Because of improved treatment for HIV infection, patients are now living longer. However, as they live longer, some are prone to dementia due to that infection. Select the statement that is true of the AIDS dementia complex.
A. Onset is sudden, and deterioration is slow. The HIV infection itself is never the cause; opportunistic brain infections cause deterioration.
B. With sudden onset, the patients show rapid and severe deterioration in their speech and language skills. This type of dementia is cortical.
C. The onset is slow, but deterioration is rapid in the final stages; tremors, seizures, gait problems, facial nerve paralysis, incontinence, and confusion, depression, hallucinations, delusions, and mutism in the final stage characterize the AIDS dementia complex.
D. Unlike other forms of dementia, AIDS dementia complex is free from problems of memory, concentration and attention, apathy, loss of interest in work; thinking is well preserved until the final stage.
C. The onset is slow, but deterioration is rapid in the final stages; tremors, seizures, gait problems, facial nerve paralysis, incontinence, and confusion, depression, hallucinations, delusions, and mutism in the final stage characterize the AIDS dementia complex. You have been referred a 75-year-old woman by a neurologist who suspects hypokinetic dysarthria in her and has requested a speech evaluation and diagnosis of her communication difficulties. To confirm a diagnosis of hypokinetic dysarthria, you will be especially alert to which of the following?
A. Symptoms of Parkinson's, Alzheimer's, or Pick's disease, evidence of damage to the basal ganglia, mask-like face, slowness of movement, micrographic writing, monopitch and imprecise articulation among other symptoms
B. Bilateral facial weakness with less severe lower face weakness, perhaps normal jaw strength, hyperactive gag reflex, hyperadduction of vocal folds, short phrases, continuous breathy voice, and predominant hypernasality, among other symptoms
C. Fasciculations and fibrillations of muscles, progressive muscle weakness with use and recovery with rest, nasal emissions, harsh voice, monopitch, and monoloudness, among other symptoms
D. Evidence of cerebellar damage; rotated or tilted head posture; over- and undershooting of movement targets; jerky, inaccurate, and halting movement; prolonged phonemes and intervals between words or syllables; and impression of drunken speech; among other symptoms
The parents of 4-year-old Mariah consult a clinician. They have moved several times since Mariah was born; her father is a construction worker, and her mother works full-time inside the home caring for Mariah and her three siblings. The family has "struggled financially," according to Mariah's mother, Mrs. E. The clinician obtains the following information from Mrs. E. about Mariah's history: Mariah was born with a cleft of the soft palate and "a funny-looking face." Mrs. E. shares that "it was a nightmare to feed Mariah when she was a baby—the milk always came out through her nose." Mrs. E. begins to get angry as she describes the hospital staff in the town where Mariah was born. She states, "They said Mariah had some sort of syndrome and that she might always have special needs. I think that's bunk. Those people were so insensitive. They were just too busy to work with her properly. Mariah will be fine. I know she has had her problems, but I'm going to put her into a Montessori preschool because she is so smart." When the clinician sees Mariah for the first time, she notes that Mariah has a wide nose, small ears, almond-shaped eyes, and an elongated face. In addition, the clinician finds during assessment that she has a significant expressive language delay. The clinician will probably also find that she has
A. articulation disorders and an intellectual disability.
B.an above-average IQ.
C. no history of failure to thrive.
D. normal hearing with no history of middle ear infections.
A person with otosclerosis often has an audiogram reflecting Carhart's notch, which is
A. a specific loss at 2,000 Hz, as indicated by air-conduction testing.
B. a specific loss at 4,000 Hz, as indicated by both air- and bone-conduction testing.
C. a specific loss at 2,000 Hz, as indicated by bone-conduction testing.
D. specific losses at both 2,000 and 4,000 Hz, as indicated by bone-conduction testing.
What does the cover-body theory of phonation state?
A. The superficial layer and much of the intermediate layer of the lamina propria vibrate as a "cover" on a relatively stationary "body" that is made up of the remainder of the intermediate layer, the deep layer, and the thyroarytenoid (TA) muscle.
B. The epithelium, the superficial layer of the lamina propria, and much of the intermediate layer of the lamina propria vibrate as a "cover" on a relatively stationary "body" that is made up of the remainder of the intermediate layer and the deep layer.
C. The epithelium, the superficial layer of the lamina propria, and much of the intermediate layer of the lamina propria vibrate as a "cover" on a relatively stationary "body" that is made up of the remainder of the intermediate layer, the deep layer, and the TA muscle.
D. The epithelium, the deep layer of the lamina propria, and much of the superficial layer of the lamina propria vibrate as a "cover" on a relatively stationary "body" that is made up of the remainder of the superficial layer, the deep layer, and the TA muscle.
The parents of a 10-year-old child consult a clinician. The child is short and has intellectual delay, cryptorchidism, and sleeps excessively. He also has a speech delay, hyperphagia, and is obese. The clinician notices that the child has a prominent nasal bridge, high, narrow forehead, thin upper lip, downturned mouth, almond-shaped eyes, and small hands and feet. The parents report that he frequently picks his skin. They report that the genetic counselor informed them that his condition is caused by autosomal dominant inheritance and deletion in the long arm of chromosome 15 (15q11015q13) in some cases. The child has
A. Cornelia de Lange syndrome.
B. Apert syndrome.
C. Prader-Willi syndrome.
D. Dandy-Walker syndrome.
You are asked to see a 6-year-old boy, Gabe, for potential therapy because he is very hoarse and has been hoarse for approximately 7 months. He is an active, happy first grader who loves sports and is engaged in various types of sports (e.g., soccer, baseball) year-round. Reportedly, he frequently screams at games. At the school, there is one 15-minute recess in the morning and a 30-minute recess after lunch. You observe Gabe on the playground at recess several times over a period of 2 weeks and see that he loves to run, play, and yell loudly with his friends. His parents have given you a letter from the ENT that definitively states that Gabe has vocal nodules. After an evaluation, what is the first thing you would do?
A. Send Gabe to a counselor to probe into any possible psychological or emotional factors that are contributing to his vocally abusive behavior.
B. Focus on identification and reduction of vocally abusive behavior such as yelling and screaming; use computer games and prizes to help motivate Gabe to use better vocal habits.
C. Monitor Gabe's vocal status by seeing him once every 3 months for the next year to observe whether his hoarseness gets better or worse.
D. Prescribe 3 or 4 weeks of almost total voice rest, telling Gabe and his parents that he can speak only when he absolutely has to—no yelling at recess or when he plays sports.