A patient comes to the ER with a fever, headache and nuchal rigidity. They are found to have aseptic meningitis. What is likely the cause of this infection?

Consider two patients. Patient 1 comes to the ER with a fever, nausea and nuchal rigidity. Patient 2 comes to the ER with fever, headache and altered mental status and is diagnosed with encephalitis. Both patients are actually infected by the same type of microorganism. Which of the following could it be?

A 23 year-old woman begins experiencing significant hair loss after starting a new medication to prevent frequent headaches. Her cousin has epilepsy and takes the same drug to prevent seizures. What drug are they most likely taking?

A friend of yours is overly concerned about getting meningitis and wants to dedicate their research to making the Blood-Brain barrier impermeable. You explain that this may not be a great idea because complete separation may cause:

A 35-year-old patient comes to the emergency room with symptoms of tachycardia, confusion, and nystagmus. She has a history of depression and is currently taking citalopram (a SSRI) daily. She tells you that the symptoms started an hour after she took medication for her severe migraine headaches. What is the mechanism of action of the drug she took?

A 22 y.o. female college student comes to your office concerned about a headache she experienced this morning. She describes the pain as having been severe and pulsating in quality, only having been on one side of her head, and tells you that the headache was accompanied by feelings of nausea. She also tells you that she has experienced similar headaches in the past. The most likely diagnosis is….

A patient with a history of migraine comes into your office. She says the headaches have been much worse lately, and that they are now accompanied by feelings of confusion and impaired alertness, and that her medicine has not been effective in treating them. What is the best course of action?

Upon shining a light into the left eye of a patient, a normal Pupillary Reflex is observed. This suggests that which region of the brain is most likely to be intact?

You are currently a PGY3 pathology resident, your attending calls you over to look at a specimen slide that you had only ever seen in your textbooks. She asks you what you think the diagnosis is based off the histological slides (pictured below) She tells you that your patient is a 7 y/o male with a chief complaint of intermittent headaches for the past 3 months, abdominal pain, nausea, and vomiting. She states the Emergency Room physician ordered an MRI and it showed a solid mass in the midline of the cerebellum. You suspect the patient has:

A patient presents with recurrent headaches and onset of seizures. Suspecting a tumor, you order an MRI which shows a lesion in the frontal lobe. To make the best treatment plan for this patient, you decide to biopsy the lesion. Never having been good at histology, you call your friendly neighborhood pathologist. She indicates increased number of “fried egg” shaped cells with cellular atypia. There is no evidence of anaplasia nor mitotic figures. How would this tumor be classified on the WHO tumor grading scale?

A 28 year old woman suffering from chronic classic migraine has taken three sublingual tablets of ergotamine to abort an impending migraine attack. Which of the following describes the mechanism of ergotamine?

Serotonin syndrome is associated with the coingestion of drugs increasing serotonergic effects (e.g. triptans or ergotamine with SSRIs or MAOIs) and develops within minutes to hours of the inciting action. Manifestations of serotonin syndrome include:

A 35-year-old male comes to the ED complaining of extreme pain over his left eye and temple starting 40 minutes ago. He had a similar attack 2 days ago, but the pain went away and the patient felt completely normal until it happened again today. “This kind of thing happens to me whenever Springtime rolls around,” he states. Which other associated symptom is most likely to accompany the patient’s clinical presentation?

A patient comes to the ED complaining of a progressively worsening, severe, right-sided headache with associated nausea/vomiting starting 1 hour ago. Which physical exam finding best indicates migraine instead of some sort of cerebrovascular accident?

Up and coming Peruvian superstar Erik Gamarra is a healthy 26-year-old male who recently developed a severe bacterial infection while sailing across the Pacific Ocean to film his new music video “estoy en un bote”. Upon medical examination Erik was diagnosed with a gram-positive bacterial infection but doctors could not identify the infecting microbial species. Which treatment option would be the best option for Erik?

After taking Vancomycin for two months Erik’s physician decided to change his antibiotic treatment because his infection had built up a resistance to Vancomycin. Normally, Vancomycin acts by binding to an acceptor molecule peptide which blocks the binding of a modified disaccharide and results in the inhibition of cell wall synthesis. Following whole genome sequencing of this pesky bacteria Erik’s physician identified the Van A gene which confers Vancomycin resistance via an enzyme that can convert the acceptor molecule peptide terminal residue “alanine” into a: