Abnormal Exam 3

Copy number variants involve: A. Deletions or duplications of chunks of DNA B. Deletions or duplications of genes C. Both A and B

A

BPD does not occur in individuals without childhood trauma of some sort, such as complex trauma. A. True B. False

B

De novo mutations are: A. Inherited B. Spontaneous

B

The majority of people on the autistic spectrum have savant skills. A. True B. False

B

What medications consistently and dramatically improve functioning in people with BPD. A. SSRIs B. SSNRIs C. Benzodiazepines D. None of the answers is correct

D

Of the following, who were instrumental in the formulation and/or treatment of BPD? Select all that apply _____ Erik Erickson _____ John Gunderson _____ Milton Erickson _____ Marsha Linehan _____ Carl Jung

_____ John Gunderson _____ Marsha Linehan

According to Dawson and colleagues , perfect pitch perception is held in short term memory in neurotypical individuals, yet perfect pitch is held in short- and long-term memory in musical savants such as those with William's syndrome. A. True B. False

A

According to Dawson and colleagues, ______________ processing from _____________ cortex modifies sensory perception so that most of what you "see" is remembered and made up from memory rather than directly perceived. A. Top-down, frontal cortex B. Bottom up, posterior cortex C. Forward, parietal D. Backward, cerebral

A

Brain imaging studies show that people with BPD may be hypersensitive to subtle facial expressions, yet they are impaired when it comes to perceiving true signs of social collaboration or the lack of it. A. True B. False

A

Dawson and colleagues attribute "verbal adhesion" in autistic individuals to the use of object recognition brain circuits (ventral stream), rather than phonological processing areas in the frontal lobes, when reading letters and words. Treffert refers to this same quality as "rote memory" when describing Kim Peek's early reading and prodigious memory for written material. What is verbal adhesion? A. A prodigious memory for written material without abstraction or insight B. The repetition of certain words and phrases that elicit emotional content C. It can be likened to a tune that you can't get out of your head and therefore hear mentally over and over again for a period minutes or hours D. All answers are correct

A

Despite Kim Peek's prodigious memory for facts and musical pitch, scores, and musicians, and his very high scores on verbal testing, he was intellectually disabled. A. True B. False

A

Greater numbers of children worldwide are now suffering serious consequences of measles, mumps, and rubella because their parents refuse to vaccinate them due to: A. Misinformation about an increased risk of autism related to the MMR vaccine B. Demonstrated increases in the risk of autism in children shortly after receiving the MMR vaccine C. Shortages of the vaccine due to increased demand related to demonstrated protection of the MMR vaccine against autism D. Healthcare workers advise against vaccinating children against MMR because of the potential for serious side effects

A

In William's syndrome, low activity in the __________ leads to social disinhibition. A. Orbital frontal cortex B. Dorsolateral prefrontal cortex C. Cingulate cortex D. Amygdala

A

Intellectual disability is a universal feature in children diagnosed with William's Syndrome. A. True B. False

A

Many children with autistic spectrum disorder have _________ than normal heads, whereas children with William's Syndrome often have ________ than normal heads. A. Larger, smaller B. Smaller, larger

A

Margaret Bauman observed immature development of the _____ of people with autistic spectrum disorder, which may be related to problems with social emotional behavior. A. Amygdala B. Basal ganglia C. Hypothalamus D. Medial dorsal thalamus

A

More than half of the children diagnosed with autistic spectrum disorder also have intellectual disability. A. True B. False

A

People with borderline personality disorder (BPD) can be bright and charming when they are not symptomatic. A. True B. False

A

Pointing and gaze following is abnormal in both autistic spectrum disorder and Willaim's syndrome. A. True B. False

A

Problems with sensory integration in people with autistic spectrum disorder appear to be related to abnormalities in what brain structure? A. Cerebellum B. Visual cortex C. Auditory cortex D. Posterior parietal cortex

A

The accompanying illustration drawn by an autistic savant is an example of what principle outlined by Dawson and colleagues? A. Pattern completion within restricted interests, showing sensitivity to small anomalies or distinctions B. Savant abilities generate positive emotions C. Verbal adhesion D. Object recognition brain areas used for letter recognition

A

What is the best explanation for why some individuals with fronto-temporal dementia (FTD) develop savant skills? A. Degeneration in the frontal lobes and anterior temporal lobes release posterior, sensory portions of the cortex from inhibition, providing different perceptual experiences B. The dementia that accompanies this FTD makes affected individuals believe that they have artistic skills when in fact they don't, so they take more artistic risks C. FTD consistently affects only the left hemisphere so right hemisphere skills are exaggerated D. People with FTD develop more gray matter in the cortical areas in the posterior part of the brain to compensate for the loss of grey matter in the front part of the brain

A

What unusual brain defect was responsible for Kim Peeks ability to read a different page with each eye, so that he could read two pages simultaneously?

Agenesis of the corpus callosum (no callosum)

13. People with autistic spectrum disorder don't have emotions. A. True B. False

B

16. One observation used to explain the tendency for people with autistic spectrum disorder to focus on detail rather than more abstract concepts suggests what problems with how the brain is wired? A. Too few neurons in the amygdala B. An excess of local synaptic connections and an insufficient number of long connections between distant brain areas. C. An excess of sulci and gyri in the posterior part of the brain D. The absence of myelination

B

According to Barak and Feng, many of the ASD linked genes encode synaptic proteins at ______________ synapses. A. GABA B. Glutamate C. Acetylcholine D. All answers are correct

B

According to visiting clinician Dr. Natalie Noonan, if someone is not diagnosed with autistic spectrum disorder according to the ADOS technique by the time they enter middle school they are unlikely to have the disorder. A. True B. False

B

Autism shares much of its genetic origins with other developmental neuropsychiatric disorders such as: A. Down's syndrome B. Schizophrenia C. William's syndrome D. All answers are correct

B

De novo mutations appear to be more frequent in children of ____________. A. Older mothers B. Older fathers C. Children of people with autistic spectrum disorder D. All answers are correct

B

One of the neurodevelopmental problems associated with autistic spectrum disorder that may be linked to head size is abnormal _______________ in the cerebral cortex. (Hint: this problem is associated with mutations on chromosome 16) A. Neurogenesis B. Neuronal migration C. Neuronal differentiation D. Myelination

B

Visuospatial processing (recall drawing of elephant or bicycle) is deficient in children with Williams syndrome due to deficiencies in what brain pathway? A. Retinogeniculate B. Dorsal stream C. Ventral stream D. Long connections from posterior to frontal cortex

B

What is Trefferts explanation for the greater number of male than female savants? A. Estrogen protection hypothesis B. Left hemisphere develops late and is more sensitive to testosterone C. On average, males have a larger brain than females D. All answers are correct

B

Which of the following is the best description of the genetic cause of Williams Syndrome? A. A polygenetic disorder with a heterogeneous genotype and phenotype B. Deletion of 28 genes on the long arm of chromosome 7 A. Trisomy 21 B. The genetic cause of William's syndrome is not known

B

William's syndrome is more difficult to diagnose than autistic spectrum disorder. A. True B. False

B

Williams syndrome is characterized exclusively by neurodevelopmental problems and no other medical issues involving other organ systems. A. True B. False

B

fMRI studies show that the _____________, is underactive in people with autistic spectrum disorder compared with those with Williams Syndrome and neurotypical controls when performing a task that requires them to differentiate faces. A. Amygdala B. Fusiform cortex C. Hypothalamus D. Cerebellum

B

Match: which of the following capabilities does Treffert ascribe to the right hemisphere? A. Right hemisphere B. Left hemisphere _____ habit memory _____ non-symbolic _____ directly perceived _____ sequential _____ logical _____ semantic memory _____ concrete _____ language based

B_____ habit memory A_____ non-symbolic A_____ directly perceived B_____ sequential B_____ logical B_____ semantic memory A_____ concrete B_____ language based

A brain imaging study at Baylor focused on the ability to accurately perceive a breakdown of trust showed unresponsiveness in the ___________ in people with BDP. A. Anterior cingulate cortex B. Amygdala C. Insula D. All answers are correct

C

According to the "BPD Brief" by John Gunderson, symptoms of BPD emerge: A. Infancy B. Early childhood C. Adolescence to early adulthood D. No consistent symptom emergence across individuals with BPD

C

In the article "When Passion is the Enemy'' Amanda Wang was at a rehearsal dinner for a wedding when she was suddenly compelled to go into the ladies room and choke herself with her belt. A. This was a suicide attempt that failed B. This was self-harm used to draw attention to herself C. This was self-harm used to stop herself from feeling crazy, edgy, anxious. D. All answers are correct

C

This liability threshold is: A. Different for males and females B. The sum of all environmental risks C. The sum of all genetic risks D. The likelihood that a sibling of someone with ASD will also have the disorder.

C

Which of the following is considered the gold standard for treatment of BPD: A. Cognitive behavior therapy B. Psychodynamic therapy C. Dialectical behavior therapy D. Behavioral Activation

C

According to Mottron, Dawson, and Soulieres (Dawson and colleagues), people with savant syndrome have: A. Superior low level cognitive operations discrimination B. Functional autonomy from top-down processing. C. Enhanced target detection e.g., for pitch and memory D. All answers are correct

D

According to the genetic model known as the liability threshold, most cases of autistic spectrum disorder can be attributed to: A. Single gene mutations such as Rhett or Fragile X syndrome B. Common variants amounting to some 1,000 gene mutations C. De novo mutations D. Common variants plus an epigenetic event or de novo mutation

D

Koenigsber's fMRI study in people with BPD showed: A. No activity in the dorsal cingulate cortex, which regulates the amygdala B. Underactive intraparietal sulcus which directs visual attention C. Weaker neurological brakes on emotional reactions, i.e., an inability to distract themselves D. All answers are correct

D

PET scans show that compared with controls, the amygdala in Williams syndrome is: A. More activated to threatening scenes B. More activated to threatening faces C. Both A and B D. Less activated to threatening faces

D

People with BPD appear to be deliberate attention seekers, but recent studies suggest that their behavior actually stems from: A. Unusual sensitivity to subtle facial expressions B. Extreme difficulty controlling emotions C. Impulsivity D. All answers are correct

D

People with William's syndrome show increased thickness in the part of the cerebral cortex the processes ____________. A. Language B. Sound C. Facial recognition D. All answers are correct

D

The autism sequencing consortium shows that autistic spectrum disorders are related to mutations in genes that affect: A. Synaptic function B. DNA transcription C. Chromatin remodeling D. All answers are correct

D

Which of the following makes BPD patients challenging for outpatient providers? Select all that apply: A. Emotional lability of the client B. Legal liability C. Abrupt termination of therapy by the client D. All answers are correct

D

Which of the following suggests a deficiency in conceptual language development in children with Williams Syndrome. A. Comprehension is more limited than expression B. Articulation is superficial, i.e., pseudomature C. Vocabulary development precedes sorting D. All answers are correct

D

What are the two CORE clinical features of autistic spectrum disorder?

Deficits in communication - language and social cognition Restricted interests and repetitive behaviors

BPD is frequently comorbid with which of the following, which, along with variable symptoms, makes diagnosis difficult. A. Depression B. Bipolar disorder C. Substance abuse D. Eating disorders E. All answers are correct

E

Please give an example of a monogenic syndrome (single gene disorder) associated with autistic spectrum disorder.

Fragile x, Rett syndrome, timothy syndrome, phelan-McDermid syndrome

What is "acquired savant syndrome?"

Savant capabilities that follow CNS injury or CNS disease (most state injury and disease for full credit)

What's the difference between a savant and a prodigy?

Savants are intellectually disabled whereas prodigies simply have a remarkable skill in the context of no intellectual disability.

A person with autistic spectrum disorder might have difficulty understanding deception because of problems with what aspect of social cognition?

Theory of mind

What are the core features of dialectical behavior therapy?

Validation, mindfulness (meditation), self-soothing techniques to manage mood swings. May also include: therapist modeling healthy relationship, appreciate others points of view (dialectical), physical health, trust (might also answer: "feel better about themselves, identify thoughts feelings and assumptions that cause trouble, work through problems in relationships.")

Please list two reasons why borderline personality disorder is so often misdiagnosed?

Variable set of symptoms, many comorbidities

Dawson and colleagues focus on four types of structured material that they call "human codes" in their consideration of savant syndrome. What are they?

Written language, music, numeration, complex 3-d graphic representations

Which of the following is used as a diagnostic method for autistic spectrum disorders. Check all that apply: _____ IQ tests _____ Speech evaluation _____ Occupational therapy evaluation _____ Hearing test _____ Autism specific questionnaire _____ Autism Diagnostic Observation Scale (ADOS) _____ Checklist for Autism in Toddlers (CHAT)

____ IQ tests _____ Speech evaluation _____ Occupational therapy evaluation _____ Hearing test _____ Autism specific questionnaire _____ Autism Diagnostic Observation Scale (ADOS) _____ Checklist for Autism in Toddlers (CHAT)

Which two hormones have been linked to the vulnerability to developing autistic spectrum disorder (these may be protective or causal)? Check those that apply. _____ estrogen _____ cortisol _____ thyroid hormone _____ brain derived neurotrophic factor

____ estrogen _____ cortisol

What differentiates BPD from bipolar disorder. Check all that apply. _____ Impulsivity _____ Suicidality _____ Cycles of highs and lows are less lengthy _____ They are often very functional when not exhibiting symptoms _____ Low self-esteem, poor self-image

_____ Cycles of highs and lows are less lengthy _____ Low self-esteem, poor self-image

According to the "BPD Brief" by John Gunderson, in what ways has our understanding of BPD changed in recent years? Check all that apply. _____ Once thought to be mainly environmental (due to trauma), it is now thought to be heavily genetic _____ Once thought to be genetic, it is now regarded as mainly environmental _____ Once thought to be chronic and resistant to change, it now has a much more favorable prognosis _____ Once requiring heroic commitment on the part of the therapist, a variety of interventions specifically designed for BPD can have enduring benefits

_____ Once thought to be mainly environmental (due to trauma), it is now thought to be heavily genetic _____ Once thought to be chronic and resistant to change, it now has a much more favorable prognosis _____ Once requiring heroic commitment on the part of the therapist, a variety of interventions specifically designed for BPD can have enduring benefits

Which of the following is a potential treatment of autistic spectrum disorder? Check all that apply. _____ SSRIs _____ applied behavior analysis _____ social skills training _____ mainstreaming

_____ SSRIs _____ applied behavior analysis _____ social skills training _____ mainstreaming

According to Dawson and colleagues, which of the following is an example of "within code isomorphisms?" Check all that apply _____ arithmetical structure _____ calendar structure _____ syntax _____ 3-D perspective

_____ arithmetical structure _____ calendar structure _____ syntax _____ 3-D perspective

Which of the following is a relative strength in children with William's Syndrome. Check all that apply. _____ expressive language _____ facial recognition _____ musical ability _____ social judgment/cognition

_____ expressive language _____ facial recognition _____ musical ability

In the video with Daniel Levitin, a woman with William's Syndrome was playing the piano with good technique and singing with the appropriate pitch and tempo. When asked to touch her finger to the tip of her nose for one second, she left it there for about a minute. What do you suppose is the cognitive difference between musical tempo and estimating elapsed time?

musical tempo is automatic, unconscious, probably habit memory or part of music circuitry that is separate from conscious time awareness.