PRITE Neuroscience Exam 100%
Accurate!
60 y/o right-handed M, getting lost, only writes on right half of paper. Left-sided hemi-neglect.
Where is the lesion? (8x) - ANSWERRIGHT 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) -
ANSWERLATERAL 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) - ANSWERRIGHT 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) - ANSWERCEREBELLUM
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 - ANSWERLEFT
MEDIAL TEMPORAL STROKE
Visual disturbances associated with occlusion of the right posterior cerebral artery? - ANSWERLEFT
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: - ANSWERLEFT BASAL GANGLIA
Atrophy of right temporal lobe on cross section associated with occlusion of: - ANSWERMIDDLE
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 than leg. CT head: no hemorrhage. Pathology type and area: - ANSWERTHROMBOEMBOLIC
STROKE OF LEFT MCA
Sudden onset vertigo/nausea, hoarseness/dysphagia, right sided face numbness, diminished gag
reflex on right, decreased pinprick and temperature sensation on left: - ANSWERRIGHT MEDULLARY
INFARCTION
65 y/o diabetic pt presents to ED c/o acute L sided weakness, deviation of gaze to R, L hemiplegia and
hemisensory deficit, and L homonymous hemianopsia. 12 hrs later, pt is unconscious, L pupil
, enlarged and unreactive. CT will show what? - ANSWERR MCA INFARCT W/ EDEMA AND UNCAL
HERNIATION
Pt with acute onset vertigo, what will suggest R lateral medullary infarct? - ANSWERRIGHT FACIAL
LOSS OF TOUCH AND TEMPERATURE SENSATION
46 y/o M w/ double vision + pain R eye. Exam: ptosis R eyelid, inability to elevate or adduct R eye + R
pupillary dilation. This is caused by: - ANSWERPOST. COMMUNICATING ARTERY ANEURYSM
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: - ANSWERLEFT 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? - ANSWERPOSTERIOR 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? - ANSWERPOSTERIOR CEREBRAL
Bilateral lower extremity weakness, abulia, mutism, urinary incontinence are most likely to result
from occlusion of which of the following arteries? - ANSWERAnterior cerebral
Pure sensory deficit extending to midline and involving face, arm, trunk, and leg caused by lacunar
infarct where? - ANSWERLATERAL THALAMUS
Blocking R PCA (posterior cerebral artery) causes which visual disturbance? - ANSWERLEFT
HOMONYMOUS HEMIANOPSIA
The clinical syndrome associated with occlusion of the cortical branch of the posterior cerebral artery
would result in which of the following? - ANSWERHOMONYMOUS HEMIANOPIA WITH ALEXIA
WITHOUT AGRAPHIA
Previously pleasant mom becomes profane and irresponsible over 6 months. Most likely a pathology
in: (2x) - ANSWERFRONTAL LOBE
Rapid onset of right facial weakness, left limb weakness, diplopia: (2x) - ANSWERBRAIN STEM
INFARCTION
MRI scan of head reveals an infarct in distribution of left anterior cerebral artery. Pt most likely
exhibits: (2x) - ANSWERWEAKNESS OF CONTRALATERAL FOOT AND LEG
Amnesia preceded by epigastric sensation/fear is associated with electrical abnormalities where? -
ANSWERTEMPORAL 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: - ANSWERRIGHT 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 -
ANSWERCEREBELLAR INFARCT
Lower facial weakness w/ relative sparing of forehead, stroke in? - ANSWERINTERNAL CAPSULE
Accurate!
60 y/o right-handed M, getting lost, only writes on right half of paper. Left-sided hemi-neglect.
Where is the lesion? (8x) - ANSWERRIGHT 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) -
ANSWERLATERAL 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) - ANSWERRIGHT 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) - ANSWERCEREBELLUM
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 - ANSWERLEFT
MEDIAL TEMPORAL STROKE
Visual disturbances associated with occlusion of the right posterior cerebral artery? - ANSWERLEFT
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: - ANSWERLEFT BASAL GANGLIA
Atrophy of right temporal lobe on cross section associated with occlusion of: - ANSWERMIDDLE
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 than leg. CT head: no hemorrhage. Pathology type and area: - ANSWERTHROMBOEMBOLIC
STROKE OF LEFT MCA
Sudden onset vertigo/nausea, hoarseness/dysphagia, right sided face numbness, diminished gag
reflex on right, decreased pinprick and temperature sensation on left: - ANSWERRIGHT MEDULLARY
INFARCTION
65 y/o diabetic pt presents to ED c/o acute L sided weakness, deviation of gaze to R, L hemiplegia and
hemisensory deficit, and L homonymous hemianopsia. 12 hrs later, pt is unconscious, L pupil
, enlarged and unreactive. CT will show what? - ANSWERR MCA INFARCT W/ EDEMA AND UNCAL
HERNIATION
Pt with acute onset vertigo, what will suggest R lateral medullary infarct? - ANSWERRIGHT FACIAL
LOSS OF TOUCH AND TEMPERATURE SENSATION
46 y/o M w/ double vision + pain R eye. Exam: ptosis R eyelid, inability to elevate or adduct R eye + R
pupillary dilation. This is caused by: - ANSWERPOST. COMMUNICATING ARTERY ANEURYSM
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: - ANSWERLEFT 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? - ANSWERPOSTERIOR 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? - ANSWERPOSTERIOR CEREBRAL
Bilateral lower extremity weakness, abulia, mutism, urinary incontinence are most likely to result
from occlusion of which of the following arteries? - ANSWERAnterior cerebral
Pure sensory deficit extending to midline and involving face, arm, trunk, and leg caused by lacunar
infarct where? - ANSWERLATERAL THALAMUS
Blocking R PCA (posterior cerebral artery) causes which visual disturbance? - ANSWERLEFT
HOMONYMOUS HEMIANOPSIA
The clinical syndrome associated with occlusion of the cortical branch of the posterior cerebral artery
would result in which of the following? - ANSWERHOMONYMOUS HEMIANOPIA WITH ALEXIA
WITHOUT AGRAPHIA
Previously pleasant mom becomes profane and irresponsible over 6 months. Most likely a pathology
in: (2x) - ANSWERFRONTAL LOBE
Rapid onset of right facial weakness, left limb weakness, diplopia: (2x) - ANSWERBRAIN STEM
INFARCTION
MRI scan of head reveals an infarct in distribution of left anterior cerebral artery. Pt most likely
exhibits: (2x) - ANSWERWEAKNESS OF CONTRALATERAL FOOT AND LEG
Amnesia preceded by epigastric sensation/fear is associated with electrical abnormalities where? -
ANSWERTEMPORAL 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: - ANSWERRIGHT 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 -
ANSWERCEREBELLAR INFARCT
Lower facial weakness w/ relative sparing of forehead, stroke in? - ANSWERINTERNAL CAPSULE
