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Which of the following medications are known to develop neutralizing antibodies (NAbs) against it with chronic use?
A 45-year-old patient presents with complaints of new-onset double vision. On the general neurologic exam, you note the patient tilts their head to the left. The remainder of the physical exam is unremarkable. Which of the following is the most common underlying pathologic cause of this issue?
A 3-day-old male infant is evaluated in the NICU for fever and focal seizures. He was born at 39 weeks gestation via uncomplicated vaginal delivery and had good APGAR scores. Brain imaging shows periventricular calcifications and severe ventriculomegaly. Auditory testing also demonstrates bilateral hearing impairment. What is the most likely cause of the patient’s symptoms?
A 24-year-old healthy male with recent right-sided otitis media complicated by mastoiditis presents to the ER with a first-time seizure. On examination the patient is somnolent and febrile, MRI brain shows a right temporal lobe intraparenchymal mass with a solid rim of contrast enhancement and surrounding vasogenic edema, what is the most likely etiology?
A 56-year-old male with a past medical history of smoking presents to the clinic with the chief complaint of a 1-month history of progressive muscle weakness. Interestingly, he notes that his strength seems to improve with repeated use. The physical examination is notable for proximal muscle weakness of the bilateral lower extremities and areflexia in all extremities. Serology and electrodiagnostic testing confirm the diagnosis. What is the first-line therapy for symptomatic management?
The patient is a 79-year-old male with a past medical history of myocardial infarction who was referred for a nerve conduction study (NCS) to evaluate his slowly progressive lower extremity numbness and weakness. Which of the following pathologies is most commonly associated with the findings shown in the (NCS) shown below?
Which of the following is the most classic finding of early inclusion body myositis?
A 40-year-old textile worker is brought to the clinic for slowly progressive symptoms including shuffling gait, tremor, and profuse drooling. On examination, his speech is difficult to understand and there is cogwheel rigidity in his arms and legs. His tremor is most evident when his limbs are at rest. Exposure to which of the following is the most likely cause of the patients’ symptoms?
A 23-year-old female with a past medical history of depression presents with right arm paralysis that started after she found out her boyfriend died from a motor vehicle accident. Her physical exam shows no effort during muscle strength testing and positive withdrawal when a noxious stimulus is applied. The rest of the neurological examination, including reflexes, was normal. MRI of the brain and cervical spine were unremarkable. Which of the following is the most likely diagnosis?
Which of the following medications do not worsen myasthenia gravis symptoms?
You are caring for a 65-year-old that sustained a small hypertensive intracranial hemorrhage. Early physical therapy is initiated. They discover that while she can sit unassisted, she is unable to stand. When standing, she sways and falls forward, backward, or to one side. On a detailed physical exam, strength is 5/5 to flexion and extension at the ankle, knee, hip, shoulder, elbow, and wrist bilaterally.
Which of the following locations of the bleed best explains this finding?
What anatomical structure is the most common location for a Mycobacterium tuberculosis-related CNS infection?
A 48-year-old man with a 20-year history of HIV stable on HAART therapy presents to your clinic accompanied by his partner who states that the patient has had mounting difficulties over the last 3 years. Most recently he has been unable to effectively manage finances, cook for himself, or arrange appointments. What is the best diagnosis at this time?
Which of the following is the mechanism of action for selegiline?
A 15-year-old male comes to the clinic with his parents as they complain he has periods of the year where he will sleep up to 20 hours a day for multiple days in a row, as well as uninhibited eating and inappropriate sexual behavior. These episodes last for up to around 2 weeks at most, and then he is behaviorally back to normal in between episodes. Which is the most likely diagnosis?