest to most severe). Different kinds of cerebral palsy include spastic diplegia, hemiplegia, and complex/spastic tetraplegia.
3.
You just met a client who herniated a disk after moving heavy boxes at work. What can you tell him about his prognosis?
Correct Answer
D. There will likely be no need for surgery. The injury usually resolves itself within six weeks
Explanation
A herniated disk occurs when there is compression of a spinal disk on to the nerve root. Symptoms can include pain, numbness, and weakness. Generally, symptoms resolve without surgical intervention within six weeks.
4.
Which of the following best describes Dementia?
Correct Answer
C. A non-specific illness syndrome in which areas of cognition are impaired
Explanation
Dementia, a non-specific illness syndrome in which areas of cognition are impaired, can affect problem solving, learning, memory, orientation, and judgment, among other things. Answer "A" describes Korsakov's syndrome. Answer "B" describes Alzheimer's disease. Answer "D" describes amnesia.
5.
After a car accident, one of your clients has Brown-Sequard syndrome, which means that he has suffered a hemisection of his spinal cord. What would you expect to see in terms of his somatosensory functioning?
Correct Answer
D. All of the above
Explanation
Because the STT tract decussates at the level of the spinal cord and the DCML tract decussates in the medulla, the loss of pain and temperature (STT) will be felt contralaterally, while the loss of proprioception and discriminative touch will be felt ipsilaterally. In addition, paralysis will occur ipsilaterally in every spinal cord injury.
6.
If a client complained of dark or blurred central vision, what would you first suspect he or she might have?
Correct Answer
B. Macular degeneration
Explanation
Macular degeneration occurs when the central vision is lost or impaired. Bilateral hemianopia would involve bilateral loss of the peripheral vision field. A spinal cord injury would not necessarily be accompanied by any vision problems. Acoustic neuroma would cause problems with hearing and balance, not vision.
7.
Your client complains that although she has no visual impairments, she is unable to recognize familiar faces. You conclude that she must have alexia, a type of agnosia.
Correct Answer
B. False
Explanation
You would conclude that your client had prosopagnosia, a type of agnosia that involves the inability to recognize familiar faces. Alexia, another type of agnosia, is the inability to comprehend written language. (Agnosia is a general term for the inability to recognize or make sense of incoming information despite intact sensory abilities.)
8.
Spinal polio attacks which of the following neuroanatomical structures?
Correct Answer
D. Lower motor neuron bodies
Explanation
While bulbar polio attacks the central nervous system cell bodies, spinal polio attacks the lower motor neuron bodies. The basal ganglia and brachial plexus are not generally involved in polio.
9.
Your client's wife is confused about what caused her husband's Alzheimer's and what is happening inside his brain. You tell her that while the cause of Alzheimer's is unknown, you can tell her a little about what neural mechanisms are at work during the course of the disease. Which of the following might you mention?
Correct Answer
E. Both A & C
Explanation
Answer "B" describes a cause of Parkinson's. Answer "D" describes an injury to the visual system. In addition to options "A" and "C," you might mention decreased ACh in the basal nucleus of the frontal lobe as another neural mechanism involved in Alzheimer's.
10.
What is the etiology of Multiple Sclerosis?
Correct Answer
B. Autoimmune
Explanation
Multiple Sclerosis is an autoimmune disorder causing demyelination of the oligodendrocytes in the central nervous system.
11.
One of your clients, an eight-year old boy, has Duchenne's Muscular Dystrophy (DMD). Which of the following symptoms would he be most likely to demonstrate?
Correct Answer
E. Both A & C
Explanation
DMD causes Gower's sign (occurring when a patient must use his or her arms and hands to "walk" up from a squatting position due to lack of lower extremity strength) as well as enlarged calf muscles (due to fatty deposits, not larger muscles). A pounding headache would be a symptom of autonomic dysreflexia. Ptosis, or drooping eyelids, would not be caused by DMD.
12.
You ask your client to use a carrot scraper to peel a carrot. Instead, she appears to try to cut the carrot scraper with the carrot. What diagnosis might you
suspect she has?
Correct Answer
B. Conceptual limb apraxia
Explanation
Apraxia is defined as the inability to perform purposeful movement (in the absence of paralyis or paresis). It is most often caused by damage to the left hemisphere. In ideomotor limb apraxia, the patient is unable to carry out a motor command. In conceptual limb apraxia, the patient has difficulty using tools. In ideational limb apraxia, the patient is unable to create a plan for a specific movement and has difficulty sequencing. Dressing apaxia involves the inability to dress oneself.
13.
A person with hydrocephalus suffers from blocked circulation of cerebrospinal fluid. Fortunately, this
condition can sometimes be alleviated by the insertion of a shunt.
Correct Answer
A. True
Explanation
Hydrocephalus is a condition characterized by the blockage of cerebrospinal fluid circulation in the brain. This blockage can lead to an accumulation of fluid, causing increased pressure on the brain. Fortunately, one possible treatment for hydrocephalus is the insertion of a shunt. A shunt is a medical device that helps redirect the excess fluid to another part of the body, relieving the pressure on the brain. Therefore, the statement "A person with hydrocephalus suffers from blocked circulation of cerebrospinal fluid. Fortunately, this condition can sometimes be alleviated by the insertion of a shunt" is true.
14.
Which of the following symptoms are most commonly associated with an upper motor neuron lesion?
Correct Answer
B. Hyperreflexia
Explanation
Upper motor neuron lesions are often associated with hyperreflexia, hypertonicity, paralysis, paresis, hyperstiffness, and abnormal reflexes such as the Babinski reflex.
15.
Your client has trouble with a complex perceptual function called figure ground discrimination. Which of the following activities might she have the most trouble with?
Correct Answer
C. Picking out a black pen from a drawer full of other pens
Explanation
Your client would have trouble picking a black pen out of a drawer of other pens because figure ground discrimination allows us to differentiate foreground objects from background objects. She would have a hard time avoiding the coffee table if she had no spatial relations, and she would have difficulty discriminating between the left and right sides of her body if she had right/left discrimination problems. Remembering the route from her house to her daughter's school would require good topographical orientation.