Dementia 02
Topic: Imaging
Created on Thursday, February 22 2007 by jdmiles
Last modified on Thursday, February 22 2007.
A 89 year-old female presents to your office accompanied by her cousin, who provides most of the history.
The cousin states that for quite some time, the patient has complained of rigidity, has been distressed from seeing people in the room that nobody else sees, has had worsening bradykinesia, has had more and more trouble remembering things, has complained of a tremor in his hands, and occasionally will stare off into space for long periods of time.
Which of the following pathology findings is MOST characteristic of this patient's disease?
A) Neuronal aggregates B) Amyloid plaques C) Inclusions comprised primarily of alpha-synuclein D) Neurofibrillary tangles, E) Inclusions comprised primarily of tau protein
This question was created on February 22, 2007 by jdmiles.
This question was last modified on February 22, 2007.
ANSWERS AND EXPLANATIONS
A) neuronal aggregates
This answer is incorrect.
This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Neuronal aggregates and Bunina bodies are seen in amyotrophic lateral sclerosis. (
See References)
B) amyloid plaques
This answer is incorrect.
This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Amyloid plaques are seen in DLB, but widespread Lewy bodies are a more defining feature. (
See References)
C) inclusions comprised primarily of alpha-synuclein
This answer is correct.
This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Lewy bodies are eosinophilic cytoplasmic inclusions which contain alpha-synuclein. (
See References)
D) neurofibrillary tangles,
This answer is incorrect.
This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Neurofibrillary tangles tend to be sparse in DLB. Neurofibrillary are more commonly associated with Alzheimer disease. (
See References)
E) inclusions comprised primarily of tau protein
This answer is incorrect.
This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Lewy bodies are eosinophilic cytoplasmic inclusions comprised mainly of alpha-synuclein, not tau protein. (
See References)
References:
1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York. | |
2. DeKosky, S.T., Kaufer, D.I., and Lopez, O.L. (2004). The Dementias. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, 4th Edition. Butterworth Heinemann, Philadelphia. Pp. 1901-1951 | |
3. Prayson, R.A., and Goldblum, J.R. (Eds.) (2005). Neuropathology. Elsevier, Philadelphia. | |
FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review
imaging
Dementia 02
Question ID: 02220701
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 02/22/2007
Modified: 02/22/2007
Estimated Permutations: 0