Quiz 07/26/2022

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?

A 55-year-old was recently diagnosed with breast cancer. She required a right mastectomy, lymph node resection, and local radiation. She presents to your clinic with right arm pain and weakness. On exam, she has weakness only to forearm pronation, and flexion at the wrist and biceps. She also has numbness of the lateral hand and the first 3 digits.

Which cord or nerve was likely injured from the surgery or radiation?

Deep brain stimulation has been effective in the management of Parkinson’s disease when it targets which of the following structures?

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

What is the mechanism of action of abciximab?

The axial T2 brain MRI image shown below is from a 20-year-old man who presented to the hospital after experiencing a motor vehicle accident. Which of the following associated findings would be expected given the abnormality shown?

A 38-year-old man with a prolonged history of intravenous drug use, HIV, and poor compliance with HAART therapy is brought to the hospital by police after being seen wandering across a busy street intersection. His last CD4 count was 180 cells/microliter 8 months ago. Vitals appear within normal limits on arrival. Neurological examination shows inattention, poor short-term memory, and difficulties with abstract thought. An MRI is performed and shown below. What is the likely etiology of his symptoms?

Which of the following cranial nerve(s) transverses through the structure (blue arrow) shown below?

Which of the following cranial nerves is most likely to be affected by increased intracranial pressure?

The brain MRI (susceptibility-weighted imaging) shown below is most likely associated with which of the following conditions?

A 58-year-old male with a prolonged history of myasthenia gravis was recently discharged 4 months ago from the hospital with his second myasthenic crisis requiring transient intubation. Since that hospitalization, he was on prednisone, tapered down to 40 mg a day, cyclosporine and pyridostigmine. He comes to the ED today after having a generalized tonic-clonic seizure. On arrival to the ED, the patient is post-ictal and has vision deficits on exam. MRI of the brain shows T2 hyperintensities on the posterior cerebral hemispheres. Which of the following is the likely etiology of this clinical presentation?

An 18-year-old male with a history of IV drug use was found unresponsive on a park bench by police. He was intubated by EMS and sent directly to the emergency room. The patient is comatose on examination. CT scan of the head is shown below. What is the likely diagnosis?

A 47-year-old woman from the Caribbean presents to the clinic with a seven-year history of progressive difficulty with ambulation. The exam is notable for lower extremity spasticity. An MRI is ordered and shows atrophy of the spinal cord without other changes. The clinical and MRI findings for this patient are most likely secondary to which of the following infections?

Which of the following nerve conduction study abnormalities is least likely to be seen during the initial phase of acute inflammatory demyelinating polyneuropathy (AIDP)?

All of the following therapies can be useful in the management of cluster headaches except: