1.
A 55-year-old male was admitted to the hospital after suffering from a stroke. He later succumbed. The diagram below represents a cross-section of his lower pons obtained at autopsy. The dark shaded area presents a lesion resulting from an embolus in which artery?
Correct Answer
E. Paramedian branch of the basilar artery
Explanation
The dark shaded area in the cross-section of the lower pons indicates a lesion caused by an embolus. The paramedic branch of the basilar artery supplies blood to this area. Therefore, the correct answer is the Paramedian branch of the basilar artery.
2.
An infarct involving the hypothalamus would most likely result from occlusion of the?
Correct Answer
D. Perforating arteries associated with the Circle of Willis
Explanation
The hypothalamus, a crucial part of the brain, receives its blood supply from the perforating arteries associated with the Circle of Willis. If there is an occlusion or blockage in these arteries, it can lead to insufficient blood flow, causing an infarct (tissue damage) in the hypothalamus. This can result in various neurological and endocrine disturbances, affecting vital functions regulated by the hypothalamus, such as temperature regulation, hormone secretion, and control of appetite and sleep.
3.
A neurological examination of a 51-year old woman indicated that she had a loss of pain and temperature sense on the right side of her body, a decreased sense of taste on the left side and hoarseness of voice when speaking. She also complained of dizziness and nausea. Which of the following arteries may be occluded in this patient?
Correct Answer
C. Posterior Inferior Cerebellar Artery (PICA)
Explanation
The symptoms described in the question suggest a lesion in the brainstem, specifically affecting the lateral medulla. This is known as Wallenberg syndrome or lateral medullary syndrome. The PICA supplies the lateral medulla, and its occlusion can result in the symptoms described, including loss of pain and temperature sensation on the opposite side of the body, decreased taste sensation on the same side of the tongue, hoarseness, dizziness, and nausea. Therefore, the occlusion of the Posterior Inferior Cerebellar Artery (PICA) is the most likely cause of the patient's symptoms.
4.
As a resident physician you are viewing an angiogram, which illustrates the occlusion of the Anterior Cerebral Artery supplying the right hemisphere. Because of this information, you know that the patient will have a deficit in which of the following?
Correct Answer
B. Motor and sensory function in the left lower limb
Explanation
The occlusion of the Anterior Cerebral Artery supplying the right hemisphere would result in a deficit in motor and sensory function in the left lower limb. This is because the Anterior Cerebral Artery supplies blood to the motor and sensory areas of the opposite side of the body. Therefore, the occlusion of this artery would affect the motor and sensory function on the opposite side, which is the left lower limb in this case.
5.
An occlusion of which artery would result in a loss of voluntary motor function and an oculomotor nerve palsy?
Correct Answer
E. Posterior cerebral artery
Explanation
An occlusion of the posterior cerebral artery would result in a loss of voluntary motor function and an oculomotor nerve palsy. The posterior cerebral artery supplies blood to the occipital lobe of the brain, which is responsible for visual processing. When this artery is blocked, it can lead to a loss of motor function and paralysis on one side of the body, as well as damage to the oculomotor nerve, which controls eye movement.
6.
A patient has a severe stroke in the artery marked in the below angiogram. As the physician you know (i) the name of the artery and (ii) the region of the body which will present with motor and somatosensory deficits.
Correct Answer
C. Middle Cerebral Artery -Deficits to right upper limb
Explanation
The correct answer is Middle Cerebral Artery - Deficits to the right upper limb. This is because the middle cerebral artery supplies blood to the lateral surface of the brain, including the motor and sensory areas for the upper limb. Therefore, a severe stroke in this artery would result in deficits in the right upper limb.
7.
Which of the following is an arterial branch of the vertebral system supplying the brain?
Correct Answer
B. Posterior inferior cerebellar artery (PICA)
Explanation
The Posterior inferior cerebellar artery (PICA) is an arterial branch of the vertebral system that supplies the brain. It is responsible for providing blood flow to the posterior inferior cerebellum, as well as other areas of the brainstem.
8.
A blood clot that can block the flow of blood in the vessel is called what?
Correct Answer
D. Thrombosis
Explanation
Thrombosis is the correct answer because it refers to a blood clot that can obstruct the normal flow of blood in a blood vessel. Hemorrhoids, Lupus, and Nephrotic syndrome are all unrelated medical conditions and do not involve the formation of blood clots.
9.
A 49-year old man keeps complaining of a loss of taste, a loss of pain and temperature on the left side below his neck, hoarseness of voice and he is also exhibiting a slight ataxia. You believe that which of the following has occurred?
Correct Answer
A. A small stroke in the right posterior inferior cerebellar artery (PICA)
Explanation
The symptoms described in the question, including loss of taste, loss of pain and temperature on the left side below the neck, hoarseness of voice, and slight ataxia, are consistent with a small stroke in the right posterior inferior cerebellar artery (PICA). The PICA supplies blood to the lateral medulla, which controls functions such as taste, pain and temperature sensation, and coordination of movement. Therefore, a stroke in this artery would result in the observed symptoms on the left side of the body.
10.
You are caring for a patient who has suffered a stroke and has issues comprehending any spoken language. Branches of what artery do you know have been compromised?
Correct Answer
B. Middle cerebral artery
Explanation
The middle cerebral artery supplies blood to a large portion of the brain, including areas responsible for language comprehension. Since the patient has difficulty comprehending spoken language, it suggests that the branches of the middle cerebral artery have been compromised.