Quiz 07/24/2022

Which of the following is the most likely cause for the gross pathology shown in the image below?

A 68-year-old man presents with word-finding difficulties and speech hesitancy. His wife notices that he struggles to name objects and sometimes mispronounces words. On examination, he can name objects but has significant difficulty repeating long sentences. While his spontaneous speech is slow, it is grammatically correct. Which of the following is the most likely diagnosis.

Initiating HAART therapy for a patient with poorly controlled HIV places them at an increased risk for which of the following?

A 68-year-old female presents to your clinic with the chief complaint of daytime somnolence. She endorses an unpleasant feeling in her lower extremities while trying to go to bed which prevents her from sleeping. Moving her limbs gives transient relief. What is the most appropriate first diagnostic test?

A 90-year-old woman presents to the emergency room with an acute change in mental status. On examination, she is alert but is not answering questions or following commands. Speech is fluent, but not interpretable. Comprehension is severely impaired. Interestingly she was able to repeat full sentences without much difficulty. Which of the following is the most likely territory of ischemic damage?

A 32-year-old female with a history of schizophrenia is brought to the emergency room by her husband for acute psychosis. She receives a medication while in the emergency room to aid in her agitation. Soon after administration, the patient develops involuntary contractions of muscles of her face and neck. Which of the following medications was most likely administered to cause these symptoms?

A 40-year-old woman is hospitalized at an inpatient psychiatric facility for new behavioral disturbances and a suicide attempt. She has also begun to develop unusual movements of her bilateral upper extremities. The movements are non-rhythmic, high-amplitude, low-frequency, and involve the entire extremity. Her brain MRI is shown below. Which of the following may help to treat her movements?

A two-month-old female presents to the clinic with her mother for episodes of abnormal posturing of her head, neck, and abdomen when breastfeeding. Her mother states that the episodes last approximately 30 seconds to 1 minute. Episodes are followed by crying. Her birth history was normal, and she has met all of her developmental milestones. Of the following, what is the best treatment for this patient’s condition?

An 18-year-old woman with a history of symptomatic epilepsy presents with medically-refractory seizures. An MRI brain is performed during presurgical evaluation and reveals the non-contrast-enhancing lesion shown below on T2 FLAIR. This lesion is most likely which of the following?

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

A 63-year-old female presents to the office, accompanied by her husband who has become increasingly worried about his wife’s ability to perform tasks at home. He states that for the past three months she has not been able to tie her shoes, and fumbles with the shoelaces in her hands. Additionally, within the past month, she has not been able to brush her teeth, and simply holds the toothbrush in her hand, without moving. Lastly, her husband has noticed that the patient moves slower on their morning walks together, and her arms and legs seem more tight and rigid. A brain MRI is ordered which shows asymmetric atrophy of the superior parietal lobule. Which of the following is the most likely diagnosis?

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?

An 8-year-old child with a past medical history of tuberous sclerosis presents urgently to the emergency room with lethargy. Funduscopic examination shows blurring of the optic discs. An MRI is performed and shown below. Which of the following is the most likely cause of the patient’s symptoms?

A 69-year-old female is brought to the emergency room by her daughter for excessive stumbling, often tripping on things on the floor. The daughter also says her mother has been behaving oddly, complaining about seeing darkness in a fully lit room, and the inability to recognize her family members. Bilateral pupillary light reflexes are normal. If symptoms are secondary to an ischemic injury, an MRI would show a lesion in which of the following regions?

A 5-year-old boy is seen in the clinic for seizures, vision loss, and progressive loss of milestones. MRI of the brain shows a posterior predominant leukodystrophy. Which of the following is the most likely diagnosis?