Quiz 06/07/2022

Which of the following medications is the first-line treatment for trigeminal neuralgia?

A full-term (40 weeks gestational age) male had an uncomplicated delivery with good APGAR scores. However, the family has noticed unexplained episodes of tremulousness. Because of these abnormal movements, an EEG was ordered. Which of the following is the most accurate description of the findings shown in the epoch below?

A 6-year-old female is seen in the clinic for decreased balance and numbness in her fingers and toes. Her father, who is with her at the clinic visit, states that she was developmentally normal until 2 years of age, at which time she began to have frequent falls. During the past year, she has also developed slurred speech. The neurological exam reveals truncal ataxia, ataxic gait, scanning speech, and decreased sensation to vibration and pinprick in her extremities. The ocular exam reveals irregular capillary dilation of the retina and skin. What is the most likely diagnosis?

A 21-year-old woman with a past medical history of depression presents with recurrent episodes of out-of-body sensations lasting 30 seconds. This may be followed by 1-2 minutes of staring and unresponsiveness that she does not remember. She often remains confused for 10 minutes after an event. They occur 1-3 times every 2 weeks. An MRI brain is done and shows no pathology. Which test is the most diagnostically valuable next step in her workup?

Which of the following primary CNS tumors carries the highest risk of disseminated metastatic disease through the spine via CSF seeding?

An otherwise healthy 17-year-old female presents to the emergency department with right arm weakness. The symptoms started insidiously over the weekend and haven’t improved over the last 3 days. Examination shows 4/5 strength of the right upper extremity. A brain MRI is performed and shows a T2 hyperintense lesion in the subcortical white matter with contrast enhancement. No other lesions are seen. Upon further questioning, she states that she has never experienced any similar episodes of transient neurologic symptoms before. Which of the following is the correct diagnosis?

A patient with an AVM rupture is admitted to the ICU. On exam, the patient has abnormal neck, elbow, and knee extensor posturing, and wrist flexion. In which of the following locations was the AVM most likely located?

Which of the following comorbidities would prohibit the use of dalfampridine?

A 4-month-old infant of Amish parents is evaluated in the emergency department for an acute onset of weakness, poor feeding, and irritability that started 2 days ago. Neurologic examination of the child was impressive for ptosis, decreased tone, generalized weakness, a poor suck reflex, and mydriasis. MRI of the brain was normal. Which of the following is the most likely cause of the patient’s symptoms?

Which of the following is the reversal agent for dabigatran?

A 33-year-old female presents to the clinic for evaluation of a left lower extremity foot drop. On physical examination, there is weakness in dorsiflexion. Ankle eversion, inversion, and plantar flexion strength are normal. Hip abduction strength is normal as well. Which of the following is the most likely etiology for the patient’s symptoms?

Initiation of urination involves which of the following physiologic processes?

A 65-year-old man comes to the clinic with a one-year history of difficulty walking. More recently, he has also noticed a tendency to drop things. On examination, he was found to have weakness in his bilateral lower limbs, predominantly in his quadriceps muscles, along with finger flexion weakness that is worse on the left side. His sensory examination was normal. Which of the following is the most likely diagnosis?

A 68-year-old female presents with a one-year history of progressive memory problems and deteriorating mobility. Upon further questioning the patient notes incontinence. A physical exam reveals a wide-based gait with shuffling steps. A brain MRI shows widening of the temporal horns of the lateral ventricles. Which of the following is the best next step in management?

Anti-Ma2 autoantibodies are most commonly associated with which of the following tumors?