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Flashcards in chapter 10-11-12 Deck (46):
1


For each of the following clinical descriptions, select the appropriate descriptive term for
the disorder from the following list:
A. Akinesia
B. Detective response inhibitor
C. Ideational apraxia
D. Ideamotor apraxia
E. Hypometria
F. Limb- kinetic apraxia
G. Motor impersistence
H. Motor preseveration

A patient is asked to hold his arms extended for 20 seconds, but lets then drop after a
few-seconds. When asked to protrude the tongue, he also fails to keep it protruded for the
requisite 20 seconds.

G

2

For each of the following clinical descriptions, select the appropriate descriptive term for
the disorder from the following list:
A. Akinesia
B. Detective response inhibitor
C. Ideational apraxia
D. Ideamotor apraxia
E. Hypometria
F. Limb- kinetic apraxia
G. Motor impersistence
H. Motor preseveration

A patient is asked to rotate a coin in her hand but cannot do it despite intact strength and
absence of corticospinal tract signs. When the same coin is placed on the table, the patient
has difficulty lifting the coin off of the table.

F

3

For each of the following clinical descriptions, select the appropriate descriptive term for
the disorder from the following list:
A. Akinesia
B. Detective response inhibitor
C. Ideational apraxia
D. Ideamotor apraxia
E. Hypometria
F. Limb- kinetic apraxia
G. Motor impersistence
H. Motor preseveration

A patient is asked to show how to light a cigarette in pantomime, and has difficulty
performing the task despite absence of paralysis.

D

4

For each of the following clinical descriptions, select the appropriate descriptive term for
the disorder from the following list:
A. Akinesia
B. Detective response inhibitor
C. Ideational apraxia
D. Ideamotor apraxia
E. Hypometria
F. Limb- kinetic apraxia
G. Motor impersistence
H. Motor preseveration

A patient is asked to move the contralateral arm when the one hand is stimulated The
patient consistently moves the ipsilateral hand.

B

5

For each of the following clinical descriptions, select the appropriate descriptive term for
the disorder from the following list:
A. Akinesia
B. Detective response inhibitor
C. Ideational apraxia
D. Ideamotor apraxia
E. Hypometria
F. Limb- kinetic apraxia
G. Motor impersistence
H. Motor preseveration

A patient is asked to copy a cube as part of mental status testing, and repeatedly draws
over the same lines.

H

6

Which of the following statements are true regarding limb-kinetic apraxia'1
1. Limb-kinetic apraxia typically occurs in the limb contralateral to a hemispheric lesion
2. Injury- to the premotor cortex produces limb-kinetic apraxia
3. Limb-kinetic apraxia is loss of deftness of independent finger movements
4. Dominant hemisphere lesion may evoke limb-kinetic apraxia in the ipsilateral hand
Select: A = 1. 2. 3. B = 1. 3. C = 2, 4. D - 4 only. E - All

E

7

A patient is examined and found io have no paralysis but is unable to imitate gestures and
pantomime using tools with the left hand. However, when the tool is available, the patient
retains the ability to use it correctly. Which of the following is the most likely location of
lesion0
A, Premotor area
B. Corpus callosum
C. Supplementary motor cortex
D. Motor cortex
E. No structural lesion, a psychogenic manifestation

B

8

Which of the following statements is regarding the differentiation between the primary
motor and supplementary motor areas?
1. Apraxia can result from SMA lesions but not the primary motor cortex.
2. SMA neurons discharge prior to the neurons of the primary motor cortex.
3. The SMA is located immediately lateral to the primary motor cortex.
4. The SMA mediates complex movements whereas the primary motor cortex
mediates simple movements.
Select: A = i, 2,3. B = i. 3. C = 2,4. D = 4 only. E = All

C

9

A patient with stroke is presented to you by a medical student. He has difficulty with
performing task^ and the student thinks he has ideomotor apraxia. On your exam, he
demonstrates worse performance with imitation than with command. Which of the
conclusions is true?
A. The patient has conduction apraxia rather than ideomotor apraxia
B. The findings confirm ideomotor apraxia
C. The patient exhibits oppositional behavior
D. The patient exhibits dissociation apraxia

A

10

Examination of a patient with stroke shows that the patient has full use of the limbs, but
has difficulty with tool use. The patient is shown how to use a screwdriver, then when
grabbing the screwdriver uses it as a hammer. Which of the following types of motor
deficit does he have?
A. Limb-kinetic apraxia
B. Ideomotor apraxia
C. Conceptual apraxia
D. Conduction apraxia

C

11

Which of the following are characteristic of aperceptivc visual agnosia'/
A. Inability to see to one side on extinction testing
B. Can see yet have object-recognition unpainnent
C. Unable to distinguish colors and brightness
D. Unable to distinguish motion

B

12

Which of the following differentiates aperceptive visual agnosia from associative \visual
agnosia'7
A. Figure copying is preserved with associative visual agnosia and impaired in aperceptivc visual agnosia
B. Naming objects is impaired in aperceptive visual agnosia but not associative visual agnosia
C. Associative visual agnosia is a disorder of language affecting visual inputs
D. Associative visual agnosia is characterized by having more difficulty with face recognition than object recognition

A

13

For the following questions, indicate which of the following disorders describes the
clinical Situation. Select from the following list.
A. Aperceptive visual agnosia
B. Associative visual agnosia
C. Pure alexia
D Prosopagnosia
Impaired visual word recognition with intact auditory word recognition.

B

14

For the following questions, indicate which of the following disorders describes the
clinical Situation. Select from the following list.
A. Aperceptive visual agnosia
B. Associative visual agnosia
C. Pure alexia
D Prosopagnosia
Impaired object recognition with preserved copying ability.

C

15

For the following questions, indicate which of the following disorders describes the
clinical Situation. Select from the following list.
A. Aperceptive visual agnosia
B. Associative visual agnosia
C. Pure alexia
D Prosopagnosia
Impaired facial recognition, cut of proportion to object recognition.

D

16

For the following questions, indicate which of the following disorders describes the
clinical Situation. Select from the following list.
A. Aperceptive visual agnosia
B. Associative visual agnosia
C. Pure alexia
D Prosopagnosia
Impaired visual object recognition with defective copying.

A

17

For the following questions, select the clinical syndrome which is associated with the
clinical presentation. Select,from the following list.
A. Nonverbal auditory agnosia
B. Pure word deafness
C. Auditory amusia
D. Phonagnosia
Inability to recognize familiar voices.

D

18

For the following questions, select the clinical syndrome which is associated with the
clinical presentation. Select,from the following list.
A. Nonverbal auditory agnosia
B. Pure word deafness
C. Auditory amusia
D. Phonagnosia
Inability to recognize common objects by their sounds, e.g., dog. keys.

A

19

For the following questions, select the clinical syndrome which is associated with the
clinical presentation. Select,from the following list.
A. Nonverbal auditory agnosia
B. Pure word deafness
C. Auditory amusia
D. Phonagnosia
Impaired comprehension of spoken language with preservation of basic hearing abilities.

B

20

For the following questions, select the clinical syndrome which is associated with the
clinical presentation. Select,from the following list.
A. Nonverbal auditory agnosia
B. Pure word deafness
C. Auditory amusia
D. Phonagnosia
Loss of ability to recognize music.

C

21

Which of the following features differentiates pure word deafness from Wernicke's aphasia'7
A. Preservation of reading
B. Preservation of writing
C. Preservation of spontaneous speech
D. All of the aoove

D

22

Which of the following features are typical of tactile agnosia?
1. The disorder is unilateral
2. Tactual memories are intact
3. Basic soiiiesthetic abilities are preserved
4. Language is intact
Select: A = 1, 2, 3. B = 1, 3. C = 2,4. D - 4 only. E = A11

E

23

Which of the following statements is true regarding handedness and language dysfunction?
A. Left-handed patients usually develop aphasia after lesions of the right hemisphere
B. The language centers of most patients who are left handed is in the left hemisphere
C. Right hemisphere lesions never result in language problems in right-handed patients
D. Recovery of aphasia is commonly better in right-handed patients than in lefthanded patients
E. All are true

B

24

Aphemia is a rare condition affecting language function. Which of the following are
features of aphemia?
1. Causanve lesion is in the dominant inferior frontal gyrus
2. Writing is preserved
3. Auditor/ comprehension is normal
4. Patient speaks with phoneme substitutions
Select: A - 1. 2. 3. B - I. V C - 2.4. D =4 only. E = All

E

25

Wernicke's aphasia is characterized by all of the following except:
A. Lesion of the don.ina.it superior temporal gyms
B. Anomia
C. Deficit of auditor, language comprehension wiih preservation of reading comprehension
D. Writing is impaired with poor spelling and impaired content of the proses

C

26

Conduction aphasia can be recognized only if specifically tested for, Typical features
include ail of ihe following except:
A. Impaired repetition
B. Coexistence of anomia
C. Lesion in the region of the arcuate fasciculus in die dominant hemisphere
D. Deficit in comprehension of purely verbal commands

D

27

For each of the following vignettes, select the language disorder from the list below
which most closely fits the clinical description.
A. Transcortical motor aphasia
B. Thalamic aphasia
C. Transcortical sensory aphasia
D. Wernicke's aphasia
Speech is impaired, with telegrapic output. Comprehension is good. Repetition is good.

A

28

For each of the following vignettes, select the language disorder from the list below
which most closely fits the clinical description.
A. Transcortical motor aphasia
B. Thalamic aphasia
C. Transcortical sensory aphasia
D. Wernicke's aphasia

Speech is fluent, although with paraphrasic errors and echolalia. Comprehension is
impaired. Repetition is normal.

C

29

For each of the following vignettes, select the language disorder from the list below
which most closely fits the clinical description.
A. Transcortical motor aphasia
B. Thalamic aphasia
C. Transcortical sensory aphasia
D. Wernicke's aphasia
Fluent speech although poor information content. Poor comprehension. Poor repetition.

D

30

Which of die following statements are true regarding subcortical language deficits?
1. Thalamic aphasia resembles Wernicke's aphasia
2. Basal ganglia hemorrhage can cause anterior subco^ical aphasia
3. Basal ganglia infarction produces language dysfunction resembling Brcca's aphasia
4. Thalamic aphasia can result from a right-thalamic lesion in a left-handed person
Select: A = I, 2. 3. B = 1. 3. C = 2. 4. D = 4 only. E = All

E

31

Which of the following statements are true regarding pure alexia without agraphia?
1. Patients cannot write
2. Patients can only read their own writing but not others writings
3. Lesion is usually infarction in the superior temporal gyrus
4. Hemifield visual defect is present in most patients
Select: A = I. 2. 3. B - 1. 3. C = 2. 4. D - 4 only. E = All

D

32

Which of the following statements regarding language in dementia from Alzheimer's
disease are true?
1. Grammar and receptive vocabulary are affected early in the course of AD
2. Early stages of AD are associated with cognitive and memory' deficits with less prominent language deficits
3. Reading and writing are preserved until later stases of AD
4. Patients with early AD often have anomic aphasia
Select A= 1,. 2. 3. B = 1. 3. C = 2, 4. D - 4 only. E = All

C

33

For the following vignettes, select the most likely cause from the following list,
A. Left hemisphere cortical infarction
B. Lett thalamic infarction
C. Left occipital infarction
D. Left basal ganglia hemorrhage
E. Any of these
Abrupt onset of headache and right hemiparesis along with dysarthria and expressive difficulty.

D

34

For the following vignettes, select the most likely cause from the following list,
A. Left hemisphere cortical infarction
B. Lett thalamic infarction
C. Left occipital infarction
D. Left basal ganglia hemorrhage
E. Any of these
Naming difficulty

E

35

For the following vignettes, select the most likely cause from the following list,
A. Left hemisphere cortical infarction
B. Lett thalamic infarction
C. Left occipital infarction
D. Left basal ganglia hemorrhage
E. Any of these

You are asked to see a patient because of the acute onset of confusion. Examination
shows no motor deficit, and the patient is able to speaxk. but the speech is relatively
devoid of content, and there are frequent paraphrasic errors.

A

36

Degenerative dementia can be characterized by which of the following language deficits?
1. Anomia
2. Progressive aphasia without dementia
3. Global aphasia
4. Alexia without agraphia
Select: A = 1. 2. 3. B = 1. 3. C = 2, 4. D = 4 onlv. E — All

A

37

Patients with Parkinson's disease have which features of speech?
1. Decreased and monotonous speech
2. Increased rate of speech
3. Absence of fluctuation in loudness and pitch
4. Consonant substitution
Select: A - 1.2.3. B = i.3.0 2.4. D = 4 only. E = All

E

38

Which of the following are features of speech in Huntington': disease0
1. Decreased variability in rate and loudness
2. Sudden stoppages of speech
3. Soft-smooth voice
4. Hyperkinetic dysarthria
Select: A = 1. 2. 3. B = 1. 3. C = 2, 4. D = 4 only. E - All

C

39

Apraxia of speech lias which of the following features
1. Fffortful speech
2. Prominent difficulty with polysyllabic words
3. Abnormal prosody of speech
4. Difficulty initiating speech
Select: A = 1. 2. 3. B = 1. 3. C = 2, 4. D = 4 only. E - All

E

40

A 58-year-oid man presents with inability to speak and is found on examination to have
decreased facial movements. He can follow complex commands with his arms but is
unable to do so with his cranial nerves, including inability to smile or close eyes on
command. During the interview, he does smile spontaneously and appropriately. Which
of the following statements is true?
A. I lis deficit is psychogenic
B. He has pseudobulbar palsy
C The most likely lesion in the ventral midbrain and pons
D. He would be unable to yawn

B

41

For questions I2B-5 through 12B-9. select the correct speech disturbance from the follow
me list.
A. flaccid dysarthria
B. Spastic dysarthria
C. Ataxia dysarthria
D. Hypokinetic dysarthria
E. Hyperkinetic dysarthria

Marked variation in rate. loudness, and timing with distortion of vowels. Sudden
stoppages of speech.

E

42

For questions I2B-5 through 12B-9. select the correct speech disturbance from the follow
me list.
A. flaccid dysarthria
B. Spastic dysarthria
C. Ataxia dysarthria
D. Hypokinetic dysarthria
E. Hyperkinetic dysarthria

For questions I2B-5 through 12B-9. select the correct speech disturbance from the follow
me list.
A. flaccid dysarthria
B. Spastic dysarthria
C. Ataxia dysarthria
D. Hypokinetic dysarthria
E. Hyperkinetic dysarthria

Spontaneous speech is irregular in timing with pauses. On testing, the patient has
irregular timing of repeated phonemes with pauses.

C

43

For questions I2B-5 through 12B-9. select the correct speech disturbance from the follow
me list.
A. flaccid dysarthria
B. Spastic dysarthria
C. Ataxia dysarthria
D. Hypokinetic dysarthria
E. Hyperkinetic dysarthria
Speech is breathy and nasal with indistinct consonants.

A

44

For questions I2B-5 through 12B-9. select the correct speech disturbance from the follow
me list.
A. flaccid dysarthria
B. Spastic dysarthria
C. Ataxia dysarthria
D. Hypokinetic dysarthria
E. Hyperkinetic dysarthria
Patient has Parkinson's disease.

D

45

For questions I2B-5 through 12B-9. select the correct speech disturbance from the follow
me list.
A. flaccid dysarthria
B. Spastic dysarthria
C. Ataxia dysarthria
D. Hypokinetic dysarthria
E. Hyperkinetic dysarthria
Patient with pseudobulbar palsy.

no highlights

46

Acquired stuttering is most commonly seen in patients with lesions in which region of the brain?
A Left hemisphere cortex
B. Right hemisphere cortex
C. Left hemisphere thalamus
D. Bilateral thalamus

A