Quiz 07/13/2022

Which of the following is the mechanism of action of ropinirole?

A 46-year-old male with a 2-month history of progressive headache and behavioral changes presents to the ED after experiencing a first-time seizure. An MRI was performed and shown below. A brain biopsy confirmed the diagnosis when it found pseudopalisading necrosis and microvascular proliferation. Which of the following treatment(s) is the standard of care for this patient?

A 32-year-old man with a past medical history significant for major depressive disorder is brought to the emergency department after he was found by his roommate attempting suicide by hanging. His roommate states that he has been noncompliant with his medications and had been going through a depressive episode before his suicide attempt. After 6 weeks of trying several different antidepressants while on the inpatient psychiatric service, his major depression symptoms have not improved. Which of the following is the most appropriate next step in treatment?

Which of the following embryologic derivatives myelinates the peripheral nervous system (PNS)?

Which of the following seizure characteristics are typically seen in patients with temporal lobe epilepsy?

A 36-year-old woman was recently started on natalizumab for management of her multiple sclerosis. Over the next several months, she develops progressive weakness, incoordination, and speech disturbances before passing away six months after initiating natalizumab. Testing for which of the following pathogens should have been performed prior to natalizumab initiation to prevent this outcome?

A 16-year-old male with no significant past medical history presents to the emergency room with vision complaints and coordination issues. Four days ago, he began experiencing double vision and since then has had progressive difficulty picking up objects and buttoning his shirts. On physical exam, the patient has a decreased range of motion of the extraocular muscles bilaterally, as well as areflexia and ataxia when walking. What is the most likely diagnosis?

A 23-year-old female with a past medical history of depression presents with right arm paralysis that started after she found out her boyfriend died from a motor vehicle accident. Her physical exam shows no effort during muscle strength testing and positive withdrawal when a noxious stimulus is applied. The rest of the neurological examination, including reflexes, was normal. MRI of the brain and cervical spine were unremarkable. Which of the following is the most likely diagnosis?

Patients with neurofibromatosis type 1 (NF1) classically have which of the following associated with their disease?

A 28-year-old woman of Chinese descent was recently diagnosed with focal/symptomatic epilepsy. Which of the following medications should best be avoided in the management of her epilepsy?

A 10-month-old male with no significant past medical history has had a 2-month history of abnormal movements. The family describes these events as head drops and head-turning. On examination, horizontal nystagmus is appreciated. MRI revealed no abnormal findings. What is the most likely diagnosis?

Which is the following potentials on EMG has an irregular firing pattern?

Which direction are the patient’s eyes moving at the points marked by the green circles?

Which of the following testing can be used to diagnose a small fiber neuropathy?

A 50-year-old man presents with slowly progressive cognitive decline and personality changes. Over the past several months, he has been having trouble remembering the names of relatives/close friends and he has also become more apathetic. He is known to have trisomy 21. His exam is notable for memory deficits, but no rigidity or tremor. What is the name of the region of the brain that synthesizes the neurotransmitter that is decreased in this patient’s disease?