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Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 65 year-old female presents to your office accompanied by her niece, who provides most of the history.
The niece states that for quite some time now, the patient has had more and more trouble remembering things, lost his balance a few times, occasionally will stare off into space for long periods of time, occasionally mentions that she is seeing people in the room that nobody else sees, developed a tremor, and has had worsening bradykinesia.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Inclusions comprised primarily of nacho cheese

B) Basophilic nuclear inclusions

C) Lewy bodies

D) Basophilic cytoplasmic inclusions

E) Eosinophilic nuclear inclusions

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This question was created on February 22, 2007 by jdmiles.
This question was last modified on February 22, 2007.

ANSWERS AND EXPLANATIONS

A) inclusions comprised primarily of nacho cheese

This answer is incorrect.

Oh, come on. Nacho cheese? (See References)

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B) basophilic nuclear inclusions

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. (See References)

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C) Lewy bodies

This answer is correct.

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D) basophilic cytoplasmic inclusions

This answer is incorrect.

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E) eosinophilic nuclear inclusions

This answer is incorrect.

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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