Quiz 07/10/2022

Initiation of urination involves which of the following physiologic processes?

A 45-year-old female presents as a trauma for an unhelmeted motorcycle accident. She has sustained significant blunt head trauma, and CTH shows hydrocephalus caused by edematous mass effect compressing the fourth ventricle. Which of the following shows the correct directional flow of CSF in a normal individual?

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?

Identify the pathological abnormality shown in the image below.

What is the mechanism of action of dabigatran?

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

Of the following, which region of the adult brain is most susceptible to hypoperfusion injury and ischemia?

Cerebral amyloid angiopathy would be best appreciated on which of the following MRI sequences?

Which of the following anatomic structures is responsible for the perception of superficial light touch?

A 61-year-old male with hypertension, hyperlipidemia, diabetes, and coronary artery disease presents after a sudden onset of headache and difficulty speaking, with left arm and leg weakness. Their blood pressure is 212/105 mmHg, and their blood glucose is 275 mg/dL. You notice aspirin on his medication list. A CTH is performed and is notable for a 25 cc hemorrhage in the right basal ganglia. Which of the following is correct?

Which of the following medications has been shown to improve neurological outcomes in patients with subarachnoid hemorrhage?

Paralysis of the stapedius muscle can occur with ipsilateral damage to which cranial nerve?

A 68-year-old man with left leg weakness and pain has an MRI performed to evaluate for a possible etiology. Her imaging is provided below. Based on the location of the lesion, which of the following muscles is most likely weak on examination?

The cell marked by the blue arrow is derived from which germ layer?

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?

Which of the following vessels that supply the thalamus typically originates from the posterior communicating artery (PCOM)?

You are asked to see a 64-year-old man with hypertension, hyperlipidemia, and peripheral vascular disease who is post-operative day 1 from an aortic aneurysm repair. On exam, he exhibits bilateral lower extremity weakness, as well as loss of pain and temperature sensation below the umbilicus. Light touch and proprioception are intact in the lower extremities. What is the most likely diagnosis?

A 67-year-old male with a past medical history of hypertension and diabetes presents with a 5-day history of facial paralysis and an ear rash. The patient states he returned from a 4-day backpacking trip in the Adirondacks 2 weeks ago in upstate New York where he engaged in hiking and freshwater swimming. His temperature is 36.9 °C (98.5°F), pulse is 72/min, and blood pressure is 131/78. Examination reveals an erythematous vesicular rash in the left auditory canal and pinna and drooping of the left face, forehead, and eyelid. A Weber test lateralizes to the right ear and a Rinne test shows air conduction greater than bone conduction in both ears. What is the most likely diagnosis?

A 37-year-old female with a past medical history of chronic fatigue and heat intolerance presents with right arm weakness. A cervical spine MRI is performed and shown below (Left: T2 sagittal. Right: T2 axial). Which of the following is the most likely diagnosis?

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

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 4-year-old boy with a history of mild cerebral palsy comes to the clinic for his annual follow-up. Since last seen in the clinic the patient and family have noted that he has been having increased difficulties with his left leg. Most days he is able to ambulate with a hand-held mobility device. However, more recently family has noticed that he not walking as much as he used to. On examination, there is increased spasticity and hyperreflexia at the ankle. The right leg had normal strength and tone. What is the most appropriate therapy for the patient’s symptoms?

A 6-month-old boy with no significant past medical history is brought to the clinic by his father because of abnormal limb movements that occur multiple times a day. His father describes high-frequency, low amplitude rhythmic movements that start in the child’s head and quickly spread down the shoulders. Episodes last approximately 1-2 seconds. There are no clear triggers and there is no loss of consciousness associated with the events. Family history is significant for essential tremor in the patient’s mother. Which of the following is the most likely diagnosis?

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

Which of the following is the correct order of venous structures related to cerebral blood drainage?

Cytotoxic edema would be best appreciated on which of the following MRI sequences?

Which of the following identifies the straight sinus?

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

A 72 y.o. female presents to the clinic with complaints of decreased interest in eating, and has lost weight. She states foods have an unusual taste and are not appealing. On detailed examination, she is found to have normal extraocular movements, normal facial muscle symmetry, and normal facial sensation and swallowing. On further detailed examination, she has a loss of taste sensation in the right anterior two-thirds of her tongue. Of the following, which is the most likely area of injury?

The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?