Quiz 06/07/2022 (4)

A 67-year-old male with a gait disorder is having a polysomnogram due to aggressive leg movements during sleep. During the study, an abnormality is noted during sleep. The EMG and chin leads show excessive muscle artifact during sleep, while at the same time the EEG shows quick deflections in the lateral leads, indicating rapid alternating eye movements. He is given a diagnosis and started on medication. Which of the following is the most appropriate treatment for this sleep issue?

An 85-year-old man presents back to your clinic for follow-up with his family for a slowly progressive neurologic decline over the past 4 years, namely with memory and cognitive decline. You have already performed a brain MRI and additional testing and suspect that the patient has Alzheimer’s dementia. The family expresses concerns over the patient’s driving. Which of the following, if true, is not a useful tool to identify driving risk according to updated practice guidelines?

A 6-year-old Amish female presents to the emergency department with a 2-month history of gradual cognitive decline and jerking limb movements. A routine EEG was obtained (see below). Which of the following diseases is consistent with these EEG findings?

Which of the following neurological diseases has a higher incidence in patients with systemic lupus erythematosus (SLE)?

A 7-year-old boy was brought to the ED by his mother for a three-week history of involuntary movements. He was initially seen by his pediatrician two weeks ago. MRI of the head was performed and was unremarkable. Methylphenidate was trialed for a presumed tic disorder but it had no benefit. The Movements resolve with sleep. On examination, he has difficulty controlling facial and extremity movements as well as maintaining tetanic contraction of his hands. There was also a newly appreciated cardiac murmur. What is the most likely diagnosis?

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

A 48-year-old man with a 20-year history of HIV stable on HAART therapy presents to your clinic accompanied by his partner who states that the patient has had mounting difficulties over the last 3 years. Most recently he has been unable to effectively manage finances, cook for himself, or arrange appointments. What is the best diagnosis at this time?

A 24-year-old female with a past medical history of major depressive disorder with her last major depressive episode 6 months ago is brought to the emergency room by her boyfriend because of unusual behavior. For the past 4 weeks, the patient has had bizarre delusions, auditory hallucinations, and disorganized speech. She believes that her boyfriend is having a sexual relationship with a character from one of the early morning soap operas on television. Outside of her psychiatric symptoms, her neurologic examination is normal. Which of the following is the most likely diagnosis?

A 6-year-old developmentally normal male presents after experiencing an episode of jerking of the right side of his mouth and inability to speak lasting 2 minutes. The patient is now back to baseline and has an EEG performed. Based on this clinical picture, which of the following abnormalities would you most expect to see on the EEG?

A 65-year-old male comes into the office with his wife for follow-up after a recent hospitalization for HSV encephalitis.  The wife says before his hospitalization, he used to be a quiet, shy man but recently has been making sexually inappropriate remarks to women at the park. The patient also has an increase in appetite and an urge to touch everything at the grocery store. Based on his cognitive deficits, which of the following areas of the brain is likely affected?

On microscopic evaluation, which of the following is a classic finding present in the Parkinson-plus syndromes of both progressive supranuclear palsy and corticobasal degeneration, but not Parkinson’s disease?

Which of the following diseases does not contribute to the pathology appreciated in this pathology image?

Which of the following medications is approved only for moderate to severe Alzheimer’s Disease?

Which of the following features on EMG is suggestive of chronic denervation?

The following gross pathologic coronal section is presented to you for evaluation. The area shown by the black arrow is a sign indicative of which of the following disorders?