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A 72 y.o. female presents to the clinic with complaints of decreased interest in eating, and has lost weight. She states foods have an unusual taste and are not appealing. On detailed examination, she is found to have normal extraocular movements, normal facial muscle symmetry, and normal facial sensation and swallowing. On further detailed examination, she has a loss of taste sensation in the right anterior two-thirds of her tongue. Of the following, which is the most likely area of injury?
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?
Based on the MRI imaging shown below, which of the following structural abnormalities is likely also present?
Which of the following medications is considered a first-line agent for the management of juvenile myoclonic epilepsy?
Which of the following arteries supplies the head of the caudate nucleus and the anterior limb of the internal capsule?
A 27-year-old man presents after having an unprovoked generalized tonic-clonic seizure. Which of the following should he be told regarding his clinical situation?
A 78-year-old male with no past medical history presents to the ED with left-sided hemiparesis and slurred speech at 9 AM. She is unable to provide a clear clinical history. She was noted to be found at 7:30 AM in bed with the above-stated symptoms. Her husband states that the patient went to bed at 10:00 PM the previous night without any symptoms. CT head shows no blood or hypodensities, and CTA head/neck reveals a right MCA occlusion. Her NIHSS is 17. Which of the following treatment options is the most appropriate next step based on the available data?
A newborn is evaluated in the NICU hours after birth to a G1P1 mother with poor prenatal care at 36 weeks. Upon evaluation, the newborn is macrocephalic, jaundiced, and hypotonic. She also has a faint purpuric rash on her extremities and redness of both eyes. CT of the head shows periventricular and basal ganglia calcifications. This condition is likely caused by which of the following organisms?
Which of the following is the mechanism of action of aspirin?
A 65-year-old male comes into the office with his wife for follow-up after a recent hospitalization for HSV encephalitis. The wife says before his hospitalization, he used to be a quiet, shy man but recently has been making sexually inappropriate remarks to women at the park. The patient also has an increase in appetite and an urge to touch everything at the grocery store. Based on his cognitive deficits, which of the following areas of the brain is likely affected?
Which of the following vessels that supply the thalamus originates from the P2 segment of the posterior cerebral artery and supplies the lateral geniculate nucleus?
A 74-year-old female presents to the ED for trouble with swallowing and balance. On physical examination, she is unable to speak clearly and has no gag reflex. Pain and temperature sensation on the right side of her body and the left side of her face is decreased. She is unable to walk unassisted and has dysmetria on the finger-to-nose exam. MRI of the brain shows an ischemic stroke. The artery that is affected most commonly branches off of which of the following?
Socially inappropriate behavior, disinhibition, echopraxia, and utilization behavior are typically seen in which of the following?
A two-week-old, full-term female with an uncomplicated delivery is brought to the clinic with abnormal jerky movements. Her father states that episodes occur right after the patient is put down for a nap, last for roughly 3 minutes, and resolve with arousal. During the episodes, the patient has rapid, repetitive myoclonic movements of her upper limbs. The physical exam is unremarkable. The patient was admitted to the Epilepsy Monitoring Unit where a typical event was captured and had no EEG correlate. Which of the following is the most likely diagnosis?
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 4-month-old boy is brought by his parents due to difficulty in feeding, and episodes of apnea. Physical examination reveals tongue fasciculations, a bulging anterior fontanelle, and an abducens nerve palsy. MRI reveals an Arnold Chiari malformation type II. What additional defect is this child likely to have?
A 68-year-old right-handed male with HTN and atrial fibrillation formerly taking Eliquis, but stopped months ago due to GI bleed, presents for acute onset neurologic symptoms. He is able to understand speech and commands, however, he is unable to speak fluently and can not get the right words out. Despite this, he is able to accurately repeat words you say and correctly name items that are pointed to. What other neurologic symptom is also likely to be present on the exam?
A 67 y.o. female with HTN and atrial fibrillation on coumadin was in the Neuro ICU in a comatose state after a large intracranial hemorrhage. After a couple of days of monitoring, she had a new finding on her physical exam that prompted stat imaging, which showed signs of uncal herniation. Surgery was not performed due to goals of care preferences, and she, unfortunately, passed away from her ailment. An autopsy was requested. The image below shows compression on a cranial nerve from the herniation. Through which anatomic structure does this nerve pass to exit the skull?
A 50-year-old female presents with altered mental status. Her family states that over the past couple of weeks, the patient has had progressive memory loss, mood changes, and poor judgment. On examination, the patient has involuntary arm movements and an exaggerated startle response. Brain MRI, DWI sequence, is shown below. Which of the following is the most likely diagnosis?
An MRI is ordered on a man with a known history of ischemic stroke and bilateral upper extremity weakness. Which of the following was the most likely cause of his ischemic injury?
Which of the following is not one of the absolute exclusionary criteria for tissue plasminogen activator (tPA)?
Which of the following structures is not primarily involved in the processing and relay of auditory information in the central nervous system?
Identify the pathological abnormality shown in the image below.
Initiation of urination involves which of the following physiologic processes?
Which of the following structures has an intact blood-brain barrier?
A 38-year-old man with a past medical history of HIV, depression, and asthma presents after experiencing a first-time seizure. He was last seen normal about 45 minutes ago by his husband, who witnessed him seizing for about 10 minutes. A CTH is performed and normal. A lumbar puncture is performed and reveals the findings below. Which of the following is the most likely cause of the patient’s symptoms?
A 35-year-old male with a past medical history of intravenous drug use presents with back pain, fever, anorexia, and generalized weakness. An MRI of his sagittal spine is shown below. Which of the following is the most likely diagnosis?
Which of the following identifies the vein of Galen?
Which of the following antiplatelet medications rely heavily on the cytochrome P450 system for its therapeutic effect?
Which of the following best describes the clinical features seen in transcortical motor aphasia?