FrontalCortex, Inc. is a non-profit corporation dedicated to neurology education.

Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 71 year-old female presents to your office accompanied by her caretaker, who provides most of the history.
The caretaker states that for the past 5 years, the patient has been forgetting things more frequently, developed a tremor, has had worsening bradykinesia, has complained of stiffness, occasionally mentions that she is seeing visions of old fuchsia pointers, and has had periods when she is lethargic and drowsy, and others when she is more alert.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Inclusions comprised primarily of alpha-synuclein

B) Punctate hemorrhages in periaqueductal grey and in the grey matter surrounding the 3rd and 4th ventricles

C) Lesions in the mammillary bodies

D) Amyloid plaques

E) Bunina bodies

	= Go back to the top of the page.
	= Reload a different version of this question ().
	= Load a random question from the database.
	= Use this question as a template to create a totally NEW question.
	= Enter detailed rating for this question!
Average rating not yet available	= How users like you have rated this question.

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 alpha-synuclein

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)

					Average rating not yet available
Please log in if you want to rate questions.

B) punctate hemorrhages in periaqueductal grey and in the grey matter surrounding the 3rd and 4th ventricles

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. Punctate hemorrhages in periaqueductal grey and in the grey matter surrounding the 3rd and 4th ventricles are seen in Wenicke encephalopathy. (See References)

					Average rating not yet available
Please log in if you want to rate questions.

C) lesions in the mammillary 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. Lesions in the mammillary bodies are seen in Korsakoff amnestic state. (See References)

					Average rating not yet available
Please log in if you want to rate questions.

D) 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)

					Average rating not yet available
Please log in if you want to rate questions.

E) 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)

					Average rating not yet available
Please log in if you want to rate questions.

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.

					Average rating not yet available
Please log in if you want to rate questions.

FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review
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