Quiz 07/01/2022

Which is the following findings on EMG is suggestive of a chronic neurogenic lesion?

A 15-year-old male comes to the clinic with his parents as they complain he has periods of the year where he will sleep up to 20 hours a day for multiple days in a row, as well as uninhibited eating and inappropriate sexual behavior. These episodes last for up to around 2 weeks at most, and then he is behaviorally back to normal in between episodes. Which is the most likely diagnosis?

Occlusion of the vessel labeled 1 in the angiogram below would lead to which of the following symptoms?

Which of the following nerve conduction study abnormalities is least likely to be seen during the initial phase of acute inflammatory demyelinating polyneuropathy (AIDP)?

Congenital muscular dystrophies are most often associated with which of the following pathophysiologies?

A 15-day-old female is evaluated in the NICU after being born to a G2P2 mother. On exam, the infant is jaundiced. Abdominal ultrasound shows severe hepatosplenomegaly. CT scan of the head shows hydrocephalus and periventricular calcifications, and a fundoscopic exam shows bilateral chorioretinitis. Serological testing is most likely to show infection with which organism?

Identify the pathological abnormality shown in the image below.

Which of the following is not a recommended screening test for cognitive dysfunction?

A 48-year-old woman presents with acute onset of seizures, myoclonus, ataxia, and rapidly progressive dementia. CSF analysis reveals an elevated protein and mild pleocytosis. Brain MRI with and without contrast is unremarkable. Further investigation reveals elevated thyroid-stimulating hormone levels and anti-thyroid peroxidase antibodies. Which of the following is the most appropriate therapy?

Which of the following is the mechanism of action of tolcapone?

An 18-year-old woman presents as a new patient to your clinic for “seizures”. On review of her medical records, you find that she has had numerous ED visits and inpatient admissions for generalized shaking spells. Several of them have been captured on video EEG recording and there was no EEG correlate with the behavior, suggesting that they are psychogenic non-epileptic attacks/spells (PNEA/PNES). She says she is seeing you today because “I need someone to refill my seizure medications.” Which of the following basic principles of medical ethics could be best applied to this scenario?

A 79-year-old woman presented with the acute onset of difficulty walking and nausea that started about 24 hours before presentation. Examination revealed left-beating nystagmus and left-sided appendicular and truncal ataxia. Her axial FLAIR MRI imaging is shown below. The pathology shown is seen in which of the following vascular territories?

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?

With of the following CMT types present with an axonal pre-dominant peripheral neuropathy?

A 78-year-old woman is brought to the neurology clinic by her husband for memory loss. Her husband states for the past 6 months he has noticed a progressive decline in her memory, particularly with recent events. She has also lost her keys and cell phone on numerous occasions around the house. Her MOCA score in the clinic was 25/30, with points lost for poor delayed recall and attention. Neurodegenerative disease is suspected. Which of the following medications is the most appropriate for this patient to help with her cognition?