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A 48-year-old patient with a past medical history of chronic migraines is brought in by her family with sudden-onset memory complaints. She is unable to recall where she lives or even her own name. A brain MRI (Left: DWI. Right: ADC.) is shown below. Which of the following is the most likely diagnosis?
Which of the following is an appropriate test to assess for dorsolateral frontal lobe dysfunction?
A 39-year-old male presents to the clinic for hallucinations. His medical history is only remarkable for a chemical accident at his job resulting in severe corneal scarring bilaterally, for which he now requires a seeing-eye dog.
His hallucinations are usually of tall figures dressed in black with long fingers. He is not frightened by this because he knows they are not real. He denies other neurologic deficits, denies auditory hallucinations and describes his mood as “good”. The rest of his exam is normal.
You are familiar with the underlying syndrome the patient is experiencing. You inform the patient that in the rest of the population the most common cause of this syndrome is actually…
A 65-year-old man presents to the emergency room with progressive weakness over the course of several months. Examination shows pure motor weakness with no sensory involvement, decreased reflexes, and diffuse fasciculations. An EMG shows a conduction block of motor neurons outside of compression sites and normal sensory conduction velocities. Which of the following of most appropriate for treatment?
A 45-year-old patient presents with complaints of new-onset double vision. On the general neurologic exam, you note the patient tilts their head to the left. The remainder of the physical exam is unremarkable. Which of the following is the most common underlying pathologic cause of this issue?
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 39-year-old male presents with right-sided weakness and aphasia. NIHSS is 22 on physical exam. He was last known well 2.5 hours prior. The past medical history does not reveal any contraindications to tPA. A CT head is done and shows a hyperdense left MCA sign. The tPA is mixed by the nursing staff while you consent his wife for its administration. When you return to the bedside his aphasia has improved but his NIHSS is still 13. The blood pressure is 189/105 and the glucose is 225. What is the most appropriate next step?
What is the mechanism of action of pregabalin?
A 38-year-old man with a past medical history of chronic cough, and shortness of breath presents with a three-week history of recurrent headaches, confusion, and difficulty with speech. On exam, there are difficulties with attention and mild aphasia. Additionally, there appear to be erythematous nodules along his shins bilaterally. Brain MRI shows a contrast-enhancing lesion in the left hemisphere. Due to the patient’s chronic pulmonary complaints, a chest X-ray is also performed. Which of the following is most likely seen on a chest X-ray?
A 65-year-old male is referred to the EMG lab with a recent right leg injury and associated weakness. Based on the EMG shown below, where is the most likely site of neuronal injury?
A 4-month-old male with no significant past medical history was admitted to the epilepsy monitoring unit with episodes concerning for possible seizures. The family has noticed that events tend to occur when the child is angry. One episode is captured during his stay. The first symptoms appreciated were excessive crying followed by loss of tone and a few myoclonic jerks for 20 seconds. The patient then rapidly returned to baseline thereafter. There were no epileptiform discharges seen during this episode. Based on the most likely diagnosis, what is the most appropriate next step in management?
Which way are the patient’s eyes moving at the point of the asterisk marked below?
A 71-year-old male with a history of mild ankle weakness and balance issues for the last 6 years is referred to the lab for a nerve conduction study (NCS). While performing the testing the patient states that a few of his siblings, as well as his father, had similar issues. Examination showed high arches and hammertoes. Based on the clinical history and NCS, what is the most likely diagnosis?
A 65-year-old man presents to the emergency room with progressive weakness over the course of several months. Examination shows pure motor weakness with no sensory involvement, decreased reflexes, and diffuse fasciculations. An EMG shows conduction block of motor neurons outside of compression sites and normal sensory conduction velocities. Which of the following antibodies is associated with this disease?
Which of the following is the thalamic relay center for auditory stimuli?