Quiz 06/17/2022 (1)

A 65-year-old female presents to the Emergency Room with a 2-month history of altered mental status and jerking. On examination, you appreciate an exaggerated startle response. Her MRI was shown below. Which of the following statements is true?

Which of the following symptoms seen with normal pressure hydrocephalus (NPH) is the most responsive CSF shunt placement?

A 65-year-old mechanical engineer presents with increasing word-finding difficulties. He is particularly concerned that he is forgetting the names of people, places, and objects. On examination, he has difficulty naming objects when shown (i.e. keys, watch, etc.). Otherwise, his speech is fluent. A SPECT scan shows hypometabolism in the left anterior temporal lobe. Which of the following is the most likely diagnosis?

A 4-year-old girl with multiple seizure types and intellectual disability has an EEG performed that shows 1.5 Hz to 2.5 Hz spike and wave discharges. Which of the following is the most likely diagnosis?

This brain biopsy is consistent with which of the following pathologies?

Which of the following brain metastases has the highest risk of intracranial hemorrhage?

Which of the following is appreciated in the right posterior quadrant in the EEG shown below?

Identify the pathological abnormality shown in the image below.

A 62-year-old male with a past medical history of hypertension, type 2 diabetes, and dyslipidemia presents with a stepwise progression of worsening forgetfulness over the last three years. Physical examination reveals a score of 20/30 on the Mini-Mental State Examination with deficits in multiple cognitive domains. Hyperreflexia in the left upper and lower extremities is also appreciated. Her axial FLAIR sequence brain MRI scan is shown. Which of the following is the most likely diagnosis?

A 12-year-old boy with no significant past medical history is admitted to the neurology service after presenting with acute-onset fever, personality changes, and difficulties with speech. His mother states that three days ago he also reported seeing bats and other wild animals running around his room. She decided to bring him to the hospital today after she noticed that he seemed more tired and was moving slower than normal. A lumbar puncture and MRI of the brain are ordered. The CSF shows elevated protein, elevated lymphocyte and red blood cell counts, and normal glucose. MRI of the brain is shown below. What is the most likely diagnosis?

A 35-year-old female with a history of heroin abuse was found unresponsive and received 35 minutes of CPR before a return of spontaneous circulation (ROSC). She was intubated in the field and was brought urgently to the hospital. While in the ICU, the nursing staff noticed abnormal movements concerning for possible seizure. An EEG was performed and shown below. What is this finding most consistent with?

A 54-year-old male with hypertension, hyperlipidemia, and atrial fibrillation on warfarin is newly diagnosed with epilepsy. Of the following medications, which is the most appropriate anti-seizure medication to prescribe?

A 65-year-old woman with a past medical history of hypertension presents with recent onset of bilateral eye discomfort and diplopia. She states that she is unable to completely close her eyes. On exam, pain is elicited when testing extraocular movements. Visual acuity and visual fields are unremarkable. MRI of the brain reveals excessive peri-orbital subcutaneous tissue bilaterally. Which of the following is the most likely diagnosis?

Initiating HAART therapy for a patient with poorly controlled HIV places them at an increased risk for which of the following?

A patient with a history of hypertension and provoked seizures secondary to posterior reversible encephalopathy syndrome (PRES) has come to your clinic for a 6-month follow-up after her associated hospitalization. It was found that abrupt discontinuation of her hypertensive medications due to medication noncompliance was the cause of the PRES. She was started on the anti-seizure medication (ASM) levetiracetam at the time of her PRES and has had no seizures since being discharged. She asks you about the risk of future seizures. What is the most appropriate response?

A 55-year-old female with a past medical history of coronary artery disease and ischemic stroke with residual mild left arm weakness presents with headaches for a year. Episodes occur two to three times a month. The pain is unilateral and is associated with nausea and photophobia. During this episode, she is unable to go to work and over-the-counter anti-inflammatories have been ineffective. Physical exam and vitals are normal. Which abortive therapy is the most appropriate next step in management?

A previously healthy 14-year-old female presents to the emergency room after experiencing a trip and fall where she hit her head. She returns to baseline, but out of caution a CT head and subsequent MRI brain are performed in the ED. What is a potential complication caused by this lesion seen in this MRI?

A 75-year-old patient is brought in by her husband because of word-finding difficulty.  On cognitive testing, the most impressive finding was that the patient could not recall many colors of the rainbow. Based on this finding, what kind of memory is most impaired?

The EEG shown below is consistent with which of the following?

A 45-year-old man comes into the ED complaining of a severe headache. A spinal tap shows xanthochromia. The patient is treated immediately and spends the next two weeks in the neurocritical care unit. On day nine of his stay, his speech becomes slurred and the neurologist notices that the left side of his face is drooping. What is the class of drugs that could have potentially prevented these findings?

A 55-year-old male presents to the clinic with a complaint of right lower extremity pain and weakness. On examination of the right lower extremity, there is decreased sensation to pinprick on the medial calf and foot, 4/5 strength with knee extension, and a mute patellar reflex. These findings are most likely due to radiculopathy of which of the following nerve roots?

All of the following therapies can be useful in the management of cluster headaches except:

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?

Which of the following is not a risk factor for suicide?

A 50-year-old male presents to the emergency room with a three-day history of double vision and difficulty walking. Neurological examination reveals decreased eye movements. Strength in the limbs is relatively preserved but all reflexes are absent. There is also marked limb clumsiness. Which of the following is the most likely diagnosis?