Quiz 07/25/2022

Which of the following is not a recommended screening test for cognitive dysfunction?

Which of the following medications used in the management of attention deficit hyperactivity disorder (ADHD) can worsen comorbid Tourette syndrome if present?

A 19-year-old boy presents with his mother for complaints of frequent eye blinking and shoulder-shrugging spells occurring multiple times a day. He also has frequent episodes of humming a three-note tune randomly throughout the day. He has had these problems since he was 17. He had an MRI brain and EEG that were negative. He takes no medications. The symptoms do not impact his activities of daily living, but he does feel embarrassed by the symptoms. He went to cognitive behavioral therapy for this for a year and has not seen a benefit. Which of the following is a first-line medication for this patient?

Which of the following pathologic findings is associated with posterior cortical atrophy?

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 6-year-old girl presents to the clinic with frequent episodes of awakening from sleep in extreme fear. Sometimes she has a brief twitching of the limbs with this. She has these events in clusters on some nights, lasting seconds to minutes. On further questioning, you discover the mother had a similar problem when she was around this age, which slowly got better over time. Both patient and mother are otherwise healthy with no intellectual deficits or symptomatic features. Which of the following gene mutations do they both likely share?

A 32-year-old man with a past medical history of major depressive disorder is brought to the emergency department by his roommate who states that a few days ago the patient stopped taking his medications. Vital signs were within normal limits. On examination, the patient was non-verbal except for occasionally repeating words spoken by the examiner. He would not follow commands. When his arms were positioned off the bed they remained there for several minutes. CT head and CTA of the head and neck were normal. Which of the following is the most appropriate next step in treatment?

A consult is placed for paroxysmal episodes in a 6-day-old male infant born at 32 weeks gestation. According to his mother, the infant seems to be shivering a lot “like he is cold”. The mother states that she has been wrapping him in warm blankets and keeping the room at a warm temperature. On physical exam, the infant is alert and interactive, without persistent focal neurological deficits. However, when touching the left arm, the patient develops a fine tremor that resolves after flexing the affected limb. Vital signs are within normal limits. Which of the following is the most likely diagnosis?

A 41-year-old male presents to the emergency room with a two-day history of neck pain and speech difficulties. CT head shows scattered hypodensities in the left ACA and MCA territories. His Sagittal CT angiogram of the neck is shown below. What is the most likely cause of the patient’s symptoms?

A 39-year-old male presents to the clinic for hallucinations. His medical history is only remarkable for a chemical accident at his job resulting in severe corneal scarring bilaterally, for which he now requires a seeing-eye dog.

His hallucinations are usually of tall figures dressed in black with long fingers. He is not frightened by this because he knows they are not real. He denies other neurologic deficits, denies auditory hallucinations and describes his mood as “good”. The rest of his exam is normal.

You are familiar with the underlying syndrome the patient is experiencing. You inform the patient that in the rest of the population the most common cause of this syndrome is actually…

Patients with Alzheimer’s disease usually have a loss of cholinergic neurons from which of the following regions?

Which of the following syndromes are most likely associated with the lesion shown in the image below?

A newborn male is evaluated in the NICU for a lesion on his lower back. He was born to a mother with no prenatal care at 37 weeks gestation. Imaging of his lower back shows the meninges and spinal cord herniated through the defect, covered in a membrane. His condition could have most likely been prevented through prenatal supplemental with what?

Which of the following medications has the highest risk for QT prolongation?

A patient with an AVM rupture is admitted to the ICU. On exam, the patient has abnormal neck, elbow, and knee extensor posturing, and wrist flexion. In which of the following locations was the AVM most likely located?