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A 30-year-old male presents to the emergency room with weakness in his bilateral lower extremities. On arrival, he was hypertensive and bradycardic. 2/5 strength is appreciated in his bilateral lower extremities. A loss of pinprick sensation is also appreciated from his lower extremities, but proprioception and vibratory sensation are intact. These findings are most likely secondary to a lesion of which of the following blood vessels?
A 34-year-old male presents with personality changes that started after a motor vehicle accident-related traumatic brain injury. His family has noticed that since the accident, the patient no longer actively seeks out hobbies that he once enjoyed. He will often forget to eat meals unless prompted, even if the food is placed in front of him. Which of the following medications would most likely help with his behavior?
Congenital muscular dystrophies are most often associated with which of the following pathophysiologies?
Which of the following is the mechanism of action of mitoxantrone?
You are caring for a 1-month-old infant in the neonatal ICU with abnormal movements since birth. The baby is seen writhing in bed, with her arms and legs and axial trunk moving in a snake-like pattern. A CT head is done and shows bilateral cystic lesions on the basal ganglia. Toxic levels of which of the following are most likely at play?
An 82-year-old female patient with a history of atrial fibrillation is brought to the emergency department after being found down at home. She is unable to move her extremities, although she is able to blink and move her eyes vertically. Occlusion of which artery/arteries is the most likely cause of her symptoms?
A 14-year-old male is referred to the neurology clinic by his PCP with the complaint of bilateral hearing loss. Neurological examination shows a sensorineural hearing loss. Multiple hyperpigmented lesions on the chest and back were also appreciated. An MRI of the brain was ordered that showed bilateral posterior fossa lesions. Genetic testing would reveal a mutation on which chromosome?
Which of the following is the mechanism of action of tolcapone?
A 35-year-old male presents to the neurology clinic for the management of seizures. The patient reports having focal to bilateral tonic-clonic seizures (FTBTC) since the age of 15. His seizures are usually preceded by the smell of burning rubber. He will then have left hand automatisms followed by whole-body tonic-clonic activity. Levetiracetam monotherapy was initially effective. However, 1 year ago seizures returned, occurring once every two months. Lacosamide was added 6 months ago but there has been no significant improvement in his seizure frequency. Levels of these two anti-seizure medications (ASMs) are therapeutic and there have been no concerns regarding medication adherence. What is the most appropriate next step in management?
A 67 y.o. female with HTN and atrial fibrillation on coumadin was in the Neuro ICU in a comatose state after a large intracranial hemorrhage. After a couple of days of monitoring, she had a new finding on her physical exam that prompted stat imaging, which showed signs of uncal herniation. Surgery was not performed due to goals of care preferences, and she, unfortunately, passed away from her ailment. An autopsy was requested. The image below shows compression on a cranial nerve from the herniation. Through which anatomic structure does this nerve pass to exit the skull?
An abnormal breathing pattern described as irregular inspiratory phases and variable intervals of apnea can localize to damage to which of the following regions along the neuraxis?
The abnormalities appreciated on the MRI below are due to a defect in which of the following processes?
An 11-month-old male is brought to the emergency room with agitation, fever, and nuchal rigidity. A review of the patient’s electronic medical record shows that the patient was admitted with meningitis 2 months ago. While no clear focal neurological symptoms were appreciated on examination, there was a midline dimple appreciated in the lumbosacral region. Which of the following is the most likely etiology of the patient’s recurrent illness?
A 65-year-old woman with a past medical history of hypertension, hyperlipidemia, and migraine headaches previously well-controlled on propranolol, presents to the clinic with new headache characteristics. The patient states that she recently has a new scalp tenderness. On further history, she endorses jaw soreness after eating. What is the most appropriate initial diagnostic test?
You are caring for a 19-year-old male in the neurocritical care unit after drowning. His brain MRI is pending clinical stability. Which finding on brain MRI is most likely after a severe global hypoxic injury?
An EMG/NCS is performed for the evaluation of subacute left upper extremity weakness in an adult female. There are fibrillation potentials in the deltoid and biceps on EMG and decreased median and radial sensory amplitudes on NCS. Which portion of the brachial plexus was injured?
You have recently diagnosed an asymptomatic 45-year-old man with Huntington’s disease based on genetic testing which was requested based on a family history of the disease. The patient was informed of these findings in the clinic with his wife by his side. On the following day, you receive a phone call from the patient’s 23-year-old son asking what the results of the testing were. What is the most appropriate response to this question?
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?
In the diagram below, what neurologic information is carried by the tract labeled with the green arrow?
Which of the following drug-mechanism pairs is incorrect?