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Which of the following is the mechanism of action of tolcapone?
A 65-year-old female comes to the clinic complaining of weakness in his extremities. Symptoms are more prominent in the legs than in the arms. Oddly, when he tries to exert himself, he notes an improvement in his strength. Neurodiagnostic testing reveals low amplitude compound muscle action potentials (CMAPs) with an increase in amplitude on high frequency (50 Hz) rapid repetitive stimulation. Which of the following malignancies is most closely associated with this patient’s neurologic syndrome?
A 9-year-old boy with no significant past medical history was referred to get an EEG because of declining school performance and concern for staring vs. daydreaming episodes. Hyperventilation was performed and shown below. His EEG was otherwise unremarkable. Based on the available data which is the most appropriate next clinical step?
A 48-year-old man with a 20-year history of HIV stable on HAART therapy presents to your clinic accompanied by his partner who states that the patient has had mounting difficulties over the last 3 years. Most recently he has been unable to effectively manage finances, cook for himself, or arrange appointments. What is the best diagnosis at this time?
A 58-year-old male with a prolonged history of MG was recently discharged 4 months ago from the hospital with his second myasthenic crisis requiring transient intubation. Since that hospitalization, he was on prednisone, tapered down to 40 mg a day, cyclosporine, and pyridostigmine. He comes to the ED today after having a generalized tonic-clonic seizure. On arrival to the ED, the patient is post-ictal and has vision deficits on exam. MRI shows T2 hyperintensities on the posterior cerebral hemispheres. Which of the following is the likely etiology of the clinical presentation?
A 14-year-old girl with no significant past medical history is brought to the clinic with a 1-week history of involuntary movements of the left side of her body. Her mother reports that 1 month ago, she experienced a week of fever, malaise, and fatigue, but they did not seek medical treatment at the time. On physical exam, the patient exhibits involuntary, irregular movements of her neck, left arm, and left leg, and generalized hypotonia. What is the most likely diagnosis?
Which of the following areas, if selectively lesioned, would cause an error with voluntary vertical saccades with spared horizontal saccades and sparred occulocephalic vertical reflex?
A 56-year-old man with a past medical history of hypertension and type II diabetes presents to the hospital with acute onset left-sided weakness which started 90 minutes prior to your evaluation. His only medications prior to admission were metformin and verapamil. Vitals were within normal limits except for a blood pressure of 154/92. Physical examination reveals 3/5 weakness in the left arm, leg, and face as well as a moderate sensory disturbance in the same regions. CT head was unremarkable and CT angiogram (CTA) showed no large vessel occlusion. A brief history gathered from his wife revealed no other comorbidities or active medical issues. At this point in his clinical presentation, what is the mechanism of action of the most appropriate therapy?
What is the mechanism of action of pregabalin?
A 65-year-old male comes into the office with his wife for follow-up after a recent hospitalization for HSV encephalitis. The wife says before his hospitalization, he used to be a quiet, shy man but recently has been making sexually inappropriate remarks to women at the park. The patient also has an increase in appetite and an urge to touch everything at the grocery store. Based on his cognitive deficits, which of the following areas of the brain is likely affected?
A 57-year-old male with HIV who is non-compliant with HAART therapy presented to the emergency room with a 4-week history of altered mental status and falls. On neurological examination, the patient was altered, ataxic, and had right upper extremity weakness. An MRI was performed and shown below. Based on the clinical presentation and imaging provided, what is the most appropriate first step in medical management?
Which of the following regions of the brain, when active, promotes the switch from drowsiness to non-REM sleep?
Which of the following is the most classic finding of early inclusion body myositis?
A 40-year-old male presents to the clinic with difficulty swallowing. On additional questioning, he reports difficulty walking, falls, and dysarthria. Examination shows bilateral facial weakness, fasciculations, and gynecomastia. A CAG trinucleotide repeat on which of the following genes is the cause of this disease?
The PET scan shown is most consistent with which of the following diseases?