Quiz 06/08/2022

Which of the following is the relay center for hearing?

Cool limbs during a nerve conduction study will have which of the following effects on the data recorded?

Which of the following medications is the most appropriate pharmacologic agent for paroxysmal kinesigenic dyskinesia?

A 47-year-old former football player with a history of diabetes and hypertension presents to the EMG lab with left upper extremity weakness and pain. Motor and sensory nerve conduction studies were normal. An EMG was performed and shown below. What is the most likely diagnosis?

A 6-month-old boy with no significant past medical history is brought to the clinic by his father because of abnormal limb movements that occur multiple times a day. His father describes high-frequency, low amplitude rhythmic movements that start in the child’s head and quickly spread down the shoulders. Episodes last approximately 1-2 seconds. There are no clear triggers and there is no loss of consciousness associated with the events. Family history is significant for essential tremor in the patient’s mother. Which of the following is the most likely diagnosis?

Which of the following conditions is most likely to have an associated disorder of abnormal motor activity during the following sleep state?

A 46-year-old male with a 2-month history of progressive headache and behavioral changes presents to the ED after experiencing a first-time seizure. An MRI was performed and shown below. A brain biopsy confirmed the diagnosis when it found pseudopalisading necrosis and microvascular proliferation. Which of the following treatment(s) is the standard of care for this patient?

A 29-year-old man with a 10-pack-year smoking history comes into the clinic with a severe headache. The pain surrounds his right eye and is associated with a runny nose, excessive tearing, and a “droopy eyelid.” He describes the pain as stabbing that usually lasts about 30 minutes and occurs every day after he eats dinner. What is the most likely diagnosis?

The pathologic findings marked by the blue arrows in the image below are most likely which of the following?

A patient with medically refractory epilepsy secondary to mesial temporal sclerosis recently had a right hemispheric anterior temporal lobectomy. He is complaining of a post-operative visual field deficit. Which of the following is most likely to be appreciated on the exam?

A 67-year-old male presents to the clinic with his wife due to a gradual decline in his balance over the past two years. His balance issues have resulted in him falling twice in the past month. His wife states that she notices that he has been walking more slowly than usual. The patient also complains of double vision when reading the newspaper. On physical exam, the patient is noted to have a vertical gaze palsy and impaired smooth ocular pursuit, and a subtle right hand resting tremor. A brain MRI is ordered which shows atrophy in the midbrain tegmentum. What is the most likely diagnosis?

A patient with a past medical history of Parkinson’s disease is brought to the emergency room with the chief complaint of a severe headache, chest pain, and shortness of breath. His blood pressure on arrival was 196/122 mmHg. The patient states that he was in his usual state of health earlier in the day but started feeling unwell after attending a wine and cheese pairing event at a local winery. Which of the following medications is likely the cause of the patient’s symptoms?

A 55-year-old was recently diagnosed with breast cancer. She required a right mastectomy, lymph node resection, and local radiation. She presents to your clinic with right arm pain and weakness. On exam, she has weakness only to forearm pronation, and flexion at the wrist and biceps. She also has numbness of the lateral hand and the first 3 digits.

Which cord or nerve was likely injured from the surgery or radiation?

Identify the pattern seen in the 5th second of this EEG recording.

Which of the following is the reversal agent for dabigatran?

Cerebral amyloid angiopathy would be best appreciated on which of the following MRI sequences?

A 56-year-old man with idiopathic Parkinson’s disease presents to the emergency department for hypertensive emergency and tachycardia. You suspect that this may be an adverse effect related to one of his medications. Patients that are prescribed MAO-B Inhibitors should be counseled on avoiding which of the following?

A 65-year-old man presents to the emergency room with progressive weakness over the course of several months. Examination shows pure motor weakness with no sensory involvement, decreased reflexes, and diffuse fasciculations. An EMG shows a conduction block of motor neurons outside of compression sites and normal sensory conduction velocities. Which of the following of most appropriate for treatment?

A patient with end-stage amyotrophic lateralized sclerosis (ALS) presents to the emergency room from a nursing home alone. His vitals show hypoxemia and he appears tachypneic on examination. On examination, he is also paraplegic with significant weakness in the upper extremities and mild dysarthria. His mental status examination appears intact. Between short breaths, he says that he does not wish to be intubated. This is consistent with the end-of-life discussions documented in the outpatient clinic notes. As his hypoxemia worsens his wife arrives at the bedside and with urgency asks you to intubate the patient. What is the most appropriate response?

An MRI is performed on a 40-year-old man after experiencing his first unprovoked seizure. The lesion appreciated on the MRI T2 sequence shown below is most likely which of the following?

Lesion to which area of the brain causes impairment in naming, fluency, and repetition with intact comprehension?

Identify the finding noted with a blue arrow.

An 11-month-old male is brought to the emergency room with agitation, fever, and nuchal rigidity. A review of the patient’s electronic medical record shows that the patient was admitted with meningitis 2 months ago. While no clear focal neurological symptoms were appreciated on examination, there was a midline dimple appreciated in the lumbosacral region. Which of the following is the most likely etiology of the patient’s recurrent illness?

A 75-year-old woman with HTN presents with sudden memory deficits and a change in emotional regulation. She is found to have a lacunar infarct, and you feel a disconnection of the Papez circuit may explain her symptoms. Which of the following is not considered a part of the Papez circuit?

A 41-year-old male presents to the emergency room with a two-day history of neck pain and speech difficulties. CT head shows scattered hypodensities in the left ACA and MCA territories. His Sagittal CT angiogram of the neck is shown below. What is the most likely cause of the patient’s symptoms?