Neurology 4

A 44-year-old woman complains of severe headaches occurring before, during and after menses that render her unable to engage in normal activities. The headaches have been getting worse and more frequent over the past year and occasionally are accompanied by nausea and vomiting. Which of the following medications would be most effective for prophylaxis for her headaches?

A 37-year-old female with type 1 diabetes awakes with left-sided facial weakness and vague periauricular pain. She is unable to close her left eye. Which of the following is the most likely diagnosis?

A 37-year-old man has newly diagnosed cluster headaches. Administration of which of the following is the preferred initial therapy?

A 54-year-old woman has right sciatic nerve impingement caused by arthritis. Which of the following physical examination signs is most likely to be present on the ipsilateral side?

Objective signs of nerve root compression such as in cauda equina include all of the following except:

A 57-year-old man has progressive weakness of his arms and legs, without associated urinary or bowel incontinence. Examination reveals weakness of the extremities, fasciculations of the tongue, overactive deep tendon reflexes in the arms and legs, and bilateral positive Babinski sign. Which of the following is the most likely diagnosis?

A 49-year-old patient had a 45-minute episode of weakness, numbness and heaviness of the left arm and left leg approximately 5 hours ago. She is brought to the ER for evaluation, while there she is given aspirin 325mg orally. At the time of examination she is alert and asymptomatic. BP 142/88 mmHg (right arm; sitting). Pulse is 74 bpm (regular). Examination of the heart is normal. A left carotid bruit is heard. No neurologic deficits are noted. CT scan of the brain is negative for hemorrhage. The most appropriate next step is:

A 10-year-old boy has a 1 day history of photophobia, headache, fever, and vomiting. Examination shows a lethargic, but oriented, patient with nuchal rigidity. No localizing neurologic signs are present. Which of the following is the most likely diagnosis?

A 46-year-old malnourished, alcoholic arrives from home via EMS. His wife states that he drinks every day but he drank heavy last night and consumed an entire bottle of vodka. It is now approximately 6 hours after his heavy drinking episode and he is stuporous. Vital signs are BP: 92/42 mmHg (right arm, supine); pulse: 64 bpm (regular); respirations: 12 breaths/min (nonlabored); temp: 97.1 degrees F (oral). Which one of the following conditions requires immediate intervention?

A 45-year-old man states that he has had severe headaches daily over the past three weeks, each lasting from 15 minutes to about two hours. The pain is over his right eye which becomes red and tears during these attacks. He also experiences nasal congestion at these times. Which of the following symptoms is he also likely to have during his headaches?

A 57-year-old woman has a 2 month history of tingling and numbness in the first 3 fingers of each hand. Symptoms are worse at night. There is no associated weakness of the hand. Carpal tunnel syndrome is suspected. The clinician should specifically perform which of the following on a focused neurologic examination?

A 64-year-old male presents with recurring episodes of light-headedness, dimming of vision and a fainting sensation over the past several weeks. He states that symptoms usually occur when he gets up after watching television for several hours in the evening. His blood pressure in the left arm is as follows: 134/72 mm Hg (supine) and 98/52 mm Hg (standing). Which of the following is the most likely cause of his symptoms:

A 59-year-old woman has a 3 month history of fatigue, cold intolerance, dry skin, and constipation. Which of the following signs is most suggestive of hypothyroidism?

A patient with vertigo secondary to a peripheral lesion exhibits which of the following?

Which of the following diagnostic studies is recommended for syncope?

Which of the following is a peripheral lesion causing vertigo?

Which of the following is a characteristic of bacterial meningitis in a 3-year-old child?

Which of the following is included in the management of transient ischemic attacks?

Which of the following is a clinical characteristic of phenylketonuria?

Which of the following is included in the management of neurosyphilis?

Prenatal genetic testing should be done during which of the following gestational ages of the fetus?

A 7-month-old patient is suspected of having acute bacterial meningitis. Initial therapy may include:

A 67-year-old man has difficulty remembering where his keys and newspaper are located. He becomes confused when given traffic directions and occasionally cannot remember simple words. Which of the following is the most likely diagnosis?

Which of the following is the common name for frontotemporal lobe dementia?

A 66-year-old gentleman presents with complaints of memory problems. He appears to be upset or distressed. Examination reveals attention span and concentration to be intact. Based on patient’s presentation and examination, which of the following is the most likely diagnosis?

Which of the following diagnostic exams is frequently used to monitor seizure activity?

Which of the following radiologic imaging modalities are useful to differentiate frontotemporal dementia from Alzheimer’s disease?

A 26-year-old female presents with episodes of unexplained muscle weakness and muscle fatigue that fluctuate throughout the day and are resolved with rest. She also complains of double vision and difficulty chewing. Lab work reveals elevated levels of circulating acetylcholine receptor anti-bodies. Physical examination reveals ptosis, normal sensation in the limbs, and no reflex changes. Based on the patient’s presentation and physical examination, which of the following is the most appropriate diagnosis?

Which of the following radiologic modalities is most effective in visualizing white matter lesions in the central nervous system associated with multiple sclerosis?

Which of the following classes of medications has been proven successful for the treatment of fibromyalgia?