Quiz 07/17/2022

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?

Optic nerve glioma is associated with which of the following diseases?

A 32-year-old woman comes into the clinic complaining of severe right-sided headaches around the temple. The pain occurs several times a day and lasts approximately 15 minutes and radiates to the right shoulder and arm. There is also associated nasal congestion and lacrimation during the episodes. The patient was treated with indomethacin with complete resolution of symptoms. What is the most likely diagnosis?

A 68-year-old male presents with complaints of insomnia for 2 years. On further questioning, he also endorses a 2 years period of feelings of guilt about his sleeping, considerably low appetite (current BMI = 17), and low energy. He used to enjoy checkers but has lost interest in most activities these days. He denies suicidal ideation. He has previously declined medications to help with this, but he says he is ready to try something. Which of the following medications is most appropriate?

A 24-year-old with a history of a motor vehicle accident and a broken leg is referred to the EMG lab with a left leg foot drop. Based on the EMG table outlined below, where is the most likely site of neuronal injury?

A 32-year-old woman with a known history of relapsing-remitting multiple sclerosis currently on ocrelizumab presents to the emergency room with the concern of having a demyelinating attack. An MRI brain with contrast shows a single, ovoid, juxtacortical white matter lesion with contrast enhancement that was not present on her last MRI scan. Which of the following is the most appropriate next step in medical management?

A 78-year-old male with a past medical history of diabetes presents to the clinic with a 2-year history of progressive lower extremity numbness and pain. He describes the pain as “pins and needles”. Physical examination reveals loss of pinprick sensation to the ankles bilaterally, mute Achilles reflexes, and moderate difficulty with tandem gait. A diagnosis is made based on examination and clinical history. What is the mechanism of action of the most appropriate first-line therapeutic agent?

A 17-month male was brought to the pediatric neurology clinic was brought to the clinic with concerns for developmental delay. Parents note that the child was a product of a normal pregnancy and his delivery was uncomplicated. A developmental delay was appreciated by 8 months of age. He is largely non-verbal. He appears happy in the room, laughing spontaneously without any external stimuli. Which of the following abnormalities most likely explains this developmental disorder?

A 32-year-old female who is currently 39 weeks pregnant was brought to the emergency room after experiencing a first-time seizure. Neurological examination is non-focal except for mild somnolence and decreased visual acuity in both eyes. Vitals signs were normal except for a blood pressure of 192/104 mmHg. An MRI was performed and shown below. Which of the following is the most appropriate step in management?

A mutation in which of the following genes would be most likely in a patient with numerous cavernous malformations seen on head imaging?

A morbidly obese patient with a past medical history of brainstem stroke and excessive daytime sleepiness undergoes polysomnography. Polysomnographic testing revealed an average of 8-10 apnea/hypopneas per hour during sleep. During prolonged periods of apnea, there were no out-of-phase movements on plethysmography. Which of the following is the most likely diagnosis?

Which of the following is associated with a “delta brush” pattern on EEG?

A 35-year-old male presented for sudden onset painless central vision loss. An outside hospital emergency room physician suggested he may have had a CRAO, but recommended immediate ophthalmology outpatient evaluation. The patient was unfortunately lost to follow-up for a few months. He presents today due to a sudden onset of central vision loss in the other eye.

On your ophthalmologic exam, you note hyperemic optic nerve and tortuous central retinal vessels, without evidence of vessel cutoff. He has a central scotoma bilaterally, with peripheral vision intact. He has red color desaturation as well. MRI brain w/ and w/o contrast with fat suppression and thin cuts through the orbits is performed, and normal.

This disorder is caused by which of the following pathologic processes?

Paralysis of the stapedius muscle can occur with ipsilateral damage to which cranial nerve?

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?