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A 33-year-old woman has recently given birth to a healthy 3-month-old boy. She has been complaining of poor sleep for the past year, mainly from an uncontrollable urge to move her legs that is only relieved by moving them. This is present during the day to a small degree but is much worse at night and during periods of rest. What would be the best test to order for her?
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?
An 8-year-old male is seen in the clinic for difficulty paying attention at school and at home for the past 9 months. His mother reports that his elementary school teacher has called the home multiple times because the patient will often run around the classroom during assignments and frequently interrupts classmates. The mother states that at home, the patient has difficulty sitting still long enough to finish his dinner and homework. This patient’s condition is best treated with a medication that has what action?
Which of the following is the mechanism of action for amantadine?
What is the mechanism of action of phenobarbital?
A 7-year-old male with a history of multiple febrile seizures has recently presented repeatedly with new recurrent non-febrile clonic seizures. Which of the following gene mutations is associated with this epilepsy syndrome?
Which of the following genetic abnormalities is most common in the pathology shown in the image below?
A 37-year-old female presents to the emergency room with diplopia and ambulation issues. Other than having an upper respiratory tract infection two weeks ago, there is no other significant past medical history. On physical exam, the patient has a decreased range of motion of the extraocular muscles bilaterally, diffuse areflexia, and marked dysmetria on finger-to-nose and alternating movements testing. Which of the following autoantibodies is most likely associated with this disease?
Which of the following medication regimens would put a patient at the highest risk of medication overuse headaches?
A 32-year-old man with a past medical history significant for major depressive disorder is brought to the emergency department after he was found by his roommate attempting suicide by hanging. His roommate states that he has been noncompliant with his medications and had been going through a depressive episode before his suicide attempt. After 6 weeks of trying several different antidepressants while on the inpatient psychiatric service, his major depression symptoms have not improved. Which of the following is the most appropriate next step in treatment?
A 32-year-old man was recently admitted to the stroke service for an intracranial hemorrhage secondary to an arteriovenous malformation. In addition to his acute focal neurological deficits, the following skin lesions are appreciated (see image below). A genetic syndrome is suspected. Based on the most likely clinical diagnosis, what is the risk of his son having the same condition?
A patient presents to the emergency room with sudden onset weakness and dysphagia. On exam, the patient’s tongue deviates to the left, and there is right hemiparesis and right-sided loss of position and vibratory sensation. Pain and temperature sensation is intact. Which of the following arteries supplies blood to the damaged area?
A 26-year-old female with a past medical history of pulmonary embolism presents with seizures and left-sided weakness. She had been complaining about a headache for the past week. An MR venogram is shown below. Which of the following is the next best step in management?
You are consulted to the psychiatric hospital to see a 48-year-old female with schizophrenia who has been under psychiatric care for 2 weeks after ingesting hundreds of pennies over a prolonged period. You are asked to address her new complaints of numbness in her feet and trouble walking. On exam, she had a broad-based gait and a positive Romberg. What could explain these findings?
A 30-year-old woman presents to the clinic with severe headaches requesting treatment because she “can’t live with this pain”. Episodes are left-sided, occur multiple times a day, and last about 20 minutes each. During episodes, she will also have eye tearing and rhinorrhea. What is the appropriate therapy?