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Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 64 year-old female presents to your office accompanied by her daughter, who provides most of the history.
The daughter states that for quite some time now, the patient has complained of a tremor in his hands, has had dramatic fluctuations in her level of arousal, has complained of stiffness, has had increasing difficulty inititiating movement, has been increasingly forgetful, and has complained of seeing visions of fanatical green koalas.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Basophilic nuclear inclusions

B) Eosinophilic cytoplasmic inclusions

C) Amyloid plaques

D) Inclusions comprised primarily of tau protein

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) 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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B) eosinophilic cytoplasmic inclusions

This answer is correct.

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C) 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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D) inclusions comprised primarily of tau protein

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