Quiz 07/12/2022 (1)

A 38-year-old man with a prolonged history of intravenous drug use, HIV, and poor compliance with HAART therapy is brought to the hospital by police after being seen wandering across a busy street intersection. His last CD4 count was 180 cells/microliter 8 months ago. Vitals appear within normal limits on arrival. Neurological examination shows inattention, poor short-term memory, and difficulties with abstract thought. An MRI is performed and shown below. What is the likely etiology of his symptoms?

A 65-year-old woman with a past medical history of hypertension, hyperlipidemia, and migraine headaches previously well-controlled on propranolol, presents to the clinic with new headache characteristics. The patient states that she recently has a new scalp tenderness. On further history, she endorses jaw soreness after eating. What is the most appropriate initial diagnostic test?

A 78-year-old man presents to the ER with headache, fever, diplopia, and hiccups. MRI with the brain with and without contrast shows small contrast-enhancing abscesses in the brainstem, sparing supratentorial cerebral tissue. Which of the following infectious agents classically presents in this fashion?

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?

A 32-year-old Chinese male is referred to the epilepsy clinic after experiencing two episodes concerning for possible seizures. The first episode was unwitnessed, but the patient states that there was an abrupt loss of consciousness and that he woke up with the side of his tongue bitten and generalized myalgias. The second event was witnessed by his wife who noticed one day that the patient was unresponsive and lip-smacking for 2 minutes before returning back to baseline. MRI brain was performed and showed left-sided mesial temporal sclerosis. Which of the following medications should be avoided for this patient?

This muscle biopsy is most consistent with which myopathic disease?

Which of the following is the antibody associated with dermatomyositis that is known to confer the highest risk of cancer?

Patients with Charcot-Marie Tooth disease that have the CMT1A phenotype will have which of the following genetic mutations?

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

What is the benefit of using glucocorticoids in the treatment of bacterial meningitis?

Which of the following is the reversal agent for apixaban?

Oculomotor nerve palsy is most likely to be seen secondary to an aneurysm in which of the following arteries?

Cool limbs during a nerve conduction study will have which of the following effects on the data recorded?

A 10-year-old female from the northeastern United Stated presents to the ED with her mother after a one-week history of difficulties in school and difficulties with speech. Her mother states that two weeks ago the patient had a rash on her leg and viral-like symptoms that went away within a few days. Then, this past week the patient’s teacher reported that she was having difficulties with attention in school and was performing very poorly on assignments. Her mother also confirmed that the patient has been more forgetful and is also slurring her speech. An MRI of the brain was performed and it showed multifocal white matter lesions. Of note, the patient likes to spend a lot of time outdoors and recently went on a camping trip. Which of the following is the most likely cause of the patient’s symptoms?

Which of the following identifies the straight sinus?