Quiz 06/23/2022 (1)

A 14-year-old male is referred to the neurology clinic by his PCP with the complaint of bilateral hearing loss. Neurological examination shows a sensorineural hearing loss. Multiple hyperpigmented lesions on the chest and back were also appreciated. An MRI of the brain was ordered that showed bilateral posterior fossa lesions. Genetic testing would reveal a mutation on which chromosome?

An autopsy was performed on a 30-week gestational age stillborn infant. An image of the brain before histopathologic analysis is shown below. Which of the following was likely also appreciated during the autopsy?

A 32-year-old female with an acute ischemic stroke was sent for an urgent angiography. Below is the image captured from this study. What is the likely etiology of the patient’s acute ischemic stroke?

A 24-year-old patient had a severe unhelmeted motorcycle accident and despite best efforts by medication providers, he passed away two days later. An autopsy was performed. Identify the structure marked by the white arrow.

A 72-year-old woman is brought to the clinic by her family with concerns about living at home alone. Her daughter states that the patient’s “memory is not what it used to be” and that she will often think that there are little children in her house when no one is there. On exam, you appreciate a bilateral upper extremity resting tremor. A functional PET scan will most likely show which of the following?

A 77-year-old male presents with a 1-year history of worsening bradykinesia, recurrent falls, and a shuffling gait. Past medical history is significant for REM-sleep behavior disorder and diet-controlled hypertension. Neurologic examination reveals a tremor at rest that improves with movement, along with bilateral upper-limb spasticity. Impaired dopaminergic signaling is most likely to be found in which of the following locations?

Which of the following muscles is solely innervated by the C5 nerve root?

You are caring for a 38-year-old man with schizophrenia since his early twenties. He has had many years of uncontrollable irregular facial movements including tongue writhing, lip smacking, and frequent blinking. His psychiatrist stopped the medication suspected to cause this problem a year ago, yet he is still having the symptoms and they are especially bothersome. Which of the following medications is FDA approved for the treatment of this problem?

A 40-year-old male with bilateral mesial sclerosis and medically refractory epilepsy presents to the epilepsy monitoring unit for a presurgical evaluation. His current anti-seizure medication regimen includes levetiracetam, lamotrigine, and clobazam. Over three days and weaned medication, the patient had 7 seizures; four from the left temporal lobe, and three from the right temporal lobe. Which of the following is the most appropriate next step in treatment?

A patient with newly-diagnosed early state amyotrophic lateralized sclerosis (ALS) presents to your multidisciplinary clinic for the first time. After discussing the effectiveness and side effects of riluzole and endavarone, the patient informs you that he doesn’t want to start either medication. Which of the following basic principles of medical ethics could be best applied to this scenario?