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Initiating HAART therapy for a patient with poorly controlled HIV places them at an increased risk for which of the following?
Which of the following blood vessels that supply the thalamus is the only one to branch off of the posterior communicating artery (PCOM) instead of the posterior cerebral artery (PCA)?
A 57-year-old navy veteran with a history of PTSD presents with a 2-year history of progressive, asymmetric weakness. The patient states that symptoms started in his left arm. Six months later he started to have falls due to tripping over his right foot. His neurological examination shows weakness of the intrinsic hand muscles of the left arm, ⅖ strength on dorsiflexion of the right ankle, and no sensory disturbances. Reflexes were mute in the left upper extremity and there were several beats of clonus at the right ankle. Fasciculations were present in the tongue, right gastrocnemius, and left tibialis anterior. An EMG is recommended for diagnosis. Which of the following EMG findings are most likely seen in this patient?
Aquaporin-4 (AQP4) channels are found on which cell type?
Paraphasic and semantic errors in speech can occur secondary to a lesion in which of the following regions?
A 61-year-old male with a past medical history of GI cancer status post gastric resection at age 57, consequently on parenteral nutrition, presents to your clinic for a second opinion. He complains of slow movements and rigidity in his arms and legs that have slowly progressed over the last year. He denies tremors or cognitive change. He saw a different neurologist who started him on carbidopa/levodopa 6 months ago but the response has been minimal and he continues to get worse. You decide to perform a brain MRI and you see bilateral hyperintensity of the globus pallidi on the T1-weighted image. What treatment should you add?
A 35-year-old Dominican Republic immigrant is brought to the emergency room for a first-time seizure. He is currently back to baseline and has a normal neurological exam. His only complaint is a multiple-month history of chronic headaches. A head CT scan is performed and shown below. Which of the following is the most likely etiology of his symptoms?
A patient with an AVM rupture is admitted to the ICU. On exam, the patient has abnormal neck, elbow, and knee extensor posturing, and wrist flexion. In which of the following locations was the AVM most likely located?
A patient with a clinical history concerning for hydrocephalus has an MRI brain completed (see below). Surgical resection was completed and genetic analysis revealed no presence of an IDH mutation or 1p/19q co-deletion. What is the most likely diagnosis?
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?
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?
The medulla develops from which of the five primary vesicles of the brain?
A two-week-old, full-term female with an uncomplicated delivery is brought to the clinic with abnormal jerky movements. Her father states that episodes occur right after the patient is put down for a nap, last for roughly 3 minutes, and resolve with arousal. During the episodes, the patient has rapid, repetitive myoclonic movements of her upper limbs. The physical exam is unremarkable. The patient was admitted to the Epilepsy Monitoring Unit where a typical event was captured and had no EEG correlate. Which of the following is the most likely diagnosis?
Which of the following medications do not worsen myasthenia gravis symptoms?
Immunohistochemical staining with GFAP is particularly useful in identifying which of the following cell types?
Which of the following findings is depicted in the vessel imaging shown?
A 67-year-old woman with a past medical history of osteoporosis, hypertension, bipolar disorder, and a remote right MCA stroke is referred to the epilepsy clinic after experiencing her first epileptic seizure. An EEG has shown right temporal epileptiform discharges. Which of the following medications are most appropriate to start as initial therapy?
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?
A 4-year-old male with no significant past medical history presents to the emergency room after experiencing a first-time seizure. An EEG is obtained and captures a seizure arising from the left hemisphere and polymorphic delta slowing on the same side. Over the next several months the child continues to experience focal-onset seizures despite being on 2 maximally-dosed seizure medications. His brain MRI, below, shows asymmetric left-hemispheric atrophy. His clinic presentation and imaging are most consistent with which of the following diseases?
This muscle biopsy is most consistent with which myopathic disease?