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What is the earliest NCS/EMG abnormality found in AIDP?
A 45-year-old male with a history of IV drug use, HIV, and medication non-compliance is admitted to the hospital with a two-week history of headache, fever, malaise, and double vision. His most recent CD4 count was 180. Lumbar punction is performed. CSF analysis with India ink strain shows encapsulated yeast. Which of the following is the most likely cause of the patient’s symptoms?
A 62-year-old man comes to the clinic complaining of a 2-month history of difficulties getting up from a chair, climbing steps at work, and lifting objects above his head. His primary care physician also noticed a rash on sun-exposed areas of the man’s body. EMG of proximal muscles on this patient with likely reveal which is the following?
A 58-year-old male with a prolonged history of myasthenia gravis 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 of the brain shows T2 hyperintensities on the posterior cerebral hemispheres. Which of the following is the likely etiology of this clinical presentation?
A 23-year-old female with relapsing-remitting multiple sclerosis (RRMS) that is well-controlled on teriflunomide presents for routine follow-up. Today she expresses interest in having a child. Which of the following statements regarding multiple sclerosis and pregnancy is true?
A 50-year-old male has noted winging of his right scapular and pain for the past four months following a hyperextension injury. Based on the EMG data outlined below where is this patient’s pathological lesion?
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?
A 65-year-old woman with a past medical history of hypertension presents with recent onset of bilateral eye discomfort and diplopia. She states that she is unable to completely close her eyes. On exam, pain is elicited when testing extraocular movements. Visual acuity and visual fields are unremarkable. MRI of the brain reveals excessive peri-orbital subcutaneous tissue bilaterally. Which of the following is the most likely diagnosis?
A 6-month-old boy with no significant past medical history is brought to the clinic by his father because of abnormal limb movements that occur multiple times a day. His father describes high-frequency, low amplitude rhythmic movements that start in the child’s head and quickly spread down the shoulders. Episodes last approximately 1-2 seconds. There are no clear triggers and there is no loss of consciousness associated with the events. Family history is significant for essential tremor in the patient’s mother. Which of the following is the most likely diagnosis?
Identify the lesion shown in the imaging below:
A 16-year-old male with no significant past medical history presents to the emergency room with vision complaints and coordination issues. Four days ago, he began experiencing double vision and since then has had progressive difficulty picking up objects and buttoning his shirts. On physical exam, the patient has a decreased range of motion of the extraocular muscles bilaterally, as well as areflexia and ataxia when walking. What is the most likely diagnosis?
Which of the following medications is an acetylcholinesterase inhibitor that is FDA approved in the U.S. for the treatment of severe Alzheimer’s disease?
What sensitivity should the EEG be at to qualify for brain death criteria?
A 30-year-old female presents to the ER with a three-day history of progressive weakness, double vision, and slurred speech. The first symptoms appreciated were double vision and slurred speech, followed by weakness in the upper extremities. Symptoms then descended to involve the lower extremities. On examination, the patient had decreased tone, areflexia, mydriasis, and restricted extraocular movements bilaterally. A neuromuscular junction disorder is suspected. Based on the most likely diagnosis, which of the following would be seen in this patient’s neurodiagnostic testing?
A 40-year-old male with bilateral mesial sclerosis and medically refractory epilepsy presents to the epilepsy monitoring unit for a presurgical evaluation. His current anti-seizure medication regimen includes levetiracetam, lamotrigine, and clobazam. Over three days and weaned medication, the patient had 7 seizures; four from the left temporal lobe, and three from the right temporal lobe. Which of the following is the most appropriate next step in treatment?