Mood disorders: secondary mania after stroke: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Mood disorders: secondary mania after stroke

Sample item

A 66-year-old man with no psychiatric history becomes elated, sleeps three hours a night, spends recklessly and talks incessantly three weeks after a right-hemisphere infarct. Lesions in which region are most typically associated with this picture?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Right orbitofrontal or basotemporal cortex

Secondary mania is linked to right-hemisphere lesions, particularly the orbitofrontal and basotemporal regions, whereas depression is more typical of left frontal lesions. A new first manic episode in late life should always prompt a search for an organic cause.

Option by option

  • A. Right orbitofrontal or basotemporal cortex (correct)

    Correct. Right orbitofrontal and basotemporal damage is the classic site for secondary mania.

  • B. Left frontal pole

    Left frontal pole lesions are more often associated with depression.

  • C. Left dorsolateral prefrontal cortex

    Left dorsolateral prefrontal lesions are associated with post-stroke depression.

  • D. Occipital cortex

    Occipital lesions cause visual deficits, and do not cause elation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Right orbitofrontal or basotemporal cortex. Secondary mania is linked to right-hemisphere lesions, particularly the orbitofrontal and basotemporal regions, whereas depression is more typical of left frontal lesions.

Why is "Left frontal pole" not the answer?

Left frontal pole lesions are more often associated with depression.

Why is "Left dorsolateral prefrontal cortex" not the answer?

Left dorsolateral prefrontal lesions are associated with post-stroke depression.

Why is "Occipital cortex" not the answer?

Occipital lesions cause visual deficits, and do not cause elation.

What concept does this question test?

It tests Mood disorders: secondary mania after stroke in Psychiatry. A new first manic episode in late life should always prompt a search for an organic cause.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mood disorders: secondary mania after stroke?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.