DO (IQ) 5 ā Questions and Answers
Question 1: An osteopathic physician notices that a patient from a low socioeconomic background scores 10 points lower than expected on IQ testing. Which environmental factor has the STRONGEST evidence for depressing IQ scores?
- Lack of vitamin C supplementation
- Chronic psychosocial stress and poverty (Correct answer)
- Excess dietary sugar intake
- Urban air pollution from nitrogen dioxide
Correct answer: Chronic psychosocial stress and poverty
Chronic poverty and psychosocial stress are among the strongest environmental suppressors of IQ, mediated by cortisol effects on developing brain architecture and reduced cognitive stimulation.
Question 2: A 35-year-old with Down syndrome presents with rapidly declining IQ scores and memory loss. Which diagnosis should be prioritized in the differential?
- Hypothyroidism
- Alzheimer's disease (Correct answer)
- Major depressive disorder
- Vitamin B12 deficiency
Correct answer: Alzheimer's disease
Individuals with Down syndrome have an extremely high lifetime risk of Alzheimer's disease, often presenting in the 40sā50s, due to triplication of the APP gene on chromosome 21.
Question 3: Which subtest of the WAIS-IV is considered the single best predictor of Full Scale IQ?
- Digit Span
- Matrix Reasoning
- Vocabulary (Correct answer)
- Coding
Correct answer: Vocabulary
Vocabulary is consistently the highest g-loaded subtest on the WAIS and the best single predictor of Full Scale IQ.
Question 4: A 2-year-old child is found to have an IQ equivalent of 40. The MOST important next diagnostic step is:
- Repeat IQ testing at age 5
- Comprehensive etiological workup including genetic and metabolic testing (Correct answer)
- Enroll in speech therapy and monitor for 12 months
- MRI of the brain as the only necessary test
Correct answer: Comprehensive etiological workup including genetic and metabolic testing
An etiological workup including chromosomal microarray, metabolic screening, and neuroimaging is recommended to identify treatable causes and inform prognosis.
Question 5: Which statement about the relationship between IQ and academic achievement is most accurate?
- IQ accounts for approximately 10% of variance in academic achievement
- IQ accounts for approximately 25ā50% of variance in academic achievement (Correct answer)
- IQ accounts for over 90% of variance in academic achievement
- IQ and academic achievement are not correlated after controlling for socioeconomic status
Correct answer: IQ accounts for approximately 25ā50% of variance in academic achievement
Meta-analyses consistently show IQ explains approximately 25ā50% of the variance in academic achievement, leaving substantial variance explained by motivation, teaching quality, and other factors.
Question 6: A physician treating a patient with profound intellectual disability (IQ < 20) is determining appropriate pain assessment tools. Which approach is MOST appropriate?
- Standard numeric pain rating scale (0ā10)
- Visual analog scale (VAS)
- Behavioral observation scales such as NCCPC or FLACC (Correct answer)
- Self-report only; no proxy measures are valid
Correct answer: Behavioral observation scales such as NCCPC or FLACC
Patients with profound intellectual disability cannot use self-report scales; behavioral observation tools like the NCCPC or FLACC are validated for assessing pain in non-verbal patients.
Question 7: Iodine deficiency during pregnancy is associated with which outcome in offspring?
- Autism spectrum disorder
- Preventable intellectual disability (Correct answer)
- Increased risk of ADHD only
- No measurable cognitive effects if maternal diet is otherwise adequate
Correct answer: Preventable intellectual disability
Iodine deficiency remains the world's leading preventable cause of intellectual disability, as thyroid hormones are essential for fetal brain development.
DO (IQ) 5
An osteopathic physician notices that a patient from a low socioeconomic background scores 10 points lower than expected on IQ testing.
Which environmental factor has the STRONGEST evidence for depressing IQ scores?