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A previously healthy 15-year-old male presents to the emergency room after experiencing a concussion while playing soccer. He is now back to baseline but to be thorough the ED physician orders an MRI which is shown below. What is the lesion shown in this MRI?
A 75-year-old patient is brought in by her husband because of word-finding difficulty. On cognitive testing, the most impressive finding was that the patient could not recall many colors of the rainbow. Based on this finding, what kind of memory is most impaired?
Which of the following is most likely to be damaged by carbon monoxide toxicity?
Eteplirsen is an effective treatment in patients with Duchenne muscular dystrophy (DMD) that have which of the following dystrophin mutations?
A 36-year-old man with no significant past medical history presents with lower back pain, lower extremity weakness, and urinary incontinence. A non-contrast enhancing lesion was found on lumbar MRI (T1 sequence without contrast image shown below). What is the most likely diagnosis?
You are caring for a 19-year-old male in the neurocritical care unit after drowning. His brain MRI is pending clinical stability. Which finding on brain MRI is most likely after a severe global hypoxic injury?
Which of the following medications is an acetylcholinesterase inhibitor that is FDA approved in the U.S. for the treatment of severe Alzheimer’s disease?
The paraspinal muscles are innervated by which of the following?
A 57-year-old male with an unknown past medical history who recently immigrated from South Asia presents to the emergency department with new-onset skin lesions on his arms. On physical exam, the patient has two large, erythematous lesions with a clearly demarcated but flat border. The nerves around these lesions appear thickened. Biopsy of the lesions shows epithelioid cell granulomas and few bacteria. What is the most likely diagnosis?
A 17-month male was brought to the pediatric neurology clinic was brought to the clinic with concerns for developmental delay. Parents note that the child was a product of a normal pregnancy and his delivery was uncomplicated. A developmental delay was appreciated by 8 months of age. He is largely non-verbal. He appears happy in the room, laughing spontaneously without any external stimuli. Which of the following abnormalities most likely explains this developmental disorder?
A 25-year-old male with a history of sensorineural hearing loss and tinnitus has an MRI brain ordered as part of his workup (see below). A genetic syndrome is suspected. Which of the following is also likely to be found on imaging?
A 66-year-old male presents to the emergency room as an unrestrained driver in a motor vehicle accident. While initially only complaining of mild neck pain, within 30 minutes of the collision he started to experience bilateral numbness in his hands and significant symmetric upper limb weakness. Soon thereafter, the weakness extended down to his lower extremities. Neurologic examination is remarkable for loss of pain and temperature sensation in his bilateral upper extremities and symmetric bilateral upper extremity greater than lower extremity weakness. Which of the following is the most likely diagnosis?
A 6-year-old male is brought to the pediatrician with multiple-decaying teeth since 2-3 years of age with no associated pain. He was born via C-section at term with no complications. Past medical history is significant for developmental delay and intellectual impairment. On physical exam, the patient is short-statured and obese with hypogonadism. His parents state that he has always been an overeater. What is the most likely diagnosis?
Which of the following findings is most typically seen with HIV-associated neurocognitive disorder?
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?
A 32-year-old man with no significant past medical history presents to the emergency department after experiencing a generalized tonic-clonic seizure. His neurological examination was unremarkable. As part of his work-up, an MRI was obtained (see FLAIR axial image below). What is the most appropriate next step in management?
A 65-year-old female presents with an abrupt onset of akinetic mutism, lack of motivation, apathy, bilateral leg weakness, and incontinence. A lesion to which of the following vascular territories could explain her symptoms?
Deep brain stimulation has been FDA approved for the management of medically refractory epilepsy when it targets which of the following structures?
A 56-year-old woman with recent open-heart surgery develops sudden onset, painless right eye vision loss. On funduscopic examination, the optic disc appears swollen and pale. No other significant findings were appreciated on the funduscopic exam. Damage to which of the following structures is the most likely cause of the patient’s symptoms?
A 23-year-old female with a history of optic neuritis presents with a 1-week history of left leg weakness. Neurologic examination reveals decreased strength of the left lower extremity. A lumbar puncture reveals oligoclonal bands with lymphocytic pleocytosis. What stain can be used to identify the dysfunctional cells in this condition?
Which of the following anatomic structures is responsible for the perception of superficial light touch?
Which of the following is the most appropriate pharmacologic agent for type II episodic ataxia?
A 38-year-old man with a prolonged history of intravenous drug use, HIV, and poor compliance with HAART therapy is brought to the hospital by police after being seen wandering across a busy street intersection. His last CD4 count was 180 cells/microliter 8 months ago. Vitals appear within normal limits on arrival. Neurological examination shows inattention, poor short-term memory, and difficulties with abstract thought. An MRI is performed and shown below. What is the likely etiology of his symptoms?
Which of the following structures has an intact blood-brain barrier?
How long ago did the ischemic injury seen on the micropathology slide below of neuronal tissue occur?
What is the pathophysiology that leads to the pathology shown in the image below?
A 48-year-old woman presents with acute onset of seizures, myoclonus, ataxia, and rapidly progressive dementia. CSF analysis reveals an elevated protein and mild pleocytosis. Brain MRI with and without contrast is unremarkable. Further investigation reveals elevated thyroid-stimulating hormone levels and anti-thyroid peroxidase antibodies. Which of the following is the most appropriate therapy?
The pathology seen in the image below is most likely related to maternal use of which of the following medications?
A 10-year-old girl is brought to the clinic with a 1-month history of progressive clumsiness. Neurological examination shows significant bilateral ataxia. Imaging was performed and showed a midline lesion in the 4th ventricle. A biopsy was performed and shown below. Based on the most likely diagnosis, what is the most appropriate treatment plan?
An 83-year-old man with a history of Parkinson’s disease is brought to the office with worsening hallucinations. She says that she sees things around the house and is starting to get paranoid that their neighbors are spying on them. Which of the following medications would help this patient’s symptoms?
A 16-year-old girl with no significant past medical history presents to the clinic with 2 episodes of syncope in the past month. She states that both of the episodes occurred while giving oral presentations in front of her class. She reports that she has been under a lot of stress lately because of a midterm paper and that her parents are going through a divorce, which has taken an emotional toll on her. Before each episode of syncope, she feels warm and starts to get lightheaded, and “sees stars”. Each episode of syncope lasts approximately 15 seconds, and she does not have any confusion after the episodes. The physical exam is within normal limits. Which of the following is the most likely cause of this patient’s syncope?
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 enzymes are deficient with Fabry Disease?
A lesion to which of the following arteries could produce the ischemic findings shown in the MRI below (Brain MRI, axial cuts. Left: DWI sequence. Right: ADC sequence).
A 32-year-old female with a history of schizophrenia is brought to the emergency room by her husband for acute psychosis. She receives a medication while in the emergency room to aid in her agitation. Soon after administration, the patient develops involuntary contractions of muscles of her face and neck. Which of the following medications was most likely administered to cause these symptoms?
Which of the following is the mechanism of action of entacapone?
A 38-year-old man presents with frequent headaches over the past year and recent development of polydipsia and polyuria. He has also been complaining of a dry cough, shortness of breath, and erythematous nodules along his shins bilaterally. MRI of the brain shows a contrast-enhancing lesion of the hypothalamus. Which of the following is the most likely diagnosis?
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?
Which of the following structures is supplied by the recurrent artery of Heubner?