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Which of the following anti-seizure medications carries the highest risk of major congenital malformations?
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 55-year-old male presents to the clinic with a complaint of right lower extremity pain and weakness. On examination of the right lower extremity, there is decreased sensation to pinprick on the medial calf and foot, 4/5 strength with knee extension, and a mute patellar reflex. These findings are most likely due to radiculopathy of which of the following nerve roots?
Which of the following best describes the clinical features seen in transcortical motor aphasia?
Anti-GQ1b antibodies are associated with which syndrome?
Which of the following infectious agents is most likely responsible for the pathology seen in the image below?
A 72-year-old woman is brought to the clinic by her family with concerns about living at home alone. Her daughter states that the patient’s “memory is not what it used to be” and that she will often think that there are little children in her house when no one is there. On exam, you appreciate a bilateral upper extremity resting tremor. A functional PET scan will most likely show which of the following?
Patients with Charcot-Marie Tooth disease that have the CMT1A phenotype will have which of the following genetic mutations?
A 35-year-old woman presents to the clinic with headaches. Her past medical history is significant for migraines and a sprained ankle four months ago that she has been managing with daily NSAIDs. Her headaches started a month ago and have been occurring every day for the past three weeks. She describes the headaches as a band-like pressure around her head. Nothing has helped but the symptoms are worse in the mornings. A recent brain MRI was completed during an emergency room visit which was unremarkable. Which of the following is the most appropriate next step in therapy?
Which of the following muscles is solely innervated by the C5 nerve root?
A 67-year-old woman suffers from sustained involuntary contraction causing her head to be forcibly turned to the right and significant discomfort. On exam, her left sternocleidomastoid is significantly hypertrophied. She receives treatment with Botulism Toxin A. Subtype A of botulism toxin acts to reduce synaptic action of acetylcholine by what mechanism?
Which one of the following pairs regarding antipsychotic drugs and their adverse effects is incorrect?
A 65-year-old man presents to the emergency room with progressive weakness over the course of several months. Examination shows pure motor weakness with no sensory involvement, decreased reflexes, and diffuse fasciculations. An EMG shows conduction block of motor neurons outside of compression sites and normal sensory conduction velocities. Which of the following antibodies is associated with this disease?
A 26-year-old woman presents to the emergency department with third-degree burns covering the entire palmar aspect of her right hand. She claims that she was cooking dinner and touched the stove, but states that she “didn’t notice it was hot”. On neurologic exam, she is unable to distinguish between hot and cold sensations on her hands, arms, shoulders, chest, and back. She also fails to respond to pinprick sensation in the same distribution. She denies any major recent traumatic injuries. Which of the following is the most likely cause of her symptoms?
A 21-year-old male with a history of cirrhosis, dysarthria, and personality changes was brought to the emergency room after experiencing a 20-minute episode of right-sided weakness. An MRI was performed to evaluate for a possible stroke. An axial cut of a FLAIR sequence is provided below. What is the likely diagnosis of the patient’s chronic illness?
A 4-year-old male is brought to your clinic by his father who states that he has been experiencing random jerky movements of his arms and his neck for the past year. His father states that the jerky movements have not gotten worse over time but tend to appear more when the boy is agitated or under stress. The movements cease when he is asleep. The patient has otherwise been meeting all of his developmental milestones. Genetic testing reveals a mutation in TITF1, a thyroid transcription factor. What is the diagnosis?
A 36-year-old man with no significant past medical history presents with lower back pain, lower extremity weakness, and urinary incontinence. A non-contrast enhancing lesion was found on lumbar MRI (T1 sequence without contrast image shown below). What is the most likely diagnosis?
A 24-year-old college student presents with uncontrolled epilepsy. His seizures consist of an aura of déjà vu followed by oral automatisms and periods of unresponsiveness. The neurological examination is normal. MRI of the brain is performed and shown below. What is the etiology of this patient’s epilepsy?
A blood clot in which artery explains the findings below?
Which of the following dermatomes are correctly matched with their associated anatomical location?
Which of the following is not a risk factor for carotid dissection?
A 56-year-old woman with recent open-heart surgery develops sudden onset, painless right eye vision loss. On funduscopic examination, the optic disc appears swollen and pale. No other significant findings were appreciated on the funduscopic exam. Damage to which of the following structures is the most likely cause of the patient’s symptoms?
Which of the following is not a recommended screening test for cognitive dysfunction?
Identify the pathological abnormality shown in the image below.
Alzheimer’s disease typically has which of the following findings on functional PET imaging?
A 40-year-old woman is hospitalized at an inpatient psychiatric facility for new behavioral disturbances and a suicide attempt. She has also begun to develop unusual movements of her bilateral upper extremities. The movements are non-rhythmic, high-amplitude, low-frequency, and involve the entire extremity. Her brain MRI is shown below. Which of the following may help to treat her movements?
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 53-year-old male presents with a 3-month history of hypersexuality, visual agnosia, excessive chewing, and lip-smacking. Past medical history is notable for HSV encephalitis 6 months ago, which was treated with IV acyclovir. Based on the clinical history and examination, which of the following would most likely be appreciated on a brain MRI?
What are the 3 most common causes of bacterial meningitis in neonates (0-1 months)?
A 28-year-old woman of Chinese descent was recently diagnosed with focal/symptomatic epilepsy. Which of the following medications should best be avoided in the management of her epilepsy?
Paraphasic and semantic errors in speech can occur secondary to a lesion in which of the following regions?
A 4-day-old full-term baby is brought to the hospital for two episodes of generalized stiffening and apnea for less than 1 minute followed by a return to baseline. The physical exam is unremarkable and CTH is negative. The mother reports having similar episodes shortly after birth. What is the most likely cause of the episodes?
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?
A 66-year-old female comes to the EMG lab with the chief complaint of muscle cramps in the right lower extremity. She started having symptoms after treatment with a cholesterol-lowering medication but despite discontinuing the medication her symptoms persisted. Reflexes are 2+ in upper and lower extremities, except 1+ in the right Achilles. Nerve conduction studies of both lower extremities were normal. An EMG was performed and shown below. What is the most likely diagnosis?
A patient with a history of a right shoulder anterior dislocation comes to the clinic with the chief complaint of right arm numbness. On examination, there is a loss of sensation to light touch on the lateral portion of the upper arm. Based on the sensory disturbance, which of the following nerves is most likely injured?
A 45-year-old man presents to the clinic with a disc of the following MRI. Which symptom is the patient likely experiencing?
Which of the following comorbidities are responsible for the lesion appreciated in the image below?
A 65-year-old male presents with an acute onset of back pain, bilateral lower extremity weakness, and bladder incontinence. A physical exam reveals decreased strength and loss of pain and temperature sensation in both legs. Vibratory and light touch sensation and proprioception remain intact. A lesion to which of the following arteries would most likely be responsible for this clinical presentation?
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 side effect of topiramate?