PLAB Question 21

A young man develops nonfluent, effortful speech with dysarthria. he is able to undertsand speech. He fails to repeat the sentence "no ifs, ands or buts about it". A CT scan is normal.

The investigation of choice at this stage would be:

a) skull x-ray
b) non-contrast CT scan brain
c) contrast CT scan brain
d) contrast enhanced MRI of the optic nerves
e) four vessel cerebral angiogram
f) single vessel cerebral angiogram
g) MR cerebral Angiography
h) mri with emphasis on the frontal lobe
i) mri of the pituitary gland
j) mri with emphasis on the temporal lobe








ANSWER
The correct answer is J



Explanation
The clinical features are suggestive of what is known as Broca's aphasia. It is also known as expressive aphasia. It is characterized by nonfluent, effortful speech with dysarthria.

Comprehension is usually good. It is Typically caused by frontal lobe lesions. Typical tasks on examination that they fail is to repeat the sentence "no ifs, ands or buts about it".

These patients may only have (for example), a single word left in their vocabulary. Aphemia means mute but writes fluently.

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