Quiz 07/20/2022 (5)

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?

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 31-year-old male comes to the clinic for evaluation of recurrent nightmares after returning from a tour of duty with the military two months ago. He is unable to concentrate on his new desk job and flinches every time he hears a door close. While once an avid bowler, he no longer goes to the bowling alley because the sounds of the pins falling remind him of bomb explosions. Which of the following is the most likely diagnosis?

A 75-year-old patient is brought by her husband because of word-finding difficulty. On cognitive testing, the most impressive finding was that the patient couldn’t recall many colors of the rainbow. Based on this finding, what kind of memory is most impaired?

A 64-year-old woman is brought to the office by her husband for changes in her speech pattern. While neurocognitive testing was largely unremarkable, her spontaneous speech appears effortful, halting, and laced with grammatical errors. MRI of the brain revealed left posterior frontal and insular atrophy. Which of the following is the most likely diagnosis?

A 65-year-old woman with a past medical history of hypertension presents with recent onset of bilateral eye discomfort and diplopia. She states that she is unable to completely close her eyes. On exam, pain is elicited when testing extraocular movements. Visual acuity and visual fields are unremarkable. MRI of the brain reveals excessive peri-orbital subcutaneous tissue bilaterally. Which of the following is the most likely diagnosis?

Which one of the following pairs regarding antipsychotic drugs and their adverse effects is incorrect?

What is the most appropriate therapy for the infection depicted in the pathology slide below?

You are caring for a 50-year-old with amyotrophic lateral sclerosis (ALS). Which of the following disorders is most likely to also develop in patients with ALS?

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?

A 7-year-old girl presents with 2 weeks of a right-sided unilateral throbbing headache. She has otherwise been healthy with no other symptoms and has no past medical history except for a light pink birthmark around her right eye. What is the most appropriate next step?

Which synapsed of the peripheral nervous system is acetylcholine the primary neurotransmitter?

Which of the following arteries provides the prominent supply to the posterior limb of the internal capsule?

A 27-year-old woman comes to the clinic for a routine checkup. She appears shy and does not make much eye contact. She mentions that she doesn’t have many friends because feels like she doesn’t deserve them and is fearful of rejection. She has had some depressive episodes in the past, but “does not want to bother anyone” about it. Which of the following is the most likely diagnosis?

A 27-year-old presents to the clinic with finger extension, wrist extension, shoulder abduction, and shoulder adduction weakness. There is also numbness along the lateral and posterior arm. Which of the following is the most likely cause of the patient’s symptoms?

A 45-year-old female with a past medical history of hypertension and medication non-adherence presents to the emergency department with weakness on the left side of the body and a drooping right eye. Her blood pressure is 220/100. On physical exam, her right eye is inferiorly and laterally deviated and the pupil is non-reactive. Her strength was 3/5 on the left side. MRI brain identifies an ischemic lesion. Based on the clinical exam, which of the following arteries is most likely the cause of the patient’s symptoms?

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?

Which of the following medications can potentially reduce the platelet inhibition of clopidogrel?

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?

An 18-year-old woman with a history of symptomatic epilepsy presents with medically-refractory seizures. An MRI brain is performed during presurgical evaluation and reveals the non-contrast-enhancing lesion shown below on T2 FLAIR. This lesion is most likely which of the following?