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Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 69 year-old female presents to your office accompanied by her live-in masseuse, who provides most of the history.
The live-in masseuse states that for quite some time, the patient developed a tremor, has had dramatic fluctuations in her level of arousal, lost his balance a few times, has been seeing people in the room that nobody else sees, has complained of stiffness, and has been having progressively worsening memory problems.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Basophilic cytoplasmic inclusions

B) Inclusions comprised primarily of beta amyloid

C) Bunina bodies

D) Neuronal aggregates

E) Inclusions comprised primarily of alpha-synuclein

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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) inclusions comprised primarily of beta amyloid

This answer is incorrect.

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C) Bunina bodies

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)

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D) 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)

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E) inclusions comprised primarily of alpha-synuclein

This answer is correct.

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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