PRITE CORRECT QUESTIONS &
ANSWERS
Amnesia preceded by epigastric sensation and fear are associated with electrical
abnormality where? - ANSWER Temporal lobe
Memory loss pattern in dissociative amnesia - ANSWER Memory loss occurs for a
discrete period of time
Amnesia characterized by loss of memory of events that occur after onset of etiologic
condition or agent - ANSWER Anterograde
What psychoactive drug produces amnesia? - ANSWER Alcohol
Brain Lesions - ANSWER ...
Visual problem in pituitary tumor compressing optic chiasm - ANSWER Bitemporal
Hemianopsia
32 y/o pt 1-month history of worsening headaches, episodic mood swings and
occasional hallucinations with visual, tactile and auditory content. CT head reveals
tumor where: - ANSWER Temporal lobe
Syndrome characterized by fluent speech, preserved comprehension, inability to repeat,
w/o associated signs. Location of lesion in the brain? - ANSWER Supramarginal gyrus
or insula
Acute onset of hemiballismus of LUE & LLE. MRI is most likely to show lesion located
where? - ANSWER Subthalamic nucleus
Left sided hemi-neglect is associated with lesion located where? - ANSWER Right
Parietal Lobe
60M right-handed, getting lost, only writes on right half of paper. Where is lesion -
ANSWER Right parietal
Which hormone secreted in functional pituitary adenoma: - ANSWER Prolactin
CT & MRI show ventriculomegaly are out of proportion to sulcal atrophy. This is
suggestive of what diagnosis? - ANSWER Normal Pressure Hydrocephalus
5 y/o with 4 month history of morning HA, vomiting, and recent problems with gait, falls,
and diplopia - ANSWER Medulloblastoma
,20 y/o with 1 yr of bitemporal headaches, polydipsia, polyuria, bulimia. For 2 months
emotional outburst aggressive and transient confusion neuro exam normal. What will
MRI of brain show? - ANSWER Hypothalamic tumor
Previously pleasant mom becomes profane and irresponsible over 6 months: -
ANSWER Frontal lobe
Unilateral hearing loss with vertigo, unsteadiness with falls and headaches, mild facial
weakness and ipsilateral limb ataxia is most commonly associated with tumors in what
locations: - ANSWER Cerebellopontine angle
Catatonia - ANSWER ...
52 y/o with h/o unipolar depression is brought to ED with a first episode of catatonia.
Patient is on no meds, UDS is neg. Further w/u should initially focus on what factor? -
ANSWER Metabolic disorders
Which term describes state of immobility that is constantly maintained? - ANSWER
Cataplexy
Ability of catatonic pt to hold same position - ANSWER Catalepsy
CVA - ANSWER ...
Chronic Afib develops aphasia and R hemiparesis at noon. ER exam notes weakness of
R extremities and severe dysfluent aphasia, but CT at 1:30 PM has no acute lesion.
Most appropriate treatment: - ANSWER TPA
Young adult gained 70 lbs in last year c/o daily severe headaches sometimes assoc
with graying out of vision. Papilledema present. CT and MRI brain no abnormalities but
ventricles smaller than usual. Goal of treatment in this case: - ANSWER Prevent
blindness
Patient with hypertension develops vertigo, nausea, vomiting, hiccups, left sided face
numbness, nystagmus, hoarseness, ataxia of the limbs, staggering gait, and is falling to
the left. Dx? - ANSWER Lateral medullary stroke
Rapid onset of right facial weakness, left limb weakness, diplopia - ANSWER Brain
Stem Infarction
Transient symptom associated with carotid stenosis: *** - ANSWER Monocular
blindness
62 y/o M w DM is not making sense, saying "thar szing is phrumper zu stalking". Normal
intonation but no one in the family can understand it. He verbally responds to questions
,with similar utterances but fails to successfully execute any instruction. **** - ANSWER
Wernicke's aphasia
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. Unintelligable sounds for speech. Alert but appeared
frustrated. R hemiplegia with arm and face weaker than leg. CT head showed no
hemorrhage. Pathology type and area: - ANSWER Thromboembolic stroke L MCA
(middle cerebral artery)
Abulia refers to impairment in ability to: - ANSWER Spontaneously move and speak
Sudden-onset left hemiparesis with deviation of eyes to the right - ANSWER Right
putaminal hemorrhage
Sudden onset vertigo/nausea, hoarseness/dysphagia, right sided face numbness,
diminished gag reflex on right, decreased pinprick and temp sensation on left -
ANSWER Right medullary infarction
65 y/o diabetic 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
Pt with acute onset vertigo, what will suggest R lateral medullary infarct? - ANSWER R
facial loss of touch + temp 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: - ANSWER Post. Communicating
artery aneurysm
Aphasia w/ effortful fragmented, dysfluent, telegraphic speech, is seen in a lesion
where? - ANSWER Post frontal lobe
39 year old with h/o of multiple miscarriages develops an acute left sided hemiparesis.
Work up revels elevated anticardiolipin titers and no other risk factors for stroke.
Appropriate intervention at this point is? - ANSWER Plasmapheresis
Abnormal elevated metabolic findings associated with increased risk of stroke in
patients under 50 - ANSWER Plasma homocysteine
73 y/o found on floor, unaware of L UE/LE. Flaccid L arm, but denies anything wrong
and when asked to raise L arm raises R. When asked which arm is her L, she replies
"yours." Dx? - ANSWER Parietal lobe CVA
, CT scan with occipital and intraventricular hyperintensities - ANSWER Parenchymal
hemorrhage
Which med has secondary prevention against embolic stroke in patients with Afib? -
ANSWER Oral warfarin
As opposed to strokes caused by arterial embolism or thrombosis, those caused by
cerebral vein or venous sinus thrombosis are - ANSWER More often associated with
seizures at onset
Atrophy of right temporal lobe on cross section associated with occlusion of: - ANSWER
Middle cerebral artery
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? -
ANSWER Left parietal cortex
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
Visual disturbances associated with occlusion of the right posterior cerebral artery? -
ANSWER Left homonymous hemianopsia
65 y/o with HTN collapsed. In ED is stuporous, R hemiparesis + hemisensory deficit,
eyes deviate to L. CT would show intraparenchymal hemorrhage in: - ANSWER Left
basal ganglia
Higher frequency & greater severity of depression associated w/ cortical & subcortical
strokes - ANSWER Left anterior frontal
Pt with hypertension develops painless vision loss on the left eye. PE revels blindness
in the left eye and afferent papillary defect on the left. MRI shows several T2
hyperintensities in the white matter periventricularly. No corpus callosum lesions. No
enhancement with gadolinium. Dx? - ANSWER Ischemic optic neuropathy
63 y/o with new onset aphasia and R hemiparesis, 2 days ago had milder/similar
symptoms that resolved in 30 minutes, yesterday had similar episode x45 minutes.
Current sx started 1.5 hrs ago. CT shows no stroke or hemorrhage. Tx? - ANSWER
Intravenous thrombolytic agents
Lower facial weakness w/ relative sparing of forehead can be stroke in - ANSWER
Internal capsule
Prosopagnosia is: - ANSWER Inability to recognize faces
ANSWERS
Amnesia preceded by epigastric sensation and fear are associated with electrical
abnormality where? - ANSWER Temporal lobe
Memory loss pattern in dissociative amnesia - ANSWER Memory loss occurs for a
discrete period of time
Amnesia characterized by loss of memory of events that occur after onset of etiologic
condition or agent - ANSWER Anterograde
What psychoactive drug produces amnesia? - ANSWER Alcohol
Brain Lesions - ANSWER ...
Visual problem in pituitary tumor compressing optic chiasm - ANSWER Bitemporal
Hemianopsia
32 y/o pt 1-month history of worsening headaches, episodic mood swings and
occasional hallucinations with visual, tactile and auditory content. CT head reveals
tumor where: - ANSWER Temporal lobe
Syndrome characterized by fluent speech, preserved comprehension, inability to repeat,
w/o associated signs. Location of lesion in the brain? - ANSWER Supramarginal gyrus
or insula
Acute onset of hemiballismus of LUE & LLE. MRI is most likely to show lesion located
where? - ANSWER Subthalamic nucleus
Left sided hemi-neglect is associated with lesion located where? - ANSWER Right
Parietal Lobe
60M right-handed, getting lost, only writes on right half of paper. Where is lesion -
ANSWER Right parietal
Which hormone secreted in functional pituitary adenoma: - ANSWER Prolactin
CT & MRI show ventriculomegaly are out of proportion to sulcal atrophy. This is
suggestive of what diagnosis? - ANSWER Normal Pressure Hydrocephalus
5 y/o with 4 month history of morning HA, vomiting, and recent problems with gait, falls,
and diplopia - ANSWER Medulloblastoma
,20 y/o with 1 yr of bitemporal headaches, polydipsia, polyuria, bulimia. For 2 months
emotional outburst aggressive and transient confusion neuro exam normal. What will
MRI of brain show? - ANSWER Hypothalamic tumor
Previously pleasant mom becomes profane and irresponsible over 6 months: -
ANSWER Frontal lobe
Unilateral hearing loss with vertigo, unsteadiness with falls and headaches, mild facial
weakness and ipsilateral limb ataxia is most commonly associated with tumors in what
locations: - ANSWER Cerebellopontine angle
Catatonia - ANSWER ...
52 y/o with h/o unipolar depression is brought to ED with a first episode of catatonia.
Patient is on no meds, UDS is neg. Further w/u should initially focus on what factor? -
ANSWER Metabolic disorders
Which term describes state of immobility that is constantly maintained? - ANSWER
Cataplexy
Ability of catatonic pt to hold same position - ANSWER Catalepsy
CVA - ANSWER ...
Chronic Afib develops aphasia and R hemiparesis at noon. ER exam notes weakness of
R extremities and severe dysfluent aphasia, but CT at 1:30 PM has no acute lesion.
Most appropriate treatment: - ANSWER TPA
Young adult gained 70 lbs in last year c/o daily severe headaches sometimes assoc
with graying out of vision. Papilledema present. CT and MRI brain no abnormalities but
ventricles smaller than usual. Goal of treatment in this case: - ANSWER Prevent
blindness
Patient with hypertension develops vertigo, nausea, vomiting, hiccups, left sided face
numbness, nystagmus, hoarseness, ataxia of the limbs, staggering gait, and is falling to
the left. Dx? - ANSWER Lateral medullary stroke
Rapid onset of right facial weakness, left limb weakness, diplopia - ANSWER Brain
Stem Infarction
Transient symptom associated with carotid stenosis: *** - ANSWER Monocular
blindness
62 y/o M w DM is not making sense, saying "thar szing is phrumper zu stalking". Normal
intonation but no one in the family can understand it. He verbally responds to questions
,with similar utterances but fails to successfully execute any instruction. **** - ANSWER
Wernicke's aphasia
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. Unintelligable sounds for speech. Alert but appeared
frustrated. R hemiplegia with arm and face weaker than leg. CT head showed no
hemorrhage. Pathology type and area: - ANSWER Thromboembolic stroke L MCA
(middle cerebral artery)
Abulia refers to impairment in ability to: - ANSWER Spontaneously move and speak
Sudden-onset left hemiparesis with deviation of eyes to the right - ANSWER Right
putaminal hemorrhage
Sudden onset vertigo/nausea, hoarseness/dysphagia, right sided face numbness,
diminished gag reflex on right, decreased pinprick and temp sensation on left -
ANSWER Right medullary infarction
65 y/o diabetic 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
Pt with acute onset vertigo, what will suggest R lateral medullary infarct? - ANSWER R
facial loss of touch + temp 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: - ANSWER Post. Communicating
artery aneurysm
Aphasia w/ effortful fragmented, dysfluent, telegraphic speech, is seen in a lesion
where? - ANSWER Post frontal lobe
39 year old with h/o of multiple miscarriages develops an acute left sided hemiparesis.
Work up revels elevated anticardiolipin titers and no other risk factors for stroke.
Appropriate intervention at this point is? - ANSWER Plasmapheresis
Abnormal elevated metabolic findings associated with increased risk of stroke in
patients under 50 - ANSWER Plasma homocysteine
73 y/o found on floor, unaware of L UE/LE. Flaccid L arm, but denies anything wrong
and when asked to raise L arm raises R. When asked which arm is her L, she replies
"yours." Dx? - ANSWER Parietal lobe CVA
, CT scan with occipital and intraventricular hyperintensities - ANSWER Parenchymal
hemorrhage
Which med has secondary prevention against embolic stroke in patients with Afib? -
ANSWER Oral warfarin
As opposed to strokes caused by arterial embolism or thrombosis, those caused by
cerebral vein or venous sinus thrombosis are - ANSWER More often associated with
seizures at onset
Atrophy of right temporal lobe on cross section associated with occlusion of: - ANSWER
Middle cerebral artery
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? -
ANSWER Left parietal cortex
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
Visual disturbances associated with occlusion of the right posterior cerebral artery? -
ANSWER Left homonymous hemianopsia
65 y/o with HTN collapsed. In ED is stuporous, R hemiparesis + hemisensory deficit,
eyes deviate to L. CT would show intraparenchymal hemorrhage in: - ANSWER Left
basal ganglia
Higher frequency & greater severity of depression associated w/ cortical & subcortical
strokes - ANSWER Left anterior frontal
Pt with hypertension develops painless vision loss on the left eye. PE revels blindness
in the left eye and afferent papillary defect on the left. MRI shows several T2
hyperintensities in the white matter periventricularly. No corpus callosum lesions. No
enhancement with gadolinium. Dx? - ANSWER Ischemic optic neuropathy
63 y/o with new onset aphasia and R hemiparesis, 2 days ago had milder/similar
symptoms that resolved in 30 minutes, yesterday had similar episode x45 minutes.
Current sx started 1.5 hrs ago. CT shows no stroke or hemorrhage. Tx? - ANSWER
Intravenous thrombolytic agents
Lower facial weakness w/ relative sparing of forehead can be stroke in - ANSWER
Internal capsule
Prosopagnosia is: - ANSWER Inability to recognize faces
