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Non-Fluent Variant PPA — SCE Neurology MCQ

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HardNeurodegenerative DiseaseNon-Fluent Variant PPASCE Neurology

A 65-year-old woman presents with progressive non-fluent, effortful speech with agrammatism and speech sound errors. Comprehension of single words is preserved. MRI shows left inferior frontal and insular atrophy. What is the diagnosis?

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Correct answer: D — Non-fluent/agrammatic variant PPA

The best answer is “Non-fluent/agrammatic variant PPA”. Neurological assessment localises the lesion from positive clinical features, selects the test that answers the remaining question, and escalates urgent red flags without repeating an already established investigation. The alternatives “Alzheimer disease”, “Broca's aphasia from stroke”, “Semantic variant PPA”, “Logopenic variant PPA” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG127 suspected neurological conditions recommendations: https://www.nice.org.uk/guidance/ng127/chapter/Recommendations-for-adults-aged-over-16