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Which of the following enzymes are deficient with Fabry Disease?
This brain biopsy is consistent with which of the following pathologies?
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 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 49-year-old woman with recurrent episodes of vertigo and has an MRI brain performed at the request of her neurologist. Imaging reveals a well-circumscribed dural-based homogenous contrast-enhancing lesion. What is the most likely etiology of the lesion outlined above?
A 37-year-old male with the chief complaint of insidious unilateral hearing loss was found to have an acoustic neuroma on MRI. If a brainstem auditory evoked potential (BAEP) was performed which of the following would be most likely found?
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?
A 7-month-old girl with a past medical history of hypotonia, weight loss, and failure to thrive is brought to the clinic by her parents. An MRI was performed and T2 sequence images from this study are shown below. What is the most likely diagnosis?
Stiff person syndrome is associated with which of the following auto-antibodies?
A patient with Duchenne muscular dystrophy (DMD) most likely has which of the following findings on electromyography (EMG)?
A lesion to which of the following neuroanatomical structures causes dysphagia, decreased gag reflex, and hoarseness?
A 22-year-old woman with a previously diagnosed history of prior suicide attempts, EEG-confirmed epilepsy, and non-epileptic seizures comes to your clinic to establish herself as a new patient under your care. Upon entering the room she immediately tells you about her horrible relationship with her last epileptologist and how abandoned she felt when he decided to retire. While gathering her social history, she endorses a history of excessive spending on new cars, reckless driving, and alcohol-driven physical altercations. Which of the following personality disorders is most consistent with this clinical presentation?
A 45-year-old patient presented to the emergency room unresponsive. Emergency medical services noted that the patient was found in his garage with the car running in an apparent suicide attempt. Despite appropriate medical care, the patient passed away. An autopsy was performed. A gross pathology image is shown below. Identify the following regions marked by the white arrows.
A 55-year-old male cigarette smoker with a past medical history of hypertension and medication non-compliance presents to the emergency room with an excruciating headache and altered mentation. An MRI of the brain is completed and provided below (T2 sequence). Which of the following is the most likely diagnosis?
Which of the following is not part of Gerstmann’s syndrome?
Which synapsed of the peripheral nervous system is acetylcholine the primary neurotransmitter?
You are caring for a 78-year-old man with slowly progressive memory loss and behavioral change. You are concerned about either frontotemporal dementia (FTD) or Alzheimer’s disease (AD). Which of the following tests would be the most sensitive and specific in differentiating the two?
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 15-year-old male comes to the clinic with his parents as they complain he has periods of the year where he will sleep up to 20 hours a day for multiple days in a row, as well as uninhibited eating and inappropriate sexual behavior. These episodes last for up to around 2 weeks at most, and then he is behaviorally back to normal in between episodes. Which is the most likely diagnosis?
Which of the following is the mechanism of action of prazosin?
A 23-year-old female with a past medical history of depression presents with right arm paralysis that started after she found out her boyfriend died from a motor vehicle accident. Her physical exam shows no effort during muscle strength testing and positive withdrawal when a noxious stimulus is applied. The rest of the neurological examination, including reflexes, was normal. MRI of the brain and cervical spine were unremarkable. Which of the following is the most likely diagnosis?
A 56-year-old man with idiopathic Parkinson’s disease presents to the emergency department for hypertensive emergency and tachycardia. You suspect that this may be an adverse effect related to one of his medications. Patients that are prescribed MAO-B Inhibitors should be counseled on avoiding which of the following?
A 4-year-old boy is in the hospital for headache and abdominal pain and is being treated by the pediatric service for possible constipation, for which they have given polyethylene glycol. You are consulted due to the new onset of inability to extend his left wrist. On exam, you note a bluish coloration of the gingiva.
A peripheral blood smear is requested and shows microcytic RBCs with basophilic stippling. Anemia in this disease is caused in part by inhibition of which of the following?
A 65-year-old man comes to the clinic with a one-year history of difficulty walking. More recently, he has also noticed a tendency to drop things. On examination, he was found to have weakness in his bilateral lower limbs, predominantly in his quadriceps muscles, along with finger flexion weakness that is worse on the left side. His sensory examination was normal. Which of the following is the most likely diagnosis?
Which of the following findings is depicted in the vessel imaging shown?
Which of the following is associated with a “delta brush” pattern on EEG?
A 75-year-old man with hypertension and diabetes presents to the emergency department with a sudden onset of loss of sensation in the buttocks, perineum, and inner surfaces of both thighs, and urinary and fecal incontinence. On physical exam, he has loss of pain and light touch in the area described, as well as a loss of sphincter tone, and hyperreflexia in the lower extremities. Strength is mildly decreased in the distal lower extremities, without atrophy. What structure is most likely injured?
Which of the following arteries supplies the head of the caudate nucleus and the anterior limb of the internal capsule?
A 56-year-old female with a past medical history of IgA deficiency presents to the emergency room with a 4-day history of progressive, ascending lower extremity weakness. Neurological examination reveals flaccid paralysis of the bilateral lower extremities and areflexia. Imaging of the lumbar spine shows contrast enhancement of the cauda equina and CSF studies show elevated proteins and a normal WBC count. What is the most appropriate next step in therapy?
A 7-year-old girl presents with 2 weeks of a right-sided unilateral throbbing headache. She has otherwise been healthy with no other symptoms and has no past medical history except for a light pink birthmark around her right eye. What is the most appropriate next step?
A patient with end-stage amyotrophic lateralized sclerosis (ALS) presents to the emergency room from a nursing home alone. His vitals show hypoxemia and he appears tachypneic on examination. On examination, he is also paraplegic with significant weakness in the upper extremities and mild dysarthria. His mental status examination appears intact. Between short breaths, he says that he does not wish to be intubated. This is consistent with the end-of-life discussions documented in the outpatient clinic notes. As his hypoxemia worsens his wife arrives at the bedside and with urgency asks you to intubate the patient. What is the most appropriate response?
Cytotoxic edema would be best appreciated on which of the following MRI sequences?
What is the pathophysiology that leads to the pathology shown in the image below?
A 90-year-old woman presents to the emergency room with an acute change in mental status. On examination, she is alert but is not answering questions or following commands. Speech is fluent, but not interpretable. Comprehension is severely impaired. Interestingly she was able to repeat full sentences without much difficulty. Which of the following is the most likely territory of ischemic damage?
Which of the following is the most likely cause for the gross pathology shown in the image below?
Which of the following is most likely to cause the pathology seen in the image below (white arrow)?
Identify the structure (blue arrow) shown below:
A 14-year-old male is evaluated in your clinic for seizures. Past medical history is significant for brief staring spells in elementary school. Now the patient is having generalized seizures especially when he is sleep-deprived. Additionally, the patient has recently been experiencing jerky movements of both arms in the morning, resulting in him dropping objects from his hands. An EEG shows generalized 4-6 Hz polyspike and wave discharges. What is the most likely diagnosis?
The pathologic findings appreciated on this slide are secondary to which of the following pathologies?
A 26-year-old female presents with unilateral vision loss. She says that she noticed the symptoms upon awakening yesterday morning and has gotten progressively worse since then. On neurological examination, she has 20/70 visual acuity of the left eye and 20/20 of the right. There is a left afferent pupillary defect (APD). Extraocular movements are intact but cause pain. What is the most appropriate treatment?
The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?
A three-month-old female born full-term and without any significant past medical history is brought to the clinic with episodes of head-nodding for the past one week. Episodes last for only a few seconds and only occur while awake. On physical exam, there is an abnormal head tilt to the left and intermittent head nodding. Intermittent, horizontal, and bilateral nystagmus was also appreciated. Routine EEG and MRI of the brain with and without contrast were normal. Which of the following is the most likely diagnosis?
A 32-year-old woman with a known history of relapsing-remitting multiple sclerosis currently on ocrelizumab presents to the emergency room with the concern of having a demyelinating attack. An MRI brain with contrast shows a single, ovoid, juxtacortical white matter lesion with contrast enhancement that was not present on her last MRI scan. Which of the following is the most appropriate next step in medical management?
Deep brain stimulation has been effective in the management of Parkinson’s disease when it targets which of the following structures?
Exposure to which of the following in utero is associated with low birth weight?
Which of the following is the thalamic relay center for proprioception of the face?
A 30-year-old male presents to the emergency room with weakness in his bilateral lower extremities. On arrival, he was hypertensive and bradycardic. 2/5 strength is appreciated in his bilateral lower extremities. A loss of pinprick sensation is also appreciated from his lower extremities, but proprioception and vibratory sensation are intact. These findings are most likely secondary to a lesion of which of the following blood vessels?
Which of the following features on EMG is suggestive of chronic denervation?
Lesion to which area of the brain causes impairment in naming, fluency, and repetition with intact comprehension?
Which of the following would not constitute or be concerning for a HIPAA violation?