Quiz 07/22/2022

Which of the following is the mechanism of action of mitoxantrone?

A 68-year-old male with a 10-year history of Parkinson’s disease comes to the clinic for routine follow-up. He currently is taking levodopa/carbidopa, entacapone, and ropinirole. The patient is complaining of significant dyskinesias and unpredictable motor fluctuations between doses of levodopa/carbidopa. What is the most appropriate next best step in management?

A 66-year-old male presents to the emergency room as an unrestrained driver in a motor vehicle accident. While initially only complaining of mild neck pain, within 30 minutes of the collision he started to experience bilateral numbness in his hands and significant symmetric upper limb weakness. Soon thereafter, the weakness extended down to his lower extremities. Neurologic examination is remarkable for loss of pain and temperature sensation in his bilateral upper extremities and symmetric bilateral upper extremity greater than lower extremity weakness. Which of the following is the most likely diagnosis?

A 30-year-old male presents to the clinic with a fifteen-year history of progressive weakness and sensory loss in his lower extremities. Examination shows hammertoes, high arches on his feet, 4/5 ankle dorsiflexion strength, and a mild decrease in sensation to pinprick in the 1st toes bilaterally. Upon questioning he mentions that his father had similar-looking feet and started to use a cane in his fifties. What is the most likely diagnosis for his symptoms?

A 45-year-old female presents to the emergency room after experiencing a first-time seizure. On examination, she has some mild RUE weakness and anomia. MRI w/o contrast was performed and shown below. Which of the following is the likely cause of her lesion?

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

The MR angiogram shown below demonstrates which of the following?

What clinical diagnosis does this EEG tracing suggest?

Which of the following has the longest half-life?

Which of the following medications increase the risk of contraceptive failure in patients taking estrogen-containing oral contraceptive pills (OCPs)?

Which of the following is the best prognostic finding on EEG after cardiac arrest?

You are caring for a patient in the Neuro ICU for loss of consciousness after 3 convulsive episodes within a 2 hour period. She required intubation with rocuronium and sedation with propofol. She was loaded with 2000 mg of Keppra and had received 2 mg of Ativan in the ED. You obtain a spot EEG and left temporal epileptiform discharges are seen, but no additional seizures. Unfortunately, your hospital does not have continuous EEG capabilities. Of the following options, which physical exam change in this paralyzed patient is most likely to indicate potential repeat seizure and prompt stat repeat spot EEG and consideration of antiepileptic bolus?

A 78-year-old male with a past medical history of depression and chronic alcohol use presents to the clinic with his wife for evaluation of a tremor. He states that the tremor is most severe at rest and disappears with purposeful movement. His wife states that he has been having slower movements over the past year. On physical exam, a “pill-rolling” resting tremor is noted in his left hand and the patient has difficulty with gait initiation and takes short steps when walking forward. Which dopaminergic pathway is most likely affected in this patient?

Which of the following medications, when taken alongside statin therapy, increases the risk of statin-induced myopathy?

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?