Cognitive/Behavioral

Question 1

cant navigate familiar places, draw maps

Answer 1

topographagnosia
localizes to nondominant posterior parahippocampal region, nondominant parietal lobe

Question 2

optic ataxia + oculomotor apraxia + simultanagnosia

Answer 2

Balint’s syndrome
bilateral parieto-occipital region

Question 3

“where” pathway

Answer 3

dorsal visual pathways
parieto-occipital regions

Question 4

“what” pathway

Answer 4

ventral visual pathways
temporo-occipital

Question 5

cortical blindness + confabulation

Answer 5

Anton’s syndrome
bilateral medial occipital lobes

Question 6

blind person with vivid hallucinations, but they know it’s a hallucination

Answer 6

Charles Bonnet syndrome

Question 7

alexia without agraphia (AKA pure word blindness)

Answer 7

disconnection syndrome
lesion in dominant PCA territory, often involving splenium (so words cant get transmitted to Broca’s area)
will have contralateral homonymous hemianopia

Question 8

patient can’t understand when people talk to them, but they can speak normally and reading comprehension is fine

Answer 8

verbal auditory agnosia (pure word deafness)
hearing is fine, but can’t comprehend auditory language

bilateral middle superior temporal gyri (spares Wernicke’s area)
disrupted connections between primary auditory cortex (Heschl’s gyrus) and temporal lobe association cortices

Question 9

can’t comprehend, can’t read, can’t repeat
fluent, nonsensical speech

Answer 9

Wernicke’s aphasia

Question 10

agnosia to sounds, like animal sounds or environmental sounds

Answer 10

nonverbal auditory agnosia

bilateral anterior temporal lobe lesions

Question 11

patient can write fine, but speech is fragmented and effortful. brief phrases, paraphasic errors. can’t repeat. can comprehend fine.

Answer 11

aphemia - pure word mutism

verbal apraxia
different from Broca’s because retained ability to to write and comprehend written language

lesion to dominant frontal operculum

Question 12

can’t speak, write, name, or repeat. can comprehend fine

Answer 12

pure Broca’s expressive aphasia

posterior inferior frontal gyrus

Question 13

severe dysarthria + bilateral VOLUNTARY paralysis of lower cranial nerves, preserved involuntary and emotional innervation (will laugh at joke, yawn fine but can’t voluntarily smile on command)

Answer 13

Foix-Chavany-Marie syndrome

aka ANTERIOR OPERCULAR SYNDROME (insula)

Question 14

patient speaking fluently, nonsensically, comprehension impaired. but can repeat and has echolalia. recent hypotension

Answer 14

transcortical sensory aphasia
watershed infarct MCA-PCA territory or thalamic lesion (thalamic aphasia), Alzheimer’s

basically Wernicke’s but with intact repetition

Question 15

patient can’t verbalize besides few 1-2 word phrases, can’t write. can comprehend and can REPEAT

Answer 15

transcortical motor aphasia (like Broca’s but with intact repetition)

watershed infarcts in ACA/MCA sparing connections between Wernicke’s and Broca’s, but messing up connections between Broca’s and supplementary motor area

Question 16

normal speech, normal language comprehension, normal naming. CAN’T REPEAT

Answer 16

conduction aphasia
lesion in internal arcuate fasciculus (connects Wernicke’s to Broca’s)

Question 17

patient can’t vary speech based on their emotions, so they sound super monotonous

Answer 17

amelodia or affective motor aprosodia

nondominant posteriro inferior frontal gyrus (basically the ‘nondominant broca’s area’)

Question 18

can’t understand emotional variation of other people’s speech

Answer 18

sensory/receptive aprosodia

nondominant Wernicke’s area (posterior superior temporal gyrus)

Question 19

pseudobulbar affect - where is the injury

Answer 19

bilateral lesions that disconnect corticobulbar tracts from brainstem cranial nerve nuclei

seen in ALS, MS, TBI, stroke, mass

tx detromethorphan-quinidine

Question 20

ideomotor apraxia

Answer 20

using a body part to pantomime - weird postures and errors, use their tooth as a toothbrush rather than pretending to hold a toothbrush.

localizes to dominant parietal cortex

Question 21

dressing apraxia localizes where

Answer 21

right parietal lobe

often seen with neglect

Question 22

part of brain responsible for judgment, inhibition of socially inappropriate behaviors, emotional/visceral functions. lesions –> change in personality

Answer 22

orbitofrontal cortex

Question 23

part of brain responsible for motivation, lesion –> apathy, indifference, loss of initiative, abulia, reduced movement/communication

Answer 23

dorsoMedial prefrontal cortex (M for motivation)

also bilateral anterior cingulate

often due to ACA strokes/tumors

most severe form when bilateral dorsomedial prefrontal cortex affected is akinetic mutism

Question 24

part of brain responsible for planning motor activity, executive functioning, problem solving –> lesion causes lack of interest in prior interests, can’t plan/multitask/problem solve

Answer 24

dorsoLateral prefrontal cortex (L for Likes, Logic puzzles)

Question 25

Wisconsin Card Sorting Test

Answer 25

measures prefrontal cortex function have to arrange cards based on a concept

Question 26

Grooved Pegboard Test

Answer 26

tests finger dexterity - fine motor function

Question 27

Trail Making Test

Answer 27

part A: processing speed, visual search, attention part B: set shifting, working memory

Question 28

Clock Drawing Test

Answer 28

tests visuospatial function also auditory comprehension, attention, executive function

Question 29

Capgras delusion

Answer 29

people in your life are imposters

Question 30

Fregoli's syndrome

Answer 30

same person, different disguises

Question 31

Cotard's delusion

Answer 31

patient believes they are dead or dying

Question 32

right-left confusion and finger agnosia localizes where

Answer 32

Gerstmann's syndrome localizes to dominant inferior parietal lobe (dominant angular gyrus) - can be seen in inferior division MCA stroke 4 things: finger agnosia, left/right disorientation, acalculia, agraphia

Question 33

hemispatial neglect localizes where

Answer 33

nondominant parietal cortex involving primary somatosensory cortex thalamus can also do it

Question 34

left hemiparesis and left gaze deviation could localize where?

Answer 34

right pons unopposed action of left PPRF leads to ipsilateral conjugate gaze towards left not overcome by oculocephalic maneuver

Question 35

hyper orality, hypersexuality, blunted emotional affect, hypokinesia - localizes where?

Answer 35

Kluver Bucy syndrome bilateral medial temporal lobe lesions involving amygdala can happen after HSV encephalitis, neurodegen disorders, anoxic brain injury

Question 36

alien limb syndrome associated with what

Answer 36

corticobasal syndrome descriptive term for many etiologies - can be seen in PSP, CBD

Question 37

consciousness localizes to

Answer 37

reticular activating system in brainstem thalamus medial frontal lobes

Question 38

biomarkers for Alzheimer's

Answer 38

hippocampal atrophy on MRI CSF findings: reduced CSF beta-amyloid, increased CSF tau FDG-PET hypometabolism in temporoparietal regions amyloid PET imaging

Question 39

14-3-3

Answer 39

CJD

Question 40

phases of Alzheimer's

Answer 40

1. preclinical (no clinical sx but can see amyloid imaging changes, predates AD by years) 2. prodromal (+biomarkers and early sx) 3. Alzheimer's dementias (+biomarkers + functional deficits)

Question 41

apoE2 vs apoE4 allele

Answer 41

2 - two phew! lower risk of Alzheimer's 4 - four is more risk of late-onset Alzheimer's