Quiz 06/16/2022

A 24-year-old college student presents with uncontrolled epilepsy. His seizures consist of an aura of déjà vu followed by oral automatisms and periods of unresponsiveness. The neurological examination is normal. MRI of the brain is performed and shown below. What is the etiology of this patient’s epilepsy?

Which of the following is most likely to show temporal dispersion of the action potential?

A 71-year-old female with a past medical history of hypertension presents to the clinic with a 1-year history of a progressive right tremor. She only notices the tremor when she is sitting still. On physical exam, you notice that her movements are not smooth, and she seems rigid in her extremities. She also demonstrates a slow, shuffling gait. This patient’s condition is most likely due to the loss of which neurotransmitter?

Which of the following is the most likely diagnosis based on the EMG provided below?

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 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?

Which of the following issues in early development has occurred in the photograph below?

A 2 month-old female is brought to the emergency room by her mother after she noticed abnormal movements concerning for possible seizure. The child was born at term and was the product of a normal pregnancy and delivery. While gathering a history, the child is lying on the bed still when you notice repetitive movements of his bilateral lower limbs. When her mother notices she picks up the patient and the movements resolve. What is the most likely diagnosis?

A 63-year-old woman with a history of right-sided breast cancer status post-mastectomy, chemotherapy, and radiation presents to your clinic with a 2 months history of right arm pain and paresthesias. Which of the following findings on EMG/NCS would most likely suggest a radiation-induced plexopathy over a recurrent neoplastic plexopathy?

Which of the following structures has an intact blood-brain barrier?

A 40-year-old man comes into the clinic with headaches. He has stabbing pain around the left temple that occurs numerous times during the day. The pain lasts 10-30 seconds at a time. He says he has excessive tearing from the left eye during these episodes. What is the most appropriate therapy?

Which synapsed of the peripheral nervous system is acetylcholine the primary neurotransmitter?

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

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

A 55-year-old male with a recent history of losing 50 pounds after gastric bypass is referred to the EMG lab with difficulty walking. He has noticed that his left foot drags occasionally causing him to trip and that he has numbness on the top of his left foot up to the middle of his shin. Which of the following statements is the most accurate based on the EMG findings shown below?

You are caring for a 65-year-old that sustained a small hypertensive intracranial hemorrhage. Early physical therapy is initiated. They discover that while she can sit unassisted, she is unable to stand. When standing, she sways and falls forward, backward, or to one side. On a detailed physical exam, strength is 5/5 to flexion and extension at the ankle, knee, hip, shoulder, elbow, and wrist bilaterally.

Which of the following locations of the bleed best explains this finding?

You are asked to evaluate a patient in the neurointensive care unit who is comatose and has had a somatosensory evoked potential performed. Which of the following is most suggestive of a poor prognosis for this patient?

What is the pathophysiology that leads to the pathology shown with a black arrow in the image below?

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