Title: Neurocognitive and Other Disorders
Course: Question bank check

Q: What are the differences between major and mild neurocognitive disorders?
- Individuals with major neurocognitive disorders have an underlying brain pathology. (Incorrect. People who have a major neurocognitive disorder may have an underlying brain pathway.)
- People with minor neurocognitive disorders are affected in one cognitive area. (Incorrect. The distinction between major and minor is the extent to which the cognitive decline affects a person, not how many areas of cognitive decline or impairment.)
- An individual’s age at diagnosis is younger for a minor neurocognitive disorder. (Incorrect. Age of diagnosis does not determine the type of neurocognitive disorder diagnosed.)
- Mild neurocognitive disorder means a less extreme decline in one or more areas of cognitive functioning. (Correct! People who have mild neurocognitive disorders have a less severe form of cognitive decline than those with major neurocognitive disorders. For example, people with a mild neurocognitive disorder can live independently but still struggle with cognitive areas like attention, memory, language, or social cognition.)
A: Mild neurocognitive disorder means a less extreme decline in one or more areas of cognitive functioning.

Q: Regina is an 80-year-old woman who has always been able to function on her own. Up until about six months ago, Regina has been able to go to the store alone for her groceries. However, in the past six months, her daughter has noticed that she has difficulty finding the items on her list even though she has been going to the same store for 20 years. In addition, her daughter also witnessed Regina struggling to count her money and change for the store clerk. Regina can articulate what she wants and how much of each grocery item. Regina is showing signs of minor cognitive decline primarily in which of the following cognitive areas?
- concentration (Incorrect. Regina does not suffer from challenges associated with social cognition.)
- language (Incorrect. Regina does not suffer from challenges associated with language as she can articulate what she wants and how much.)
- problem-solving (Incorrect. Regina does not suffer from challenges associated with problem-solving as she does not change stores or encounter new problems to solve.)
- memory (! Regina demonstrates cognitive dysfunction in the form of memory as she is struggling with maintaining and encoding information about where to find items in the grocery store.)
A: memory

Q: What are the primary causes of neurocognitive disorders?
- Developmental disorders such as cerebral palsy, autism spectrum disorder, and fragile X syndrome. (Incorrect. Developmental disorders are not connected to neurocognitive disorders)
- traumatic brain injuries (Incorrect. Traumatic brain injuries can and do lead to neurocognitive disorders, but these are not the primary causes.)
- dementia (Incorrect. Dementia is another term used to describe the cognitive decline associated with neurocognitive disorders; it does not lead to the disorder, but is the disorder.)
- Neurodegenerative diseases such as Alzheimer's disease, Parkinson's Disease, and Huntington's disease (Correct! Degenerative diseases that most commonly occur with old age, are the primary causes of neurocognitive disorders.)
A: Neurodegenerative diseases such as Alzheimer's disease, Parkinson's Disease, and Huntington's disease

Q: Olive has a diagnosis of Alzheimer’s disease. She had started to leave the stove on at her house, got lost when driving into town, and got easily frustrated while shopping, often finding herself in tears. She recently moved to an assisted living facility. Doctors would describe Olive’s diagnosis as
- mild neurocognitive disorder. (Incorrect. Olive’s Alzheimer's disease prevents her from living independently, so it would be considered more severe than mild.)
- chronic neurocognitive disorder. (Incorrect. Neurocognitive disorders are not described this way.)
- moderate Alzheimer’s disorder. (Incorrect. Alzheimer’s disease progression is not described this way.)
- major neurocognitive disorder. (Correct! AD is a disease that continues to get work over time and causes problems with memory, thinking, and behavior. Olive is unable to live independently, and has more advanced symptoms of AD, which would give her a diagnosis of major neurocognitive disorder.)
A: major neurocognitive disorder.

Q: Hank had a stroke and was hospitalized for a week. On the second day in the hospital, he began hallucinating, showing disorganized speech, and had seroius lapses in his memory. These symptoms improved alsmost completely by the time he was released. Hank was likey diagnosed with
- dementia. (Incorrect. Dementia describes a mild or major neurocognitive disorder and lasts longer than a few days.)
- Alzheimer’s disease. (Incorrect. Alzheimer’s is gradual and worsens over time.)
- Korsakoff’s disease. (Incorrect. These cognitive decline symptoms would need to last for a long enough duration to be diagnosed with Korsakoff’s disease.)
- delirium. (Correct! Delirium is a state of confusion that sometimes occurs following a stroke, or changes in medication.)
A: delirium.

Q: Impaired consciousness or changes in mental functioning that occur over the course of hours or days is
- dementia. (Incorrect. Dementia describes a mild or major neurocognitive disorder and lasts longer than a few days.)
- Alzheimer’s disease. (Incorrect. Alzheimer’s is gradual and worsens over time.)
- Korsakoff’s disease. (Incorrect. These cognitive decline symptoms would need to last for a long enough duration to be diagnosed with Korsakoff’s disease.)
- delirium. (Correct! Delirium is a state of confusion that may result from medication-related abstinence or excess.)
A: delirium.

Q: Mindy is a model with no known medical conditions, but she has recently been on an extreme diet to cope with stress. She has started showing confusion, disorientation, and extreme anxiety. Mindy is likely experiencing delirium due to
- medication. (Incorrect. Mindy does not take medication.)
- underlying disease processes. (Incorrect. Mindy has no known other underlying disease processes.)
- mental health issues. (Incorrect. Psychological conditions do not cause delirium.)
- malnutrition. (Correct! Delirium is a state of confusion that may result from malnutrition.)
A: malnutrition.

Q: Meredith is a middle-aged woman who has a history of liver disease from being a long-term alcoholic. When she became sober she was able to stabilize her health and was taking medication to support her liver function. One day her family came to visit and noticed that she seemed “out of it” and acted like she was drunk and noticed she had a spilled pill bottle on the floor. Meredith was confused about what time it was, where she was, and could not explain why the pills were on the floor. After a medical exam, her family found out that Meredith experienced
- dementia. (Incorrect. Meredith does not show signs of dementia.)
- Parkinson’s disease. (Incorrect. Meredith does not show signs of Parkinson’s disease.)
- Korsakoff’s disease. (Incorrect. Meredith has not shown these cognitive decline symptoms for a long enough duration to be diagnosed with Korsakoff’s disease.)
- delirium. (Correct! Delirium is a state of confusion that may result from medication-related abstinence or excess.)
A: delirium.

Q: Sylvia is a 75-year-old retired school teacher who currently lives independently with her husband. Recently, Sylvia has begun to act confused in the mornings, has had difficulty expressing herself clearly, and has had more anxiety. One morning, she even got dressed and told her husband that she needed to find her school papers to give back to the children. As a result, her husband was concerned and asked her to go to the doctor to check-in. The doctor ran blood tests, did a brain scan, and used several dementia screening tools. He found that Sylvia’s brain scans had some evidence of amyloid plaque on them. What kind of neurocognitive disorder do you think she will likely receive a diagnosis for?
- neurocognitive dementia due to Lewy bodies (Incorrect. Sylvia is not able to live independently and significant cognitive impairments and has no presence of Lewy bodies in her brain scan.)
- Parkinson's disease (Incorrect. Sylvia does not have any motor impairment symptoms that correspond with Parkinson's disease or associated dementia.)
- neurocognitive dementia disorder due to vascular disease (Incorrect. Sylvia does not meet the criteria for neurocognitive dementia disorder due to vascular disease.)
- Alzheimer's disease (Correct! Sylvia demonstrates cognitive dysfunction and also indicates an underlying neural pathology to explain her cognitive decline associated with Alzheimer’s disease. Also, her cognitive impairments have become noticeable by family and disrupt her daily life.)
A: Alzheimer's disease

Q: The presentation of symptoms associated with Alzheimer disease is described as
- pervasive. (Incorrect. Alzheimer’s disease progression is not described as pervasive.)
- chronic. (Incorrect. Alzheimer’s disease progression is not described as chronic.)
- rapid. (Incorrect. Alzheimer’s disease progression is not described as rapid.)
- progressive. (Correct! AD is a disease that continues to get work over time and causes problems with memory, thinking, and behavior.)
A: progressive.

Q: Usually the first sign of Alzheimer’s disease is/are
- mood swings. (Incorrect. Usually memory symptoms appear first, followed by things like mood swings, confusion, or lack of self-care.)
- confusion. (Incorrect. Usually memory symptoms appear first, followed by things like mood swings, confusion, or lack of self-care.)
- lack of self-care. (Incorrect. Usually memory symptoms appear first, followed by things like mood swings, confusion, or lack of self-care.)
- memory loss. (Correct. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self-care, and behavioral issues.)
A: memory loss.

Q: Ruth is a woman in her late seventies who has recently begun to show emotional mood shifts and confusion in familiar situations. About three years ago, and since then, Ruth has demonstrated memory loss like losing her keys or getting lost in the grocery store. Now, Ruth is easily disoriented and has difficulty recognizing faces, places, or her relationship to a person. Her symptoms are continuing to gradually get worse and she now cannot remember what decade it is and often gets confused about which stage of life she is experiencing. What diagnosis would you give Ruth?
- Parkinson's disease. (Incorrect. Ruth does not display the progression of Parkinson's disease. Parkinson’s disease is characterized by tremors and changes in muscle movement.)
- Multiple Sclerosis. (Incorrect. Ruth does not display the progression of multiple sclerosis.)
- Lewy body dementia. (Incorrect. Ruth does not display the progression of Lewy body dementia as she does not show cognitive decline in terms of memory loss, hallucinations and visualizations, and movement impairments similar to those found in Parkinson's disease.)
- Alzheimer’s disease. (Correct! AD is a disease that continues to get work over time and causes problems with memory, thinking, and behavior.)
A: Alzheimer’s disease.

Q: How do Lewy bodies cause changes in brain tissue for patients diagnosed with a neurocognitive disorder?
- Lewy bodies shrink brain tissue in multiple parts of the brain. (Incorrect. Lewy bodies do not shrink brain tissue.)
- Lewy bodies are accumulations of white matter that increase the size of the ventricles. (Incorrect. Lewy bodies do not shrink the size of the ventricles.)
- Lewy bodies affect the brainstem only. (Incorrect. Lewy bodies can be found in the brainstem, but also the cortex.)
- Lewy bodies are abnormal aggregations of protein that develop inside nerve cells. (Correct! Lewy bodies develop inside nerve cells that are abnormal aggregations of protein that cause neurocognitive declines such as dementia, parkinsonian symptoms, and neuropsychiatric disturbances.)
A: Lewy bodies are abnormal aggregations of protein that develop inside nerve cells.

Q: Sabrina is a 55-year-old woman who has started to act “off” in her family’s opinion. Sabrina has always been a person who is “on edge” but recently she has begun to have difficulty remembering where she is, has had a slower walking pace and takes shorter steps, and asks to talk to people who are not in the room. Her family is concerned about the progressive decline of their mother and they take her to a neurologist. While a biopsy cannot be conducted to check for aggregations of protein on her nerve cells, the doctor thinks this is likely. What diagnosis is the doctor likely to give her?
- Alzheimer’s disease (Incorrect. Patients with Alzheimer’s disease do not typically have Parkinson’s symptoms.)
- Dementia (Incorrect. Sabrina’s case is more complicated than just dementia.)
- a mild neurocognitive disorder (Incorrect. Sabrina’s life is disrupted by her symptoms that she cannot function independently and they go beyond just cognitive decline to physical symptoms.)
- Neurocognitive disorder with Lewy bodies (Correct! When Lewy bodies develop inside nerve cells that are abnormal aggregations of protein that cause neurocognitive declines such as dementia, parkinsonian symptoms, and neuropsychiatric disturbances.)
A: Neurocognitive disorder with Lewy bodies

Q: Regina has a diagnosis of neurocognitive disorder with Lewy bodies. What are the unique symptoms that distinguishes her diagnosis from other neurocognitive disorders?
- She experiences fluctuating cognition and, most uniquely, extreme tiredness. (Incorrect. Patients with other neurocognitive disorders will also demonstrate fluctuating cognition, and tiredness is not a major concern.)
- She experiences memory issues and, most importantly, trouble concentrating. (Incorrect. Patients with other neurocognitive disorders will also demonstrate fluctuating cognition.)
- She experiences recurrent visual hallucinations. (Incorrect. Patients with other neurocognitive disorders will also demonstrate recurring visual hallucinations.)
- She experiences fluctuating cognition, hallucinations, and most uniquely, sleep disturbances (Correct! One of the major suggestive diagnostic features is sleep disturbances.)
A: She experiences fluctuating cognition, hallucinations, and most uniquely, sleep disturbances

Q: Harry has a diagnosis of Parkinson’s disease in the beginning stages. What movements would you find Harry showing?
- physical movements during sleep. (Incorrect. Patients will exhibit physical movements in sleep in the later stages of Parkinson's disease.)
- shaking and rigidity, increased speed of movements, and difficulty walking with increased gait. (Incorrect. People with Parkinson's disease have decreased speed of movement.)
- slowness of movement only. (Incorrect. People can have other related movement disruptions with early Parkinson's disease.)
- shaking and rigidity, slowness of movement, and difficulty walking with decreased gait. (Correct! People in the early stages of Parkinson's disease can include any of the following movements: shaking and rigidity, slowness of movement, and difficulty walking with decreased gait.)
A: shaking and rigidity, slowness of movement, and difficulty walking with decreased gait.

Q: Maeve was recently told that she was in the early stages of Parkinson’s disease. She learns that ________of people with Parkinson’s also experience neurocognitive decline, so she is working to learn as much as she can and be proactive about her cognitive health to prevent decline as much as possible.
- 10%-30% (Incorrect. More people with Parkinson’s also experience neurocognitive degeneration.)
- 40%-80% (Incorrect. The chances of neurocognitive decline with Parkinson’s are lower than this.)
- 60%-90% (Incorrect. The chances of neurocognitive decline with Parkinson’s are lower than this.)
- 20%-60% (Correct! Dementia has been reported to occur in approximately 20%-60% of individuals with Parkinson's disease and is more likely to be present in older individuals or those with more severe or advanced disease.)
A: 20%-60%

Q: Sally has been diagnosed with neurocognitive disorder due to Parkinson’s disease. Her dementia is characterized by
- fluctuating cognition, hallucinations, and sleep disturbances. (Incorrect. These symptoms are most closely aigned with dementia due to Lewy bodies.)
- shaking and rigidity, decreased speed of movements, and difficulty walking with increased gait. (Incorrect. This describes some of the physical symptoms of Parkinson’s disease, but not the dementia.)
- difficulty in remembering recent events, disorientation (including easily getting lost), and mood swings. (Incorrect. This better describes symptoms of Neurocognitive Disorder Due to Alzheimer's Disease.)
- cognitive and motoric slowing, executive dysfunction, and impairment in memory retrieval. (Correct! These are the main signs of dementia caused by Parkinson’s disease.)
A: cognitive and motoric slowing, executive dysfunction, and impairment in memory retrieval.

Q: Frontotemporal disorders primarily affect patients younger than ________ years of age.
- 75 (Incorrect. 75-years-old is not the most common age for people with Frontotemporal disorders.)
- 30 (Incorrect. 30-years-old is not the most common age for people with Frontotemporal disorders.)
- 80 (Incorrect. 80-years-old is not the most common age for people with frontotemporal disorders.)
- 60 (Correct! Approximately 60% of people diagnosed with FTLD are 45-60 years old.)
A: 60

Q: If a doctor has suspicions that a person has “Picks disease” what test can be done to examine the patient’s neurons for damage to the brain?
- A CT scan of a brain, looking for damage in the parietal and occipital lobes. (Incorrect. Pick bodies cannot be detected through a CT scan of the brain.)
- A histology of brain tissue looking for Lewy bodies. (Incorrect. Pick bodies cannot be detected through a histology test, but Lewy bodies can. These are only identified via autopsy.)
- A fMRI scan of the brain looking for damage to the frontal or parietal lobes. (Incorrect. Pick bodies cannot be detected through an fMRI as it detects activity within the brain.)
- A MRI scan of the brain looking for damage in the frontal or temporal lobes. (Correct! A brain MRI can demonstrate cortical and white matter atrophy of the frontal lobes.)
A: A MRI scan of the brain looking for damage in the frontal or temporal lobes.

Q: Tig is a 60-year-old woman who is demonstrating signs of dementia. In particular, she is exhibiting unusual behaviors like washing the floor with shampoo. Emotionally, she is highly reactive and is more argumentative with her spouse and neighbors. When her daughter recently visited her she noticed that she was having difficulty when preparing a meal, and even put her hand directly into the boiling water to pull out the noodles. What neurocognitive disorder would you suspect that Tig is developing?
- neurocognitive disorder due to Parkinson's disease (Incorrect. Tig does not meet the main diagnostic criteria for neurocognitive disorder due to Parkinson's disease.)
- Alzheimer’s disease (Incorrect. Tig does not meet the main diagnostic criteria for neurocognitive disorder due to Alzheimer’s disease.)
- neurocognitive disorder due to Lewy bodies (Incorrect. Tig does not meet the main diagnostic criteria for neurocognitive disorder due to Lewy bodies.)
- frontotemporal disorder (Correct! Tig displays unusual behavior, emotional problems, and is having trouble walking and coordinating tasks like cooking that require executive function. Also, Tig is the most common age for people to develop frontotemporal disorder.)
A: frontotemporal disorder

Q: Joan is an elderly woman who worked until her early seventies. She was bright, attentive, and lived an independent lifestyle, then her behavior changed gradually following a stroke. Lately, her spouse has noticed that she is having trouble maintaining her attention and navigating her environment outside of the house. Also, she is experiencing urinary incontinence multiple times per week. When her husband tells her he is concerned she tells him to bug off and lacks apathy about his concerns. What neurocognitive disorder does Joan have?
- Alzheimer’s disease (Incorrect. Joan does not have Alzheimer’s disease.)
- Parkinson’s disease (Incorrect. Joan does not have Parkinson's disease.)
- Lewy bodies (Incorrect. Joan does not have neurocognitive disorder due to Lewy bodies.)
- vascular (Correct! Joan exhibits signs of dementia such as apathy, problems with orientation, orientation, and urinary incontinence, which indicate a vascular neurocognitive disorder.)
A: vascular

Q: If a doctor has suspicions that a person has vascular neurocognitive disorder what medical screening tool can they use?
- a genetic screening (Incorrect. The vascular neurocognitive disorder cannot be identified from a genetic screening test.)
- histology of brain tissue (Incorrect. The vascular neurocognitive disorder cannot be identified from a histology test.)
- a western blot test of brain tissue (Incorrect. The vascular neurocognitive disorder cannot be identified from a western blot test.)
- MRI or CT brain scan. (Correct! A brain MRI or CT scan can indicate whether a patient has brain damage from strokes and lesions.)
A: MRI or CT brain scan.

Q: Sia is a 52-year-old woman who is showing dementia. Her doctor has her participate in cognitive screening tools to learn more about the presentation of her dementia. If Sia was in the beginning stages of neurocognitive disorder due to vascular disease what cognitive results would you find in comparison to other neurocognitive disorders?
- Sia will have worse free recall and more recall intrusions as compared to patients with Alzheimer's disease. (Incorrect. Sia will not have worse free recall and more recall intrusions as compared to patients with Alzheimer's disease.)
- Sia will have greater short term memory loss as compared to patients with Alzheimer’s disease. (Incorrect. Sia will not have worse short-term memory loss as compared to patients with Alzheimer’s disease.)
- Sia will have faster free recall and fewer distractions as compared to patients with Alzheimer’s disease. (Incorrect. Sia will not have faster free recall and fewer distractions as compared to patients with Alzheimer’s disease.)
- Sia will have better free recall and fewer recall intrusions as compared to patients with Alzheimer's disease. (Correct! Sia will have better free recall and fewer recall intrusions as compared to patients with Alzheimer's disease.)
A: Sia will have better free recall and fewer recall intrusions as compared to patients with Alzheimer's disease.

Q: Oscar lived in the United Kingdom during the 1980s and loved to go to his local pub to eat hamburgers and chips. Oscar died within six months of his first symptom, which was rapidly progressive dementia, jerky movements, and emotional and personality changes. Within a month of his first symptom, he had a speech impairment and could not work due to poor motor coordination and increased involuntary muscle movements. What disease did Oscar likely have?
- neurocognitive disorder due to Lewy bodies. (Incorrect. Oscar has another neurocognitive disorder.)
- neurocognitive disorder due to vascular disease. (Incorrect. Oscar has another neurocognitive disorder.)
- chronic wasting disorder. (Incorrect. Oscar has another neurocognitive disorder as a chronic wasting disorder is the prion disease for sheep.)
- Creutzfeldt-Jakob disease. (Correct! Oscar ate meat from cows infected with bovine spongiform encephalopathy (BSE) otherwise known as “Mad cow disease.”)
A: Creutzfeldt-Jakob disease.

Q: Oscar is a patient with Cretuztfeldt-Jakob disease. While Cretuzfeldt-Jakob disease cannot be cured, ________ can be used to address motor movement issues.
- sedatives and antidepressants (Incorrect. Sedatives and antidepressants can be used for depression and anxiety.)
- L-Dopa (Incorrect! L-Dopa will not address the movements that result from the structure of the brain changes due to the misfolding of proteins.)
- opiates (Incorrect. Opiates can be used for pain.)
- clonazepam. (Correct. While the disorder cannot be cured Clonazepam can be used for myoclonic jerks.)
A: clonazepam.

Q: Sylvester developed a neurocognitive dementia disorder and died within six months of his first symptom. He started with showing signs of dementia which rapidly progressed and was accompanied by jerky movements. He also developed anxiety and ataxia. Sylvester likely has
- neurocognitive dementia due to Lewy bodies (Incorrect. Sylvester does have Creutzfeldt-Jakob’s disease as he does not meet the criteria that also include early onset as well as hallucinations.)
- Alzheimer’s disease (Incorrect. Sylvester does not have Alzheimer's disease as he has significant motor impairment..)
- Parkinson’s disease (Incorrect. While Sylvester has significant motor impairment ataxia is not a major symptom of Parkinson’s disease.)
- neurocognitive disorder due to prion disease. (Correct. While Sylvester has Creutzfeldt-Jakob’s disease caused by prions changing the brain.)
A: neurocognitive disorder due to prion disease.

Q: The distinction between Huntington’s disease and Parkinson’s disease is that the risk of developing Huntington’s disease is dependent on
- age. (Incorrect. Risk factors for people with Huntington’s do not include age.)
- mental health disorders. (Incorrect. Risk factors for people with Huntington’s do not include other mental health disorders.)
- a family history of vascular disease. (Incorrect. Risk factors for people with Huntington’s do not include a family history of vascular disease)
- genetics. (Correct! Huntington’s disease is an autosomal dominant disease and has an insidious onset with a gradual progression.)
A: genetics.

Q: A famous folk singer, Woody Gutherie started showing irritability of mood and compulsive behaviors at age 35. Eventually the emotional and behavioral turned into difficulty controlling voluntary movements. During the later stages of this disease, he had progressively worse chorea and significant impairment in his emotion, judgment, and cognitive functioning. What neurodegenerative disorder did the folk singer have?
- Alzheimer’s disease (Incorrect. The folk singer does not have Alzheimer’s disease.)
- neurocognitive disorder due to Lewy bodies (Incorrect. The folk singer does not have neurodegenerative disorder due to Lewy bodies.)
- neurocognitive disorder due to vascular disease (Incorrect. The folk singer does not have neurodegenerative disorder due to vascular disease.)
- Huntington's disease (Correct! Huntington’s disease is an autosomal dominant disease and has an insidious onset with a gradual progression that results as nerve cells die.)
A: Huntington's disease

Q: To receive a diagnosis for HIV Neurocognitive disorder how many cognitive domains of impairment must be present in the patient’s behavior?
- 1. (Incorrect. A person needs more than one form of cognitive impairment to receive a diagnosis of HIV neurocognitive disorder.)
- 3. (Incorrect. A person needs less than three forms of cognitive impairment to receive a diagnosis of HIV neurocognitive disorder.)
- 4. (Incorrect. A person needs less than three forms of cognitive impairment to receive a diagnosis of HIV neurocognitive disorder.)
- 2. (Correct! A person must present with at least two forms of cognitive impairment such as information processing and concentration/attention)
A: 2.

Q: Given the complicated nature of HIV and how it affects individual patients, how would a doctor assess and diagnose a neurocognitive disorder for someone who also has HIV?
- confirm the presence of HIV infection and rule out other possible CNS causes that could explain dementia. (Incorrect. A doctor needs more medical information to confirm dementia related to HIV neurocognitive dementia and address treatment.)
- screen the patient for dementia and delirium to eliminate other possible contributing diseases. (Incorrect. A doctor needs more medical information to confirm dementia related to HIV neurocognitive dementia and address treatment.)
- screen the patient for dementia and delirium to eliminate other possible contributing diseases and check the timeline of the symptoms. (Incorrect. A doctor needs more medical information to confirm dementia related to HIV neurocognitive dementia and address treatment.)
- confirm the presence of HIV infection, rule out other possible CNS causes that could explain dementia, and also check for substance abuse. (Correct! A person must have a confirmed diagnosis of HIV and also all other possibilities, both CNS and substance abuse should be explored to rule out other forms of dementia.)
A: confirm the presence of HIV infection, rule out other possible CNS causes that could explain dementia, and also check for substance abuse.

Q: How could a physician narrow down the diagnosis of neurocognitive disorder due to HIV?
- confirm the presence of HIV infection and rule out other possible CNS causes that could explain dementia.
- screen the patient for dementia and delirium to eliminate other possible contributing diseases.
- screen the patient for dementia and delirium to eliminate other possible contributing diseases and check the timeline of the symptoms.
- confirm the presence of HIV infection, rule out other possible CNS causes that could explain dementia, and also check for substance abuse.
A: confirm the presence of HIV infection, rule out other possible CNS causes that could explain dementia, and also check for substance abuse.

Q: Timo tested positive for HIV several years ago, but takes highly active antiretroviral therapy and has thus far avoided any serious side effects that could potentially lead to neurocognitive disorder due to HIV. Behavioral signs of the disoder that Timo should look for include
- irritability or anger. (Incorrect. Generally, behavioral changes may present as apathy, lethargy, and diminished emotional responses, and spontaneity.)
- aggression or frustration. (Incorrect. Generally, behavioral changes may present as apathy, lethargy, and diminished emotional responses, and spontaneity.)
- added intensity and hyperactivity. (Incorrect. Generally, behavioral changes may present as apathy, lethargy, and diminished emotional responses, and spontaneity.)
- apathy or lethargy. (Correct! Behavioral changes may present as apathy, lethargy, and diminished emotional responses, and spontaneity.)
A: apathy or lethargy.

Q: Colin is a chronic alcoholic who is showing symptoms of alcohol-related dementia during the most common onset period. How old is Colin?
- 35 (Incorrect! 30-50 is not the most common age for alcohol dementia to reveal itself.)
- 28 (Incorrect! 20-40 is not the most common age for alcohol dementia to reveal itself.)
- 65 (Incorrect. Incorrect! 60-80 is not the most common age for alcohol dementia to reveal itself.)
- 55 (Correct! The most common age for alcohol dementia to reveal itself is between the ages of 50 to 70.)
A: 55

Q: Felicity is a chronic alcoholic who is showing symptoms of alcohol-related dementia during the most common onset period. How old is Felicia?
- 35
- 28
- 65
- 55
A: 55

Q: Given the complicated nature of substance abuse and how it affects individual patients, how would a doctor assess and diagnose a neurocognitive disorder?
- psychological evaluation including substance abuse history and rule out other possible CNS causes that could explain dementia. (Incorrect. A doctor needs more medical information to confirm dementia related to substance abuse neurocognitive dementia and address treatment.)
- screen the patient for dementia and delirium to eliminate other possible contributing diseases. (Incorrect. A doctor needs more medical information to confirm dementia related to substance abuse neurocognitive dementia and address treatment.)
- screen the patient for dementia and delirium to eliminate other possible contributing diseases and check the timeline of the symptoms. (Incorrect. A doctor needs more medical information to confirm dementia related to substance abuse neurocognitive dementia and address treatment.)
- psychological evaluation including substance abuse history, rule out other possible CNS causes that could explain dementia, and laboratory tests to assess malnutrition. (Correct! A person must have a confirmed diagnosis of substance abuse and also all other possibilities of CNS diseases and current substance abuse (i.e., medication-related dementia) should be explored to rule out other forms of dementia.)
A: psychological evaluation including substance abuse history, rule out other possible CNS causes that could explain dementia, and laboratory tests to assess malnutrition.

Q: Jason has Korsakoff’s disease from long term alcohol abuse. He is showing signs of dementia as a result of the alcohol damaging the brain. How does alcohol damage the brain directly in neurocognitive dementia disorders?
- malnutrition (vitamin B1 deficit) (Incorrect. An excess of alcohol does not cause brain damage from Malnutrition of vitamin B1.)
- produces an excess of dopamine production (Incorrect. An excess of alcohol does not cause an excess of dopamine production to damage the brain directly.)
- dehydration (Incorrect. An excess of alcohol does not cause dehydration to damage the brain directly.)
- neurotoxin. (Correct! An excess of alcohol can damage the brain as a neurotoxin.)
A: neurotoxin.

Q: To receive a diagnosis for neurocognitive disorder due to TBI how many of the following symptoms must present in a patient: loss of consciousness, posttraumatic disorientation, confusion, or neurological impairment?
- 2 (Incorrect. A person needs less than two symptoms from the list of loss of consciousness, posttraumatic disorientation, confusion, or neurological impairment.)
- 3 (Incorrect. A person needs less than three symptoms from the list of loss of consciousness, posttraumatic disorientation, confusion, or neurological impairment.)
- 4 (Incorrect. A person needs less than four symptoms from the list of loss of consciousness, posttraumatic disorientation, confusion, or neurological impairment.)
- 1 (Correct! A person must present with at least one symptom from the list of loss of consciousness, posttraumatic disorientation, confusion, or neurological impairment.)
A: 1

Q: The timeline of emergency treatment is important for recovery from a TBI to prevent neurocognitive decline. What is the most optimal time to start treatment after a TBI?
- 24 hours (Incorrect. Twenty four hours is not optimal because the initial damage from the injury may not be able to be reversed.)
- 36 hours (Incorrect. Thirty-six hours is not optimal because the initial damage from the injury may not be able to be reversed.)
- 4 hours (Incorrect. Four hours is not optimal because the initial damage from the injury may not be able to be reversed.)
- the “golden hour”. (Correct! The “golden hour” is the best time post-concussion/head injury to stabilize the patient and try to reverse trauma to the brain.)
A: the “golden hour”.

Q: Steve is a talented hockey player who has been on elite teams since he was seven years old. He is currently 18-years-old and has a history of concussions from direct hits from other hockey players. Steve is a good student who has a strong athletic career and he wants to sign with a Division I hockey team with an athletic college scholarship. His parents are hesitant to allow him to continue playing high-level hockey because they are afraid of negative cognitive consequences. Which of the following neurocognitive disorders are they afraid their son might have?
- delirium (Incorrect. Steve’s parents are not concerned about delirium as to why they do not want him to sign with the college.)
- neurocognitive dementia due to Lewy bodies (Incorrect. Steve’s parents are not concerned about neurocognitive dementia due to Lewy bodies as to why they do not want him to sign with the college.)
- neurocognitive dementia due to vascular disease (Incorrect. Steve’s parents are not concerned about neurocognitive dementia due to vascular disease as to why they do not want him to sign with the college.)
- chronic traumatic encephalopathy (CTE). (Correct! Steve’s parents fear that he will have a cumulative effect of all his concussions.)
A: chronic traumatic encephalopathy (CTE).

Q: One of the most effective forms of intervention for neurocognitive dementia disorders is which of the following?
- aggressive treatment (Incorrect. Aggressive treatment may not be able to reverse cognitive impairments or slow down disease if a diagnosis indicates an advanced disorder.)
- regular medical testing and examinations in elderly patients or those at risk (Incorrect. Medical screening is important in monitoring but even people without risk factors can still have dementia.)
- collecting family reports about the patient’s behavior (Incorrect. The family report is just one part of an intervention plan and is not the most effective form of intervention.)
- early diagnosis. (Correct! The earlier a person with a neurocognitive dementia disorder can receive a diagnosis the more that intervention and treatment can delay the progression of cognitive symptoms and control/stabilize psychiatric manifestations.)
A: early diagnosis.

Q: Research studies have investigated predictive factors of major neurocognitive dementia disorders and found three major categories of risk factors. All of the following may increase the risk of dementia EXCEPT
- sociodemographic factors. (Incorrect. Sociodemographic factors are one of the categories of predictive factors to assess the risk of developing a major neurocognitive dementia disorder.)
- health factors. (Incorrect. Health factors are one of the categories of predictive factors to assess the risk of developing a major neurocognitive dementia disorder.)
- bio-behavioral factors. (Incorrect. Bio-behavioral factors are one of the categories of predictive factors to assess the risk of developing a major neurocognitive dementia disorder.)
- cognitive ability and achievement factors. (Correct! Cognitive ability and achievement factors are not one of the categories of predictive factors to assess the risk of developing a major neurocognitive dementia disorder.)
A: cognitive ability and achievement factors.

Q: ________ is an approach to treating neurocognitive dementia disorders through medication that is most effective when combined with ________ interventions.
- biological;lifestyle. (Incorrect. Biological or lifestyle interventions are not a category of treatment and interventions, but rather a framework to understand the disease and treatment.)
- pharmacological; physical activity level. (Incorrect. When pharmacological and physical activity level interventions are combined it is not most likely that the patient with MND will have the best outcome possible.)
- pharmacological; dietary. (Incorrect. When pharmacological and dietary interventions are combined it is not most likely that the patient with MND will have the best outcome possible.)
- pharmacological; behavioral/environmental. (Correct! When pharmacological and behavioral interventions are combined it is most likely that the patient with MND will have the best outcome possible.)
A: pharmacological; behavioral/environmental.

Q: Taylor is a 65-year-old woman who is demonstrating signs of dementia. In particular, she is exhibiting unusual behaviors like washing the floor with shampoo. Emotionally, she is highly reactive and is more irritable with her spouse and grandchildren. When her daughter recently visited her she noticed that she was also having difficulty when preparing a meal. Taylor had difficulty physically moving around the kitchen and struggled with following the recipe in the correct order. What neurocognitive disorder would you suspect that Taylor is developing?
- neurocognitive disorder due to Parkinson's disease. (Incorrect. Taylor does not meet the main diagnostic criteria for neurocognitive disorder due to Parkinson's disease.)
- Alzheimer’s disease. (Incorrect. Taylor does not meet the main diagnostic criteria for neurocognitive disorder due to Alzheimer’s disease.)
- neurocognitive disorder due to Lewy bodies. (Incorrect. Taylor does not meet the main diagnostic criteria for neurocognitive disorder due to Lewy bodies.)
- frontotemporal disorder. (Correct! Taylor displays unusual behavior, emotional problems, and is having trouble walking and coordinating tasks like cooking that require executive function. Also, Taylor is the most common age for people to develop a frontotemporal disorder.)
A: frontotemporal disorder.

Q: Thomas is an 80-year-old who has found pride in his ability to function independently. Up until about six months ago, Thomas has been able to go to the store alone for his groceries. However, in the past six months, his daughter has noticed that he has difficulty finding the grocery items on his list even though he has been going to the same store for 20 years. In addition, his son also witnessed him struggling to count her change for the store clerk. Thomas still can clearly state what food items he wants and how much. Thomas is showing signs of minor cognitive decline primarily in which of the following cognitive areas :
- social cognition.
- language
- problem-solving
- memory.
A: memory.

Q: Harold is a 55-year-old man who has started to “act off” in her family’s opinion. Harold has always been an anxious person but recently he has begun to have difficulty remembering where he is, has a slower walking pace and takes shorter steps, and asks to talk to people who are not present in the room. His family is concerned about the progressive decline of their father and they take her to a neurologist. What diagnosis is the doctor likely to give him?
- Alzheimer’s disease (Incorrect. Patients with Alzheimer’s disease do not typically have Parkinson's symptoms.)
- dementia. (Incorrect. Harold’s case is more complicated than just dementia.)
- a mild neurocognitive disorder. (Incorrect. Harold’s life is disrupted by her symptoms that she cannot function independently and they go beyond just cognitive decline to physical symptoms.)
- neurocognitive disorder with Lewy bodies. (Correct! When Lewy bodies develop inside nerve cells that are abnormal aggregations of protein that cause neurocognitive declines such as dementia, parkinsonian symptoms, and neuropsychiatric disturbances.)
A: neurocognitive disorder with Lewy bodies.

Q: Alyssa is a woman in her late seventies who has recently begun to show emotional mood shifts and confusion in familiar situations. About three years ago, and since then Alyssa has demonstrated memory loss by losing her wallet or getting lost in her neighborhood during her daily walks. Now, Alyssa is easily disoriented has difficulty recognizing faces, places, or her relationship to a person. Her symptoms are continuing to gradually get worse and she now cannot remember what decade it is and often gets confused about which stage of life she is experiencing. What diagnosis would you give Alyssa?
- Parkinson's disease. (Incorrect. Alyssa does not display the progression of Parkinson's disease.)
- Multiple Sclerosis. (Incorrect. Alyssa does not display the progression of multiple sclerosis.)
- Lewy body dementia. (Incorrect. Alyssa does not display the progression of Lewy body dementia.)
- Alzheimer’s disease. (Correct! AD is a disease that continues to get worse overtime and causes problems with memory, thinking, and behavior.)
A: Alzheimer’s disease.

Q: ________ is a disorder that results from people taking dopamine-receptor blocking medications like antipsychotics and metoclopramide that causes people to have involuntary movements such as jerking, repetitive, and movements of the mouth (e.g, grimacing, sticking out the tongue, and smacking the lips).
- Tardive Akathisia (Incorrect. People with Tardive Akathisia have a compulsive drive to move the body due to painful feelings of inner tension or anxiety.)
- Tardive Dystonia (Incorrect. People with tardive dystonia have permanent sustained or repetitive muscle contractions that result in twisting or abnormal fixed postures.)
- neuroleptic-induced parkinsonism (Incorrect. People with neuroleptic-induced parkinsonism have symptoms similar to Parkinson's disease when a person changes medication.)
- Tardive Dyskinesia. (Correct! People with tardive dyskinesia have involuntary movements such as jerking, repetitive, and movements of the mouth (e.g, grimacing, sticking out the tongue, and smacking the lips).)
A: Tardive Dyskinesia.

Q: Clinicians will use which of the following efforts to prevent medication-induced movement disorders when prescribing for patients?
- prescribing the lowest dose possible (Incorrect. Doctors will always try to prescribe medication at the lowest dose possible but also use another guideline.)
- prescribing a different class of medication (Incorrect. This prescription plan does not include all of the options necessary to fully prevent medication-induced movement disorders)
- keep the medication dose consistent but add another medication to address symptoms (Incorrect. This prescription plan does not include all of the options necessary to fully prevent medication-induced movement disorders.)
- prescribing the lowest dose possible and discontinue the use of neuroleptics. (Correct! Doctors will always try to prescribe medication at the lowest dose possible and also avoid using neuroleptics unless necessary.)
A: prescribing the lowest dose possible and discontinue the use of neuroleptics.

Q: Shirley is a 50-year-old woman who recently became a widow. After losing her spouse Shirley fell into a deep depression, lost intrinsic motivation, and became incredibly lethargic. The doctor prescribed an SSRI medication to help her manage her emotions and improve her quality of life. The medication helped, but she stayed on these medications for 10 years and at 60-years-old she began to notice she had involuntary muscle movements, weakness, and rigidity. What disorder does Shirley have?
- Parkinson's disease (Incorrect. Shirley has symptoms that are similar to Parkinson's disease, but she does not meet the criteria for diagnosis.)
- Huntington's disease (Incorrect. Shirley does not have Huntington's disease.)
- Korsakoff’s disease (Incorrect. Shirley does not have Korsakoff’s disease as it is dementia as a result of long-term severe alcohol consumption.)
- antidepressant-associated movement disorder. (Correct! Shirley is suffering from a medication-induced movement disorder from the long term use of SSRI, which is an anti-depressant medication.)
A: antidepressant-associated movement disorder.

Q: Children who experience poverty have constant exposure to stress and trauma. It is suggested that society could improve the lives of children, their development and functioning in later life, and reduce the trauma in their lives by providing which of the following?
- support for parents (Incorrect. Support for parents would benefit children but not stabilize their primary environment.)
- educational outreach in communities (Incorrect. Educational outreach in communities would benefit children but not stabilize their primary environment.)
- supplemental food (Incorrect. Providing families with nutritional resources would benefit children but not stabilize their primary environment.)
- quality housing (Correct! Children with house inequality are exposed to many stressors and inequality of neighborhood amenities like the quality of local schools, air pollution, exposure to chemicals and toxins, and crime.)
A: quality housing

Q: Jess’s mother abused drugs when she was a child, so Jess and her sister bounced between living with their mother, other family members, and a few foster families. She was persistently worried about finding a safe place to live and, now as an adult, she has a hard time forming close relationships and trusting others. Her therapist helps her see that the ________ of her youth connect to her current mental health.
- relational problems (Incorrect. Jess’s experiences demonstrate that her concern was predominately related to housing and her economic situation.)
- crime or interaction with the legal system (Incorrect. Crime or legal issues may cause stress and anxiety that could lead to mental health concerns, but this is not true of Jess’s experience.)
- emotional and occupational problems (Incorrect. Workplaces, as well as emotional disturbances, may cause anxiety and depression, but this is not true of Jess’s experience.)
- housing and economic problems (Correct! Jess’s housing and economic problems may cause anxiety and depression, and lingering trauma that could affect Jess today.)
A: housing and economic problems

Q: A man fears that his body is offensive to other people in his culture. This fear manifests in terms of constantly brushing his teeth due to fear of having bad breath and offending people; making small movements on the street so as not to offend passersby. What cultural-specific mental disorder does this man have?
- Nervios (Incorrect. This man does not have nervios as he does not have anxiety or mental distress aby difficult life circumstances.)
- Dhat (Incorrect. This man does not have dhat as he does not have hypochondriacal concerns.)
- Susto (Incorrect. This man does not have susto as he does not fear his soul is leaving his body.)
- Taijin kyofusho (Correct! This man has Taijin kyofusho as he has an intense fear that his body is offensive to other people.)
A: Taijin kyofusho

Q: A man fears that his body is failing him. This fear manifests in terms of constantly brushing his teeth due to fear of developing an infection; constantly checking for bumps after walking down a crowded street, and obsessing about his pain. What is this an example of?
- A mental disorder brought about due to community health issues.
- A mental disorder found in Japan called taijin kyofusho.
- A Latin-American based mental disorder known as susto.
- The cultural-specific mental disorder called dhat.
A: The cultural-specific mental disorder called dhat.