Dementia 02
Topic: Imaging
Created on Thursday, February 22 2007 by jdmiles
Last modified on Thursday, February 22 2007.
A 78 year-old male presents to your office accompanied by his second cousin, who provides most of the history.
The second cousin states that for the past 16 months, the patient has been having progressively worsening memory problems, has had dramatic fluctuations in his level of arousal, has been distressed from seeing people in the room that nobody else sees, has complained of rigidity, developed a tremor, and lost his balance a few times.
Which of the following pathology findings is MOST characteristic of this patient's disease?
A) Neuronal aggregates B) Inclusions comprised primarily of beta amyloid C) Lewy bodies D) Inclusions comprised primarily of Swiss cheese E) Neurofibrillary tangles,
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) inclusions comprised primarily of beta amyloid
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 beta amyloid. (
See References)
C) Lewy bodies
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) inclusions comprised primarily of Swiss cheese
This answer is incorrect.
No. No, no, no. You are wrong. There is no Swiss cheese in Lewy bodies. You are a silly person. (
See References)
E) 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)
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. | |
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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