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Which of the following regions of the brain, when active, promotes the switch from drowsiness to non-REM sleep?
Which of the following arteries supplies the head of the caudate nucleus and the anterior limb of the internal capsule?
An 18-year-old woman with a history of symptomatic epilepsy presents with medically-refractory seizures. An MRI brain is performed during presurgical evaluation and reveals the non-contrast-enhancing lesion shown below on T2 FLAIR. This lesion is most likely which of the following?
A 78-year-old man presents to the ER with headache, fever, diplopia, and hiccups. MRI with the brain with and without contrast shows small contrast-enhancing abscesses in the brainstem, sparing supratentorial cerebral tissue. Which of the following infectious agents classically presents in this fashion?
An unresponsive patient with an ischemic stroke is transferred to the intensive care unit. On physical exam, the patient has flexion of the bilateral elbows, wrists, and fingers, but extension of the legs. Where is the stroke most likely located?
At a national conference, a pharmaceutical representative reaches out to you and offers you an all-inclusive trip to the Bahamas to hear about their newest available preventative migraine therapy. As a resident, which is the most appropriate response:
A 24-year-old male with no known past medical history experienced a first-time generalized tonic-clonic seizure while at work. She is now in the emergency room and back to her neurological baseline. Bloodwork was unremarkable. A routine EEG and MRI of the brain were normal. Which is the most appropriate next step in management?
A 38-year-old man visiting from India presents to your clinic as a new patient for months of weakness in bilateral ankles to dorsiflexion and plantar flexion. On exam, he has diminished reflexes. He had an EMG done recently, showing axonal neuropathy in the lower extremities. He does not have his medication list with him, but he states he has taken a medication prescribed in India for “a cough” for several months. Which of the following labs would provide the highest yield?
A 36-year-old woman presents with facial weakness. She states that symptoms started on the right side of the face one week ago, but since then the left side has also become progressively weak. Other pertinent complaints include dry cough, shortness of breath, and joint pain. MRI of the brain shows bilateral contrast enhancement of the facial nerves. Chest X-ray reveals bilateral hilar adenopathy. A diagnostic lymph node biopsy is performed. Which of the following is most likely appreciated on pathologic analysis?
A 25-year-old woman with no significant medical history comes to the clinic for a routine physical exam. During the interview, she states that she is in a relationship with a famous singer for the last three months. She says his song lyrics are about her and his social media contains hidden messages that only she understands. The singer recently filed for a restraining order, but the patient says that’s “just for show.” She works at a local coffee shop and just recently got a promotion to manager. She denies any drug or alcohol use and takes no medications. Which of the following is the most likely diagnosis?
A 63-year-old female presents with a 6-month history of difficulty walking and muscle weakness. Neurologic examination reveals normal bulk but muscle fasciculations, bilateral extensor plantar responses, muscle spasticity, and hyperreflexia. Pathology at which of the following structures could explain these symptoms?
Opsoclonus-Myoclonus Syndrome (OMS) is associated with which autoimmune antibody?
A 45-year-old man with a past medical history of cardiac arrhythmia requiring pacemaker placement is referred to the clinic with a twenty-five-year history of slowly-progressive bilateral ptosis and diplopia. On examination, he has bilateral ptosis, decreased range of motion of the extraocular muscles, and mild proximal weakness in his upper and lower extremities. Which of the following is the most likely diagnosis?
An 8-year-old boy is brought to the neurology clinic due to an 18-month history of repetitive, involuntary movements of his face and body. His mother states that he has been bullied at school because of it, which is causing him significant distress and anxiety. His birth history and developmental history are normal. On physical exam, the patient has excessive blinking and occasionally jerks his right shoulder upwards at rest. The physical exam is otherwise within normal limits. which of the following is the most likely diagnosis?