PRITE Neuroscience Exam with
Complete Solutions
17y/o is evaluated for binge eating associated with a 60 lb weight gain over the past
four months. CT shows a craniopharyngioma that likely disrupts what structure? -
ANSWER-VENTROMEDIAL HYPOTHALAMUS
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? - ANSWER-HYPOTHALAMIC TUMOR
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) - ANSWER-CEREBELLUM
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? - ANSWER-ANTERIOR SPINAL
ARTERY INFARCTION
32 y/o pt 1-month hx of worsening headaches, episodic mood swings and occasional
hallucinations with visual, tactile and auditory content. CT head reveals tumor where: -
ANSWER-TEMPORAL LOBE
34 y/o M is referred for psychiatric evaluation 5 years after sustaining a head injury at
work. Prior to the accident, he was a stable, happily married man. Since the accident,
he has been described as overly talkative and restless. His wife divorced him because
he was acting irresponsibly, which also resulted in termination from his job.
Psychometric testing reveals that the man has average intelligence and no detectable
memory deficits. Pt's clinical presentation is most consistent with damage to which to
the following brain areas? - ANSWER-FRONTAL LOBE
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: - ANSWER-POST.
COMMUNICATING ARTERY ANEURYSM
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: - ANSWER-THROMBOEMBOLIC STROKE OF LEFT MCA
, 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 - ANSWER-LEFT MEDIAL TEMPORAL STROKE
60 y/o right-handed M, getting lost, only writes on right half of paper. Left-sided hemi-
neglect. Where is the lesion? (8x) - ANSWER-RIGHT PARIETAL LOBE
62yo progressive personality changes, has dull emotions, lack of initiative, and apathy.
An autopsy is likely to show atrophy of ...? - ANSWER-FRONTAL LOBE
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? - ANSWER-R MCA
INFARCT W/ EDEMA AND UNCAL HERNIATION
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: - ANSWER-LEFT ANTERIOR CEREBRAL ARTERY
65 y/o w/ HTN collapsed. In ED is stuporous, R hemiparesis + hemisensory deficit, eyes
deviate to L. CT would show intraparenchymal hemorrhage in: - ANSWER-LEFT
BASAL GANGLIA
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 - ANSWER-CEREBELLAR INFARCT
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) - 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) - ANSWER-RIGHT PARIETAL LOBE
A compound that increases muscle mass by increasing episodic secretion of GH (2x): -
ANSWER-GAMMA HYDROXYLBUTYRATE
A pituitary tumor that protrudes through the diaphragmatic sella is most likely to cause?
- ANSWER-BITEMPORAL HEMIANOPSIA
Complete Solutions
17y/o is evaluated for binge eating associated with a 60 lb weight gain over the past
four months. CT shows a craniopharyngioma that likely disrupts what structure? -
ANSWER-VENTROMEDIAL HYPOTHALAMUS
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? - ANSWER-HYPOTHALAMIC TUMOR
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) - ANSWER-CEREBELLUM
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? - ANSWER-ANTERIOR SPINAL
ARTERY INFARCTION
32 y/o pt 1-month hx of worsening headaches, episodic mood swings and occasional
hallucinations with visual, tactile and auditory content. CT head reveals tumor where: -
ANSWER-TEMPORAL LOBE
34 y/o M is referred for psychiatric evaluation 5 years after sustaining a head injury at
work. Prior to the accident, he was a stable, happily married man. Since the accident,
he has been described as overly talkative and restless. His wife divorced him because
he was acting irresponsibly, which also resulted in termination from his job.
Psychometric testing reveals that the man has average intelligence and no detectable
memory deficits. Pt's clinical presentation is most consistent with damage to which to
the following brain areas? - ANSWER-FRONTAL LOBE
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: - ANSWER-POST.
COMMUNICATING ARTERY ANEURYSM
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: - ANSWER-THROMBOEMBOLIC STROKE OF LEFT MCA
, 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 - ANSWER-LEFT MEDIAL TEMPORAL STROKE
60 y/o right-handed M, getting lost, only writes on right half of paper. Left-sided hemi-
neglect. Where is the lesion? (8x) - ANSWER-RIGHT PARIETAL LOBE
62yo progressive personality changes, has dull emotions, lack of initiative, and apathy.
An autopsy is likely to show atrophy of ...? - ANSWER-FRONTAL LOBE
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? - ANSWER-R MCA
INFARCT W/ EDEMA AND UNCAL HERNIATION
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: - ANSWER-LEFT ANTERIOR CEREBRAL ARTERY
65 y/o w/ HTN collapsed. In ED is stuporous, R hemiparesis + hemisensory deficit, eyes
deviate to L. CT would show intraparenchymal hemorrhage in: - ANSWER-LEFT
BASAL GANGLIA
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 - ANSWER-CEREBELLAR INFARCT
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) - 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) - ANSWER-RIGHT PARIETAL LOBE
A compound that increases muscle mass by increasing episodic secretion of GH (2x): -
ANSWER-GAMMA HYDROXYLBUTYRATE
A pituitary tumor that protrudes through the diaphragmatic sella is most likely to cause?
- ANSWER-BITEMPORAL HEMIANOPSIA
