Quiz 08/01/2022 (3)

A 68-year-old male with a 10-year history of Parkinson’s disease comes to the clinic for routine follow-up. He currently is taking levodopa/carbidopa, entacapone, and ropinirole. The patient is complaining of significant dyskinesias and unpredictable motor fluctuations between doses of levodopa/carbidopa. What is the most appropriate next best step in management?

A 13-year-old girl presents with headache, confusion, and polyuria. MRI brain with contrast shows a heterogeneous, contrast-enhancing lesion with mass effect located in the pineal region. A biopsy was performed. Immunohistochemical staining for cKIT of the biopsied tissue is shown below. Which of the following is the most likely diagnosis?

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?

A 27-year-old female with a history of cataracts and an unknown family history was referred to the neurology clinic for excessive daytime sleepiness. On examination facial weakness and grip myotonia were appreciated. Genetic testing revealed a mutation in the DMPK gene. Based on her diagnosis, which of the following tests should be performed annually?

According to the Bouthillier Classification, which segment of the internal carotid artery is colored below in orange in this sagittal angiogram?

A pediatric neurology consult was placed for a 5-day-old, full-term newborn with macrocephaly. When formally measured his head circumference was 46 cm. A tense fontanelle was appreciated on examination. A bedside ultrasound was performed and the only abnormality appreciated was significant hydrocephalus. What is the most likely etiology of the patient’s symptoms?

A 75-year-old man with a past medical history of hypertension, hyperlipidemia, and diabetes presents with acute onset right arm weakness and speech problems. He can speak fluently and his comprehension is intact. However, he is unable to repeat even simple sentences. Reading and writing are preserved. Which of the following is an accurate description of his speech dysfunction?

Which of the following findings is depicted in the vessel imaging shown?

Which of the following nerves when damaged can lead to scapular winging?

An 8-year-old girl presents with a progressive neurologic disorder. She initially was noted to have slow learning and clumsiness years ago. Shortly thereafter she developed a seizure disorder of unclear etiology. Now, she has been having progressive visual changes and worsened cognition and memory. To aid in the diagnosis, a muscle biopsy is done and shows autofluorescent curvilinear bodies. Her disorder falls into which category of disease?