Title: Usmle Step 1 MCQ’s # 30
Subject: Behavioral Science
Q NO 30: A 35-year-old patient is given a battery of neuropsychological tests. He scores 85 on the Wechsler Adult Intelligence Scale (WAIS) Verbal 10, 135 on the Performance 10 test, and 125 on the Wechsler Memory Scale test. Which of the following is the most likely site of his brain dysfunction?
A. Bilateral frontal lobes
B. Bilateral hippocampal gyri
C. Bilateral occipital lobes
D. Left hemisphere
E. Right hemisphere
Explanation:
The correct answer is D. The pattern presented suggests this person is having difficulties with verbal material (WAIS verbal IC of 85) but not with visual-spatial tasks (performance 10) or memory (Wechsler memory scale). Since the left hemisphere is dominant for speech and verbal material in the majority of individuals the lesion is most likely in the left hemisphere.
Choice A is incorrect since the frontal lobes control socially appropriate behavior, sequencing, and future planning. There is no indication that these are deficient in this person.
Since memory is intact, a lesion in the bilateral hippocampal gyri (choice B) is unlikely.
Bilateral occipital lesions (choice C) would produce problems with visual recognition, which are not apparent in this person.
The right hemisphere (choice E) is related to control of visual-spatial functions (e.g., map reading, locating oneself in space, etc.) rather than verbal ability.
Source: http://usmleworldwide.com/blog/?p=621
Subject: Behavioral Science
Q NO 30: A 35-year-old patient is given a battery of neuropsychological tests. He scores 85 on the Wechsler Adult Intelligence Scale (WAIS) Verbal 10, 135 on the Performance 10 test, and 125 on the Wechsler Memory Scale test. Which of the following is the most likely site of his brain dysfunction?
A. Bilateral frontal lobes
B. Bilateral hippocampal gyri
C. Bilateral occipital lobes
D. Left hemisphere
E. Right hemisphere
Explanation:
The correct answer is D. The pattern presented suggests this person is having difficulties with verbal material (WAIS verbal IC of 85) but not with visual-spatial tasks (performance 10) or memory (Wechsler memory scale). Since the left hemisphere is dominant for speech and verbal material in the majority of individuals the lesion is most likely in the left hemisphere.
Choice A is incorrect since the frontal lobes control socially appropriate behavior, sequencing, and future planning. There is no indication that these are deficient in this person.
Since memory is intact, a lesion in the bilateral hippocampal gyri (choice B) is unlikely.
Bilateral occipital lesions (choice C) would produce problems with visual recognition, which are not apparent in this person.
The right hemisphere (choice E) is related to control of visual-spatial functions (e.g., map reading, locating oneself in space, etc.) rather than verbal ability.
Source: http://usmleworldwide.com/blog/?p=621
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