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A 37-year-old female presents to the emergency room with diplopia and ambulation issues. Other than having an upper respiratory tract infection two weeks ago, there is no other significant past medical history. On physical exam, the patient has a decreased range of motion of the extraocular muscles bilaterally, diffuse areflexia, and marked dysmetria on finger-to-nose and alternating movements testing. Which of the following autoantibodies is most likely associated with this disease?
The electrographic pattern appreciated in the 6th second of this recording likely represents which of the following?
A 65-year-old woman with a history of a known right posterior communicating artery aneurysm comes to the emergency department with focal neurological symptoms. Brain MRI shows interval enlargement of the aneurysm. Which of the following clinical symptoms is most likely?
A 51-year-old woman with a past medical history of migraines and irritable bowel syndrome comes to the physician because of abnormal shaking of both hands for the past two months. The shaking improves after two glasses of wine. Examination shows symmetric hand tremors that worsen when the patient reaches for objects in front of her. What is the mechanism of action of the most appropriate first-line treatment?
A 17-year-old female with a past medical history of anxiety, depression, and irritable bowel syndrome presents to the emergency room after a transient clinical episode. Her mother states that they were eating dinner when her daughter dropped to the floor and began having generalized shaking movements of her arms and her legs. She was unresponsive during the event and her eyes were closed. The event lasted approximately 30 seconds and there was no post-ictal confusion. In the emergency room, the patient has another event, where pelvic thrusting and asynchronous movements were appreciated for 2 minutes before resolution. The patient stated that she remembered having no control of her body during the event in question. Based on the most likely diagnosis, which of the following is the most appropriate treatment?
The imaging shown below is most consistent with which of the following diseases?
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?
A 42-year-old woman with major depressive disorder and anxiety who has recently completed treatment for gambling addiction presents with a unilateral upper extremity resting tremor and the feeling that she is “stiff all of the time”. Her husband remarks that she has become much more soft-spoken lately and that five years ago she began acting out her dreams. Which of the following medications should be avoided in this patient?
A nine-month-old boy with no significant past medical history is brought to the clinic by his mother because of paroxysmal episodes of unknown etiology. His mother states that since he was six months old, she noticed that his head would intermittently tilt to his right lateral side when he woke up. His head tilt would always disappear during sleep. During these “attacks” the patient would become irritable and would occasionally vomit. The symptoms last up to 48 hours before resolution. Imaging of the brain and EEG do not demonstrate any abnormalities. Which of the following is the most likely cause of these symptoms?
Which of the following is the relay center for sensory information of the body?
Which of the following is the best prognostic finding on EEG after cardiac arrest?
A 40-year-old textile worker is brought to the clinic for slowly progressive symptoms including shuffling gait, tremor, and profuse drooling. On examination, his speech is difficult to understand and there is cogwheel rigidity in his arms and legs. His tremor is most evident when his limbs are at rest. Exposure to which of the following is the most likely cause of the patients’ symptoms?
A 46-year-old female presents to the clinic with complaints of recurring headaches. She states that she experiences episodes of sharp pain in her left cheek, which is exacerbated by eating or a cold wind blowing on her face. Outside of these triggers, she is largely pain-free. She doesn’t endorse any associated rhinorrhea, lacrimation, or facial flushing. Which of the following is the most appropriate treatment for her disease?
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?
Which of the following does this EEG tracing reveal?