Quiz 06/25/2022

Which of the following is the most appropriate initial screening test for suspected restless leg syndrome?

An 85-year-old man presents back to your clinic for follow-up with his family for a slowly progressive neurologic decline over the past 4 years, namely with memory and cognitive decline. You have already performed a brain MRI and additional testing and suspect that the patient has Alzheimer’s dementia. The family expresses concerns over the patient’s driving. Which of the following, if true, is not a useful tool to identify driving risk according to updated practice guidelines?

Which of the following vessels drains into the sigmoid sinus?

A two-month-old female presents to the clinic with her mother for episodes of abnormal posturing of her head, neck, and abdomen when breastfeeding. Her mother states that the episodes last approximately 30 seconds to 1 minute. Episodes are followed by crying. Her birth history was normal, and she has met all of her developmental milestones. Of the following, what is the best treatment for this patient’s condition?

A 14-year-old girl with no significant past medical history presents with an acute presentation of left-sided weakness. CTH was negative but MRI shows an acute lacunar ischemic stroke in the right hemisphere. An angiogram was performed which revealed segmental arterial constriction followed by segments of arterial dilation in multiple intracranial vessels. Which of the following is the most likely etiology of her ischemic stroke?

A 26-year-old female with a past medical history of pulmonary embolism presents with seizures and left-sided weakness. She had been complaining about a headache for the past week. An MR venogram is shown below. Which of the following is the next best step in management?

A 45-year-old female with a recent diagnosis of multiple sclerosis, based on MRI and CSF analysis, is referred to your clinic to discuss possible disease-modifying therapies. You review the clinical history with her and she states that for the past 18 months she has experienced progressive right upper and lower extremity weakness. She denies any periods of transient improvement or dramatic worsening of symptoms. Based on this clinical history, what is the most appropriate disease-modifying therapy for this patient?

An 83-year-old man with a history of Parkinson’s disease is brought to the office with worsening hallucinations. She says that she sees things around the house and is starting to get paranoid that their neighbors are spying on them. Which of the following medications would help this patient’s symptoms?

A 7-day-old infant is in the hospital since birth when he starts having seizures. He has been feeding poorly thus far. On examination, he has hypotonia, as well as distinctive facial features of midface hypoplasia, hypoplastic supraorbital ridges, and a prominent high forehead. The metabolic testing panel returns with elevated very-long-chain fatty acids. What is the physiology of this disorder?

Which of the following is an appropriate test to assess for dorsolateral frontal lobe dysfunction?

A 3-year-old female with a past medical history of recurrent sinus infections is brought to the clinic by her father because of unsteadiness on her feet for the past 4 months. Her father states that she began walking at 12 months. However, more recently, she has been losing her balance and has been falling. On physical exam, she has truncal ataxia and an ataxic gait. An ocular exam reveals dilation of the retinal capillaries. Labs are ordered that show an elevated alpha-fetoprotein. Which of the following is the most likely diagnosis?

A 58-year-old male with a prolonged history of MG was recently discharged 4 months ago from the hospital with his second myasthenic crisis requiring transient intubation. Since that hospitalization, he was on prednisone, tapered down to 40 mg a day, cyclosporine, and pyridostigmine. He comes to the ED today after having a generalized tonic-clonic seizure. On arrival to the ED, the patient is post-ictal and has vision deficits on exam. MRI shows T2 hyperintensities on the posterior cerebral hemispheres. Which of the following is the likely etiology of the clinical presentation?

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?

What is the typical brainstem auditory evoked response (BAER) finding with cortical hearing loss?

A focal seizure must involve how much cortex in order to be appreciated with scalp EEG recording?