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An 80-year-old woman with a history of Parkinson’s disease that is well controlled with carbidopa-levodopa presents with her husband for evaluation of delusions. Her husband states that the patient believes that she is being consistently monitored by the FBI and will avoid eating certain foods for fear of being poisoned. She is also constantly worried that her husband will leave her for a younger woman. Which of the following medications would be the most appropriate FDA-approved treatment for these symptoms?
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?
Based on the MRI imaging shown below, which of the following structural abnormalities is likely also present?
A mutation in which of the following genes would be most likely in a patient with numerous cavernous malformations seen on head imaging?
A 67-year-old male with a gait disorder is having a polysomnogram due to aggressive leg movements during sleep. During the study, an abnormality is noted during sleep. The EMG and chin leads show excessive muscle artifact during sleep, while at the same time the EEG shows quick deflections in the lateral leads, indicating rapid alternating eye movements. He is given a diagnosis and started on medication. Which of the following is the most appropriate treatment for this sleep issue?
A 16-year-old girl is seen in the clinic for episodes concerning for seizures. Episodes are characterized by staring off, unresponsiveness, and licking her lips for 30 to 60 seconds. Two weeks ago one of these episodes developed into a generalized tonic-clonic seizure. That day she went to the emergency room and had an MRI performed. The associated images are shown below. Based on the clinical history and imaging what is the most likely diagnosis?
What task is likely being performed during this EEG recording?
A 72-year-old female presents to the clinic with her husband who states that she is “seeing things that aren’t there”. For the past two weeks, she has been complaining of bats flying around her room at night. Comparable visual disturbances have occurred over the past year, but have gotten progressively worse recently. She has also been acting out a lot at night; her husband states that she has been violently kicking and flailing her arms while asleep. Finally, she has been experiencing cognitive decline, including forgetting where she lives, what year it is, and the names of her grandchildren. On exam, there is symmetric cog-wheel rigidity appreciated. What is the most likely diagnosis?
Which of the following nuclei of the hypothalamus is involved in temperature regulation?
A 30-year-old woman presents to the clinic with severe headaches requesting treatment because she “can’t live with this pain”. Episodes are left-sided, occur multiple times a day, and last about 20 minutes each. During episodes, she will also have eye tearing and rhinorrhea. What is the correct diagnosis?
A 50-year-old male is admitted for 3 months of progressive memory loss, visual hallucinations, and myoclonus. Examination revealed myoclonic jerks. Which of the following tests is the most specific for this disease?
A 32-year-old woman comes into the clinic complaining of severe right-sided headaches around the temple. The pain occurs several times a day and lasts approximately 15 minutes and radiates to the right shoulder and arm. There is also associated nasal congestion and lacrimation during the episodes. The patient was treated with indomethacin with complete resolution of symptoms. What is the most likely diagnosis?
A 33-year-old woman has recently given birth to a healthy 3-month-old boy. She has been complaining of poor sleep for the past year, mainly from an uncontrollable urge to move her legs that is only relieved by moving them. This is present during the day to a small degree but is much worse at night and during periods of rest. What would be the best test to order for her?
The following is a sample of gray matter stained with Anti-NeuN and viewed under a low-power microscope lens. The pathology marked by the blue arrow is most consistent with which of the following causes of epilepsy?
Patients with neurofibromatosis type 1 (NF1) classically have which of the following associated with their disease?
A 35-year-old female with a history of heroin abuse was found unresponsive and received 35 minutes of CPR before a return of spontaneous circulation (ROSC). She was intubated in the field and was brought urgently to the hospital. While in the ICU, the nursing staff noticed abnormal movements concerning for possible seizure. An EEG was performed and shown below. What is this finding most consistent with?
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?
Which of the following conditions is most likely to have an associated disorder of abnormal motor activity during the following sleep state?
A 12-year-old male is brought to the clinic accompanied by his father who states that for the past 4 months he has been randomly flailing his arm during class and calling out in the middle of the teacher’s lectures. He has been sent to the principal’s office twice in the past month for his disruptions. His father states that this is very out of character for him. In the clinic, the patient has intermittent movements of his right arm, where he raises his arm above his head and then slaps it down on his leg. Additionally, during the exam, he blurts out words that do not make contextual sense in the conversation. Two months later, the patient follows up with his father who states that all of the abnormal movements and vocalizations have resolved. What is the most likely diagnosis?
A 55-year-old male with a 3-year history of postural hypotension, incontinence, and ataxia comes to the clinic for evaluation. An MRI brain shows degeneration of the pontocerebellar and olivocerebellar fibers. What is the most likely diagnosis?