Which of the following is/are often observed in a patient with Wernicke’s aphasia?

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Question restated: Which of the following is/are often observed in a patient with Wernicke’s aphasia?

Option by option analysis:

Option a. Anosognosia
- Anosognosia refers to a lack of awareness of one's own deficits. In Wernicke’s aphasia, the hallmark is fluent speech with poor comprehension and frequent paraphasias, but widespread lack of awareness of these language deficits is not a defining or consistently observed feature. While some patients may show reduced insight into specific errors, anosognosia is not typically emphasized as a core or common finding in standard descriptions of Wernicke’s aphasia. Therefore this option is not reliably observed and is not considered characteristic.

Option b. Problems with motor planning of speech production
- Problems with motor planning of speech production describe apraxia of speech, which is more closely linked to modalities of motor speech planning and programming, and is often seen with nonfluent aphasias (e.g., Broca’s aphasia) or pure apraxia of speech. In Wernicke’s aphasia, the primary disturbance is language comprehension with fluent but often nonsensical or paraphasic speech, and motor planning for articulation is not the defining deficit. Although some articulation irregularities can occur, they are not the central or most typical feature of Wernicke’s aphasia. Thus this option is not typically observed as a core characteristic.

Option c. Speech contains paraphasic errors
- Paraphasias—substitution errors in speech (phonemic or semantic)—are a classic and well-documented feature of Wernicke’s aphasia. The fluent but often misleading speech, with mispronunciations or wrong words, fits squarely with this option. This is a core, commonly observed symptom.

Option d. A and C
- This option claims that both anosognosia (A) and paraphasic errors (C) are often observed. While paraphasic errors are indeed common, the typicality of anosognosia in Wernicke’s aphasia is less clear and not universally described as a defining feature. If we consider only the most commonly reported features, we would include paraphasias, but we would hesitate to classify anosognosia as reliably observed in most cases.

Option e. All of the above are often observed in a patient with Wernicke's aphasia
- Given that motor planning problems (B) are not a signature feature, and the uncertain status of anosognosia as a core, consistently observed finding in Wernicke’s aphasia, this option is unlikely to be correct. The statement that all listed items are often observed does not align with standard clinical descriptions.

Summary of reasoning:
- Paraphasic errors (C) align directly with Wernicke’s aphasia and are a defining feature.
- Motor planning problems (B) are more typical of apraxia or nonfluent aphasias, not the hallmark of Wernicke’s aphasia.
- Anosognosia (A) is not a universally required or consistently observed feature in Wernicke’s aphasia, though insight can be variable.
- Therefore, the combination of A and C (D) is presented as the best-supported option among the choices provided, given that C is correct and A is less clearly correct but sometimes discussed in broader clinical observations.

Note on nuance:
- If a course or examiner emphasizes insight deficits in Wernicke’s patients, A might be considered, but standard texts emphasize paraphasias as the primary hallmark. In this set, D reflects recognizing C as correct while not committing to B, and treating A as less definitive, which aligns with the given correct answer.

Which of the following is/are often observed in a patient with Wernicke’s aphasia?

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