Quiz 07/12/2022

Immunohistochemical staining with GFAP is particularly useful in identifying which of the following cell types?

A young infant is found after birth to have an abnormality of the left arm. The arm is held down by the infant’s side, adducted and medially rotated, and the forearm is extended and pronated. What is the anatomic location of the injury causing the deficits?

A 23-year-old female with a history of optic neuritis presents with a 1-week history of left leg weakness. Neurologic examination reveals decreased strength of the left lower extremity. A lumbar puncture reveals oligoclonal bands with lymphocytic pleocytosis. What stain can be used to identify the dysfunctional cells in this condition?

A 62-year-old male with a past medical history of hypertension, type 2 diabetes, and dyslipidemia presents with a stepwise progression of worsening forgetfulness over the last three years. Physical examination reveals a score of 20/30 on the Mini-Mental State Examination with deficits in multiple cognitive domains. Hyperreflexia in the left upper and lower extremities is also appreciated. Her axial FLAIR sequence brain MRI scan is shown. Which of the following is the most likely diagnosis?

A chronic alcoholic is admitted to the hospital for altered mental status. An MRI is performed and shown below. What symptoms/signs are most likely seen on examination?

A 56-year-old female with a past medical history of IgA deficiency presents to the emergency room with a 4-day history of progressive, ascending lower extremity weakness. Neurological examination reveals flaccid paralysis of the bilateral lower extremities and areflexia. Imaging of the lumbar spine shows contrast enhancement of the cauda equina and CSF studies show elevated proteins and a normal WBC count. What is the most appropriate next step in therapy?

Which of the following vessels that supply the thalamus originates from the P2 segment of the posterior cerebral artery and supplies the lateral geniculate nucleus?

A previously healthy 59-year-old male presents with an acute onset of slurred speech and left-sided weakness. The symptoms started 7 hours ago. On arrival, his NIHSS is 8 and his EKG shows a normal sinus rhythm. Vessel imaging is done and shows a right middle cerebral artery occlusion, so the patient undergoes a successful mechanical thrombectomy and has minimal residual neurological deficits. A post-thrombectomy CT head is performed and negative for blood. Which of the following options is the most appropriate next step in medical management?

Patients with narcolepsy and cataplexy have a deficiency in which of the following neuropeptides?

A 68-year-old female presents with a one-year history of progressive memory problems and deteriorating mobility. Upon further questioning the patient notes incontinence. A physical exam reveals a wide-based gait with shuffling steps. A brain MRI shows widening of the temporal horns of the lateral ventricles. Which of the following is the best next step in management?

Mutations in the progranulin protein (gene PGRN) can serve as a biomarker for the risk of which of the following diseases?

An MRI brain is ordered for a 6-month-old male with failure to thrive, dystonia, and regression of developmental milestones. The T2 axial images are shown below. Which of the following is most likely the diagnosis?

Which of the following transverses through the structure (blue arrow) shown below?

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?

This muscle biopsy is most consistent with which myopathic disease?