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Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 83 year-old female presents to your office accompanied by her cousin, who provides most of the history.
The cousin states that for the past 2 years, the patient developed a tremor, has had increasing difficulty inititiating movement, has complained of seeing people in the room that nobody else sees, has been having progressively worsening memory problems, has complained of rigidity, 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) Basophilic cytoplasmic inclusions

B) Amyloid plaques

C) Eosinophilic cytoplasmic inclusions

D) Inclusions comprised primarily of Swiss cheese

E) Inclusions comprised primarily of Huntingtin

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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) basophilic cytoplasmic 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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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)

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C) eosinophilic cytoplasmic inclusions

This answer is correct.

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D) inclusions comprised primarily of Swiss cheese

This answer is incorrect.

Oh, how cute. You chose the silly answer. (See References)

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E) inclusions comprised primarily of Huntingtin

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