Quiz 07/04/2022

A patient with a history of hypertension and provoked seizures secondary to posterior reversible encephalopathy syndrome (PRES) has come to your clinic for a 6-month follow-up after her associated hospitalization. It was found that abrupt discontinuation of her hypertensive medications due to medication noncompliance was the cause of the PRES. She was started on the anti-seizure medication (ASM) levetiracetam at the time of her PRES and has had no seizures since being discharged. She asks you about the risk of future seizures. What is the most appropriate response?

Alemtuzumab is a monoclonal antibody therapy that targets which of the following proteins?

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 37-year-old man with a past medical history of depression, hypothyroidism, fibromyalgia, and nephrolithiasis presents with a well-documented history of migraine headaches. In the past, his headache frequency was less than 5 days a month but they are now occurring at least three times a week. Your suspicion of secondary causes of headache is low and you are considering starting a prophylactic migraine treatment. Which of the following medications should be avoided?

A 35-year-old woman with a past medical history of ocular and oral dryness presents with a 5-month history of progressive difficulties with ambulation. On exam, there is diminished vibratory sensation along the plantar/dorsal surfaces of her feet, 1+ ankle reflexes bilaterally, and a positive Romberg sign. Strength is normal. A tissue biopsy confirms the diagnosis. Which of the following is the most likely diagnosis?

The lesion shown below (blue arrow) is most consistent with which of the following pathologies?

Identify the darkly stained structures.

A 59-year-old woman presents to the emergency room with dizziness and left ear fullness. The symptom is described as a spinning sensation that is present at rest and with action. She has had comparable events before, which have self-resolved over time. The patient is ataxic on the exam and has difficulty hearing out of her left ear. An MRI brain with and without contrast was normal. Which of the following is the most appropriate line of therapy that will decrease the risk of future recurrent events?

Which of the following autoantibodies are associated with myasthenia gravis?

A 37-year-old female with a past medical history of acne, obesity, anxiety, and fibromyalgia presented to the emergency room with a severe headache, papilledema, and visual disturbances. MRI shows an empty sella and MRV was normal. Symptoms started two weeks after her primary care physician initiated a new medication. Which of the following was the most likely medication initiated by the primary care physician?

Which of the following is most likely to cause the pathology seen in the image below (white arrow)?

An 80-year-old woman with uncontrolled HTN presents to the ED with symptoms upon awakening of left hemi-sensory loss, last seen well 8 hours prior. MRI is done and shows a lateral thalamic lacunar stroke. The small branch affected in this lacune is most often a branch of which major artery?

The ophthalmic branch of the trigeminal nerve exits the skull from which cranial foramina?

Which of the following is the annual conversion rate of mild cognitive impairment (MCI) to dementia?

Based on the MRI imaging shown below, which of the following structural abnormalities is likely also present?