Quiz 07/15/2022 (4)

Which of the following autoantibodies are associated with myasthenia gravis?

An 87-year-old male presents with a 2-year history of worsening cognitive decline and speech difficulties. Brain MRI reveals multiple chronic cerebral infarcts. The neurological exam reveals adequate comprehension and fluency but naming was impaired. What is the most likely diagnosis?

A 75-year-old female with a past medical history of hypertension on lisinopril presents to the emergency department with weakness on the left side of the body and a drooping right eye. On exam, her right eye is inferiorly and laterally deviated. This pupil is also non-reactive. Her strength is 3/5 on the left side. Where is this patient’s lesion?

You are interested in initiating tetrabenazine for a patient with refractory chorea. You should educate the patient that this medication carries a black box warning for which of the following?

What is the pathophysiology that leads to the pathology shown in the image below?

A 57-year-old man with a past medical history of bipolar disorder, atrial fibrillation, and type 2 diabetes presents to the clinic with complaints of a tremor. Symptoms have been present for years but they have not seemed to progress significantly over time. His current medications are warfarin, metformin, low-dose aspirin, and lithium. His neurological examination was unremarkable except for the presence of a fine, high-frequency tremor in his bilateral upper extremities. Based on the most likely diagnosis, what is the most appropriate next step in medical management?

A 75-year-old man with a past medical history of hypertension, hyperlipidemia, and diabetes presents with acute onset right arm weakness and speech problems. He can speak fluently and his comprehension is intact. However, he is unable to repeat even simple sentences. Reading and writing are preserved. Which of the following is an accurate description of his speech dysfunction?

What is the typical brainstem auditory evoked response (BAER) finding with cortical hearing loss?

A 77-year-old male presents with a 1-year history of worsening bradykinesia, recurrent falls, and a shuffling gait. Past medical history is significant for REM-sleep behavior disorder and diet-controlled hypertension. Neurologic examination reveals a tremor at rest that improves with movement, along with bilateral upper-limb rigidity. Impaired dopaminergic signaling is most likely to be found in which of the following locations?

A 75-year-old female with a past medical history of atrial fibrillation and hypertension presents to the ER with garbled speech. She seems unaware that her speech is nonsensical. On physical exam, she is unable to follow verbal commands but can understand visual cues. An ischemic injury is suspected. If this is true, a brain MRI would show which of the following areas of the brain is/are affected?

Which of the following nerves when damaged can lead to scapular winging?

A 72-year-old male with a past medical history of hypertension presents with an acute onset of right upper and lower extremity weakness. The sensory exam is normal. Right homonymous hemianopia is also appreciated. Which of the following vessels is most likely affected?

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

You are caring for a 78-year-old man with slowly progressive memory loss and behavioral change. You are concerned about either frontotemporal dementia (FTD) or Alzheimer’s disease (AD). Which of the following tests would be the most sensitive and specific in differentiating the two?

A 61-year-old male with no past medical history presents to the clinic with difficulty moving for the past year. He states that it takes him a lot longer to do daily tasks such as walking to the mailbox and that it is getting worse. He is accompanied by his daughter who states that she notices that he shuffles his feet when walking. On physical exam, the patient is observed to have a 4-6 Hz resting tremor in his hand. Pathologic examination of this patient’s brain tissue would most likely show which of the following?