Quiz 07/08/2022 (1)

A 33-year-old woman has recently given birth to a healthy 3-month-old boy. She has been complaining of poor sleep for the past year, mainly from an uncontrollable urge to move her legs that is only relieved by moving them. This is present during the day to a small degree but is much worse at night and during periods of rest. What would be the best test to order for her?

An 85-year-old woman presents to the hospital with an acute onset of language impairment. On examination, she has difficulty with comprehension but her verbal fluency and repetition are normal. Which of the following best describes her deficits?

A 66-year-old male presents to the emergency room as an unrestrained driver in a motor vehicle accident. While initially only complaining of mild neck pain, within 30 minutes of the collision he started to experience bilateral numbness in his hands and significant symmetric upper limb weakness. Soon thereafter, the weakness extended down to his lower extremities. Neurologic examination is remarkable for loss of pain and temperature sensation in his bilateral upper extremities and symmetric bilateral upper extremity greater than lower extremity weakness. Which of the following is the most likely diagnosis?

An otherwise healthy 17-year-old female presents to the emergency department with right arm weakness. The symptoms started insidiously over the weekend and haven’t improved over the last 3 days. Examination shows 4/5 strength of the right upper extremity. A brain MRI is performed and shows a T2 hyperintense lesion in the subcortical white matter with contrast enhancement. No other lesions are seen. Upon further questioning, she states that she has never experienced any similar episodes of transient neurologic symptoms before. Which of the following is the correct diagnosis?

A 53-year-old man has had increasing difficulty falling and staying asleep over the past 3 months. This is accompanied by hallucinations, delirium, and general clumsiness. He was an orphan as a child and does not know his family’s medical history. If a sleep study is performed, during which stage of sleep would you most likely expect to find an absence of normal sleep architecture?

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?

Which of the following is most consistent with this EEG tracing?

An 8-year-old girl is brought to the clinic by her mother for complaints of progressive insomnia, difficulty walking, and worsening vision. On exam, the patient is found to be unable to look upwards and her pupils accommodate but fail to react to light. On further questioning, it is found that menarche occurred at 7 years of age. MRI is most likely to demonstrate a tumor of which brain structure?

A 61-year-old male with no past medical history presents to the clinic with difficulty moving for the past year. He states that it takes him a lot longer to do daily tasks such as walking to the mailbox and that it is getting worse. He is accompanied by his daughter who states that she notices that he shuffles his feet when walking. On physical exam, the patient is observed to have a 4-6 Hz resting tremor in his hand. Pathologic examination of this patient’s brain tissue would most likely show which of the following?

Anti-Ma2 autoantibodies are most commonly associated with which of the following tumors?