Quiz 05/19/2022

Match the phase of the Valsalva maneuver with its associated physiology.

Identify the pathological abnormality shown in the image below.

A 4-year-old boy with a history of mild cerebral palsy comes to the clinic for his annual follow-up. Since last seen in the clinic the patient and family have noted that he has been having increased difficulties with his left leg. Most days he is able to ambulate with a hand-held mobility device. However, more recently family has noticed that he not walking as much as he used to. On examination, there is increased spasticity and hyperreflexia at the ankle. The right leg had normal strength and tone. What is the most appropriate therapy for the patient’s symptoms?

Identify the pathological abnormality shown in the image below.

The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?

Which of the following genetic abnormalities is most common in the pathology shown in the image below?

A 17-month male was brought to the pediatric neurology clinic was brought to the clinic with concerns for developmental delay. Parents note that the child was a product of a normal pregnancy and his delivery was uncomplicated. A developmental delay was appreciated by 8 months of age. He is largely non-verbal. He appears happy in the room, laughing spontaneously without any external stimuli. Which of the following abnormalities most likely explains this developmental disorder?

Which of the following issues in early development has occurred in the photograph below?

Which of the following genetic disorders is most commonly associated with holoprosencephaly?

In normal neonatal development, which of the following structures myelinates the latest?

A 2 month-old female is brought to the emergency room by her mother after she noticed abnormal movements concerning for possible seizure. The child was born at term and was the product of a normal pregnancy and delivery. While gathering a history, the child is lying on the bed still when you notice repetitive movements of his bilateral lower limbs. When her mother notices she picks up the patient and the movements resolve. What is the most likely diagnosis?

Which of the following embryologic derivatives myelinates the peripheral nervous system (PNS)?

The medulla is an embryologic derivative of which of the following structures?

Initiation of urination involves which of the following physiologic processes?

A 78-year-old patient with a history of multiple system atrophy (MSA) presents to your clinic for falls. The patient states that while standing he initially experiences feelings of lightheadedness and tunnel vision before a loss of consciousness. While on the ground he will be “twitching” for 30 seconds before he regains consciousness. Which of the following tests is the most likely to be diagnostic in this case?

A full-term male is having a routine awake and sleep EEG performed because of episodes concerning for possible seizures. These episodes were first noticed four days after an uncomplicated vaginal delivery. On the video EEG recording, you notice a violent jerking of the limbs followed by sustained stiffening after a phone rings loudly in the room. What is the most likely diagnosis?

Identify the lesion shown in the imaging below:

What is a common comorbid issue seen in newborns with the vascular abnormality appreciated in the imaging provided?

A 3-year-old male with a history of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) was referred to neurology by his PCP for concern of a genetic disorder. On examination, the patient appears to have a long face, large ears, and a prominent jaw. Genetic testing shows that the patient has a pathologic gene mutation with over 200 trinucleotide CGG repeats. Which of the following is a comorbidity appreciated in this patient’s neurologic syndrome?

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?

A 42-week gestational age female was born vaginally to a mother with a history of type 2 diabetes. Delivery was complicated by shoulder dystocia and required assistance with forceps. Apgar scores at 1 and 5 minutes were seven and nine, respectively. Her birth weight was 9 pounds and 6 ounces. Examination after birth showed there was no appreciable left arm bicep or deltoid function. What is the most likely etiology for this finding?

Identify the pathological abnormality shown in the image below.

Which synapsed of the peripheral nervous system is acetylcholine the primary neurotransmitter?

The thalamus and hypothalamus are derived from what embryonic structures?

The anatomical structure identified in the image below (blue arrow) derives from which of the following embryonic tissues?

A newborn male is evaluated in the NICU for a lesion on his lower back. He was born to a mother with no prenatal care at 37 weeks gestation. Imaging of his lower back shows the meninges and spinal cord herniated through the defect, covered in a membrane. His condition could have most likely been prevented through prenatal supplemental with what?

What is the likely etiology of the findings appreciated on the imaging below?

An 11-month-old male is brought to the emergency room with agitation, fever, and nuchal rigidity. A review of the patient’s electronic medical record shows that the patient was admitted with meningitis 2 months ago. While no clear focal neurological symptoms were appreciated on examination, there was a midline dimple appreciated in the lumbosacral region. Which of the following is the most likely etiology of the patient’s recurrent illness?

The cell marked by the blue arrow is derived from which germ layer?

The pathology shown in the image below is most likely which of the following?

The pathology seen in the image below is most likely related to maternal use of which of the following medications?

Nursing staff in the neonatal intensive care unit noticed that a 32-week gestational age newborn with a complicated delivery and low initial Apgar scores and intracranial hemorrhage developed abnormal movements on the 2nd day of life. The movements were described as rhythmic, high-frequency movements of the left limb. There were no associated autonomic changes appreciated with events. The child was placed on continuous EEG recording and an event was captured which had no EEG correlate. What is the most likely diagnosis?

An autopsy was performed on a 30-week gestational age stillborn infant. An image of the brain before histopathologic analysis is shown below. Which of the following was likely also appreciated during the autopsy?

A 22-month-old girl presents with her mother for abnormal movements and loss of milestones. The mother describes the patient frequently and repetitively squeezes and twists her hands, and has lost some of her developmental milestones including fine motor skills and verbal speech. She has stopped walking as well. On examination of growth curves, her head circumference percentile appears to have fallen off of the curve. The patient has no other past medical problems, no past trauma, or past infections, and had been developing normally up until now. Of the following, which is most likely true?

The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?

Motor unit action potential (MUAP) conduction velocities of a newborn are what percentage of an adult?

A 37-year-old male presents with sudden onset of tachycardia and hypertension, followed shortly by unilateral rhythmic facial and then arm jerking. The autonomic symptoms of tachycardia and hypertension are most likely to reflect the involvement of which region of the brain during a seizure?

Neural tube defects will develop at which point in fetal development?

Which of the following structures is well myelinated in a full-term (40-week) infant?

Based on the MRI imaging shown below, which of the following structural abnormalities is likely also present?

The medulla develops from which of the five primary vesicles of the brain?