EPPP Biological Bases of Behavior Practice Questions

Question 1

A client who has taken lithium for bipolar I disorder for several years begins taking ibuprofen daily for back pain. Two weeks later the client has a coarse tremor, vomiting, diarrhea, and confusion. What is the MOST likely explanation?

Accepted Answer

C. Lithium toxicity, because NSAIDs reduce the kidneys' clearance of lithium C is correct because NSAIDs such as ibuprofen decrease renal lithium excretion, so serum levels rise; coarse tremor, gastrointestinal upset, and confusion are classic signs of lithium toxicity. A is incorrect because neuroleptic malignant syndrome is associated with dopamine-blocking antipsychotics and presents with severe muscle rigidity and high fever. B is incorrect because tardive dyskinesia is a late effect of long-term dopamine antagonists that produces involuntary orofacial movements, not acute vomiting and confusion. D is incorrect because serotonin syndrome follows combinations of serotonergic drugs and typically shows hyperthermia, clonus, and agitation; ibuprofen is not serotonergic.

Question 2

Following a stroke, a patient speaks in short, effortful phrases with many omitted function words but understands spoken conversation fairly well. Damage to which area is MOST likely?

Accepted Answer

C. The left inferior frontal gyrus (Broca's area) C is correct because nonfluent, effortful, telegraphic speech with relatively preserved comprehension is the pattern of Broca's aphasia, which follows damage to the left inferior frontal region. A is incorrect because right parietal damage is linked to neglect and visuospatial problems, and language is lateralized to the left hemisphere in most people. B is incorrect because damage there produces fluent but meaningless speech with poor comprehension. D is incorrect because damage to this pathway causes conduction aphasia, marked by poor repetition with fluent speech and fair comprehension.

Question 3

After a frontal head injury in a car crash, a previously reserved accountant makes crude jokes to strangers, spends impulsively, and shows little concern about the consequences. Memory and language test scores are in the average range. Damage to which region BEST accounts for this change?

Accepted Answer

D. The orbitofrontal cortex D is correct because damage to the orbitofrontal (ventromedial) prefrontal cortex produces disinhibition, impulsivity, and poor social judgment with relatively intact memory and language, the pattern made famous by the case of Phineas Gage. A is incorrect because dorsolateral damage mainly impairs executive functions such as planning, set shifting, and working memory, producing a more apathetic and disorganized picture. B is incorrect because damage there causes weakness or paralysis on the opposite side of the body rather than a change in personality. C is incorrect because medial temporal damage produces anterograde amnesia, and memory is intact here.

Question 4

A patient who had a stroke eats only the food on the right side of the plate, shaves only the right side of the face, and leaves out the left half when copying a clock. Visual fields are intact on formal testing. Where is the lesion MOST likely located?

Accepted Answer

C. The right posterior parietal lobe C is correct because neglect of the left side of space with intact visual fields most often follows damage to the right posterior parietal cortex, which directs attention to both sides of space. A is incorrect because damage there produces Broca's aphasia, a language disorder, not inattention to one side of space. B is incorrect because left parietal damage seldom produces marked neglect and, when it does, the neglect affects the right side of space. D is incorrect because damage there causes a left visual field cut (homonymous hemianopia), and this patient's visual fields are intact.

Question 5

After bilateral surgical removal of the medial temporal lobes to control seizures, a patient cannot remember new people or events for more than a few minutes, yet over several days becomes faster at a mirror-tracing task without recalling ever having practiced it. What does this pattern BEST demonstrate?

Accepted Answer

C. Declarative and procedural memory depend on separate brain systems C is correct because the hippocampus and nearby medial temporal structures are needed to form new declarative memories, while skill learning relies on other systems such as the basal ganglia and cerebellum, as shown in the case of H.M. A is incorrect because the patient has no recollection of practicing, so the improvement reflects implicit procedural learning. B is incorrect because an inability to form new memories after the surgery is anterograde amnesia, the defining deficit after bilateral medial temporal removal. D is incorrect because the patient can hold information for a few minutes; the hippocampus is needed to consolidate information into long-term memory, not to hold it briefly.

Question 6

Korsakoff syndrome, which involves severe anterograde amnesia and confabulation in people with chronic alcohol use disorder, is caused MAINLY by a deficiency of which nutrient?

Accepted Answer

D. Thiamine (vitamin B1) D is correct because chronic heavy drinking impairs thiamine intake and absorption, and thiamine deficiency damages the mammillary bodies and medial thalamus, producing Wernicke encephalopathy and then Korsakoff syndrome. A is incorrect because niacin deficiency causes pellagra, marked by dermatitis, diarrhea, and dementia, not Korsakoff syndrome. B is incorrect because folate deficiency is linked to anemia and to neural tube defects in pregnancy, not to the amnesic syndrome of Korsakoff. C is incorrect because B12 deficiency causes anemia, neuropathy, and cognitive changes, while Korsakoff syndrome is specifically due to thiamine deficiency.

Question 7

The resting tremor, rigidity, and slowed movement of Parkinson's disease result MAINLY from loss of dopamine-producing neurons in which structure?

Accepted Answer

A. The substantia nigra A is correct because degeneration of dopamine neurons in the substantia nigra depletes dopamine in the striatum along the nigrostriatal pathway, producing the core motor signs of Parkinson's disease. B is incorrect because this nucleus supplies acetylcholine to the cortex, and its loss is associated with Alzheimer's disease. C is incorrect because atrophy of the caudate nucleus is the hallmark of Huntington's disease, which causes chorea rather than resting tremor. D is incorrect because the locus coeruleus is the brain's main source of norepinephrine, not the dopamine neurons whose loss causes the core motor signs.

Question 8

Which structure serves as the body's master circadian clock, receiving light information from the retina and coordinating daily rhythms such as melatonin release?

Accepted Answer

B. The suprachiasmatic nucleus of the hypothalamus B is correct because the suprachiasmatic nucleus receives direct input from the retina and synchronizes circadian rhythms, in part by regulating melatonin secretion from the pineal gland. A is incorrect because the lateral geniculate nucleus relays visual information to the primary visual cortex for conscious vision. C is incorrect because the reticular formation regulates general arousal and wakefulness but does not set the timing of circadian rhythms. D is incorrect because the pineal gland secretes melatonin under the control of the suprachiasmatic nucleus rather than serving as the master clock itself.

Question 9

A patient whose corpus callosum was cut to treat epilepsy sits at a screen while a picture of a key is flashed briefly to the left visual field. Several objects are hidden behind a curtain within reach. What is the patient MOST likely to do?

Accepted Answer

B. Say nothing was seen but pick out the key by touch with the left hand B is correct because the left visual field projects to the right hemisphere, which cannot pass the image to the left hemisphere's language areas, so the patient cannot name it, but the right hemisphere can guide the left hand to choose it. A is incorrect because this reverses the pattern; naming requires the left hemisphere, which did not receive the image. C is incorrect because after the callosum is cut, an image presented only to the right hemisphere cannot reach the left hemisphere's language areas. D is incorrect because the right hand is controlled mainly by the left hemisphere, which did not see the image.

Question 10

A 72-year-old has had a year of cognitive decline with marked day-to-day swings in alertness, recurring detailed visual hallucinations of children in the house, and mild rigidity with a shuffling gait. After a low dose of haloperidol is started for the hallucinations, the patient becomes severely rigid and confused. Which diagnosis BEST fits?

Accepted Answer

C. Major neurocognitive disorder with Lewy bodies C is correct because fluctuating cognition, well-formed visual hallucinations, and parkinsonism are core features of Lewy body disease, and severe sensitivity to antipsychotics is a supportive feature. A is incorrect because frontotemporal disorder presents with early behavioral change or language decline, not prominent visual hallucinations and parkinsonism. B is incorrect because Alzheimer's disease typically begins with gradual memory loss, and early hallucinations, parkinsonism, and marked fluctuations point elsewhere. D is incorrect because vascular disorder tends to follow strokes, often with stepwise decline and focal signs, and does not explain the extreme antipsychotic sensitivity.

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