Quiz 05/15/2022

A 40-year-old woman with a history of neurofibromatosis type 2 is presenting to the clinic with chronic anosmia and progressive left eye vision loss. Visual acuity testing reveals 20/200 OS and 20/20 OD. There is a left eye afferent pupillary defect. Funduscopic examination shows pallor of the left optic disc and blurring of the disc margins of the right optic disc. An MRI brain is ordered to localize the lesion. Based on the clinical examination, where will the pathologic lesion most likely be found?

An 82-year-old female presents with her family for a 3-year slow decline in memory. On examination, she has a MOCA of 23/30. She does not feel that she has any issues, but her family feels that she has trouble remembering important dates in her life and will repeat stories to them. Despite this, she has lived alone since her husband died 2 years ago and is able to cook, clean, and bathe on her own. She also balances her own checkbook and does her own grocery shopping. According to the DSM-V, this patient meets the criteria for which disorder?

A 65-year-old woman with a past medical history of hypertension presents with recent onset of bilateral eye discomfort and diplopia. She states that she is unable to completely close her eyes. On exam, pain is elicited when testing extraocular movements. Visual acuity and visual fields are unremarkable. MRI of the brain reveals excessive peri-orbital subcutaneous tissue bilaterally. Which of the following is the most likely diagnosis?

A 46-year-old female presents to the clinic with complaints of recurring headaches. She states that she experiences episodes of sharp pain in her left cheek, which is exacerbated by eating or a cold wind blowing on her face. Outside of these triggers, she is largely pain-free. She doesn’t endorse any associated rhinorrhea, lacrimation, or facial flushing. Which of the following is the most appropriate treatment for her disease?

Which of the following neurological diseases has a higher incidence in patients with systemic lupus erythematosus (SLE)?

A blood clot in which artery explains the findings below?

A 39-year-old male presents with right-sided weakness and aphasia. NIHSS is 22 on physical exam. He was last known well 2.5 hours prior. The past medical history does not reveal any contraindications to tPA. A CT head is done and shows a hyperdense left MCA sign. The tPA is mixed by the nursing staff while you consent his wife for its administration. When you return to the bedside his aphasia has improved but his NIHSS is still 13. The blood pressure is 189/105 and the glucose is 225. What is the most appropriate next step?

A 24-year-old with a history of a motor vehicle accident and a broken leg is referred to the EMG lab with a left leg foot drop. Based on the EMG table outlined below, where is the most likely site of neuronal injury?

A 10-month-old male with no significant past medical history has had a 2-month history of abnormal movements. The family describes these events as head drops and head-turning. On examination, horizontal nystagmus is appreciated. MRI revealed no abnormal findings. What is the most likely diagnosis?

Which of the following is the most appropriate pharmacologic agent for type II episodic ataxia?

In the diagram below, what neurologic information is carried by the tract labeled with the green arrow?

A patient with relapsing-remitting multiple sclerosis presents to the emergency department with a new headache, confusion, and vision loss. A T2 sequence from their MRI is shown below. Lumbar puncture is positive for JCV in the CSF. What is the mechanism of action of the disease-modifying therapy most likely to be attributed to this clinical scenario?

A 65-year-old male with a history of alcoholic cirrhosis presents to the emergency department with dark black coffee-ground emesis. He is found to have a systolic blood pressure of 76/40 and is tachycardic to 120 BPM. Which nerve is most responsible for carrying the afferent fibers from carotid sinus baroreceptors that cause the reflex increase in heart rate seen in this patient?

A two-week-old female is evaluated in the clinic. Upon physical exam, you notice a dimple and overlying tuft of hair on her lower back. This finding is most likely associated with a defect that occurs during which week of gestation?

Carbidopa is given concurrently with levodopa to reduce the risk of which of the following side effects?