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Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 80 year-old male presents to your office accompanied by his second cousin twice removed, who provides most of the history.
The second cousin twice removed states that for quite some time now, the patient has been increasingly slow getting around, occasionally will stare off into space for long periods of time, has complained of rigidity, has been having progressively worsening memory problems, developed a tremor, and occasionally mentions that he is seeing visions of flirtatious black spoonbills.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Inclusions comprised primarily of Huntingtin

B) Inclusions comprised primarily of beta amyloid

C) Inclusions comprised primarily of alpha-synuclein

D) Inclusions comprised primarily of nacho cheese

E) Basophilic 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) 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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B) inclusions comprised primarily of beta amyloid

This answer is incorrect.

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C) inclusions comprised primarily of alpha-synuclein

This answer is correct.

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D) inclusions comprised primarily of nacho cheese

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, and contain little or no cheese of any kind. (See References)

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E) basophilic 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