Quiz 07/18/2022

What is the pathophysiology of the lesion provided below?

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

A 40-year-old male is brought to the emergency room unresponsive after getting into a motor vehicle accident. On physical exam, his pupils are equally reactive to light. He can close his eyes and look up and down but not side to side. His motor exam otherwise has 0/5 strength symmetrically. The Babinski reflex is upgoing bilaterally. These symptoms can be explained by occlusion of which of the following vessels?

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

Which of the following is present in the image shown below?

A patient with a history of a chronic ischemic stroke has an MRI performed for new-onset seizures. Based on the imaging provided, what is the likely etiology of the patient’s past stroke?

A patient with a history of hypertension and provoked seizures secondary to posterior reversible encephalopathy syndrome (PRES) has come to your clinic for a 6-month follow-up after her associated hospitalization. It was found that abrupt discontinuation of her hypertensive medications due to medication noncompliance was the cause of the PRES. She was started on the anti-seizure medication (ASM) levetiracetam at the time of her PRES and has had no seizures since being discharged. She asks you about the risk of future seizures. What is the most appropriate response?

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

Identify the lesion below.

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?

A 69-year-old female is brought to the emergency room by her daughter for excessive stumbling, often tripping on things on the floor. The daughter also says her mother has been behaving oddly, complaining about seeing darkness in a fully lit room, and the inability to recognize her family members. Bilateral pupillary light reflexes are normal. If symptoms are secondary to an ischemic injury, an MRI would show a lesion in which of the following regions?

Which of the following vessels drains into the sigmoid sinus?

A 65-year-old right-handed man presents with acute onset speech difficulties, a mild right-sided facial droop, and right-sided arm weakness. While talking to his wife over breakfast this morning he suddenly stopped speaking and could only make unintelligible sounds. On examination, he is unable to speak any words but has intact comprehension. He is able to write clearly what he wants in full sentences with intact grammar and reading is also preserved. Which of the following best describes his language deficit?

Which of the following is the most likely cause of the findings appreciated on the axial CT head shown below?

Which of the following medications has been shown to improve neurological outcomes in patients with subarachnoid hemorrhage?

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?

A 65-year-old female presents with complaints of hearing a strange “clicking sound” all of the time which started suddenly 6 weeks ago. On exam, you note a rhythmic tremor of the upper palate. The patient also has pendular horizontal nystagmus. Which MRI finding is most likely?

Which of the following antiplatelet medications rely heavily on the cytochrome P450 system for its therapeutic effect?

Which of the following is the reversal agent for dabigatran?

A 65-year-old male with a past medical history of diabetes, hypertension, and a 40-pack-year smoking history comes into the ED with an acute onset of ataxia, left facial numbness, right arm, and leg numbness, and dizziness. He also has intractable hiccups. A CTA angiogram shows the cause of the patient’s symptoms. Based on the clinical exam, which of the following arteries is occluded?