PRITE – Questions With Comprehensive Answers
"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)" Right Ans - 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) Right Ans - CEREBELLUM
Adult neurogenesis in which area of the brain? (x2) Right Ans -
HIPPOCAMPUS
Previously pleasant mom becomes profane and irresponsible over 6 months.
Most likely a pathology in: (2x) Right Ans - FRONTAL LOBE
Rapid onset of right facial weakness, left limb weakness, diplopia: (2x)
Right Ans - BRAIN STEM INFARCTION
MRI scan of head reveals an infarct in distribution of left anterior cerebral
artery. Pt most likely exhibits: (2x) Right Ans - WEAKNESS OF
CONTRALATERAL FOOT AND LEG
Neurogenesis in adult brain is restricted to what region of brain? Right Ans
- DENTATE GYRUS (gyrus-generates dentrites/neurons)
bipolar has decreased connectivity here Right Ans - AMYGDALA AND PFC
Biogenic amine made in Locus Coeruleus Right Ans - NE
CNS response to fear mediated by what structure. Right Ans - CENTRAL
NUCLEUS OF THE AMYGDALA
,Brain area activated by subliminal presentations of emotional faces Right
Ans - AMYGDALA
CNS region from where dopaminergic neurons projecting to caudate and
putamen Right Ans - SUBSTANTIA NIGRA
Area of brain responsible for face recognition Right Ans - FUSIFORM
GYRUS
area of brain to remember a number to make a phone call Right Ans -
DORSOLATERAL PFC
Which part of cortical-striatal-pallidal-thalamic cortical circuit evaluates
painful stimuli Right Ans - LATERAL ORBITOFRONTAL
The dorsolateral-prefrontal cortex, striatum and are part of a loop circuit that
produces worry and obsessive symptoms Right Ans - THALAMUS
blood-brain barrier is made up of this cell type? Right Ans - ENDOTHELIAL
Orexin is made in what part of the brain? Right Ans - HYPOTHALAMUS
So dopamine neurons in what system is primarily implicated in tasks related
to cognitive processing? Right Ans - MESOCORTICAL "DA makes Me So
Cognitive"
Which dopaminergic pathway includes the nucleus accumbens and mediates
addiction and associated behaviors? Right Ans - MESOLIMBIC
Development of brain grey-matter volume peaks at what stage Right Ans -
LATE CHILDHOOD
In a pt with hippocampus damage, what allows them to still learn new skills
like playing tennis? Right Ans - BASAL GANGLIA
12 TO 14 YEARS (EARLY ADOLESCENCE)(STAGES OF DEVELOPMENT IN
SULLIVAN'S INTERPERSONAL THEORY) Right Ans - Learning to form
satisfactory relationships with persons of the opposite sex; developing a sense
of identity
,Neuroanatomy Right Ans - ***Neuroanatomy
60 y/o right-handed M, getting lost, only writes on right half of paper. Left-
sided hemi-neglect. Where is the lesion? (8x)
*(w)Rights Partial= R Parietal Right Ans - 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)
*Le MI PICcup Miself, Eye am Tipsi and my other side is numb Right Ans -
LATERAL MEDULLARY STROKE
65 y/o pt has a stroke which causes him to fall. On exam, weakness of the right
leg, with only minor weakness of the right hand, no weakness of the face, no
sensory deficit. Speech is not affected, but pt seems unusually quiet and
passive. The stroke most likely involves the: Right Ans - LEFT ANTERIOR
CEREBRAL ARTERY
Hemisensory loss followed by pain and hyperpathia involving all modalities
and reaching the midline of trunk and head is most consistent with ischemia
in the distribution of which of the following arteries? Right Ans -
POSTERIOR CEREBRAL
Right-side palsy with equal involvement of the face, arm and leg combined
with third nerve palsy is most likely due to occlusion of a branch of which
artery? Right Ans - POSTERIOR CEREBRAL
Bilateral lower extremity weakness, abulia, mutism, urinary incontinence are
most likely to result from occlusion of which of the following arteries?
Right Ans - ANTERIOR CEREBRAL Artery
Pure sensory deficit extending to midline and involving face, arm, trunk, and
leg caused by lacunar infarct where? Right Ans - LATERAL THALAMUS
Blocking R PCA (posterior cerebral artery) causes which visual disturbance?
Right Ans - LEFT HOMONYMOUS HEMIANOPSIA
, The clinical syndrome associated with occlusion of the cortical branch of the
posterior cerebral artery would result in which of the following? Right Ans
- HOMONYMOUS HEMIANOPIA WITH ALEXIA WITHOUT AGRAPHIA (when
extended to splenium of corpus callosum)
28 y/o cocaine user complains of LBP, numbness in both legs and feet, thighs,
buttocks, abdomen, and says R leg is weak and clumsy, L leg is tired. Has
urinary incontinence and difficulty walking. Decreased light touch, pinprick,
and temperature. Normal vibration and proprioception. DTR is hard to elicit.
Muscle tone is normal. Decreased strength in B/L LE but worse on right.
Diagnosis? Right Ans - ANTERIOR SPINAL ARTERY INFARCTION
Loss of ability to execute previously learned motor activities (which is not the
result of demonstrable weakness, ataxia or sensory loss) is associated with
lesions of? Right Ans - LEFT PARIETAL CORTEX
Normal Romberg w/ eyes open but loses balance with eyes closed. Where is
the abnormality? Right Ans - CEREBELLAR VERMIS
Motor speech paradigm activation task on fMRI - hyperactivity in right
temporal lobe. Damage is where? Right Ans - CALCARINE FISSURE
Aphasia w/ effortful fragmented, non-fluent, telegraphic speech, is seen in a
lesion where? Right Ans - POSTERIOR FRONTAL LOBE
A pituitary tumor that protrudes through the diaphragmatic sella is most
likely to cause? Right Ans - BITEMPORAL HEMIANOPSIA
Conduction aphasia often occurs as a result of damage to which structure?
Right Ans - ARCUATE FASCICULUS: (can't repeat phrases)
Unilateral hearing loss, vertigo, unsteadiness, falls, headaches, mild facial
weakness and ipsilateral limb ataxia is most commonly associated with
tumors in what locations? Right Ans - CEREBELLOPONTINE ANGLE
20 y/o with 1-year h/o bitemporal headaches, polydipsia, polyuria, and
bulimia plus 2-month h/o emotional outbursts, aggression, and transient
confusion. Neuro exam normal. What will MRI of brain show? Right Ans -
HYPOTHALAMIC TUMOR
"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)" Right Ans - 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) Right Ans - CEREBELLUM
Adult neurogenesis in which area of the brain? (x2) Right Ans -
HIPPOCAMPUS
Previously pleasant mom becomes profane and irresponsible over 6 months.
Most likely a pathology in: (2x) Right Ans - FRONTAL LOBE
Rapid onset of right facial weakness, left limb weakness, diplopia: (2x)
Right Ans - BRAIN STEM INFARCTION
MRI scan of head reveals an infarct in distribution of left anterior cerebral
artery. Pt most likely exhibits: (2x) Right Ans - WEAKNESS OF
CONTRALATERAL FOOT AND LEG
Neurogenesis in adult brain is restricted to what region of brain? Right Ans
- DENTATE GYRUS (gyrus-generates dentrites/neurons)
bipolar has decreased connectivity here Right Ans - AMYGDALA AND PFC
Biogenic amine made in Locus Coeruleus Right Ans - NE
CNS response to fear mediated by what structure. Right Ans - CENTRAL
NUCLEUS OF THE AMYGDALA
,Brain area activated by subliminal presentations of emotional faces Right
Ans - AMYGDALA
CNS region from where dopaminergic neurons projecting to caudate and
putamen Right Ans - SUBSTANTIA NIGRA
Area of brain responsible for face recognition Right Ans - FUSIFORM
GYRUS
area of brain to remember a number to make a phone call Right Ans -
DORSOLATERAL PFC
Which part of cortical-striatal-pallidal-thalamic cortical circuit evaluates
painful stimuli Right Ans - LATERAL ORBITOFRONTAL
The dorsolateral-prefrontal cortex, striatum and are part of a loop circuit that
produces worry and obsessive symptoms Right Ans - THALAMUS
blood-brain barrier is made up of this cell type? Right Ans - ENDOTHELIAL
Orexin is made in what part of the brain? Right Ans - HYPOTHALAMUS
So dopamine neurons in what system is primarily implicated in tasks related
to cognitive processing? Right Ans - MESOCORTICAL "DA makes Me So
Cognitive"
Which dopaminergic pathway includes the nucleus accumbens and mediates
addiction and associated behaviors? Right Ans - MESOLIMBIC
Development of brain grey-matter volume peaks at what stage Right Ans -
LATE CHILDHOOD
In a pt with hippocampus damage, what allows them to still learn new skills
like playing tennis? Right Ans - BASAL GANGLIA
12 TO 14 YEARS (EARLY ADOLESCENCE)(STAGES OF DEVELOPMENT IN
SULLIVAN'S INTERPERSONAL THEORY) Right Ans - Learning to form
satisfactory relationships with persons of the opposite sex; developing a sense
of identity
,Neuroanatomy Right Ans - ***Neuroanatomy
60 y/o right-handed M, getting lost, only writes on right half of paper. Left-
sided hemi-neglect. Where is the lesion? (8x)
*(w)Rights Partial= R Parietal Right Ans - 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)
*Le MI PICcup Miself, Eye am Tipsi and my other side is numb Right Ans -
LATERAL MEDULLARY STROKE
65 y/o pt has a stroke which causes him to fall. On exam, weakness of the right
leg, with only minor weakness of the right hand, no weakness of the face, no
sensory deficit. Speech is not affected, but pt seems unusually quiet and
passive. The stroke most likely involves the: Right Ans - LEFT ANTERIOR
CEREBRAL ARTERY
Hemisensory loss followed by pain and hyperpathia involving all modalities
and reaching the midline of trunk and head is most consistent with ischemia
in the distribution of which of the following arteries? Right Ans -
POSTERIOR CEREBRAL
Right-side palsy with equal involvement of the face, arm and leg combined
with third nerve palsy is most likely due to occlusion of a branch of which
artery? Right Ans - POSTERIOR CEREBRAL
Bilateral lower extremity weakness, abulia, mutism, urinary incontinence are
most likely to result from occlusion of which of the following arteries?
Right Ans - ANTERIOR CEREBRAL Artery
Pure sensory deficit extending to midline and involving face, arm, trunk, and
leg caused by lacunar infarct where? Right Ans - LATERAL THALAMUS
Blocking R PCA (posterior cerebral artery) causes which visual disturbance?
Right Ans - LEFT HOMONYMOUS HEMIANOPSIA
, The clinical syndrome associated with occlusion of the cortical branch of the
posterior cerebral artery would result in which of the following? Right Ans
- HOMONYMOUS HEMIANOPIA WITH ALEXIA WITHOUT AGRAPHIA (when
extended to splenium of corpus callosum)
28 y/o cocaine user complains of LBP, numbness in both legs and feet, thighs,
buttocks, abdomen, and says R leg is weak and clumsy, L leg is tired. Has
urinary incontinence and difficulty walking. Decreased light touch, pinprick,
and temperature. Normal vibration and proprioception. DTR is hard to elicit.
Muscle tone is normal. Decreased strength in B/L LE but worse on right.
Diagnosis? Right Ans - ANTERIOR SPINAL ARTERY INFARCTION
Loss of ability to execute previously learned motor activities (which is not the
result of demonstrable weakness, ataxia or sensory loss) is associated with
lesions of? Right Ans - LEFT PARIETAL CORTEX
Normal Romberg w/ eyes open but loses balance with eyes closed. Where is
the abnormality? Right Ans - CEREBELLAR VERMIS
Motor speech paradigm activation task on fMRI - hyperactivity in right
temporal lobe. Damage is where? Right Ans - CALCARINE FISSURE
Aphasia w/ effortful fragmented, non-fluent, telegraphic speech, is seen in a
lesion where? Right Ans - POSTERIOR FRONTAL LOBE
A pituitary tumor that protrudes through the diaphragmatic sella is most
likely to cause? Right Ans - BITEMPORAL HEMIANOPSIA
Conduction aphasia often occurs as a result of damage to which structure?
Right Ans - ARCUATE FASCICULUS: (can't repeat phrases)
Unilateral hearing loss, vertigo, unsteadiness, falls, headaches, mild facial
weakness and ipsilateral limb ataxia is most commonly associated with
tumors in what locations? Right Ans - CEREBELLOPONTINE ANGLE
20 y/o with 1-year h/o bitemporal headaches, polydipsia, polyuria, and
bulimia plus 2-month h/o emotional outbursts, aggression, and transient
confusion. Neuro exam normal. What will MRI of brain show? Right Ans -
HYPOTHALAMIC TUMOR
