Chronic And Degenerative Neurologic Disorders Practice Test

A 32-year-old woman presents to the emergency department with a 2-day history of blurry vision and pain with movement in her right eye. She also reports that colors appear 'washed out' with that eye. She has a history of an episode of tingling and numbness in her left leg that resolved spontaneously 18 months ago. On examination, her visual acuity is 20/100 in the right eye and 20/20 in the left. She has a right afferent pupillary defect. The remainder of her neurologic examination is normal. An MRI of the brain and orbits is ordered.

A 65-year-old man presents with a 9-month history of progressive weakness. It began as difficulty with fine motor tasks in his right hand, such as buttoning his shirt. Now, he notes tripping frequently and has weakness in his left foot. He also reports muscle twitching in his arms and cramping in his calves. On examination, there is asymmetric weakness and atrophy of the intrinsic hand muscles and tibialis anterior. Fasciculations are noted in his biceps and quadriceps. Deep tendon reflexes are 3+ in the upper and lower extremities, and Babinski sign is present bilaterally. Sensation is intact.