Quiz 07/28/2022

A 55-year-old male presents with progressive worsening new headache over several months. He did not wish to seek medical attention but now presents because his family reports his facial expressions “look different”. On exam, he has impaired upgaze, light near dissociation, and convergence retraction nystagmus. An MRI is done and shows a lesion. Where is the lesion likely located?

Which of the following is appreciated in the right posterior quadrant in the EEG shown below?

Uncal herniation compressing on the structure marked below (black arrow) would lead to which of the following symptoms?

What is the most likely clinical scenario related to the EEG provided below?

Which of the following can not passively diffuse across the blood-brain barrier?

A 32-year-old man with a past medical history significant for major depressive disorder is brought to the emergency department after he was found by his roommate attempting suicide by hanging. His roommate states that he has been noncompliant with his medications and had been going through a depressive episode before his suicide attempt. After 6 weeks of trying several different antidepressants while on the inpatient psychiatric service, his major depression symptoms have not improved. Which of the following is the most appropriate next step in treatment?

A 29-year-old female taking oral contraceptive pills (OCPs), but with no other known medical history, presents for a 3-week course of progressive headache. Given her risk factors, the following imaging study is performed. An occlusion within which of the following structures is seen?

A previously healthy 14-year-old female presents to the emergency room after experiencing a trip and fall where she hit her head. She returns to baseline, but out of caution a CT head and subsequent MRI brain are performed in the ED. What is a potential complication caused by this lesion seen in this MRI?

A neurology consult is placed on a full-term newborn male after being delivered by an uncomplicated vaginal delivery with good APGAR scores. The physical exam reveals a midline lesion in his lumbar region. Based on the pathology shown below, which of the following would most likely also be present on head imaging?

A 17-month male was brought to the pediatric neurology clinic was brought to the clinic with concerns for developmental delay. Parents note that the child was a product of a normal pregnancy and his delivery was uncomplicated. A developmental delay was appreciated by 8 months of age. He is largely non-verbal. He appears happy in the room, laughing spontaneously without any external stimuli. Which of the following abnormalities most likely explains this developmental disorder?

A 7-year-old girl presents with 2 weeks of a right-sided unilateral throbbing headache. She has otherwise been healthy with no other symptoms and has no past medical history except for a light pink birthmark around her right eye. What is the most appropriate next step?

A 25-year-old female with no significant past medical history presents with a two-day history of progressive bilateral lower extremity weakness and numbness. On physical exam, she has 3/5 strength in hip flexion and knee extension bilaterally, along with a loss of sensation. She is up to date on all vaccinations. She is afebrile. Sagittal (left) and axial (right) T2 thoracic MRI images are shown below. Which of the following is the most likely diagnosis?

Which of the following diseases does not contribute to the pathology appreciated in this pathology image?

A 4-year-old male is brought to your clinic by his father who states that he has been experiencing random jerky movements of his arms and his neck for the past year. His father states that the jerky movements have not gotten worse over time but tend to appear more when the boy is agitated or under stress. The movements cease when he is asleep. The patient has otherwise been meeting all of his developmental milestones. Genetic testing reveals a mutation in TITF1, a thyroid transcription factor. What is the diagnosis?

Which of the following identifies the vein of Galen?

A 45-year-old male with AIDs presents with headache and fever. His recent CD4 count was 80, and he does not take his HAART therapy or prophylaxis. You perform a brain MRI (shown below) and discover a contrast-enhancing lesion with much vasogenic edema. With concern for cancer, a biopsy is performed. It shows microglial nodules with encysted bradyzoites and tachyzoites. What is the treatment of choice?

Based on the findings on the muscle biopsy (trichrome stain) shown below, which of the following is most likely seen on examination of this patient?

A 25-year-old female presents with anisocoria; her right eye is significantly more dilated when compared to the left eye in ambient light. The right pupil is also irregular in shape, does not respond to light, and is sluggish to constrict to near accommodation. When dilute pilocarpine (0.125%) is administered to the right pupil it constricts but the left eye doesn’t react at all.

Which of the following is the most likely cause of the patients’ symptoms?

The pathology shown in the image below is most likely which of the following?

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