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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?
An 87-year-old male presents with a 2-year history of worsening cognitive decline and speech difficulties. Brain MRI reveals multiple chronic cerebral infarcts. The neurological exam reveals adequate comprehension and fluency but naming was impaired. What is the most likely diagnosis?
Which of the following anti-seizure medications carries the highest risk of major congenital malformations?
Which of the following is a common side effect of dimethyl fumarate?
Which of the following nuclei of the hypothalamus is involved in temperature regulation?
A 35-year-old Dominican Republic immigrant is brought to the emergency room for a first-time seizure. He is currently back to baseline and has a normal neurological exam. His only complaint is a multiple-month history of chronic headaches. A head CT scan is performed and shown below. Which of the following is the most likely etiology of his symptoms?
A 31-year-old male comes to the clinic for evaluation of recurrent nightmares after returning from a tour of duty with the military two months ago. He is unable to concentrate on his new desk job and flinches every time he hears a door close. While once an avid bowler, he no longer goes to the bowling alley because the sounds of the pins falling remind him of bomb explosions. Which of the following is the most likely diagnosis?
Parents bring their 3-year-old son to the clinic for difficulty walking. On examination, the patient has a waddling gait and enlarged calf muscles. When rising from a seated position he has to rely extensively on his arms to stand up. Which of the following is the most likely inheritance pattern of the genetic disorder affecting this patient?
Which of the following is not a risk factor for the development of natalizumab-associated PML?
A 30-year-old man with a past medical history of migraines presents to the emergency department for his typical migraine symptoms, which have become intractable. He is treated with a “migraine cocktail” (normal saline, acetaminophen, and prochlorperazine) with some improvement. You are then called to the bedside for concern that he is having a possible seizure. His head is turned forcibly to the right without eye deviation and he is able to follow commands and verbalize. Which of the following is the best next step in management?
A 56-year-old male with a past medical history of smoking presents to the clinic with the chief complaint of a 1-month history of progressive muscle weakness. Interestingly, he notes that his strength seems to improve with repeated use. The physical examination is notable for proximal muscle weakness of the bilateral lower extremities and areflexia in all extremities. Serology and electrodiagnostic testing confirm the diagnosis. What is the first-line therapy for symptomatic management?
A 37-year-old female with a past medical history of obesity presented to the emergency room with a severe headache and visual disturbances. The funduscopic exam shows bilateral papilledema. An MRI of the brain shows an empty sella and MRV was normal. A lumbar puncture was performed. The opening pressure was 38 and there were no WBCs or RBCs appreciated in the CSF. What is the most appropriate therapy for her disease?
Which of the following medications is an NMDA receptor antagonist?
An overweight 24-year-old woman complains of neck stiffness, daily headaches, and blurred vision. She has disc edema on fundoscopic exam and slit-like ventricles on MRI brain. A spinal tap was performed and confirmed the diagnosis. Which of the following is the first-line therapy?
Which of the following is the most likely cause of the findings appreciated on the axial CT head shown below?
Which of the following comorbidities are responsible for the lesion appreciated in the image below?
A 59-year-old woman presents to the emergency room with dizziness and left ear fullness. The symptom is described as a spinning sensation that is present at rest and with action. She has had comparable events before, which have self-resolved over time. The patient is ataxic on the exam and has difficulty hearing out of her left ear. An MRI brain with and without contrast was normal. Which of the following is the most appropriate line of therapy that will decrease the risk of future recurrent events?
A 4-month-old boy is brought by his parents due to difficulty in feeding, and episodes of apnea. Physical examination reveals tongue fasciculations, a bulging anterior fontanelle, and an abducens nerve palsy. MRI reveals an Arnold Chiari malformation type II. What additional defect is this child likely to have?
A 50-year-old man presents with slowly progressive cognitive decline and personality changes. Over the past several months, he has been having trouble remembering the names of relatives/close friends and he has also become more apathetic. He is known to have trisomy 21. His exam is notable for memory deficits, but no rigidity or tremor. What is the name of the region of the brain that synthesizes the neurotransmitter that is decreased in this patient’s disease?
The EEG pattern shown below is most consistent with which of the following?
Which of the following autoantibodies are associated with myasthenia gravis?
A 49-year-old male with a chronic history of myalgias was referred to the EMG lab with progressive muscle weakness. Based on the EMG table shown below what is the most likely diagnosis?
A 1-year-old female with a past medical history of iron deficiency anemia presents to your clinic with her mother for recurrent episodes of loss of consciousness. Her mother states that whenever she gets very agitated and starts crying, her lips turn blue and she will ”pass out.” She will then awaken after a few seconds. Her neurological exam is normal. Which of the following is the most likely cause of her episodes?
Deep brain stimulation has been effective in the management of Parkinson’s disease when it targets which of the following structures?
A two-month-old female presents to the clinic with her mother for episodes of abnormal posturing of her head, neck, and abdomen when breastfeeding. Her mother states that the episodes last approximately 30 seconds to 1 minute. Episodes are followed by crying. Her birth history was normal, and she has met all of her developmental milestones. Of the following, what is the best treatment for this patient’s condition?