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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?
You are caring for a patient with Lewy body dementia who is having difficulty with myoclonic jerks. Which of the following is considered the first-line treatment for cortical myoclonus?
A 57-year-old woman with a past medical history of hypothyroidism was referred to the EMG lab with a one-year history of right-hand numbness. Based on the EMG data shown below, what is the most appropriate next step in medical management?
A 30-year-old male presents to the clinic with a fifteen-year history of progressive weakness and sensory loss in his lower extremities. Examination shows hammertoes, high arches on his feet, 4/5 ankle dorsiflexion strength, and a mild decrease in sensation to pinprick in the 1st toes bilaterally. Upon questioning he mentions that his father had similar-looking feet and started to use a cane in his fifties. Which of the following genetic mutations may be the cause of the patient’s symptoms?
EMG abnormalities in which of the following muscles can not localize to the brachial plexus?
A 32-year-old man with a past medical history of major depressive disorder is brought to the emergency department by his roommate who states that a few days ago the patient stopped taking his medications. Vital signs were within normal limits. On examination, the patient was non-verbal except for occasionally repeating words spoken by the examiner. He would not follow commands. When his arms were positioned off the bed they remained there for several minutes. CT head and CTA of the head and neck were normal. Which of the following is the most appropriate next step in treatment?
Charcot Marie Tooth disease (CMT) is associated with which of the following pathologic findings?
Patients with Charcot-Marie Tooth disease that have the CMT1A phenotype will have which of the following genetic mutations?
A 27-year-old previously healthy female is seen at the clinic for 5 days of leg weakness. The weakness has progressively been getting worse and now she has difficulty rising from a chair. Her past medical history is unremarkable except for a few days of an upset stomach and diarrhea that occurred two weeks ago. On physical exam, strength is diminished in the bilateral lower extremities. Deep tendon reflexes are 1+ in the lower extremities. A lumbar puncture is ordered. Testing of the cerebral spinal fluid (CSF) in this patient is most likely to show which of the following?
A 19-year-old boy presents with his mother for complaints of frequent eye blinking and shoulder-shrugging spells occurring multiple times a day. He also has frequent episodes of humming a three-note tune randomly throughout the day. He has had these problems since he was 17. He had an MRI brain and EEG that were negative. He takes no medications. The symptoms do not impact his activities of daily living, but he does feel embarrassed by the symptoms. He went to cognitive behavioral therapy for this for a year and has not seen a benefit. Which of the following is a first-line medication for this patient?
Which of the following structures is well myelinated in a full-term (40-week) infant?
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?
What is the most appropriate therapy for the infection depicted in the pathology slide below?
The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?
Which of the following findings is most typically seen with HIV-associated neurocognitive disorder?
A 56-year-old woman with recent open-heart surgery develops sudden onset, painless right eye vision loss. On funduscopic examination, the optic disc appears swollen and pale. No other significant findings were appreciated on the funduscopic exam. Damage to which of the following structures is the most likely cause of the patient’s symptoms?
A 6-year-old male with a history of medically-refractory epilepsy (on three anti-seizure medications), and right-sided-hemiparesis, presents to the emergency room with a three-day history of continuous right facial twitching. Symptoms persist during sleep and have not responded to benzodiazepines. On examination, the patient has retained awareness despite the continuous facial movements. MRI brain was performed and shown below. Of the following, which is the most appropriate therapy to achieve seizure freedom?
Based on the MRI imaging shown below, which of the following structural abnormalities is likely also present?
A 43-year-old female presents with rapidly declining cognitive function over the past few weeks. She is no longer able to hold a sustained conversation, she is no longer able to drive, and has worsening insomnia. CSF analysis shows increased 14-3-3 protein levels. What is the pathogenesis of this patient’s disease?