A 63-year-old man comes to the clinic for a new patient visit.  He is pleasant and says he “has never felt healthier.”  The patient presents a list of regularly taken medications, which include atenolol, sildenafil, terbinafine, minoxidil (topical), aspirin, and saw palmetto.  He has no known drug allergies and has a remote history of cholecystectomy.  He drinks an ounce of bourbon before bed each night.  The patient has a remote 15-pack-year smoking history and has never used illicit drugs.  He is married, has 3 grown children, and was recently transferred to this city to assume direction of a local factory.  Physical examination is remarkable for a soft midsystolic murmur that is loudest in the second right intercostal space.  There is some bony enlargement of the distal interphalangeal joints bilaterally.  The patient wishes to discuss his medication list in more depth and indicates an increasing interest in alternative medicines.

Item 1 of 2

Which of the following conditions is saw palmetto most commonly used to treat?

Item 2 of 2

The patient is counseled appropriately regarding his use of alternative medicines.  Which of the following side effects is most strongly associated with saw palmetto?

An 18-year-old man comes to the emergency department due to sudden-onset left-sided weakness.  The patient has a seizure disorder but reports no seizures prior to current symptom onset.  Neurological examination shows left-sided hemiparesis and hemianopia.  On further questioning, the patient says that several of his family members also have a history of epilepsy and stroke, as shown in the pedigree diagram below (red arrow represents the patient).

Which of the following is the most likely inheritance pattern of this patient’s condition?