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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. What is the most likely diagnosis for his symptoms?
A 32-year-old male with a longstanding history of epilepsy secondary to mesial temporal sclerosis returns to your clinic. Despite being on appropriate doses of levetiracetam and valproic acid he continues to have 20 partial seizures and 4 generalized tonic-clonic seizures per month. Which of the following is the next best step in his care?
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?
You are caring for a 78-year-old man with slowly progressive memory loss and behavioral change. You are concerned about either frontotemporal dementia (FTD) or Alzheimer’s disease (AD). Which of the following tests would be the most sensitive and specific in differentiating the two?
A 21-year-old woman with a past medical history of depression presents with recurrent episodes of out-of-body sensations lasting 30 seconds. This may be followed by 1-2 minutes of staring and unresponsiveness that she does not remember. She often remains confused for 10 minutes after an event. They occur 1-3 times every 2 weeks. An MRI brain is done and shows no pathology. Which test is the most diagnostically valuable next step in her workup?
Which of the following is the mechanism of action of prazosin?
Which of the following is not one of the absolute exclusionary criteria for tissue plasminogen activator (tPA)?
A 65-year-old female comes to the clinic complaining of weakness in his extremities. Symptoms are more prominent in the legs than in the arms. Oddly, when he tries to exert himself, he notes an improvement in his strength. Neurodiagnostic testing reveals low amplitude compound muscle action potentials (CMAPs) with an increase in amplitude on high frequency (50 Hz) rapid repetitive stimulation. Which of the following malignancies is most closely associated with this patient’s neurologic syndrome?
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?
Identify the structure (blue arrow) shown below:
Which of the following is most often associated with late-onset Alzheimer’s disease?
Which of the following is an appropriate test to assess for dorsolateral frontal lobe dysfunction?
A 15-day-old female is evaluated in the NICU after being born to a G2P2 mother. On exam, the infant is jaundiced. Abdominal ultrasound shows severe hepatosplenomegaly. CT scan of the head shows hydrocephalus and periventricular calcifications, and a fundoscopic exam shows bilateral chorioretinitis. Serological testing is most likely to show infection with which organism?
Chronic exposure to which of the following medications can cause the pathology appreciated on the pathology slide below?
Which of the following is not part of Gerstmann’s syndrome?