Quiz 06/01/2022

A 75-year-old female with a past medical history of hypertension on lisinopril presents to the emergency department with weakness on the left side of the body and a drooping right eye. On exam, her right eye is inferiorly and laterally deviated. This pupil is also non-reactive. Her strength is 3/5 on the left side. Where is this patient’s lesion?

A 24-year-old female in her third trimester of pregnancy, with no other past medical history, presents with complaints of 1-2 times monthly episodes of sudden onset severe room spinning, nausea, and vomiting for 3 months. They happen randomly and are not associated with head movement. During an episode, sounds and bright light seem to bother her more. She denies motor weakness or hearing change. Her spells resolve after about 1 hour. She endorses she has had bad headaches in the past, but not with these episodes. She endorses she gets car sick easily. On neurologic examination, she has no focal findings, and her vitals are within normal limits. She had an MRI brain with MRA and MR Venogram, all of which were unremarkable. Which is the most likely etiology?

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

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 two-month-old boy is brought to the Emergency Room by his mother because of lethargy for the past 3 hours. His mother states that earlier today the child rolled off the couch and hit his head on the hardwood floor. Physical exam shows excessive somnolence, tense anterior fontanelle, and fundoscopic exam shows bilateral retinal hemorrhages. A non-contrast CT of the head shows subdural hematomas of varying ages. A CT head is ordered and pending. Otherwise, what is the next most appropriate step in the management of this patient?

A 16-year-old girl with no significant past medical history presents to the clinic with 2 episodes of syncope in the past month. She states that both of the episodes occurred while giving oral presentations in front of her class. She reports that she has been under a lot of stress lately because of a midterm paper and that her parents are going through a divorce, which has taken an emotional toll on her. Before each episode of syncope, she feels warm and starts to get lightheaded, and “sees stars”. Each episode of syncope lasts approximately 15 seconds, and she does not have any confusion after the episodes. The physical exam is within normal limits. Which of the following is the most likely cause of this patient’s syncope?

A healthy 12-year-old female has a brain MRI performed because of a history of medically refractory headaches. Her imaging is shown below. What is the diagnosis?

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

A 32-year-old obese and pregnant female in her third trimester presents to the clinic with pain and tingling of the lateral thigh with occasional aching in the groin. It is worsened by moving to a standing or sitting position and by wearing tight underwear. She has numbness on the right anterolateral thigh up to the level of the hip. The strength exam is normal. Which nerve is likely affected?

Uncal herniation compressing on the structure marked below (black arrow) would lead to which of the following symptoms?

The usage of bupropion increases the risk of which of the following?

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

You are evaluating a patient in the clinic for loss of light touch, pain, and body position in the left upper and lower limbs. Within which of the following thalamic nuclei do these signals synapse to third-order neurons?

A 37-year-old man with a past medical history of depression, hypothyroidism, fibromyalgia, and nephrolithiasis presents with a well-documented history of migraine headaches. In the past, his headache frequency was less than 5 days a month but they are now occurring at least three times a week. Your suspicion of secondary causes of headache is low and you are considering starting a prophylactic migraine treatment. Which of the following medications should be avoided?