Quiz 06/24/2022

A 47-year-old man with a history of bilateral cataract surgery at the age of 20 presents to the clinic for evaluation of progressive unsteadiness and cognitive decline. His father and older brother reportedly had similar symptoms in their early adulthood as well. On exam, there is notable dysmetria and gait ataxia. There were also abnormal soft-tissue masses appreciated near the Achilles tendons bilaterally. Which of the following is most likely to be abnormal in this patient blood?

An 11-year-old girl has a neurosurgical resection of a brain mass. You are consulted post-op day 2 due to speech decline progressing to complete mutism. She does not have any weakness on exam. What type of tumor was most likely resected?

Based on the histopathologic findings shown below, how long ago did this patient experience an ischemic stroke?

A 63-year-old woman with right leg weakness and pain has an MRI performed to evaluate for a possible cause. Her imaging is provided below. Based on the location of the lesion, which of the following muscles is most likely weak on examination?

What is the state of the patient in the EEG shown below?

An 8-year-old girl is brought to the clinic by her mother for complaints of progressive insomnia, difficulty walking, and worsening vision. On exam, the patient is found to be unable to look upwards and her pupils accommodate but fail to react to light. On further questioning, it is found that menarche occurred at 7 years of age. MRI is most likely to demonstrate a tumor of which brain structure?

Bilateral exotropia is typically seen with which of the following lesions?

A 28-year-old caucasian male was last seen well at 9:00 AM when he got into a verbal argument with his girlfriend. When the girlfriend returned from work at 5:00 PM, she found the patient on the floor of the garage altered, and states he “smelled unusual”. In the emergency department, the patient is disoriented but arousable with much effort. He complains of a headache and blurred vision, and he appears uncomfortable with a respiratory rate of 40. You send stat labs and they are listed below. What treatment should you administer immediately?

ABG: 7.18 pH, PCO2 = 28, PO2 = 118
Electrolytes: Na 135 mEq/L, K 5.0 mEq/L, Cl 105 mEq/L, HCO3 15 mEq/L

A mutation in which of the following genes would be most likely in a patient with numerous cavernous malformations seen on head imaging?

A patient presents with double vision that improves when tilting their head to the right. A lesion is most likely to be present in which of the following cranial nerves?

A patient with a history of a right shoulder anterior dislocation comes to the clinic with the chief complaint of right arm numbness. On examination, there is a loss of sensation to light touch on the lateral portion of the upper arm. Based on the sensory disturbance, which of the following nerves is most likely injured?

A 19-year-old male presents to the ED during finals week of college after he had witnessed generalized convulsive activity on the floor of his dorm room. He has since returned to baseline. He states he has never had shaking like this before, other than when he wakes in the morning he’ll get an occasional twitch or two. An EEG is performed as below. Which is the treatment of choice?

A 56-year-old male presents with unusual behavior of compulsive eating and inappropriate sexual gestures. On exam, the patient has difficulty keeping his hands to himself and is distracted by the objects in his bed. A lesion in which area(s) of the brain would explain this syndrome?

A 17-year-old woman with no significant past medical history except for an upper respiratory tract infection 2 weeks ago presents with a one-day history of fever, headache, and altered mental status. On examination, the patient also had right-sided ataxia. An MRI brain was ordered and T2 sequence images are shown below. The lesions showed minimal lesional enhancement with contrast administration (image not shown). What is the most likely diagnosis?