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A 65-year-old male with a history of alcoholic cirrhosis presents to the emergency department with dark black coffee-ground emesis. He is found to have a systolic blood pressure of 76/40 and is tachycardic to 120 BPM. Which nerve is most responsible for carrying the afferent fibers from carotid sinus baroreceptors that cause the reflex increase in heart rate seen in this patient?
Which of the following is the mechanism of action for amantadine?
A 67-year-old man presents urgently to the emergency room with an acute onset of left-sided weakness and numbness. A CT head was performed and shown below. What is the most likely etiology of the patient’s symptoms?
A 45-year-old man presents to the clinic with a disc of the following MRI. Which symptom is the patient likely experiencing?
Bilateral exotropia is typically seen with which of the following lesions?
Which of the following is the mechanism of action for natalizumab?
An 11-month-old male is brought to the emergency room with agitation, fever, and nuchal rigidity. A review of the patient’s electronic medical record shows that the patient was admitted with meningitis 2 months ago. While no clear focal neurological symptoms were appreciated on examination, there was a midline dimple appreciated in the lumbosacral region. Which of the following is the most likely etiology of the patient’s recurrent illness?
Which of the following botulinum serotypes cleaves synaptosomal-associated protein (SNAP)-25.
A 30-year-old man with a past medical history of migraines presents to the emergency department for his typical migraine symptoms, which have become intractable. He is treated with a “migraine cocktail” (normal saline, acetaminophen, and prochlorperazine) with some improvement. You are then called to the bedside for concern that he is having a possible seizure. His head is turned forcibly to the right without eye deviation and he is able to follow commands and verbalize. Which of the following is the best next step in management?
A 69-year-old man with HTN, CKD, HLD, tension headaches, and gout presents for 6 months of slowly progressive weakness. He has trouble rising from a chair without assistance and lifting objects above his head. On sensory exam, you note a bilateral symmetric loss of proprioception, vibration, and light touch in the feet and distal lower legs. He brings with him an EMG/NCS report from last week from an outside provider. It shows a length-dependent axonal neuropathy, as well as early recruitment and low amplitude action potentials on EMG of the proximal muscles. Serum CK is obtained and 3200. Which of the following is the most likely cause of his problem?
A 50-year-old male with a 1-year history of behavioral changes and abnormal movements has a CT head performed after having a fall at his nursing home. Based on the imaging and brief clinical history what is the likely genetic abnormality associated with his neurological disease?
A 67-year-old man with a past medical history of obstructive sleep apnea is being evaluated for bilateral arm tremors. His symptoms started insidiously 5 years ago. It is best appreciated when the patient brushes his teeth or eats with a fork. Oddly, he has noticed that a glass of wine at night can help with his symptoms. What is the most appropriate therapy for his movement disorder?
A 28-year-old female is brought to the emergency room by her husband because of behavioral changes and memory issues over the last 4 days. Right after the MRI, shown below, the patient had a tonic-clonic seizure. Based on the limited clinical history and imaging provided, which of the following is the most likely diagnosis?
Which of the following does this EEG tracing reveal?
A 42-year-old woman with multiple sclerosis presents to the ER after having worsening confusion over a few days with worsening weakness and vision loss. She was on natalizumab for years and her most recent JCV antibody titer was negative. She has missed several months of infusions due to her helping a sick relative. Her MRI shows multiple new T2 hyperintensities with enhancement in the periventricular and subcortical white matter. What is the most likely diagnosis?