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A 41-year-old female smoker with HTN is admitted to the Neuro ICU after having acute onset worst headache of life, found to have hyperdensity tracking sulcal lines on CTH. Her physical exam is otherwise normal on admission. On the fourth day of admission, she develops acute onset right arm and leg weakness and aphasia. She was last seen well 30 minutes prior. Which of the following is true?
A 5-year-old female was brought to the neurology clinic for a second opinion for paroxysmal spells of dizziness. The family states that several times a month the patient will develop severe dizziness, nausea, and vomiting. Symptoms usually only last less than 5 minutes. An MRI and 24-hour ambulatory EEG have been performed in the last 3 months. Both were unremarkable. What is the most likely diagnosis?
A 22-month-old girl presents with her mother for abnormal movements and loss of milestones. The mother describes the patient frequently and repetitively squeezes and twists her hands, and has lost some of her developmental milestones including fine motor skills and verbal speech. She has stopped walking as well. On examination of growth curves, her head circumference percentile appears to have fallen off of the curve. The patient has no other past medical problems, no past trauma, or past infections, and had been developing normally up until now. Of the following, which is most likely true?
Alemtuzumab is a monoclonal antibody therapy that targets which of the following proteins?
A 3-year-old female with a past medical history of recurrent sinus infections is brought to the clinic by her father because of unsteadiness on her feet for the past 4 months. Her father states that she began walking at 12 months. However, more recently, she has been losing her balance and has been falling. On physical exam, she has truncal ataxia and an ataxic gait. An ocular exam reveals dilation of the retinal capillaries. Labs are ordered that show an elevated alpha-fetoprotein. Which of the following is the most likely diagnosis?
Deep brain stimulation has been effective in the management of Parkinson’s disease when it targets which of the following structures?
A patient presents with sudden-onset gait instability and dysphagia. On exam, he has dysmetria of the right hand, anisocoria, loss of pain and temperature of the right face, and loss of pain and temperature of the left arm and leg. An MRI of the brain is performed and shows a stroke. What other symptom is often also a part of the syndrome this patient is experiencing?
A 6-year-old male is brought to the pediatrician with multiple-decaying teeth since 2-3 years of age with no associated pain. He was born via C-section at term with no complications. Past medical history is significant for developmental delay and intellectual impairment. On physical exam, the patient is short-statured and obese with hypogonadism. His parents state that he has always been an overeater. What is the most likely diagnosis?
A 71-year-old male with a history of mild ankle weakness and balance issues for the last 6 years is referred to the lab for a nerve conduction study (NCS). While performing the testing the patient states that a few of his siblings, as well as his father, had similar issues. Examination showed high arches and hammertoes. Based on the clinical history and NCS, what is the most likely diagnosis?
A 14-year-old girl with no significant past medical history presents with an acute presentation of left-sided weakness. CTH was negative but MRI shows an acute lacunar ischemic stroke in the right hemisphere. An angiogram was performed which revealed segmental arterial constriction followed by segments of arterial dilation in multiple intracranial vessels. Which of the following is the most likely etiology of her ischemic stroke?