Quiz 07/17/2022 (1)

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

A 25-year-old female presents to the clinic with headaches for a year that occur two to three times a month. The pain usually occurs on one side and is associated with nausea and light and sound sensitivity. During these episodes, she is unable to go to work. Over-the-counter anti-inflammatories are ineffective. Physical exam and vitals are normal. Which therapy is the most appropriate next option in treatment?

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?

Which of the following is most likely to cause the pathology seen in the image below (white arrow)?

You are consulted to the psychiatric hospital to see a 48-year-old female with schizophrenia who has been under psychiatric care for 2 weeks after ingesting hundreds of pennies over a prolonged period. You are asked to address her new complaints of numbness in her feet and trouble walking. On exam, she had a broad-based gait and a positive Romberg. What could explain these findings?

A 72-year-old male with diabetes, hyperlipidemia, and tobacco abuse is admitted to the stroke service after he is found to have a left superior middle cerebral artery territory stroke. His EKG on admission showed a normal sinus rhythm. A transthoracic echocardiogram (TTE) is performed. Which of the following findings on TTE would lead to the recommendation of an anticoagulant medication over an antiplatelet medication for secondary stroke prevention?

A 37-year-old female with a PMH of Sjogren’s, and a recent motor vehicle accident (MVA) is referred to the EMG Lab for evaluation of right arm pain/weakness. The patient endorses right head pain which radiates down her neck into the right shoulder and wrist. Examination shows 5/5 strength in the upper extremities except for 4+/5 deltoid and 4+/5 biceps strength in the right upper extremity. Sensation to light touch was intact throughout. Sensory nerve conduction studies of the right upper extremity were normal. Based on the patient’s EMG results outlined below what is the most likely diagnosis?

A 55-year-old male presents to the clinic with a complaint of right lower extremity pain and weakness. On examination of the right lower extremity, there is decreased sensation to pinprick on the medial calf and foot, 4/5 strength with knee extension, and a mute patellar reflex. These findings are most likely due to radiculopathy of which of the following nerve roots?

A 57-year-old male with an unknown past medical history who recently immigrated from South Asia presents to the emergency department with new-onset skin lesions on his arms. On physical exam, the patient has two large, erythematous lesions with a clearly demarcated but flat border. The nerves around these lesions appear thickened. Biopsy of the lesions shows epithelioid cell granulomas and few bacteria. What is the most likely diagnosis?

A 20-month-old female presents for regression of milestones. She was walking, and now crawls or refuses to move. The parents are concerned she may be having seizures because they notice she has intermittent jerks of the limbs and trunk, especially when she is startled. on physical exam, you note conjugate random darting of the eyes in vertical and horizontal directions. Tone, strength, and deep tendon reflexes are normal.

What test is most likely to identify the underlying etiology of this problem?