Quiz 05/26/2022

A 62-year-old woman with a history of rheumatoid arthritis presents with insidious onset of painless proximal muscle weakness and atrophy. A serum CK is obtained and is normal. TSH is also normal. Her medication list includes lisinopril, aspirin, and prednisone. EMG shows short-duration motor unit potentials in the deltoids and quadriceps bilaterally. A muscle biopsy is performed. Which of the following will most likely be appreciated?

A 30-year-old female with no known past medical history comes to the emergency room after a generalized tonic-clonic seizure. Her friend says that she has been behaving oddly over the past couple of days and has been complaining of a headache. An axial T2 brain MRI is shown below. Which of the following is the most likely diagnosis?

A 40-year-old male with a history of headaches, seizures, and recurrent strokes has a brain biopsy performed to aid in diagnosis. Electron microscopy of his brain tissue shows granular osmiophilic material in the basal lamina of small cutaneous arterioles. What is the cause of this patient’s disease?

A 32-year-old male comes into the headache clinic for severe headaches. They occur several times a day and last approximately one hour. They are only felt on the left side of his head, and he says he gets a runny nose and a little teary during the episodes. What is a notable side effect of the prophylactic medicine that is considered first-line therapy for this condition?

Which of the following is the first branch of the internal carotid artery once it enters the skull?

You are caring for a 19-year-old male in the neurocritical care unit after drowning. His brain MRI is pending clinical stability. Which finding on brain MRI is most likely after a severe global hypoxic injury?

Which of the following is the most likely cause for the gross pathology shown in the image below?

A 10-year-old girl is brought to the clinic with a 1-month history of progressive clumsiness. Neurological examination shows significant bilateral ataxia. Imaging was performed and showed a midline lesion in the 4^th ventricle. A biopsy was performed and shown below. Based on the most likely diagnosis, what is the most appropriate treatment plan?

Which of the following symptoms can be seen with MCA-PCA watershed infarcts?

Aquaporin-4 (AQP4) channels are found on which cell type?

A 56-year-old man with a past medical history of hypertension and type II diabetes presents to the hospital with acute onset left-sided weakness which started 90 minutes prior to your evaluation. His only medications prior to admission were metformin and verapamil. Vitals were within normal limits except for a blood pressure of 154/92. Physical examination reveals 3/5 weakness in the left arm, leg, and face as well as a moderate sensory disturbance in the same regions. CT head was unremarkable and CT angiogram (CTA) showed no large vessel occlusion. A brief history gathered from his wife revealed no other comorbidities or active medical issues. At this point in his clinical presentation, what is the mechanism of action of the most appropriate therapy?

Which of the following combinations of tumor genetic markers carry the most favorable prognostic value for anaplastic astrocytoma?

Alzheimer’s disease typically has which of the following findings on functional PET imaging?

A 65-year-old right-handed man presents with acute onset speech difficulties, a mild right-sided facial droop, and right-sided arm weakness. While talking to his wife over breakfast this morning he suddenly stopped speaking and could only make unintelligible sounds. On examination, he is unable to speak any words but has intact comprehension. He is able to write clearly what he wants in full sentences with intact grammar and reading is also preserved. Which of the following best describes his language deficit?

All of the following therapies can be useful in the management of cluster headaches except: