Deck 14: Dementia, Delirium, and Amnestic Disorders

Question 1

Last year, Bob was admitted and released from the hospital within two days. The diagnosis was a cognitive disorder. Since that time he has held down a job as a carpenter. Which of the following disorders is most likely to have caused Bob's hospitalization?

A) delirium
B) dementia
C) Parkinson's disease
D) Huntington's disease

Answer 1

delirium

Question 2

A television report described a case of a person who exhibited a disturbance in consciousness accompanied by memory deficits and disorientation to time and place. If these symptoms occurred in the last 24 hours, you believe the diagnosis is

A) apraxia.
B) dementia.
C) delirium.
D) amnestic disorder.

Answer 2

delirium.

Question 3

Castle is in the early stages of dementia. Which of the following is most characteristic of the type of problem she is likely to exhibit?

A) She shows writhing movements.
B) She cannot be understood when she speaks.
C) She can't remember the new neighbor she met yesterday.
D) She can't remember the name of the town she grew up in.

Answer 3

She can't remember the new neighbor she met yesterday.

Question 4

Your textbook states that the hallmark of dementia is _________.

A) aphasia
B) hallucinations
C) delirium
D) memory loss

Question 5

At the insistence of family members you take your elderly grandfather to a general practice physician who refers him to a neurologist. When you ask for a description of neurologists, the general practitioner tells you they are

A) psychologists specializing in neuroses.
B) psychiatrists specializing in nervous disorders.
C) psychologists specializing in neuropsychological testing.
D) physicians specializing in diseases of the brain and nervous system.

Question 6

Which of the following individuals exhibits behavior that would most likely meet the criteria for amnestic disorder?

A) Kim has severe memory impairments along with aphasia and apraxia.
B) Jose has difficulty with motor functions, frequently exhibits tremors, and has developed depression.
C) Steve has severe difficulty in learning new information, but his use of language is otherwise unaffected.
D) Al has been in a confused state with agitation and hyperactivity and memory impairment that began two days ago.

Question 7

Which of the following is characteristic of amnestic disorder?

A) usually worse at night
B) language abilities are unaffected
C) reduced awareness of one's surroundings
D) impaired reasoning and decision-making

Question 8

While hospitalized, Jack's physician notices that he is beginning to show signs of delirium. Which of the following was a possible clue that led the physician to suspect that Jack was experiencing delirium?

A) He reported paranoid delusions.
B) He was experiencing fleeting perceptual disturbances.
C) Motor functions on his right side have slowed.
D) He appeared sedated and didn't show much emotion.

Question 9

The cognitive symptoms seen in dementia, delirium, and amnestic disorders

A) are not seen in any other disorders.
B) are seen in other disorders as well but are not defining features.
C) are seen in other disorders but are not as severe.
D) are only seen in schizophrenia and other psychotic disorders.

Question 10

What was one of the first indications that 84-year-old Mary (whose case was described in the text) was suffering from dementia?

A) She could not remember her age.
B) She reported hearing voices calling her.
C) Some of her animals were found dead because she forgot to feed them.
D) After being admitted to a nursing home, she became agitated and belligerent.

Question 11

In trying to make a differential diagnosis between delirium and dementia each of the following would be accurate EXCEPT

A) Delirium has a rapid onset and typically fluctuates. Dementia develops slowly and steadily.
B) Delirium often involves hallucinations and dementia rarely.
C) With delirium one has consistently poor insight, but with dementia there are often insightful periods.
D) Sleep is more disturbed with delirium than dementia.

Question 12

Aphasia refers to various types of loss or impairment in

A) language.
B) spatial ability.
C) muscle coordination.
D) neurotransmitter production.

Question 13

What is the most obvious problem during the beginning stages of dementia?

A) chorea
B) delirium
C) retrograde amnesia
D) anterograde amnesia

Question 14

After suffering a head injury in a car accident, Molly cannot remember anything that happened before the accident. What term will her physician use to describe her condition?

A) agnosia
B) apraxia
C) retrograde amnesia
D) dissociative amnesia

Question 15

A group of medical students is learning the criteria used to diagnose cognitive disorders. The professor is discussing evidence of disturbances of consciousness along with changes in cognition such as memory deficits that occur rapidly. What type of disorder is being discussed?

A) dementia
B) delirium
C) amnestic disorder
D) depersonalization

Question 16

A 68-year-old man is brought to the emergency room by his family. Family members tell the physician that their relative has been confused, agitated, and exhibiting memory impairments. These symptoms developed in the last few days; he has no prior history of memory problems. Based on the family's information, the physician suspects the man is experiencing delirium. Which of the following questions would provide information that could confirm this diagnosis?

A) "Does schizophrenia run in your family?"
B) "Is he taking any medications at this time?"
C) "Does he experience any difficulties with motor movements?"
D) "Do any members of the family suffer from Huntington's disease?"

Question 17

You are head of an assessment team that needs some testing to determine the level and type of cognitive impairment being experienced by your client. You call on the services of which type of team member for this assessment?

A) psychiatric social worker
B) neuropsychiatrist
C) neuropsychologist
D) psychiatric nurse

Question 18

Which of the following is characteristic of delirium?

A) agnosia
B) delusions
C) identity confusion
D) clouded consciousness

Question 19

Stanley is 65, and for the past couple of years he has been suffering a gradual worsening of his memory as well as some language difficulties and problems with his reasoning and decision making. What is the most likely diagnosis?

A) delirium
B) organic psychosis
C) dementia
D) schizophrenia

Question 20

Typically the symptoms of delirium

A) develop rapidly and then remain at a steady level as they slowly develop.
B) develop slowly and fluctuate throughout the day.
C) occur rapidly and then fluctuate throughout the day.
D) None of the above are accurate.

Question 21

A psychologist holds out a comb and asks Mr. Bonte "What is this called in my hand?" Mr. Bonte replies, "I have no idea what that's called." The psychologist then asks Mr. Bonte to show what he would do with the object. Mr. Bonte says, "How should I know? I don't know what it is!" Mr. Bonte's response led the psychologist to describe his condition as

A) aphasia.
B) agnosia.
C) apraxia.
D) Alzheimer's disease.

Question 22

The disruption of short-term memory, perceptual skills, and higher-level cognitive abilities for people with dementia can also lead to

A) hallucinations.
B) disruptions of judgment.
C) aggressive outbursts and use of obscene language.
D) disorientation to time, place and person.

Question 23

People with dementia often show difficulty with abstract thinking. Which of the following questions to a person with dementia would help to demonstrate this difficulty?

A) "What time is it?"
B) "What was the name of your first grade teacher?"
C) "Why are a basketball and a football helmet alike?"
D) "What would you like to have for supper tonight?"

Question 24

In a study of mental functioning comparing young adults to individuals in their sixties, a psychologist asks questions such as, "You are about to buy a new car, what factors will you have to consider?" What is the psychologist doing and what is he likely to find?

A) The psychologist is using questions that tap fluid intelligence; the older group will perform at a higher level.
B) The psychologist is using questions that tap wisdom; the two groups will not differ in their performance.
C) The psychologist is using questions that tap wisdom; the young adults will outperform the older group.
D) The psychologist is using questions designed to tap fluid intelligence; the two groups will not differ in their responses to these types of items.

Question 25

What is the relationship of personality changes, emotional difficulties, and motivational problems to dementia?

A) They are essential to the diagnosis of dementia.
B) They only occur in early-onset forms of dementia.
C) They are frequently associated with dementia and have an impact on the person's adjustment.
D) They are among the most important causes of dementia.

Question 26

Your aunt who is in her 70s has been referred to a professional. The aunt is given a series of tests that assess cognitive, sensorimotor, perceptual, and speech function. It is most likely that your aunt is seeing a

A) physician.
B) neuropsychologist.
C) psychiatrist.
D) mneumonist.

Question 27

Imagine you were listening to Jimmie G (the case study presented in the textbook) as he was recounting his life. What note would you jot down that would help in your assessment of the case?

A) He referred to the doctor as "doc."
B) He was interested in children playing baseball.
C) He spoke of his post WWII experiences in the present tense.
D) He thought there was something wrong with his nerves because he was interviewed by a neurologist.

Question 28

You need to look up the DSM-IV-TR diagnostic criteria for dementia and delirium. Under what heading will you find these disorders?

A) psychotic disorders
B) cognitive disorders
C) somatoform disorders
D) organic mental disorders

Question 29

Which problem is experienced by someone with apraxia?

A) cannot understand speech
B) forgets the names of objects
C) muscles are too weak to move
D) cannot translate ideas into meaningful action

Question 30

The current perspective on the etiology of Korsakoff's syndrome emphasizes the role of

A) a vitamin deficiency.
B) disruption of neurotransmitter functioning.
C) a head injury that typically occurs while intoxicated.
D) heavy alcohol use, regardless of nutritional habit.

Question 31

Which type of amnestic disorder is associated with chronic alcoholism?

A) Pick's disease
B) Alzheimer's disease
C) Huntington's disease
D) Korsakoff's syndrome

Question 32

Dyskinesia is a symptom characterized by

A) involuntary movements.
B) exaggerated emotionality.
C) inability to name objects.
D) loss of memory for past events.

Question 33

What were the two forms of dementia described by Emil Kraepelin in his 1910 textbook on psychiatry?

A) aphasia and apraxia
B) Huntington's disease and Pick's disease
C) Alzheimer's disease and senile dementia
D) retrograde amnesia and anterograde amnesia

Question 34

Two patients on the neurology ward at the hospital have different memory problems. Ann has difficulty remembering what happened before a car accident, whereas Carson's difficulty is in learning to remember new material. At a case conference, how will these two cases be described?

A) Ann has apraxia; Carson has aphasia
B) Ann has aphasia; Carson has apraxia
C) Ann has retrograde amnesia; Carson has anterograde amnesia
D) Ann has anterograde amnesia; Carson has retrograde amnesia

Question 35

The Mini-Mental State Examination is used to assess

A) cognitive impairment.
B) microscopic brain lesions.
C) a patient's level of depression.
D) clinicians' qualifications as neurologists.

Question 36

What was the critical factor that distinguished between the two forms of dementia described by Emil Kraepelin?

A) presence or absence of psychotic symptoms
B) age of onset
C) organic versus psychosocial etiology
D) auditory versus visual hallucinations

Question 37

What two terms does Paul Baltes and colleagues use to describe aspects of mental functioning?

A) verbal and visual
B) acquired and innate
C) academic and practical
D) fluid intelligence and wisdom

Question 38

Which of these individuals is experiencing visual agnosia?

A) Tim, who cannot see as a result of a sensory deficit
B) Ted, who knows what an object is for, but not its name
C) Teresa, who cannot move the mouth muscles to name an object
D) Tess, who does not recognize a pencil as something meaningful

Question 39

A neuropsychologist is describing several patients at a case conference. He says John does not know the names of common objects such as shoes, shirts, and screwdrivers. Jill does not know how to use such objects. When he asks what terms are used to describe their difficulties, what should he hear?

A) John exhibits apraxia; Jill exhibits aphasia
B) John exhibits aphasia; Jill exhibits apraxia
C) John exhibits retrograde amnesia; Jill exhibits anterograde amnesia
D) John exhibits anterograde amnesia; Jill exhibits retrograde amnesia

Question 40

Korsakoff's syndrome is thought to be caused by

A) damage to specific parts of the brain.
B) a recessive gene.
C) an as-yet unidentified virus.
D) the isolation and loneliness of old age.

Question 41

What are the typical symptoms that mark a diagnosis of Parkinson's disease?

A) chorea, tremors, and retardation
B) tremors, dementia, and postural abnormalities
C) writhing, aimless exploration, and depression
D) tremors, reduction in voluntary movements, and rigidity

Question 42

Neurofibrillary tangles, which are typically found in patients with Alzheimer's disease,

A) are unique to that disease and allow for definite diagnosis.
B) are found in adults with other cognitive disorders.
C) have not yet been identified.
D) do not appear until the end stage of the disease.

Question 43

All of the following symptoms are characteristic of Parkinson's disease EXCEPT

A) tremor.
B) muscle rigidity.
C) postural abnormalities.
D) catatonia.

Question 44

All of the following brain regions are implicated in Huntington's disease EXCEPT

A) Putamen.
B) Head of caudate nucleus.
C) Parietal lobe.
D) Amygdaloid body.

Question 45

The cognitive and motor deficits associated with Huntington's disease are due to neuronal degeneration in the

A) hippocampus.
B) frontal lobe.
C) basal ganglia.
D) medial thalamus.

Question 46

In comparison to Alzheimer patients, patients with frontotemporal dementia (FTD) are

A) more likely to engage in impulsive sexual actions and roaming and aimless exploration.
B) less likely to engage in impulsive sexual actions and roaming and aimless exploration.
C) likely to engage in impulsive sexual actions and roaming and aimless exploration at about the same rate.
D) more likely to develop impaired perception.

Question 47

Chorea is a symptom of

A) vascular dementia.
B) Alzheimer's disease.
C) Parkinson's disease.
D) Huntington's disease.

Question 48

What is an infarct?

A) dementia due to depression
B) clogged arteries in the brain
C) a surgical procedure to clear brain plaques
D) an area of dead brain tissue caused by a stroke

Question 49

Many conditions other than those that attack the brain tissue directly can also produce symptoms of dementia. These can be either medical conditions or other types of mental disorders. One cause of dementia is the severe interruption of blood flow to the brain; known as __________.

A) stroke
B) myocardial infection
C) vascular occlusion
D) vasodementia

Question 50

What is one way that Huntington's disease and Parkinson's disease can usually be distinguished?

A) Only Parkinson's disease involves motor symptoms.
B) Huntington's disease usually leads to dementia while Parkinson's does not.
C) It is possible to recover from Huntington's disease but not Parkinson's.
D) Only Huntington's disease carries a risk for depression.

Question 51

What are the distinguishing characteristics of the brain lesions found in Alzheimer's disease?

A) microtubules and dopamine deposits
B) neurofibrillary tangles and amyloid plaques
C) ballooning of nerve cells and loss of myelin sheaths
D) clogged arteries in the train and enlarged microtubules

Question 52

Franklin has Huntington's disease, and on that basis we can be virtually certain that

A) Franklin is at least 70 years old.
B) Franklin has a history of excessive alcohol consumption.
C) Franklin's family has a history of this disease.
D) Franklin can be effectively treated with anti-Parkinsonian drugs.

Question 53

DSM-IV-TR lists many specific forms of dementia, which are distinguished primarily on the basis of

A) the specific types of brain lesions.
B) the specific types of chromosomal abnormalities.
C) degree of severity.
D) age of onset.

Question 54

You are reading a medical chart in which a patient is referred to as displaying chorea. If you met this patient, you might expect a lot of

A) restless and fidgety movements.
B) incoherent speech.
C) obscene language.
D) listlessness and psychomotor retardation.

Question 55

A doctor has just finished her examination of a seventy-two-year-old patient who is has recently been showing significant and worsening memory loss and other forms of cognitive impairment, and the doctor says, "This woman is definitely suffering from Alzheimer's disease." Why should you be skeptical about this diagnosis?

A) Alzheimer's disease only affects younger people.
B) Alzheimer's disease does not typically involve memory problems.
C) A definite diagnosis of Alzheimer's can only be determined by an autopsy.
D) The patient's condition is worsening, but Alzheimer's disease involves very stable symptoms.

Question 56

Although Marsha is unable to move the right side of her body, the other side of her body is mobile. What is the most likely cause of this problem?

A) stroke
B) Pick's disease
C) Parkinson's disease
D) neurofibrillary tangles

Question 57

Which of the following describes the amyloid plaques found in Alzheimer's disease?

A) asymmetrical neurofibrils
B) ballooning of nerve cells
C) clogged arteries in the frontal lobes
D) a central core of protein material surrounded by clumps of debris from destroyed neurons

Question 58

A stroke occurs when

A) the heart stops beating.
B) blood flow to the brain is interrupted.
C) a seizure disrupts neuronal transmissions.
D) head injury causes damage to the frontal lobe.

Question 59

Alzheimer's disease is distinguished from other types of dementia in DSM‑IV-TR based on

A) muscular impairment.
B) personality changes.
C) gradual speed of onset.
D) more significant memory impairment.

Question 60

Frontotemporal dementia (FTD) is a rare form of dementia associated with atrophy of the frontal and temporal lobes of the brain. In FTD __________________ generally precede(s) the onset of cognitive impairment.

A) extreme anxiety
B) personality changes
C) lose of long-term memory
D) hallucinations

Question 61

A new form of dementia has just been discovered, and researchers have determined that the disorder is transmitted genetically as an autosomal dominant trait. If a child's father has one of the genes and the mother has none of the genes for the disorder, what is the probability that the child will inherit this disorder?

A) 25 percent
B) 50 percent
C) 75 percent
D) 100 percent

Question 62

Vascular dementia and Alzheimer's disease have very similar

A) cause.
B) rate of onset.
C) motor impairments.
D) cognitive impairments.

Question 63

All of the following are true with regard to the incidence of Alzheimer's disease EXCEPT

A) The incidence of AD is about the same for men and women until age 90.
B) The incidence of AD is greater for men at all ages.
C) After age 90 the incidence of AD decreases for men.
D) After age 90 the incidence of AD increases for women.

Question 64

Why are researchers who study Alzheimer's disease also very interested in Down syndrome?

A) both are known to be caused by a recessive gene
B) people with Down syndrome almost always develop Alzheimer's
C) both have been linked to dopamine and serotonin deficiencies
D) the possible link of both to chromosome 21

Question 65

ALL of the following are true with regard to genetic studies of the cause of Alzheimer's disease EXCEPT.

A) There are markers for Alzheimer's disease on a dozen gene alleles.
B) There are markers for Alzheimer's disease on the chromosome 21.
C) There are associations between the gene responsible for producing amyloid precursor protein, or APP, and Alzheimer's disease.
D) There are markers for Alzheimer's disease on the same gene associated with Down syndrome.

Question 66

Approximately what percentage of individuals over the age of ninety will exhibit symptoms of moderate to severe dementia?

A) 5 percent
B) 15 percent
C) 30 percent
D) 40 percent

Question 67

Approximately what percentage of patients diagnosed with dementia also show signs of major depressive disorder?

A) 10 percent
B) 25 percent
C) 35 percent
D) over 50 percent

Question 68

The senile plaques and neurofibrillary tangles that are typical in Alzheimer's disease are also found in people with

A) schizophrenia.
B) Down syndrome.
C) Parkinson's disease.
D) Korsakoff's syndrome.

Question 69

If the Word Health Organization assembled the most respected researchers on the genetics of Alzheimer's disease and asked them to review the research, which of the following would make for the most appropriate title for that report?

A) "A Single Disease, a Single Gene"
B) "How Toxins Affect Genetic Vulnerability"
C) "Link Identified: Distractibility as the Key"
D) "Alzheimer's Disease: No Single Genetic Path"

Question 70

One Swedish study of genetic factors in the cause of dementia found the following concordance rate for monozygotic twins.

A) 1 percent
B) 20 percent
C) 40 percent
D) over 50 percent

Question 71

What is genetic linkage analysis?

A) microscopic analysis of nerve cell damage
B) documentation of patterns of inheritance in families
C) educating family members about chances of inheritance
D) locating a gene that is responsible for a disorder or trait

Question 72

"Pseudodementia" refers to a condition in which

A) symptoms are faked.
B) memory loss is not severe.
C) motor impairment affects cognitive functioning.
D) cognitive impairment is produced by major depression.

Question 73

In studies of extended families in which some members are affected by a disease and other members are unaffected by it, which of the following must be established in order to identify genetic linkage?

A) Both affected and unaffected members have the marker.
B) Family members affected by the disease do not have the marker.
C) The marker is only present in one family and not in other families.
D) Family members with the disease have the marker; unaffected members do not have the marker.

Question 74

The average time between the diagnosed onset of Alzheimer's disease and death is

A) six months.
B) one year.
C) six years.
D) twelve years.

Question 75

A group of clinicians has identified a syndrome they call dementia with Lewy bodies. This newly identified syndrome overlaps with which of these disorders?

A) Down syndrome and Pick's disease
B) Alzheimer's disease and Down syndrome
C) Parkinson's disease and Alzheimer's disease
D) Huntington's disease and Parkinson's disease

Question 76

Studies suggest that

A) Alzheimer's disease is more common is Asian countries compared to North America.
B) Alzheimer's disease is most common in North America and Europe.
C) Alzheimer's disease is most common in developing countries.
D) None of the above is accurate.

Question 77

A pathologist has just finished an autopsy and includes in her report a reference to "Lewy bodies." This means that in her autopsy she has discovered

A) senile plaques filled with protein.
B) ballooning of nerve cells and enlarged areas between adjacent neurons.
C) rounded clumps of protein surrounded by masses of destroyed neural tissue.
D) rounded deposits in nerve cells often found in the brains of patients with Parkinson's disease.

Question 78

What do patients with Alzheimer's disease and Down Syndrome have in common?

A) Pick's bodies
B) an extra chromosome
C) neurofibrillary tangles
D) degeneration of the substantia nigra

Question 79

All of the following are indications of vascular dementia except

A) Parkinsonian symptoms.
B) focal neurological signs.
C) weakness in the extremities.
D) laboratory evidence of blood vessel disease.

Question 80

All of the following have been seen to cause delirium EXCEPT

A) antipsychotic medications.
B) antihistamines.
C) pain killers.
D) stimulants.