Quiz 07/25/2022

An overweight 24-year-old woman complains of neck stiffness, daily headaches, and blurred vision. She has disc edema on fundoscopic exam and slit-like ventricles on MRI brain. A spinal tap was performed and confirmed the diagnosis. Which of the following is the first-line therapy?

A 40-year-old previously healthy man arrives in the emergency room with a 1-week history of slowly progressive leg weakness. Symptoms initially started with burning-type pain in his bilateral lower extremities. Neurological examination shows 4-/5 strength in bilateral lower extremities and areflexia of the patella and Achilles. MRI is shown below. Which of the following is the most likely diagnosis?

Which of the following muscles is solely innervated by the C5 nerve root?

A 32-year-old female presents to the emergency room after a motor vehicle accident as a restrained back seat passenger. Her only complaint on arrival is back pain. She has bruises across her abdomen and chest and a normal neurological exam. Thoracic spine imaging was completed and is shown below. Which of the following is the most likely diagnosis?

A 14-year-old male is referred to the neurology clinic by his PCP with the complaint of bilateral hearing loss. Neurological examination shows a sensorineural hearing loss. Multiple hyperpigmented lesions on the chest and back were also appreciated. An MRI of the brain was ordered that showed bilateral posterior fossa lesions. Genetic testing would reveal a mutation on which chromosome?

Which of the following areas, if selectively lesioned, would cause an error with voluntary vertical saccades with spared horizontal saccades and sparred occulocephalic vertical reflex?

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

A 48-year-old patient with a past medical history of chronic migraines is brought in by her family with sudden-onset memory complaints. She is unable to recall where she lives or even her own name. A brain MRI (Left: DWI. Right: ADC.) is shown below. Which of the following is the most likely diagnosis?

Which of the following is the thalamic relay center for auditory stimuli?

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

A patient with end-stage amyotrophic lateralized sclerosis (ALS) presents to the emergency room from a nursing home alone. His vitals show hypoxemia and he appears tachypneic on examination. On examination, he is also paraplegic with significant weakness in the upper extremities and mild dysarthria. His mental status examination appears intact. Between short breaths, he says that he does not wish to be intubated. This is consistent with the end-of-life discussions documented in the outpatient clinic notes. As his hypoxemia worsens his wife arrives at the bedside and with urgency asks you to intubate the patient. What is the most appropriate response?

Which of the following can be appreciated on the T1 MRI sequence shown below?

A 58-year-old woman presents with worsening memory loss and a 50-pound weight gain over the past six months. On neurological exam, her Mini-Mental Status Examination (MMSE) yields a score of 21/30. She has intact sensation, normal muscle bulk, tone, and strength, but diffuse hyporeflexia. Which of the following is most likely the diagnosis?

A 56-year-old male with a past medical history of smoking presents to the clinic with the chief complaint of a 1-month history of progressive muscle weakness. Interestingly, he notes that his strength seems to improve with repeated use. The physical examination is notable for proximal muscle weakness of the bilateral lower extremities and areflexia in all extremities. Serology and electrodiagnostic testing confirm the diagnosis. What is the first-line therapy for symptomatic management?

A 65-year-old female comes to the clinic complaining of weakness in his extremities. Symptoms are more prominent in the legs than in the arms. Oddly, when he tries to exert himself, he notes an improvement in his strength. Neurodiagnostic testing reveals low amplitude compound muscle action potentials (CMAPs) with an increase in amplitude on high frequency (50 Hz) rapid repetitive stimulation. Which of the following malignancies is most closely associated with this patient’s neurologic syndrome?