Quiz 07/19/2022 (3)

A 68-year-old woman with no significant medical history presents in the emergency room with acute aphasia and right-sided weakness. Her wife who is in the room states the patient was last seen well one hour prior to arrival at the hospital. A CT scan of the head showed no acute hemorrhage. After screening the patient and discussing the risks and benefits of acute pharmacological therapy with her significant other the patient was given intravenous tPA. Thirty minutes later the patient had an acute neurological decline. She was sent for a repeat CT scan which showed a new 16 cc intraparenchymal hemorrhage in the left hemisphere. What is this an example of?

A 50-year-old male with a 1-year history of behavioral changes and abnormal movements has a CT head performed after having a fall at his nursing home. Based on the imaging and brief clinical history what is the likely genetic abnormality associated with his neurological disease?

Narcolepsy is associated with which of the following HLA alleles?

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

A 32-year-old female with a history of schizophrenia is brought to the emergency room by her husband for acute psychosis. She receives a medication while in the emergency room to aid in her agitation. Soon after administration, the patient develops involuntary contractions of muscles of her face and neck. Which of the following medications was most likely administered to cause these symptoms?

A 56-year-old male comes to the clinic with a burning and tingling sensation in his feet and hands for the past 4 months. He has a history of morbid obesity and underwent gastric bypass surgery last year. On physical exam, he has 3+ ankle and patellar reflexes. He also has a positive Babinski and positive Romberg sign. There is impaired position and vibration sense in his big toe bilaterally. This patient’s condition is most likely due to a deficiency of which of the following?

What findings would be found on EMG/NCS in a patient who presents with a small fiber neuropathy?

A 62-year-old male with a past medical history of hypertension, type 2 diabetes, and dyslipidemia presents with a stepwise progression of worsening forgetfulness over the last three years. Physical examination reveals a score of 20/30 on the Mini-Mental State Examination with deficits in multiple cognitive domains. Hyperreflexia in the left upper and lower extremities is also appreciated. Her axial FLAIR sequence brain MRI scan is shown. Which of the following is the most likely diagnosis?

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 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?

What task is likely being performed during this EEG recording?

What is the anatomical structure marked by the blue arrow?

A 15-year-old male is brought to his primary care doctor by his parents because of learning difficulties in school. Examination revealed several pigmented skin lesions (see below). Which of the following additional findings may be present on examination?

A 32-year-old female comes into the clinic with a continuous, throbbing headache for 5 months. The pain is unilateral near the temple. The headache is constant but there are periods of pain exacerbations that can last from minutes to days and are debilitating. There is associated lacrimation and rhinorrhea on the ipsilateral side. What is the most likely diagnosis?

A 24-year-old patient had a severe unhelmeted motorcycle accident and despite best efforts by medication providers, he passed away two days later. An autopsy was performed. Identify the structure marked by the white arrow.