Quiz 07/21/2022

A 77-year-old male presents with a 1-year history of worsening bradykinesia, recurrent falls, and a shuffling gait. Past medical history is significant for REM-sleep behavior disorder and diet-controlled hypertension. Neurologic examination reveals a tremor at rest that improves with movement, along with bilateral upper-limb spasticity. Impaired dopaminergic signaling is most likely to be found in which of the following locations?

Identify the pathologic finding marked by the red arrow.

A 50-year-old female presents with altered mental status. Her family states that over the past couple of weeks, the patient has had progressive memory loss, mood changes, and poor judgment. On examination, the patient has involuntary arm movements and an exaggerated startle response. Brain MRI, DWI sequence, is shown below. Which of the following is the most likely diagnosis?

A previously healthy 15-year-old male presents to the emergency room after experiencing a concussion while playing soccer. He is now back to baseline but to be thorough the ED physician orders an MRI which is shown below. What is the lesion shown in this MRI?

A 12-year-old boy with a past medical history of sickle cell disease was admitted to the emergency room in a pain crisis. While being treated with morphine the patient developed acute left arm/leg weakness and numbness. Which of the following is the most likely etiology for the patient’s new neurologic symptoms?

Cytotoxic edema would be best appreciated on which of the following MRI sequences?

A 37-year-old female presents to the emergency room with diplopia and ambulation issues. Other than having an upper respiratory tract infection two weeks ago, there is no other significant past medical history. On physical exam, the patient has a decreased range of motion of the extraocular muscles bilaterally, diffuse areflexia, and marked dysmetria on finger-to-nose and alternating movements testing. Which of the following autoantibodies is most likely associated with this disease?

A 67 y.o. female with HTN and atrial fibrillation on coumadin was in the Neuro ICU in a comatose state after a large intracranial hemorrhage. After a couple of days of monitoring, she had a new finding on her physical exam that prompted stat imaging, which showed signs of uncal herniation. Surgery was not performed due to goals of care preferences, and she, unfortunately, passed away from her ailment. An autopsy was requested. The image below shows compression on a cranial nerve from the herniation. Through which anatomic structure does this nerve pass to exit the skull?

The usage of bupropion increases the risk of which of the following?

A 55-year-old female with a past medical history of coronary artery disease and ischemic stroke with residual mild left arm weakness presents with headaches for a year. Episodes occur two to three times a month. The pain is unilateral and is associated with nausea and photophobia. During this episode, she is unable to go to work and over-the-counter anti-inflammatories have been ineffective. Physical exam and vitals are normal. Which abortive therapy is the most appropriate next step in management?

What clinical diagnosis does this EEG tracing suggest?

The pathology shown in the image below is likely secondary to which of the following?

Which of the following structures is well myelinated in a full-term (40-week) infant?

A chronic alcoholic is admitted to the hospital for altered mental status. An MRI is performed and shown below. What symptoms/signs are most likely seen on examination?

A 16-year-old girl is seen in the clinic for episodes concerning for seizures. Episodes are characterized by staring off, unresponsiveness, and licking her lips for 30 to 60 seconds. Two weeks ago one of these episodes developed into a generalized tonic-clonic seizure. That day she went to the emergency room and had an MRI performed. The associated images are shown below. Based on the clinical history and imaging what is the most likely diagnosis?