Quiz 07/10/2022

Which of the following identifies the vein of Galen?

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?

What is the mechanism of action of clopidogrel?

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 is an absolute contraindication for the use of tPA?

An MRA is ordered for a patient presenting with an acute stroke. Based on the lesion appreciated in the image below (white arrow), what symptom is likely to be seen on examination?

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

Which of the following identifies the straight sinus?

A 7-year-old girl presents with 2 weeks of a right-sided unilateral throbbing headache. She has otherwise been healthy with no other symptoms and has no past medical history except for a light pink birthmark around her right eye. What is the most appropriate next step?

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

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?

Which of the following arteries is the first branch of the internal carotid after it enters the cranial cavity?

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 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?

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

A 90-year-old woman presents to the emergency room with an acute change in mental status. On examination, she is alert but is not answering questions or following commands. Speech is fluent, but not interpretable. Comprehension is severely impaired. Interestingly she was able to repeat full sentences without much difficulty. Which of the following is the most likely territory of ischemic damage?

Which of the following is not one of the absolute exclusionary criteria for tissue plasminogen activator (tPA)?

A 72-year-old male with diabetes, hyperlipidemia, and tobacco abuse is admitted to the stroke service after he is found to have a left superior middle cerebral artery territory stroke. His EKG on admission showed a normal sinus rhythm. A transthoracic echocardiogram (TTE) is performed. Which of the following findings on TTE would lead to the recommendation of an anticoagulant medication over an antiplatelet medication for secondary stroke prevention?

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

A 12-year-old boy with a past medical history of sickle cell disease was admitted to the emergency room in a pain crisis. While being treated with morphine the patient developed acute left arm/leg weakness and numbness. Which of the following is the most likely etiology for the patient’s new neurologic symptoms?