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A 47-year-old female presents to the clinic with the chief complaint of slowly progressive proximal muscle weakness. Electromyography showed short duration, low amplitude motor unit action potentials. A muscle biopsy was performed and shown below. A diagnosis is made and the patient is started on a therapeutic agent. What is the most likely medication initiated?
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?
The anatomical structure identified in the image below (blue arrow) derives from which of the following embryonic tissues?
A patient with relapsing-remitting multiple sclerosis presents to the emergency department with a new headache, confusion, and vision loss. A T2 sequence from their MRI is shown below. Lumbar puncture is positive for JCV in the CSF. What is the mechanism of action of the disease-modifying therapy most likely to be attributed to this clinical scenario?
Anti-GQ1b antibodies are associated with which syndrome?
Oculomotor nerve palsy is most likely to be seen secondary to an aneurysm in which of the following arteries?
A 40-year-old male is brought to the emergency room unresponsive after getting into a motor vehicle accident. On physical exam, his pupils are equally reactive to light. He can close his eyes and look up and down but not side to side. His motor exam otherwise has 0/5 strength symmetrically. The Babinski reflex is upgoing bilaterally. These symptoms can be explained by occlusion of which of the following vessels?
Which of the following antiepileptic drugs can induce myoclonic seizures?
Which of the following is the mechanism of action of clonidine?
A patient with Duchenne muscular dystrophy (DMD) most likely has which of the following findings on electromyography (EMG)?
Which of the following is the mechanism of action of riluzole?
Which of the following medications is an NMDA receptor antagonist?
A 76-year-old man with a five-year history of idiopathic Parkinson’s disease presents to your office accompanied by his daughter. She remarks that he has started talking to his wife who passed away 5 years ago. She also frequently finds him frightened, looking around the room at “small people” who are not there. Which of the following is a treatment of choice that is correctly paired with its associated monitoring parameters?
Which of the following nerves when damaged can lead to scapular winging?
Which of the following findings is depicted in the catheter angiogram shown?
Which of the following comorbidities would prohibit the use of dalfampridine?
A mother and father bring in their 8-month-old son to your clinic for clinical events described as sudden flexion of the limbs and trunk, seen most often upon awakening or falling asleep. His interictal EEG is demonstrated below. Which of the following is the most likely cause of the patient’s symptoms and EEG findings?
A 50-year-old male with a 1-year history of behavioral changes and abnormal movements has a CT head performed after having a fall at his nursing home. Based on the imaging and brief clinical history what is the likely genetic abnormality associated with his neurological disease?
A nine-month-old boy with no significant past medical history is brought to the clinic by his mother because of paroxysmal episodes of unknown etiology. His mother states that since he was six months old, she noticed that his head would intermittently tilt to his right lateral side when he woke up. His head tilt would always disappear during sleep. During these “attacks” the patient would become irritable and would occasionally vomit. The symptoms last up to 48 hours before resolution. Imaging of the brain and EEG do not demonstrate any abnormalities. Which of the following is the most likely cause of these symptoms?
Concentrically-layered Schwann-cell processes (“onion bulbs”) are seen surrounding nerve fibers on nerve biopsy in which of the following diseases?
A newborn is evaluated in the NICU hours after birth to a G1P1 mother with poor prenatal care at 36 weeks. Upon evaluation, the newborn is macrocephalic, jaundiced, and hypotonic. She also has a faint purpuric rash on her extremities and redness of both eyes. CT of the head shows periventricular and basal ganglia calcifications. This condition is likely caused by which of the following organisms?
Which of the following symptoms is atypical for essential tremor?
A 57-year-old woman with a past medical history of hypothyroidism was referred to the EMG lab with a one-year history of right-hand numbness. Based on the EMG data shown below, what is the most appropriate next step in medical management?
You are caring for a 65-year-old that sustained a small hypertensive intracranial hemorrhage. Early physical therapy is initiated. They discover that while she can sit unassisted, she is unable to stand. When standing, she sways and falls forward, backward, or to one side. On a detailed physical exam, strength is 5/5 to flexion and extension at the ankle, knee, hip, shoulder, elbow, and wrist bilaterally.
Which of the following locations of the bleed best explains this finding?
A 34-year-old man was admitted to the hospital and intubated after a severe motor vehicle accident leading to multiple bone fractures two days ago. Despite weaning IV sedation, the patient continues to be unarousable to stimulation. An MRI was performed and DWI imaging is shown below. What is the most likely diagnosis?