A 68-year-old woman develops progressive difficulty naming objects over two years; she asks her husband to pass 'the thing for cutting' instead of scissors. She cannot recognise the meaning of familiar words presented visually, though she reproduces their sounds correctly. Single-word comprehension is severely impaired while other cognitive domains remain relatively preserved. Which syndrome is described?
- A Semantic variant primary progressive aphasia ✓
- B Nonfluent or agrammatic variant primary progressive aphasia
- C Logopenic variant primary progressive aphasia
- D Wernicke aphasia following stroke
Correct answer: A. Semantic variant primary progressive aphasia
Explanation
Semantic variant primary progressive aphasia, usually associated with frontotemporal lobar degeneration and TDP-43 or tau pathology, features progressive loss of word meaning, anomia with circumlocution ('the thing for cutting'), and impaired single-word comprehension with fluent speech. Nonfluent variant shows effortful agrammatic speech, and logopenic variant shows word-finding pauses with preserved comprehension, so both fail the comprehension criterion here. Wernicke aphasia is abrupt in onset after stroke.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.