Quiz 07/22/2022

Which of the following is the antibody associated with dermatomyositis that is known to confer the highest risk of cancer?

A 4-year-old male is brought to your clinic by his father who states that he has been experiencing random jerky movements of his arms and his neck for the past year. His father states that the jerky movements have not gotten worse over time but tend to appear more when the boy is agitated or under stress. The movements cease when he is asleep. The patient has otherwise been meeting all of his developmental milestones. Genetic testing reveals a mutation in TITF1, a thyroid transcription factor. What is the diagnosis?

Which of the following is the most sensitive test for myasthenia gravis (MG)?

Aquaporin-4 (AQP4) channels are found on which cell type?

A 19-year-old female who was admitted to the epilepsy monitoring unit for medically refractory epilepsy had one of her typical seizures captured during recording (see below). Which of the following symptoms did the patient most likely experience at the time of this recording?

A 40-year-old male presents to the clinic with difficulty swallowing. On additional questioning, he reports difficulty walking, falls, and dysarthria. Examination shows bilateral facial weakness, fasciculations, and gynecomastia. A CAG trinucleotide repeat on which of the following genes is the cause of this disease?

You are reading a visual evoked potential (VEP) that has a prolonged P100 latency in the right eye and a normal latency in the left eye. Of the following, which pathology is most consistent with this study?

A 65-year-old female presents with an abrupt onset of akinetic mutism, lack of motivation, apathy, bilateral leg weakness, and incontinence. A lesion to which of the following vascular territories could explain her symptoms?

A 60-year-old female with a past medical history of chronic alcohol use was admitted to the hospital 4 days ago for community-acquired pneumonia. Over the last 48 hours, the patient developed severe encephalopathy and generalized weakness. An axial T2 FLAIR MRI is shown. Which of the following is the most likely diagnosis?

A 10-year-old female from the northeastern United Stated presents to the ED with her mother after a one-week history of difficulties in school and difficulties with speech. Her mother states that two weeks ago the patient had a rash on her leg and viral-like symptoms that went away within a few days. Then, this past week the patient’s teacher reported that she was having difficulties with attention in school and was performing very poorly on assignments. Her mother also confirmed that the patient has been more forgetful and is also slurring her speech. An MRI of the brain was performed and it showed multifocal white matter lesions. Of note, the patient likes to spend a lot of time outdoors and recently went on a camping trip. Which of the following is the most likely cause of the patient’s symptoms?

Which of the following clinical features is most suggestive of logopenic primary progressive aphasia?

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

A 74-year-old female presents to the ED for trouble with swallowing and balance. On physical examination, she is unable to speak clearly and has no gag reflex. Pain and temperature sensation on the right side of her body and the left side of her face is decreased. She is unable to walk unassisted and has dysmetria on the finger-to-nose exam. MRI of the brain shows an ischemic stroke. The artery that is affected most commonly branches off of which of the following?

A 15-year-old male comes to the clinic with his parents as they complain he has periods of the year where he will sleep up to 20 hours a day for multiple days in a row, as well as uninhibited eating and inappropriate sexual behavior. These episodes last for up to around 2 weeks at most, and then he is behaviorally back to normal in between episodes. Which is the most likely diagnosis?

A 22-year-old woman with a previously diagnosed history of prior suicide attempts, EEG-confirmed epilepsy, and non-epileptic seizures comes to your clinic to establish herself as a new patient under your care. Upon entering the room she immediately tells you about her horrible relationship with her last epileptologist and how abandoned she felt when he decided to retire. While gathering her social history, she endorses a history of excessive spending on new cars, reckless driving, and alcohol-driven physical altercations. Which of the following personality disorders is most consistent with this clinical presentation?