Quiz 07/05/2022

Which of the following muscles is innervated by the vagus nerve (CN X)?

Which of the following medications is an NMDA receptor antagonist?

A 6-year-old developmentally normal male presents after experiencing an episode of jerking of the right side of his mouth and inability to speak lasting 2 minutes. The patient is now back to baseline and has an EEG performed. Based on this clinical picture, which of the following abnormalities would you most expect to see on the EEG?

A 5-year-old boy is seen in the clinic for seizures, vision loss, and progressive loss of milestones. MRI of the brain shows a posterior predominant leukodystrophy. Which of the following is the most likely diagnosis?

A 14-year-old girl with no significant past medical history is brought to the clinic with a 1-week history of involuntary movements of the left side of her body. Her mother reports that 1 month ago, she experienced a week of fever, malaise, and fatigue, but they did not seek medical treatment at the time. On physical exam, the patient exhibits involuntary, irregular movements of her neck, left arm, and left leg, and generalized hypotonia. What is the most likely diagnosis?

The usage of bupropion increases the risk of which of the following?

Which of the following genes is responsible for familial ALS?

A 24-year-old man comes to the emergency room with severe left-hand pain after a fall at home. The patient refuses to allow the nurse or doctor to do a physical exam. A hand X-ray is unremarkable. She insists that all she needs is a note for two weeks of paid leave from her job. Which of the following is the most likely diagnosis?

A pure sensory stroke is most likely to damage which structure?

The EEG pattern shown below is most consistent with which of the following?

A 65-year-old woman with a past medical history of hypertension presents with recent onset of bilateral eye discomfort and diplopia. She states that she is unable to completely close her eyes. On exam, pain is elicited when testing extraocular movements. Visual acuity and visual fields are unremarkable. MRI of the brain reveals excessive peri-orbital subcutaneous tissue bilaterally. Which of the following is the most likely diagnosis?

A lesion to which of the following neuroanatomical structures causes dysphagia, decreased gag reflex, and hoarseness?

A patient with Duchenne muscular dystrophy (DMD) most likely has which of the following findings on electromyography (EMG)?

A 6-year-old girl presents to the clinic with frequent episodes of awakening from sleep in extreme fear. Sometimes she has a brief twitching of the limbs with this. She has these events in clusters on some nights, lasting seconds to minutes. On further questioning, you discover the mother had a similar problem when she was around this age, which slowly got better over time. Both patient and mother are otherwise healthy with no intellectual deficits or symptomatic features. Which of the following gene mutations do they both likely share?

A 68-year-old man presents with word-finding difficulties and speech hesitancy. His wife notices that he struggles to name objects and sometimes mispronounces words. On examination, he can name objects but has significant difficulty repeating long sentences. While his spontaneous speech is slow, it is grammatically correct. Which of the following is the most likely diagnosis.

A 31-year-old man presents after being found down at the scene of an armed robbery. On physical examination, there is lower extremity weakness and loss of proprioception and vibration on the right side, as well as loss of pain and temperature sensation on the left leg. His sagittal CT spine is shown below. Which is the most likely condition suffered by this man?

You are caring for a 19-year-old male in the neurocritical care unit after drowning. His brain MRI is pending clinical stability. Which finding on brain MRI is most likely after a severe global hypoxic injury?

You are caring for a 1-month-old infant in the neonatal ICU with abnormal movements since birth. The baby is seen writhing in bed, with her arms and legs and axial trunk moving in a snake-like pattern. A CT head is done and shows bilateral cystic lesions on the basal ganglia. Toxic levels of which of the following are most likely at play?

A 28-year-old woman with a history of intractable epilepsy presents to you for outpatient follow-up. She has been seizure-free on valproic acid and levetiracetam for the last 18 months. She reports a desire to become pregnant and asks if she has an increased risk of in-utero defects with her medications. Which of the following is the most appropriate answer to this question?

Which of the following drug-mechanism pairs is incorrect?

What is the pathophysiology of the lesion provided below?

A 4-year-old male with no significant past medical history presents to the emergency room after experiencing a first-time seizure. An EEG is obtained and captures a seizure arising from the left hemisphere and polymorphic delta slowing on the same side. Over the next several months the child continues to experience focal-onset seizures despite being on 2 maximally-dosed seizure medications. His brain MRI, below, shows asymmetric left-hemispheric atrophy. His clinic presentation and imaging are most consistent with which of the following diseases?

A patient presents to the emergency room after experiencing a syncopal event. On history, he endorses unilateral, paroxysmal pain in the tonsil, tongue, and ear triggered by swallowing. What is the most likely diagnosis?

A 68-year-old right-handed male with HTN and atrial fibrillation formerly taking Eliquis, but stopped months ago due to GI bleed, presents for acute onset neurologic symptoms. He is able to understand speech and commands, however, he is unable to speak fluently and can not get the right words out. Despite this, he is able to accurately repeat words you say and correctly name items that are pointed to. What other neurologic symptom is also likely to be present on the exam?

Patients with Von-Hippel Lindau (VHL) syndrome are at risk of developing which of the following?

Exposure to which of the following in utero is associated with low birth weight?

A 34-year-old man was admitted to the hospital and intubated after a severe motor vehicle accident leading to multiple bone fractures two days ago. Despite weaning IV sedation, the patient continues to be unarousable to stimulation. An MRI was performed and DWI imaging is shown below. What is the most likely diagnosis?

A 6-year-old Amish female presents to the emergency department with a 2-month history of gradual cognitive decline and jerking limb movements. A routine EEG was obtained (see below). Which of the following diseases is consistent with these EEG findings?

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 30-year-old female with a past medical history significant for acne, migraine without aura, and depression presents to the emergency room with severe recurrent headaches. She says the headaches come on quickly and only last a couple of minutes but are debilitating. CTH was normal. A CTA head and neck was performed which showed segmental artery narrowing in the proximal MCA territory. Which of the following medications was the most likely trigger of this patient’s presentation?

A 30-year-old female with no known past medical history comes to the emergency room after a generalized tonic-clonic seizure. Her friend says that she has been behaving oddly over the past couple of days and has been complaining of a headache. An axial T2 brain MRI is shown below. Which of the following is the most likely diagnosis?

Which of the following CSF findings would be expected in a patient with AIDP?

A 6-year-old patient presents with a decline in neurologic function with ataxia, optic atrophy, spastic tetraparesis, and cognitive decline. MRI shows diffuse white matter demyelination with sparing of the U fibers. Which of the following laboratory tests is most likely to diagnose this problem?

A 30-year-old male presents to the clinic with a fifteen-year history of progressive weakness and sensory loss in his lower extremities. Examination shows hammertoes, high arches on his feet, 4/5 ankle dorsiflexion strength, and a mild decrease in sensation to pinprick in the 1st toes bilaterally. Upon questioning he mentions that his father had similar-looking feet and started to use a cane in his fifties. Which of the following genetic mutations may be the cause of the patient’s symptoms?

A 40-year-old male with a history of headaches, seizures, and recurrent strokes has a brain biopsy performed to aid in diagnosis. Electron microscopy of his brain tissue shows granular osmiophilic material in the basal lamina of small cutaneous arterioles. What is the cause of this patient’s disease?

A 5-year-old female was brought to the neurology clinic for a second opinion for paroxysmal spells of dizziness. The family states that several times a month the patient will develop severe dizziness, nausea, and vomiting. Symptoms usually only last less than 5 minutes. An MRI and 24-hour ambulatory EEG have been performed in the last 3 months. Both were unremarkable. What is the most likely diagnosis?

An 80-year-old woman with a history of Parkinson’s disease that is well controlled with carbidopa-levodopa presents with her husband for evaluation of delusions. Her husband states that the patient believes that she is being consistently monitored by the FBI and will avoid eating certain foods for fear of being poisoned. She is also constantly worried that her husband will leave her for a younger woman. Which of the following medications would be the most appropriate FDA-approved treatment for these symptoms?

A young infant is found after birth to have an abnormality of the left arm. The arm is held down by the infant’s side, adducted and medially rotated, and the forearm is extended and pronated. What is the anatomic location of the injury causing the deficits?

The electrical fields that generate the cortical activity appreciated on electroencephalogram (EEG) are the result of which of the following?