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Concentrically-layered Schwann-cell processes (“onion bulbs”) are seen surrounding nerve fibers on nerve biopsy in which of the following diseases?
What anatomical structure is the most common location for a Mycobacterium tuberculosis-related CNS infection?
Which of the following is the correct order of venous structures related to cerebral blood drainage?
Stevens-Johnson syndrome associated with carbamazepine use is more likely in patients with which of the following HLA alleles?
Which of the following CSF findings would be expected in a patient with AIDP?
Identify the darkly stained structures.
A 15-year-old boy with a past medical history of ADHD presents with odd behaviors including shrugging his shoulders and blinking frequently. His mother also states that he used to have some similar movements when he was younger, but they seem to have worsened since starting a new medication for his ADHD. Which of the following medications is most likely responsible for his symptoms?
A 60-year-old woman with a history of diabetes is presenting to the neurology clinic with a 4-month history of burning/tingling in her bilateral toes. Neurological examination revealed 5/5 strength in all muscle groups, normal reflexes, and intact sensation to light touch in the bilateral lower extremities. There was mildly decreased sensation to pinprick in the 1st toe bilaterally. Which of the following tests is the most likely to be diagnostic for this patient?
Which of the following medications used in the management of multiple sclerosis is the most teratogenic?
A 28-year-old caucasian male was last seen well at 9:00 AM when he got into a verbal argument with his girlfriend. When the girlfriend returned from work at 5:00 PM, she found the patient on the floor of the garage altered, and states he “smelled unusual”. In the emergency department, the patient is disoriented but arousable with much effort. He complains of a headache and blurred vision, and he appears uncomfortable with a respiratory rate of 40. You send stat labs and they are listed below. What treatment should you administer immediately?
ABG: 7.18 pH, PCO2 = 28, PO2 = 118
Electrolytes: Na 135 mEq/L, K 5.0 mEq/L, Cl 105 mEq/L, HCO3 15 mEq/L
An MRA is ordered for a patient presenting with an acute stroke. Based on the lesion appreciated in the image below (white arrow), what symptom is likely to be seen on examination?
Which of the following is the most classic finding of early inclusion body myositis?
A 45-year-old female presents to the emergency room after experiencing a first-time seizure. On examination, she has some mild RUE weakness and anomia. MRI w/o contrast was performed and shown below. Which of the following is the likely cause of her lesion?
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?
Opsoclonus-Myoclonus Syndrome (OMS) is associated with which autoimmune antibody?
A 19-year-old male with a history of a motorcycle accident 6 weeks ago with several bone fractures of the arms and legs was referred to the EMG lab with right arm numbness since the accident. Where is the most likely site of this patient’s neuronal injury?
Which of the following is the genetic mutation commonly seen in patients with hereditary neuropathy with liability to pressure palsy (HNPP)?
A 6-year-old Amish female presents to the emergency department with a 2-month history of gradual cognitive decline and jerking limb movements. A routine EEG was obtained (see below). Which of the following diseases is consistent with these EEG findings?
The axial T2 brain MRI image shown below is from a 20-year-old man who presented to the hospital after experiencing a motor vehicle accident. Which of the following associated findings would be expected given the abnormality shown?
The MR angiogram shown below demonstrates which of the following?
A 31-year-old female with depression, anxiety, and migraines presents to the ED for altered mentation. On arrival, she has a temperature of 41 degrees Celcius, HR 130, and a systolic blood pressure of 190. On exam, she is diaphoretic and agitated, with increased tone, hyperreflexia, shivering, and dilated pupils.
You call her family who states that the patient has a hard time keeping down a job, frequently moving from state to state. She has had a number of different psychiatrists over the years, and you, therefore, are unable to find a comprehensive medication list. In her purse, she has a pill bottle of sertraline, with 85/90 pills remaining.
Which of the following other medications is this patient likely taking?
A 65-year-old man with a history of severe depression is bought to the clinic by his wife after losing 15 pounds in the last month. The patient states that he believes that his stomach and intestines have been removed and that he died several weeks ago. Which of the following is the most likely diagnosis?
A 32-year-old woman comes into the clinic complaining of severe right-sided headaches around the temple. The pain occurs several times a day and lasts approximately 15 minutes and radiates to the right shoulder and arm. There is also associated nasal congestion and lacrimation during the episodes. The patient was treated with indomethacin with complete resolution of symptoms. What is the most likely diagnosis?
A 32-year-old man with a past medical history significant for major depressive disorder is brought to the emergency department after he was found by his roommate attempting suicide by hanging. His roommate states that he has been noncompliant with his medications and had been going through a depressive episode before his suicide attempt. After 6 weeks of trying several different antidepressants while on the inpatient psychiatric service, his major depression symptoms have not improved. Which of the following is the most appropriate next step in treatment?
A 65-year-old woman with a past medical history of hypertension, hyperlipidemia, and migraine headaches previously well-controlled on propranolol, presents to the clinic with new headache characteristics. The patient states that she recently has a new scalp tenderness. On further history, she endorses jaw soreness after eating. What is the most appropriate initial diagnostic test?