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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?
A 30-year-old female with no known past medical history comes to the emergency room after a generalized tonic-clonic seizure. Her friend says that she has been behaving oddly over the past couple of days and has been complaining of a headache. An axial T2 brain MRI is shown below. Which of the following is the most likely diagnosis?
A 24-year-old healthy male with recent right-sided otitis media complicated by mastoiditis presents to the ER with a first-time seizure. On examination the patient is somnolent and febrile, MRI brain shows a right temporal lobe intraparenchymal mass with a solid rim of contrast enhancement and surrounding vasogenic edema, what is the most likely etiology?
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?
What are the 3 most common causes of bacterial meningitis in neonates (0-1 months)?
A 14-year-old girl with no significant past medical history is brought to the clinic with a 1-week history of involuntary movements of the left side of her body. Her mother reports that 1 month ago, she experienced a week of fever, malaise, and fatigue, but they did not seek medical treatment at the time. On physical exam, the patient exhibits involuntary, irregular movements of her neck, left arm, and left leg, and generalized hypotonia. What is the most likely diagnosis?
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 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?
A 10-year-old female from the northeastern United Stated presents to the ED with her mother after a one-week history of difficulties in school and difficulties with speech. Her mother states that two weeks ago the patient had a rash on her leg and viral-like symptoms that went away within a few days. Then, this past week the patient’s teacher reported that she was having difficulties with attention in school and was performing very poorly on assignments. Her mother also confirmed that the patient has been more forgetful and is also slurring her speech. An MRI of the brain was performed and it showed multifocal white matter lesions. Of note, the patient likes to spend a lot of time outdoors and recently went on a camping trip. Which of the following is the most likely cause of the patient’s symptoms?
A 4-month-old infant of Amish parents is evaluated in the emergency department for an acute onset of weakness, poor feeding, and irritability that started 2 days ago. Neurologic examination of the child was impressive for ptosis, decreased tone, generalized weakness, a poor suck reflex, and mydriasis. MRI of the brain was normal. Which of the following is the most likely cause of the patient’s symptoms?