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A 24-year-old weight-lifter presents after sudden-onset neck pain. On exam, there is right eye ptosis and asymmetric right pupil constriction. Additionally, the patient appreciated decreased sweat production on the right side of his face. 1% hydroxyamphetamine eye drops are administered to the right eye and it dilates. Where is the most likely site of the patient’s lesion?
An 80-year-old woman with uncontrolled HTN presents to the ED with symptoms upon awakening of left hemi-sensory loss, last seen well 8 hours prior. MRI is done and shows a lateral thalamic lacunar stroke. The small branch affected in this lacune is most often a branch of which major artery?
An overweight 54-year-old male presents to the neurology clinic with excessive daytime sleepiness. His wife states that the patient snores excessively during sleep. Which of the following is the most appropriate diagnostic test?
A 32-year-old man with a past medical history of major depressive disorder is brought to the emergency department by his roommate who states that a few days ago the patient stopped taking his medications. Vital signs were within normal limits. On examination, the patient was non-verbal except for occasionally repeating words spoken by the examiner. He would not follow commands. When his arms were positioned off the bed they remained there for several minutes. CT head and CTA of the head and neck were normal. Which of the following is the most appropriate next step in treatment?
A 64-year-old female with no significant past medical history presents to the clinic because of concerns related to her memory. She states that she has difficulty recalling names and recent conversations. She had a planned retirement two years ago and was functioning well at work at that time. She continues to live alone and is independent with her basic and instrumental daily life activities. Depression screening is negative, but she scores a 27/30 on the Montreal Cognitive Assessment (MOCA), with deficits in delayed recall. Her neurological examination is otherwise non-focal. What is the most likely diagnosis?
A 43-year-old man with obesity and hypertension presents with complaints of excessive daytime sleepiness, gasping awakenings, and witnessed periods of not breathing during sleep. A polysomnogram is performed and confirms the presence of sleep-disordered breathing. What feature would point to a central rather than obstructive cause?
Which of the following structures has an intact blood-brain barrier?
What task is likely being performed during this EEG recording?
A 28-year-old caucasian male was last seen well at 9:00 AM when he got into a verbal argument with his girlfriend. When the girlfriend returned from work at 5:00 PM, she found the patient on the floor of the garage altered, and states he “smelled unusual”. In the emergency department, the patient is disoriented but arousable with much effort. He complains of a headache and blurred vision, and he appears uncomfortable with a respiratory rate of 40. You send stat labs and they are listed below. What treatment should you administer immediately?
ABG: 7.18 pH, PCO2 = 28, PO2 = 118
Electrolytes: Na 135 mEq/L, K 5.0 mEq/L, Cl 105 mEq/L, HCO3 15 mEq/L
Which of the following medications is the first-line treatment for trigeminal neuralgia?