Neurocognitive Disorders Test A

The essential feature of the DSM-5 diagnosis of delirium is a disturbance in attention/awareness and in cognition that develops over a short period of time, represents a change from baseline, and tends to fluctuate in severity during the course of a day. Which of the following additional conditions must apply?

A 79-year-old woman with a history of depression is being evaluated at a nursing home for a suspected urinary tract infection. She is easily distracted, perseverates on answers to questions, asks the same question repeatedly, is unable to focus, and cannot answer questions regarding orientation. The mental status changes evolved over a single day. Her family reports that they thought she “wasn’t herself” when they saw her the previous evening, but the nursing report this morning indicates that the patient was cordial and appropriate. What is the most likely diagnosis?

Which of the following is not a diagnostic criterion, feature, or marker of major or mild neurocognitive disorder with Lewy bodies (NCDLB)?

The diagnostic criteria for neurocognitive disorder (NCD) due to HIV infection include fulfillment of criteria for major or mild NCD and documented infection with human immunodeficiency virus (as confirmed by established laboratory methods). Which of the following is a prominent feature of NCD due to HIV infection?

Which of the following features characterizes alcohol-induced major or mild neurocognitive disorder, amnestic-confabulatory type?

Depression, irritability, anxiety, obsessive-compulsive symptoms, and apathy are frequently associated with Huntington’s disease and often precede the onset of motor symptoms. Psychosis more rarely precedes the onset of motor symptoms. Which of the following is a core feature of major or mild neurocognitive disorder due to Huntington’s disease?

Major or mild neurocognitive disorder (NCD) due to prion disease encompasses NCDs associated with a group of subacute spongiform encephalopathies caused by transmissible agents known as prions. What is the most common prion disease?

Major and mild neurocognitive disorders (NCDs) exist on a spectrum of cognitive and functional impairment. Which of the following constitutes an important threshold differentiating the two diagnoses?

A 68-year-old semiretired cardiologist with responsibility for electrocardiogram (ECG) interpretation at his community hospital is referred by the hospital’s Employee Assistance Program for clinical evaluation because of concerns expressed by other clinicians that he has been making many mistakes in his ECG interpretations over the past few months. The patient discloses symptoms of persistent sadness since the death of his wife 6 months prior to the evaluation, with frequent thoughts of death, trouble sleeping, and escalating usage of sedative-hypnotics and alcohol. He has some trouble concentrating, but he has been able to maintain his household, pay his bills, shop, and prepare meals by himself without difficulty. He scores 28/30 on the Mini-Mental State Examination (MMSE). Which of the following would be the primary consideration in the differential diagnosis?

In a patient with mild neurocognitive disorder (NCD), which of the following would distinguish probable from possible Alzheimer’s disease?

The only way that mild NCD due to probable Alzheimer’s disease can be diagnosed is if there is evidence of a causative Alzheimer’s disease genetic mutation from either genetic testing or family history. Mild NCD due to possible Alzheimer’s disease is diagnosed on the basis of the presence of all of the clinical criteria described in options B–D above. Age at onset is not a diagnostic criterion.

A previously healthy 67-year-old man, who is experiencing an acute change in mental status, is brought to the emergency department by his family. There is no evidence in the initial history, physical examination, and laboratory studies to indicate substance intoxication or withdrawal, or to suggest another medical problem as the cause of his altered mental state. Over the course of 1 hour of observation, his level of alertness varies from alert but distractible, with apparent auditory and visual hallucinations, to somnolent; he has difficulty sustaining attention to an examiner, and he cannot perform simple tasks such as serial subtractions or spelling words backwards. What is the most appropriate diagnosis?

Which of the following symptoms is not likely to be observed in a patient suffering from Alzheimer's disease?

The initial symptoms of a specific type of dementias (to which Pick's disease belongs) include language impairment and personality changes, rather than memory problems. Which type of dementia is described here?

Which of the following is NOT likely to be observed in patients suffering from Huntington's disease?

다음 보기 중에서 치매임상평가척도(Clinical Dementia Rating, CDR)에서 평가하는 영역에 해당하는 것을 모두 고르시오.

치매임상평가척도(Clinical Dementia Rating, CDR)에 대한 설명 중 틀린 것을 고르시오.

보호자는 K씨의 문제해결능력이 전반적으로 이전에 비하여 매우 좋지 않다고 진술하였다. 세부적으로는, 간단한 돈 계산이나 돈관리, 간단한 업무처리에 심한 장애를 나타내고 있으며, 위급한 일에 대처하는 능력도 현저히 저하되어 있었다. 사회생활이나 대인관계에서도 적절히 행동하는 것이 매우 어렵다고 한다. 그러나 상황이나 설명에 대해 이해하는 것의 어려움은 상대적으로 경미하였으며, 단순한 계산은 가능하였다. K씨의 판단력 및 문제해결능력에 대한 CDR 등급으로 적절한 것은?

전반적퇴화척도(Global Deterioration Scale, GDS)에 대한 설명 중 틀린 것을 고르시오.

MMSE에 대한 다음의 설명 중 틀린 것을 고르시오.

한국형 간이정신상태검사(K-MMSE)는 총 30문항으로 이루어져 있다.

MMSE의 수행성적은 연령과 교육 수준에 크게 영향받지 않는다.

강연욱 등(1997)이 국내 치매환자들을 대상으로 수행한 연구결과에 따르면 알츠하이머형 치매 환자들은 혈관성 치매 환자들에 비해 지남력과 기억회상 과제에서 더 낮은 점수를 받았다.

IADL에 대한 다음 설명 중 틀린 것을 고르시오.

NPI를 통한 평가는 보호자의 주관적 요소가 많이 개입되어 실제 환자가 경험하는 증상의 심각도나 고통 정도를 정확하게 반영한다고 볼 수는 없다.