Injury/Stroke

Question 1

ACA Occlusion

Answer 1

Hemiparesis of the contralateral foot and leg (more severely than the arm)

Sensory loss of the contralateral foot and leg

Transcortical motor aphasia (lack of fluency with intact comprehension and repetition)

Abulia, disinhibition, executive dysfunction, anosognosia (lack of insight), emotional lability, frontal release signs (re-emergence of primitive reflexes)

Question 2

Most common artery to be occluded

Answer 2

MCA

Question 3

MCA Occlusion

Answer 3

Hemiparesis of the contralateral face and limbs
Sensory loss of contralateral face and limbs
Dysphasia / aphasia (when dominant hemisphere affected) (Broca and Wernicke)
Contralateral neglect
Homonymous hemianopia or quadrantanopia without macular sparing (macular vision not preserved)
Dorsolateral prefrontal dysfunction

Question 4

PCA Occlusion

Answer 4

Alexia without agraphia (left PCA)
Contralateral loss of pain and temperature sensation
Contralateral hemianopia (with macular sparing)
Prosopagnosia
Ipsilateral cranial nerve defects (V, VIII, IX, X, & XI)
Horner’s syndrome

Question 5

sensory inattention
apraxias
astereognosis (tactile agnosia)
inferior homonymous quadrantanopia
Gerstmann’s syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation

Answer 5

Parietal lobe lesion

Question 6

homonymous hemianopia (with macula sparing)
cortical blindness
visual agnosia

Answer 6

Occipital lobe lesion

Question 7

Wernicke’s aphasia: this area ‘forms’ the speech before ‘sending it’ to Brocas area. Lesions result in word substituion, neologisms but speech remains fluent
superior homonymous quadrantanopia
auditory agnosia
prosopagnosia (difficulty recognising faces)

Answer 7

Temporal lobe lesion

Question 8

expressive (Broca’s) aphasia: located on the posterior aspect of the frontal lobe, in the inferior frontal gyrus. Speech is non-fluent, laboured, and halting
disinhibition
perseveration
anosmia
inability to generate a list

Answer 8

Frontal lobe lesion

Question 9

midline lesions: gait and truncal ataxia
hemisphere lesions: intention tremor, past pointing, dysdiadokinesis, nystagmus

Answer 9

Cerebellar lesion

Question 10

Wernicke’s /Korsakoff’s

Answer 10

Medial thalamus and mammillary bodies of the hypothalamus

Question 11

Hemibalism

Answer 11

Subthalamic nucleus of the basal ganglia

Question 12

Huntington’s chorea

Answer 12

Striatum (caudate nucleus) of the basal ganglia

Question 13

Parkinson’s

Answer 13

Substantia nigra of the basal ganglia

Question 14

Kluver-Bucy syndrome (hypersexuality, hyperorality, hyperphagia, visual agnosia

Answer 14

Amygdala

Question 15

Contralateral hemiplegia, impaired problem solving, disinhibition, lack of initiative, Broca’s aphasia and agraphia (dominant)

Answer 15

Frontal lobe dysfunction

Question 16

Wernicke’s aphasia (dominant), homonymous upper quadrantanopia, auditory agnosia (non-dominant)

Answer 16

Temporal dysfunction

Question 17

Anosognosia, dressing apraxia, spatial neglect, constructional apraxia

Answer 17

Non dominant parietal dysfunction

Question 18

Gerstmann’s syndrome

Answer 18

Dominant parietal dysfunction

Question 19

Visual agnosia, visual illusions, contralateral homonymous hemianopia

Answer 19

Occipital dysfunction

Question 20

Area affected in prosopagnosia

Answer 20

Bilateral occipitotemporal / fusiform gyrus

Question 21

First domain of orientation to go in delirium

Answer 21

Time

Question 22

Balint syndrome

Answer 22

Simultanagnosia
Ocular apraxia
Optic ataxia

Bilateral parietal occipital damage

(balint is soo bpod)

Question 23

Alexia without agraphia results from

Answer 23

Damage to dominant/left occipital lobe and corpus callosum (splenium). Also have right homonymous hemianopia

Question 24

Medial frontal and anterior cingulate gyrus lesions are associated with

Answer 24

Apathy
Abulia
Akinetic mutism
Disruptions in motivation

Question 25

Dorsolateral prefrontal circuit lesions are associated with

Answer 25

Impairments in executive function (planning, goals)
Perseveration
General academic/intellectual decline

Question 26

Orbitofrontal circuit and associated ventromedial cortex and white matter lesions associated with

Answer 26

Pseudopsychopathy/accquired sociopathy
Disturbances in personality, behaviour etc
Low tolerance for frustration, easily angered

Question 27

Which test can differentiate organic from psychogenic coma?

Answer 27

Caloric testing
(psychogenic = nystagmus AWAY from ear, structural = TOWARDS ear or no response)

Question 28

Absent ankle jerks and upgoing plantars seen in

Answer 28

Subacute combined degeneration of spinal cord

Question 29

Low score on Seashore musical aptitude test seen with what lesion?

Answer 29

Right temporal area damage

Question 30

Lesions in what structure cause finger nose ataxia?

Answer 30

Inferior olivary nucleus

Question 31

Characteristic features of progressive supranuclear palsy

Answer 31

Vertical supranuclear gaze palsy
Postural instability with early falls
Subcortical frontal dementia

(inc. brainstem degeneration, tau proteins)

Question 32

Benton verbal fluency tests test what?

Answer 32

Frontal lobe function

Question 33

Hayling tests test what?

Answer 33

Inhibition

Question 34

Neglect associated with injury where

Answer 34

Non dominant/right parietal lobe