Quiz 07/21/2022 (4)

A 49-year-old female has had a 6-month history of difficulty swallowing and weight loss. On examination, she has generalized muscle loss. On strength examination, she has 3/5 proximally and 4/5 distally in the bilateral upper extremities. There are normal tongue movements and a normal jaw jerk reflex. Deep tendon reflexes in the bilateral upper extremities are normal and sensation is intact. An EMG is performed and outlined below. What is the most likely diagnosis?

A 19-year-old male with a history of a motorcycle accident 6 weeks ago with several bone fractures of the arms and legs was referred to the EMG lab with right arm numbness since the accident. Where is the most likely site of this patient’s neuronal injury?

A 47-year-old former football player with a history of diabetes and hypertension presents to the EMG lab with left upper extremity weakness and pain. Motor and sensory nerve conduction studies were normal. An EMG was performed and shown below. What is the most likely diagnosis?

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?

Which of the following is classically seen on electromyography in a patient with an acute neuronal injury?

With of the following CMT types present with an axonal pre-dominant peripheral neuropathy?

Which of the following is correct regarding the H-reflex?

A 6-month-old full-term female is referred to the clinic with persistent right shoulder and elbow weakness since birth. Which of the following is the most likely pathologic lesion?

A 45-year-old female who is a professional pianist was referred to the EMG lab for right-hand numbness and tingling. Based on the EMG data outlined below where is this patient’s pathological lesion?

What is the earliest NCS/EMG abnormality found in AIDP?

Which of the following statements is correct regarding F-waves?

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 57-year-old woman with a past medical history of hypothyroidism was referred to the EMG lab with a one-year history of right-hand numbness. Based on the EMG data shown below, what is the most appropriate next step in medical management?

A 57-year-old male with a past medical history of progressive weakness affecting all extremities and dysphagia for the past 6 months is admitted to the hospital. An EMG was completed as part of his workup and is shown below. Based on the available information what is the most likely diagnosis?

A 62-year-old man comes to the clinic complaining of a 2-month history of difficulties getting up from a chair, climbing steps at work, and lifting objects above his head. His primary care physician also noticed a rash on sun-exposed areas of the man’s body. EMG of proximal muscles on this patient with likely reveal which is the following?

A 49-year-old male with a chronic history of myalgias was referred to the EMG lab with progressive muscle weakness. Based on the EMG table shown below what is the most likely diagnosis?

A 66-year-old female comes to the EMG lab with the chief complaint of muscle cramps in the right lower extremity. She started having symptoms after treatment with a cholesterol-lowering medication but despite discontinuing the medication her symptoms persisted. Reflexes are 2+ in upper and lower extremities, except 1+ in the right Achilles. Nerve conduction studies of both lower extremities were normal. An EMG was performed and shown below. What is the most likely diagnosis?

A 35-year-old male with balance issues is referred for an EMG/NCS. Distal sensory loss of the feet, high-arched feet, and diffuse hyporeflexia are appreciated on the exam. His nerve conduction studies are shown below. Based on the available information what is the most likely diagnosis?

A patient with right leg weakness presents to the neuromuscular lab for electromyography. The image below depicts a spontaneous finding while evaluating the right tibialis anterior muscle. This finding is most consistent with which of the following?

Charcot Marie Tooth disease (CMT) is associated with which of the following pathologic findings?

A 65-year-old male is referred to the EMG lab with a recent right leg injury and associated weakness. Based on the EMG shown below, where is the most likely site of neuronal injury?

Which of the following is classically seen on electromyography in a patient with a chronic neuronal injury?

The patient is a 79-year-old male with a past medical history of myocardial infarction who was referred for a nerve conduction study (NCS) to evaluate his slowly progressive lower extremity numbness and weakness. Which of the following pathologies is most commonly associated with the findings shown in the (NCS) shown below?

Which is the following potentials on EMG has an irregular firing pattern?

Which of the following is the first abnormal EMG/NCS finding seen in a patient with carpal tunnel syndrome?

A patient with Duchenne muscular dystrophy (DMD) most likely has which of the following findings on electromyography (EMG)?

The F wave response is an:

Submaximal muscle stimulation is used during which of the following aspects of the nerve conduction study?

A 21-year-old female was admitted to the hospital with a 3 weeks history of progressive lower extremity weakness. An EMG was performed and the results were shown below. Based on the clinical history, examination, and diagnostic testing, the patient was started on plasma exchange (PLEX) therapy. After completing her PLEX therapy there was a marked improvement in her weakness. Although not shown below, which of the following additional NCS/EMG results were also likely present on the day of recording?

A neurology consult was placed for a 35-year-old male who was admitted overnight after a motor vehicle accident that occurred earlier in the day. He experienced multiple bone fractures, including the right humerus at the spiral groove. The primary team is concerned about a radial nerve injury. Which of the following findings are most likely to be found on EMG/NCS?

Which of the following is the most likely diagnosis based on the EMG provided below?

Which of the following nerve conduction study abnormalities is least likely to be seen during the initial phase of acute inflammatory demyelinating polyneuropathy (AIDP)?

A 71-year-old male with a history of mild ankle weakness and balance issues for the last 6 years is referred to the lab for a nerve conduction study (NCS). While performing the testing the patient states that a few of his siblings, as well as his father, had similar issues. Examination showed high arches and hammertoes. Based on the clinical history and NCS, what is the most likely diagnosis?

A 19-year-old male was admitted to the hospital with a 2 weeks history of progressive lower extremity weakness. CSF studies showed an elevated CSF protein and normal WBC count. MRI of the lumbar spine showed contrast enhancement of the cauda equina. His nerve conduction study (NCS) is shown below. What is the most appropriate next step in medical management?

A 57-year-old navy veteran with a history of PTSD presents with a 2-year history of progressive, asymmetric weakness. The patient states that symptoms started in his left arm. Six months later he started to have falls due to tripping over his right foot. His neurological examination shows weakness of the intrinsic hand muscles of the left arm, ⅖ strength on dorsiflexion of the right ankle, and no sensory disturbances. Reflexes were mute in the left upper extremity and there were several beats of clonus at the right ankle. Fasciculations were present in the tongue, right gastrocnemius, and left tibialis anterior. An EMG is recommended for diagnosis. Which of the following EMG findings are most likely seen in this patient?

A 30-year-old female with a history of Charcot-Marie Tooth disease, diagnosed with genetic testing that showed a duplication of the peripheral myelin protein (PMP22) gene, returns to the clinic for a routine follow-up. She expresses interest in starting a family and wants to know what is the risk of her children having the same issues. Which of the following is the most appropriate response?

Which is the following findings on EMG is suggestive of a chronic neurogenic lesion?

Mild cases of carpal tunnel syndrome will have which of the following findings on electromyography (EMG)?

A 55-year-old male with a recent history of losing 50 pounds after gastric bypass is referred to the EMG lab with difficulty walking. He has noticed that his left foot drags occasionally causing him to trip and that he has numbness on the top of his left foot up to the middle of his shin. Which of the following statements is the most accurate based on the EMG findings shown below?

Which of the following is most likely to show temporal dispersion of the action potential?

A 63-year-old woman with a history of right-sided breast cancer status post-mastectomy, chemotherapy, and radiation presents to your clinic with a 2 months history of right arm pain and paresthesias. Which of the following findings on EMG/NCS would most likely suggest a radiation-induced plexopathy over a recurrent neoplastic plexopathy?

Patients with Charcot-Marie Tooth disease that have the CMT1A phenotype will have which of the following genetic mutations?

A 38-year-old male with a history of sarcoidosis and a one-week history of subacute onset of progressive weakness was admitted to the hospital with difficulty ambulating. On examination, you appreciate bilateral lower extremity weakness and hyporeflexia. Based on the clinical history and EMG findings shown below what is the most likely diagnosis?

Cool limbs during a nerve conduction study will have which of the following effects on the data recorded?

Fibrillations and positive waves are first seen on electromyography (EMG) at which point following a nerve transection?

A 66-year-old right-handed male presents to the EMG/NCS lab with right upper extremity pain, numbness, and weakness. Based on the data collected, what is the most likely diagnosis?

EMG abnormalities in which of the following muscles can not localize to the brachial plexus?

Which of the following is the resting membrane potential of a neuron?

A 50-year-old male has noted winging of his right scapular and pain for the past four months following a hyperextension injury. Based on the EMG data outlined below where is this patient’s pathological lesion?

A 37-year-old female with a PMH of Sjogren’s, and a recent motor vehicle accident (MVA) is referred to the EMG Lab for evaluation of right arm pain/weakness. The patient endorses right head pain which radiates down her neck into the right shoulder and wrist. Examination shows 5/5 strength in the upper extremities except for 4+/5 deltoid and 4+/5 biceps strength in the right upper extremity. Sensation to light touch was intact throughout. Sensory nerve conduction studies of the right upper extremity were normal. Based on the patient’s EMG results outlined below what is the most likely diagnosis?