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Which of the following occurs at point “4” on this diagram of an action potential?
Which of the following is not a recommended screening test for cognitive dysfunction?
A 5-year-old boy is seen in the clinic for seizures, vision loss, and progressive loss of milestones. MRI of the brain shows a posterior predominant leukodystrophy. Which of the following is the most likely diagnosis?
Which of the following EEG artifacts is prominently seen on this EEG?
A 56-year-old man with a history of a kidney transplant, on tacrolimus, presented to the hospital with a 2-week history of progressive confusion and expressive aphasia. An MRI brain with and without contrast was performed and shown below. A brain biopsy was performed and showed microglial nodules with encysted bradyzoites and tachyzoites. Which of the following is the most appropriate therapy?
A 27-year-old man presents after having an unprovoked generalized tonic-clonic seizure. Which of the following should he be told regarding his clinical situation?
Which of the following is most strongly associated with an increased risk of seizure recurrence after a first unprovoked seizure?
A patient with Alzheimer’s disease donates their brain for research on neurodegenerative disease. A histopathologic, H&E-stained, sample of his brain tissue is shown below. What is the structure marked by the black arrow?
Primary generalized dystonia is a genetic disorder that can be seen secondary to a mutation of which of the following genes?
What is a common comorbid issue seen in newborns with the vascular abnormality appreciated in the imaging provided?
A 56-year-old female presents to the clinic with right posterior leg pain. On examination, there is decreased sensation of the right posterior calf and weakness in right ankle plantarflexion. EMG testing shows fibrillations of the gastrocnemius and gluteus maximus muscles. EMG testing of the tibialis anterior, gluteus medius, and tensor fascia lata were normal. What is the most likely etiology of this patient’s symptoms?
A 28-year-old male with a known history of neuromyelitis optica spectrum disorder (NMOSD) and a recent diagnosis of acute optic neuritis returns to the emergency room for worsening monocular vision loss despite completing 5 days of high dose (1 gm/day) methylprednisolone therapy. Based on the clinical scenario and level of evidence for efficacy, what is the most appropriate next step in therapy?
A 24-year-old female in her third trimester of pregnancy, with no other past medical history, presents with complaints of 1-2 times monthly episodes of sudden onset severe room spinning, nausea, and vomiting for 3 months. They happen randomly and are not associated with head movement. During an episode, sounds and bright light seem to bother her more. She denies motor weakness or hearing change. Her spells resolve after about 1 hour. She endorses she has had bad headaches in the past, but not with these episodes. She endorses she gets car sick easily. On neurologic examination, she has no focal findings, and her vitals are within normal limits. She had an MRI brain with MRA and MR Venogram, all of which were unremarkable. Which is the most likely etiology?
A 30-year-old woman has visual evoked potentials performed that show a right eye P100 latency of 140 msec and a left eye P100 latency of 103 msec. Which of the following is the most likely cause?
A 30-year-old male presents to the clinic with a fifteen-year history of progressive weakness and sensory loss in his lower extremities. Examination shows hammertoes, high arches on his feet, 4/5 ankle dorsiflexion strength, and a mild decrease in sensation to pinprick in the 1st toes bilaterally. Upon questioning he mentions that his father had similar-looking feet and started to use a cane in his fifties. Which of the following genetic mutations may be the cause of the patient’s symptoms?
A 24-year-old man comes to the emergency room with severe left-hand pain after a fall at home. The patient refuses to allow the nurse or doctor to do a physical exam. A hand X-ray is unremarkable. She insists that all she needs is a note for two weeks of paid leave from her job. Which of the following is the most likely diagnosis?
What is the most appropriate therapy for the infection depicted in the pathology slide below?
Hyperammonemia is a side effect seen with which of the following antiepileptic drugs?
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 22-year-old woman with a previously diagnosed history of prior suicide attempts, EEG-confirmed epilepsy, and non-epileptic seizures comes to your clinic to establish herself as a new patient under your care. Upon entering the room she immediately tells you about her horrible relationship with her last epileptologist and how abandoned she felt when he decided to retire. While gathering her social history, she endorses a history of excessive spending on new cars, reckless driving, and alcohol-driven physical altercations. Which of the following personality disorders is most consistent with this clinical presentation?
Which of the following has the longest half-life?
A 35-year-old male presented for sudden onset painless central vision loss. An outside hospital emergency room physician suggested he may have had a CRAO, but recommended immediate ophthalmology outpatient evaluation. The patient was unfortunately lost to follow-up for a few months. He presents today due to a sudden onset of central vision loss in the other eye.
On your ophthalmologic exam, you note hyperemic optic nerve and tortuous central retinal vessels, without evidence of vessel cutoff. He has a central scotoma bilaterally, with peripheral vision intact. He has red color desaturation as well. MRI brain w/ and w/o contrast with fat suppression and thin cuts through the orbits is performed, and normal.
This disorder is caused by which of the following pathologic processes?
The cell marked by the blue arrow is derived from which germ layer?
A full-term (40 weeks gestational age) male had an uncomplicated delivery with good APGAR scores. However, the family has noticed unexplained episodes of tremulousness. Because of these abnormal movements, an EEG was ordered. Which of the following is the most accurate description of the findings shown in the epoch below?
A 9-year-old boy presents with his mother for 18 months of multiple complaints. He reports having continuous thoughts of needing to wash his hands and building anxiety until he can perform the action. He spends more than an hour in total every day washing his hands. He also has stereotyped movements on exam with head turning and shoulder shrug, and will sometimes shout random words. Lab and imaging workup is negative. Which of the following medications, paired with cognitive behavioral therapy, is most indicated?