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A 26-year-old woman presents to the emergency department with third-degree burns covering the entire palmar aspect of her right hand. She claims that she was cooking dinner and touched the stove, but states that she “didn’t notice it was hot”. On neurologic exam, she is unable to distinguish between hot and cold sensations on her hands, arms, shoulders, chest, and back. She also fails to respond to pinprick sensation in the same distribution. She denies any major recent traumatic injuries. Which of the following is the most likely cause of her symptoms?
What seizure type is most commonly seen with the pathology shown in the image below?
Which of the following is the reversal agent for apixaban?
A 56-year-old man with a past medical history of hypertension and type II diabetes presents to the hospital with acute onset left-sided weakness which started 90 minutes prior to your evaluation. His only medications prior to admission were metformin and verapamil. Vitals were within normal limits except for a blood pressure of 154/92. Physical examination reveals 3/5 weakness in the left arm, leg, and face as well as a moderate sensory disturbance in the same regions. CT head was unremarkable and CT angiogram (CTA) showed no large vessel occlusion. A brief history gathered from his wife revealed no other comorbidities or active medical issues. At this point in his clinical presentation, what is the mechanism of action of the most appropriate therapy?
A 68-year-old woman with a history of diabetes and hypertension presented urgently to the ED with a 2-day history of headaches and confusion. Before any imaging was able to be completed in the emergency room, the patient had a cardiac arrest and died. An autopsy was requested by the family. A gross pathologic image of the patient’s brain is shown below. What is the most likely etiology of the findings seen in this image?
A 57-year-old male with a past medical history of progressive weakness affecting all extremities and dysphagia for the past 6 months is admitted to the hospital. An EMG was completed as part of his workup and is shown below. Based on the available information what is the most likely diagnosis?
Which of the following symptoms can be seen with MCA-PCA watershed infarcts?
Which of the following is the most sensitive test for myasthenia gravis (MG)?
A 22-year-old female with chronic daily headaches and other neurological symptoms has an MRI performed as part of her diagnostic workup. Her cervical MRI imaging is provided below. In addition to her chronic daily headaches, what are the most likely additional neurological symptoms she experiences?
A 34-year-old woman comes to the emergency room with complaints of neck stiffness, headaches that are worse on standing, and diplopia. An MRI brain with contrast shows diffuse dural enhancement. Which of the following findings is also likely to be present in this case?
A 37-year-old man with poorly controlled diabetes mellitus presents to the emergency department with a three-day history of progressive headache, fever, and double vision. Examination shows bilateral proptosis, peri-ocular erythema, and ophthalmoplegia. CT of the head was ordered and showed bony destruction of the sinuses. Based on the most likely diagnosis, which of the following is the most appropriate treatment?
Identify the lesion shown in the image below.
What is a common comorbid issue seen in newborns with the vascular abnormality appreciated in the imaging provided?
A 12-year-old boy with a past medical history of sickle cell disease was admitted to the emergency room in a pain crisis. While being treated with morphine the patient developed acute left arm/leg weakness and numbness. Which of the following is the most likely etiology for the patient’s new neurologic symptoms?
A 60-year-old woman with a history of diabetes is presenting to the neurology clinic with a 4-month history of burning/tingling in her bilateral toes. Neurological examination revealed 5/5 strength in all muscle groups, normal reflexes, and intact sensation to light touch in the bilateral lower extremities. There was mildly decreased sensation to pinprick in the 1st toe bilaterally. Which of the following tests is the most likely to be diagnostic for this patient?
A 72-year-old male with a past medical history of hypertension presents with an acute onset of right upper and lower extremity weakness. The sensory exam is normal. Right homonymous hemianopia is also appreciated. Which of the following vessels is most likely affected?
A 29-year-old man with a 10-pack-year smoking history comes into the clinic with a severe headache. The pain surrounds his right eye and is associated with a runny nose, excessive tearing, and a “droopy eyelid.” He describes the pain as stabbing that usually lasts about 30 minutes and occurs every day after he eats dinner. What is the most likely diagnosis?
A 48-year-old male with a history of a motor vehicle accident and right leg tibial plateau fracture was referred to a neurologist because of right leg weakness. He states he often catches his right foot while walking and stubs his toes when he walks barefoot. On examination, there is decreased ankle dorsiflexion and eversion of the foot. Weakness of which of the following muscles is responsible for the patient’s symptoms?
Which of the following is most likely to show temporal dispersion of the action potential?
A 47-year-old woman from the Caribbean presents to the clinic with a seven-year history of progressive difficulty with ambulation. The exam is notable for lower extremity spasticity. An MRI is ordered and shows atrophy of the spinal cord without other changes. The clinical and MRI findings for this patient are most likely secondary to which of the following infections?
A 5-month-old female is brought to the emergency room by her parents because of an episode concerning for possible seizure. On arrival, the patient appears back to her clinical baseline neurologically. Several hypomelanotic lesions are appreciated while performing a skin check. The mother notes that her older brother has similar skin findings. An EEG is performed and shown below. A typical event was captured that correlated with an electrodecrement of cortical activity on EEG.
Based on the child’s diagnosis, what is the most appropriate therapy?
Which of the following blood vessels that supply the thalamus is the only one to branch off of the posterior communicating artery (PCOM) instead of the posterior cerebral artery (PCA)?
An 80-year-old woman with a history of well-controlled Parkinson’s disease presents with worsening movements at night. Her husband states that she often punches and yells during her sleep. Some of these movements have been so dramatic that she punched a hole in the wall beside her bed. Melatonin was tried but did not lead to a significant improvement in symptoms. Which of the following is the most appropriate next step in treatment?
Vasogenic edema would be best appreciated on which of the following MRI sequences?
Which of the following medications is the most appropriate pharmacologic agent for paroxysmal kinesigenic dyskinesia?
A 65-year-old female presents with a complaint of burning and tingling of her feet. Symptoms started in her toes two years ago and now extend up to her ankles. Neurological examination showed normal strength and intact sensation to light touch and vibration but an impaired sensation to pinprick in the first toes bilaterally. If performed, which of the following studies would likely be abnormal?
A 28-year-old woman of Chinese descent was recently diagnosed with focal/symptomatic epilepsy. Which of the following medications should best be avoided in the management of her epilepsy?
A 32-year-old male comes into the headache clinic for severe headaches. They occur several times a day and last approximately one hour. They are only felt on the left side of his head, and he says he gets a runny nose and a little teary during the episodes. What is a notable side effect of the prophylactic medicine that is considered first-line therapy for this condition?
A 42-year-old male presents as a trauma for a large motor vehicle accident. He is comatose, intubated but not sedated, and admitted to the trauma ICU. His brain imaging shows diffuse axonal damage. On examination, his pupils are reactive equally and corneal reflexes are intact, but otherwise, he has no motor response to pain, upgoing plantar reflexes bilaterally. The family asks if the patient is “brain dead”. Which of the following is not part of the confirmatory criteria on the standard brain death exam?
Which of the following symptoms is atypical for essential tremor?
Patients with trisomy 21 are at an increased risk for which of the following?
A 19-year-old male was admitted to the hospital with a 2 weeks history of progressive lower extremity weakness. CSF studies showed an elevated CSF protein and normal WBC count. MRI of the lumbar spine showed contrast enhancement of the cauda equina. His nerve conduction study (NCS) is shown below. What is the most appropriate next step in medical management?
Which of the following is the mechanism of action of clonidine?
Identify the lesion shown in the image below.
A full-term (40 weeks gestational age) male had an uncomplicated delivery with good APGAR scores. However, the family has noticed unexplained episodes of tremulousness. Because of these abnormal movements, an EEG was ordered. Which of the following is the most accurate description of the findings shown in the epoch below?
Which of the following nerve conduction study abnormalities is least likely to be seen during the initial phase of acute inflammatory demyelinating polyneuropathy (AIDP)?
What is the anatomical structure marked by the blue arrow?
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?
All of the following therapies can be useful in the management of cluster headaches except:
Patients with Alzheimer’s disease may have hypometabolism in which of the following brain regions?