Quiz 07/09/2022

How long ago did the ischemic injury seen on this neuronal tissue micropathology slide occur?

A 67-year-old man presents urgently to the emergency room with an acute onset of left-sided weakness and numbness. A CT head was performed and shown below. What is the most likely etiology of the patient’s symptoms?

Which of the following identifies the straight sinus?

A 75-year-old man with a past medical history of hypertension, hyperlipidemia, and diabetes presents with acute onset right arm weakness and speech problems. He can speak fluently and his comprehension is intact. However, he is unable to repeat even simple sentences. Reading and writing are preserved. Which of the following is an accurate description of his speech dysfunction?

A 32-year-old female with an acute ischemic stroke was sent for an urgent angiography. Below is the image captured from this study. What is the likely etiology of the patient’s acute ischemic stroke?

Which of the following arteries supplies the lumbar spinal cord?

The vessel labeled 1 in the angiogram provided supplies all of the following structures EXCEPT:

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

Which of the following comorbidities are responsible for the lesion appreciated in the image below?

A 58-year-old female with a history of atrial fibrillation on warfarin presents to the ED with aphasia and right-sided weakness. She was last seen well 2 hours prior. CT imaging is unremarkable. Which is the most appropriate next step?

A 41-year-old male presents to the emergency room with a two-day history of neck pain and speech difficulties. CT head shows scattered hypodensities in the left ACA and MCA territories. His Sagittal CT angiogram of the neck is shown below. What is the most likely cause of the patient’s symptoms?

How long ago did the ischemic injury seen on the micropathology slide below of neuronal tissue occur?

Which of the following findings is depicted in the vessel imaging shown?

A 45-year-old man comes into the ED complaining of a severe headache. A spinal tap shows xanthochromia. The patient is treated immediately and spends the next two weeks in the neurocritical care unit. On day nine of his stay, his speech becomes slurred and the neurologist notices that the left side of his face is drooping. What is the class of drugs that could have potentially prevented these findings?

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?

Which of the following is present in the image shown below?

A 37-year-old man with a history of hypertension presents to the emergency department with a one-day history of difficulty walking. On examination, he has right leg paresis and hyperreflexia with a right-sided Babinski response. His non-contrast axial CT scan is shown below. Which of the following is the most likely etiology of this patient’s symptoms?

A 32-year-old man with no significant past medical history presents to the emergency department after experiencing a generalized tonic-clonic seizure. His neurological examination was unremarkable. As part of his work-up, an MRI was obtained (see FLAIR axial image below). What is the most appropriate next step in management?

Which of the following findings is depicted in the MR Angiogram shown below?

A critically ill 1-month-old has cerebral vessel imaging performed and shown below. Which of the following comorbid medical issues are likely present?

An 83-year-old man presented with an acute onset of difficulty walking and nausea about 12 hours prior to being seen in the emergency room. Examination revealed vertigo and truncal ataxia. An MRI was performed to evaluate for stroke. The FLAIR axial MR image is shown below. What is the vascular territory damaged in the imaging provided?

A 78-year-old male with no past medical history presents to the ED with left-sided hemiparesis and slurred speech at 9 AM. She is unable to provide a clear clinical history. She was noted to be found at 7:30 AM in bed with the above-stated symptoms. Her husband states that the patient went to bed at 10:00 PM the previous night without any symptoms. CT head shows no blood or hypodensities, and CTA head/neck reveals a right MCA occlusion. Her NIHSS is 17. Which of the following treatment options is the most appropriate next step based on the available data?

What is the mechanism of action of clopidogrel?

A lesion to which of the following arteries could produce the ischemic findings shown in the MRI below (Brain MRI, axial cuts. Left: DWI sequence. Right: ADC sequence).

What is the pathophysiology of the lesion provided below?

Which of the following antiplatelet medications rely heavily on the cytochrome P450 system for its therapeutic effect?

A 59-year-old man with HTN, T2D, and peripheral vascular disease presents with sudden complete loss of vision in the left eye, which resolved after about 20 minutes. He denies any other symptoms. Which of the following vessels was most likely obstructed?

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