Major Neurocognitive Disorder and the role of Frontal Subcortical Circuits in Neuropsyhciatry and Neuropsychology

Question 1 of 129

1

The progressive loss of dopamine neurons between the substantia nigra and striatum is associated with which type of dementia?

Select one of the following:

Parkinson's
Alzhiemer's
Vascular Dementia
Mild Cognitive Impairment

Explanation

Question 2 of 129

1

The loss of dopamine neurons in the Basal Ganglia disease affects which subcortical circuit?

Select one of the following:

Direct motor pathway
Indirect motor pathway
Both Indirect and Direct motor pathways are affected

Explanation

Question 3 of 129

1

Which of the following are symptoms of Parkinson's Disease?

Select one or more of the following:

Difficulty distinguishing between smells, or loss of sense of smell.
Mood changes such as Apathy, Depression and Anxiety.
Autonomic dysfunction causing constipation
Sleep disturbances
Rigidity, Resting Tremor and Bradykinesia
Dyskinesia
Seizures
Smooth movement
Feeling unstable, postural difficulities

Explanation

Question 4 of 129

1

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Depression occurs in approximately ( 50%, 10%, 80% ) of Parkinson's patients.

Explanation

Question 5 of 129

1

Which statement best describes the genetic component of Parkinson's

Select one of the following:

Parkinson's is a highly heritable disease, the presence of certain genes is predominant predictor.
Parkinson's is a highly heritable disease, in which several dominant type genes predict the development of parkinson's
Parkinson's is a highly heritable disease, in which several ressesive type genes predict the development of parkinson's
Genetics explain about 15% of the incidence of Parkinson's. There are 2 rare dominant gene mutations and several recessive mutations.

Explanation

Question 6 of 129

1

Definite diagnosis of Parkinson's is possible post mortem, if depigmentation is observed in the substantia nigra.

Select one of the following:

True
False

Explanation

Question 7 of 129

1

Autonomic dysfunction, depression, memory complaints, and Bradykinesia that develops gradually over time, rather than within a year is suggestive of:

Select one of the following:

Parkinson's Disease
Lewy Body Dementia
Alzhiemer's

Explanation

Question 8 of 129

1

The one year rule regarding Lewy Bodies Dementia and Parkinson's:

Select one of the following:

If motor and cognitive disturbances that develop in less than one year is likely to be Lewy Body Dementia rather than Parkinson's.
If motor and cognitive disturbances that develop gradually over more than one year is more likely to be Lewy Body Dementia rather than Parkinson's.

Explanation

Question 9 of 129

1

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Frontal subcortical circuits are effector mechanisms that allow the organism to act on the environment. Impaired executive functions, apathy, and impulsivity are hallmarks of frontal subcortical circuit dysfunction. The ( dorsolateral prefrontal, anterior cingulate, orbitofrontal ) circuit allows the organization of information to facilitate a response; the ( anterior cingulate, dorsolateral prefrontal, orbitofrontal ) circuit is required for motivated behavior; and the ( orbitofrontal, anterior cingulate, dorsolateral prefrontal ) circuit allows the integration of limbic and emotional information into behavioral responses.

Explanation

Question 10 of 129

1

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( Parkinson's, Alzheimer's, Huntington's ) is the world's 2nd most common neurodegenerative disease

Explanation

Question 11 of 129

1

Bradykinesia refers to:

Select one of the following:

Slowed movement
Rigitity
Tremor
Stooped posture

Explanation

Question 12 of 129

1

Fill the blank space to complete the text.

The gait associated with is characterized by a forward stooped posture, diminished or absent arm swing and slow shuffling steps, with difficulty starting to walk and once walking, difficulty stopping.

Explanation

Question 13 of 129

1

Which of the following describes the speech and writing characteristic of Parkinson's disease

Select one of the following:

Writing acquires a cramped, micrographic and jerky appearance. Speech is commonly dysarthric; monotonal, low volume and variable speech speeds such that words may rush out one moment, then be halting and slow the next.
Writing acquires a cramped, micrographic and jerky appearance. Speech is commonly aphasic; nonsense babbling with fluent production and normal prosody
Writing is usually unaffected. Speech is commonly dysarthric; monotonal, low volume and variable speech speeds such that words may rush out one moment, then be halting and slow the next.

Explanation

Question 14 of 129

1

Parkinsonism refers to a

Select one of the following:

Disease
Syndrome
Early onset phase of Parkinson's Disease

Explanation

Question 15 of 129

1

Which of the following best describes the Risk factors associated with Parkinson's disease?

Select one of the following:

Repeated TBI
Men > Women
People regularly exposed to pesticides (Farmers and Agricultural Worker)
Regular Inhalation of Heavy Metals
Smokers < Non-Smokers
Coffee Drinkers < Non-Coffee drinkers
Repeated TBI
Men < Women
People regularly exposed to pesticides (Farmers and Agricultural Worker)
Regular Inhalation of Heavy Metals
Smokers > Non-Smokers
Coffee Drinkers < Non-Coffee drinkers
Single TBI
Men > Women
People regularly exposed to pesticides (Farmers and Agricultural Worker)
Fans of Heavy Metal music
Smokers > Non-Smokers
Coffee Drinkers > Non-Coffee drinkers
Repeated TBI
Men > Women
People regularly exposed to pesticides (Farmers and Agricultural Worker)
Regular Inhalation of Heavy Metals
Smokers > Non-Smokers
Coffee Drinkers > Non-Coffee drinkers

Explanation

Question 16 of 129

1

Parkinson's involves which of the following?

Select one or more of the following:

Dopminergic system
Noradrenergic system
Serotonergic system
Cholinergic system

Explanation

Question 17 of 129

1

Parkinson's Disease may begin two or more decades before the first symptoms develop.

Select one of the following:

True
False

Explanation

Question 18 of 129

1

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Progression of ( Parkinson's disease, Delirium, Lewy Bodies Dementia, Creutzfeld Jacob’s disease ) tends to be slow with most patients surviving ten to 15 years after first symptoms are noticed.

Explanation

Question 19 of 129

1

The majority of Parkinson's patients survive beyond 75 years

Select one of the following:

True
False

Explanation

Question 20 of 129

1

Earlier disease onset, tremor dominant, non-tremor dominant and rapid disease progression with dementia ar sub groups of

Select one of the following:

Alzheimer's
Vascular Dementia
Creutzfeld Jacob’s Disease
Parkinson's

Explanation

Question 21 of 129

1

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Select the appropriate incidence of each of the following Parkinson's subtypes:
Earlier disease onset ( 25%, 31%, 35%, 8% )
Tremor dominant ( 31%, 25%, 8%, 70% )
Non-tremor dominant ( 35%, 25%, 8%, 70% )
Rapid disease progression with dementia ( 8%, 60%, 25%, 31% )

Explanation

Question 22 of 129

1

Which subtype of Parkinson's disease has the slowest progression in terms of cognitive decline?

Select one of the following:

Earlier disease onset
Tremor dominant
Non-tremor dominant
Rapid disease progression with dementia

Explanation

Question 23 of 129

1

When using the Unified Parkinson's Disease Rating Scale (UPDRS) a higher scores represents

Select one of the following:

a higher level of functional disability
a higher level of functional independence

Explanation

Question 24 of 129

1

Diagnosis of Parkinson's disease is confirmed as INCORRECT in one fourth of autopsied cases.

Select one of the following:

True
False

Explanation

Question 25 of 129

1

Which of the following disorders closely resemble Parkinson's Disease?

Select one or more of the following:

Progressive supranuclear palsy
Corticobasal degeneration
Vascular Parkinsonism

Explanation

Question 26 of 129

1

Which of the following represent the early signs of Parkinson's Disease

Select one of the following:

Tremor, Rigidity, Bradykinesia, Posture
Complete loss, or less sensitive sense of smell. Numbness and Coldness.
Cognitive Decline, Posture, Loss of Balance
Loss of Balance alone

Explanation

Question 27 of 129

1

The cognitive deficits typical of the early stages of Parkinson's are most similar to

Select one of the following:

those that occur with frontal lobe damage: difficulties switching or maintaining a set in the presence of feedback, initiating responses, goal directed behaviour.
those that occur with temporal lobe damage: difficulties with recognition, orientation and digit span, but spared implicit learning
those that occur with occipital lobe damage: difficulties switching or maintaining a set in the presence of feedback, initiating responses, goal directed behaviour.
those that occur with frontal lobe damage: difficulties with recognition but spared implicit learning

Explanation

Question 28 of 129

1

Vocabulary, grammar, and syntax tend to remain intact in PD

Select one of the following:

True
False

Explanation

Question 29 of 129

1

Diagnosis of depression in Parkinson's patients can be complicated by the presence of bradykinesia. Bradykinetic patients can lack facial expressiveness giving off the impression of depression, in addition to reduced motor activity and slowed responding. This is further compounded by the unreliability of self-reports in patients who are cognitively impaired.

Select one of the following:

True
False

Explanation

Question 30 of 129

1

Depression in Parkinson's Disease tends to respond well to conventional medication used to treat idiopathic depression.

Select one of the following:

True
False

Explanation

Question 31 of 129

1

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Diagnosis of ( dementia with Lewy bodies, Parkinson's disease with dementia ) is typically made when the diagnosis of dementia precedes or coincides within one year of the onset of motor symptoms. Whereas ( Parkinson's disease with dementia, dementia with Lewy bodies ) is usually made when dementia develops within the context of established ( PD, DLB ).

Explanation

Question 32 of 129

1

Which of the following deficits tend to distinguish between Parkinson's with cognitive impairment and Parkinson's with dementia?

Select one or more of the following:

Executive dysfunction, particularly set shifting and concept formation.
Recognition Memeory
Impaired Verbal Fluency
Initiation

Explanation

Question 33 of 129

1

The positive effects of L - Dopa on movement

Select one of the following:

Tend to be stable, and can last many years.
Tend to begin to wear off after 2 - 4 years.

Explanation

Question 34 of 129

1

Parkinson's - Tango dance classes twice a week has been shown to improve balance, functional mobility and walking compared to a no dance group.

Select one of the following:

True
False

Explanation

Question 35 of 129

1

What am I?

Neurodegenerative disorder
Hereditary, Autosomal dominant
Typical Age at onset: 35-45 years
Duration: 15-20 years
Symptoms include: Bradykinesia and/or Chorea, Apathy, Executive Dysfunction, Working Memory Deficit, Psychiatric disorder, and elevated suicide rate

Select one of the following:

Huntington's Disease
Alzheimer's
Mild Cognitive Impairement
Parkinson's
Vascular Dementia
Major Depressive Disorder
Schizophrenia

Explanation

Question 36 of 129

1

All Huntington's patients develop dementia, unless they die before the disease has run it's course.

Select one of the following:

True
False

Explanation

Question 37 of 129

1

What number of trinucleotide CAG repeats (Cytosine, Adenine, Guanine) is considered pathological and linked to the development of Huntington's disease?

Select one of the following:

> 38
> 48
17 - 29
< 35

Explanation

Question 38 of 129

1

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( Huntington's disease, Alzheimer's disease, Parkinson's disease, Lewy bodies dementia, Major Depressive Disorder ) results from an excessive number of trinucleotide ( CAG, GAG, TAG ) repeats (( cytosine, adenine, guanine, tycoon, adenine, guanine, guanine, adenine, guanine )) in the ( HD gene, PD gene, AD gene, MD gene ) that encodes a protein known as ( huntingtin, tryptone, parkintin, globin ) located on chromosome ( 4, 5, 6, 7 ). People without the disease will have ( fewer than 35, more than 35, fewer than 15, more than 15 ) repeats. ( Huntington's Disease, Alzheimer's Disease, Parkinson's Disease, Major depressive disorder, Lewy bodies dementia ) is considered autosomal ( dominant, recessive ), so that ( 50%, 35%, 10% ) of all offspring of a single carrier parent will develop the disease.

Explanation

Question 39 of 129

1

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Huntington's disease is more prominent in ( Caucasian, Asian, African ) populations than either ( Asian or African, Caucasian or African, Asian or Caucasian ) populations.

Explanation

Question 40 of 129

1

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Huntington's disease - The most consistent change in neurotransmitters occurs as reduced levels of ( GABA, GATA, Glutamate, Norepinephrine ), with a consistent concomitant increase in ( excitatory, inhibitory ) neurotransmitters.

Explanation

Question 41 of 129

1

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There is a ( negative, positive ) correlation between the number of CAG repeat length and age at onset for huntington's disease. Additionally, disease severity is ( positively, negatively ) correlated with CAG repeat lengths.

Explanation

Question 42 of 129

1

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In ( Huntington's, Parkinson's ) disease early onset is associated with more severe symptoms and faster degeneration. Conversely, early onset ( Parkinson's, Huntington's ) disease is associated with a slower progression.

Explanation

Question 43 of 129

1

Cognitive Impairment is often the first expression of the disease and may predate motor symptoms by as much as two year.

This statement is consistent with

Select one of the following:

Parkinson's disease
Huntington's disease

Explanation

Question 44 of 129

1

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Huntington's Disease, Neuropsychological Profile:

Attention Span: ( Drops as disease progresses, Preserved )Set Shifting: ( Impaired, Preserved )
Working Memory: ( Impaired, Preserved )
Memory Deficit: ( Mild initially, worsen with time, Early development )
Memory deficits tend to be due to ( retention strategy, primary retention deficit )
Vocabulary and Grammar - ( Preserved early, develops last, Early sign )
Executive Function: ( Impaired, Preserved )

Explanation

Question 45 of 129

1

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Emotional disturbances of personality change develop in ( almost all, 10% of, 30% of, 50% of ) patients with Huntington's Disease.

Explanation

Question 46 of 129

1

Select ALL correct responses regarding depression in Huntington's Disease:

Select one or more of the following:

Depression often precedes motor and cognitive impairment
Depression is more common in Huntington's disease than Alzhiemers
Suicide rated for Huntington's patients are much higher than the general population. However, genetic testing that confirms HD does not appear to increase suicide risk.
Depression in Huntington's Disease is most likely a reaction to symptoms

Explanation

Question 47 of 129

1

Deep Brain Stimulation is more effective as a treatment of Huntington's Disease than Parkinson's

Select one of the following:

True
False

Explanation

Question 48 of 129

1

Which of the following is NOT classed as a subcortical dementia?

Select one of the following:

Parkinson's Disease
Huntington's Disease
Vascular Dementia
Alzheimer's Dementia

Explanation

Question 49 of 129

1

Multi Infarct Dementia (DIM), CADASIL (Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoaraiosis) and HCHWA-D (Hereditary cerebral hemorrhage with amyloidosis-Dutch type) are subtypes of which of the following?

Select one of the following:

Huntington's
Vascular Dementia
Hypertenion
Alzhiemer's
Fronto-Temporal Dementia

Explanation

Question 50 of 129

1

The umbrella term used in the DSM 5 to refer to what is commonly called dementia

Select one of the following:

Dementia
Major Dementia
Major Neurocognitive disorder
Major Neurodemented disorder

Explanation

Question 51 of 129

1

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A lacunes or microinfarct is a damaged region of the brain < ( 2mm, 10mm, 0.5mm ) in area, and typically involve central white matter tracts and ( subcortical, cortical ) regions.

Explanation

Question 52 of 129

1

Strategic infarct dementia is

Select one of the following:

dementia resulting from a single lesion in a critical brain region
dementia brought on by surgical lesions to the subthalamic nucleus
A type of alzheimer's disease
Not a true dementia

Explanation

Question 53 of 129

1

A slowly progressive form of Vascular dementia that involves subcortical white matter lesions produced by chronic ischemia.

Select one of the following:

Alzheimer's Disease
CADASIL
Binswanger's disease
Lacunar/Multi infarct dementia

Explanation

Question 54 of 129

1

Huntington's Disease, Parkinson's Disease and Vascular Dementia all involve which of the following symptoms? Choose characteristic symptoms!

Select one or more of the following:

Executive Dysfunction
Depression
Psychomotor difficulties
Intial Primary Memory Loss
Arteriosclerosis
Lacunes

Explanation

Question 55 of 129

1

Intact disease insight tends to be present in Vascular Dementia

Select one of the following:

True
False

Explanation

Question 56 of 129

1

Name this disease.

Non-familial (i.e non-genetic)
Prevalence of 1.4 per 100,000
No known disease specific biomarker
Patients often display a inability to look downwards
Primary lesion sites begin in the upper brainstem and extend to the basal ganglia. In particular, this process appears to disconnect ascending pathways from these subcortical structures to the prefrontal cortex.
Dopamine levels drop drastically in the striatum
Alzheimer's often co-occurs (69% of cases)

Select one of the following:

Parkinson's
Lewy Bodies Dementia
Progressive supranuclear palsy
Huntington's disease

Explanation

Question 57 of 129

1

Which disease displays the following symptoms:

Onset after the age of 40

Early Symptoms:
Postural Instability
Dysarthria
Bradykinesia

Within the first year:
Cognitive or behavioural changes begin to develop. Rarely develop first
Can include: deficits typical of frontal lesions: apathy, initiation difficulties, flexibility.
Memory ability may be normal but significantly slowed. Memory impairment can occur, though not to the same extent as AD
Forward digit span may be within normal limits
Language will often remain intact, but primary progressive aphasia can occur. Also note Dysarthria.

Later:
Vertical gaze palsy, when patients try to bend their head to compensate their eyes roll up reflexively.

Others:
Oculomotor defects

Death often results from respiratory arrest, either secondary to pneumonia or due to degenerative processes involving brainstem respiratory centres.

Select one of the following:

Parkinson's
Lewy Bodies dementia
Progressive supranuclear palsy
Creutzfeldt Jacobs disease

Explanation

Question 58 of 129

1

Name this disease:

Primary symptomatic features include:
Progressive gait disturbance
Urinary Incontinence
Confusion, disorientation and memory problems.

Memory problems usually develop after Urinary incontinence and gait disturbance. Though Executive dysfunction can present relatively early in the disease. Perseveration,

Typical imaging shows enlargement of the ventricle due to excess CSF and white matter damage.

Select one of the following:

Normal Pressure Hydrocephalus
Alzheimer's Disease
Parkinson's Disease
Creutzfeldt Jacob's disease

Explanation

Question 59 of 129

1

Which of the following diseases/disorders can often be successfully treated with a "shunt"

Select one of the following:

Normal Pressure Hydrocephalus
Alzheimer's disease
Parkinson's
Lewy Bodies dementia

Explanation

Question 60 of 129

1

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Normal Pressure Hydrocephalus has an incidence of approximately ( 5.5, 10.5, 20.5, 205 ) in 100,000. Progressive supranuclear palsy has an incidence of approximately ( 1.4, 5.5, 150, 500 ) in 100,000.

Explanation

Question 61 of 129

1

Name this disease:

Progressive dementia with rapid onset
Death usually occurs after 4-5 months
Atypical EEG
Myoclonus, gait disturbance, possible seizures
Psychiatric disturbance
Hallucinations

Select one of the following:

Creutzfeld Jakob’s Disease
Normal Pressure Hydrocephalus
Progressive supranuclear palsy
Early Onset Parkinson's

Explanation

Question 62 of 129

1

To receive a diagnosis of MCI the memory problems have to interfere with daily functioning

Select one of the following:

True
False

Explanation

Question 63 of 129

1

Histopathological hallmark of Alzheimer’s disease

Select one of the following:

Pick Bodies
Lewy bodies
Amyloid plaques
Ubiquitin inclusions

Explanation

Question 64 of 129

1

Sudden onset, fluctuating cognition and attention

Select one of the following:

Vascular dementia
Lewy body dementia
Delirium
Dementia

Explanation

Question 65 of 129

1

Visual hallucinations, most often

Select one of the following:

Fronto temporal dementia
Lewy body dementia
Alzheimer’s dementia
Semantic dementia

Explanation

Question 66 of 129

1

When does normal biological decay begin?

Select one of the following:

25 - 30 years
40 - 45 years
50 - 55 years
> 65 years

Explanation

Question 67 of 129

1

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What proportion of the following populations have dementia?

Of 80+ population: ( 20%, 40%, 60% ) dementia
Of 85+ population: ( 40%, 20%, 60% ) dementia

Explanation

Question 68 of 129

1

A patient who presents with dysfunction on memory tasks (or any other domain), despite some difficulties day to day they are still able to function independently at home. What would be the most appropriate diagnosis?

Select one of the following:

MCI
CADASIL
Alzheimer's
Normal Pressure Hydrocephalus

Explanation

Question 69 of 129

1

Deficits in Mild Cognitive Impairment can only occurs within the cognitive domain of memory

Select one of the following:

True
False

Explanation

Question 70 of 129

1

All patients who develop true Mild Cognitive Impairment will progress to dementia

Select one of the following:

True
False

Explanation

Question 71 of 129

1

Non-amnestic MCI though to be predictive of:

Select one of the following:

Alzheimer's disease
Forms of dementia other than Alzheimer's (e.g Lewy Bodies Dementia, FTD)

Explanation

Question 72 of 129

1

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Approximately ( 5.6 - 15%, 30 - 35%, 50% ) of MCI patients convert to Dementia each year. However in many cases MCI will not develop any further, and in some cases it is even alleviated after time.

Explanation

Question 73 of 129

1

Walking 72 blocks a week was associated with greater grey matter volume and a two fold reduced risk developing a cognitive impairment more than a decade later in a longitudinal study.

Select one of the following:

True
False

Explanation

Question 74 of 129

1

❌ - Poor memory performance, below expected for the patient's age with no other cognitive deficits and not serious enough to warrant a diagnosis of dementia.

❌ - Poor performance in any domain other than memory, below expected for the patient's age with no other cognitive deficits and not serious enough to warrant a diagnosis of dementia.

❌ - Poor performance in at least two domains, below expected for the patient's age with no other cognitive deficits and not serious enough to warrant a diagnosis of dementia.

Drag and drop to complete the text.

Amnestic MCI

Nonamnestic MCI

Multi domain MCI

Explanation

Question 75 of 129

1

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Dementia applies to a condition in which both cognitive decline AND ( functional impairment, vascular impairment, atrophy of the hippocampus, dysexecutive syndrome ) are observed.

Explanation

Question 76 of 129

1

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Alzheimer's Disease accounts for ( 60 - 80%, 10 - 20%, 45% ) of dementia, with an estimated incidence of ( 8.45 million, 4.45 million, 10.45 million, 50 million ) affected in europe alone with an annual cost of ( 141 billion, 20 billion, 300 billion ) Euro per year

Explanation

Question 77 of 129

1

A definite diagnosis of Alzheimer's is only possible after post-mortem exam in which amyloid plaques and neurofibrillary tangles are confirmed present.

Select one of the following:

True
False

Explanation

Question 78 of 129

1

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Whether ( Alzheimer's, Stroke, Normal Pressure Hydrocephalus ) disease evolves from neurofibrillary tangles and amyloid plaques or whether they are a by product of the disease ( is unknown., is certain., depends of the type of dementia )

Explanation

Question 79 of 129

1

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( Probable Alzheimer's disease, Definite Alzheimer's disease, Unlikely Alzheimer's disease, Possible Alzheimer's disease ) Dementia has been established by clinical and neuropsychological examination. Cognitive impairments also have to be progressive (ie decline from previous functioning) and be present in two or more areas of cognition. Deficit interferes with ability to work/daily functioning. Onset between the ages of 40 and 90 years and finally there must be an absence of other diseases capable of producing a dementia syndrome.

( Definite Alzheimer's disease:, Probable Alzheimer's disease, Possible Alzheimer's disease, Unlikely Alzheimer's disease ) The patient meets the criteria for probable Alzheimer's disease and has histopathologic evidence of AD via autopsy or biopsy.

( Unlikely Alzheimer's disease:, Definite Alzheimer's disease, Probable Alzheimer's disease, Possible Alzheimer's disease ) The patient presents a dementia syndrome with a sudden onset, focal neurologic signs, or seizures or gait disturbance early in the course of the illness

( Possible Alzheimer's disease, Probable Alzheimer's disease, Definite Alzheimer's disease, Unlikely Alzheimer's disease ): There is a dementia syndrome with an atypical onset, presentation or progression; and without a known etiology; but no co-morbid diseases capable of producing dementia are believed to be in the origin of it. Or a lack of sufficient patient history or objective cognitive documentation.

Explanation

Question 80 of 129

1

According to the DSM-IV a diagnosis of probable Alzheimer's must include a decline in at least two cognitive domains. One of these deficits MUST involve an inability to learn new information or recall previously learned information. The decline must also be sufficient enough to impair social or occupational functioning.

Select one of the following:

True
False

Explanation

Question 81 of 129

1

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( 30%, 60 - 80%, 10 - 20% ) of all dementia cases are due to Alzheimer's ALONE, ( 38%, 20%, 50%, 12% ) are AD with infarcts

Explanation

Question 82 of 129

1

Fill the blank space to complete the text.

A common explanation to account for the fact that people with higher levels of education have a lower risk of developing AD is that these people have a higher to compensate for the negative effects of the disease.

Explanation

Question 83 of 129

1

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Higher rates of educational attainment is associated with ( faster, slower, the same ) rates of cognitive decline after a diagnosis of dementia but ( a delayed, an early ) onset.

Explanation

Question 84 of 129

1

Alzheimer's likely does not have a genetic component.

Select one of the following:

True
False

Explanation

Question 85 of 129

1

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Roughly ( 25%, 60%, 80% ) of Alzheimer's disease is familial, this is especially the case for ( early, late ) onset AD in which ( 60%, 25%, 80% ) of cases are familial.

Explanation

Question 86 of 129

1

What percentage of Alzheimer's Begins before the age of 60 - 65? I.e What proportion of AD is "early onset"

Select one of the following:

1 - 6%
20%
10%
10 - 20%

Explanation

Question 87 of 129

1

Mutations of the presenilin-1 gene on chromosome 14, presenilin-2 gene on chromosome 1 and Amyloid precursor protein gene on chromosome 21 are associated with which form of dementia?

Select one of the following:

Early Onset Alzhiemer's
Early Onset Parkinson's
Early Onset Huntington's

Explanation

Question 88 of 129

1

Vascular risk factors such as high fat consumption, arteriosclerosis, hypertension and diabetes are risk factors for:

A. Alzheimer's Disease
B. Vascular Dementia

Select one of the following:

A
B
Both A and B
Neither

Explanation

Question 89 of 129

1

TBI increases the risk factor of which of the following diseases?

A. Alzheimer's
B. Parkinson's

Select one of the following:

A
B
A and B
Neither A nor B.

Explanation

Question 90 of 129

1

Hormone Replacement Therapy (combined estrogen and progesterone) may as much as double the risk of developing Alzheimer's Dementia.

Select one of the following:

True
False

Explanation

Question 91 of 129

1

Daily light to moderate alcohol consumption (1-2 drinks per day) is associated with a lower risk of dementia.

Select one of the following:

True
False

Explanation

Question 92 of 129

1

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( Neurofibrillary tangles, Amyloid Plaques, Lewy Bodies ) develop when the microtubules that transport substances from the nerve cell body to the end of the axon become twisted. The protein that helps to maintain these structures is known as ( tau, amyloid, Lewy protein ). In ( Alzheimer's disease, Lewy Bodies Dementia, Huntington's Disease ), this protein is altered allowing the twisted tubules to aggregate into ( tangles, plaques ).

Explanation

Question 93 of 129

1

In AD which of the following cortical regions are comparatively spared, even in later stages?

Select one of the following:

primary motor and sensory areas
primary visual areas
temporal lobe, especially the medial temporal lobe including the hippocampus and the entorhinal cortex.
prefrontal areas

Explanation

Question 94 of 129

1

Second to memory decline, which of the following presents the most sensitive measure when diagnosing AD

Select one of the following:

Hippocampal volume on MRI
Language Disorder
Blood Test
Motor coordination/Gait

Explanation

Question 95 of 129

1

Click on each orange point and select the correct answer.

Label the symptom sets

Explanation

Question 96 of 129

1

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In alzheimer's, ( older, newer ) memories tend to be better preserved than ( new, old ) memories.

Explanation

Question 97 of 129

1

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Central to language deterioration in Alzheimer's patients is a disintegration of ( semantic content of words and sentences, syntax and linguistic organisation, word pronounciation ).

Explanation

Question 98 of 129

1

Although popular as a screening measure for AD clock drawing deficits are not specific to AD, in fact they tend to occur more frequently in Parkinson's Disease and Lewy Body Dementia.

Select one of the following:

True
False

Explanation

Question 99 of 129

1

The closing in phenomenon demonstrated by some dementia patients in visuoconstruction tasks is more closely associated with:

A: Alzheimer's Disease
B: Vascular Dementia

Select one of the following:

A
B
A and B

Explanation

Question 100 of 129

1

Fill the blank spaces to complete the text.

is the uncontrolled repetition or continuation of a response (e.g., behavior, word, thought, activity, strategy, or emotion) in the absence of an ongoing occasion or rationale for that behavior or emotion (e.g., the topic or task requirements have changed). Whereas, an is defined as the inappropriate repetition of a prior response to a task after intervening stimuli, that is on a later task.

Explanation

Question 101 of 129

1

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Alzheimer's and EEG: slowing
( Increased, Decreased ) theta activity, combined with
( Decreased, Increased ) alpha activity, and
( Decreased, Increased ) beta activity
Late stages: ( Increased, Decrease ) delta activity

Explanation

Question 102 of 129

1

Fill the blank spaces to complete the text.

dementia typically involved pathology of the frontal and temporal lobes with relative sparing of the posterior regions. Age of onset is relatively young (40 - 65) and there are three main subtypes a variant, a type and .

Explanation

Question 103 of 129

1

Pick's Disease is the former name of which type of dementia/major neurocognitive disorder?

Select one of the following:

Lewy Bodies Dementia
Alzhiemer's
Frontotemporal lobar dementia FTLD
Progressive supranuclear palsy

Explanation

Question 104 of 129

1

Which of the following are considered risk factors for FTLD

Select one or more of the following:

Being Female
Old Age
Low Educational achievement
Several genetic factors, 40 - 50% of cases are transmitted by autosomal dominant inheritance
TBI may be a contributing factor

Explanation

Question 105 of 129

1

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Pick's Bodies are found in about ( 20%, 90%, 70%, 0% ) of patients with FTLD.

Explanation

Question 106 of 129

1

In pure/classic FTLD the parietal and occipital lobes remain intact.

Select one of the following:

True
False

Explanation

Question 107 of 129

1

Hippocampal atrophy in FTLD (Choose the BEST)

Select one of the following:

Is typically atrohpied
Is typically spared
Varies from case to case

Explanation

Question 108 of 129

1

Which of the following types of dementia best fits the following symptom set in its classic form:

extrapyramidal signs (shakiness, rigidity etc), apathy, relatively young onset (40 - 65), executive dysfunction, incontinence, and in particular profound social and behavioural change as an early stage symptom.

Select one of the following:

FTLD - Behavioural subtype
Normal Pressure Hydrocephalus
Parkinson's disease dementia
Alezhiemer's

Explanation

Question 109 of 129

1

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In a classic distinction Alzheimer's patients will present with ( memory, dysexecutive, incontinence ) problems as the primary symptom, whereas patients with FTLD will more often present with ( social and executive, memory related, sensory related ) primary symptoms. However these distinctions should be taken lightly as co-occurrence and symptomatic overlap are common.

Explanation

Question 110 of 129

1

Dementia patients who have more temporal than frontal involvement, little to no posterior involvement, intact autobiographical memory but impaired knowledge of word meaning. This constellation of symptoms best matches

Select one of the following:

FTLD - Semantic dementia
FTLD - Behavioural variant
Alzheimer's
Normal Pressure Hydrocephalus

Explanation

Question 111 of 129

1

Semantic dementia (FTLD) - usually grammar and syntax remains intact. Prominent anterior temporal lobes atrophy is associated.

Select one of the following:

True
False

Explanation

Question 112 of 129

1

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occurs without memory impairment or dementia in the early course. Many patients remain dementia free for at least 2 years and as many as 10. The disorder starts with anomia and proceeds to grammatical structure and language comprehension

Explanation

Question 113 of 129

1

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( Primary progressive aphasia, FTLD - Semantic Dementia ) starts with anomia and proceeds to grammatical structure and language comprehension. ( FTLD - Semantic Dementia, Primary progressive aphasia ) word meanings are usually lost with an intact sense of grammar.

Explanation

Question 114 of 129

1

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Primary progressive aphasia - Usually associated with ( FTLD, AD, PDD, HD ) although ( AD, FTLD, PDD, HD ) accounts for 30% of all cases. ( Unlike, Like ) other FTLD women are more often affected than men.

Explanation

Question 115 of 129

1

1st Step: Neurodegenerative disease: Shows ❌ of behaviour and/or cognition by observation or history (as provided by a knowledgeable informant).

II. ❌ bvFTLD
Three of the following behavioural/cognitive symptoms (A–F) must be present to meet criteria. Ascertainment requires that symptoms be persistent or recurrent, rather than single or rare events.

A. Early* behavioural disinhibition [one of the following symptoms (A.1–A.3) must be present]:
A.1. ❌
A.2. ❌
A.3. ❌

B. Early apathy or inertia [one of the following symptoms (B.1–B.2) must be present]:
B.1. Apathy
B.2. Inertia

C. Early loss of ❌ [one of the following symptoms (C.1–C.2) must be present]:
C.1. Diminished response to other people’s needs and feelings
C.2. Diminished social interest, interrelatedness or personal warmth

D. Early ❌, stereotyped or compulsive/ritualistic behaviour [one of the following symptoms (D.1–D.3) must be present]:
D.1. Simple repetitive movements
D.2. Complex, compulsive or ritualistic behaviours
D.3. Stereotypy of speech

E. ❌ and dietary changes [one of the following symptoms (E.1–E.3) must be present]:
E.1. Altered food preferences
E.2. Binge eating, increased consumption of alcohol or cigarettes
E.3. Oral exploration or consumption of inedible objects

F. Neuropsychological profile: executive/generation deficits with relative sparing of ❌ [all of the following
symptoms (F.1–F.3) must be present]:
F.1. Deficits in executive tasks
F.2. ❌
F.3. Relative sparing of visuospatial skills

III. Probable bvFTLD
All of the following symptoms (A–C) must be present to meet criteria.
A. Meets criteria for possible bvFTD

B. Exhibits significant functional decline (by caregiver report or as evidenced by Clinical Dementia Rating Scale or Functional Activities Questionnaire scores)

C. Imaging results consistent with bvFTD [one of the following (C.1–C.2) must be present]:
C.1. ❌ on MRI or CT
C.2. ❌ hypoperfusion or hypometabolism on PET or SPECT

IV. Behavioural variant FTD with definite FTLD Pathology
Criterion A and either criterion B or C must be present to meet criteria.
A. Meets criteria for possible or probable bvFTD
B. Histopathological ❌
C. Presence of a known pathogenic mutation

V. ❌ for bvFTLD
Criteria A and B must be answered negatively for any bvFTLD diagnosis. Criterion C can be positive for possible bvFTLD but must be negative for probable bvFTLD
A. Pattern of deficits is better accounted for by other non-degenerative nervous system or medical disorders
B. Behavioural disturbance is better accounted for by a psychiatric diagnosis
C. Biomarkers strongly indicative of Alzheimer’s disease or other neurodegenerative process

Drag and drop to complete the text.

Exclusionary criteria

evidence of on biopsy or at post-mortem

Frontal and/or anterior temporal atrophy

Frontal and/or anterior temporal

Socially inappropriate behaviour

Loss of manners or decorum

Impulsive, rash or careless actions

Hyperorality

progressive deterioration

memory and visuospatial functions

Relative sparing of episodic memory

perseverative

sympathy or empathy

Possible

Explanation

Question 116 of 129

1

Difficulty in language as most prominent clinical feature
Principal cause of impaired ADL
Aphasia most prominent deficit at onset and initial phase

Sounds like?

Select one of the following:

Primary Progressive Aphasia
Alzheimer's
Lewy Bodies

Explanation

Question 117 of 129

1

Click on each orange point and select the correct answer.

Dementia, Delirium or Depression?

Explanation

Question 118 of 129

1

Click on each orange point and select the correct answer.

Delirium, Depression or Dementia?

Explanation

Question 119 of 129

1

What is the relationship between the following list and dementia?

Hypothyroidism, Neurology (tumor, hematoma's), Intoxications (medication, alcohol), Infections (Lues, HIV, Lyme), Deficiencies (vit. B12, B1), Psychiatric Health.

Select one of the following:

Possible confounding factors in diagnosis
Possible causal factors

Explanation

Question 120 of 129

1

Name the dementia:

Unrecognized until the 1970s
Major features include extrapyramidal signs (parkinsonisms), fluctuating cognition, visual hallucinations
Often deficits in attention, visuoperceptual and executive function.
Not neatly classified as primarily sub-cortical nor cortical

Select one of the following:

Alzheimer's
Dementia with Lewy Bodies
Parkinson's Disease
Progressive supranuclear palsy

Explanation

Question 121 of 129

1

Lewy bodies are found in:

Select one of the following:

Dementia with Lewy Bodies
Lewy Body variant of Alzheimer's (if neurofibrillary tangles are also present)
Parkinson's Disease
All of these are correct.

Explanation

Question 122 of 129

1

Amyloid Plaques are uncommon in Dementia with Lewy bodies, though neurofibrillary tangles are common.

Select one of the following:

True
False

Explanation

Question 123 of 129

1

Lewy bodies in largely concentrated in the substantia nigra alone are characteristic of:

Select one of the following:

Parkinson's Disease
Dementia with Lewy Bodies
Alzheimer's

Explanation

Question 124 of 129

1

Lewy bodies in the substantia nigra, limbic and cortical areas, without neruofibrillary tangles (tau) is suggestive of

Select one of the following:

Dementia with Lewy Bodies.
Alzheimer's
Parkinson's

Explanation

Question 125 of 129

1

Select from the dropdown lists to complete the text.

Decline in ( DLB, AD ) is usually more rapid than decline in ( AD, DLB )

Explanation

Question 126 of 129

1

It is well known that some normally functioning elderly people at the time of death have abundant neuropathological signs of AD (etc) in post mortem exam

Select one of the following:

True
False

Explanation

Question 127 of 129

1

Label these symptoms

Drag an answer into the correct orange point.

Vascular Dementia

AD

PD or DLB

FTLD

Explanation

Question 128 of 129

1

Select from the dropdown lists to complete the text.

Label the functions associated with these frontal-subcortical circuits:

DLPFC - ( Executive Functioning, Inhibition, Social rules, Motivation and Drive )
Anterior Cingulate - ( Motivation and Drive, Executive Functioning, Inhibition, Social rules )
Orbito Frontal/Lateral Orbital PFC - ( Inhibition, Social rules, Executive Functioning, Motivation and Drive )

Explanation

Question 129 of 129

1

Depression can result in biases in

A Attention
B Processing
C Memory
D All of the above

Select one of the following:

A
B
C
D

	Created by Dan Myles over 8 years ago