Quiz 06/07/2022 (2)

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

This muscle biopsy is most consistent with which myopathic disease?

An 80-year-old woman with a history of Parkinson’s disease that is well controlled with carbidopa-levodopa presents with her husband for evaluation of delusions. Her husband states that the patient believes that she is being consistently monitored by the FBI and will avoid eating certain foods for fear of being poisoned. She is also constantly worried that her husband will leave her for a younger woman. Which of the following medications would be the most appropriate FDA-approved treatment for these symptoms?

A 38-year-old female presents for 5 weeks of worsening encephalopathy, and blurred vision. An MRI Brain with contrast is performed and shown below (T1 post-contrast, multiple axial sections). Of the following, what is the most likely diagnosis?

Which of the following is a common side effect of dimethyl fumarate?

A 45-year-old female with a past medical history significant for asthma presents to the clinic for migraines with aura. Her headaches occur at least 13 times a month. She was given sumatriptan for abortive therapy six months ago but it has become ineffective. Her vital signs are stable. Her BMI is 33. Which of the following is the best next step in treatment?

A 57-year-old male with HIV who is non-compliant with HAART therapy presented to the emergency room with a 4-week history of altered mental status and falls. On neurological examination, the patient was altered, ataxic, and had right upper extremity weakness. An MRI was performed and shown below. Based on the clinical presentation and imaging provided, what is the most appropriate first step in medical management?

A 62-year-old man complains of 5 years of vivid dreams. At times this involves punching and kicking, which has hurt his wife. He undergoes a polysomnogram and there is no sleep-disordered breathing and the EEG is normal. What would be the best first-line medication to treat this behavior?

A 63-year-old female presents to the office, accompanied by her husband who has become increasingly worried about his wife’s ability to perform tasks at home. He states that for the past three months she has not been able to tie her shoes, and fumbles with the shoelaces in her hands. Additionally, within the past month, she has not been able to brush her teeth, and simply holds the toothbrush in her hand, without moving. Lastly, her husband has noticed that the patient moves slower on their morning walks together, and her arms and legs seem more tight and rigid. A brain MRI is ordered which shows asymmetric atrophy of the superior parietal lobule. Which of the following is the most likely diagnosis?

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

A 72-year-old male with diabetes, hyperlipidemia, and tobacco abuse is admitted to the stroke service after he is found to have a left superior middle cerebral artery territory stroke. His EKG on admission showed a normal sinus rhythm. A transthoracic echocardiogram (TTE) is performed. Which of the following findings on TTE would lead to the recommendation of an anticoagulant medication over an antiplatelet medication for secondary stroke prevention?

Which of the following is most strongly associated with an increased risk of seizure recurrence after a first unprovoked seizure?

A previously healthy 25-year-old female presents to the emergency room with lower extremity weakness, numbness, and urinary retention. Lower extremity hyperreflexia and a sensory level at T10 were appreciated on examination. A contrasted cervical/thoracic and lumbar MRI was performed and shown below. Lumbar puncture was performed after imaging was completed and showed an elevated protein concentration, normal glucose, 3 WBCs, and oligoclonal bands. Rheumatologic studies are negative. Based on the most likely diagnosis, what is the most appropriate next step in medical management?

A 13-year-old male with a recent history of acute disseminated encephalomyelitis (ADEM) presents to the clinic for post-hospital follow-up. He has made a near-complete recovery from his illness but his parents want to know what is his risk of recurrence. What is the most accurate statement you can share with the parents?