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PRITE REVIEW QUESTIONS AND ANSWERS
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PRITE REVIEW QUESTIONS AND ANSWERS
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PRITE REVIEW QUESTIONS AND ANSWERSHow does lateral medullary stroke present? - Answers-Vertigo, diplopia, nausea,
vomiting, hiccups, L face numbness, nystagmus, hoarseness, ataxoia of limbs,
staggering gait, tendency to fall to the left (Wallenberg Syndrome) most commonly
secondary to occlusion of intracranial vertebral artery, PICA and branches.
- Vestibulocerebellar deficits
- Bulbar muscle dysfunction
- Autonomic dysfunction
- Sensory symptoms
Rapid onset of right facial weakness, left limb weakness and diplopia would localize to
what general CNS region? - Answers-Brain stem lesion (most likely an infarction)
Weakness of contralateral foot and leg would localize to what infarct territory? -
Answers-Left anterior cerebral artery
Bipolar disorder is associated with decreased brain connectivity where? - Answers-
Amygdala and PFC
Development of brain grey-matter volume peaks at what stage? - Answers-Late
childhood
In a patient with hippocampus damage, what allows them to still learn new skills like
playing tennis? - Answers-Basal ganglia
Hemisensory loss followed by pain and hyperpathia involving all modalities and
reaching the midline of the trunk and head is most consistent with ischemia in the
distribution of which artery? - Answers-Posterior cerebral artery
Blocking R PCA (posterior cerebral artery) perfusion territory causes which visual
disturbance? - Answers-Left homonymous hemianopsia
The clinical syndrome associated with occlusion of the cortical branch of the posterior
cerebral artery would result in which presentation/deficits? - Answers-Homonymous
hemianopsia with alexia without agraphia
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 which
area? - Answers-Left parietal cortex
Patient presents with following exam finding: Normal Romberg with eyes open but loses
balance with eyes closed. Where is the abnormality? - Answers-Cerebellar vermis
, What is the angular gyrus? - Answers-Portion of the parietal lobe (one of two parts of
the inferior parietal lobule, the other part being the supramarginal gyrus). It plays a part
in language and number processing, memory and reasoning.
A 60 y/o M (right handed) who frequently gets lost only writes on the right half of paper.
Where is the brain lesion? - Answers-Right parietal lobe (example of left-sided
hemineglect). Damage of right parietal lobe is more commonly a/w hemineglect than left
parietal lobes.
A 55 y/o female presents with inability to write, calculate or do arithmetic, and inability to
distinguish the different fingers on her hands. Where is the lesion? - Answers-Left
parietal lobe (example of "Gerstmann syndrome" and the collection of symptoms
indicate abnormalities in the left parietal lobe (dysgraphia, dyscalculia and finger
agnosia)
A 22 y/o male presents with fever, headache, seizures, confusion, stupor and coma
evolving over a few days. EEG has lateralized high voltage sharp waves arising in the L
temporal region with slow wave complexes repeating at 2-3 second intervals. CT shows
low-density lesion in the L temporal lobe. What is the most likely diagnosis? - Answers-
Herpes simplex encephalitis. Retrograde transmission of HSV from peripheral site into
the CNS along a nerve axon. Can lie dormant in the trigeminal ganglion. Targets the
temporal lobes of the brain, leading to seizures with high-voltage sharp waves and slow
wave complexes. Diagnosis is made through EEG, CT, and CSF PCR for HSV DNA or
CSF viral culture (CSF would show a lymphocytic pleocytosis).
Which cranial nerves arise from the midbrain? - Answers-CN III-V (upper part of
brainstem, contains nuclei for oculomotor, trochlear and trigeminal sensory)
Which cranial nerves arise from the pons? - Answers-CN V-IX
Which cranial nerves arise from the medulla? - Answers-CN IX-XII
A 35 y/o female presents with unilateral hearing loss, unsteadiness, falls, headaches,
mild facial weakness and ipsilateral limb ataxia. Where is the lesion? - Answers-
Cerebellopontine angle: This patient has clear symptoms of cerebellar dysfunction
(ipsilateral ataxia is specific for cerebellum). The pons has multiple CN Nuclei (V-IX)
including the facial nerve (facial weakness) and vestibular nerve (unilateral hearing and
balance). Zone 2: Middle face = Pons
A 48 y/o female with history of HTN develops vertigo, nausea, vomiting, hiccups, left-
sided face numbness, nystagmus, hoarseness, deficits in pain/temperature on the right
side of the body, ataxia of the limbs, staggering gait and falls to the left. Diagnosis? -
Answers-Lateral medullary stroke (Wallenberg's Syndrome or Posterior Inferior
Cerebellar Artery Syndrome). Occlusion of the PICA leads to lateral medullary infarct.
The symptoms include: c/l deficits in pain and temperature (lateral spinothalamic tract,
which decussates early in the spinal cord), ipsilateral loss of pain/temperature to the
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