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Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 77 year-old male presents to your office accompanied by his guardian, who provides most of the history.
The guardian states that for quite some time, the patient has had more and more trouble remembering things, occasionally will stare off into space for long periods of time, has had worsening bradykinesia, has been seeing visions of coy red calves, lost his balance a few times, and has complained of stiffness.
Which of the following pathology findings is MOST characteristic of this patient's disease?

 
        A) Basophilic cytoplasmic inclusions
 
        B) Inclusions comprised primarily of Huntingtin
 
        C) Eosinophilic nuclear inclusions
 
        D) Lewy bodies
 
        E) Inclusions comprised primarily of beta amyloid
 

 


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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 Huntingtin

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. Huntingtin is a protein associated with Huntington chorea.  (See References)

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C) eosinophilic 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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D) 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)

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E) 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)

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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

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