A 64-year-old woman develops progressive difficulty naming objects and understanding single words. Her speech remains fluent and grammatical, but she asks 'what is a fork?' while using one correctly. MRI shows asymmetric atrophy of the left anterior temporal lobe. Which diagnosis fits best?

• A Behavioural variant frontotemporal dementia
• B Semantic variant primary progressive aphasia ✓
• C Nonfluent variant primary progressive aphasia
• D Logopenic variant primary progressive aphasia

Explanation

The semantic variant presents with fluent but empty speech, loss of single-word comprehension, and anomia, reflecting anterior temporal lobe degeneration that impairs semantic knowledge storage. The nonfluent variant shows effortful agrammatic speech with apraxia of speech, and the logopenic variant shows word-finding pauses with impaired repetition and is usually amyloid related. Behavioural variant presents with conduct change, not isolated semantic loss.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.