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Which of the following is the mechanism of action of nimodipine?
A 75-year-old female with a past medical history of atrial fibrillation and hypertension presents to the ER with garbled speech. She seems unaware that her speech is nonsensical. On physical exam, she is unable to follow verbal commands but can understand visual cues. An ischemic injury is suspected. If this is true, a brain MRI would show which of the following areas of the brain is/are affected?
A 7-day-old infant is in the hospital since birth when he starts having seizures. He has been feeding poorly thus far. On examination, he has hypotonia, as well as distinctive facial features of midface hypoplasia, hypoplastic supraorbital ridges, and a prominent high forehead. The metabolic testing panel returns with elevated very-long-chain fatty acids. What is the physiology of this disorder?
Identify the finding noted with a blue arrow.
What sensitivity should the EEG be at to qualify for brain death criteria?
A patient with a history of hypertension and provoked seizures secondary to posterior reversible encephalopathy syndrome (PRES) has come to your clinic for a 6-month follow-up after her associated hospitalization. It was found that abrupt discontinuation of her hypertensive medications due to medication noncompliance was the cause of the PRES. She was started on the anti-seizure medication (ASM) levetiracetam at the time of her PRES and has had no seizures since being discharged. She asks you about the risk of future seizures. What is the most appropriate response?
Which of the following is true regarding IVIG and PLEX therapy?
A 40-year-old textile worker is brought to the clinic for slowly progressive symptoms including shuffling gait, tremor, and profuse drooling. On examination, his speech is difficult to understand and there is cogwheel rigidity in his arms and legs. His tremor is most evident when his limbs are at rest. Exposure to which of the following is the most likely cause of the patients’ symptoms?
A 34-year-old female with poorly-controlled type 2 diabetes presents to the ED with a 3-day history of sinus and orbital pain, fever, and headache. Four hours ago, she was feeling confused and dizzy, which prompted her to come to the hospital. A head CT scan is performed and it shows erosion of the nasal bones and obliteration of the sinuses. Biopsy of antral tissue shows fungal hyphae. What is the most likely diagnosis?
A 65-year-old female presents with an abrupt onset of akinetic mutism, lack of motivation, apathy, bilateral leg weakness, and incontinence. A lesion to which of the following vascular territories could explain her symptoms?
What is the pathophysiology of the lesion provided below?
A patient with a history of a chronic ischemic stroke has an MRI performed for new-onset seizures. Based on the imaging provided, what is the likely etiology of the patient’s past stroke?
A 78-year-old man presents to the ER with headache, fever, diplopia, and hiccups. MRI with the brain with and without contrast shows small contrast-enhancing abscesses in the brainstem, sparing supratentorial cerebral tissue. Which of the following infectious agents classically presents in this fashion?
A 42-year-old man with a longstanding history of chronic alcohol abuse was found down unresponsive in a public park. He was intubated in the field and brought emergently to the emergency room where his blood alcohol level was 0.32%. A chest X-ray revealed aspiration pneumonia. He was admitted to the ICU, sedated, started on broad-spectrum antibiotics, and aggressively fluid resuscitated. On the second day of the hospitalization, the sedative was weaned but the patient remained comatose. An MRI was performed to identify a possible cause of his symptoms. What is the most likely diagnosis?
A 19-year-old woman was brought to the emergency department after a rollover motor vehicle accident. On arrival, she was intubated and sedated for respiratory failure secondary to pneumothorax. Examination revealed intact brain stem reflexes and decreased spontaneous movement of the left side of her body. Her axial head CT scan is shown below. What is the most likely diagnosis?