Quiz 07/17/2022

A patient with a clinical history concerning for hydrocephalus has an MRI brain completed (see below). Surgical resection was completed and genetic analysis revealed no presence of an IDH mutation or 1p/19q co-deletion. What is the most likely diagnosis?

Which of the following is the correct order of venous structures related to cerebral blood drainage?

Bilateral exotropia is typically seen with which of the following lesions?

A 62-year-old woman with low back pain presents to the emergency department complaining of 4 weeks of a strange sensation when wiping with toilet paper, as well as urinary and fecal incontinence. On exam, she has 5/5 strength throughout her limbs and normal deep tendon reflexes. What is the location of her lesion?

A 30-year-old woman with well-controlled epilepsy with lamotrigine monotherapy comes to the clinic today stating that she and her husband are planning to start a family. Which of the following statements is most correct regarding her clinical situation?

An 83-year-old man with a history of Parkinson’s disease is brought to the office with worsening hallucinations. She says that she sees things around the house and is starting to get paranoid that their neighbors are spying on them. Which of the following medications would help this patient’s symptoms?

A 40-year-old male presents with a one-day history of numbness of his right arm. This has never happened before, but he does report an episode of left leg weakness that self-resolved two years ago. The neurological examination confirms a sensory disturbance of his right arm. Sagittal MRI of the cervical spine is shown below (Left: T1, Middle: T1 with contrast, Right: T2). Which of the following is the most likely diagnosis?

A 56-year-old man with a past medical history of hypertension and type II diabetes presents to the hospital with acute onset left-sided weakness which started 90 minutes prior to your evaluation. His only medications prior to admission were metformin and verapamil. Vitals were within normal limits except for a blood pressure of 154/92. Physical examination reveals 3/5 weakness in the left arm, leg, and face as well as a moderate sensory disturbance in the same regions. CT head was unremarkable and CT angiogram (CTA) showed no large vessel occlusion. A brief history gathered from his wife revealed no other comorbidities or active medical issues. At this point in his clinical presentation, what is the mechanism of action of the most appropriate therapy?

A 5-year-old female was brought to the neurology clinic for a second opinion for paroxysmal spells of dizziness. The family states that several times a month the patient will develop severe dizziness, nausea, and vomiting. Symptoms usually only last less than 5 minutes. An MRI and 24-hour ambulatory EEG have been performed in the last 3 months. Both were unremarkable. What is the most likely diagnosis?

A four-day-old, full-term male with an uncomplicated vaginal delivery is brought urgently by his mother to the clinic after an episode concerning for possible seizure. His mother states that this morning when she accidentally dropped a pile of dishes on the floor, the child “tensed up”. She states that both his upper and lower limbs became rigid and he had violent jerking movements of all limbs for approximately 40 seconds. This patient’s condition is most likely due to a mutation in which of the following genes?

Which of the following findings is most typically seen with HIV-associated neurocognitive disorder?

You are caring for a 1-month-old infant in the neonatal ICU with abnormal movements since birth. The baby is seen writhing in bed, with her arms and legs and axial trunk moving in a snake-like pattern. A CT head is done and shows bilateral cystic lesions on the basal ganglia. Toxic levels of which of the following are most likely at play?

A 41-year-old female smoker with HTN is admitted to the Neuro ICU after having acute onset worst headache of life, found to have hyperdensity tracking sulcal lines on CTH. Her physical exam is otherwise normal on admission. On the fourth day of admission, she develops acute onset right arm and leg weakness and aphasia. She was last seen well 30 minutes prior. Which of the following is true?

A 37-year-old retired nurse is being evaluated in the emergency room for excessive diarrhea. She has been in the emergency department multiple times in the past for similar complaints and diagnostic testing has repeatedly been unremarkable. While casually talking to the nursing staff, the patient accidentally knocks over her purse and several bottles of laxatives fall out. Which of the following is the most likely diagnosis?