In addition to a third generation cephalosporin and vancomycin, which additional empiric antibiotic should be considered in adult patients over 50 years of age who are suspected of having bacterial meningitis?

A patient presents to the emergency department with symptoms of right-sided weakness and aphasia which started 30 minutes prior to arrival. The National Institutes of Health Stroke Scale is 10. Which of the following is an absolute contraindication for intravenous thrombolytic therapy?

A 13-year-old boy on chemotherapy for acute lymphoblastic leukemia presents with progressive lower back pain for two weeks. Per the mother, he has had subjective fevers and a “bulge in his lower back” that is warm to touch. He is currently afebrile and has no focal neurologic deficits. An MRI is obtained, as seen in the image above. Which of the following regarding this patient’s condition is true?

A 6-month-old boy presents to the emergency department with sudden, brief, symmetric muscle contractions that were first noticed yesterday. These spasms last for < 2 seconds and occur several times per minute. They cause flexion of his neck, trunk, and arms and extension of the legs. They seem involuntary, are not associated with any heart rate change, and are followed by brief crying. Over the last 2 weeks, he has lost the ability to sit without support. A video electroencephalogram shows hypsarrhythmia. Which of the following is most likely to control this patient’s symptoms?

A patient is diagnosed with Campylobacter jejuni enteritis, receives treatment, and recovers. He presents with weakness in his legs followed by weakness in his arms 2 weeks later. He reports no dyspnea but reports diplopia and dysphagia. Examination reveals a mild fever, extraocular muscle palsies, hyporeflexia, distal paresthesias, and intact proprioception. Laboratory testing is significant for a normal CBC and a PaO₂ of 88 mmHg. Which of the following is the most appropriate intervention at this time?

A 10-month-old boy presents to the emergency department with trouble breathing. His parents noticed he has seemed fatigued and weak lately. He has not been having bowel movements. Today, he seems to be very weak and is struggling to breathe. The patient has generally been healthy and sees a pediatrician regularly. His parents have tried introducing new foods recently. Physical exam is notable for a child with minimal muscle tone who is limp when picked up. Given his weak respiratory effort, he is intubated. Which of the following treatments is indicated for this patient?

A 26-year-old woman with a history of dysmenorrhea and depression presents to the ED after having a seizure witnessed by her husband. He reports finding her on the bedroom floor with an empty pill bottle. Which of the following non-steroidal anti-inflammatory (NSAIDs) medications did she most likely ingest?

A 16-year-old girl presents to the ED reporting that she cannot walk up steps. She has been well recently except for an episode of gastroenteritis 2 weeks ago. On exam, she has decreased strength in her bilateral lower extremities with absent patellar and ankle jerk reflexes. What is the most important next test to perform?

Which of the following patients in the setting of a known subarachnoid hemorrhage has the worst prognosis?