Quiz 06/26/2022 (1)

You are consulted to the psychiatric hospital to see a 48-year-old female with schizophrenia who has been under psychiatric care for 2 weeks after ingesting hundreds of pennies over a prolonged period. You are asked to address her new complaints of numbness in her feet and trouble walking. On exam, she had a broad-based gait and a positive Romberg. What could explain these findings?

A 16-year-old male is brought to the emergency room by his parents for generalized weakness. The patient states that he woke up in the morning that day with flaccid paralysis of his arms and legs which was so significant that he couldn’t get out of bed. In typical teenage boy fashion, he wasn’t very worried about this at the time and went back to bed. It wasn’t until 4 hours later when he woke up again with the same degree of weakness that he became concerned and screamed for his parents to help. The patient denies any recent drug or alcohol use. The only interesting thing from the previous night was that he partook in and won a pizza-eating contest with his friends. The patient’s father admits to having had similar episodes to this when he was younger. If the patient’s symptoms are due to a genetic disorder, a mutation in which of the following genes is most likely responsible?

A 64-year-old man with idiopathic Parkinson’s disease being treated with carbidopa-levodopa is experiencing significant wearing-off despite increasing frequency and dose of levodopa-carbidopa, which is now producing significant peak dose dyskinesia. Which of the following would be a reasonable next agent to prescribe to reduce this wearing-off effect?

Which of the following is the most common gene associated with early-onset Alzheimer’s disease?

This muscle biopsy is most consistent with which myopathic disease?

The pathology shown in the image below is likely secondary to which of the following?

Which of the following symptoms can be seen with MCA-PCA watershed infarcts?

Which of the following CSF biomarker findings would be expected in someone with Alzheimer’s disease when compared to healthy controls?

A 37-year-old female presents to the emergency room with diplopia and ambulation issues. Other than having an upper respiratory tract infection two weeks ago, there is no other significant past medical history. On physical exam, the patient has a decreased range of motion of the extraocular muscles bilaterally, diffuse areflexia, and marked dysmetria on finger-to-nose and alternating movements testing. Which of the following autoantibodies is most likely associated with this disease?

A 22-year-old woman with a previously diagnosed history of prior suicide attempts, EEG-confirmed epilepsy, and non-epileptic seizures comes to your clinic to establish herself as a new patient under your care. Upon entering the room she immediately tells you about her horrible relationship with her last epileptologist and how abandoned she felt when he decided to retire. While gathering her social history, she endorses a history of excessive spending on new cars, reckless driving, and alcohol-driven physical altercations. Which of the following personality disorders is most consistent with this clinical presentation?

A 40-year-old textile worker is brought to the clinic for slowly progressive symptoms including shuffling gait, tremor, and profuse drooling. On examination, his speech is difficult to understand and there is cogwheel rigidity in his arms and legs. His tremor is most evident when his limbs are at rest. Exposure to which of the following is the most likely cause of the patients’ symptoms?

Which of the following findings is depicted in the catheter angiogram shown?

A 65-year-old man presents to the emergency room with progressive weakness over the course of several months. Examination shows pure motor weakness with no sensory involvement, decreased reflexes, and diffuse fasciculations. An EMG shows a conduction block of motor neurons outside of compression sites and normal sensory conduction velocities. Which of the following of most appropriate for treatment?

The EEG pattern on this bipolar EEG recording is most consistent with which of the following epilepsy syndromes?

A 57-year-old male with a past medical history of progressive weakness affecting all extremities and dysphagia for the past 6 months is admitted to the hospital. An EMG was completed as part of his workup and is shown below. Based on the available information what is the most likely diagnosis?