ASPPB Neuropsychology 5 — Questions and Answers
Question 1: Balint syndrome, resulting from bilateral posterior parietal damage, is characterized by which triad?
- Aphasia, apraxia, and agnosia
- Simultanagnosia, optic ataxia, and ocular apraxia (Correct answer)
- Amnesia, agnosia, and akinesia
- Acalculia, agraphia, and finger agnosia
Correct answer: Simultanagnosia, optic ataxia, and ocular apraxia
Balint syndrome consists of simultanagnosia (inability to perceive the whole visual scene), optic ataxia (misreaching), and ocular apraxia (difficulty directing gaze).
Question 2: The cerebellum's primary contribution to cognitive functions includes:
- Emotional memory consolidation
- Procedural timing, coordination, and cerebellar cognitive affective syndrome (Correct answer)
- Declarative memory encoding
- Language production via Broca's area modulation
Correct answer: Procedural timing, coordination, and cerebellar cognitive affective syndrome
Beyond motor coordination, the cerebellum supports procedural learning, timing, and when damaged can produce the cerebellar cognitive affective syndrome affecting executive function and affect regulation.
Question 3: A neuropsychologist administering a fixed battery to every patient values this approach because it:
- Allows tailoring tests to each patient's presenting complaint
- Provides comprehensive normative comparisons across all domains regardless of referral question (Correct answer)
- Reduces administration time significantly
- Avoids the use of symptom validity tests
Correct answer: Provides comprehensive normative comparisons across all domains regardless of referral question
A fixed battery ensures consistent, comprehensive coverage of all neuropsychological domains and allows profile comparisons using a single normative framework.
Question 4: Gerstmann syndrome results from damage to the:
- Left angular gyrus in the parietal lobe (Correct answer)
- Right superior temporal gyrus
- Bilateral hippocampi
- Left inferior frontal gyrus
Correct answer: Left angular gyrus in the parietal lobe
Gerstmann syndrome (finger agnosia, acalculia, agraphia, left-right disorientation) results from damage to the left angular gyrus at the parieto-occipital junction.
Question 5: Which of the following best describes the role of the basal ganglia in neuropsychological functioning?
- Primary encoding of declarative memories
- Modulation of procedural learning, habit formation, and reward-based behavior (Correct answer)
- Processing of primary sensory information
- Generation of language output
Correct answer: Modulation of procedural learning, habit formation, and reward-based behavior
The basal ganglia are critical for procedural learning, habit formation, and reward-based behavior through their connections with frontal cortex and limbic structures.
Question 6: When interpreting a neuropsychological test score, the 'reliable change index' (RCI) is used to:
- Adjust scores for demographic variables
- Determine whether score changes across evaluations exceed measurement error (Correct answer)
- Compare a patient's profile to a matched normative group
- Identify response bias in performance validity tests
Correct answer: Determine whether score changes across evaluations exceed measurement error
The RCI quantifies whether the magnitude of change between two testing sessions is statistically reliable and not attributable to measurement error or practice effects.
Question 7: In cases of herpes simplex encephalitis (HSE), which brain regions are most severely affected?
- Bilateral occipital lobes
- Medial temporal lobes and orbitofrontal cortex (Correct answer)
- Bilateral parietal lobes
- Cerebellum and brainstem
Correct answer: Medial temporal lobes and orbitofrontal cortex
HSV-1 encephalitis shows a predilection for the medial temporal lobes (including hippocampus and amygdala) and orbitofrontal cortex, producing severe amnesia and behavioral changes.
ASPPB Neuropsychology 5
Balint syndrome, resulting from bilateral posterior parietal damage, is characterized by which triad?