Quiz 05/27/2022

A 15-day-old female is evaluated in the NICU after being born to a G2P2 mother. On exam, the infant is jaundiced. Abdominal ultrasound shows severe hepatosplenomegaly. CT scan of the head shows hydrocephalus and periventricular calcifications, and a fundoscopic exam shows bilateral chorioretinitis. Serological testing is most likely to show infection with which organism?

Which of the following nerves is a terminal branch of the posterior cord?

Huntington’s disease is most commonly associated with which of the following?

A 49-year-old female has had a 6-month history of difficulty swallowing and weight loss. On examination, she has generalized muscle loss. On strength examination, she has 3/5 proximally and 4/5 distally in the bilateral upper extremities. There are normal tongue movements and a normal jaw jerk reflex. Deep tendon reflexes in the bilateral upper extremities are normal and sensation is intact. An EMG is performed and outlined below. What is the most likely diagnosis?

Which of the following medications may be unsafe for the treatment of migraine headaches in patients with a history of coronary artery disease (CAD)?

A 22-year-old woman with a previously diagnosed history of prior suicide attempts, EEG-confirmed epilepsy, and non-epileptic seizures comes to your clinic to establish herself as a new patient under your care. Upon entering the room she immediately tells you about her horrible relationship with her last epileptologist and how abandoned she felt when he decided to retire. While gathering her social history, she endorses a history of excessive spending on new cars, reckless driving, and alcohol-driven physical altercations. Which of the following personality disorders is most consistent with this clinical presentation?

The vessel labeled 1 in the angiogram provided supplies all of the following structures EXCEPT:

A 72-year-old male with a past medical history of hypertension presents with an acute onset of right upper and lower extremity weakness. The sensory exam is normal. Right homonymous hemianopia is also appreciated. Which of the following vessels is most likely affected?

A 32-year-old woman with a known history of relapsing-remitting multiple sclerosis currently on ocrelizumab presents to the emergency room with the concern of having a demyelinating attack. An MRI brain with contrast shows a single, ovoid, juxtacortical white matter lesion with contrast enhancement that was not present on her last MRI scan. Which of the following is the most appropriate next step in medical management?

Identify the pathological abnormality shown in the image below.

A 28-year-old woman with a history of intractable epilepsy presents to you for outpatient follow-up. She has been seizure-free on valproic acid and levetiracetam for the last 18 months. She reports a desire to become pregnant and asks if she has an increased risk of in-utero defects with her medications. Which of the following is the most appropriate answer to this question?

A 76-year-old man with a five-year history of idiopathic Parkinson’s disease presents to your office accompanied by his daughter. She remarks that he has started talking to his wife who passed away 5 years ago. She also frequently finds him frightened, looking around the room at “small people” who are not there. Which of the following is a treatment of choice that is correctly paired with its associated monitoring parameters?

Which of the following is the mechanism of action of mitoxantrone?

While on the consult service you are called to see a patient from the surgical ICU whose hospital course has been complicated by a prolonged episode of ventricular tachycardia and hypoperfusion. After a return to spontaneous circulation, an MRI is performed due to concerns for ischemic stroke. MRI shows bilateral parietal-occipital hyperintensities on diffusion-weighted imaging consistent with watershed infarcts. Once he recovers from his cardiac event, what neurologic symptoms would you expect based on the MRI findings?

A 30-year-old male comes into the clinic with a 3-month history of scalp tenderness. His MRI brain is shown below (Left: T1, Middle: T2, Right: T1 with contrast). Which of the following is the most likely diagnosis?