Quiz 07/21/2022

What clinical diagnosis does this EEG tracing suggest?

A 38-year-old man with long-standing migraines was recently hospitalized for an unprovoked seizure. Upon further questioning, the patient admits to a strong family history of headaches and early strokes. A brain MRI is completed and a T2 sequence image is shown below. This patient likely has a mutation in which of the following genes?

A 59-year-old woman presents to the emergency room with dizziness and left ear fullness. The symptom is described as a spinning sensation that is present at rest and with action. She has had comparable events before, which have self-resolved over time. The patient is ataxic on the exam and has difficulty hearing out of her left ear. An MRI brain with and without contrast was normal. Which of the following is the most appropriate line of therapy that will decrease the risk of future recurrent events?

A 14-year-old girl with no significant past medical history presents with an acute presentation of left-sided weakness. CTH was negative but MRI shows an acute lacunar ischemic stroke in the right hemisphere. An angiogram was performed which revealed segmental arterial constriction followed by segments of arterial dilation in multiple intracranial vessels. Which of the following is the most likely etiology of her ischemic stroke?

A 52-year-old woman is brought to the emergency room in respiratory distress. She is accompanied by her husband who stated that they were eating at a high-end sushi restaurant when his wife started to complain of perioral numbness and tingling. Two hours later she started to complain of generalized weakness and trouble breathing. Accidental poisoning is suspected. Based on the available information, what is the mechanism of action of the poison ingested?

A 40-year-old woman of Chinese descent has a cerebral angiogram performed after experiencing recurrent ischemic strokes over the past 5 years. This image is most consistent with which neurological disease?

Which of the following cranial nerves is most likely to be affected by increased intracranial pressure?

Which of the following vessels that supply the thalamus originates from the P2 segment of the posterior cerebral artery and supplies the medial geniculate nucleus?

389 Patients who had acute unilateral optic neuritis were enrolled between 1988-1991 in a study and followed for 15 years to assess their risk for developing multiple sclerosis (MS). They found that the probability of developing MS within 15 years was 50%. What type of study was this?

A 32-year-old man with a 4-week history of painful swelling on his right forehead presents to the emergency room. A CT scan of the head was performed and is shown below. What is the most likely diagnosis?

Which of the following blood vessels that supply the thalamus is the only one to branch off of the posterior communicating artery (PCOM) instead of the posterior cerebral artery (PCA)?

A 16-year-old male is brought to the emergency room by his parents for generalized weakness. The patient states that he woke up in the morning that day with flaccid paralysis of his arms and legs which was so significant that he couldn’t get out of bed. In typical teenage boy fashion, he wasn’t very worried about this at the time and went back to bed. It wasn’t until 4 hours later when he woke up again with the same degree of weakness that he became concerned and screamed for his parents to help. The patient denies any recent drug or alcohol use. The only interesting thing from the previous night was that he partook in and won a pizza-eating contest with his friends. The patient’s father admits to having had similar episodes to this when he was younger. If the patient’s symptoms are due to a genetic disorder, a mutation in which of the following genes is most likely responsible?

In the diagram below, what neurologic information is carried by the tract labeled with the green arrow?

Which of the following is the primary source of norepinephrine in the brain?

Identify the lesion shown in the image below.

Which of the following statements regarding Alexander’s disease is incorrect?

A 64-year-old man with idiopathic Parkinson’s disease being treated with carbidopa-levodopa is experiencing significant wearing-off despite increasing frequency and dose of levodopa-carbidopa, which is now producing significant peak dose dyskinesia. Which of the following would be a reasonable next agent to prescribe to reduce this wearing-off effect?

Which of the following brain metastases has the highest risk of intracranial hemorrhage?

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

An otherwise healthy 17-year-old female presents to the emergency department with right arm weakness. The symptoms started insidiously over the weekend and haven’t improved over the last 3 days. Examination shows 4/5 strength of the right upper extremity. A brain MRI is performed and shows a T2 hyperintense lesion in the subcortical white matter with contrast enhancement. No other lesions are seen. Upon further questioning, she states that she has never experienced any similar episodes of transient neurologic symptoms before. Which of the following is the correct diagnosis?