Quiz 07/27/2022 (5)

A 65-year-old female presents with complaints of hearing a strange “clicking sound” all of the time which started suddenly 6 weeks ago. On exam, you note a rhythmic tremor of the upper palate. The patient also has pendular horizontal nystagmus. Which MRI finding is most likely?

A 75-year-old female with a past medical history of hypertension on lisinopril presents to the emergency department with weakness on the left side of the body and a drooping right eye. On exam, her right eye is inferiorly and laterally deviated. This pupil is also non-reactive. Her strength is 3/5 on the left side. Where is this patient’s lesion?

A 67 y.o. female with HTN and atrial fibrillation on coumadin was in the Neuro ICU in a comatose state after a large intracranial hemorrhage. After a couple of days of monitoring, she had a new finding on her physical exam that prompted stat imaging, which showed signs of uncal herniation. Surgery was not performed due to goals of care preferences, and she, unfortunately, passed away from her ailment. An autopsy was requested. The image below shows compression on a cranial nerve from the herniation. Through which anatomic structure does this nerve pass to exit the skull?

Which of the following features on EMG is suggestive of chronic denervation?

A 57-year-old teacher presents to the clinic with reading difficulties. His first symptoms developed 12 months ago when he had trouble marking students’ homework. He progressively also lost the ability to write and had to retire from his profession. Now he needs help tying his shoes and buttoning his clothes. His visual acuity is 20/20. Funduscopic examination and the rest of the neurological examination are unremarkable. Which of the following is the most likely diagnosis?