dr_sarim
Forum Senior
Topics: 16
Posts: 75
|
1. A 72-year-old woman depressive has problems finding the correct words. Her speech is effortful, and her sentences are very short. Her comprehension of spoken language is normal, but her comprehension of written language is reduced. In writing, she makes many spelling and grammar mistakes. She is disoriented to time. Where is the lesion responsible for her symptoms most likely located?
A.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
Left angular gyrus
B.
Left frontal lobe
C.
Left temporal lobe
D.
Right frontal lobe
E.
Right parietal lobe
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,123
|
A
This patient has nonfluent aphasia, agraphia, and alexia. This is Gerstmann syndrome
___________________
The Key to Succeed is Patience.
|
| dr_sarim
Forum Senior
Topics: 16
Posts: 75
|
i doubt it is gerstman syndrome
also pt is disoriented to time not rt-lt disorientation which occurs in gerstmann syndrome..also there is no mentioning of agnosia or acalculia
|
| surgeon99
Forum Senior
Topics: 9
Posts: 98
|
is it s Wernickes speech if yes then ans is c
|
| dr_sarim
Forum Senior
Topics: 16
Posts: 75
|
very confusing question...
its from usmle 123
wernike's has impairment of comprehension of speech and impairment of comprehension of meaning of words both spoken and written (not mentioned in question)
this excludes wernikes
|
| sonaliraj99
Forum Senior
Topics: 39
Posts: 132
|
ita a.. but not gertsmann sy.. isolated abgular gyrus lesion.. kaplan neurianat.. none others fit.. not wernicke's..
___________________
ZIDDI.ZIDDI ARMAAN!!!ZIDDI.ZIDDI HAI TUFAAN.
ZIDDI.HUM BHI YAHA.
|
| dr_sarim
Forum Senior
Topics: 16
Posts: 75
|
i guess whats confusing is alexia with agraphia which is classical for angular gyrus lesion that can occur with or without gerstman tetrad ( without in this case ) and behavorial manifestatons such as depression , poor memory , frustration...............but guys what about effort speech and short sentenses ????. is spoken langusge affected in angular lesions ?
Edited by dr_sarim on 07/02/06 - 05:50 AM
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,123
|
is spoken langusge affected in angular lesions ? YES,
SYMPTOMS DO NOT MATCH EXACTLY FOR GERSTMANN SYNDROME BUT BY EXCLUSION NO CHOICE IS BETTER THAN A
___________________
The Key to Succeed is Patience.
|
| dr_sarim
Forum Senior
Topics: 16
Posts: 75
|
this is the reasoning (from usmle step123)
Option B (Left frontal lobe) is correct. The patient suffers from "Broca’s aphasia." The cause is most likely a slow-growing tumor (meningioma), which gives pressure to the left frontal lobe, causing the aphasia and the organic psychosis (disorientation, depression).
Option A (Left angular gyrus) is incorrect. A lesion in this area causes abnormal writing (spelling errors) and abnormal comprehension of written language. Spoken language is usually not affected.
Option C (Left temporal lobe) is incorrect. A lesion in this area causes Wernicke’s aphasia. Patients use wrong and nonexistent words. Comprehension of language is impaired.
Option D (Right frontal lobe) is incorrect. The language centers are located in the dominant (left) hemisphere.
Option E (Right parietal lobe) is incorrect. The language centers are located in the dominant (left) hemisphere.
BROCA'S APHASIA
Perhaps the most obvious symptom of Broca's Aphasia is effortful, non fluent speech. This speech is characterized as having many pauses, few words, and short sentences.
In addition to having impaired speech, people with Broca's aphasia also have difficulties with writing. Writing is included in expressive language, which is why damage to Broca's Area of the brain would affect it. aural comprehension for conversational speech is relatively intact.
|
|
| |
| | | | | | | | | |
Similar forum topics