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A 42-year-old man presents to the emergency department with recurrent falls, mild confusion, and visual changes. Physical examination reveals a wide-based gait, nystagmus, and ophthalmoplegia. Deficiency in which of the following is the most likely cause of the patient’s symptoms?
A 45-year-old female presents to the emergency room after experiencing a first-time seizure. On examination, she has some mild RUE weakness and anomia. MRI w/o contrast was performed and shown below. Which of the following is the likely cause of her lesion?
A 69-year-old female is brought to the emergency room by her daughter for excessive stumbling, often tripping on things on the floor. The daughter also says her mother has been behaving oddly, complaining about seeing darkness in a fully lit room, and the inability to recognize her family members. Bilateral pupillary light reflexes are normal. If symptoms are secondary to an ischemic injury, an MRI would show a lesion in which of the following regions?
Which of the following pathologic findings is associated with posterior cortical atrophy?
An 85-year-old man with memory issues donates his brain for research on neurodegenerative disease. A histopathologic, Bodian-stained, sample of his brain tissue is shown below. Based on this image provided, what was the patient’s most likely neurodegenerative diagnosis?
A 78-year-old patient with a history of multiple system atrophy (MSA) presents to your clinic for falls. The patient states that while standing he initially experiences feelings of lightheadedness and tunnel vision before a loss of consciousness. While on the ground he will be “twitching” for 30 seconds before he regains consciousness. Which of the following tests is the most likely to be diagnostic in this case?
A 45-year-old man with a past medical history of type 2 diabetes and COPD presents with a 1-week history of fever, headache, and dizziness. Additionally, for the past two days, he has had intractable vomiting. MRI of the brain with and without contrast is shown below. What is the most appropriate treatment for this patient?
Which of the following is the most likely cause for the gross pathology shown in the image below?
A 66-year-old right-handed male presents to the EMG/NCS lab with right upper extremity pain, numbness, and weakness. Based on the data collected, what is the most likely diagnosis?
A 37-year-old female presents to the emergency room with diplopia and ambulation issues. Other than having an upper respiratory tract infection two weeks ago, there is no other significant past medical history. On physical exam, the patient has a decreased range of motion of the extraocular muscles bilaterally, diffuse areflexia, and marked dysmetria on finger-to-nose and alternating movements testing. Which of the following autoantibodies is most likely associated with this disease?
Which of the following is the mechanism of action of tetrabenazine?
An 8-year-old girl is noted to have staring spells during class by her teacher. In the office, you are able to provoke an event by having her blow repeatedly into a pinwheel. What is the most likely underlying pathology of her disease?
A 64-year-old man with idiopathic Parkinson’s disease being treated with carbidopa-levodopa is experiencing significant wearing-off despite increasing frequency and dose of levodopa-carbidopa, which is now producing significant peak dose dyskinesia. Which of the following would be a reasonable next agent to prescribe to reduce this wearing-off effect?
A study published in 1992 indiscriminately assigned 457 patients with optic neuritis to receive either 14 days of oral prednisone, 3 days of intravenous methylprednisolone followed by 11 days of prednisone, or an oral placebo for 14 days as an acute therapy. Visual function testing was performed intermittently over a six-month follow-up period. The results showed that patients who received methylprednisolone followed by oral prednisone had a faster rate of visual recovery. What type of study design was this?
A patient presents with sudden-onset gait instability and dysphagia. On exam, he has dysmetria of the right hand, anisocoria, loss of pain and temperature of the right face, and loss of pain and temperature of the left arm and leg. An MRI of the brain is performed and shows a stroke. What other symptom is often also a part of the syndrome this patient is experiencing?