30 Questions
What is the most likely diagnosis for the 15-year-old girl with lightheadedness, headaches, and fatigue?
Postural orthostatic tachycardia syndrome (POTS)
Which neurotransmitter is released by sympathetic preganglionic neurons?
Acetylcholine
What does the absence of a normal increase in blood pressure during phase 4 of the Valsalva maneuver suggest?
Parasympathetic dysfunction
True or False: A patient with anhidrosis on thermoregulatory sweat testing and a normal result on quantitative sudomotor autonomic reflex testing has a preganglionic sudomotor abnormality.
True
Which of the following is associated with autonomic neuropathy?
Constipation
In a patient with suspected autonomic dysfunction, what symptom would indicate sympathetic dysfunction?
Urinary urgency
Which test is most likely to confirm the diagnosis in the text?
Serum and urine amino acid testing
What is the mechanism of action for dabigatran?
It is a thrombin inhibitor
In a patient with sickle cell disease and high-velocity flow in the middle cerebral artery, what is the best method to prevent stroke?
Avoiding iron deficiency anemia
A 30-year-old woman with a history of migraines presents with stroke. What is expected based on the information provided?
Mutation in the KRIT1 gene
Which of the following medications is recommended to treat the underlying condition in a 20-year-old man with intellectual disability, myopia, and stroke?
Pyridoxine
Which of the following tests antagonizes the vitamin K–dependent clotting pathway?
Platelet receptor binding prevention test
What is the purpose of using CHADS2 or CHA2DS2-VASc scores in patients with atrial fibrillation?
To estimate the risk for stroke
Which of the following is an element included in the CHA2DS2-VASc score for stroke risk estimation?
Hypertension
What is the acronym CHADS2 derived from?
Congestive heart failure Hypertension Age Diabetes Stroke
Which score provides better stratification for low-risk patients: CHADS2 or CHA2DS2-VASc?
CHA2DS2-VASc
What is the HAS-BLED score primarily used for in patients with atrial fibrillation?
Estimate the 1-year risk for major bleeding
Which medication can be used to prevent recurrent stroke or TIA in patients with nonvalvular atrial fibrillation?
Rivaroxaban
CADASIL is associated with fibrosis of small arteries and arterioles due to deposition of eosinophilic granular material in which layer of the blood vessels?
Media
Which gene mutation is responsible for causing CADASIL?
Missense mutation of NOTCH3 gene
What characteristic changes can be observed in the white matter of patients with CADASIL on T2-weighted MRI?
Hyperintensities in the anterior temporal poles
Which condition is associated with dilated perivascular spaces and cerebral microbleeds?
CADASIL
If gene testing for NOTCH3 mutations is negative but CADASIL is still suspected, what diagnostic procedure can be considered?
Skin biopsy
What causes cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL)?
Mutations in HTRA1 gene
What factor increases the risk for recurrence of lobar hemorrhage?
Microbleeds on gradient echo MRI
Which medication causes decreased fibrinogen, antithrombin III, protein C, and protein S?
l-Asparaginase
What surgery is recommended for patients with cerebellar hemorrhage and worsening neurologic status?
Suboccipital craniectomy
Which condition may result in acquired protein C deficiency?
Liver disease
What is the most common site of intracranial hemorrhage due to hypertension?
Putamen
Which diagnostic procedure should be performed to rule out subarachnoid hemorrhage in a concerning case?
Lumbar puncture
Explore a medical case study involving a 15-year-old girl presenting with lightheadedness, headaches, and fatigue following a viral illness. Analyze symptoms such as palpitations, sweating, and heart rate changes upon standing. Test your knowledge of diagnostic indicators and potential underlying conditions.
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