60 y/o right-handed M, getting lost, only writes on right half of paper. Left-sided hemi-neglect. Where is
the lesion? (8x) - CORRECT ANSWER -RIGHT PARIETAL LOBE
66 y/o with HTN develops vertigo, diplopia, nausea, vomiting, hiccups, L face numbness, nystagmus,
hoarseness, ataxia of limbs, staggering gait, and tendency to fall to the left. Dx? (8x) - CORRECT ANSWER
-LATERAL MEDULLARY STROKE
78 y/o pt had an ischemic stroke that left him with a residual mild hemiplegia. Pt appeared to be
unaware that there was a problem of weakness on one side of this body. When asked to raise the weak
arm, the patient raised his normal arm. When the failure to raise the paralyzed arm was pointed out to
pt, he admitted that the arm was slightly weak. He also neglects the side of the body when dressing and
grooming. Pt did not shave one side of his face, had difficulty putting a shirt on when it was turned
inside out. Area of brain likely affected by stroke? (4x) - CORRECT ANSWER -RIGHT PARIETAL LOBE
26 y.o. w/HA and R-hand clumsiness for weeks. Exam shows difficulty w/rapid alternating movements of
hand, overt intention tremor on finger-to-nose, and mildly dysmetric finger tamping. CNS intact and no
papilledema. Where will damage show on MRI? (4x) - CORRECT ANSWER -CEREBELLUM
Previously pleasant mom becomes profane and irresponsible over 6 months. Most likely a pathology in:
(2x) - CORRECT ANSWER -FRONTAL LOBE
Rapid onset of right facial weakness, left limb weakness, diplopia: (2x) - CORRECT ANSWER -BRAIN STEM
INFARCTION
MRI scan of head reveals an infarct in distribution of left anterior cerebral artery. Pt most likely exhibits:
(2x) - CORRECT ANSWER -WEAKNESS OF CONTRALATERAL FOOT AND LEG
, Amnesia preceded by epigastric sensation/fear is associated with electrical abnormalities where? -
CORRECT ANSWER -TEMPORAL LOBE
Pt w/ sudden onset of L hemiparesis, L homonymous hemianopsia, tendency to gaze to right, and
neglect left sided stimuli are deficits most likely result of occlusion of: - CORRECT ANSWER -RIGHT
MIDDLE CEREBRAL ARTERY
65 y/o w/ hx of HTN, Meniere's with sudden vertigo, N/V, worse with head movement, R beating
nystagmus on lateral gaze, finger to nose testing is ataxic, poor balance and dysarthria. Dx - CORRECT
ANSWER -CEREBELLAR INFARCT
Lower facial weakness w/ relative sparing of forehead, stroke in? - CORRECT ANSWER -INTERNAL
CAPSULE
Higher frequency & greater severity of depression associated w/ cortical & subcortical strokes: -
CORRECT ANSWER -LEFT ANTERIOR FRONTAL
58 y/o s/p CABG - anomia for fingers and body parts, errors involving right and left, inability to write
thoughts/take notes/make calculations. Fluent speech and excellent comprehension - CORRECT
ANSWER -LEFT MEDIAL TEMPORAL STROKE
Visual disturbances associated with occlusion of the right posterior cerebral artery? - CORRECT ANSWER
-LEFT HOMONYMOUS HEMIANOPSIA
65 y/o w/ HTN collapsed. In ED is stuporous, R hemiparesis + hemisensory deficit, eyes deviate to L. CT
would show intraparenchymal hemorrhage in: - CORRECT ANSWER -LEFT BASAL GANGLIA
Atrophy of right temporal lobe on cross section associated with occlusion of: - CORRECT ANSWER -
MIDDLE CEREBRAL ARTERY
58 y/o M h/o HTN, cig smoking and sudden inability to speak. Face drooping on R and dragging R leg. In
ER examined within 40 mins of onset: Aphasic, unable to understand or repeat verbal commands.
Unintelligible sounds for speech. Alert but appears frustrated. R hemiplegia with arm and face weaker
the lesion? (8x) - CORRECT ANSWER -RIGHT PARIETAL LOBE
66 y/o with HTN develops vertigo, diplopia, nausea, vomiting, hiccups, L face numbness, nystagmus,
hoarseness, ataxia of limbs, staggering gait, and tendency to fall to the left. Dx? (8x) - CORRECT ANSWER
-LATERAL MEDULLARY STROKE
78 y/o pt had an ischemic stroke that left him with a residual mild hemiplegia. Pt appeared to be
unaware that there was a problem of weakness on one side of this body. When asked to raise the weak
arm, the patient raised his normal arm. When the failure to raise the paralyzed arm was pointed out to
pt, he admitted that the arm was slightly weak. He also neglects the side of the body when dressing and
grooming. Pt did not shave one side of his face, had difficulty putting a shirt on when it was turned
inside out. Area of brain likely affected by stroke? (4x) - CORRECT ANSWER -RIGHT PARIETAL LOBE
26 y.o. w/HA and R-hand clumsiness for weeks. Exam shows difficulty w/rapid alternating movements of
hand, overt intention tremor on finger-to-nose, and mildly dysmetric finger tamping. CNS intact and no
papilledema. Where will damage show on MRI? (4x) - CORRECT ANSWER -CEREBELLUM
Previously pleasant mom becomes profane and irresponsible over 6 months. Most likely a pathology in:
(2x) - CORRECT ANSWER -FRONTAL LOBE
Rapid onset of right facial weakness, left limb weakness, diplopia: (2x) - CORRECT ANSWER -BRAIN STEM
INFARCTION
MRI scan of head reveals an infarct in distribution of left anterior cerebral artery. Pt most likely exhibits:
(2x) - CORRECT ANSWER -WEAKNESS OF CONTRALATERAL FOOT AND LEG
, Amnesia preceded by epigastric sensation/fear is associated with electrical abnormalities where? -
CORRECT ANSWER -TEMPORAL LOBE
Pt w/ sudden onset of L hemiparesis, L homonymous hemianopsia, tendency to gaze to right, and
neglect left sided stimuli are deficits most likely result of occlusion of: - CORRECT ANSWER -RIGHT
MIDDLE CEREBRAL ARTERY
65 y/o w/ hx of HTN, Meniere's with sudden vertigo, N/V, worse with head movement, R beating
nystagmus on lateral gaze, finger to nose testing is ataxic, poor balance and dysarthria. Dx - CORRECT
ANSWER -CEREBELLAR INFARCT
Lower facial weakness w/ relative sparing of forehead, stroke in? - CORRECT ANSWER -INTERNAL
CAPSULE
Higher frequency & greater severity of depression associated w/ cortical & subcortical strokes: -
CORRECT ANSWER -LEFT ANTERIOR FRONTAL
58 y/o s/p CABG - anomia for fingers and body parts, errors involving right and left, inability to write
thoughts/take notes/make calculations. Fluent speech and excellent comprehension - CORRECT
ANSWER -LEFT MEDIAL TEMPORAL STROKE
Visual disturbances associated with occlusion of the right posterior cerebral artery? - CORRECT ANSWER
-LEFT HOMONYMOUS HEMIANOPSIA
65 y/o w/ HTN collapsed. In ED is stuporous, R hemiparesis + hemisensory deficit, eyes deviate to L. CT
would show intraparenchymal hemorrhage in: - CORRECT ANSWER -LEFT BASAL GANGLIA
Atrophy of right temporal lobe on cross section associated with occlusion of: - CORRECT ANSWER -
MIDDLE CEREBRAL ARTERY
58 y/o M h/o HTN, cig smoking and sudden inability to speak. Face drooping on R and dragging R leg. In
ER examined within 40 mins of onset: Aphasic, unable to understand or repeat verbal commands.
Unintelligible sounds for speech. Alert but appears frustrated. R hemiplegia with arm and face weaker
