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The vessel imaging shown below is consistent with which of the following?
Mutations in the progranulin protein (gene PGRN) can serve as a biomarker for the risk of which of the following diseases?
Which of the following primary CNS tumors carries the highest risk of disseminated metastatic disease through the spine via CSF seeding?
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?
Which of the following medications, when taken alongside statin therapy, increases the risk of statin-induced myopathy?
A 26-year-old physics teacher and mother on valproic acid (VPA) for epilepsy presents to your clinic with her husband stating she wishes to try to become pregnant soon. She asks how anti-seizure medications (ASMs) used during pregnancy may impact the intelligence and school performance of her child. Which is the most accurate response?
Which of the following medications do not worsen myasthenia gravis symptoms?
A 50-year-old male farmer presents to the emergency department with diarrhea, steatorrhea, weight loss, abdominal pain, and joint pain in his shoulders and hips. He also displays constant rhythmic eye movements and repetitive facial muscle contractions. Intestinal biopsy reveals macrophage inclusions that positively stain with periodic acid-Schiff. What is the most likely etiology of this patient’s presentation?
This brain biopsy is representative of which of the following tumors?
A 10-year-old girl is brought to the clinic with a 1-month history of progressive clumsiness. Neurological examination shows significant bilateral ataxia. Imaging was performed and showed a midline lesion in the 4th ventricle. A biopsy was performed and shown below. Based on the most likely diagnosis, what is the most appropriate treatment plan?
A 47-year-old female presents to the clinic with the chief complaint of slowly progressive proximal muscle weakness. Electromyography showed short duration, low amplitude motor unit action potentials. A muscle biopsy was performed and shown below. A diagnosis is made and the patient is started on a therapeutic agent. What is the most likely medication initiated?
A previously healthy 15-year-old male presents to the emergency room after experiencing a concussion while playing soccer. He is now back to baseline but to be thorough the ED physician orders an MRI which is shown below. What is the lesion shown in this MRI?
A 13-year-old male with a recent history of acute disseminated encephalomyelitis (ADEM) presents to the clinic for post-hospital follow-up. He has made a near-complete recovery from his illness but his parents want to know what is his risk of recurrence. What is the most accurate statement you can share with the parents?
A 33-year-old female presents to the clinic for evaluation of a left lower extremity foot drop. On physical examination, there is weakness in dorsiflexion. Ankle eversion, inversion, and plantar flexion strength are normal. Hip abduction strength is normal as well. Which of the following is the most likely etiology for the patient’s symptoms?
What are the 3 most common causes of bacterial meningitis in neonates (0-1 months)?
A 25-year-old woman with no significant medical history comes to the clinic for a routine physical exam. During the interview, she states that she is in a relationship with a famous singer for the last three months. She says his song lyrics are about her and his social media contains hidden messages that only she understands. The singer recently filed for a restraining order, but the patient says that’s “just for show.” She works at a local coffee shop and just recently got a promotion to manager. She denies any drug or alcohol use and takes no medications. Which of the following is the most likely diagnosis?
A 59-year-old woman presents to the emergency room with dizziness and left ear fullness. The symptom is described as a spinning sensation that is present at rest and with action. She has had comparable events before, which have self-resolved over time. The patient is ataxic on the exam and has difficulty hearing out of her left ear. An MRI brain with and without contrast was normal. Which of the following is the most appropriate line of therapy that will decrease the risk of future recurrent events?
A 30-year-old man with a past medical history of migraines presents to the emergency department for his typical migraine symptoms, which have become intractable. He is treated with a “migraine cocktail” (normal saline, acetaminophen, and prochlorperazine) with some improvement. You are then called to the bedside for concern that he is having a possible seizure. His head is turned forcibly to the right without eye deviation and he is able to follow commands and verbalize. Which of the following is the best next step in management?
A 72-year-old male with a past medical history of hypertension presents with an acute onset of right upper and lower extremity weakness. The sensory exam is normal. Right homonymous hemianopia is also appreciated. Which of the following vessels is most likely affected?
A 34-year-old female with poorly-controlled type 2 diabetes presents to the ED with a 3-day history of sinus and orbital pain, fever, and headache. Four hours ago, she was feeling confused and dizzy, which prompted her to come to the hospital. A head CT scan is performed and it shows erosion of the nasal bones and obliteration of the sinuses. Biopsy of antral tissue shows fungal hyphae. What is the most likely diagnosis?
A 42-year-old welder complains of a one-year history of progressive resting tremor, shuffling gait, and drooling. He consults a physician because of frequent falls and worsening fatigue. A diagnosis of a particular type of metal toxicity was made and treatment is started. Which of the following would most likely be found if an MRI brain if ordered?
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 3-year-old girl is admitted to the hospital with a 2-day history of constipation, lethargy, and a weak cry. Repetitive stimulation performed at 20 Hz revealed incremental response. What is the likely cause of this patient’s illness?
Chronic exposure to which of the following medications can cause the pathology appreciated on the pathology slide below?
A 25-year-old male with a history of sensorineural hearing loss and tinnitus has an MRI brain ordered as part of his workup (see below). A genetic syndrome is suspected. Which of the following is also likely to be found on imaging?
Which of the following clinical features is most suggestive of logopenic primary progressive aphasia?
A 56-year-old man with a history of a kidney transplant, on tacrolimus, presented to the hospital with a 2-week history of progressive confusion and expressive aphasia. An MRI brain with and without contrast was performed and shown below. A brain biopsy was performed and showed microglial nodules with encysted bradyzoites and tachyzoites. Which of the following is the most appropriate therapy?
A 4-year-old female was brought to the emergency room for lethargy, ataxia, and nausea. MRI brain with contrast showed well-circumscribed, contrast-enhancing heterogeneous lesions in the 4th ventricle. Surgical resection was performed and histopathologic analysis was completed. Which of the following is the correct diagnosis?
Which of the following structures is supplied by the recurrent artery of Heubner?