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A 45-year-old patient presented to the emergency room unresponsive. Emergency medical services noted that the patient was found in his garage with the car running in an apparent suicide attempt. Despite appropriate medical care, the patient passed away. An autopsy was performed. A gross pathology image is shown below. Identify the following regions marked by the white arrows.
A 42-year-old welder complains of a one-year history of progressive resting tremor, shuffling gait, and drooling. He consults a physician because of frequent falls and worsening fatigue. A diagnosis of a particular type of metal toxicity was made and treatment is started. Which of the following would most likely be found if an MRI brain if ordered?
A 30-year-old female presents to the ER with a three-day history of progressive weakness, double vision, and slurred speech. The first symptoms appreciated were double vision and slurred speech, followed by weakness in the upper extremities. Symptoms then descended to involve the lower extremities. On examination, the patient had decreased tone, areflexia, mydriasis, and restricted extraocular movements bilaterally. A neuromuscular junction disorder is suspected. Based on the most likely diagnosis, which of the following would be seen in this patient’s neurodiagnostic testing?
A 19-year-old female who was admitted to the epilepsy monitoring unit for medically refractory epilepsy had one of her typical seizures captured during recording (see below). Which of the following symptoms did the patient most likely experience at the time of this recording?
Chronic exposure to which of the following medications can cause the pathology appreciated on the pathology slide below?
A 20-year-old man with a history of poorly controlled schizophrenia was admitted to the hospital by his parents for severe bizarre hallucinations. He informed the nursing staff that there were toxins in his body that needed to be flushed out and continuously asked for water. There was a concern for psychogenic polydipsia. Over the next two days, the patient was started on haloperidol, a fluid-restricted diet, and normal saline infusions. On the second day of hospitalization, the patient developed progressive confusion and gait instability. A brain MRI was performed and is shown below. Which of the following is the most likely etiology of his symptoms?
A 57-year-old male with an unknown past medical history who recently immigrated from South Asia presents to the emergency department with new-onset skin lesions on his arms. On physical exam, the patient has two large, erythematous lesions with a clearly demarcated but flat border. The nerves around these lesions appear thickened. Biopsy of the lesions shows epithelioid cell granulomas and few bacteria. What is the most likely diagnosis?
Which of the following is not part of Gerstmann’s syndrome?
A 12-year-old patient with neurofibromatosis type I is found to have a cerebellar cystic mass with a mural nodule and contrast-enhancing rim after presenting with symptoms of increased intracranial pressure. The lesion was surgically resected and an example of the pathologic findings is shown below. What is the most likely diagnosis?
A 64-year-old man with idiopathic Parkinson’s disease being treated with carbidopa-levodopa is experiencing significant wearing-off despite increasing frequency and dose of levodopa-carbidopa, which is now producing significant peak dose dyskinesia. Which of the following would be a reasonable next agent to prescribe to reduce this wearing-off effect?
Which of the following seizure characteristics are typically seen in patients with temporal lobe epilepsy?
A 38-year-old female presents for 5 weeks of worsening encephalopathy, and blurred vision. An MRI Brain with contrast is performed and shown below (T1 post-contrast, multiple axial sections). Of the following, what is the most likely diagnosis?
A 49-year-old female has had a 6-month history of difficulty swallowing and weight loss. On examination, she has generalized muscle loss. On strength examination, she has 3/5 proximally and 4/5 distally in the bilateral upper extremities. There are normal tongue movements and a normal jaw jerk reflex. Deep tendon reflexes in the bilateral upper extremities are normal and sensation is intact. An EMG is performed and outlined below. What is the most likely diagnosis?
In normal neonatal development, which of the following structures myelinates the latest?