USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 27-year-old woman comes to the emergency department because of a seizure. Her temperature is 37.6°C (99.7°F), pulse is 112/min, respirations are 17/min, and blood pressure is 120/80 mm Hg. She has an 8-month history of slurred speech, memory loss, ataxia, and myoclonic jerks. Laboratory studies show an elevated ESR and blood cultures are negative. CSF is positive for 14-3-3 protein. An MRI of the brain shows mild diffuse volume loss and the pulvinar sign. A tonsil biopsy sample is positive for the abnormal prion protein (PrPSc). Which of the following is the most likely diagnosis?